Why I am not in Oncology

This can be found in entirety at:http://rupertroo.blogspot.com/
Paul Newman died today of an unspecified cancer. I never thought he was the best actor in the world but I really liked Cool Hand Luke, The Sting and Butch Cassidey. He made some other cool films too, but those were my favs. I cannot help but feel sadness for his family and friends, although I clearly never met the man. However, I have met many other people dying from cancer.

One I recall was a pleasantly jaundiced 45y/o Hispanic man, Mr. X. He drank at holidays but never smoked. He was a DirectTV installer in Texas. He had 2 kids and a nice wife. He had colon cancer that had metastasized throughout his body, causing his jaundice. He was a Bears fan, and learning that I grew up in Chicago would call me Dr. Walter, knowing I adored Walter Payton as a kid. When surgery wouldn’t take him to the OR I tried to stand up to them, arguing he would be obstructed soon and suffer greatly. I got more upset about it than he did. He was calm. After discussing the pros and cons, Medical Oncology gave him the option of chemo. He reluctantly agreed, at his wife’s pleading. We tried to place him in home hospice, but apparently DirectTV has some really shitty health benefits. A wk later he acutely worsened. He had already agreed to “Do Not Resusitate” orders. Pupils were fixed and mid-dilated. No carotid pulses felt. No heart sounds across the entire prechordium, and no lung sounds bilaterally. I declared him dead that morning. His wife’s howl, when I called the time, is etched in my brain.

If the best you can offer people is a chance to live another 6 months of suffering… If the best you can prescribe is medicine that will make you vomit, lose weight and have your hair fall out... If the best you can expect is waiting to perforate your colon. Your best isn’t good enough. I don’t aim to attack Oncology, and I am grateful that smart people are willing to dedicate their time and genius to finding better treatments for Mr. X. But right now the technology kinda blows. It’d be like being a car salesman for a Model T in present day and everyone else is driving a Prius or Honda Accord. It’s not good enough yet. I know a lot of being an MD is giving consolation, support, hope and care to your patients. But I went into medicine to help and try to cure people. I don’t know if I’m overly sensitive and can’t take these big losses or maybe I am just a big pussy emotionally. I do know that I’m not cut out to be an Oncologist. I sure am glad that other people are.

David Wells and Me

Note:this entry can be found in entirety at: http://rupertroo.blogspot.com/
I’m not sure about the 3 people who actually read this blog, but I’m guessing that you are probably close friends or family. That said, you must know me pretty well. So I won’t get into the gritty details of what has gone wrong in my life over the past year. Odds would have it that you already know that I'm an unemployed doctor (by choice, I didn't totally fuck up or get sued or anything) living in the suburbs of Chicago in the same crappy town that I grew up in. Living with my Dad. And I turn 30 this yr.

Before you email me a suicide hotline number or self-help book ad, take solace in David Wells. No, he’s not the Rocky, turn-it-all around story. He's no Rudy, either. I don’t have unrealistic, unholy expectations like that. But on May 17th, 1998, David Wells was perfect. Wells was a fat ass, under-achieving pitcher for the NY Yankees at the time. He was reputed to show up to games drunk and let his emotions get the best of him. I can relate.

On that one day he accomplished baseball perfection. 27 outs. No walks. No errors. He was perfect. I looked it up and it’s only been done 15 times in baseball history. We’re all living history right now, though. I have 3 interviews for Attending positions at private hospitals over the next 2 wks. If I was ever going to have my David Wells moment, this is it. Wish me luck, I'm gonna need it.

Cubs Fans and Nihilism

Note:this entry can be found in entirety at:http://rupertroo.blogspot.com/
A little piece about Cubs fans and how it is negatively affecting my current existence. It's not really about Nihilism, but believe me, there's lots of potential for an entry about that connection as well.

“We are made to suffer, it's our lot in life.”
-C-3PO as he traversed the harsh terrain of Tatooine

For a brief historical trip, in no particular order:
1.Collapse of the 1969 team to the “Miracle Mets”. Pre-Rupert Roo era.

2.Leon Durham in 1983, he broke my 5-yr-old heart.

