I chose to ignore it and just enjoy my time. That night, I noticed that I had a large bump where the chafing had occurred, and as time went on, it started becoming more painful. The pain was isolated to one spot and it felt like a throbbing, stabbing pain. Sam went to the doctor the next day to get treated with antibiotics for a possible skin infection, but it was already too late. I was shivering, very breathless, could not walk and had extreme body aches. They admitted me to the ICU, and that's when I realized this was a bit more serious that I had anticipated.
I was in the ICU for almost four days, where the doctors were debating debridement surgery basically, cutting off the part of my butt that was infected. Sam told BuzzFeed that she decided to share her story because she thought it would be funny for her TikTok followers, but she never expected it to get the attention it has.
It currently has over 7. I'm happy I made the TikTok, and although it's extremely scary to have one of the most embarrassing things that has ever happened to me on the internet, it reminds people that we're all human and experience weird stuff, and it's nothing to be ashamed of. To get a better idea of how uncomfy shorts and underwear can land you in the ICU, I reached out to Dr.
Fong told BuzzFeed that more often than not, these kinds of infections and cases are caused by an anorectal abscess. Anyone can get an anorectal abscess. When not treated promptly, it can become a very bad infection and make a person very sick, although sepsis and cellulitis tend to happen more in immunocompromised people, such as those with diabetes. For anyone experiencing rectal pain they think could be serious, Dr. You may need antibiotics or a simple procedure to drain the infection.
Allow me to introduce you to brain surgery. But, to my surprise, I enjoy it from Strong, and it takes me a while to figure out why. Also, he has the talents to justify the talk. Am I crazy for wanting to see a gay version of Pretty Woman, with Connor Jessup as a streetwalking twink?
This fright-faced fraudster can't be charged for defrauding doctors, or any patients who paid through insurance. A year-old girl intentionally drove into a man jogging outside Seattle in July, killing him, and then laughed about it later with friends, according to police. Cops said the girl was speeding through Maple Valley, about 20 minutes south of downtown, and spotted Moore jogging, according to the Kent Reporter.
The girl behind the wheel later told her friends about the crash and laughed about it, according to police. The year-old was charged with second-degree murder and one count of hit-and-run in juvenile court, according to local NBC affiliate KING. She pleaded not guilty Wednesday. King County prosecutors said her lack of criminal record made trying the case in adult court impractical, KING reported.
I stayed away and warned people about him. I never associated or worked with him again. It was hard for me when Brad did. DL, you are wise and experienced. Please continue to share your collective knowledge of actress Kate Jackson with me. Written between March and the summer of this year in Cornwall surrounded by family, Ocean to Ocean is a universal story that is the path of when you touch the bottom and then renew yourself.
For a record written in an intimate setting, the rich stylistic variation amazesfrom tango to romanticism, and the expansive force of the songs that flow like a series of love letters to nearby people both present and absent.
A sense of displacement, both geographical and emotional, is present in the title track, the drama of which takes place on the coasts of the United Kingdom and the United States: a song of union and love, about clinging to each other in difficult times such as those caused by the loss of a loved one his mother and the pandemic.
It ultimately would engulf her childhood. Why does every lesbian become an angry, imperious Aspie at 25? She actually looks like she did a great job. That stained glass was done by the same folks who have worked on Notre Dame's stained glass, by the way. We've always had trolls on DL, but lately it seems there is a hate thread directed at one specific group of people each day.
Filipinos granted not the OP, but lots of nasty commentsSlavic people, Russians, white people, lesbians, and don't get me started on trans threads a few per day. I get that people want to discuss but when you start a thread with "they are thieves" or "monkeys" it's obviously a troll.
Have you seen this shit? Punk kids are trying to win Internet Points by daring each other to steal school property and post the videos to TikTok. Stealing an eraser is one thing, but walking out with a drinking fountain or a cleaver from the cafeteria is another.
They think this is fun, and funny. Schools have started locking the bathrooms and posting guards, only letting in one student at a time and inspecting for vandalism and vape-smoke. These little shitstains should've been beaten a lot harder in their formative years. I have to wonder how many kids are going to end up crapping in the bushes outside before somebody somewhere puts a stop to it.
Maybe if school districts fined the kids' parents for 10x the replacement cost of whatever they stole, or pressed criminal charges for property destruction, they'd put the kibosh on it.
Joe is way hotter, and has a way better face, beautiful coloring, better features, beautiful thick juicy ass and thighs. God I can keep going. He never reveals his age or background, but since late last year he's been inescapable. He's just my type, so I'm a fan, but does anyone know him or anything about his pre-porn reputation?
It deserves to be hawked by Johnny Depp. It smells like some kind of Axe body spray for adult men, and if someone is wearing it you cannot get away from them because it's such a beast. It features three different kinds of pepper--who the hell likes smelling pepper in the first place? The board for self-confessed Actressexuals, gays obsessed with actresses. You can't find a more interesting place to discuss movies and legends than this. Where else can you get into a feud over Meryl Streep's filmography?
Let's talk the hottest - and bitchest- members too. Is Erik really that old? Why is Dirk a bitter queen? Is McTeague closeted? OMG these are incredible! Rofl at this producer who took extra sandwiches home to his family instead of letting his PAs have one.
With the new season starting -- season 38 -- its time to start a new thread to discuss the daily Jeopardy episodes. Share your opinion of the various contestants. Did you get Final Jeopardy correct? What about the Daily Doubles? I love classic literature! However, I have discovered many people do not. Some of my favorites are:. Least favorite is probably Jane Austen. A few of her books are good, but I've realized their are a lot of people who say they love classic literature and have only read Austen.
Like many people say they love to read, but have only read Harry Potter books. The Hollywood Reporter corrals and lays out first predictions of who and what films might be in the key categories for next year.
I could be the only living person who bought Lisa Hartman's "Til My Heart Stops" album on cassette the day it was released in The sweet bliss of hearing my own thoughts. Following logic to its uninterrupted conclusion.
