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St. Gerardus Majella

I do not make a very good blogger as one of the rules is to actually write.

A few weeks ago, I stumbled across my medical record from an accident I had when I was four years old. The neurosurgeon who saved my life has passed away, and I knew him not well, other than as a patient as a young boy, and one more time, as a young man. I wish I could visit with him now. I remember sending for the records in Feb. of 2002, and receiving them in the mail on a busy day in which I glanced through them and tossed them in a safe place. A place so safe that I lost them for the next ten years.

When I read them this time, from front to back in the quiet of my office, I then realized what a gift these past 46 years have been.

I read all of the 25 pages, 46 years after this man, whose name begins with Christ, gave me life. Hence, the title for my June contribution to NWTC newsletter, What’s Cooking, was initially the same as my post, St. Gerard, but, I changed it to The Circle of Willis, thinking that there may be some objection from a secular college. It was difficult for me to write of it in less than 800 words. There is so much more to recollect, to feel, to share; nonetheless, here it is.

 

St. Gerard

My life began when I was four years old with the weight of St. Gerard filling my hand, pushing it to the linen sheet as hooded and masked people wheeled me into the operating theater with whispered assurances that all would be well, the familiar still forms of my mother and father disappearing behind the pneumatic hiss of double doors closing on one world and opening on another. That was my most poignant memory of my life that came after the day I lay on the street, four months earlier, my life leaking out of me. The neurosurgeon told my parents then that the prognosis was poor, that I had suffered a severe open brain injury from which a full recovery would be difficult to realize; but that he would do his best; that it was in God’s hands.

In the hours that followed my first operation, mother and father waited in the chapel, praying, and years later my father told me that it was only when he told God that it was okay if He took me home that he knew I would be okay. Shortly after that, Dr. Christoferson walked into the chapel with a tired, cautious smile and said that I would live, but that I may still have a significant neurological deficit. He told them that after he removed the depressed bone chips and debrided the devitalized brain tissue, when he ligated the bleeding vessel in the right side of my brain, he saw new vessels grow before his eyes, feeding the brain that had been cut off. He told them that it was a miracle.

I didn’t recognize St. Gerard when my father placed him in my hand in November of 1966. I only knew that the two-and-quarter-inch metal figurine was somehow connected to God, going to church on Sundays, and the prayer that started with “Our Father who art in heaven.” It felt heavy cool and warm all at the same time, and I kept it near, in a safe place for years after where it remained only as a memory until one day when I found it again, this time an adult, approaching the point of having barely more life in front of me than lay behind me when first I held it in my hand.

For decades, in the rare and occasional glimpses of the statue in the bottom of a safe box or in the back of a dresser drawer, I hadn’t picked it up and held it close to read the faint inscription inscribed on the base, assuming instead that it was St. Francis of Assisi because Make Me a Channel of your Peace was my father’s favorite gospel song, and because St. Francis was the only other saint I knew of outside of the Apostles. I remembered that the lettering started with a “G” and that there was an “M” and that it didn’t look anything like “St. Francis,” but I figured it must Latin, and after all, it looked like St. Francis, except that he wasn’t holding a lamb.

The years of the miniature Saint’s sequestration coincided with my years of immersion in science during which I learned about the chemistry and biology of life, and the Circle of Willis. Dr. Carlson, who was my neuro-anatomy professor in medical school sketched it out on the board in chalk, and I copied it down in red ink in my notes because red was for arteries, blue for veins, and green for nerves. He told us how, if the Circle of Willis was good, you could tie off a main artery to the brain on one side, and the arteries from the other side would fill the parts of the brain cut off from artery that was tied off because the two arteries going to the frontal lobes and the main one going to the posterior occipital lobes were connected by communicating branches that formed a generous circle in the deepest part of the brain.

So then I began to think that maybe it wasn’t a miracle. Maybe all these years of being told it was a miracle that I was alive was not true and the only reason was because I had a good Circle of Willis. Then, ten years later I sent for the medical record from The Neuropsychiatric Institute in Moorhead, MN, and ten years after that I actually read it from front to back; and, as a surgeon, having the benefit of a unique perspective on the biology of life, bearing witness on a daily basis to something that is so obviously more than the sum of its parts, I decided that it was a miracle.

St. Gerardus Majellus is what the inscription says. He is the patron saint of children, and he is with me now at work, a daily reminder of the man, whose name starts with Christ, who gave me my life in May of 1965.

The above isn’t what exactly what was submitted to NWTC. I did remove a few religious references.