3.Bartman, that’s all I’m gonna say about this one.

4.1989 team that lost game 5 to SF and I had tickets to game 6 at Wrigley. I was 10 y/o and I did cry like a little bitch.

5.Something about a goat?

6.1919 team shrouded in scandal with a despicable betting ring that would plunge baseball into darkness and forever tarnish the game… oh wait, that was a different Chicago team.

It’s been 100 yrs since the Cubs last won a WS, the same yr that my grandfather was born. An entire century of failure. That’s something of an accomplishment in itself, right? No other team, not even the Indians or BoSox can claim such consistent levels of near-mediocrity.

But that’s okay for me. I’m only 30, so I have a good 40-50yrs left to see them try to turn it around. Unfortunately that task is getting more difficult as Cubs tix are harder to find than the crate that holds the Ark of the Covenant in that massive warehouse. And if you’re lucky enough to find them, you’ll pay dearly. Back in August bleacher seats were selling for $120.

Obviously I’m pissed off at this predicament, and the seemingly inevitable reality that I will probably not get to see a single Cubs playoff game. You see, I love the Cubs. But I really hate some of the asshole fans. That’s right, I blame the asshole Cubs fans. It’s a fairly common phenomenon that when sports teams start to do well, popularity increases and ticket sales rise. In the 70’s, Chicago Bulls tickets could be found for <$5. Then they drafted some guy named Jordan and things among fans changed… And change for the worse then certainly have.

Here is my short list of things that bug me about Cubs fans today:

1.Couldn’t tell you the name of any Cubs player except, “Is Sosa still there”?

2.More interested in staring at breasts and getting shit-faced than the game. Now I am 100% for both of these activities, especially if done in tandem. But not at a Cubs game. Not at Wrigley. Do that at home with your friends, the beer will be much cheaper and you'll get better seats for the titties.

3.At any given point >33% of the fans are texting or at least talking to someone with their new iPhone, pausing sometimes to search for a clip of a monkey smelling his finger on Youtube.

4.Hordes of people arriving right on time during the bottom of the 3rd inning. Luckily these same dickholes leave in the top of the 6th.

5.Lincoln Park trixies who wear pink Cubs hats and talk about where they get their pubes waxed while the bases are loaded with 2 outs. Yes, this has happened to me.

6.The SuperDad who brings his 8 undisciplined kids to the game, one is 4 months old.

I could easily continue but I think you get my general vibe here: A lot of the ‘fans’ are ill-informed and not interested in baseball at all. They are tourists, like Ed Norton would say in Fight Club. In a way I'm jealous, b/c I feel that real fans (like me) have watched this team through the bad times and now can’t go to a game because I don’t work for some Hedge Fund that has corporate season tickets. I know that not all fans are innocuous tools. But with the rate of innocuous tools on such a dramatic upswing, they are a difficult population to ignore.

Which leads me to my conclusion. If you read through the above list and it sounds like you, please do not go to Wrigley Field, at least not in October. Think of the alternative: Stay at home with your family and watch the game on your 50 inch plasma. You can wear your extra small, Hollister faux-rugby shirt and tilt your cap to the side, just as you like it. You can get wasted in the privacy of your own home and not have to vomit in a urinal trough! You can call all your friends at any point in time and share hilarious Youtube videos from your iPhone. Just don’t call me, there’s a game on I’ve been waiting 30yrs to see.

Decline of the American Physician Won’t You Be My Neighbor?

Note:I am admittedly basing this entry on a Wall Street Journal article originally published by Jeffrey Zaslow in 7/07. To read this full article visit:
http://online.wsj.com/public/article/SB118358476840657463.html

A doctor used to be a position of responsibility, respect and power. And while responsibility, especially the legal kind, still rests firmly on the shoulders of most American docs, respect and power are truant comrades. I’ll be a little more specific from a personal standpoint as I go on here. Otherwise you’ll just have to trust me that being a doctor ain’t what it used to be. You can trust me, can’t you? I am a doctor.