Reading genuine thoughts and comments. Some hearty chuckles and a few tears. The wind periodically wafting through the open screen on a beautiful fall day. Crickets chirping, taking the place of the birds who have begun to flock away.
Maybe Queen Mary who tried to sabotage Part I will be back to bump this along. Everyone's welcome! I'm not usually a Springsteen guy, but 'Nebraska' hits right for me at the moment. One of the great albums of our time. In a way, I'm living a distorted version of 'Atlantic City' in my own way. The princess is planning to wed her college sweetheart by the end of the year, meaning she will have to forfeit her royal titles.
They essentially control actors. Some are spiteful control Freaks. They are usually nerds who were continuously rejected in school.
With Twitter taken away from him, former President Donald Trump has been largely out of the spotlight and unable to drive news narratives the way he did when he was president and on social media. But Trump continues to have great influence with Republican elected leaders because of his continued popularity with the GOP base. And he's ramping up the messages he's sending for all to see on the blog-like portion of his post-presidency website. What's he focused on? Relitigating his election loss.
An analysis of Trump's posts on the site shows that his entries have spiked so far this month and that overall a plurality of the statements have mentioned his election loss or baseless claims of fraud or have cited efforts at relitigating the results.
One focus for the former president has been the controversial election review that continues in Arizona. And the messages come as that state and other Republican-led states, like Georgia, have enacted new voting restrictions.
By the numbers, here's a look at the kinds of posts that Trump has put out, through midday Wednesday:. Liz Cheney, R-Wyo. It's clear where Trump's focus is.
He wants to continue to influence the GOP message and be a kingmaker. Given his current front-runner status for the presidential nomination and his popularity within the Republican Party, he's well situated to do that. The bill passed with all Democrats and a few dozen Republicans supporting it. But Republican House leadership formally opposed it and urged conference members to vote against it. Republican Senate leader Mitch McConnell also opposes the measure.
On Jan. On the House floor, McCarthy voiced disapproval of Trump's actions that day, but since then, he has done an about-face. And after initially backing Cheney to stay in leadership, McCarthy later joined ranks with those calling for her ouster. Cheney voted for Trump's impeachment and has continued to speak out against the former president, his baseless claims about the election and his role in the Jan. Cheney was voted out of conference leadership last week.
Now, in the hope of drawing the flames of controversy away from the vulnerable women on whom this law will have an immediate effect, I am sharing my own experience. You might not be interested in the opinions of an actress, but given this new outrage, I feel it is my responsibility to stand up in their shoes.
I started my acting career at 15, working in an environment where I was often the only kid in the room. In my late teens, I was accidentally impregnated by a much older man. I was living out of a suitcase in Europe, far from my family, and about to start a job. I struggled to figure out what to do. I wanted to keep the baby, but how? He let me suck his nipples at a party in Brooklyn once. He played it like a gag but I could tell he was low key into it. After reading an excellent thread asking a similar question about Arlene Dahl It occurred to me that another actress with the initials AD from the golden age of classic Hollywood was also worth considering in this light.
Perhaps I am wrong and in the USA and perhaps beyond she is considered a gay icon. She was certainly not a s typical housewife. Sexually and her romantic life she was certainly more adventurous and was independent minded and pursued her desires. No s housewife! Very glamorous and well connected in Hollywood. A beautiful butterscotch blonde. They all look wonderful! They must be fans of James Bond to go to a movie premiere. I just wish Harry and Meghan were there.
George Malkemus, the steady, sunny Texan who helped turn the designs of an eccentric shoe designer named Manolo Blahnik into a global empire, and then attempted the same business alchemy with the actress Sarah Jessica Parker for her own shoe brand, died on Sept. He was Help me DL. We have a great connection and out-of-this-world sex. He is stable, kind and caring. A good man to the core. He immigrated to the US and earns an average American income.
He is stable and has somehow built up savings. I grew up in a highly-educated upper-middle-class family. I make a mid six-figure salary but also have a ton of financial commitments kids!
Things are great with this guy. I think I love him. What do you think? Will I grow to resent this over time? Warren Beatty and Shirley MacLaine are the most unlikely celebrity siblings.
They don't look, act or sound alike, and both have huge Hollywood reputations while taking separate paths in the same business. I think they mostly stick with their own kind, right? Some of them will date or marry someone close to normal, like someone who works in their industry producer, manager, agent, whatever.
But very few will date someone "below" them i. If the person doesn't have some kind of clout, they will likely not interact with them in any meaningful way at all except for raving adoring fans, and even that is superficial. This phenomenon of fame is so puzzling, why we exalt some people over others, and why we imbue them with this power.
Not just fame, but the social hierarchy. In companies, why do some become "stars" and others remain unrecognized? It is always up to ability or talent? I don't think it is. And yeah, celebrities like really fucking insular lives. Not really people we should be looking to for relatability. They may not even be truly human anymore if they come to believe they are more worthy than others and only exist in another sphere.
They are like demigods. This new trash season of AHS hinted at this idea, and even looking at the actors, we see Kaia Gerber, a girl who is only getting these opportunities because of who her mother is. But most of these celebrities exist on another plane.
Anyway, what was the original question? Oh, do celebrities fuck non-celebrities? Do you think they do? She looks beautiful! On being totally himself on their first date, on never having yet seen "Girls," and on "conscious drinking. Not last week or yesterday or in general, I'm talking about right now at this very moment. What is bothering you? No annoyance too small or too petty, Unload here.
Me: I waited too long to eat the nectarines I bought over the weekend and now they are overripe mush and leaking juices. I don't want to watch any of their new content, which all sounds so pompous. Do they really think themselves so much better than the work they used to put out?
His research interest is in artificial intelligence, specifically deep learning. He enjoys developing new statistical and information theoretical techniques for use in neural networks, as well as practical optimization techniques general to any learning task. Matt grew up in a suburb of Cleveland, Ohio. He completed his undergraduate studies at the Ohio State University before working in D. He is an ardent baseball fan as well as a trivia enthusiast. This seminal artwork has been posted in its entirety on YouTube.
