The Republican Debates

I am an adult independent voter who watched the whole show last night, both the minor four and the major seven, two hours of each group. Several senators, several ex-governors, and several professionals from other fields. Each one obviously an achiever in his/her selected field, and each able to think rapidly enough to reply to challenges, even if not always relevant to the question asked. (They did, after all, have their own agenda to emphasize.)

I personally liked the Ohio ex-governor; he seems to have paid attention to the needs of his state. I respect the neurosurgeon for his manner and speech, but his background in medicine does not prepare him in foreign policy or government finance. Mr. Trump is entertaining, in a manner of speaking, but that does not prepare him to be a diplomatic world leader.

Recent terrorist activity was a major topic (carefully avoiding discussion of gun control.) The proposed solutions emphasized forbidding terrorists' entry into America, military destruction of the jihadist Caliphate in Syria, updating the size and armament of USA's military, building walls along our borders, and filtering out the persons and their communications who have evil on their mind. There was passing mention of the need for updating America's physical infrastructure and the education of the next generation, but no mention of what existing government programs to cut or taxes to raise, or any other way to finance the very ambitious projects they envisioned. No mention of working with others in Congress to even finance the government budget for next week, let alone next year.

So who's going to pay for all this? Donald Trump's personal billions are chicken-feed compared with the trillion dollar cost of modernizing the military, or rebuilding America's bridges and highways, let alone erecting walls hundreds of miles long (which a tunnel or a helicopter can penetrate.

And while you're at it, candidates, let's hear at least a little well-deserved praise for some of the things the Obama government HAS done. Saving the economy from going bankrupt when the banks collapsed, for example. Or providing medical care to millions who were going broke paying their medical costs?

Freedom

Freedom has become an object of worship in America. If you invoke the word, you can sell almost anything—a political viewpoint, religion, war, selling automatic weapons to Mexican drug lords, pornography, lower taxes, lies, almost anything, good or bad. Ask an American his/her idea of what heaven might be, and you often hear the word again.
Instead of labeling freedom "good" or "bad" we can avoid a lot of name-calling and yelling by asking "freedom from"? or "freedom to"? Neither kind is always good or always bad. We talk about freedom from pain, freedom from hunger, freedom from oppression or bullying, freedom from fear. Most us want such freedoms, both for ourselves and, in theory at least, for others too.
"Freedom to" is also good, but often ambiguous. Freedom to work is hard to dispute; if someone can earn a living, he can provide for himself and his family. Freedom to speak is good, unless it is used to slander or destroy someone else.
Freedom to drive a car on public roads depends on registration with the state after passing a brief examination, but that freedom can be forfeited if one is repeatedly convicted of DUI.
Freedom to own a gun is guaranteed by the Constitution, but may be forfeited if one is convicted of a felony, and in any case the gun owner must register the gun.
Freedom from being shot and/or killed is protected by law provided one is not seriously threatening the life of someone else; yet death from gun violence is more and more common among citizens in USA - arguably more so than in any other first-world nation not at war. It appears that many of those who gun people down are found later to have many guns in their possession. One license to carry covers all. No need to explain to anyone.
The US Constitution states: “A well regulated Militia being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.” This is reasonable; people may defend themselves against unwarranted assault. It does not imply, however, that anyone is free to shoot other people simply to make a statement, nor does it deal with those who amass unlimited quantities of weapons.
In this week's slaughter (December 4th, 2015) in San Bernardino, California, two people wearing body armor and using military assault rifles, killed 14 people at a holiday party and wounded many more. After police killed the two, they were found to have a total of more than 4,500 rounds of ammunition and twelve pipe bombs in their possession.
Last week, an apparently mentally ill lone man shot and killed 3 people in Colorado Springs. When such tragedies occur frequently, something is wrong.
It should be pointed out that certain weapons are forbidden. Bombs. Mortars. Anti-aircraft weapons. There are limits to which one may personally defend his rights. Should there not be limits to how many weapons an individual may own? The question of these gunslingers belonging to “a well-regulated militia” does not seem to arise. For those few gun collectors whose ego depends on a hundred varieties of guns to exhibit, let the extra ones he does not carry to protect himself in church or post office be disabled. That's what the cannon in our local town park required before the army donated it.
The NRA is fond of saying, “Guns don't kill people, people do.” But gun registration can be better regulated, to decrease opportunities.

Achieving Large Goals coming soon

I haven'tmade many posts recently, while getting my 7th book ready for publication with CreateSpace. It is now in its final (I hope) proofing, and should be published and available in November.

Achieving Large Goals; True Stories of accomplishment. Inspirational non-fiction.

21 chapters, each describing an individual the author has met. Achievers, from a plumber to a pediatric neuropathologist, illustrate paths to success by which seemingly ordinary people affect those around them in a positive manner, whether in a single community or worldwide. 

 

Success does not always depend on blind chance, intense effort, money, or whom you know. The factor shared in common seems to be a certain attitude. Not an opportunity to seize, but one to be guided by, if one is open-minded and perceptive.

Dahlberg Books Announces its new website!

Readers will have noticed that the website www.dahlbergbooks.com has malfunctined for about the past five years, ever since its webhost,  SiteStudio  went out of business. You can access it from this blog site but there has been no way to change the content. The company who took over SiteStudio seemed unable to solve the problem.

We are now building a new website from scratch: www.dahlbergbooks.net. Eventually it will absorb the old site's essays, memoirs, and perhaps the links that are still relevant.  For now, we are updating the main pages. 

There have been no new posts here for the past month, while I have been finishing my seventh book, Achieving Large Goals, which I hope to have in print and online this fall. Excerpts may appear on  Old Doc's Blog from time to time.

I thank readers for their patience these past weeks, and hope to have more activity, and space for comments soon.

Vaccine Nonsense

Recently, on the street of a nearby town, my wife encountered a man who was passing out postcard-sized “Vaccine Fact Sheets” on which are gathered statements about the alleged dangers and uselessness of giving vaccines to prevent various childhood and adult diseases. After surveying one his cards, she quietly asked him, “Have you ever seen a child with diphtheria, or a man with lockjaw?

To her alarm, the man exploded with rage. “You don't need those vaccines!”, he shouted. She quickly moved on, but his shouts followed her down the street. She brought the card home; it bears the name of VacLib.com/AvatarProducts.com. It cites articles by a number of people, some with MD, DO, DC, JD, or PhD after the name, and “facts you should know.” It quotes half-truths and some statements that are just plain false, which I would sum up as dangerous rubbish.