This downgrade in physician standing has permeated to the point of being institutionalized. The bureaucracy itself not only condones treating doctors like children, it regulates and endorses it. As a senior resident I remember nurses and social workers passing around red buttons that said “Ask ME! About proper hand washing hygiene”. As if my OCD-ridden mind needed another reminder to wash my hands. Another good example of this blatant mistreatment was our weekly discharge meetings where we would discuss reasons why our patients remained hospitalized. These meetings would typically take place between me, a couple of secretaries, a social worker, a dietician, a physical therapist and a pharmacist. So I would usually rattle off a little: “Pt is a 54 y/o white man w/ hypertension, diabetes, hypercholesterolemia and gout presenting with subacute bacterial endocarditis on day #5 of amp and gent plus vanc as cultures remain negative but clinical suspicion remains high for Eikenella or Actinobacillus and-“

At this point I realize that no one in the room has any clue to what I just said or what the plan for this guy is. Usually someone would condescendingly ask, “Amp and gent, can’t he just go home on that?” To which I would reply, “Not unless you want him main-lining the heroin that gave him that infection in the first place directly into his jugular. Then there’s the whole deafness problem”. And the dissent is not limited to the support staff, oh no!

Even in my first clinical encounters as a 1st yr med student I was shocked at the relationships I saw between patient and doctor. Angry, poor people clearly suffering from some malady I had yet to study barking orders at doctors. That’s right the loonies were running the crazy house, and not in a semi-cool Randle McMurphy sort of way. I remember a particularly pissed crack head ordering up some vicodin. Would you like BBQ sauce and a 6-pack of McNuggets with those opiates, sir?

This situation did not improve much as I advanced in my training. If anything, I grew closer to this diseased mindset of privilege. My friends and I grew to label this the “culture of entitlement”. Succinctly this term applies to generally poor and non-producing members of society (although it’s certainly not limited to poor ass people) who, for reasons not entirely apparent, believe that not only do they deserve goods or services of exceptional quality and expediency, but also if they do not receive said goods or services a grave wrongdoing has occurred. Such is the crack head ordering up narcotics with his #4 extra value meal.

The threat of litigation runs deep in these individuals, though I’m fairly certain the only time they’ve spoken to an attorney has been a public defender who is fortunate enough to pick up their public urination case. These individuals are far too common in medicine. The fact that I trained at a county hospital contributes largely to this belief that I maintain is fact. For some reason the worst off in the community expect the best. As if the chronic low back pain you’ve had for 8 yrs and seen 5 different specialists for is going to magically improve instantly when I see you. The truth is that there are many diseases that modern medicine cannot treat and many more that it cannot cure. Truth is, a lot of the treatments that are available are Carlton Banks expensive, take a long time to show any improvement and have considerable side effect profiles.

But I don’t think that truth is what the self-entitled are searching for. Maybe validation of their station in life, shitty as it may be. I keep repeating it, but I really don’t understand the motivation or cause of this all. Then I read this Wall Street Journal Article.

This well written piece describes, from a college professor’s perspective, what he coins as my culture of entitlement that he noticed in asshole college students expecting to get A’s in all their classes simply by “working hard” and showing up. The author blames, drum roll please: Mr. Rogers.

That’s right, sweater wearing ‘ol Fred is to blame. The reason? He “told several generations of children that they were ‘special’ just for being whoever they were”. The writer elaborates that, “Mr. Rogers spent years telling little creeps that he liked them just the way they were. He should have been telling them there was a lot of room for improvement”. Boy if any of those kids had my Dad in their childhood, they would be experts on this ‘room for improvement’ thing.

I don’t think that Mr. Rogers personally is to blame for this cultural shift, particularly toward physicians. But his message and the way it has penetrated my generation is to blame for the narcissistic tendencies of today’s youth. I’d like to borrow a line from Chuck Palahniuk’s Fight Club when I say to these kids, “You are a not a special and unique snow flake”.

