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Harry’s Big Day: The History Of A Dastardly Practical Joke

Fire

Harry wandered in, mumbled his announcement, and wandered whence he came. I heard myself mutter, “We just can’t leave it,” “No we can’t,” Hilary chimed in.

Technicon SMA 12/60

Technicon SMA 12/60

This is the story of my most dastardly practical joke, and I seriously doubt that I will better it (which doesn’t mean I will not try). Let me set the scene. It was in olden times, i.e. the 1980s, before the personal computer and well before mobile telephones. The nearest thing most people came to a computer was their electricity bill. Still, the march of Science had arrived in our little Clinical Chemistry Department of our little suburban hospital. We still had a few test tubes and Bunsen Burners. I recall performing an enzyme assay for Acid Phosphatase (a test for prostate cancer) using a rack of test tubes suspended in a water bath and I suppose the Radioimmune Assays for hormones – then the big thing – did use dozens of little plastic tubes, but on the whole the test tube thing and naked flames were on the way out; most of the work was done by machines.

Greg Saunders of CSI and his bank of wiz bang, internet enabled, Deep Minded gizmos were 20 years in the future. Instead a company called Technicon had cornered the hospital chemistry market with the notion of a bubble. In the most simplistic terms, a drop of blood serum was sipped from a little plastic cup held on a carousel and diluted with water, salts and detergent to become a sample. This sample was feed through clear plastic tubing where it was mixed with chemical solutions, and the resulting chemical reaction produced a color change, which was measured using a photocell. The bubble prevented one sample drop washing into the next.

The machines were magnificent, and their memory is sadly lacking on the Internet. The chemical solutions could be vibrant colors, such as a deep magenta for measurement of total carbon dioxide. The form of the machines was a network of transparent tubing, imbedded with handsome springy glass coils, oil heating baths, transparent acrylic blocks and finally blocky colorimeters. The biggest machine in the lab was a magnificent SMA2 whose great rack of tubing was back-lit, highlighting the flickering voyage of the bubbles, and the magenta and peach solutions. All in all, they were something I feel Willie Wonker would have been proud of.

The bulk of the analyzes and running these machines was done by the serfs like Hilary and me, who gloried in the name of Medical Laboratory Scientific Officer. Harry, however, was of the nobility, a doctor destined to become a consultant. On that glorious morning when Harry made his big announcement, Hilary and I were doing the second most popular set of tests, those used to assist in diagnosing Liver Function. We used blood serum but there were some test tube tests for liver function performed on urine. Harry’s announcement? He had asked for an opportunity to do a pee test for liver function.

He had asked because he was taking the big exam, the one which made him a Consultant. He had already passed the written portion of the final exam but unlike the exams you or I would take, after the written bit there was a practical bit. And the practical bit had teeth; if you failed it then you had to do the whole exam all over again. Just the kind of thing to catch Harry – a low riding, laid back, Hush Puppy driving individual – out.

Harry wanted to practice.Ho, ho, ho! Hillary and I would give it to him. This was an act of some temerity on our part. Doctors, as you undoubtedly know, are far more intelligent than non-doctors. Only they have opinions which have merit, on the human body and pretty well anything else. To publicly mock one in his natural habitat was not necessarily a hanging offence. This was not the Japan of Edo, but it was not the done thing; words would be said.

Technicon sample carousel

Technicon sample carousel

Once, when I was the on-call chemist working in the evening, the duty admitting surgeon sent down a sample for the standard tests for admitting a patient, a Urea and Electrolytes, done on the glorious SMA2. The patient had an ‘acute abdo’ as we say, a painful stomach. I suggested that I also did the test for the enzyme Amylase which screens for pancreatitis. This ailment causes nasty stomach pains but is much loved by surgeons because in patients with pancreatitis surgery is contraindicated, as they say. The immediate treatment is to tuck them up in a cozy bed with lots of morphine and fluids, and wait for the consultant round in the morning. However there are many other abdominal pains,  e.g. appendicitis, which do require surgery. After an hour or so, a groggy patient was in the receiving room of an operating suit and a  newly minted consulting surgeon, not the admitting surgeon, was reviewing his notes. The aforesaid was a Mr.: a fully certified surgeon will insist on the Mr. instead of Dr. to which he is perfectly entitled, to distinguish them from those mere purveyors of potions. The attachment to being a Mr. (or a Miss – I never met a Mrs. but undoubtedly they exist) is something which harks back to when the principle skill required of a surgeon was to remove a leg in less than 25 seconds and follow that up with a good shave. Mr. – I forget his name – called and wondered if I might do the Amylase after all. Alas I didn’t have enough blood so he sent me down some more. The test included a 20 minute incubation/cooking time, so for around half-an-hour the operating theater, surgeon, anesthetist and staff waited. I suspect that during this time a rather cross phone call went from operating room to Casualty; a fiery dressing down down the clearly defined totem pole. This is my theory anyway. From then on every patient Dr. P admitted that night also had this Amylase test requested. By the 7th patient, I was well past just complaining to my team of doctors. I was fuming and marched into the little office, to be confronted by one of the most beautiful women I have ever met –  Dr. P  and her  exquisite almond eyes. She apologized and I was allowed to say it was my pleasure, shucks.

