When a leg, or a large part of a leg, is removed for any reason,  the image of the leg remains as a phantom and you may alight from your bed after a sound sleep and attempt to stand on something that isn't there. The cortical imprint in your brain of your leg remains for some period of time despite the sensory input of something that no longer exists. This is called the phantom image.
     The larger map representing the neural areas in the brain for the lower limb are the joints, knee, ankle and the great toe.  These are the phantom images most commonly identified by the patient,  but as the brain adapts to the loss of the limb, recognition occurs and there is perception of a fore shortening of the phantom towards the stump, rather than just fading away. Before it fades away completely the foot may image on the end of the stump.
        If a history of  severe chronic and unrelenting pain has been elicited before the amputation of the limb, rather than just a phantom image,  phantom pain will also sometimes ensue. The brain we know has a self-adjusting capacity to add or delete mapped areas of itself that serve the body parts as need be and it is increasingly understood, but change is slower and less deliberate than we may wish. Despite the impatience we may have this capacity is wonderful adaptation in time. Where chronic pain has been present the cortical representation is larger and adaptation slower.
        Given this problem of pain perceived in our parts generally, there is something to learn from the phenomenon  of phantom limb. Given the mystery of pain where the physical  source no longer exists;  it could follow that, that pain in other parts  of the human vessel we call our own, might also be "remembered" when the part is removed or no  residual pathology remains.  Phantom pain in the low back or empty gall bladder bed or a legion of other painful conditions, corrected, but still slow to be deleted by the cerebral cortex.
           When they say it's all in your head, it would have a different meaning if the analogy to phantom limb is a viable theory. It just might mean that it's still on your cerebral cortical spot in it's usual place for a while  until that three pounds of grey matter remaps itself. It may be my simpleton's theory to a high powered neurophysiologist. but I am long in the tooth and have too little time left to shut up!

Scrub your hands and bottom best
And treat with gentleness the rest.
        The hype of the skin moisturizers and their pitches of skin care have prompted me to attack the whole idea for 95% of people who have healthy skin since the claims  are under the guise of entirely cosmetic. The television ads undermine the natural and promote plasticity in human beings. I am not a dermatologist, but I do have common sense and know this :  that Mother Nature is never wrong and Ockham's Razor is usually right.
         The fetish of bathing or showering once or twice a day, robbing one's epidermis by scouring off Mother Nature's lipids, wax esters, glycerides, squalene, and sialomucin, all it's natural sebum oils, and then , when one has denuded their epidermis of this protective coating, adding some cream that smells like a flower, resists vitamin D , and is manufactured from the petroleum industry is an act of violation. The natural epidermal ooze is much more complex than I have elaborated,  but one came with it in abundance when we traversed the birth canal with our lipid covering of Vernix Caseosa. It accumulated in utero and protect us. We are still protected if we allow it to remain after a modest fashion.
            It's not that one should not bathe at all ; it is just that it is badly overdone. I guess it's OK to smell like a flower some of the time, but the erotic scent of the healthy hominid  will always trump the contrived scent of everyone smelling inhuman. Even your dog will celebrate your natural scent.
             The Dermatological scientists can't agree on the specific utility of all these waxy coatings we have been provided with, but human beings should still smell like people and retain their natural oils and waxes minus the dirt and grime. The coating is there for a reason. Not knowing the whole of the role they supply doesn't count. As I said , "Mother Nature is always right, and the correct answer according to William of Ockham is usually the simplest answer."
              Soap and water and a fresh towel is the sexy answer for the natural hominid then and now. Moreover everyone is going to look like they really look like!  That will be interesting. Let's not get plastered too often. Lets not stay in the sun endlessly without our natural oils and wax esters to protect our epidermis. Let's not worry about being white or wrinkled. Let's agree that the added sort of beauty may not be even skin deep.