In closing I’d like to reinforce that I never did wear those stupid, “Ask me” red buttons that administrative morons thought every doctor in the hospital should don. As if your doctor wearing a sign that basically reads, “I’m so stupid, I need a constant reminder on my chest so I remember to wash my hands” will inspire confidence in anybody. Using some white-out and a Sharpie I modified one of the buttons to read, “Respect ME!”, but I was always too chicken to wear the darn thing around the hospital. Doctors in the 21st century and me too afraid to wear a stupid pin: oh, how the mighty have fallen.

My Best Years at Buffalo Grove High School

What’s the purpose of telling high school kids that they are living the good life? Make them more appreciative of their surroundings? I would question the veracity of such a claim. Back in my BG days this cliché would depress the shit out of me. And if those 4 yrs are really the best of your life what about the other 60+ yrs? You know, adulthood? Is that just supposed to be a downward spiral of shame and disappointment culminating in your eventual demise? In my time at BG I can remember thinking, “This is as good as it’s going to get? I have no money, no car, no sex, little direction in life… heck I don’t even know myself!” Yes, I really did think that last part.

I spent a lot of my time and energy trying to get the fuck out of high school and I had it better than most kids. I had a group of interesting, intelligent friends that genuinely looked out for me. Sure there were good times, and I have plenty of funny stories and embarrassing pictures (before they were all digital) to prove it. But it wasn’t all Friday Night Lights and 90210. Still I gave it my best.

“Losers always whine about their best. Winners go home and fuck the prom queen.”
-Crazy ass Sean Connery character from The Rock


A lot of my high school was spent desperately trying to fit in and being sure not to get my ass kicked in gym class or have text books knocked out of my hands by some anonymous asshole (or not so anonymous, Yonatan Zamir). I remember being extremely self-conscious and dreadfully aware of my shortcomings, physical and mental. I had my heart broken at least 3 times at BG, and that was really tough for an overly sensitive 16 year-old raised on 80’s romantic comedies. At some point I really thought I was Lloyd Dobler, or at least his less attractive 2nd cousin. It was in high school that I realized for the first time that my parents were, in fact, real adult humans who can be hurt, who can openly weep and much worse.

And for some people life did get much worse. Jordan Fenchel died from an opiate overdose after graduation. Mike Flores burned to death in a car accident in 1998. Bet you don’t remember him, but I was in Saul’s AP Physics class w/ him.


I only wished good endings for these guys, but it doesn’t appear to have finished up that way. If high school was the highlight of your life, I really do feel badly for you. Talk about peaking too soon, that’s like being born with an 18 inch cock only to have it shrink one inch per year until your 18th birthday, when you’re finally prepared to use it, and all you’re left with is a one inch stub of flesh barely representative of anything masculine.

For a good transition of things less than masculine:I’d like to say to you that my life right now, as I sit here and eat nachos w/ Diet Dr. Pepper, is the best I’ve ever known it. Of course that would be a lie. In the past I’ve eaten Chicago pizza, Eli’s Cheesecake, a steak at Smith and Wollensky… I’ve had it good before. It’s not so much that life is incredible for me right now, Diet Dr. Pepper aside, but the hope and potential promise that I will have it greater some time soon. Sure the chocolate chip cookies at the BG cafeteria were soft and delicious… but I’m holding out for the bigger things; right or wrong, true or false, I’m sticking around for it.

SAT vocabulary time

What is a merkin? Betcha don’t know, despite your freakish SAT score. I didn’t know until a few months ago and even now I’m skeptical as to the accuracy of my knowledge. In short:a merkin a pubic prosthetic. It’s a toupee for your pubes. Why would someone need a wig for their pubes?

Harsh Chicago winters, perhaps?

First is the aesthetic purpose. In the past syphilis ran rampant throughout the Western world, much as it does on many college campuses today (check out my Nietzsche article if you don’t believe me). One of the supposed cures for syphilis was believed to be shaving off all of your pubes. For posterity’s sake the merkin was created to appease the self-conscious nature of the 17th century common day, syphilitic whore. Those marketing guys think of everything!