The reason I say that is, my wife and I have seen children die with the diseases those vaccines prevent. We worked fifteen years in the hinterlands of South East Asia. We are among the last people in the world to see smallpox in the wild, when an epidemic broke out in a village which the Burmese government vaccinator had not yet reached, back in 1961. We have seen diphtheria close the throat of a child, who survived only because of an emergency operation to open her windpipe. I watched a ten-year-old girl die of whooping cough (pertussis). I have watched one adult and several infants die of lockjaw (tetanus) when they reached the hospital too late for antitoxin to take effect. Before polio vaccine was developed, the city of Syracuse NY (where I went to med school) had a hospital for polio patients, some of them destined for life in an “iron lung” machine. A measles epidemic wiped out forty children in a group of villages in the mountains in Thailand. It's small comfort for their parents to know that at least their children didn't get a vaccine reaction. Too bad they didn't get the vaccine either.

Diptheria, pertussis, tetanus, measles still happen still happen to children and adults in the United States. Get yourself and your children immunized. If you don't like the doctor's fee, get it done at Public Health. Only the ignorant or the misinformed refuse.

A Week on an Indian reservation

In the year 2015, several American Indian relief groups have zeroed in on my mailing address and phone in hopes of my donating to their cause. An especially insistent phone caller yesterday, trying to shame me into feeding the starving children in South Dakota, prompted me to review my own experience on a South Dakota reservation, which is recorded below. It does not qualify me as an expert, but offers a different perspective:

In 2001, when I worked as a locum "rent-a-doc", a medical staffing agency assigned me to fill in for a week as the night-shift emergency room doctor in Eagle Butte, South Dakota. Although I have lived and worked in Asia among tribal groups, this was my first time with a minority culture in my own nation. My work schedule was fifteen hours on call each night, with the day time for sleep and everything else. This would leave little time for sightseeing, so I came a day early to look around.

A town of about a thousand people at that time, Eagle Butte was the center of the Cheyenne River Reservation, an area of some 4,000 square miles, comparable in size to the entire state of Connecticut. Except for all the government offices, the town looked about like any other high-plains community, amid hay fields and cattle, with rolling prairie stretching out to a far horizon in the July sunshine.

Next to the motel was a building decorated in Native American motif, labeled Cultural Center. A monument outside honors the "Sioux Chiefs who gave their lives in World War I." But the word "Sioux" isn't heard often; the people prefer the name "Lakota." Sioux comes from the Chippewa language, meaning snake or enemy. I soon found that using the word "Sioux" could shut down a conversation.

The Center's door stood open. The lobby held a guest book and four glass cases of artifacts. The high-domed hall beyond stood empty except for pictures on some of the wall panels, and stacked chairs against one wall. Aside from a small gift shop, that was it.

I spent some time with the pictures, most of them tribal leaders of by-gone times. One panel held a six-page account of the massacre at Wounded Knee Creek, by a survivor who was an eleven-year-old girl at the time. She told a vivid account of what she saw and heard, but it was mostly the "what" with little of the "why". Perhaps from her standpoint there was no why; the white soldiers killed for no reason.

But there is always a why. Someone digging superficially might give a ready answer: for example, "greed―the white men wanted our land." This is probably true, but I suspect that digging more deeply might shed light on the interplay of fears and goals and of character strengths and weaknesses on both sides. That, in turn, might provide clues to some of today's issues, in particular the division that even a new-comer can sense between the haves and the have-nots within the tribe itself.

For there is such a division. I include among the haves the apparently prosperous Lakota farmers in the region, the competent and caring Lakota nurses and medical technicians I worked with in the town's hospital, and some of the young families who came as patients with the usual night-time emergencies―earache, abdominal pain, childbirth, etc.

The have-nots included a nightly procession of very obese, diabetic, hypertensive, and acutely alcoholic patients, and both victims and abusers in domestic fights. They were cooperative within their ability to function at the moment, had a passive acceptance of their situation, and glib agreement: "Yes, Doc, I know I drink too much; yes, I'll try to lose some weight," etc., but no expressed intent to carry through. The Native American nurses and doctors were appalled at the nightly number. People lined up in the waiting area each day from five pm (when the day-clinic closed) until well past midnight. I have worked in much bigger hospitals with half the number.

A well-built youth in his early teens with a high blood alcohol had been beaten unconscious by unknown assailants. Soon after the ambulance came in, his mother arrived wearing a look of quiet despair.

A middle-aged man had a blood alcohol five times the legal limit, and the ambulance crew found him lying in the street downtown. As we waited for the X-rays, one of the Lakota staff remarked that the man's abdominal scar was from the time he swallowed a sharp object to qualify for permanent disability.

And there was an elderly woman, beaten up by her drunken son, and so obese that the x-ray tech was unable to show me her neck spine. I had to send her 175 miles by ambulance to Rapid City where there is better x-ray equipment. Her diabetes was was poorly controlled; her son had been harassing her that day to the point where she had neglected to take her insulin.

I saw a poster on a hallway bulletin board showing an elderly farm couple standing in their barn doorway: the message read "When Jim hurt his back, his neighbors helped him get his hay crop in. They helped him with his chores. They even helped him beat his wife to within an inch of her life. Because they knew. And they did nothing to HELP HER. Sometimes it's hard for a neighbor to know what to do. You can call us, at . . ."

Up until this trip, I had encountered the aggressive, politically active side of the Lakota occasionally in the news media. But here "on the Rez," in the emergency room, I saw the other side: quietly non-confrontational, but quietly non-cooperative with the majority white culture. A five-day visit does not give an outsider the authority to analyze behavior, especially that which is not unique to that group, but I can speculate. Alcoholism is often associated with chronic depression and a perception of "no way out." There is a tendency to look back at former days. Military victory against the invader is no longer a viable option, but Wounded Knee is still fresh in the collective memory, more than a century later.

Few raise their voice or argue unless really stressed. Few in this under-layer of Lakota society comply with suggested treatment. The patient may take the pills, but advice on lifestyle change meets passive resistance.

But apparently the tribal leaders, social activists, or others are trying to teach the younger people better self-help skills. I saw two such groups in session in the motel conference room as I passed by. (The local Super 8 Motel itself is a Lakota enterprise.) And there is a satellite college campus on the far edge of town, though no one at the hospital could tell me much about it. The future is not yet set in stone. The Lakota may one day overcome the alcohol and metabolic diseases that devastate their people, though maybe not in this decade.

