Veteran's Day, 2015

What is a veteran?

People, of course, are the best known. Those who risk it all to protect others.

But humans certainly aren't the only ones. For most of history, horses were a key factor in military campaigns, serving even into WW2 (although not widely known, most of Germany's logistics early in the war depended on horses).

Of course, dogs have played a key role, and are likely the most important non-human serving in the military today. So have birds, dolphins, bats, elephants, monkeys, and many other creatures.

But what about a ship?

Except maybe warplanes, perhaps no inanimate object carries in it the spirits of those who built and fought in them. The people who mined and processed ores and turned them into metal parts. Sat at a desk and carefully designed the finished product. Welded, riveted, and cut steel to build it. And, finally, lived, served..., even died, on board.

Every country has its museum ships. Here in the U.S. we have an assortment of preserved battleships, aircraft carriers, submarines, and a few other fighting machines.

Perhaps the most meaningful ships are the ones that never fired a shot, but contributed as much (if not more) than any warship ever did. Yet they're often the most forgotten.

Sadly, there are only 2 of such left intact in the world. But in the horror of WW2, they were one of the most critical factors in crushing Nazi Germany.

Britain, like Earth's other island empire, Japan, is heavily dependent on trade to supply her people. Food, fuel, and countless other necessities of life are imported through a vast network of oceanic routes. This obvious weakness was attacked twice by U-Boats in the last century. It was a war of numbers: if Germany could sink supply ships faster than the allies could build them, the Nazis would win. And, for a while, this appeared to be the case.

While a late comer to World War 2, the massive American industrial output quickly rose to the challenge. An 1879 (yes, you read the year right) British design for a cargo ship was taken, modified for technical advancements, and simplified for mass construction. Companies run by the American industrialist Henry Kaiser (ironically the son of German immigrants) had developed mass production techniques in building the Hoover, Bonneville, and Grand Coulee dams. They turned these skills into the production of freighters - called Liberty Ships - at a level never seen before.

In 4 years, 18 shipyards built 2,710 of these ships. At 1 ship every 2 days, it was by far the largest number of ships ever built to a single design. Like many other industries, their construction depended heavily on the huge number of women - including a large percentage of black women - who entered the workforce in the war effort. Society made some huge changes in WW2, and would never be the same again.

The ships were designed to have a service life of 5 years, though most survived far longer. Although many were sunk by U-Boats, Germany was never able to catch up with the rate of production. This was a key factor that led to the ever-growing bridge across the Atlantic carrying the soldiers, tanks, planes, and other supplies that eventually landed at D-Day and moved into Germany. Many, including the S.S. Jeremiah O'Brien, served at Normandy. Offshore at D-Day, they rapidly unloaded supplies of every kind onto barges and smaller boats, which were then taken to the beach for the men who needed them.

Cargo ships, while far from the glory that the battleships, carriers, and submarines are accorded, are fighting ships all the same. Without them no overseas war can be fought or won. Logistics and supply lines are everything.

A few Liberty ships actually did fight, including the Stephen Hopkins. Using her single gun, she battled the German raider Stier until they both sank.

The sailors on these forgotten ships gave as much as those in other service branches... if not more. By percentage, more men in the U.S. Merchant Marine died in WW2 than in any other branch, and statistically were over twice as likely to be killed as someone in all other services combined:

Source: USMM.org

(Air Force veterans wondering why you aren't on the list: you're grouped in with the Army. The USAF didn't become its own service until after WW2)

After the war the Liberty ships - so crucial to victory - were forgotten. Now they were just surplus freighters, far more than the world needed. Some were sold off, others put in reserve, and others... just left in port with no where to go.

They sat and rusted, and, eventually, when it was clear they weren't needed, sold for scrap.

But a few of these veterans are still with us. Trident Seafood has the former Albert M. Boe (renamed Star of Kodiak), now land-locked, working as a processing plant in Kodiak, Alaska.

Yes, that's a Liberty ship

The hulls of 2 others serve in Portland, Oregon as dock supports. Another, without engines, is a museum in Greece. Another... isn't quite as popular.

But 2 of them, remarkably, are still operational. One is the John W. Brown, in Baltimore and the other the Jeremiah O'Brien (named after an American Revolutionary War sailor) in San Francisco. I visited the latter this summer.