The other main use of the merkin was for theater and film. Period pieces have been particularly popular lately (There Will Be Blood and No Country for Old Men) and if there’s ever a scene that shows a character’s crotch a merkin can be used for full authenticity. For example a Hugh Hefner biopic is in the works for Hollywood. Much of Hef’s life and the development of Playboy took place in the 60’s and 70’s. I wasn’t alive for that time period but I don’t think it was routine for women to rim the hedges back then. Ergo, the merkin will help achieve a realness that would otherwise not be possible without extensive overgrowth. In a way it kind of cheating though. Like if De Niro had worn a fat suit in Raging Bull instead of gaining all that weight. And since we’re talking about the genuine article and striving for realness, I wonder what these merkins are made out of in the first place?

Suicide vs My Super Sweet Sixteen

One of the more popular programs on MTV, Destroyer of Souls, is My Super Sweet 16. I know I'm not the only person to say that that the kids featured on this show are pretty messed up. And I certainly know that I'm not the only person who tunes in to see just how far the monstrous jerks on Sweet 16 push the envelope. To start I'd like to describe the basic format of this show.


"You will never see a more wretched hive of scum and villainy"
-Obi-Wan Kenobi

The audience is first introduced to a self-entitled, thoughtless teen who insists that their birthday celebration should be treated with the adoration of the second coming of Christ. As if the day that they were shat from their mom's va-jay-jay is such an impt event that it must be held in great reverence. WTF did they ever accomplish to warrant such attention; most handjobs given to the JV Lacrosse team? And speaking of the mothers, the parents of these kids are usually unfit to even own a dog. The adults are completely subservient to any demand, and they are demands, made by their foul spawn. I place most of the blame on these cowardly and supremely dense parents.

Blame aside, the attitude of these teenagers is completely appalling. What may surprise viewers is that this behavior is accepted as completely normal by the family and especially the friends of the "chosen child" featured in each episode. This acceptance leads me to suspect that the friends depicted are from equally privileged backgrounds and possess the same skewed set of values.
These values become lucid as the show progresses.

Sweet 16 follows this brat as she selects a dress, decorations, a venue and often a guest star to perform at the event. In a display reminiscent of the golden goose scene from the original Charlie and the Chocolate Factory, the girl will often insist something like, "But I neeeed the RED Ferrari, Daddy!" (with an English accent in my head, anyway). And like a bad car wreck, I am sickened yet I cannot help but stare with curiosity.


"Monsters are real, and ghosts are real too. They live inside us, and sometimes, they win."
-Stephen King


The party is what one would expect. After all it does cost around 200k. The entranced guests usually make such claims as, “This is the most amazing experience of my life”. Upon reflection of how exaggerated that statement is, I instantly realize that it’s probably true. Frequently there are mishaps like a guest having an altercation with the chosen brat, or the cake not getting to the party on time. Something trivial like that. Obviously the asshole gene prevalent in these kids cannot just dismiss a minor faux paus. The cameras catch most of the bitchy action in all its glorious repugnance. The birthday girl gets an obscenely expensive car at the closing, as all her friends cheer on, only further encouraging her deplorable behavior.

Near the end a voice over will frequently suggest something like, "It was the best day of my life and I'll never forget it. That my parents were willing to spend all that money on my birthday just proves how much they really love me". These young women already equate financial expense with love, a true emotion that they are not likely to experience in its pure form; in real life.

My 16th birthday was spent at a semi-fancy restaurant with my immediate family and about 10 of my best friends from high school. Afterwards my friends took me out for a movie and we stayed up all night in my Dad’s basement shooting pool and talking about how much money it would take to be a real life Batman, the pitfalls inherent in a flat tax system and unfairly dissecting flaws of the hot girls at our high school who wanted nothing to do with us (probably because we discussed the first two topics). Overall it was a pretty cool birthday for me. Sure it would’ve been nice to get a Bentley. But I thought that my birthday really was super sweet, and I didn’t have to act like a total douche for any of it, either.

Sexual Humiliation Story #43b

Note:This is a true and somewhat graphic story involving sexual situations. Proceed at your own risk, and if you know me, probably mine.