When that day comes, it probably won't happen through the U.S. Indian Health Service bureaucracy, nor the well-intentioned efforts of outside organizations, but from the initiative of the Lakota themselves. These people were, after all, the prime warriors of the plains, who with their allied tribes beat the hell out of the United States army at the battle of Little Big Horn. Back then, they coped very well.

The depression following their loss of land and way of life, and some of the policies from Washington, have led many of them to focus on the past. But when forward-looking tribal members increase in number, this is going to change. The Cheyenne River Reservation potential is good. The land is fertile and green even in July, unlike some other Native American lands.

And ironically, many tribes lately have discovered a way to "rob the white race back," raising capital funds by operating gambling casinos. Whatever it takes (within reason anyway), more power to them!

How Fund-raisers Waste Your Money

Fund raisers waste thousands of dollars trying to make you give more.

For the last three months, I have been keeping detailed track of all the uninvited requests for money that come into my house. These are not advertisements or catalogs – I get some of them too, but these are only the ones that tell you how much you should give.

In the 91 calendar days (including postal holidays and Sundays) from April 20 through July 20, I recorded 209 letters, 24 phone calls and 1 e-mail; 234 in ¼ of a year. Over 800 envelopes annually into this one home, each containing a return envelope to send money in. (800 more.)

Many contain gifts – a sheet of return address labels, membership cards for organizations I have not joined, note pads, calendars, certificates of appreciation, “surveys”with no-brainer questions to fill out, petitions to sign.

Most go directly into the waste basket, but never mind: the promotional agency hired to raise their funds will send another request in a month, sometimes with a protest that they haven't yet heard from me.

I do support some them, but never more than once a year for any of them regardless of how many times they ask. And I choose which ones I support, not the other way around. Mostly I support a few medical, refugee, educational groups that I consider are doing a good job but do not have mass appeal – Doctors without Borders, MADD, an orphanage in Myanmar, several missionaries I know personally, a couple of famine/disaster relief organizations. Probably 1 or 2 groups in most of the categories listed below. I tend to avoid those sending unsolicited gifts; why should my donation pay for junk?

Out of curiosity, I have tried to categorize them and found among these 234:

50 political

43 medical diseases

20 religious groups

12 poverty or hunger

6 refugee support

13 protecting the environment

6 protecting animals (but a tiger farm in Colorado? C'mon!)

9 American Indian groups, all using the same Minnesota address

12 Veterans groups

10 Gun Control

8 Planned parenthood

Most of the rest had miscellaneous objectives; about 9 appeared to be scams.

It's not that most of these groups are unworthy. If I could support them all, I would. But a dollar to each, less 49 cents postage, would accomplish little. I sometimes explain that to a phone caller. But sending a form letter in the enclosed envelope is pointless. Nobody from the organization is at that address, that's just the group hired to collect the money, in most cases. They would handle my letter the same way I handle theirs.

How about you? How many do you average per week? And how do you handle them?

SMALL TOWN PARADE 1995

A parade is always better if the drums can be heard even before the marchers come in sight. Even better if it's the home town all-class alumni marching band.

The all-class high school reunion is in full swing in the little mining town of Kellogg, Idaho. The main street is crowded with alumni from out of town, peering at each others' name tags and screaming in recognition, while twenty-somethings rescue toddlers from the middle of the street as the marchers advance.

The all-class band sounds good after only one night of practice together. The drums give an introductory roll, the band members lift their instruments and erupt into the Wildcat Fight song. A dozen lithe and long-haired cheerleaders form a human pyramid and then tumble into a series of cartwheels, while a gray-haired drum majorette from the class of about 1963 struts her stuff ahead of the musicians, faultlessly twirling her baton. The first verse ends and the cheer leaders face the crowd, pom-poms held high. KAY! EE! DOUBLE-ELL O! GEE GEE KELLOGG! GO! GO! GO!! and the band crashes into the second verse, turning the corner to march down the hill. The drill team of a decade ago marches proudly by, followed by truckload of four and five-year-olds wearing Wildcat sweaters with the logo "Cheerleading Clinic 1995."

Each class has been told to get a car of its own vintage, and they have outdone themselves. The Class of 1924 has an old red roadster with two elderly, barrel-chested men holding a banner, "State Football Champions, 1924!" A muddy jeep bears the announcement "No cars made in 1943." 1941 alums ride in a gleaming black hearse with the slogan "Always Prepared!" And as always in any parade, the Fire Department has an entry: old Engine Number One, its 70-year-old motor puttering softly and smoothly.

A police car brings up the rear of the thirty-class procession, its driver announcing over his loudspeaker, "This is the last parade vehicle. Please return to the sidewalks to make way for following traffic!" But this is a small town and we all overflow back into the street, greeting people we haven't seen in years as we make our way up the block to get coffee and pie at the P.E.O. booth, to hold us over until the barbecue tonight at the football field.

Keith Dahlberg

4TH OF JULY PARADE

1995 Alpena, Michigan

No stirring music announces the approach. No Seventy-Six Trombones, nor Stars and Stripes Forever that used to thrill my children and me as the bands and flags passed by years ago.

Only a slowly moving police car sounding its siren periodically, followed by a car towing an oversized rigid American flag on a trailer. Silent.

Then a dozen men in battle helmets and camouflage. Desert Storm, I think at first, but no. As they come nearer, there is no parade formation, no marching step; no banner or label. Gray-painted faces, blank expressions, large automatic weapons held loosely, some with infra-red scanners attached, one man festooned with machine gun belts. They walk along slowly, seeming uncertain, surrounded by a crowd like this. As one young soldier half turns toward a cluster of small boys, his automatic weapon inadvertently points into their midst. A nearby soldier growls a command, and he sheepishly raises the muzzle to point skyward and moves along. Silently.

Now World War II veterans are passing by with their battle flags, and the crowd applauds the elderly men and women who fought fifty years ago. But I gaze thoughtfully after the silent, camouflaged men. I am a stranger here, and I wonder what I am getting into . . . . try to recall which Michigan town has the militia. Are these gray-faced men defenders of America, or of some private political credo? I don't know whom to ask. Keep silent. Watch the parade.