She's remarkably well-preserved, still set in the 1940's. After the war she quickly went into the reserve fleet, and was never sold off or modified. She spent over 30 years in mothballs before it was decided (in 1979) that a Liberty Ship should be saved for future generations. Amazingly, it was found she was still operational after 34 years of sitting at anchor, and became the only Liberty ever to leave the reserve fleet under her own power. Volunteers swarmed her, cleaning, polishing, and painting.

Under the gray reserve paint at the bow they discovered the original crew had painted a googly-eyed topless lady, and she was carefully restored following the original outlines (ensuring snickers from teenage boys for generations to come).

Inside, the ship is in great condition, with very few restrictions on where you can go. The kids and I wandered the passageways, peering into cabins and imagining the merchant marine sailors who lived here as she crossed the ocean and supplied Operation Overlord. You walk across the simple bridge - a far cry from those on a warship - and imagine staring out at the vicious waves of a North Atlantic winter crossing as the ship pitched and rolled beneath you.

Her single small artillery piece is still there, quite different from the massive guns in fortified turrets you see on warships. Here the fighting men were exposed to the elements and enemy fire, and their aim was entirely by sight. Today the gun is protected... from roosting pigeons by a line of spikes on the barrel.

Marie draws a bead on the Transamerica Pyramid.

The engine rooms are open for access, though it involves squeezing through hatchways and taking steep ladders up & down. Beneath the water line engineering buffs will find one of the few working triple-expansion reciprocating engines left in the world. The engine is so well-preserved that (if it looks familiar) it was where they filmed the engine room scenes in 1995's Titanic.

The film's sound engineers also recorded the creaking and rocking of a metal hull as she steamed through San Francisco bay, and the clanking of the obsolete engines. They went on to win 2 Academy awards for their work.

But the Jeremiah O'Brien wasn't content with just sailing around San Francisco harbor. In 1994, with the 50th anniversary of D-Day approaching, a crew of volunteers climbed aboard her. Many of them were veterans of Liberty Ships (even some who'd served on her) and brought her back to prime shape. She had a long trip ahead.

Setting out from northern California, her outdated engine and single propeller drove her south to the Panama Canal, from where she crossed into the Atlantic and turned north again.

On the morning of June 6, 1994 she was again off the beaches of Normandy. She'd brought a crew and passengers who'd fought there. Now, 50 years later, she was back at the site of the largest military operation in history.

She was the only large ship who'd been there originally and returned for the anniversary. Only one other big ship that served that fateful day still exists - the battleship U.S.S. Texas - and she's long been immobile.

In a former cargo hold aboard, there's now a D-Day museum. One of the items there is simply this picture, taken at Normandy beach on the morning of June 6, 1994. The simplicity of the black & white print belies the subject: 4 men who'd swarmed ashore that terrible morning 50 years earlier, and now returned to the same spot, alone in their thoughts.

All around them, but not seen, are many others who never left the beach that day.

November 10, 1975

40 years ago today, 29 men died on the Edmund Fitzgerald.

In terms of shipwrecks, 29 isn't much, but if one of those is your father, or spouse, or sibling, or friend... it can be everything.

Like the recent El Faro sinking, the overwhelming lesson of the Fitzgerald is simple: the forces of nature are bigger and stronger than can be overcome by technology and metallurgy. As long as people have been sailing the seas, some have been lost to storms. In our era of GPS, radar, and satellites we're lured into believing the sea is safe. And, compared to previous eras, it is.

But the power of a storm can be far beyond our best designs. Even if you take out the factor of human error, the sheer destruction caused by storms, tsunamis, and many other natural phenomena is overwhelming.

On December 17, 1944, during WW2, the U.S. Pacific fleet lost to a violent foe. 790 men were killed. Of the 86 ships present in Admiral Halsey's Third Fleet that day, 3 destroyers were sunk and 27 other ships (including massive battleships and aircraft carriers) suffered serious enough damage that they had to return to base for extensive repairs... And the Japanese never touched them.

All of that damage was inflicted by a typhoon. Admiral Nimitz, in his report on the disaster, wrote it "represented a more crippling blow to the Third Fleet than it might be expected to suffer in anything less than a major action."