Hilary and I laid our plans well. First, we concocted our urine sample, A.K.A. The Bait, with tap water, a splurge of blood serum for protein, a spatula of glucose, some aspirin (which Hilary swore would work “just like urobilin”) and a drop of bilirubin, the yellow pigment of jaundice, from an old brown glass stoppered bottle hidden away in the dark recesses of the chemicals store. I invented a patient who I called Eileen Whitling, The word “whitling” sounds like a family name and my thesaurus told me was from the Anglo Saxon for a lie. She had a test request card created for her which put her on Intensive Care unit (ICU) and gave her a diagnosis of ‘Acute Abdo’, i.e. her tummy hurt, a lot. much like Dr. P’s patient. The plausible back-story was that poor old Eileen had arrived in Casualty feeling very poorly and was clearly unwell; what of, no one knew, perhaps pancreatitis, so she had been sent to ICU to be carefully monitored, and meanwhile a bunch of tests had been ordered looking for clues. Now, it so happens that the first symptom of acute liver failure is bilirubin appearing in a patient’s urine so there were good clinical grounds to do the test. The fact that over the previous two years Harry had never had such a request didn’t seem to bother him. Nor did he notice that The Bait was the only test requested for Eileen. To make The Bait a little more convincing I put it in a high risk bag reserved for suspected Hepatitis patients. On the off chance that there really was an Eileen Whitling and she was on the ICU I called sister in charge of the ICU to tell her about the plot. Very, very unlikely but stranger things have happened.

Now the hardest part: waiting. I recall having The Bait in place dangling from a brass hook on the pigeonholes of the separating bench, the initial point where samples were received. A crack crew such as Hilary and I zapped through the day’s analyses, converting graphs drawn by the machines to numbers and writing up the report cards, well before 4 pm which was last call for the report cards to be glanced over by a medico or a biochemist and sent out to the wards, the GPs and the satellite hospitals. Harry had seen the treasure, carefully folded back the results sticker to read the fallacious patient detail and quietly burbled, replaced the prize on its hook and wandered off, again – he did do a lot of wandering off. The minutes ticked by. I found myself on several occasions wandering towards the separating bench to find a mildly expectant Harry hovering around awasting time. I found my face spreading into the broadest grin and had to turn away smartly and find cover. Folk started to accumulate around the general area of the separating bench. They made half-hearted, general conversation. They frequently glanced at (a) the clock and (b) The Bait .

At long last Harry came through, collected The Bait, inquired as to whether there were any more, was told no, and proceeded with as much aplomb as he could muster into the bowels of the lab to perform these most vital of tests. Hilary and I were invited to the hospital bar for a quick drink. She declined as she had to go home to make tea. How everyone knew I do not know to this day. Our preparations weren’t terribly subtle and someone with some knowledge could have figured out what was afoot. Hilary claimed she hadn’t told anyone. But there you are – the only person in the lab who didn’t know was Harry. Moreover, the noncommissioned management must have known fairly early in the afternoon and could have stopped the prank in an instant. Yet they just let it roll along. Seems that various people had a rather low opinion of our Harry.

So we sat in the bar supping tepid beer waiting for the shoe to drop. Christine – one of the seven Chrises in the lab at the time – arrived late to report that Dr. Harry was carefully performing the tests, carefully measuring the test ingredients, which was totally unnecessary in these qualitative tests. He had picked off the two easiest, those for protein and sugar, first. They proved to be splendidly positive. Then he did the bilirubin test which was also satisfactorily positive. Harry apparently started chortling. Poor Eileen may have succumbed to some dreadful autoimmune disease which was damaging not only her liver, but her kidneys and pancreas. This would need careful investigation. Christine described his enthusiasm as gruesome. Then Helen decided to up the ante and called him to make a totally specious request as anewly minted admitting clinician. This combined with rather lackluster performance of aspirin to imitate urobilin gave the game away. Harry’s wife who had patiently waited for him while he was doing the tests took the poor man away.

