Raining In Seattle And That’s OK

Seattle umbrellaWe just got back from our vacation trip to Seattle, which is Pacific Northwest native american dialect for “land of the broken umbrella.” It rained a lot but that didn’t stop us. We put around 25 miles in on the pedometer over the week we were there. We flew first class for the first time ever, if you can believe it. It was great to be able to cross my legs and the in-flight meal was tasty.Airplane first class meal

Seattle is a city of contrasts. On the one hand, the city is growing as people move there in droves seeking economic opportunity. On the other, homelessness is a serious challenge. On our arrival, the cab driver’s radio announced the shooting of a homeless man who was involved in a fight with another in one of the many tent cities there, a place called The Jungle, one of several targets of a “sweep,” an effort to reduce the size and number of large homeless camps which can become dangerous areas.

However, most of the homeless were more tragic than dangerous. Many have chronic, severe mental illness and one of them even apologized to us after asking for spare change.

A City Council meeting recently ran very long and was the scene of  loud conflict between what are usually liberal Seattleites and those who are struggling to maintain a balance between raising taxes and caring about the homeless population.

That said, you can almost feel their restless vitality and we found them to be almost universally friendly and helpful. We can’t recall anyone being the least bit snotty, of which you’ll sometimes hear them being criticized.

Sena and Jim at Thompson Seattle HotelWe stayed at the Thompson Seattle. Uniformly, the staff there went out of their way to make us comfortable. One of the servers even paid for our breakfast one morning after it was a little slow in getting to our table.

Pike Place Fish CoI was eager to get a short video of one of the Pike Place Fish Co. fish-throwing fests. While I was fumbling with my camera, one of the workers and my wife, Sena, stood there and looked at each other for a few seconds. Then Sena asked simply, “When’s it gonna happen?” He says, “Tell your husband to get his camera ready and we’ll get it going!”

It happened! Afterward, the guy said this would be more fun if people bought something. I wanted to but didn’t have a place to keep raw salmon in our hotel room.

Snoqualmie Falls Park signThe trips to Snoqualmie Falls and Mt. Rainier National Park were neck and neck for favorite attractions. Terry Divyak, the owner of Shutter Tours, was one of the nicest tour guides we’ve ever met. He didn’t even lose his temper after discovering he’d been given a parking ticket while he was greeting us at Pike Place Market. Terry is an expert photographer and gave us some tips on how to get the best shots.

He’s the one who took the best pictures of me and Sena at the falls and at Kerry Park, sometimes known as Post Card Park. One of the first questions he asked our group was whether or not we’d had a chance to see the Gum Wall yet. This was a surprise because Sena had pressed me to Sena and Jim at the Gum Wallget directions on one of my smartphone apps to the Gum Wall although we probably would never have found it if she hadn’t asked somebody for directions, who was very happy to oblige. Terry also took us to see the Fremont Troll, which is a huge sculpture of a troll clutching a volkswagen and who has a hubcap for a left eye. He lives under a bridge.Fremont troll

Terry also told us a tidbit about Howard Schultz, a former employee of Starbucks back in the day before they ever sold coffee by the cup. Howard later became a multimillionaire as a Starbucks tycoon. Howard got an epiphany about selling coffee by the drink while he was in Italy, visiting a coffee emporium. It struck him after a few cups of espresso. I wonder if it was the caffeine.

Joe was our leader on the all day tour of Mt. Rainier National Park. He was generous enough to buy a big cake as well as cupcakes for everyone to celebrate both a birthday and an anniversary for members in our small group. He never tied his shoes and almost never stopped talking. He had an uncanny sense of timing for exactly when to arrive at a street crossing for a photo op of the Mt. Rainier Scenic Railroad steam engine train passing whistling through, a cloud of steam in its wake.

