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Many of my generation came of age with the music of Simon and Garfunkel. They provided a poetic and intellectual counter to the shallow, mass-market Top 40 hits on AM radio and the raucous, sometimes angry but certainly eardrum-shattering music of the late 1960s, which now we quaintly refer to as “classic rock” with the same disdain heaped on “your Golden Years.”

I listened to their Bookends album recently during a flight from Portland, Oregon back to Chicago. I hadn’t listened to it for at least two decades; I’d been trying to shed my sensitive side for a more curmudgeonly and safe persona.

I’m now ambivalent about Simon and Garfunkel. Yes, the music was poetic unlike anything I’d ever heard, but it could also be depressing and insistently New York City, an unfathomable existence to someone raised in the desert and then the Midwest. These are Walden’s “mass of men leading lives of quiet desperation.” People who read Emily Dickinson and Robert Frost while pondering if both God and the theatre have died; living in dingy, walk-up flats with noisy radiators and even noisier neighbors. I often imagined a grainy photo of Paul Simon in that black overcoat from the Sounds of Silence cover, walking on a rainy spring day near the Berlin Wal at Checkpoint Charlie past a sign saying “Eintritt Verboten” (Entrance Forbidden).

Bookends is one of Simon and Garfunkel’s more depressing albums, if such a thing is possible. America is a song of lost hope which, for some inexplicable reason Bernie Sanders chose as background for campaign ads. Did no one even listen to the lyrics?

“’Kathy, I’m lost’, I said,
Though I knew she was sleeping.
‘I’m empty and aching and
I don’t know why.’”


The next song is “Overs,” a song about a relationship waiting to die:

“Why don’t we stop fooling ourselves?
The game is over…

…We might as well be apart.
It hardly matters,
We sleep separately.

And drop a smile passing in the hall
But there’s no laughs left
‘Cause we laughed them all.
And we laughed them all
In a very short time”

The first side of the album ends with “Voices of Old People”, followed by “Old Friends/Bookends.” The voices are those of elderly people – presumably New Yorkers, possibly Jewish or Italian – kvetching about their infirmities and resigning to their fates; they are waiting to die in a nursing home, in their adult children’s homes after a stunning role-reversal, or alone in a tenement, waiting to be discovered when the body starts to smell. I was a teenager then and now, fifty years later, we’ve vowed not to “go gentle into that good night,” but instead take Zumba classes, pursue the dreams we postponed as responsible adults raising families and acquire gonorrhea and chlamydia in retirement communities for “active seniors.”  It’s no longer “terribly strange to be seventy.” We’re more like the lecherous old lady in the Playboy cartoons. Mick Jagger is still prancing around the stage and we’re 35-year-olds in our minds, wondering what the hell happened.

I’d completely forgotten “Mrs. Robinson,” which brought back a whole bunch of bad memories of cinematic dysfunctional adult relationships – Doctors’ Wives, Ordinary People Carnal Knowledge, Women in Love and The Graduate – and those I observed in real life. The bar in the Robinson’s house, well-stocked with liquor and the kitschy “Bar” light in the corner, symbolized the emptiness of their relationship.  He was the successful, country-club-and-Cadillac businessman; she was the restless, neglected wife who could buy anything but what she really needed. It reminded me of an old girlfriend who lived in tony Glencoe, IL. The expansive house on an enormous, well-manicured lot obscured the psychopathology within.

Paul Simon reflected on American’s need for heroes in “The Silent Superstar,” a piece the New York Times ran the day after DiMaggio’s death as “subconscious desires of the culture.”

“Where have you gone, Joe DiMaggio
Our nation turns its lonely eyes to you…
…What’s that you say, Mrs. Robinson
Jolting Joe has left and gone away”

At The Zoo” is the only uplifting song and it’s uncharacteristically humorous. Paul Simon adapted the lyrics for a children’s book in 1999. Who wouldn’t love this?