The next day a zephyr blew around. Helen caught the little ire that Harry felt but mostly he was disappointed to find that Eileen would not be needing him.

The Decay of the Art of Lying

Portrait of Mark Twain ca. 1905 owned by the Mark Twain Library in Redding CT, by Terry Ballard

by Professor S. Clements, Chair of Ozology, Agloe, NY

Essay, for discussion, read at a meeting of the Skull and Bones Club of Haarvaard, Boston, Mass., and offered for the three hundred thousand dollar prize, now first published.  [1]

Obviously, lying isn’t dying out. Even the most cursory check by the most careless nincompoop will find that the universal custom of lying is alive and well. As the Sage of Calaveras County reminded us, “…the Lie, as a Virtue, a Principle, is eternal; the Lie, as a recreation, a solace, a refuge in time of need, the fourth Grace, the tenth Muse, man’s best and surest friend, is immortal, and cannot perish from the earth ….” We are eternally indebted to the Sage’s profound insight and professional zeal.

Silvio Berlusconi

Silvio Berlusconi

Since Twain’s times, mankind has been the soul of diligence and industry, developing ever more excellent ways to doublespeak, distort, hype, misinform, mislead, mis-speak, sex-up, spin, overstate, understate, puff, rationalize and economize/stretch/twist the truth, The Sage would marvel at the burgeoning of the humble telegraph: acquiring a voice with the telephone, taking flight as radio waves, fusing Greek with Latin in order to draw in pictures, all to provide more and better ways to inform the general public about winning jackpots, the best car deals, and elixirs still not subject to FDA approval. He would gawp at the industry – which would humble the builders of The Pyramids – which has gifted the common man with the tools for truth adjustment, with its crowning achievement: Facebook.

So, given this sublime pinnacle of endeavor, what have I to complain about? What is so special about our current times? Why is there “a decay in the art of lying?” It is simply this: No educated person, no one well-traveled and familiar with the finer things in life could “contemplate the lumbering and slovenly lying of the present day without grieving to see a noble art so prostituted.” Our age is now described as one of “post-truth.” Apparently, truth has been optimized and upgraded to lo-cal truthiness. The fiction that most of the time most people, politicians and car salesmen included, tell the truth is finally exposed as a callow fiction. Could this be true? Is this like the Space Race, some moment, some small step which has been set in history never to be repeated?

The Libration of Paris

The Libration of Paris

Now the children are abed, we can all agree: not in the least. The Lie is a Necessity, an Understanding, a Facilitation, a recreation and is Eternal; application does not wither her, nor custom stale. Many examples worthy of superlatives have slipped passed into dusty forgetfulness and as for truthiness, this too shall pass. After all, previous ages have gifted us such great legacies of lying. Who can forget the creativity evinced by Indulgences of the medieval church, the peace accords made with Native Americans, the Nazi-Soviet Nonaggression Pact, the benefits of the British Empire, or De Gaulle’s liberation of Paris? And what of the good Doctor Goebbels, and his breathtaking achievements?

Has the use of the euphemism, the fig leaf of propriety, fallen from fashion? We have more than enough to cover the embarrassment of members of all parties, persuasions, and proclivities: you may “hike the Appalachian Trail”, “discuss Uganda”, adopt a “wide stance”, have the “utilizzatore finale”, “watch badgers”, “slip your moorings”, and although one may not have “inhaled” nor “had sex” the public feels she certainly swallowed.

Bernie Madoff, By U.S. Department of Justice

Bernie Madoff, By U.S. Department of Justice

The fecund field of finance has always been a profitable venue for lying. In recent years, it has benefited from scientific advances in confabulation, theprinciple being an arcane, redundant vocabulary which includes a lot of numbers and now mathematical inscriptions. This gives any fiduciary pronouncement an aura of science and certainty. Who can forget the masterpieces of Enron, Madoff’s marvels, or the creative opportunities offered by mortgage-backed securities and collateralized debt obligations? Nothing says a job well done than a $134.1 million golden parachute.

Science, the objective search to understand the universe and everything within it, has had its fair share of shady hypotheses: the four humors, the Martian canals, the racial inferiority of anyone not male, white, and educated at a fine university like this. Now science is big governance and big business, there is all the more reason to bend the rules, trim the results, overestimate a success. The title of a paper by John Ioannidis is suggestive: “Why Most Published Research Findings Are False”. The central tenant of the scientific method is that “the facts, ma’am,” can be shown to be true by someone other than the proposer. That is reproducibility. Two papers studying reproducibility in psychology show that between a third and two-thirds are – how does one say – unproven, ranging from not wholly true to pure invention. It is worse in pharmaceuticals. Of the 74 antidepressants licensed by the FDA only 37 have positive clinical trials. Most (60%) new drugs licensed by the FDA do not have published clinical trials, at all. This opens the door to a wonderful new variant on the “silent lie” so prized by the Sage. Isn’t a relief to know that a member of the legal profession will be on hand should you be maimed or die as a result?