The State of Obesity in America

Or, I liked this too:

Beware the Ides of March

when choosing a title for my March contribution to the NWTC newsletter, What’s Cooking.

This one was a relative quickie, only a couple of hours, but I was pretty revved up after spending three or four hours on an earlier post on another place; however, I did shamelessly plagiarise my good friend, Wm. Shakespeare.

Beware the Ides of March

Perhaps you heard the good news? The obesity rate among adult men and women has plateaued at 35.5% and 35.8%, respectively, when compared to the data from ten years ago. The bad news is that the obesity rate among adult men and women has plateaued over the past ten years, rather than decreasing. Moreover, pediatric obesity has not leveled off; obesity rates for boys (2-19yo) rose to 18.6% from 14% in the past ten years while the rate for girls remained stable at 15%.

Obesity trends have been followed by the CDC since 1960, and the rate remained fairly stable through 1980 at around 10-12% but then increased steadily to their current rates. If you include those overweight, the total incidence of overweight and obese is 68%.

I suppose it’s the old analogy of the cup being half-full, or half-empty. Maybe the US citizenry has reached the apogee of obesity and it’s physiologically impossible to become any fatter. Hmmm…not very likely because I know I could easily become fatter, and in fact have even become so despite the plateauing and my best efforts, and a fifteen pound carrot cake I made last week; but, I am only one out of 300 million, and wasn’t one of the 9000 measured.

Maybe the incidence of obesity is as a baseball thrown mightily skyward, rising steadily, pausing briefly at its point most distant from earth (this would be now) before coasting back to the baseline level of historical normal. I suppose this is possible, but we’ll need to wait ten years to find out. I have my doubts. Something changed after 1975, and I don’t know what it was; if I did, I’d probably be writing this from a private tropical island. There are plenty of suspects that I’ve previously written about; the adenovirus-36 (first isolated from the feces of a diabetic in 1978), High Fructose Corn Syrup (HFCS), which is so ubiquitous in our diet that any attempt to remove it would be akin to trying to remove the argon (0.9%) from the air we breathe, video games, the proliferation and ready availability of high-fat/high carb empty calories, etc., etc.

There have been no new anti-obesity drugs in the past decade because the ones in development proved to be too risky; one was linked to brain tumors in rats, another seemed to cause oral clefts in babies of mothers who took it, and yet another was held up because of a need for a large study about heart risks. There is still no magic pill, and the most effective surgical treatment is a fairly invasive procedure that requires stapling your stomach nearly shut, hooking up a loop of intestine to what remains, and it still requires a lifestyle modification.

Fie, on’t fie! Tis an unweeded garden that grows to seed; things rank and gross in nature possess it merely. Woe unto us! Beware the ides of March, and all that…Perhaps our national epidemic of obesity is as Julius Caesar approaching his demise on the 15th and joking with the seer on the way to the Theatre of Pompey, “The ides of March have come,” to which the seer replied, “Ay, Caesar; but not gone.” Perhaps this leveling off of the obesity rates is our ides of March…to which I would proffer, “Ay, citizenry; but not gone.”

Taking responsibility for your weight and losing weight is no easy matter; and keeping it lost does not become any easier, unless you would be so fortunate as to become infected with a tapeworm that is not of the variety that spreads hematogenously to your liver, lungs and brain. It is not the case that there is a lack of public awareness of the problem of obesity for we are literally surrounded by the evidence if not evidence of it ourselves, speaking as a formerly obese, now merely overweight, adult male. The problem is a lack of education; not that it isn’t there, but that we do not avail ourselves of it; or, if not that, then failing to act upon it.

Pray thee, take heart Citizenry. Take heart you quintessence of dust, you paragon of animals; for you are noble in reason, in apprehension how like a God you are.

 

Mr. Hayden

My monthly obligation, a burden with no renumeration other than a vicarious pleasure in suffering others the effort of my thought, ideally should relate, at least obliquely, to food, or education of some sort, or self-improvement even. Sadly, this month falls far short of that. Perhaps it’s the product of the book I’m re-reading for my book club. At any rate, for what it’s worth, I’ll put it out there with everything else. I called it “Mr. Hayden.” And, yes, I changed the name.

Mr. Hayden

After 25 years of seeing patients, there are those who’ve left an indelible imprint in my memory, as familiar as an old photo in a frame hanging in the hallway that you pass by every day. This is one of those.