THE scene begins at about and the monologue takes off shortly thereafter. A tour de force performance by La Franklin. I read a reviewer describe Bananarama as The Go-Go's under a wet blanket, but they had their own sound and style and both bands had an equal amount of good songs. The Brits are as cute as ever, Tracy has a boy toy, Heather has more plastic than a Chinese toy factory.
Okay, I know it's a teen show but the music is actually really good and the male eye candy is plentiful. Straights with mild wanderlust and mild travel funds seem to enjoy taking cruises to Alaska and the cleaner parts of the Caribbean. But cruises seem to have a lot of food poisoning, balcony murders, crew labor abuses, and pollution problems.
Also, they seem like they're just a floating hotel full of fats and drunks. Are they ever worth it, or are they just a low-rent way to get loaded in the sun for a week without having to speak a word of Spanish or carry a suitcase through a hotel lobby? I pray for them every night. I wish them well.
We give them lots of love. Via social media we advertised we had free landscaping rocks available. I exchanged messages with the first person who responded and when he stated when he was coming I told him "Just pull up in the driveway and load up your truck".
I was the only one home when he pulled into the driveway to pick up the shit. I didn't bother going out to say hello or anything. When my partner heard about it he thought it was really bad etiquette!! What say you? Because so many people told me to watch Ted Lasso, I gave it a try. Can't say I love it, but it seemed like a pretty good-natured program at a time when most tv is dark and gloomy. A nice respite from crime and horror.
Why would anyone want to watch a program that extols the glories of a selfish, cruel philosophy? I don't get it. Do any of you have experience living anywhere in Manitoba? What are the pros and cons? She has been a chronic alcoholic for decades. Look at the distended belly and toothpick legs? How can her liver still be functioning? The progressive Democrats are insisting that the Build Back Better bill must be passed before the Infrastructure bill.
They have enough votes to block passage of Infrastructure but not enough to pass Build BackBetter. They obviously have no control over what the Senate does, but are using the Infrastructure bill as leverage. What do you think they should do? Everything is online except "Bands Reunited: Klymaxx" - the best episode of all - the next best alternative is "Unsung: Klymaxx". Christine Lahti giving an Emmy-worthy performance. Ted Danson as Sam Malone the adulterer.
Sam Waterston at his fumbling best. I work with a woman in her thirties who spent her time away from the office getting gigantic Dolly Parton-level DDs. I'm watching this series now and it's incredibly heart-touching. The families that give them all the support, the counselors that help them, the personalities of the people that they feature. I kind of love Australian shows Steve Martin and Martin Short are good. Selena Gomez is…pretty. Her flat line readings already drive me crazy.
Short plays a Broadway director-a hetero one. Which is stupid. I once loved writing letters and reading letters, a practice that has been enduring a progressive march toward death since email. I still get a holiday card from that type of friend many of us have…the friend who includes the folded up photocopied letter with the boring list of everything she and her family did that year.
I also love reading the letters of famous people like Dorothy Parker and Tennessee Williams…the quips and the penmanship and the stationery. But even the short letters are amusing: they tell you so much about people. This channel was somehow recommended to me on my youtube account.
Karen Carpenter looks like Chrissy Metz compared to her. How is this allowed on Youtube?? This is fucked up. If I had to choose one book that made a profound impact on my life, it would be the Betty Crocker Cookbook. This was appointment television for a lot of people who lived their lives hinging upon every utterance made by Linda Dano. Her shoulder pads were legendary and trend-setting. There was something off-putting and automaton about Nancy Glass. Almost as if she was hollow inside, yet had a reverse vacuum otherworldly, menacing, eerie, soul sucking quality about her.
I'm stuck in tahiti right now! I need you're help and support starting with your credit card info to come back to America and promote my album that dropped! Co-host Sunny Hostin and guest host Ana Navarro both learned they tested positive for breakthrough cases ahead of the interview. Both Navarro and Hostin were at the table for the start of the show, but then were pulled from the set.
I wholeheartedly agree. Of course, it would be better if these drugs were not scheduled and access to them easier. If you could get a prescription for medicinal ketamine, marijuana, shrooms, or LSD easily from your doctor, that would change everything. The price of these medicines would also fall dramatically. Elon is a bit of a kook but I find I agree with him more often than not. I still don't like Tesla and what it represents though.
Part Two was paywalled, so go ahead and discuss our working-class homo who is moving on up. Serving tea? Making your bed? Anal douching? Nicolas is here to help. I wasn't interested in this at all but my husband wanted to watch and now I am obsessed. Funny, sweet, and lots of shirtless dudes. Jason Sudekis' Ted Lasso is such a kind smart character. All the supporting characters are fantastic and the character Roy played by Brett Goldstein pretty much doesn't own a shirt and is hot as fuck.
Can you believe Dancing with the Stars is already in season 30!? The 30th season is set to kick off on ABC in Septemberbut the casting rumors have already begun! I went to the grocery store and CVS in the past few days, and each place was very low on a number of essential items. I have been down with something for over a week.
Going out of my mind staying in bed, and sinking to new depths -to wit watching Love Boat episodes on YouTube. Tonight I came across something, well Everyone is singing and dancing -all of the regulars Jill Whelan and Fred Grandy actually have nice voices. Oh, and there are some original songs I'm trying to get back into shape and running is always my best bet, but I have knee pain some days other days are fineand I've read that maximalist shoes can help. Though I've also read that they're a waste of money.
The couple built the first West Coast resort for Black people in before they were ran out of Manhattan Beach almost a century ago. According to Toledo Police, witnesses say it was destroyed by a lightning strike.
Toledo police were seen outside the building, which used to house the Mugshots Bar, setting up tape around the pile of bricks that once formed the artwork. The mural was painted nearly one year to the date of its collapse in July Groups have held memorial services for Floyd in front of the mural, including on the one-year anniversary of his death at the hands of Minneapolis Police Officer Derek Chauvin.
Chauvin was later convicted of murder and sentenced to The building itself is structurally sound, according to a City of Toledo building inspector. All but one of the City Council members present on Wednesday said they supported the proposed "emergency" ordinance, which would require proof of vaccination to enter restaurants, bars, shopping centers, gyms and other indoor spaces.