View from the carrier U.S.S. Cowpens as the storm approached.

For many, their first (and only) knowledge of the Fitzgerald comes from the Gordon Lightfoot song. That's where I first learned of it, too. But there's more.

She was named after the CEO at the time of Northwestern Mutual Life Insurance, who commissioned and financed her construction. Built in 1958, she was (at the time) the biggest boat on the Great Lakes (yes, on the lake they're technically called boats), and remains the largest one ever lost there. She spent her entire career hauling ore between ports.

The lifespan of a Great Lakes freighter is generally twice that of their ocean-going counterparts. Spared the corrosive effects of saltwater, at 17 the Fitzgerald was still in overall good shape, though had the usual wear & tear all ships (and people) get with age. By 1975 she'd made 748 trips on the lakes, for a distance equivalent to circling the Earth 44 times. She set several records for ship size and loads carried.

She set out on November 9, 1975 from Superior, Wisconsin to Detroit, under the command of Ernest McSorley. A second freighter, the venerable Arthur M. Anderson (enroute to Gary, Indiana), joined her for a distance. The Anderson was skippered by Jesse Cooper.

As they sailed, a vicious November storm was brewing, though the initial predictions said it would pass south of the lake. As the day went on it moved northwards, going across the lake and taking the ships into its path.

As the afternoon of November 10 went on, they encountered winds averaging 50 mph (93 kph) with gusts up to 75 mph, and waves 35' (11m) high breaking over their decks. At 3:30 p.m. McSorley told Cooper the Fitzgerald had taken some damage and had a list. A few minutes later the U.S. Coast Guard issued an advisory for all ships to head for the nearest harbor due to the unexpected ferocity of the gale, and the 2 ships changed course for the nearby safety of Whitefish Bay.

At around 4:10 p.m. McSorley called Cooper to say his radar had been lost to the storm. In the blinding snow and rain, the Anderson closed the distance to the Fitzgerald, trying to act as the eyes for both of them with Cooper calling directions over to McSorley based on his radar plots.

Sometime around 5:30 McSorley told the coast guard he was "taking heavy seas over the deck in one of the worst seas I have ever been in."

At 7:10 Cooper radioed McSorley about the position of a 3rd ship that was now on his radar, and asked him how the Fitzgerald was doing. McSorley answered "We are holding our own."

It was the last message ever received from the Fitzgerald. A few minutes later the Anderson's radar was unable to find her, and she didn't answer the radio.

Cooper, not believing at first the Fitzgerald had been lost so quickly, gave it a few minutes to see if she showed up again on the radar sweep. He contacted the other ship nearby to see if they had her on radar (they didn't). Finally, at 7:39, he radioed the Coast Guard to sound the first warning. Unfortunately, in the violent storm the Anderson was the nearest ship to make a rescue attempt. Against his better judgment, Cooper turned around.

It must have been terrifying, knowingly going back into a storm that had just destroyed a ship bigger and more modern than yours. One of the Anderson's crewmen, upon hearing what they were doing, scribbled a last letter to his family, sealed it in a bottle, and tossed it overboard. A second freighter, the William Clay Ford, bravely joined the search that fateful night.

But there was nothing to be found. In the next few hours both the American and Canadian Coast Guards sent ships and planes to the area. Only a few pieces of debris, and a badly damaged lifeboat, ever turned up.

As news spread, the families of 29 men (ages 21 to 63) began coming to terms with their losses. Reverend Richard Ingalls, Sr., of the Mariner's Church in Detroit, rang its bell 29 times, a tradition that continued until 2006 when the service was changed to remember all lost on the Great Lakes.

Mr. Edmund Fitzgerald's son, also named Edmund Fitzgerald, died in 2013. Like his father, he was involved in many endeavors through the Midwest, though is perhaps best remembered for bringing the Brewers baseball franchise to Milwaukee.

The Arthur M. Anderson, now 63 years old, continues to work on the Great Lakes today, 40 years since that fateful night her name became forever entwined with the Fitzgerald.

