The science of waste disposal in the olden days had a local flavor. As a young boy in Melfort I always had an intense interest in this art. When my brother Ken was born four years later I went from good to naughty but my interest in disposal was unchanged. We had a one holer in the back lane with a back flap on a hinge and a can under the hole to receive for disposal of the contents by the honeyman. As a five year old I remember vividly lifting the flap and inspecting  what seemed like a large buttock in the process of evacuation and tickling it with a piece of grass, eliciting howls of rage.
      As a young teenager we lived in Lestock in a  small town railway station that had a two holer over  a single pit. My chores at home included emptying the can in our indoor toilet room in the winter into the two holer. I remember it was important not to trip and fall as I carried the can down the stairs to the outhouse. I got twenty dollars a month from the CNR to  put lime into the pit from time to time and make sure that paper was available in the outhouse since  that two holer was for the station's public use. Since I was shy I couldn't conceive a twosome having a chat on my two holer in a relaxed way as they engaged their process.
       In the larger town we lived in, Kindersley, the science of disposal was much more professional and though our toilet was indoors with a can we had to put our can outside on the street for the honey man to collect in his horse drawn tank. In the winter he allowed a kid to hitch his sleigh on the back of the tank for a ride on the street because it wasn't too stinky at that time of the year. You had to be careful if he stopped too fast. There was no flushing away the end of our product, sight unseen, banished from reality, detached from our humanity like those blase folks in the city
          When your mother finally persuaded, cajoled or bribed you to produce a poop in the potty, this seminal event meant for you, a showering of approval, a sense of providing great pleasure for your parent and a newly found sense of esteem. It's no wonder that in the recesses of our adult mind the appearance of the bowel movement gives a certain guilty pleasure to the assessment  of the length, breadth and color. Our cranial software retains that old imprint of wonder at that childhood event and the pleasure principle reappears.I was often denied this pleasure since the two holer outhouse was dark and dank. Inspection was difficult.The scatological merriment that often occurs when matters like these are considered by some is pointedly males only. And some males pointedly. I guess so!
      There was a time in early medical history when detailed inspection of the  lowly poop was serious business and one of the few diagnostic tools available. Appearance, consistency, color and odor all entered the diagnostic armamentarium of the good physician. It became the 'ne plus ultra tool' then. Now tools are augmented by computer imaging, fiber optic colonoscopy and microbiology. Poopology may be still a fertile source however for psychological inquiry.

Our reading group was doing Hamlet when we came upon Osric, a stooge of the king, whom we concluded, among other faults, was a fop. We then branched into other contemporary examples of  "fophood"  we could cite. I then thought of other examples of Osric, later after the meeting, that I might have described to the group, one of which was me.
    Many years ago the pianist and I went to Maui for the first time of our lives. It seemed so splendid I believed I needed to dress for the occasion in a more appropriate way. I bought a chequered seerssucker jacket, sky blue and white, lemon yellow trousers. a matching woolen lemon yellow tie, white shirts, and blue and white saddle shoes to complement the jacket. I can't remember the socks but they would have been as memorable as the rest of my ensemble. I'm not blaming the salesman at the clothing store and I did blend in with the other gentleman at the time at the old Lahaina luau.
      When we returned to Victoria  and my first day back to work I thought to wear my Lahaina clothing and came to the hospital for rounds in the morning. I hasten to say that in those days in Medicine in the 60's everyone in practice wore the uniform, dark blue or grey suit, white shirt, drab tie without food on it,  black polished shoes, and the suit buttoned up.  I had no inkling of the singularity of my garb or the consternation it created given that day, that place and that era. Some whispered I was having a breakdown. My favorite surgical nurse said, " You look like a  dressed up Ukrainian."  Someone else asked, "What country's flag was the jacket?" Shortly after I retreated back to the house and from then on dressed in dark blue or grey. I wanted to belong. I didn't want to be a fop.
       Dressing  right I found, is like real estate, location, location, location!