Tonkin Gulf incident

Tonkin Gulf incident

On the other hand, maybe some small step for mankind in the progress of lying has been achieved. Once, the explosive sinking of a warship and well timed news reportage could justify a war. Then it required two ships. Lately, inflation has set in, so a warship plus an embassy just didn’t do. It required a spectacular demolition to move the people onto a warlike footing, and, even then, it required a little bunk and hokum about yellow cake uranium to get the show on the road. Once this was achieved though, the people were touchingly believing in the President’s insistence that Saddam Hussein was an architect of 9/11. Neither did it seem strange that the incumbent President’s dad and Shafig bin Laden, brother of Osman, were together in New York on 9/10/2001. Do you believe Americans will support President Trump in his war? Would the generals be happy should he walk away from a NATO commitment to defend say Lithuania? I feel that we can no longer feel confident that a crisis containing the nuclear option would put the country on a war footing again, although no doubt our friends in the Kremlin would help if it were to their advantage. There is always the possibly of things going awry or valuable human beings like us being hurt.

Then there is the thrice-accursed Internet. Once, the wide spread dissemination of corrected news was limited to those with means and education. Everybody was entitled to their opinions, and we told them so, knowing that those opinions mattered little without ownership of at least a television station. Then the hippies struck. These wretches with their libertarian ideology created the Internet. The old expedient of looking at the letters to the editor is long gone. Ignoramuses, trolls, luddites and people of sense play as equals on the fracking field of the World Wide Web. It is also full of sink holes and silos from whence who-knows-what may erupt. Anybody can publish confabulated news and swing elections (so they say), and we can only shudder that possibilities which a world stage might be used by iron souled truth mongers.

Lying also seems to be in trouble when it comes to the fiction of politeness. Cowboys, samurai and Scottish highlanders were extremely polite. This is unsurprising when multiple means of ready death were easily available and those who might take insult well practiced in the use of those aforesaid means. Ladies who take tea were also carefully polite because of an iron etiquette and long memories. As Twain himself writes, “Is it justifiable? Most certainly. It is beautiful, it is noble. …they had a thousand pleasant ways of lying, that grew out of gentle impulses, and were a credit to their intelligence and an honor to their hearts. Let the particulars go.” Men, too, were courteous to a point although “Their mere howdy-do was a lie” and more likely meant “I wish you were with the cannibals and it was dinner time.” We are now thrust into a time when no political speech is complete without bleepable cuss words. Stupidity and cupidity are considered badges of virtue, much as, once upon a time, a holy man needs be filthy and wracked with fleas. The possibility looms that a viral video will become more influential than a White House briefing. Or worse, profitable agreements made by our kind of people may have to be shared. I’m aware of the efforts being made to tame this unruly sprawl, but we should ask how an elite can maintain its coherence and authenticity?

We now see the costs of allowing the art of lying to descend to such a level. A cost not measured by the trifles which inspire the common people – loyalty, country, community, and so on – but the only thing that counts, hard cash. Unshackled from truth, lies belong to anyone, and authenticity becomes as illusory as a quiet night out at a musical. But not all is lost and no doubt you are all aware of the challenges of the next four years. Indeed, I feel as the Sage did all those years ago, “like an old maid trying to teach nursery matters to the mothers in Israel.”  I think it only fit to finish as Twain did is his masterpiece “On the Decay of the Art of Lying”, “Joking aside, I think there is much need of wise examination into what sorts of lies are best and wholesomest to be indulged, seeing we must all lie and do all lie, and what sorts it may be best to avoid, and this is a thing which I feel I can confidently put into the hands of this experienced Club,–a ripe body, who may be termed, in this regard, and without undue flattery, Old Masters.”

[1] Took this pin money.

Images

The Featured Image: Portrait of Mark Twain ca. 1905 owned by the Mark Twain Library in Redding CT, by Terry Ballard.