The Edmund Fitzgerald lies in 2 large pieces, the bow upright and the stern inverted, in 530 feet of water, oddly straddling the American-Canadian border. The cold freshwater has kept her well-preserved and her name is still clearly visible. She's been visited several times over the years by different expeditions, though they're tightly regulated by both governments out of respect for the grave site. The ship's bell was recovered in 1995, and is now in the Great Lakes Shipwreck Museum. A replacement bell, with the names of all 29 crewmen engraved on it, was left with the ship.

In the wake of the disaster a number of regulations were changed regarding maintenance, safety equipment, weather forecasts, ship loading capacities, and annual inspections to address concerns the sinking raised. To date another large ship hasn't been lost on the lakes.

No matter what country you're reading this in, some aspect of your life depends on those who sail. Likely more than one. The clothes you're wearing, the food you eat, the computer or tablet or phone you're reading this on, the car you drive or the fuel it uses, the metals and construction materials in your home and office... may have came from somewhere else by ship.

Shipping is still, after 1000 years, one of the cheapest and most efficient ways to transport goods. All of us in our interconnected world depend on it. But never forget that for those who take the big boats to sea, sometimes the price is higher than we realize.

Dear Alzheimer's Association,

Thank you for your recent letter concerning a new Alzheimer's Disease support group in Grumpyville.

May I respectfully request you refer the person stuffing the envelopes to a neurologist?  The "enclosed fliers" about the new support group were nowhere to be found, nor was the local director's business card "to call if you have questions" attached like it said it was.

For that matter, you should probably have the person writing the letters checked out, too.




Yours truly,

Ibee Grumpy, M.D.

Quote of the day

"I saw a surgeon once. He took out my appendix, or maybe my gall bladder. Shoot... It could have been my tonsils... or an ingrown toenail... anyway, you know, it was one of those things."

Memories...

 

Growing up I had a friend named Kevin. Who had a dog named Winston.

Winston was not the brightest dog.

Kevin's family always had Italian breads with dinner. You know, the long kind with a hard crust.

One afternoon Kevin and I were playing Dungeons & Dragons at their kitchen table while his mother  got dinner ready. The usual long loaf of bread was lying on the counter.

At some point, while Kevin's mom was chopping up veggies, she bumped into the loaf and knocked it to the floor.

Winston grabbed it in the middle and made a beeline for the doggie door. Due to a terrible sense of spatial judgment, he didn't realize the bread was longer than the opening was wide, and tried to run through at warp speed.

It looked like a guy getting clotheslined. The impact dislocated his jaw. I ended up going to the emergency vet with them.

Winston was eventually fine, but never tried to steal a crusty bread again.

Seen in a chart

Mary's desk

Mary: "Dr. Grumpy's office, this is Mary."

Mr. Hand: "Hi, I need to get in today. I may have had a stroke. My left arm isn't working."

Mary: "Well, you really need to go to ER for this."

Mr. Hand: "I know. I'm there now."

Mary: "You're in ER?"

Mr. Hand: "Yeah. I called 911, and they brought me here. I'm lying in back, waiting for the doctor."

Mary: "Okay, then..."

Mr. Hand: "I've been here about 5 minutes, and they haven't sent anyone in except a nurse. So if you have something open, I'll just come over there instead."

Mary: "No, you need to stay there. You'll probably need studies, and it's not safe for you to leave the hospital to come here if you're having a stroke."

Mr. Hand: "The ambulance is still out front. I could ask them to bring me over there."

Mary: "You need to stay there."

Mr. Hand: "Sorry. Had no idea caring for people was such a waste of your time."

(click)

Overheard in ER

Dr. ERP: "Boy, your throat looks awful... why did you wait so long to see a doctor?"

Lady: "You know how it is with us medical professionals! We always try to treat ourselves first."

Dr. ERP: "What sort of medical professional are you?"

Lady: "I'm taking classes on medical billing."

Halloween reruns

Ghost ships are the stuff of legends and Halloween stories. But some ghosts are real...

The S.S. Baychimo

The Baychimo was a small, sturdy, freighter owned by the Hudson Bay Company. Her job was to travel the coast of Victoria Island in the Canadian arctic, trading supplies with the local Inuit people for valuable fur pelts. She worked during the area's brief open water season (July to September) spending the rest of the year in Vancouver.