Children scramble into the street for the candies tossed from almost every vehicle. Here is the parade marshal in a car far back in the line; there comes a beauty queen, young and serene on her float. Pre-teens in motor-powered go-karts spurt back and forth with a roar, looking back over their shoulders at friends in the crowd, oblivious to the children scurrying for candies. Only one woman restrains her grandchild until they pass.

And here, can it be – yes – finally a real live marching band! Raising their trombones and trumpets to the sun, the lone drummer rapping out a catchy marching rhythm in counter-point to the music. Then they, too, are gone – the only real band to march in the entire hour-long procession. We are back to fire engines, trucks advertising local businesses, boat safety organizations, children's bicycle groups, all of them throwing candy. Finally, two police cars end the procession, followed by campers and RV's reclaiming the highway, and the crowd breaks up.

Old folks with their folding chairs, young families with baby strollers swirl around me as I stand people-watching on this fine summer day. What sense of heritage would my own children get from this parade if they had been here? What would I tell them about what it takes to make a nation? A partial answer, at least, came from an unexpected direction. For there was a second parade soon afterward, at the edge of town. The Vietnam veterans held their own procession, perhaps still searching for an identity from an ambiguous era. Maybe reminding us of a task done for small thanks. Or expressing bitter grief for companions who did not return.

Not many spectators stay, only one or two deep along a couple of blocks on a cross-street. Some of them attracted by the “Traveling Wall” replica of the Vietnam monument in Washington, featured this week at the town's museum near by. A bearded man near me in the small crowd wears the legend “Vietnam Veteran” on his cap, and under those words a row of campaign ribbons.

The parade is not long. Police car and rigid flag-on-a-trailer again. Then massed flags, borne by a truckload of disabled veterans whom I feel moved to salute.

Then a platoon of middle-aged men and women marching to a traditional cadence chant. The tenor voice of a sergeant sings a phrase, the response from the ranks full- throated and firm:

Sound off! ONE, TWO!

Sound off! THREE, FOUR!

Bring it down! ONE, TWO, THREE, FOUR, ONE TWO - THREE-FOUR!

If I die in Vee-et nam . . . . IF I DIE IN VEE-ET NAM!

Mail my body home to Mom . . . . MAIL MY BODY HOME TO MOM!

Pin my medals to my chest . . . . PIN MY MEDALS TO MY CHEST!

Tell my girl I did my best . . . . . TELL MY GIRL I DID MY BEST!

The sound gradually fades as they march on: Sound off! One-Two! Sound off! Three-four!

Bring-it-on-down-now! One-two-three-four one-two – three-four! . . .left. . . left. . . left . . .left . . .

A woman breaks ranks and runs up to the man in the veterans cap, standing next to me. “Pete, they want you to march with them!”

He shakes his head. “No . . . I don't want to . . .”

I want to ask him about it; want to get his story. But something in the mixture of emotions on his face tells me this is a private moment.

Ila's Faith

What I remembered most about ninety-year-old Ila Mae Wild at her funeral today was her faith one week in 1995, when her then-20-year-old grandson, Marine Lance Corporal Zach Mayo, was reported missing from the aircraft carrier America in the Arabian Sea at night.

On a Saturday afternoon, marine officers visited his parents' Idaho home to report that after an unsuccessful search by four helicopters and two escort ships, Zach was missing at sea and presumed dead.

It was grandmother Ila who quietly but firmly maintained that Zach was not dead, and she prayed for his safety during the next four days. Even after a return visit from the marine officers on Tuesday brought no news except to confirm Zach was lost at sea, Ila still said Zach would be OK.

On Wednesday Zack's father's phone rang at 4 a.m. (in western USA) It was the American embassy in Pakistan, who put Zack on the line to tell his father of his rescue by a Pakistani fishing boat after 36 hours of treading water.

The national newspapers the following day were full of his story. According to the Chicago Tribune, Zach, an airplane maintenance expert, had gone out on deck to get some night air, and an opening door had brushed him into the sea. He followed marine training and tread water while fashioning make-shift life preservers by trapping air in his shed pants and shirt. The fishing boat found him a day and a half later and took him to the small seaport of Gwadar in Pakistan. It took a while to find an official who spoke enough English to connect him with the American embassy.

I talked with Zach today, now a 40-year-old civilian, at the reception after his grandmother Ila's funeral. Asked him how he had felt after treading water that long. “Very tired” was his sober response, “I was unconscious when they lifted me into the boat.”

The miracle was not only his endurance, but that anyone happened to spot him at all in the vast Arabian Sea. I have witnessed faith many times in my medical practice, but have never seen faith to match Ila's assurance that, with God's help, her grandson was safe.

Getting Back Online

Dahlbergbooks.com has been on the Internet for about sixteen years, ever since Judson Press published the first edition of my father's biography. At the time, I had just published my first novel, Flame Tree, which required a lot of research on Burma in addition to my own experiences during five years there. Burma (now Myanmar – two syllables, silent ' r ') is changing. The military government has mellowed somewhat but still maintains tight control. Ms. Aung San Suu Kyi is no longer under house arrest, and is an active member of Parliament.

My original URL was hosted by an outfit that no longer functions. Its successor still carries the site, bills me every year, but rarely answers phone calls or emails, and seems unable to update content. I can access each page, and connect with updates of existing links and my blog (a different website), but I can't enter anything about my two more recent novels or the book to come.

The local techie at the computer shop assures me my physical house network is connected right, and a friend with more cyber-expertise than I is building a new URL for me that actually works, and allows reader input.

Meanwhile my new collection of people who successfully accomplish their goal is starting to come together. Some interviews need updating, and in a couple of instances, I must be careful not to encroach on books they are working on. But it's fun to be back at work.

Injured Elephant Driver

At the age of 64, I volunteered to work at a Thailand hospital for nine months, while its only doctor, Phil McDaniel, was in America. I closed my office in Idaho and semi-retired. For the next eleven years I would work whenever I chose, as a locum tenens or “rent-a-doc”, filling in for doctors who were on leave for one reason or another.

Kwai River Christian Hospital has 30-beds, complete with lab, X-ray, and operating and delivery rooms, and some very competent Thai nurse-midwives. It's in a rural setting much like other Asian hospitals I have worked in. I am not a fully trained general surgeon, but have had a couple of years residency, plus forty years experience. At KRCH, it would soon be tested.