“…The monkeys stand for honesty
Giraffes are insincere
And the elephants are kindly but they’re dumb
Orangutans are skeptical
Of changes in their cages
And the zookeeper is very fond of rum

Zebras are reactionaries
Antelopes are missionaries
Pigeons plot in secrecy
And hamsters turn on frequently
What a gas, you gotta come and see
At the zoo…”


Sometimes I miss the music, but not the emotional vulnerability that came with it. Time to put this genie back in the bottle for another 20 years, eh?
All music/lyrics © Simon and Garfunkel

Paul Simon, The Silent Superstar. New York Times March 9, 1999, Accessed October 11, 2016.

Life As A Rental

I work as a locum tenens physician, or, as I call it, a “rent-a-doc.” I work for companies that supply temporary physician help to hospitals and clinics. I don’t have my own office practice or patients. I go where I’m needed and leave when the job is done.

I’ve done this exclusively for the past 16 years because I got tired of the people signing my paychecks lying to me.

Anyone still in traditional practice understands my feelings. For the most part, health care administrators are as inbred as St. Bernard dogs and just as crazy. The only thing that matters to them is the bottom line. Patients, physicians and staff are necessary evils they could just as well do without. I’m no different from the janitor and more than one has made that quite clear.
“You don’t like it, fine. Quit and I’ll hire three more just like you.”

Working this way comes with distinct advantages. The companies help me get and pay for state medical licenses. They provide transportation to the work site, hotel accommodations and, most important, liability insurance, which can run $150,000 a year.

I don’t get involved in hospital politics or pissing contests with other physicians. I do my job, get paid and go home. I earn about a quarter of what I could make in private practice, but I don’t have the stress and the headaches. If a job becomes untenable, I can give 30-days notice and say “adios, muchachos!”

I can work as much as I want depending on available jobs. Occasionally nothing will come up for a few months, but sometimes there are more jobs than I can do. (I’ve had to turn down jobs in Hawaii because of other commitments.) I’ve had the opportunity to visit places on someone else’s nickel, from Alaska to New Hampshire, from Michigan to New Mexico.

Most of my jobs have been covering solo physicians who want to get away, groups looking to replace physicians who have left or retired, or indigent clinics that are chronically overworked and understaffed. I filled in for an Army Reservist who went to Kuwait for three months of solo call. I subbed for a physician who needed surgery. One woman took off six weeks to have a baby. I worked at a clinic in New Mexico with eight midwives and two other physicians doing 140 deliveries a month.

Sometimes the situations are a bit more delicate. A hospital needed help after firing two physicians who’d gotten into a fist fight at a department meeting, sending one of them to the emergency room. The only two OB/GYN physicians in a remote area, each in solo practice, despised each other and wouldn’t cross cover. Another physician drew a one-week suspension for substance abuse. I’ve learned to not ask too many questions.

The only downside is being away from home and living out of a suitcase. Most of the time I stay in a hotel owned by one of many well-known chains. Occasionally, the accommodations are more upscale. And one hospital had the most luxurious call rooms I’ve ever seen: Sleep Number beds; Bose Sound Docks for iPods; desks with computers and All-Steel Acuity mesh-back chairs; mini-refrigerators; a wall-mounted LCD TV and private bathrooms with showers and motion-activated light switches. The work was grueling, but I could retreat to this relative paradise during lulls.

But some clients are cheap and I end up in a dive.

Two different hospitals put me up in mold-infested housing they owned. One client wanted me to stay at her place with her cat and asked me if that was a problem only after I’d arrived (I’m deathly allergic to the little beasts.) I shared a house with another physician, which worked out reasonably well until he decided to broil a steak at 2 am, setting off the smoke alarm.

I stayed in the last vacant room in a newly-built assisted living facility next to a hospital in south central Illinois. Not bad, but very cramped. I sent the residents a big box of old VHS movies for the enormous TV in their lounge, long before plasma and LCD TVs. I still have the thank you card they all signed.

Locum tenens isn’t for everyone. I’ve gotten used to going to work immediately with little or no orientation. Maybe that’s because no matter where I go, things are usually pretty similar. The names and faces change, but the routines, the challenges and the rewards remain the same.

Image: CBS


Welcome to my blog! After four years of procrastination, trepidation and lame excuses like “I don’t understand WordPress,” Peg has dragged me kicking and screaming into social media.  I’ll give it a shot and see what happens.