The new rule would take effect in November. Political leaders across the United States, led by Democratic President Joe Biden, have ratcheted up pressure on the unvaccinated in recent weeks. Laws requiring proof of vaccinations are deeply controversial in the United States, with many Americans criticizing them as unconstitutional and authoritarian. A majority of the Los Angeles City Council was prepared to vote in favor of the proof-of-vaccine measure on Wednesday.
They were frustrated in that effort by council member Joe Buscaino, who, by withholding his vote, stood in the way of a so-called "unanimous consent. Buscaino said the vaccine mandate could not be enforced, citing a report by the city's Department of Building and Safety that it was not equipped to take on such a law enforcement role.
The Los Angeles County Unified School District has issued an order requiring all teachers, staff and students at least 12 years old to be inoculated by Oct.
What the fuck happened? Joe Manchin is just as corrupt, if not more, than Mitch McConnell. Years ago we he had a great roast thread! I especially remember one about a Datalounger finding a creepy cubby hole in his home and discovering a particularly wonderful roast! This really makes my day.
Of the modern Who showrunners he was my favorite. Now I'm really looking forward to the new seasons. Icing on the cake would be to bring back Eccleston if they reconciled or convince Whittaker to stay on just to show how it's done. YouTuber Nicolas Fairford has been writing all along on the DL threads about him, posing as a businessman who 'came on his lips' and as a friend who saw him in a pub.
The stories don't align. Do this yourself for proof. Nicolas is possibly a very naughty boy! I'm not weighing it out, it is up to you all to decide. But this could be just a troll, but it has only written on the NF threads in recent history, which leads me to believe it's really Nicolas slicking up his threads to seem more interesting, and poorly take our constructive criticism.
It may very well have been the DL that gave him the boost he needed to succeed on YouTube. He played us, girls. I guess one great thing about it are the costumes. The actress playing Sarah Spencer is the only one who really pops off the screen. Yes it was many years ago but even this brief description is fascinating.
Ivana brought one of her furriers as a guest! How strange. His sound was one of a kind at the time. This song makes me believe in God, almost. And he wrote the song and accompaniment fast, and at What a musical genius. Police say the masked, umbrella-wielding man who smashed windows at a Minneapolis auto parts store two days after George Floyd's death has ties to a white supremacist group and specifically sought to inflame racial tensions. According to the Minneapolis Star Tribune, Minneapolis police arson investigator Erika Christensen wrote in a search warrant affidavit filed this week that the man's actions created a hostile atmosphere and sparked a series of events that turned previously peaceful protests chaotic.
She said she believed his "sole aim was to incite violence. Minneapolis police spokesperson John Elder told NPR he is unable to comment on the investigation, which is "open and active.
Does he live in the Governor's Trailer? He's not a piece of shit; he's an entire shit. I blame the parents. He's fat too. I've never been to one as I am allergic to everything about the concept. Feel It Die - Skull Cult - Vol. One (Cassette) the leave me the fuck alone, no enforced mingling with guests or owners, fed a ghastly breakfast "casserole", or share a terlit with strangers type.
Whether your work in a diner or white table cloth restaurant, what is it that customers do, that really annoy you. Now I feel like a huge piece of shit. I don't understand how people do it regularly. I met a guy who said he snorts a gram a day, has a good job and everything. I feel dirty. Plus it's close to DC and has a few colleges in town plus state government which seems to be getting bluer all Feel It Die - Skull Cult - Vol.
One (Cassette) time. The results so far are preliminary, but they do indicate that the disparities queer Americans experienced prior to the pandemic have continued to endure 18 months in. For some, those disparities have grown deeper. Let's talk soup! I remember seeing a drag queen do 'This is My Life' at one of my first drag bars when I was coming out.
I was so touched when the queen ripped off her wig at the appropriate tearful moment and all the crowd roared. Queens were allowed to to that in those days without being hissed. Since then, I have seen her in concert twice, and both were marvelous shows. The second I was so close I was able to give her flowers. She was glorious! Van Vliet's idiosyncratic vocal on Zappa's "Willie the Pimp" was among their collaborations.
Main article: The Magic Band. Main article: Captain Beefheart discography. Retrieved December 18, Retrieved July 18, Retrieved March 17, Archived from the original on October 26, Retrieved October 26, London: Bauermedia. The Guardian. London, England: Guardian Media Group. Retrieved April 28, Retrieved February 16, Retrieved August 25, New York City: Viacom. Rolling Stone. Archived from the original on March 16, Retrieved February 11, Financial Times.
Los Angeles Times. December 17, Retrieved December 17, Archived from the original on January 6, Archived from the original on February 27, The Real Frank Zappa Book. Poseidon Press. ISBN X. Archived from the original on August 17, Continuum International Publishing Group.
ISBN Retrieved January 26, The Captain Beefheart Radar Station. Archived from the original on April 7, Archived from the original on September 18, International Times. Interlink Publishing. Archived from the original on October 20, Archived from the original on June 16, Retrieved September 2, Captain Beefheart — Google Books. Retrieved January 25, Archived from the original on September 24, Lunar Notes p Guitar Player Jan. Archived from the original on December 13, Retrieved December 9, Zappa: A BiographyGrove Press, pp.
London: Cherry Red Books. New Feel It Die - Skull Cult - Vol. One (Cassette) Expressas quoted in Barnes. Robert Christgau. December 1, Perfect Sound Forever. Archived from the original on November 20, Archived from the original on January 24, Retrieved December 19, Clear SpotAllMusic. Lunar Notes pp.
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Archived from the original on December 30, Captain Beefheart Radar Station. Archived from the original on May 11, Archived from the original on January 8, Retrieved December 20, Retrieved September 4, BBC News.
Retrieved January 28, Retrieved April 23, The New York Times. Retrieved June 28, Retrieved July 1, March 30, Accessed at beefheart. The Grove Dictionary of American Music. May 2, Archived from the original on July 9, Rip it Up and Start Again — Postpunk — Faber and Faber.