In the third week of my internship I met Mr. Hayden when my team switched from the GI surgery service to the vascular service at the VA hospital. He was in his sixties at the time, a veteran of the Korean War. His hair was iron grey and cut close to the scalp, more of a stubble, as though he shaved his head but had neglected it while in the hospital. He reminded me of Anthony Hopkins in Silence of the Lambs, or I should say that Hopkins reminded me of him because the movie hadn’t been made yet.

Pale blue eyes and a square face that seemed to crack in half with a smile were further complimented by an offset nose that had been broken several times and a scar running from below the left eye down to the side of his mouth, almost parallel to the nasal-labial fold. When I pulled open his hospital gown to auscultate his lungs early that morning before rounds I saw a curious red and black tattoo over the left breast with two crossed swords and a shield with the initials “A.B.” in the center of it; there was a faded scroll below with words I couldn’t make out in the dim bedside light. I didn’t ask him about it because it struck me as somehow ominous, and besides, I couldn’t understand Mr. Hayden. He had a neurological condition that wasn’t specified in the charts that were at the nurse’s station (charts 11 of 12, and 12 of 12). He could say only simple words in drawn out monosyllables, mouth stretched wide with the effort of speech; and he moved his arms in a reptilian fashion next to his face as he talked, trying to form the words with his hands, and even that was laborious, as though he moved through an invisible medium of thick molasses.

Mr. Hayden was what we called a frequent flier. He was in about as much as he was out. His most frequent problem was severe venous stasis disease, a vascular problem from impaired return of the blood from the legs back to the heart. He had chronic ulcers on both legs that would heal up, then he would be discharged, wouldn’t comply with the treatment plan, and end up back in the hospital, often with infections and other related complications.

His body was a proving ground for interns and medical students because of his frequent visits and needs. I did my first central line on Mr. Hayden, my first skin graft, my fist unna-boot. Some other lucky resident got to fix a right inguinal hernia and I remember checking to see if I could find one on the other side for me to fix. “That’s alright, Mr. Hayden,” I said as I helped him stand at the side of the bed on swollen legs, “just turn your head and cough.” I didn’t find one.

My chief that year was Joe Long. He rolled in every morning at 6:30 with a 32oz Big Gulp Coke, and me, two other residents, and three medical students would take him on rounds. We had already written all the notes and collected all the a.m. labs and x-ray results. As we stood outside of Mr. Hayden’s room, Joe asked, “Who saw Mr. Hayden?”

“I saw him, Joe.”

“Did you like his tat?”

“A.B.?…not sure what to make of it; wouldn’t say I liked it though.”

“Stands for Aryan Brotherhood.”

“Oh,” I said, feeling stupid.

“Yeah. Seems that Mr. Hayden got into a knife fight while stationed overseas and when the anesthetist put him to sleep he didn’t realize that the oxygen tank was empty…six minutes of anoxia. When Mr. Hayden woke up, he was the way you see him now.”

“Hmm…” I nodded, “I’m guessing the anesthetist was not a member of the A. B.”

Five years of my life race by. I’m standing at the foot of Mr. Hayden’s bed. He’s recovering from a Carotid Endarterectomy I did on the right side. It’s my last day on the Vascular Service. I’m moving to the University Hospital for my final four months.

“Good bye, Mr. Hayden.” I said, “You’ve always been a good patient, and taught me much. Thank you.”

“Goh….Baaaah…”he said, with splayed fingers, palm out, straining at the side of his mouth.

New Years Resolution: Proactive

My January contribution to the NWTC Newsletter, What’s Cooking.

I think it’s healthy to begin the new year with a focus on a particular goal or goals. It may not last all year long, but, perhaps it will last long enough; and it might even change a life.

Although I’ve written a book, and a fairly hefty one at that, I never thought it’d be a non-fiction book. I really wanted to write a novel. Now that my favorite time of the year is here, I think that time might be now. That will be part of my New Years resolution to be proactive.

ProAction

2012. Another year, another raft of resolutions swirling along the treacherous river of life, bouncing off various boulders of temptation, and just as likely to careen off a cliff of calamity as it is to transiently enter a stretch of relative calm. Who knows what the new year will bring, and what does it matter? I mean, you can’t change what’s going to happen, can you?

Although there are things you cannot change, your actions and choices allows you to change the things you can, and impact those that you cannot. I think that this reality is what drives us to set goals at the beginning of the New Year. I mean, it’s a fresh start, a new calendar; it’s after a gluttonous four-week stretch of endless holidays, parties, and celebrations; and, there’s nothing that focuses your mind like a laser beam better than a barren three to four-month period of ice, cold and calm.