Silvio_Berlusconi_(2010), By Silvio_Berlusconi_(2010).jpg: www.la-moncloa.es derivative work: Off2riorob (Silvio_Berlusconi_(2010).jpg) [Public domain], via Wikimedia Commons

The_Liberation_of_Paris%2C_25_-_26_August_1944_HU66477.jpg, See page for author [Public domain], via Wikimedia Commons

BernardMadoff.jpg, By U.S. Department of Justice [Public domain], via Wikimedia Commons

Tonkin_Gulf_incident_track_chart_of_alleged_attacks_on_4_August_1964, By U.S. Navy. Post-work Cobatfor [Public domain], via Wikimedia Commons

 

Albatross: Refuge from the Craziness

Black-browed Albatross (Thalassarche melanophris) by David Cook

My, we have had a crazy week, yet the world is not quite as mad as it was one hundred years ago. Here are a wonderful song and a wonderful poem both entitled Albatross to empower your copin’ and enhance your chillin’. Love, Robert.

 

 

The Featured Image is called Black-browed Albatross (Thalassarche melanophris) by David Cook in West Point Island, Falkland Islands (Islas Malvinas). You can find it on Flickr.

 

Belgium is boring?

Brugge - Bruges – Brujas by Javier Díaz Barrera
cone full o' fries with mayo, Amsterdam style

cone full o’ fries with mayo, Amsterdam style

Belgium is boring. Lots of people say so. True, it has big neighbors. To the south is France, home to Paris fashions and the Cannes film festival. To the east is Germany where they make some of the world’s best cars. But Belgium boring, I don’t think so, not for a minute. Why’s that you might say. Let me tell you then.

To my mind the most important reason is food. It was in Belgium that the humble potato became the ポテトフライ, the French fry or in English English, the chip. There it was perfected. May I recommend a trip to Antoine’s, the best chip shop in the world and choose a cone of frites topped with the traditional Belgian sauce, mayonnaise.

Then there’s chocolate. Belgium is famous for chocolate. There are over 30 chocolate makers is Belgium including Godiva, Neuhaus, Leonidas, My favorites are Wittamer and Marco Piccolini. Both of them have shops and cafés on Sablon square. And I used to drive through that square everyday!

Good belgian chocolates or pralines by Boris & Co

Good belgian chocolates or pralines by Boris & Co

There is a reason Belgian chocolate is so good. It’s because chocolate is fermented like beer. And it so happens that Belgians are brilliant beer brewers. They make light beers, dark syrupy beers, beers like lemonade, beers made from cherries, made from raspberries and even from bananas.

So, whenever I went to Brussels, which you know is the capital of Belgium, I would pop into the best bar in the world. It is called Le Greenwich and it’s very special. It’s a chess pub. There is always someone there who will give you a game. Sometimes people will crowd around a particularly good one. There are even Russian grand masters who play there.

No art then? There’s oodles of art. The Surrealist painter Magritte lived and worked in the working-class district of Anderlech in north of Brussels. It amuses me to think of this famous painter and his wife chatting with his neighbors. Anderlech, like many working-class areas, has a famous football team. It is also home to a strange sculpture called Atomium. Brussels also has a cartoon/manga museum, home to the Belgian hero Tin-tin and his rocket. It has an enormous book shop full of cartoon books from many different countries.

Magritte-Museum_Brussels_20080531_1 by I say, have a cup of tea

Magritte-Museum_Brussels by I say, have a cup of tea

But the real gems of Belgium are the beautiful Art Nouveau houses. My favorites surround the fountains of Place Ambiorix. This most elegant of styles is based on designs taken from living things. The best examples were designed by Victor Horta. This style was copied in buildings in lots of other countries, for example the Chrysler skyscraper in New York or the Paris Metro.

Brussels is home to several international organizations, the European Union and NATO. This is a little odd as the country is deeply divided between the northern part where they speak a kind of Dutch and the southern part where they speak French.

Tassel House stairway By Henry Townsend, Wikimedia Commons

Tassel House stairway By Henry Townsend, Wikimedia Commons

In the northern part are the beautiful old towns of Ghent and Bruges and Antwerp. Antwerp was the home of the famous painter Rubens. It is also the diamond capital of the world. Ninety eight percent of all the diamonds in the world are traded in Antwerp. It was also where the biggest bank robbery ever happened. The thieves, who had nicknames like the Monster and the King of Keys, stole a hundred billion euros worth of diamonds. Perhaps, the mastermind who is now in jail says it was an insurance scam.

I particularly love the southern part though. I’ve spent wonderful summer holidays there. My many friends and I lived in a wooden house in Walsort sur la Meuse for a few weeks. It is sweet and slightly sad memory.

Thank you for listening to me.

Featured Image: Brugge – Bruges – Brujas by  Javier Díaz Barrera