Archived from the original on October 14, LA Weekly. Retrieved June 5, Entranced : the Siouxsie and the Banshees storyOmnibus Press,p. November 23, Uncut Dec. Till I Reach the Higher Ground. Guitar Player. May 18, Retrieved March 4, Retrieved June 6, Archived from the original on August 6, Archived from the original on June 6, Captain Beefheart.
Grow Fins: Rarities — Authority control. CiNii Japan. Namespaces Article Talk. Views Read Edit View history. Help Learn to edit Community portal Recent changes Upload file. Download as PDF Printable version. Wikimedia Commons Wikiquote. December 17, aged 69 Arcata, CaliforniaU. Singer-songwriter, musician, painter, poet, composer, author, record producer, film director. Vocals, harmonicasaxophoneclarinetoboehornshehnai. Epic Major League. Problems playing this file?
See media help. Problems playing these files? Wikimedia Commons has media related to Captain Beefheart. Since there is apparently some chance that these will generalize, it is probably worth while to keep the child on Dilantin therapy to suppress a grand mal seizure.
I would check the Dilantin level to make sure that it remains therapeutic…. Neil and Peggy once went through a photocopy of it with me.
The errors were invariably made by transcribers, nurses, or other physicians; their own contributions were flawless and usually even legible. He had forgotten that she had had epileptic seizures for five months before they were diagnosed and medicated, and was wondering in retrospect whether the course of her life might have been different if his hospital had offered her optimal medical care from the beginning.
Neil Ernst and Peggy Philp are married to each other. Neil and Peggy are both the children of physicians, both high school valedictorians, both Phi Beta Kappa graduates of Berkeley. They met when they were nineteen and eighteen, two tall, good-looking, athletic premed students who recognized in each other the combination of idealism and workaholism that had simultaneously contributed to their successes and set them apart from most of their peers.
Their schedules were arranged in such a way that one of them was always home in the afternoon when their two sons got out of school. Every morning, the alarm buzzed at If it was Monday, Wednesday, or Friday, Neil got up and ran eight miles.
If it was Tuesday, Thursday, or Sunday, Peggy got up and ran eight miles. They alternated Saturdays. Their runs were the only time either of them was entirely alone for more than a few minutes, and they never skipped or traded a morning, even if they had been up most of the night on call at MCMC.
Peggy was on call at the hospital. We get along real well. Real, real well. Medically, we complement each other. My strengths are infections, asthma, and allergies. Am I thinking okay? Would you offer anything else? Can I do anything else? If I feel like a dumbshit I can be a dumbshit with her. If she was not in my life it would…well, take a while for me to be able to function.
They are perfect. Few other people I know would have gone to the lengths they did to provide good medical care to Lia. They were always thinking about her. Her Physical Growth chart shows that although her height usually hovered around the fifth percentile for her age not unusual for a Hmong childher weight climbed as high as the seventy- fifth percentile. Her thick subcutaneous padding compounded the challenges that awaited the doctors in the emergency room.
Considerable effort has gone into weight control in this child. The father apparently likes Lia the way she is and is somewhat resistant to this problem. A vein hidden under fat is hard to palpate. Like a drug user who loses veins after repeated needle sticks, Lia eventually lost the antecubital veins in both forearms and the saphenous vein above her left ankle after doctors frantically searching for needle placement cut them open and tied them off.
During most of her hospitalizations, the arm or leg with the IV line was bandaged to a board, and sometimes she was secured to her crib as well. Father here. Soft restraint to L arm. Returned child to bed, soft restraint to R arm. Tried to explain to father reason but difficult due to communication barrier.
His confidence in their ability to care for Lia was further strained the morning after this note was written, when he left the hospital at a. Foua and Nao Kao believed the best way to keep Lia safe and content, especially when she was ill or in pain, was to have her sleep next to them, as she always did at home, so they could immediately comfort her whenever she cried. You see them put a bag on your kid to measure the output of urine and stool. When your child is in the hospital, suddenly somebody else is feeding them, somebody else is changing their pants, somebody else is deciding how and when they will be bathed.
It takes all the autonomy of being a parent away, even for folks who have had a lot of medical experience. Mom here. Babe content. Cruises sides of crib. Makes baby sounds. Father trying to put her back to sleep.
No seizures this shift. After she was old enough to walk, whenever she was well enough to get out of bed she ran up and down the corridor in the pediatric unit, banging on doors, barging into the rooms of other sick children, yanking open the drawers in the nursing station, snatching pencils and hospital forms and prescription pads and throwing them on the floor. She was a little Houdini. With other Hmong families the sons are the ones who are loved.
Hmong fathers say, Girl okay if die, want many boy. But this family, they wanted so much for her to live, they just adored her. When you asked for a hug you could always get one from Lia. So you kind of liked her because she was a character, even though you hated her because she was so frustrating and she caused you so much grief. Lips pursed tightly to prevent this med given. Spits well. And even when Lia was co-operative, Foua and Nao Kao were often uncertain about exactly what they were supposed to give her.
Over time, her drug regimen became so complicated and underwent so many revisions that keeping track of it would have been a monumental task even for a family that could read English. For the Lees, it proved to be utterly confounding. The anticonvulsant medication originally prescribed by Peggy Philp was Dilantin, which is commonly used to control grand mal seizures.
Three weeks after her first MCMC admission, after Lia had a seizure in the hospital waiting room that appeared to be triggered by a fever, Peggy changed the prescription to phenobarbital, which controls febrile seizures better than Dilantin.
Lia seized several times during the next two weeks, so since neither drug appeared to work adequately alone, Peggy then prescribed them both simultaneously.
Consulting neurologists later prescribed two other anticonvulsants, Tegretol which was originally to be used along with both Dilantin and phenobarbital, and then just with phenobarbital and Depakene which was to be used in place of all the previous anticonvulsants. Because these medications were prescribed in varying combinations, varying amounts, and varying numbers of times a day, the prescriptions changed twenty-three times in less than four years.
Several of the medications were available in different forms, and were sometimes prescribed as elixirs all of which were pink or red and came in round bottles and sometimes as tablets almost all of which were white and came in round bottles.