Many Thai sawmills still employ elephants to move the logs. The driver sits astride the animal's sturdy neck, steering it by jiggling his bare feet behind its ears. One night, after I had been at KRCH a month, a sawmill's pickup truck brought in a 25-year-old Karen man who had fallen off his elephant, striking his left lower ribs on a log. He had severe left-sided bellyache.

The situation is the same as a car accident in USA: any ER doc knows that left-sided rib fractures can signal a tear in the spleen, a delicate, fist-sized organ serving as a filter for the body's blood supply. The treatment is emergency surgery to remove the torn spleen and stop the internal hemorrhage. Trouble is, I had never done that operation, and had only seen it done once.

In such emergencies, I have found it useful to quietly pray as I work, and this seemed like a good time to do so. “Please, God, don't let this be a ruptured spleen! I've never done that operation, and there is no anesthetist; if I operate, he'll die on the table!” As I took his blood pressure again, the next unwelcome words came to mind unbidden:

He'll die if you don't.

That made me realize that I was stalling for time, and I gave the orders to call out the team. (No phones, but the night watchman knew which houses to go to.) A lab tech to get blood ready, three extra nurses, one to scrub and assist, and one to circulate, and one to monitor the man's vital signs after I injected a spinal anesthetic, and during surgery. The sawmill boss had brought the man and his family in; and he agreed to round up blood donors – no easy job in Asia. A nurse aide translated my Thai into Karen language, explained to the man what we had to do and had him sign the permit. She asked him if he had any medical allergies (Hkui hpae yaa rui plaaw?) He said no.

I operated, with a surgical textbook on a music stand nearby, opened to Removal of the spleen. Opening the man's abdomen, I found a belly full of blood and a torn spleen, still bleeding. I carefully clamped its blood vessels and removed it, avoiding damage to the nearby stomach and pancreas, conscious of God's help in remembering the steps I had once learned. (Readers wanting the details of the drama can find them in my novel Flame Tree, chapter 8. . . . fiction is often based on fact.)

The operation was successful, and a week later, after 3 pints of blood, the man went home. When they left, his wife had her small son place palms together, the Thai way of saying thank you. He had his daddy back.

So why am I adding this chapter to a book about pure chance versus the presence of God?

I do it to add my testimony that I believe that God exists, cares about us humans, and offers help when we ask and are willing to listen. In my experience, that seems far more likely than a mythical lady luck, or blind chance, or what-have-you. If that is true, we ignore him at our peril. Granted we have freedom of choice, our insisting on choosing our own path is arguably the cause of much of our ills, and those of the world's.

One postscript: On a coffee break last week, I chanced to get to know an acquaintance better. As often happens to a retired doctor, he turned the conversation to a recent health episode of his own. He has been diabetic for years, taking a modest dose if daily insulin. He described a recent personal “aha moment”, when he discovered that his bed-time blood sugar tested 380 for no apparent reason. He was debating how much insulin to take, when he received an unbidden thought: Sit on it. Puzzled, he continued to prepare his shot. Again came the emphatic thought, Sit   on   it. Not knowing why his sugar was that high in the first place, he interpreted the thought to mean Wait. He laid the insulin aside and went to sleep. When he tested his blood sugar again next morning, he found it to be 40, very low. Neither of us could discover any reason why it was so low, but if he had taken the night dose of insulin, his morning blood sugar level might well have been even lower, low enough to produce coma (a.k.a. “insulin shock.) Potentially fatal.

The question arises, how do we tell the difference between a presumed message of God's Spirit, or some other source? The first thought that comes to my mind is, prayer and practice.

Mass Response to Genocide: Part 3

Everywhere there were volunteers who came in from Bangkok on a day-to-day basis. The American Embassy sent a daily bus; others came by car. Some volunteers took over the job of keeping the diarrhea patients clean (There were new clothes and blankets now); Some spoon-fed the weak. Others ran errands, or helped discharged patients get settled out in the camp, or passed out food. One afternoon I found each patient holding a hard-boiled egg (which not all stomachs were up to handling); another day each had an orange or a loaf of French bread. One elderly European man, with whom I could speak only in Thai, stayed in the tent next to ours all night watching over an especially sick Khmer whom he had sort of adopted.

A few came only to sight-see. The French ward got a group who wanted to feed patients lunch. The doctor explained that they had already had their lunch but some were badly in need of a bath. The visitors said they didn't come to do that kind of work, they just wanted to feed people. We had a couple of Thai student volunteers who mostly just drank our pop. But another Thai girl student stayed with an old lady who was too listless to eat, and kept gently spooning gruel into her. “She's not going to die is she?” the girl kept asking me nervously, “I don't want to see anyone die!” But three or four days later when another patient died, it was the student who rounded up stretcher bearers and escorted the body over to the morgue tent, where a group of Buddhist monks took care of burials. The Khmer refugees themselves had teams of girls (Khmer army medics, we were told) who helped bathe and feed people. Like the volunteers from Bangkok, some were very good, and others not very useful.

As time went on, CAMA sought other temporary help. A Brazilian doctor and his nurse wife arrived, a couple of doctors from USA, and a young Khmer girl now living in New Zealand (who was at first terrified that the Khmer Rouge would murder her.) We now had at least two doctors in tent number 8, and sometimes three. We still received about ten new patients per day, but many others were getting well enough for discharge out into the camp, so our patients no longer had to lie shoulder-to-shoulder.

Cameras and reporters were everywhere. As I worked with an unconscious kid a man with a microphone squatted down beside me and asked me to describe the case. I'm told I was on Voice of America that night. Another night I was on NBC-TV all over both America and Europe as a “malnutrition expert”. I tried to send them to the camp's nutrition doc, but it turned out I was the only doctor in camp that day who had been in Asia a while and who had an American accent. Probably my audience in the next 24 hours totaled around one hundred million. I remember struggling to explain how starvation of the degree seen after six months in the jungle was like being isolated in a blizzard. When the firewood was used up, you will burn the furniture to keep life alive, and finally you burn the house walls themselves. And I remember that my main concern was to keep the TV cameras from showing the folks back home how swollen my own legs had become after a week of twelve to fourteen hour shifts.

Not everyone realizes that Lois was also on TV, her back to the camera as President Carter's wife, Rosalyn, walked through our tent and talked with her briefly. Lois' most memorable utterance was about the horde of reporters, who kept shouting “Get down! Get down” at her while they tried to get the First Lady's picture. Lois finally said, “If they just moved back a little, they wouldn't be standing in the patient's latrine ditch.” And a Secret Service man in the group grinned to Lois, “Say it louder. We're being recorded.”