 Mother Nature and Human Nature are really one--- indivisible. If we see ourselves as a food source amongst any other of our useful attributes, we can embrace all of the other similar ions and atoms we are related to, plant and animal and mineral that spend much of the time eating and being eaten, digested or absorbed by one another while perched on the food chain of life or death.
     If you believe you are at the top of the food chain, know that you are living food for the mosquito, tape worm, E. coli, the commensals, any number of hosts of micro-cellular organisms, and at the end, the Yew tree and all trees, the grass, vultures , carrion beetles and other members of the so-called lower orders that enjoy you in perpetuity, along with the maggots that often enjoy the gift we finally give.
     The so- called lower order of the food chain just completes the circle of life as we eventually embrace and enter the mineral world, when that erstwhile flesh and bone rises again in new vegetation. Therefore it is hard to call any feeder a lower order since we all are part of the wheel of life.
      There is no humiliation in this matter. How can there be any humiliation when we are one with Mother Nature and Human Nature? The sin in the garden of Eden was in believing that we were different from the garden and could eat freely from the Tree of Knowledge, thinking we were different from the tree. That is;  of another substance than the tree, rather than being content to linger for our  little while in the shade of The Tree of Life.
    

Today we heard the Stations of the Cross , and this is Holy Week. I, and everyone I know, has had to carry a cross at some time in their life. Therefore there is nothing unique in my view about the carrying of the cross. The only thing that might be unusual about it is that someone may think it is unfair that they, or someone they love , must carry it.
         Sometimes I have been a bystander and watched the struggle, I confess, thinking "I;m glad it's not me, or by the grace of God it's not me."  Sometimes I am impelled to carry the cross with them, but if you practice Medicine it can be part of the job and it's not the same, or at least it does not seem the same. It's  convenient to have a role.
        A bystander or passer-by in Jerusalem, Simon of Cyrene was minding his own business at the time a parade of convicts went by and because Jesus who was with them and had been roughed up badly beforehand,  he was falling down carrying the cross  So Simon was co-opted by the guards to help  carry the cross.
        Matthew says,  "As they went out, they came across a man of Cyrene, Simon by name;  this man they compelled to carry his cross."
         Mark says,  "And they compelled a passer-by, Simon of Cyrene, who was coming in from the country, the father of Alexander and Rufus, to carry his cross. "
         Luke says,  "And as they led him away, they seized one Simon of Cyrene, who was coming in from the country, and laid on him the cross to carry it behind Jesus. "
         We don't know what happened to Simon of Cyrene after he carried the cross, having by the grace of God carried the instrument of crucifixion,  probably unwillingly.  It's a human thing. The Centurians were tough and in charge and the crowds passionate and pushy. We are all short of time and have our own stuff to do. And what can I really do? What difference can I really make?  It's really too bad but I am only just one of many.
       Simon of Cyrene was not one of many.  We hear no more of him.  But then, I can imagine.  Time and event have thrust him forever, willing or not, into the warp and weave of God and Man

I was the last kid in my age group to get rid of short pants and allowed to quit Sunday School, by my mother. In Kindersley, the prairie town we lived in.  I had to wear short pants in the summer and what was called breecks in the winter. I believed that my secular and spiritual bondage had interfered with my coming of age and failure to thrive, though it wouldn't exactly have been put in those words. I just wanted long pants and to avoid Sunday School and the horrible girls. The only other boy was my younger brother so that didn't count.
      I argued that since I had agreed to confirmation, I might give God and Jesus a try one day.  I stressed might. I could usefully argue my case with her since my father was not going to church at that time. She also gave up on the short pants too because my knees were always dirty and hardly ever got washed. When I think of it now, I would have grieved if my children would have become too cool too soon in life and I thank God for my mother.
        Finally baseball Sunday morning, ball glove and long pants. So lucky at the coming of age. It took me longer to realize it wasn't me ;  it was mini-me.; it was good then and it's good now. My mother was right all along. I finally gave lucky Jesus a chance and I still get to wear long pants.
     