My father's youngest brother, Edjerton, was 15 years old when his mother died and she was buried on Christmas day 1932. It was the height of the great depression and the dirty thirties  in the prairies and he was raised by his father and largely his sister and adult brothers. These were hard times on the prairie farms. He joined the Canadian army after schooling and was shipped to England as a corporal in the Canadian 2nd Infantry Division. He was part of the Dieppe raid on August 19, 1942 and was captured by the German army after 4 days inland. He was to remain a prisoner of war in Stalag 8b for the remainder of the war. I must have written to him when I was 8 years old because he wrote back to me thanking me for the carton of cigarettes and the chewing gum. I still have the letter with the censor stamp.
    When he was repatriated he tried a variety of jobs in the Okanagan where his sister and brother lived, but he was rootless. He became an alcoholic. He had a serious car accident when he was drinking and driving and his passenger was killed. He was convicted of manslaughter and jailed. He had other convictions later. Thoughout the time we knew our uncle he was sweet and kind to us, his nieces and nephews, and was always interested in us. There was a Jekyll and Hyde characteristic to him in retrospect.
     He eventually realized he couldn't cope with the "civilized world of the 60's" and he learned to cook and spent the rest of his life working in the mining camps of northern Alberta and the Yukon. He wrote to us at Christmas and more often to his sister. My father received a letter sometime in the 80's from a friend of my uncle in Edmonton who reported that He had been in hospital with TB and had died several weeks earlier. He left no possessions and had no issue. He had enough money to pay for his burial. His family had despaired of him and came to try to forget as much as they could. Post Traumatic Stress Disorder was not defined in my uncles time. Sadly, we were all black and white in those days and just wondered why they didn't " just get on with it? "
      Winston Churchill  wrote 4,987 pages in 6 volumes detailing the events of the 2nd world war. He only devoted 2 and one half pages to the Dieppe raid in his volume the Hinge of Fate. It was largely confined to his "good reasons" to proceed with the raid with primarily 6,000 Canadian troops. 3,367 were killed, wounded, or captured. He determined the raid was a success. Some success!

I had left home to go to university when my mother and dad moved to Vancouver from the prairies  with three other children to look after in the early fifties. My father was very short of income at the time with the new costs. He worked in the daytime as a telegrapher at the CNR station from 8 am to 5 pm, but to make ends meet he took another job.
    This is what he said in his Memoire. 
     "I worked in the Vancouver Herald for a time to supplement our income by selling subscriptions over the phone. About fifty sellers were in separate cubbyholes, and we were each given a sheet out of the phone book. You called each number with a sob story about paying for a crippled children's Easter bus and the like. You got 15 cents for each subscriptions you sold and the manager got 5 cents  each for all the subscriptions sold by the fifty cubbyhole occupants. The hours were 5 pm to 9 pm. I got home at 10 pm and ate. I caught the bus at 7 am the next morning to go to my regular job. I made 15 dollars a week selling subscriptions."
     Each time I read his story and every time I receive a telephone pitch from someone, I think of my dad, coping as best as he could at the time with a family and an income shortfall. I am ambivalent about boiler rooms and the hardships of telephone sales persons because of him. But we are called in this life to value connectedness and avoid judgment. We can't really say we are able to  walk in anyone else's shoes. I have to say to myself,  "Just shut up and do your best."

My loss of balance required me to use the wheeled walker for a period of time. I had fallen on the road  again recently when my center of gravity took the opportunity to shift substantially to the  right of center and I have no righting reflex. I injured my hip and chest wall.The passersby in Chemainus rushed to my aid. They were caring and helped me to my feet. The nurses in my life say I am a high falling risk. I no longer have the control displayed by the broken field running halfback, to twist, shift, tilt and recover through a maze of defenders.
     Joan drove to the market later and took my wheeled walker out and I went off to the liquor store. On my way back, approaching me from the opposite direction was a grizzled oldster I had never seen before on a rickety walker. We stopped to talk.  Maybe commune! I had a sense in the air of the Brethren.  There was nothing more than a familial salute but the underlying expression was tangible.
     Maybe he will be sitting at the sidewalk cafe having a coffee and a smoke and I will find myself next to him and we will talk about broken field running in football, or sliding safely into home plate, or dipsidoodling between two tough defencemen and scoring a goal. I think that's something similar state  Brethren might do.