That second week,we were still dog-tired but felt we could probably make it till more help arrived. Lois and I, with another nurse and Tann, our interpreter, even took our turn at night duty – fourteen hours watching over the whole hospital. There's not much you can do for a thousand unfamiliar patients. Most of the ward aides were sound asleep. We toured all the wards every three hours, restarting a few IV's, carried out a couple of dead bodies (whose beds were shared with other patients) cleaned up one teen-age boy covered with bloody diarrhea from the waist down, watched over a couple of women in labor. Took a 2 am break to visit with the Israeli doctor in the emergency tent – the only other doctor permitted to stay through curfew. He and I watched a Thai construction crew digging a deep-water well and erecting tall poles to light the area. I looked up at the poles and said meditatively “Haman built a gallows, fifty cubits high . . .”  The startled Israeli looked at me; “How did you know what I was thinking? Where did you hear that story?”

“Hey, the story of Queen Esther is in the Christian scriptures too.”

We left ward 8 in the hands of a Dutch lady, Eva Hartog, a TV personality who brought a team of eight Dutch nurses to work with the three American doctors who would inherit our tent. A letter from our Brazilian doctor friend several weeks later said the whole hospital is now in more permanent buildings, and there had been a day when there had not been even one death in the whole hospital. New waves of refugees were coming in then, some with war wounds on top of their starvation and diseases. Sa Kaew now had a small surgical unit, he wrote.

The day we left, several cases of epidemic meningitis (meningococcemia) threatened the camp, but I guess it did not develop. Most of the patients were visiting back and forth. Kids were playing games, or standing in line for milk, wearing their tin bowls on their heads as helmets. The girl on the TV spot who couldn't walk squealed in pretend terror and ran, when her sister told her I was coming to give her a shot. It's good to know we made a difference, but I don't mind admitting that all of us were glad to get away and rest.

A week or two later, my colleague at Maesariang, Dr. Bina Sawyer and two more nurses went down to another refugee camp. Even being the only doctor there, in her absence, seemed leisurely in contrast to Sa Kaew.

But once in a while I still reflect on how much difference a single piece of mail can make when it carries the right offer.

Mass Response to Genocide part 2

The dead bodies were still there or, more probably, new ones. What struck us most about the hospital was the lack of conversational background noise. Just coughing, in a constant undercurrent.

Our new tent, Ward 8 (someone later altered the numeral to depict a snowman-like figure gripping his belly) was ninety feet long and twenty feet wide, open sided, with 150 sick human beings, everyone crowded in at random, lying on bamboo mats on the ground. About fifteen more outside the far end of the tent were under lean-tos of plastic and sticks. Some had tags noting treatment given at the Thai border; others had letters inked on their arms standing for medicines they had received; Q for quinine, F for fansidar (another anti-malaria drug). We had no idea what some of the other letters meant. We had no translator the first couple of days, and the patients spoke only Khmer.

If any of them had education, they weren't about to let the Khmer Rouge soldiers among them know about it. It is said that Pol Pot's government summarily shot anyone wearing eyeglasses. The Khmer Rouge's brave new world had no use for any schooling other than their own indoctrination. Those first few days, no refugee wanted to call attention to himself by being the first to do anything.

Lois and I, with a clipboard and basket of medicines, started on the nearest patient. We marked a number 1 on her arm, listened to her chest, felt her abdomen. Started her on

anti -malaria treatment, B-complex for beri-beri, and iron for anemia, made a note on the clip-board, and moved on.

Patient number 4 had diarrhea. There were no bedpans. Those patients who were strong enough crawled to the 8-inch-deep latrine ditch at the edge of the tent. Weaker ones lay where they were. There were no clean clothes to change into; that first day there wasn't even a rag to wash them with. We found some old newspapers to put under her, gave her paregoric and an antibiotic, started a bottle of intravenous fluid, hanging the bottle from the tent frame on a bent piece of wire.

We moved slowly on down the tent. Some had massive swelling of their legs and bellies from protein deficiency; many were burning with fever. Many were pale from severe anemia, or too weak to stand, from lack of vitamin B. Both the Khmer (Cambodian) and Vietnamese armies, seeking to win their war at any cost, destroyed each others farm crops. Many of these people had had nothing to eat for months, except leaves from the trees in their forest refuge; no protection from malarial mosqitoes and other jungle fevers. Several had deep ulcers, bed sores from lying for days in one position out in the jungle. Many children lay listlessly, or having a futile try at their mother's dried up breasts. Children and some adults had arms and legs not much bigger around than my thumb.

      I felt a dull, bitter anger inside me toward leaders who make war and make other people pay the price. But mostly there was only time for squatting down again to listen to another chest, feel another abdomen, start another IV bottle. My muscles ached with the constant bending, kneeling, and stooping. We drank quarts to replace the sweat. On later days we ate all the lunch that Winnie and Aree packed for us, but that first day the scene was all too new for us, we weren't hungry. Somewhere in that day, an American Embassy doctor pitched in and helped; but by sunset, when it was time to go, we still hadn't seen everybody.

      Bob Jono and I had to stay after dark to attend the nightly staff meeting, where the day's problems were ironed out. When I learned that each group had to provide a doctor and nurse every five days to cover the whole 1,200-bed hospital from 6 pm to 8 am, I thought I'm finally getting too old to take it anymore! We got back to town about 7:30, ate supper and fell into bed.

But as we weathered he first few days, things got better. We got a small tent to keep our medicines and eat our lunch. We built up our stock of medicines, and what we didn't have we knew where we could trade. Bob found us a refugee who spoke fluent Thai and a little English, and we could finally communicate with our patients instead of practicing veterinary medicine. Weena mass-produced a gruel of milk and protein food made by Thailand's Kasetsart University and passed it around, a cupful to each patient twice a day, to supplement the food from the camp kitchen. We got so we could finish morning rounds by 3 pm, and one afternoon we cleaned out the dirtiest mats and had the patients lie in three rows, with space to walk between. We discharged enough healed patients into the larger camp (now numbering 35,000), bringing our tent's count down to 100, and moved all the outside patients in under the tent. We shared medicines and nurses with tent 9 next door, where a couple of American doctors on loan from some research group were getting acquainted with clinical medicine.