The winter of 1931 came early, and Baychimo was frozen in ice several times while returning home. By mid-October she was stuck fast near Point Barrow, Alaska. Most of her crew were evacuated by aircraft (the first time a long-range air rescue was accomplished).

The Baychimo trapped in ice, November, 1931.

A group of hardy souls decided to stay with her until the spring thaw, as they'd collected a particularly valuable fur cargo that year. They built a shelter ashore, and settled in for several months of night.

On November 24 an exceptionally violent blizzard struck, surprising even the arctic veterans with its ferocity. In the morning, mountains of ice 70 feet high were piled where the ship had been. The Baychimo was gone, crushed under tons of ice and snow and sent to the bottom.

Or so they thought...

The men radioed for rescue, but it would take a few days. As they waited a passing Inupiat told them the ship was adrift several miles down the coast. They set out on foot, finding her again trapped in ice. They took as many pelts as they could before returning to the shelter. Another violent storm was coming, and they assumed it would sink her.

The Baychimo had other ideas.

The second storm pushed her out of the ice and into the open sea, free to wander the icy north alone.

Over the next several years she was infrequently seen, and rarely boarded. Some of the valuable furs were even removed. But no one was able to bring her in. Attempts to restart her engines failed, and storms (which some claimed the ship had summoned) always drove would-be salvagers away. In one harrowing case a group of Inupiat boarded her, only to have a sudden storm trap them on the derelict for 10 days.

She was seen every few years, and each time the assumption was made that it would be the last. Only to have her show up again. Scientists, hunters, and fishermen. Inupiat tribe members. Russian, American, & Canadian ships and planes. All reported her at one time or another as she wandered the Arctic waters.

She was last seen in the Beaufort Sea in 1969, having survived 38 years afloat and alone in one of the world's harshest environments.

Today it's assumed she's at the bottom, and I suspect they're right. But who knows? Alaska has begun trying to catalog the estimated 4000 wrecks along the state's shores, and maybe she'll be found.

Or maybe not.

Brad

More than 20 years later, and I still hate Brad.

Brad was the chief resident when I did my 3rd year medical school surgery rotation.

And he was a prick.

The rivalry between surgeons and non-surgeons (cutters vs. thinkers) goes back to the dawn of medicine. Generally it's a source of good-natured joking. After all, we really complement each other more than compete. Patients will generally need both of us, and the goal is to do what's best for them.

Not to Brad.

When I met him, Brad was in the last few months of his year as chief surgical resident, and had already been accepted to a vascular surgery fellowship. Medical students, to him, were the scum of the Earth. Long removed from being one, he made no secret of his distaste for us.

By the end of the 3rd year of medical school most doclings have some idea of what they want to do. My interest in neurology was no secret, and I didn't hide it.

The other 4 med students on my rotation were smarter than me. Terrified of Brad, they all claimed to be interested in surgery even though none of them were. Vijay was planning on radiology, Michelle pediatrics, John dermatology, and Amy pulmonology. But I was the only one who freely admitted to having no interest in surgery.

Brad drove all of us hard, but treated me with particular disgust. I had to be the first one there in the morning (he considered 4:30 a.m. to be late) and made sure I wasn't done with anything until the other 4 had left. He'd give me extra work to ensure I couldn't leave. When the other 4 were told to go get lunch, Brad would ask the nurses to find something for me to do so I couldn't go.

Everyday he'd tell me (and have me repeat back) the mantra he believed: "If you're not a surgeon, then you're not a doctor. And if you're not a vascular surgeon, then you're not a surgeon." He made sure I knew how little he thought of neurologists, non-surgeons in general, and medical students. Since I was all 3...

I remember one night in spring, during that annual rite of American lunacy, March Madness. Back then I was a rabid basketball fan, and Angie and I had set-up the med student coverage schedule weeks in advance so I could watch the championship game (I don't remember who it was that year). She had no interest in it, so took call that night.

Late that afternoon, as we were getting ready for check-out, Brad pulled Angie aside and told her he'd decided that I needed to be on-call that night in case there were any surgeries (realistically, you don't need ANY med student there for surgery. We get in the way). Angie didn't have a choice, and wasn't in any more position to protest than I was.