I was cutting the ends of green string beans today getting ready for a dinner party of eight. The beans reminded me of the great venture of my parents in their fifties when they moved to BC from the small prairie town where my dad was the railroad station agent.  The rules of the railway were , if you moved to a new province you lost all your seniority for three months, so you had to take jobs from the bottom of the barrel. They had a family of three boys with them and little money saved and income was tight so they lived in a comfortable barn on friend's property in Chilliwack and he bicycled to work at Port Mann, a fair distance,  at 5 am every morning. My mother and my brother Ken worked all day on the bean belt in Chilliwack.
    The month or two after they arrived he was short of cash before payday and he phoned me where I was working in my summer job at Prince Rupert to see if I could send him 15 dollars. I didn't know how to do that. At the end of his shift he rode his bike back to Chilliwack to meet Ken and mother when they finished working on the bean belt. He sat by the outside door to wait for them and found an upturned large oil can to sit on while he waited.
    The foreman of the bean belt came across of him sitting and relaxing in the sun and said to him, " Fella, you are fired. Go now and pick up your time and don't come back."  My dad said to him, " I'm not working here."  He said, " Fella, I already told ya that" !
It wasn't that easy moving to British Columbia.

It's a bit gloomy but reality, ---"you are dust and to dust you shall return". Of course it is stunning insight to realize that we are not "in nature" to dominate, but "of nature", composed of the same atoms and molecules as everything else, so to arise from the earth and return to it is food for thought as we celebrate Ash Wednesday and contemplate our lives between the dust of creation and the dust of reunion.
    Last night I dreamt I was in a bar in Toronto with the pianist. I was served a poorly dressed pizza by a server dressed scanty. The pizza also had a thin brush of something resembling cheese with a single tiny tomato on top. The server offered to speak to my psychiatrist and my realtor for two sawbucks. I had to eat the pizza by hand and no serviette was offered. If I try to think of my life between the dusts, the glare of this metropolitan nonsense gives no immediate clue. Carl Jung where are you?
      I was out of my element. Toronto is transit for me. It was hard to reconcile "of nature" in the city and contemplation with my preparation for Ash Wednesday, and the joy of my life between the dusts when I drew my being from the earth and joined the tree, the pansy and the feathered and furry friends and mankind of every ilk as part of the carboniferous earth. It is enough for me now. If there is more my curiosity is piqued to wait and see. Oil and ash and a crucifix on my forehead gives me hope.
      Carl Sandburg may have written the lament about dust in his Chicago poem Limited but he was young. It's too easy to pigeonhole people.   Still I see it in the light of  Ash Wednesday though he certainly doesn't say it. The ashes and the poem are worth forty days. You have to have your own ashes to last you forty days and they will remind you of your own shortcomings. Here is a mix of hope and lament at the beginning of Lent. It won't make you feel good.
       
      "I am riding on a limited express, one of the crack trains of the nation.
       Hurtling across the prairie into the blue haze and dark air
       Go fifteen all steel coaches holding a thousand people.
       (All the coaches shall be scrap and rust
       And all the men and women laughing in the diners and sleepers shall pass to ashes.}
       I ask a man in the smoker where he is going and he answers , "Omaha."

I was speaking with a friend about Downton Abbey and Lady Mary Crawley's dilemma with the Turkish gentleman who, given his age, must have had a fatal arrrhythmia during intercourse. It reminded me of a similar little known, but celebrated circumstance a bit after the mid 20th century when I began to practice. The city was small at the time and medical practices were both tight and longitudinal so the same physicians attended families virtually from cradle to grave. As a result of this, patient and doctor loyalties were high. The doctor I refer to attended two carriage trade families who lived in the same neighborhood as him. One night he received a call at midnight from  his patient, the wife of a prominent businessman, in a panic, that a friend of hers, had died in her bed. The man who died, a lawyer, was also the doctor's patient, a widower who had enjoyed a meal and later, congress with the lady since her husband was away on business. Unfortunately good living had rendered the older lawyer unfit for such action.
     Faced with such a situation and the possible eruption of a scandal involving two of his patient's families, the doctor's dilemma arose. The man had clearly had a heart attack at the time. As a result the doctor and the lady, no doubt fueled by adrenaline at the time, carried the man to his car and transported him to his house, put him in new pajamas and tucked him into his bed. The doctor made a house call in the morning and called the coroner.
     The question is of course, what is the moral imperative that contended with the legal requirement of the doctor? A physician has a duty to the country, his colleagues, and to his regulatory body to obey the law. He also owes a duty, to the welfare of his patients, whether dead or alive, and their privacy, at some personal cost if necessary. He risked his medical  practice by illegal transport of a human body from the place of sudden death to cover up a truth! However, dead is dead and a bed is a bed. What was the harm? It would have been safer for the doctor to have avoided criticism by a self righteous tack. He took a chance in a small city where everyone knew everyone else's business, or thought they did.
      Succor for the innocent of the families I suppose, and avoiding the trials and near disasters that befell Lady Mary. The secret was kept for years!