      And the tent grew noisier. People had enough strength to talk now, and sometimes even smile. One little girl with diarrhea and pneumonia and no family to look after her, whom we left each night not expecting her to survive till morning, sat up one day and began shouting something. Tann, our translator, grinned and explained, “She' s saying she doesn't want that old soup, she wants a fish!” We not only found her that, but a banana too.

Excitement broke out at the far end of the tent one afternoon. A girl who had been separated from her family a year ago suddenly spotted her father and sister walking by outside.

      There were discouraging things too. People who couldn't be persuaded to eat, the comatose who sank lower and lower and quietly died a few days after reaching camp. (Miserable as the camp was at first, it was a big step up from starving unattended in the hills.) Our ward averaged about one death a day now, as did other wards. The record for the whole hospital and camp was 42 deaths in a single day.

      We got to know many of our patients after a fashion. (Asking their personal history was taboo; there were still Khmer Rouge agents among them.) There was the mother who hated shots more than her three kids did. The one-legged man on crutches who led his blind friend with a stick. The young man with TB. The comatose girl with cerebral malaria who developed a bed sore overnight when there was no one to turn her. The old man with gradually healing leg sores.

In our second week there, an Israeli team arrived to take over the tent next door from the departing American researchers. Wearing green scrubs emblazoned with a red star of David, they soon developed a receiving ward and accepted all new hospital patients around the clock for emergency treatment before distribution to other wards. The Israelis were a friendly bunch, but we were embarrassed to have only ham sandwiches to share the day they arrived.

      The hospital as a whole, now down to 1,000 patients was under the joint direction of the International and Thai Red Cross, but we other groups operated under them almost independently: the French “Medicin Sans Frontiers”, World Vision, C&MA (us), and the Israelis. A group of Catholic sisters took care of about 400 orphans; a German doctor had a special nutrition unit, and a lab technician from somewhere opened up a blood bank. He drew blood from the many visitors to the camp and split each unit into two two half pints. (When your hemoglobin is down to 2 grams, even half a unit of blood can double it. The French unit delivered two or three babies a day. Even at full term, they mostly weighed only 3 or 4 pounds.
     to be continued . . .

Mass Response to Genocide

Fall harvest time was never very busy at Maesariang Hospital in northwestern Thailand. Patients don't want to leave their fields unless they are practically dying. Seeing some of the refugee horror stories in the Bangkok newspapers, and having time on our hands, we wrote a letter to the mission refugee committee, offering some time if they needed us. A telegram from committee member Pat Coats asked for as many as possible to come right away to work at the Cambodian border, 500 miles to the southeast.

Half the hospital wanted to go, but of course our hospital in Maesariang had to be kept running too. Five of us finally went, Rosa, a Puerto Rican nurse; Mala, a Karen nurse; Weena, a Karen aide; and my wife, Lois and myself. We got the telegram October 25 and were on our way next morning, taking the bus to Chiangmai, and the overnight train to Bangkok.

We would be on loan to CAMA services, Inc., the service arm of the Christian and Missionary Alliance mission, which has long worked in Cambodia. We drove over to their offices to meet our co-workers and learned that the Thai military had just opened a large refugee center at Sa Kaew. The International Red Cross had set up a hospital there with several hastily gathered medical teams. CAMA had a permanent medical team forming in the Netherlands, but it would not arrive for two weeks.

Some of their workers had helped in the search for refugee groups along the border near the Thai border town of Aranyaprathet,and reported thousands scattered here and there in the bush, many dying or too weak to walk. They were being moved back away from the border to cut the risk of hot pursuit into Thai territory by the advancing Vietnamese army tanks. These refugees were mostly people pressed into service by the Khmer Rouge, whose army remnants were backed up against the Cambodian forest border with Thailand. 

 

It's a three-hour drive by mini-bus from Bangkok to Sa Kaew; good highway through farm country, where the pervasive vinegar-like smell of the drying tapioca crop permeated the air. Our guide said we might as well stop at the camp before going on to our living quarters in Sa Kaew town, ten miles further on, so we pulled off on a dirt side-road, where armed guards checked all traffic, and handed out passes for those authorized to enter the camp.

Our first impression was of barbed wire and mud. The camp was only in its fourth day of operation, bulldozed out of swampy rice fields, sheltering about 30,000 black-clad people behind a fence. We had to step from grass hummock to tree root to get around. At one point, Lois had to reach elbow-deep into the mud to retrieve a shoe.

The hospital area was on slightly higher ground but otherwise chaotic. We were introduced to someone who said, “Fine, go to work in that tent over there.” We had been up since 5 am, some of the girls needed a toilet, and we hadn't even seen where we were supposed to lodge. But the word was “Work a little now, so you'll know the problems by tomorrow.”

I entered the indicated tent, where a harried-looking doctor was carrying a large cardboard box. Motionless patients lay every whichway on bamboo mats on the mud floor. We had to duck to avoid the bamboo cross-pieces in the tent frame. His box contained a jumble of paper cups of pills, syringes, bottles of liquids, bags of intravenous fluids, six-by-eight inch cards and so forth. The first thing that happened was the bottom dropped out of the box and everything slid among the patients. I went to find another box, finally dumping some bottles out of a carton I found in a supply tent. A patient needed a shot. I borrowed one from the more organized tent next door. The doctor himself had only started work that morning. Two Red Cross doctors had already quit after working only two days. He looked at another patient. “The A on his arm means he's been given ampicillin. We'll give him another shot of it now.”

“That's an every-six-hour drug,” I said, “Who gives it at night when we're gone?”

“Nobody.”

Most of my three-hour stint that afternoon was spent looking for things. The doctors in the far tent spoke French. The British lady presiding over a card table full of medicines in Tent No. 1 was having enough trouble supplying her own patients, so I hunted among the unattended supply tents. I began to get dizzy every time I stood up. The heat was oppressve, and I was wet with sweat. The other members of our team were presumably off with other doctors. Several dead bodies, rolled up in the mats on which they'd lain, were in a row between the tents. No one paid them much attention. It began to rain lightly.

At dusk, our guide found us and told us to round up and move on. I found Lois way over in the orphans' tents, following a doctor with no more idea than I where to find the medicines he was ordering. Then the word word went through the hospital, “They're unloading another convoy. Come and help!”