Brad told me he wanted me to wait, in scrubs, in the surgery holding room... just in case I was needed. There was no TV in there. Brad sat across the hall with another resident, in the surgeon's lounge, watching the game and cheering.

Occasionally he'd walk over to make sure I was still there, and even told the nurse watching the one post-op patient to page him immediately if I went anywhere except the station's bathroom.

As soon as the game ended, Brad came over to dismiss me and said "well, I guess we didn't need you tonight. Too bad you had to miss the game, it was a good one."

On my evaluation, Brad gave me a low pass and wrote "lazy, incompetent, socially retarded, uncaring, unmotivated, and the poorest quality house officer material I've ever been suffered to put up with."

Brad, you probably don't remember me, but I'll never forget you. I googled you last night. Looks like you've lost some hair and shaved the mustache, but your smirking asshat smile is still the same one I remember from 25 years ago.

I'm sure I wasn't the only one you treated like that, and you probably haven't changed much. I doubt you read this, either, since something written by a non-physician, like a neurologist, is beneath your contempt.

But, on the off-chance you are... Fuck you.

Annie's desk

Annie: "Dr. Grumpy's office, this is Annie."

Mr. Camp: "Hi, I'm trying to find out what my MRI showed."

Annie: "Okay, hang on..."

Mr. Camp: "It was done 3 days ago."

Annie: "Huh. Usually we call as soon as... I'm sorry, but I don't show you in our system. Are you a patient of Dr. Grumpy's?"

Mr. Camp: "No, I see Dr. Darth."

Annie: "Well, we're not in practice with him. You'll need to call his office for results."

Mr. Camp: "But you guys use the same MRI place. Don't you have access to their system?"

Annie: "Yes, but we can't go looking up patients who aren't ours. You'll have to get the results from the ordering doctor."

Mr. Camp: "That's Dr. Darth."

Annie: "Yeah, you'll have to call his office."

Mr. Camp: "His phones are down today because of the storm last night, otherwise I wouldn't be calling you in the first place."

Annie: "I'm sorry, but..."

Mr. Camp: "Thanks for nothing."

Click

Long time, no see

Dr. Grumpy: "Which doctor sent you over to me?"

Mr. Leg: "My internist, Dr. Stache. He gave me a form to show you."


He reached in his wallet and pulled out a heavily creased and folded referral form that said "see Dr. Grumpy for numbness" signed by Dr. Stache.


Dr. Grumpy: "Um... Did you know Dr. Stache died in 2003?"

Mr. Leg: "Yeah, I'm not very good at following-up."

Department of Redundancy Department

Seen in a chart:

I'd like to start a semi-regular feature of the worst, stupidest, crap seen in EHR (computerized charts). Anyone wishing to contribute please email me de-identified pics or screenshots. Your identity won't be revealed. I think we owe it to others to show what POS's most of these systems really are.

Twinkle, twinkle

This morning I was at the office early. As I walked to the front of the building I noticed a line-up of planets in the east. Curious to know which they were, I pulled out my phone and used a planet-finder app.

A guy out walking his dog went by.


Dog Guy: "What are you looking at?"

Dr. Grumpy: "Those planets."

Dog Guy: (looks up) "Those are planets? Not stars?"

Dr. Grumpy: "Yeah, see how bright they are? And they don't twinkle."

Dog Guy: "Which planets are they?"

Dr. Grumpy: "Looks like... Venus, Jupiter, and Mars."

Dog Guy: "I had no idea they were so close together."

Dr. Grumpy: "That's..."

Dog Guy: "Shit! I bet they're going to collide any day now! I mean, they're really close!"

Dr. Grumpy: "Well, they only look like that from here. They're actually..."

Dog Guy: "Why haven't I seen anything about this on the news? YOU'D THINK A COLLISION BETWEEN GIANT PLANETS WOULD BE SERIOUS! THE ASTEROIDS FROM IT COULD KILL US ALL!"

Dr. Grumpy: "They're really not..."

Dog Guy: "The government knows all about it, I bet, and is covering it up. The media is keeping quiet to prevent a panic."

Dr. Grumpy: "Uh..."

Dog Guy: "Fuck you. You're in it with them. If I hadn't come by when I did, I wouldn't have figured it out either. Let's go, Fluffy."

He picked up his dog and walked away.