Starbucks on PikeSeattle is known, of course, for coffee and seafood. There’s a lot more to coffee there than Starbucks, although it has a rich history in the city. We saw many small places that vie for the traveler’s attention including an unpretentious and very friendly place called Seattle Coffee Works. There was even a small note on the bulletin board saying “We’re not snotty.”Seattle Coffee Works free drink card

Star Trek at Seattle CenterWe saw a lot of sights, including the Experience Music Project Museum at the Seattle Center, which included exhibits about musicians especially from Seattle, such as Kurt Cobain and Jimi Hendrix as well as one about the Star Trek TV series, which ran from 1966 to 1969 and which was, in part, a vehicle for Gene Roddenberry’s vision of the future for humanity, which included promoting civility, restraint, justice, freedom, acceptance of others who are different from us, mercy, and other qualities which appear to be lost on certain political candidates these days. No, I’m not watching the 3rd episode of “My So-Called Debates.”

Seattle doesn’t get as much rain as a lot of places although it sure seems like it does. Despite that, nobody there wastes any time complaining about it.

What’s Obecalp Got to Do with Elvis Anyway? Another Post from the Extended Stay Hotel

I just recently re-encountered the word “obecalp” and this brings back memories of medical school. You know, “obecalp”, which is just “placebo” spelled backwards, turned up in Dr. Henry Nasrallah’s editorial in the August issue of Current Psychiatry, link http://www.currentpsychiatry.com/article_pages.asp?aid=9753. I had no idea obecalp was being marketed on-line. I also didn’t know that the term was allegedly coined by an Australian physician in 1998. I didn’t have ready, free access to the full-text article by Michael Axtens in New Scientist, link http://www.newscientist.com/article/mg15921467.300-mind-games.html, but it sounds like he was disenchanted by his experience prescribing antidepressants (which he rather unscientifically characterized as placebos) for his patients. My first encounter with obecalp was in my senior year of medical school, which incidentally was well before 1998 (and that’s all you’ll get out of me!).

I was doing a 4th year elective as a subintern on the Medical-Psychiatry Unit (nowadays the preferred term is Complexity Intervention Unit). My senior resident was trying to come up with a benign and effective intervention for one patient’s persistent medically unexplained physical symptom. He finally decided on what he called “obecalp”, and presented the idea to the treatment team one day on rounds. He began by writing “Obecalp” on the blackboard. We didn’t have whiteboards in those days. His short elevator speech and proposal to offer obecalp to the patient, who never failed to remind us that we were not addressing a most distressing symptom, met with a chilly reception from the co-attending faculty physicians, consisting of an internist and a psychiatrist. Nevertheless, they grudgingly accepted the proposal.

The patient got obecalp and was cured of the complaint within days. I think the recovery was as much a function of the resident’s dramatically persuasive and convincing explanation of the benefit of obecalp as the sugar-pill itself. He was a bright and engaging fellow, though his sense of humor was a bit twisted at times. One example was his impression of Elvis, which consisted of quickly dropping to the floor on his back, closing his eyes and folding his hands across his chest…in an obvious “rest in peace” pantomime.

Dr. Nasrallah says the placebo effect is more a function of the prescriber than the pill itself [1]. I’m a believer.

1. Nasrallah, H. A., MD (2011) The most powerful placebo is not a pill. Current Psychiatry 10,

Camping at the Extended Stay Hotel

We’re camping at the extended stay hotel while we wait to close on our new house. It’s not brand new but seems like it. The sound of “extended stay” and what that could portend gets to me a little sometimes. I keep reminding myself its temporary. Hey, the desk clerks are friendly and helpful. Our room window looks out on pretty sunsets. I’m pretty sure we can check out…and leave. The place is small compared to the house we left, but a little privation every once in a while is good for the soul.

The first night there, I couldn’t make the phones in the room work and couldn’t get internet access for my brand new laptop for keeping up with the blog while we’re between houses. My wife calmed me down and figured out what even the hotel desk clerk could not…that everything worked fine if you switched the ethernet jack with the telephone jack.

Hey, there’s nothing more practical than the wife of a  Practical Psychosomaticist.