Out on the road we stood in back of several large Thai army trucks, helping down emaciated people who couldn't have weighed more than sixty pounds apiece. Most needed help to walk, and held on to small bundles or cooking pots. Several husky young volunteers scrambled up into the truck to hand down a half dozen people who made no effort to move. Some felt very hot to the touch. I found myself trying to hoist the mid-section of a rather large unconscious man onto a piece of cardboard. Four of us struggled through the mud to the fence and pushed apart two strands of barbed wire to hand him through to volunteers inside.

We were all bone-tired on the 10-mile ride into town. I admired the two Red Cross doctors who had managed to last two whole days. We got Chinese food at a restauurant, and finally arrived at the house rented for us by CAMA. A lady introduced herself as Winnie, and said there was plenty of bath water and clean beds ready, dormitory style. It was Winnie, and later her husband and Aree the cook, who made life possible during those next two weeks. Other teams told us later about their grungy hotel rooms and worse food, and coming home too tired to fix any dinner, but after our second day we always had a hot meal waiting.

Up next morning at sunrise. Our team leader, Bob Jono, told us we would have our own newly established tent to work in today. Remembering the disorganization of the day before, we stopped in town to buy a couple of folding card tables, plastic baskets, cups and tea kettles to carry water in, and five-gallon cans to carry it from the camp's water tanks.

We looked like we were on safari, moving through the hospital gate. On subsequent days we also carried cases of pop and big containers of crushed ice to combat the heat exhaustion we had felt the first day.

To Be Continued

New book coming

My blog posts have been infrequent lately, taking second place to a new work in progress, as yet untitled.
It is non-fiction, an inspirational collection of brief profiles of actual people I know - or have known - personally. Probably 1,000 to 3,000 words each, in final draft. They are people who have touched other lives around them, whether in their local community, or on a much broader scale.

Some of them I discovered by merest chance; others were my colleagues for several decades whose work took unexpected turns. I will try to discover how those lives did take that turn and, where applicable, because any of us might find such possibilities in our own future.

I think you will find them interesting, with occasional surprises. Deo volente, it will be ready for market this fall.

I am also trying to improve this blog and the nearly defunct website from which it sprang. I am a klutz with computers, so it may take awhile before I get two-way comment capability.  Come visit.

My Kind of Poetry

Many poets nowadays tend to be as obscure as possible. Individual preferences differ, but I have met poets who contend that meaning doesn't matter at all; poets who eliminate prepositions and connecting verbs, or who want the listener to "feel" the work rather than comprehend it. Playing such mind games is all right as an exercise, I suppose; I find the individuals themselves entertaining (and I mean that in a positive sense); I enjoy them as people, but when they finish their reading and look around the small group expectantly, I panic. Each obviously expects some comment.

What reaction is best? To say,"I haven't any idea what you were talking about" seems rude, even when true. "Impressive imagery" can be used only a few times. "Wow" or "Fantastic" rarely measure up to even low levels of sophistication, and are too likely to invite further questions.

But whatever happened to meaning? When I take the time to travel to a writers' group, the literary equivalent of strobe lights or aroma therapy aren't enough to satisfy me. I want something I can retain and ponder, perhaps even recall word for word while I use my exercise bike, or lie awake in the night. Meter and rhyme used to have purpose, not only for any pleasure they bring in themselves, but as a means to imprint the poetry on my mind, to be recalled days or years later.

A poem need not have meaning, meter, and rhyme, all three, to make it memorable. Like the body's physical sense of balance (derived from inner ear, eyesight, and awareness of body position), one can be removed without loss. Remove two out of the three, and the mind in the one instance, or the body in the other, begins to stagger.

The time has come, the Walrus said, to talk of many things;

Of shoes and ships and sealing wax, of cabbages and kings.

And why the sea is boiling hot, and whether pigs have wings.

(Lewis Carroll, Through the Looking Glass.)

Utter nonsense, unless you suspect satire about pompous professors the author, Lewis Carroll, may have known. But Carroll descends further into meaninglessness in his poem Jabberwocky. It starts:

'Twas brillig, and the slithy toves

Did gyre and gimble in the wabe;

All mimsy were the borogoves,

And the mome raths outgrabe.

Even though there is little meaning in the words, the mind constructs a picture, carried on by the perfect rhythm and rhyme of his lines. The poem goes on to tell the tale of a man sending his son to kill a forest monster, and the poem became so famous that it has planted several new words in the English language (e.g. chortle, galumphing, beamish.)

Ancient Hebrew poetry, translated into English, has no rhyme, and no definite rhythm,but depends instead on a repeat of a phrase in different words. But the meaning has inspired readers for three thousand years: 

 

Whither shall I go from thy Spirit?

Or whither shall I flee from thy presence?

If I ascend up into heaven, thou art there.

If I make my bed in hell, behold, thou art there.

If I take the wings of the morning, and dwell in the uttermost parts of the sea;

Even there shall thy hand lead me, and thy right hand shall guide me.

(Psalm 139)

Contemporary poetry, on the other hand, is easier to remember because the similarly inspiring thoughts also scan and rhyme. Consider:

Though the cause of evil prosper, still 'tis truth alone is strong.

Though her portion be the scaffold, and upon the throne be wrong.

Yet that scaffold sways the future, and behind the dim unknown

Standeth God within the shadow, keeping watch above his own.

(Lowell, Once to Every Man and Nation)

Finally, poetry can be simply enjoyed for its wit and humor. Starting as nursery rhymes long ago, limericks were made popular by Edward Lear in the nineteenth century. He, however, usually ended the first line and last line with the same word, robbing the verse of any surprise. Later limericks are more imaginative, greatly improving their popularity:

The humor may be gentle:

A Canadian fisher named Peck

Fell through the ice up to his neck.

When asked, "Are you froze?"

He said, "Yes, I suppose,

But we don't call this cold in Quebec."

Or merely ridiculous:

There was a young lady from Natchez

Whose garments were always in patchez.

When comment arose

On the state of her clothes,

She would drawl, "When ah itchez, ah scratchez."

(author unknown)

In our writers group in Kellogg, Idaho, there is a man, Jeff Simonson, who can produce original limericks almost without effort - sometimes as a narrative poem of five or six verses, each verse a faultless limerick, expressing his mood or a recent event. I envy his skill, but poetry is not my major literary interest. I have rarely tried to compose any poetry since high school class assignments long ago.

My favorite form remains the limerick. It permits satire, surprise, rhythm and rhyme, and is brief enough to memorize. Mind games and cross-cultural poetry have their appeal, but I still treasure the traditional forms that can be easily recalled and retained in the mind.