Foua and Nao Kao, of course, had no idea what the labels said. Even if a relative or the hospital janitor was on hand to translate when a bottle was handed to the Lees, they had no way of writing down the instructions, since they are illiterate in Hmong as well as English; and because the prescriptions changed so frequently, they often forgot what the doctors told them. Measuring the correct doses posed additional problems. Liquids were difficult because the Lees could not read the markings on medicine droppers or measuring spoons.
Pills were often no easier. At one point, when Lia was two, she was supposed to be taking four different medications in tablet form twice a day, but because each of the pills contained an adult dose, her parents were supposed to cut each of the tablets into fractions; and because Lia disliked swallowing the pills, each of those fractions had to be pulverized with a spoon and mixed with food.
If she then ate less than a full helping of the adulterated food, there was no way to know how much medicine she had actually consumed. This was a dismaying realization. The only way to determine the optimal type and amount of anticonvulsant medications for Lia was to observe the level of her seizure activity and repeatedly test the medication level in her blood, but the test results were inconclusive unless the doctors knew exactly what was going into her system.
Neither doctor could tell how much of their inability to get through was caused by what they perceived as defects of intelligence or moral character, and how much was caused by cultural barriers. She was the first of a succession of public health nurses who were to visit the Lees over the next four years. Febrile seizures, noncompliant mother, noncompliant mother, noncompliant mother, noncompliant mother, noncompliant mother.
When Lia was taking elixirs, they tried drawing lines on the plastic syringes or medicine droppers to mark the correct doses. When she was taking pills, they tried posting charts on which they had drawn the appropriate pie-shaped fractions. They tried taping samples of each pill on calendars on which they had drawn suns and sunsets and moons. They tried putting the pills in plastic boxes with compartments for each day. There they would be, a little stack of bottles in the kitchen next to the tomatoes and onions, sort of like a decoration in the corner.
Because Lia was on such high doses, she had an appointment with Dr. Philp or Dr. Ernst almost every week and had a blood level drawn two or three days before and maybe another blood level two or three days afterwards, and there were so many changes that it was just totally mind-boggling.
My general impression was that they really felt we were all an intrusion and that if they could just do what they thought best for their child, that child would be fine. They were courteous and they were obstinate. They told us what we wanted to hear. Parents state infant is doing the same. Were unaware of appt. Peds clinic for today. Were confused about proper dosage of medicine and which to give…. Several meds in refrigerator that are outdated included Amoxil and Ampicillin.
Also one bottle of medication with illegible label. Ernst contacted concerning correct dosage of Phenobarb and Dilantin. Correct administration demonstrated. Outdated medication discarded. Mother states she went to MCMC as scheduled for blood test, but without interpreter was unable to explain reason for being there and could not locate the lab.
Is willing to have another appt. States infant has not had any seizures. Have finished antibiotic. Are no longer giving Phenobarb because parents insist it causes diarrhea shortly after administration. Mother states she feels intimidated by MCMC complex but is willing to continue treatment there. Agree to have continued care at Peds clinic. Home visit made with interpreter.
Mother has now decided to give mg. Phenobarb at night. Mother seems very agitated. Father out of house for rest of day—shopping. Assured mother that child can be seen in Peds clinic Monday even without the Medi-Cal card. Home visit by interpreter to discuss childs care with father. Mother states they just returned from hospital that AM…. Diagnosis for hospitalization unknown to mother but antibiotic prescribed. Their faith in medicines had not been strengthened by two routine immunizations Lia had received against diphtheria, pertussis, and tetanus, to which, like many children, she had reacted with a fever and temporary discomfort.
In some cases phenobarbital can cause hyperactivity—it may have been responsible for the riotous energy the nurses always noticed when Lia was hospitalized—and, in several recent studies, it has been associated with lowered I. Dilantin can cause hair to grow abnormally all over the body, and gum tissue to bleed and puff out over the teeth.
Too much phenobarbital, Dilantin, or Tegretol can cause unsteadiness or unconsciousness. Doctors are used to hearing patients say that drugs make them feel bad, and indeed the unpleasant side effects of many medications are one of the main reasons that patients so often stop taking them.
Doctors who deal with the Hmong cannot take this attitude for granted. John Aleman, a family physician in Merced, once hospitalized a Hmong infant with severe jaundice.
After two Feel It Die - Skull Cult - Vol. One (Cassette) three samples, the parents said their baby might die if any more blood was removed.
The doctor explained through an interpreter that the body is capable of manufacturing new blood, and he poured one cc of water into a teaspoon to demonstrate what an insignificant amount was being taken. They said if the doctor drew any more blood against their will, they would both commit suicide. Fortunately, at this point Dr. The baby had the blood tests and was successfully treated with phototherapy.
His parents, both teenagers who had attended American high schools and spoke and read English fairly well, consented, though reluctantly, to the surgical removal of the affected testis.
She handed the parents a piece of paper on which she had typed the names of the drugs he would receive and their possible side effects.
Her predictions turned out to be accurate. Arnie, who had appeared perfectly healthy after his surgery, lost all his shiny black hair within three weeks after his first cycle of chemotherapy, and every time the drugs were administered, he vomited. I say, Wait for my husband. I say, Please that you go away. I hold my son. I hold him so tight. I say, Give my son back. Two police, they hold my hand behind my back. I am scared. My two daughters are crying. The police hold my hand, they take my son away!
I scream and cry. They were two long guns. We bought them to shoot squirrels and deer, not to shoot people. I just yell, Please bring my son back to me. I say, Just bring! I want to hold my son! Finally some police officers brought Arnie back from the hospital, and when Dia Xiong saw him, she dropped the guns and was driven, in handcuffs, to the psychiatric unit of a local hospital.
She was released the next day, and no criminal charges were filed against her. Arnie is still in remission today. It is likely that the only Western drugs Foua and Nao Kao had encountered in Asia were fast-acting antibiotics.
I felt they really cared for Lia, and they were doing the best, the absolute best they knew how as parents, to take care of the kid. That is what I felt about them.