During the summer of ’99 I was living in Cleveland, OH at Case Western Reserve doing neuroscience research. And you thought that summer you spent in Cabo was wild, let me tell you! J/k… contrary to what Drew Carey says, Cleveland in fact does not rock. I was staying in dorm-style living quarters sans air conditioning. To make this arrangement that much sweeter, I was 20 y/o and all my friends were 21. NTM, my girlfriend of 4 yrs cheated on and broke up with me via long distance phone call. Nice.

Seeing as I hadn’t really dated since high school, my game was… a little off. Across the courtyard from my dorm I had a good view of one of the only single, attractive women in the Cleveland area. Given my voyeuristic nature, I used this eagle eye view of her dorm liberally and was quickly smitten. Her name was Dana, and I made sure to “accidentally” run into her in the laundry room one morning. To my extreme surprise we hit it off pretty well. Despite being gorgeous, at least by traditional, cable TV benchmarks, she was a bit of geek. Dana was studying for the dental school admission test that summer. I had taken the MCAT the previous yr and a lot of the material was similar. Often I would see her in the dorm carrying a stack of index cards that she had turned into flash cards. We became fast friends and even though I had no big test, we were good study partners.

Naturally my motives were outside the realm of academia. One day after a morning spent reading at the Arabica cafe we ended up kissing underneath a willow tree by the art history museum. It was romantic even by my current standards and it felt good to be back in the starting lineup. But my time in Ohio was limited so I felt that I had to speed up the normal timeline of things. Did I mention I was borderline retarded?

There was only 3 wks left of my research proposal so I had to move swiftly. I planned an afternoon at a jazz club (where I had to bribe the manager just to let me in b/c I was underage) complete with wine tasting and picnic near the museum where we first kissed. Things went great. We talked about all the usual, get-to-know-you questions and then some of the deeper ones. And she didn’t talk about her dental school test at all, so I figured I at least provided her with a solid distraction.

Later we returned to my oh so suave dorm room. For being 20 yrs old and dirt poor, it was the best I could muster. We started to kiss on my tiny twin bed when the lack of air conditioning started to be very noticeable. She started to take my clothes off, so I complied and began to reciprocate. Once I removed her jeans and placed my hands on her panties she paused. “What is it?” I asked.

“I just, I wouldn’t want you to think I was easy.” And she took my hands off the elastic band and placed them around her waist. We kissed like that for almost an hour but never advanced further. She left my room and went across the courtyard to her place with the promise that we’d have lunch the next day.

Less than 1 millisecond after she left I was in full masturbation mode. A 20 yr old making out with a hot coed for an hr in her bra and panties, come on! Apparently “blue balls” were not a topic that was heavily covered on her dental school exam. So things didn’t take too long. I finished up and went to bed.

The next morning I slipped on my flip-flops and headed to the shower. I noticed one of Dana’s homemade flash cards had been pushed under my door. I picked it up and could feel the air leave my chest, like being punched in the dick, as I read the words:

“Next time you jerk off, you might want to close the blinds. –Dana”

I had lunch alone that day. And pretty much every day following that one, as I suspected that Dana wasn’t the only person who saw me that night. Some people look back at their youth and think, in a very Bryan Adams-type tone, “Those were the best years of my life”. Since my past is mainly littered with stories like this one, I hope you can see why I disagree with Mr. Adams.

MTV Destroyer of Souls

People older than about 23 may remember a time when MTV used to be cool. In the 80’s MTV showed mainly music videos. Over time the programming changed. Initial shows included Liquid Television, Headbangers Ball and Yo! MTV Raps, NTM the groundbreaking reality show called The Real World. The whole idea of Real World was fascinating and very new. I remember the first couple of seasons were enthralling. Slowly Real World would morph into a vacuous 30 minutes of shit, devoid of anything intelligent or valuable. The same degenerative transformation happened to all of MTV. Now it’s a network of self-entitled, self-advocating, shameless, dumb fucks that encourage some of the worst qualities of mankind: greed, materialism and ignorance with little emphasis on music at all. The scarce music that is promoted via MTV is not created by the artists but by companies and groups of songwriters using vigorous surveys and test groups. After the most marketable, most likely to be commercially successful songs are chosen, an attractive face is attached to this newly manufactured sound. The complete package is sold to America’s youth in an over-sexed fashion. It is an entirely soulless and callous enterprise.