Some years ago a noted senior surgeon in Lotus City often sang during his surgical procedure as he toiled away freeing up the gall bladder or small bowel, or whatever. He appeared to know only one tune; sang it softly , or hummed, but always audibly. I think it relaxed him in his work and he was often unaware that he was singing. Sometimes he would catch himself, as if he was always in command, and look fixedly at his scrub. He had a commanding presence and could fix you with his eye and say something like "Fresh Fish" and you might think an important message was delivered since his phrases always had a certain sonority.
     Though singing is not that uncommon in routine surgical procedures, it is usually during the closure and when the mood lightens. Most surgeons that sing have a very modest repertoire to draw on and will drone on tonelessly, but it is relaxing to the staff to know that the operator is at least content with the progress of their case. The senior one of whom I speak apparently knew only the hymn, Nearer My God to Thee, which he sang at occurring intervals during the procedure, not always at the most relaxed time. Thankfully the patients, at least the pessimists, in those days were almost always asleep, not overhearing the hymn as a premonition of some trip they were unwilling to take. On the other hand the more optimistic of the patients may well have considered that they were simply being operated on by a saintly man whose connection with God was immediate and proximate. Since, however, they all lay blissfully ignorant of the heavenly melody that was mercilessly massacred by the operator, they could be reassured that their organ, which he had in his hands was treated with more skill and care than any organ with which he may have attempted to accompany his hymn.

The College of Physicians and Surgeons forbids intimate relations with patients on pain of loss of one's licence to practice Medicine. This was stressed in our training for years. At the time of my testing I was a junior intern working  that night on my rotation in the Emergency department of the Vancouver General Hospital. Things had settled down by one am when a cab driver suddenly broke into the room in a panic.
   "I have a woman having a baby in my cab."
   "Well take her to Obstetrics , not here ," said the nurse.
   "She's having it in my cab."
   "Let's go look." I said.
He and I ran down the hall and out to the cab which was still running with the rear door wide open. There she was in the dark, half sitting and half lying on the back seat, panting frantically,wet and sticky from the waist down, dressed in a nighty with one slipper on, looking fearful.
    I said to her," I'm going to feel where the baby is," and crawled into the cab beside her.
    I yelled at the cab driver, " Go to Obstetrics."
The Obstetrical building was across the quadrangle from the Emergency. As I felt the oncoming head under the nighty it was crowning and she had stopped panting.
    "Pant" I said, "Pant and don't push; don't push, just open your mouth and pant."
    "Go to Obstetrics," I said as the cab driver still looked at us.
    "Where?"
     "That building in front of you with the light on that says Obstetrics. Just go straight across."
    "Where do I park?"
    "Don't park. Head for the door."
He started with a lurch and as I looked up, my hand still under the nighty, I saw two small children about two or three ,standing on the seat by their mother, wide eyed and silent, watching me. Then the head started to descend.
    "Pant, stop pushing. Pant"
He  stopped at the door and thank goodness Emergency had called ahead and three people and a gurney were at the door.
    "Keep panting." I said as she carefully slid off the back seat.
    "You can let go now." said the Resident in Obstetrics, "We usually use gloves for that.
    "Resident prick", I thought, "any occasion useful to pontificate.
    As she lay on the gurney I said to her, "Don't worry about your kids."
She put both arms around my neck and gave me a big wet kiss on the mouth and then disappeared into the hall and up the elevator. We had never talked but the connection was real.
     The cab driver said to me, "What about my fare?"
     "What about it? Don't you know how important you were? That seems good enough. And, you can't keep the kids"
I guess I was feeling euphoric about the turn of events and had found an acceptable definition of intimacy in medical practice and it was good.