It was very foreign to me that they had the ability to stand firm in the face of expert opinion. And the other thing that was different between them and me was that they seemed to accept things that to me were major catastrophes as part of the normal flow of life.
For them, the crisis was the treatment, not the epilepsy. The parents report that they had discontinued the medications about 3 months ago because the patient was doing so well. At p. He therefore had to deal on his own with the most severe episode of status epilepticus Lia had yet suffered.
He administered two more massive doses of phenobarbital. First Dan gave her mouth-to-mouth resuscitation, and when she failed to resume breathing on her own, he decided that a breathing tube had to be placed down her trachea.
This time I saw what I needed to see and the tube went right in and it worked perfectly and I felt really good. I thought, well, I guess I am becoming a doctor. I remember that they were very upset about that. I remember that the mother just had a very displeased look on her face.
She regained consciousness there, and was able to breathe on her own after twenty-four hours on a respirator. Lia spent nine days in Fresno, spiking high temperatures from aspiration pneumonia and gastroenteritis, but did not seize again. Through an English-speaking cousin who accompanied Foua and Nao Kao to Fresno, the admitting resident was told that Lia had been off medications for one week rather than the three months recorded by Dan Murphy because the prescription had run out and the family had not refilled it.
It is not surprising that a child who had seized as frequently and severely as Lia was beginning to show the first signs of retardation, but Neil and Peggy found the situation particularly tragic because they considered it preventable. Neil and Peggy perceived Lia as being more retarded though still only mildly so than the visiting public health nurses did.
Unfortunately, the Lees had now decided that they liked phenobarbital, disliked Dilantin, and were ambivalent about Tegretol. The mother brought a large sack full of medication bottles and on closer examination by myself there were 3 half empty bottles of Tegretol.
The mother stated that she was unaware that these bottles were Tegretol. In addition, the mother also was unable to identify the Dilantin bottle and gave that bottle to me and said that she did not want it at home. On rereading this note many years later, Neil said he could still remember the rage he had felt when he wrote it.
A handful of times, Neil gave Foua a hug while Lia was seizing, but most of the time, while Lia was between the ages of eighteen months and three and a half years, he was too angry to feel much sympathy toward either of her parents. It was like banging your head against a wall constantly and not making any headway.
There was the frustration of the nighttime calls and the length of time it took and the amount of energy and sorrow and lack of control. I mean, every time I saw Lia I would just, you know, it was like—ohhhhh, you would just get so frustrated! When she came to the emergency room in status there would be sort of like a very precipitous peak of anger, but it was quickly followed by the fear of having to take care of a horribly sick child who it was very difficult to put an IV in.
From our own fear. No other pediatricians practicing in Merced at that time were willing to accept Medi-Cal patients. The Lees also never showed their doctors the kind of deference reflexively Feel It Die - Skull Cult - Vol. One (Cassette) by even their most uncooperative American patients.
The worst aspect of the case was that as conscientious physicians and dedicated parents, they found it agonizing to watch Lia, as it would have been for them to watch any child, fail to receive the treatment they believed might help her lead a normal life.
And it seemed as if the situation would never end. However frustrated they were, they never considered abandoning the case. Unless Lia died, they could see themselves driving to the emergency room in the middle of the night until she was grown up and had graduated to the care of an internist, with whom they already felt an anticipatory bond of sympathy. In June ofNeil and Peggy found out that Foua was pregnant again. They were appalled. This baby would be number fifteen; eight had survived.
We were just dreading how this baby might turn out, that it might have Down syndrome and heart problems and that we were going to have to deal with two sick kids in this family. Just what we needed. Not that she would have aborted anyway. She continued to breast-feed Lia throughout her pregnancy. On November 17,when Lia was two and a half, Pang Lee—a healthy, vigorous, completely normal baby girl—was born.
After the birth, Foua breast-fed both Lia and Pang. In it, he also wrote that because of poor parental compliance regarding the medication this case obviously would come under the realm of child abuse, specifically child neglect….
It is my opinion that this child should be placed in foster home placement so that compliance with medication could be assured. It was also said that Hmong women were forced into slavery, forced to have sex with American men, and forced to have sex with animals. Dinosaurs lived in America, as well as ghosts, ogres, and giants. With all this to worry about, why did the 15, Hmong who gathered on the Ban Vinai soccer field to voice their deepest fears about life in the United States choose to fixate on doctors?
A year after I first read the account of that gathering, as I was attempting to deal out a teetering pile of notes, clippings, and photocopied pages from books and dissertations into several drawerfuls of file folders, I had a glimmering of insight. There were hundreds of pages whose proper home I was at a loss to determine.
Should they go in the Medicine folder? The Mental Health folder? The Animism folder? The Shamanism folder? The Social Structure folder? I hovered uncertainly, pages in hand, and realized that I was suspended in a large bowl of Fish Soup. Medicine was religion. Religion was society. Society was medicine.
The Hmong carried holism to its ultima Thule. As my web of cross-references grew more and more thickly interlaced, I concluded that the Hmong preoccupation with medical issues was nothing less than a preoccupation with life. And death. And life after death. Not realizing that when a man named Xiong or Lee or Moua walked into the Family Practice Center with a stomachache he was actually complaining that the entire universe was out of balance, the young doctors of Merced frequently failed to satisfy their Hmong patients.
How could they succeed? All of them had spent hundreds of hours dissecting cadavers, and could distinguish at a glance between the ligament of Hessel-bach and the ligament of Treitz, but none of them had had a single hour of instruction in cross-cultural medicine.
To most of them, the Hmong taboos against blood tests, spinal taps, surgery, anesthesia, and autopsies—the basic tools of modern medicine—seemed like self-defeating ignorance. They had no way of knowing that a Hmong might regard these taboos as the sacred guardians of his identity, indeed, quite literally, of his very soul. What the doctors viewed as clinical efficiency the Hmong viewed as frosty arrogance. And no matter what the doctors did, even if it never trespassed on taboo territory, the Hmong, freighted as they were with negative expectations accumulated before they came to America, inevitably interpreted it in the worst possible light.