There are rare bright spots that have littered the vast sea of emptiness known as MTV. Beavis and Butthead was hilarious and novel for it’s time. Remote Control was one of the first game shows to scrutinize it’s subset of pop culture. But for every thoughtful show like Unplugged, executives would make Undressed followed quickly w/ TRL and Laguna Beach.

Of all the despicable options to pick on the MTV lineup there is no more abhorrent selection than My Super Sweet 16. My next piece will specifically investigate this show, why I believe it is contributing to the downfall of humanity and most curiously, why I still insist on watching it.

Rupert the Prude and Craigslist Personals

Craigslist has an interesting section called “Barter” where people can exchange goods or services for currency other than American dollars. I found this board interesting, for example:Will trade singing lessons for a Nintendo Wii. Will trade my CD collection for a Fender Stratocaster. Then I saw this one from a guy who will trade his services as a personal trainer for time with “a woman that takes good care of her feet so that I can kiss, lick, smell, and smother my face into them”. Yup, that’s right. Then I got to the Craigslist personals and was even more aghast.

At this point in my life, there isn’t much that can gross me out. Even the most masochistic and depraved sex internet sites might initially surprise me, but they don’t bother me. This is what happens when you see 3 unrelated men in the ER in the same night, each with different objects jammed up their rectums (a cigar case, a handle of a soup ladle and a gherkin). Then there was the guy who liked sticking swizzle sticks into his urethra until it perforated into what is commonly called the chode. So you can see how this process can be a bit desensitizing to all things gross.

Then there’s Craigslist personal ads. All I want to say is that if you want to find 100’s, nay 1000’s of pictures of penis, look no further. Don’t try Google Image or Yahoo. Craigslist has them all beat by a mile. Apparently a lot of guys think that this is the best approach to meeting someone; show pictures of your cock. The “Men seeking Men” category was almost entirely cock pics, but a large portion of the hetero section was also penisful (don’t think that’s a real word, but it means “full of penis”).

The raw nature of these pictures didn’t really shock me. But then I got to thinking about the whole concept and became depressed. It occurred to me that with the large volume of these penis pic ads, clearly they must be working for someone, right? Already almost everything my parents and teachers ever told me about relationships is not only wrong, but in fact the perfect opposite. Real life can be so disappointing sometimes.

Gay Lisp Investigation

Per Wikipedia: careful pronunciation, wide pitch range, high and rapidly changing pitch, breathy tone, lengthened fricative sounds, and pronunciation of /t/ as /ts/ and /d/ as /dz/

A lot of gay men speak with a lisp. And not just any lisp, it is a characteristic lisp very distinct to this subset of individuals. Growing up I knew a few little kids who grew up to be gay men. One of them had a lisp but given the small sample size, it wasn’t statistically significant. When I moved to Lakeview, AKA “Boystown”, my 3rd yr of med school this sample size increased greatly. And about 10-20% of these guys indeed did have a lisp. I don't know for sure if this number is truly higher than in the straight population, although I suspect that it is elevated.

So of the people I’ve met in my life, more gay guys have a lisp (and this lisp in particular) compared to straight guys. Still not a good sample size, but I’ll take what I can get. The vast majority of these guys are American, thus I’m not sure if this is an international phenomenon or purely limited to the US. Than the question becomes: Is this a learned, social behavior or an inherited trait?

I did a pubmed search on this topic and it came up pretty dry. If you believe the idea that being gay is an inherited quality, it could be that the lisp is related to this genetic quality. I do believe that being gay is very much genetic (with some social influence, albeit minor) so this is a real possible answer for me. But it also makes sense that this is a learned stereotype.

The one study I did find (of dubious quality, but I won’t get into that) was from Canada. It’s designers found that, “some gay men may be subconsciously imitating certain female speech patterns and if this is true, we want to know how men acquire this way of speaking”. So basically some gay guys are emulating female behaviors, consciously or not, as a means of attracting male attention. All you have to do is watch one episode of Project Runway and I could’ve told you that.