    

      

Years ago on a cold blustery winter evenings we dined with family friends  and relations and played Murder. Sitting around the living room, ten or twelve adults and teenagers in a ring facing one another; a single card was dealt to each and if it was the Queen of Spades that person was the murderer. The assassin murdered as many as they could by way of a wink. If anyone caught the wink in action the murderer was revealed.  If you were winked at directly  you were dead and the dying process was usually  theatrical especially with the children whose gyrotechnics and groans were on full display.
     The skillfull murderer had perfected the wink, dropping the eyelid without screwing up the face or nodding the head and waited their chance without rush, so the tension grew with every minute and panic became restive. I suppose we could have played Charades as well, though most of us were older and post-prandial exercise would have brought on indigestion. It was better and more restful to wink and die or kill. This activity was always  performed with those we knew well but I am sure it would have been a great game as a mixer as well as were Charades. Simple pleasures, being silly, digging deep to willy-nilly.

   I wrote this 10 years ago today. St Patrick's day is tomorrow. Memory, how it lingers.  I was buzzed by the bumblebee then. As well the pianist and I counted fourteen seals in the harbor waiting for the spawning herring.Four lazy swimmers and ten treading water, sharp little snouts up in the air skyward sniffing the breeze for the return of their prey.  The Bufflehead ducks are weaving in and out of the waiting seals, taking the small minnows that the seals ignore.
      The Indian Plum was then in full flower and the Alder catkins were a cloud of red-brown in the background. The raspberries and the loganberries had started to leaf and the rhubarb was poking out through the leaf mold. The gooseberries and black currents were leafed as well but the red currents were a bit behind. The apples didn't show any green but the pears had swollen flower buds.
       The late storm surges over the early March had thrown up an abundance of seaweed and also sucked up a lot of loose winter vegetation from the shore shrubs. This detritus had mixed together and harbored all the tiny denizens of the shore that feed the gulls and crows.
       The ground was like a wet sponge with all the rain and the moss was especially thick that year which gave a yellow-green luminosity to the canvas of Mother Nature as she lay supine in the sunlight.
      I saw the little red squirrel that day, scampering about and he  (or she ) allowed me to approach within 4 or 5 feet which is pretty good.  They are confidant and quick but I worried a lot because the eagles were hunting in earnest then for their growing fledglings.
      There was green, green,  green everywhere on Lotus Island  that day and since St Patrick is of the green it seems right. We hadn't diverted at that point from the green but the vibrant colors would always come in the next month. Even the daffodil blossoms were still in the anteroom then. The greens are as restful and holy as St. Patrick to me. I thought then I would toast the monk with a cup or two of Black Bush. Now I am too old for whiskey and will fall down.  Memories, Precious Memories, How They Linger.

The Scion is a precious plsnt shoot, or the precious offspring of a great family, both severed from their roots   and moved to grow  with new roots.
     Grafting a shoot of a fine plant specimen on a hardy rootstalk in order to propagate it widely or create a more hardy plant, or one with altered shape or size makes sense. It's been done for years and horticulture as we know it could not exist without grafting. Down deep however, it still seems to me a manipulation of Mother Nature. It's a bit hypocritical of me to say this because my garden is full of , like everyone else's,  grafted specimens.
       To classify such a shoot as a  "scion"  must come from a particular past when the possibly promising offspring of a great or wealthy family was grafted or lifted to a new setting. A successful take of the plant shoot would depend on the accurate matching of the cut surface of the cambium layer with that of the root stalk to which it was grafted,  required secure fixation for a period of time until union and the avoidance of contamination and dehydration at the graft site.
        This careful attention to detail was not practised by those charged with the grafting and transplanting to our country in the seventeen and eighteenth centuries, dispersing excess populations to this shore. It was a higgledy-piggledy mix and included both the pianist's and my family in the early eighteeen hundreds. There were no scions amongst them. Some survived, some didn't. There was no careful matching of the cambium layers and no organic union to rely on for them. There was no consideration of the right season to graft and the Atlantic storms were high. There were no tight wrappings at the graft site or waxing to avoid undue motion and dehydration. There were no measures taken to avoid contamination.
         Luck and pluck were the governing principles of that transplantation and grafting. We tend to forget how much we owe our forebears. They are a national treasure, warts and all. They never pretended to be scions but they were precious and brave.
     Someone in the family hopefully will be  the librarian and emerge to retain his story or her story. Then we will augment the knowledge of from whom we came, from where we came, and by what means we were grafted.