Whenever I talked to Hmong people in Merced, I asked them what they thought of the medical care they and their friends had received. They do what they want to do. Doctor want to look inside the woman body. She do not want doctor to see her body. But this country there is the rule. If you want to stay here you must let doctor examine the body. They feel, maybe doctor just want to study me, not help my problems. They scary this. If they go one time, if they not follow appointment and do like doctor want, doctor get mad.
Doctor is like earth and sky. He think, you are refugee, you know nothing. Other people who are rich, they treat them really well and they do not wait. She say, no, I just need medication for pain only. And he say, I know more than you do. He completely ignore what she ask. But he say to me, I already sign everything and the doctor going to send me to jail if I change my mind. The student doctors just want to experiment on the poor people and they kill the poor people.
He takes people that are sick, he produces people that are healthy. If he do not produce, his economic will be deficit. But the Hmong, he will want the doctor to calmly explain and comfort him. That does not happen. I do not blame the doctor. It is the system in America. Nonetheless, their version of reality fails to match that of their doctors pretty much across the board. The young residents are all M. The Hmong spend a long time in the waiting area, but so does everyone else. Patients who change their minds about surgery do not go to jail.
The doctors do not experiment on their patients. Neither do they kill them, though their patients do sometimes die, and are more likely to do so if, like the Hmong, they view the hospital as a dreaded last resort to be hazarded only when all else fails.
The residents may be exhausted since their shifts are up to twenty-four hours long, and until recent years were up to thirty-three hours long ; they may be rushed since many clinic appointments are only fifteen minutes long ; but they are not—and they know they are not —greedy or spiteful. Most of them have chosen the field of family practice, which is the lowest-paying of all medical specialties, for altruistic reasons.
It was he who first told me about the Hmong of Merced, whom he described as being such challenging patients that some of his fellow doctors suggested the preferred method of treatment for them was high-velocity transcortical lead therapy.
He had politely declined. When they undressed for an examination, the women were sometimes wearing Jockey shorts and the men were sometimes wearing bikini underpants with little pink butterflies.
They wore amulets around their necks and cotton strings around their wrists the sicker the patient, the more numerous the strings. They smelled of camphor, mentholatum, Tiger Balm, and herbs. When they were admitted to the hospital, they brought their own food and medicines. Hmong patients made a lot of noise. Sometimes they wanted to slaughter live animals in the hospital.
Finally we had to talk to them. No gongs. And no dead chickens. They looked like burns. Some of the lesions had healed and others were still crusty, suggesting that the skin had been traumatized on more than one occasion. Neil and Peggy immediately called the Child Protective Services office to report that they had identified several cases of child abuse.
The father hanged himself in his cell. The story is probably apocryphal though it is still in wide circulationbut Dan and the other doctors believed it, and they were shaken to realize how high the stakes could be if they made a tactical error in dealing with the Hmong.
And there were so many ways to err! When doctors conferred with a Hmong family, it was tempting to address the reassuringly Americanized teenaged girl who wore lipstick and spoke English rather than the old man who squatted silently in the corner. Yet failing to work within the traditional Hmong hierarchy, in which males ranked higher than females and old people higher than young ones, not only insulted the entire family but also yielded confused results, since the crucial questions had not been directed toward those who had the power to make the decisions.
Doctors could also appear disrespectful if they tried to maintain friendly eye contact which was considered invasivetouched the head of an adult without permission grossly insultingor beckoned with a crooked finger appropriate only for animals. The young residents at MCMC did not enhance their status by their propensities for introducing themselves by their first names, wearing blue jeans under their white coats, carrying their medical charts in little backpacks, and drinking their coffee from Tommee Tippee cups.
On the other hand, bending over backwards to be culturally sensitive did not always work. Bill Selvidge once examined a depressed middle-aged Hmong woman with severe headaches. Surmising that some of her problems stemmed from cultural dislocation and that her spirits might be buoyed by traditional treatment, he recommended that she see a txiv neeb.
She may have tried this in the past because she indicates a previous landlord told her to leave home after police were called when some members of her family were just about to sacrifice a Feel It Die - Skull Cult - Vol. One (Cassette). Compared to the other patients that frequented Merced Community Medical Center, the Hmong were not only trickier but sicker.
They had a high incidence of high blood pressure, anemia, diabetes, hepatitis B, tuberculosis, intestinal parasites, respiratory infections, and tooth decay. Some of them had injuries or illnesses they had acquired during the war in Laos or its aftermath: gunshot wounds, chronic shoulder pain from carrying M rifles, deafness from exploding artillery shells.
Before receiving clearance to be admitted to the United States, all Hmong, like other refugees, undergo medical screenings by physicians employed by the International Organization for Migration.
In fact, the exam takes approximately ten seconds. Early on, you could buy a clear X ray on the black market. Once a refugee arrives in the United States, post-immigration screening is not legally required, so although most states have refugee health programs, many Hmong choose not to be screened and thus encounter the medical system for the first time during an emergency.
Though funding is too meager to allow more than a cursory examination during which the patient undresses only from the waist up, refugees who are pregnant or have glaringly evident medical problems are referred to the hospital or clinic. So she went over there on some other pretext, and there were the rat cages.
She could see the rats were from the pet store, not the gutter—they were big whoppers. Instead of making the family feel bad about the rats, she simply suggested that they raise rabbits instead. Low start-up cost, high yield, high protein. It turned out that for a major feast on a hot summer day, a pig infected with salmonella had been butchered, ripened in the sun for six hours, and served in various forms, including ground raw pork mixed with raw blood. Although by the mid-eighties the regular staffs of the health department and the hospital had become inured, if not resigned, to dealing with the Hmong, each year brought a fresh crop of family practice residents who had to start from scratch.
When an interpreter was present, the duration of every diagnostic interview automatically doubled. Or tripled. Or centupled. Because most medical terms had no Hmong equivalents, laborious paraphrases were often necessary. The prospect of those tortoise-paced interviews struck fear into the heart of every chronically harried resident.
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