An interesting contrast with our American friends is the ostensible passion they bestow on their city-states in song. Celebrating themselves and the cities in metrical dreaming. I can't imagine a Canadian rhapsodizing about Edmonton, Winnipeg or Ottawa or others. What is it about us, because we love our country, but tend to praise it with a faint damn most of the time, rather than the corny, evocative, efflorescence I am getting around to. Maybe we are just too prosaic. We sometimes , I think , wear our national heart off our sleeve.
     If it's "Down in New Orleans",  or " Meeting in St. Louis", or " Dreaming  in Galveston" , it seems to me Americans want to be somewhere they aren't.  If it's " Vagabond Shoes in New York"  or. "Flowers in the Hair in San Francisco" it seems to me they are looking for change of life style. They are not sure where they are going but they want to  know  " The Way to San Jose " without much idea of what they will do when they get there.
      Having said all that,  maybe we Canadians are a charmless bunch without finer feelings about our cities in song, or maybe it's just me that is charmless . Certainly the Irish and Scots are also full of musical blather about their bays and Islands and their songs are both evocative and passionate. Or, maybe we see our cities as not needing promotion, or it's the job of the Board of Trade and we are for " peace, order and good government." At least our constitution says so. We live in a country that has the largest land mass in the world and there is only 32 million or so, of us to manage it. We are blest with a life of cities that are safe and sound. Why would we continually brag about them when much of the world is enduring the conniptions they are enduring. It isn't kind to brag about your good luck. Maybe kindness is a substitute for charm.
       
          

Ponce de Leon  (b 1471)  in his search for the Fountain of Eternal Youth discovered instead and mapped much of Florida. He never achieved the immortality he sought because at about fifty years of age  his search for the fountain was interrupted by a Seminole arrow.
        The recent genetic discoveries of telomere shortening in the aging process and the role of the enzyme, telomerase in reversing the cellular aging, in vitro,  has led to new speculation. Extending life with enzymatic treatment, or alternatively extending cellular health through a normal life span has been an engaging idea for some scientists. It has also piqued the interest of some entrepreneurs one of which it seems was the pioneer Ponce de Leon.
         We are more and more in pursuit of physical health and longevity which is somehow related to happiness. We seek freedom from illness and stress, and so we exercise without goals other than achieving or maintaining self-health. Now, emerging interest and emphasis will be, maintain your telomerase levels and prevent the shortening of your telomeres.
            Those of us that are long in the tooth of the health field were often beset by the perfectly fit,  { the worried well },  who wanted more, actually the most, and took our time from those who were ill who really needed us. When Oliver Wendell Holmes, a physician wrote "The Deacon's Masterpiece", a one horse shay he was really talking about his patient, like the shay,  a metaphor , that lived for a hundred years in pristine health and the fell apart all at once. As I understand it, a complete and expected  and necessary, systemic failure.
         Those many of my colleagues  in Victoria who volunteered freely to work in primitive surroundings for six month stints in Vanuato will recognize that The Fountain of Eternal Youth is a self indulgent fantasy of the affluent world. The scientist who tries to touch this star towards immortallity shouldn't say, " I am doing this because it can be done."  but say , " Why am I doing this? " This is a fundamental question in Medicine. It's undoubtedly  fascinating research, but why is it that technology always seems to drag ethics a long way  behind it ?