Proactive. That’s my resolution for the New Year; a resolution that’s all-encompassing, purposefully ambiguous so that the occasional misstep will be absorbed by the forgiving sponge of positive intent. Instead of being a purely reactive organism responding to painful stimuli, physical or otherwise, I will strive to exercise wisdom and take action before said painful stimuli actually occurs.

Instead of reacting to the pain of an inflamed, seven-millimeter ulcer at the base of my alar (nose) cartilage from a stiffened, yellowish, three-and-a-half year-old nasal pillow of my CPAP machine, I will change out my headgear every six months like Dr. Hogan told me to and like the insurance guidelines suggest. Instead of plummeting twelve feet to the bed of a stony creek while pedaling down the road with my mind on pretty much everything but the road in front of me, I will pay attention to the road in front of me. Instead of going to see Dr. Hogan because of chest pain because of starting my summer exercise program with a twenty-mile run to Murphy Park and back, I will institute a thoughtful and graduated exercise program when the snow and ice leaves the streets and the month of May’s welcoming warmth once again causes me to poke my head outside the front door.

Instead of sheepishly running into Julie at Younkers, or Barb at On Deck with a pair of 38s or 40s in my hand on the way to the dressing room, I will pay attention to what I eat and how much of it, then I’ll walk up to the counter, like cool hand Luke, with a pair of thirty-sixes draped carelessly over a brawny arm, and when asked if I’d like to try them on, I’ll say, “Aw, shucks; that won’t be necessary, pardner.” Instead of going to see Ed with a sore tooth from savagely attacking a salad in Cancun while the fork was still between my teeth, or because of a rigid dental-care regimen consisting of a good teeth-cleaning and dental exam every five years whether I needed it or not, I will see the dentist for an exam and teeth cleaning every six months, and make sure all utensils are completely out of my mouth prior to commencing mastication.

Instead of saying, “Why…it’s Thursday, isn’t it,” when Sue asks me what day it is, I will put an email reminder on my Google calendar so when she asks next time, I’ll say, “Happy Anniversary, Baybee, how about dinner and a movie.” I could go on, and on, and on. There is so much that I can do, that you can do in being an active participant in the universe. From past experience, I can say that it seems to be much easier to a passive participant, mindlessly responding to what the world and fate throws your way; but, that’s where accepting the things you cannot change and having the courage to change the things you can comes into play, and of course, having the wisdom to know the difference.

So, rather than focusing on just one thing, like losing weight, which is fine, and the most common New Year’s resolution; I’d suggest that you go large. Be proactive. Consider carefully all the steps and choices you make leading up to that goal or goals you may have for 2012, and understand and have appreciation for the power that you hold to improve the course and outcomes in each of your own lives.

Happy New Year, dear readers.

 

Frankincense

My December contribution to  the NWTC Newsletter, “What’s Cooking.”

Futher comments follow the body of the article.

boswellia sacra tree

Boswellia Sacra tree

flower

Boswellia in bloom

Frankincense

The three primary trunks of the tree twisted skywards like
arthritic arms from a common bulbous origin that welled up from a flattened
area in the rock notched into the side a ravine eight-hundred feet above the
sea. The old man rested in the shade, against the base of the tree, tired from
the climb, thinking that this trip would be his last. The tree had been in full
bloom three weeks earlier when he’d scraped away the dried resin of cloudy
amber and made the fourth and deepest vertical cut in each of the trunks.

He missed the smell of the small white flowers; five petals,
laid back, arrayed around an orangish-red center that sprouted bulbous stamens
waiting to be ravished by the birds and the bees. He rested his hand on the
scarred bark, where his father had helped him make his first cut in the tree a
lifetime ago, and settled his gaze on the far horizon. On a clear day, as most
where, he could see the tip of Sabthecha on the other side of the Gulf of Aden.
He’d never been there, but knew of it from the traders passing through in
endless caravans traveling north along the coast to Medina.

The tree was hundreds of years old, and his father had told
him how his father had taught him to harvest the yellowish clumps of levonah,
and how it would travel over land and over sea to all parts of the world, and
how the very finest, as was collected from the trunk of this very tree, would
be used by kings and queens in faraway places. He closed his eyes and saw his
mother burning the incense inside the courtyard to keep the insects away, and
then saving the ash from which she made Kohl to put around her eyes just like
the queen, Cleopatra.

The old man lifted his arm to the lowest branch and pulled
himself to his feet, grunting with the effort. He walked around to the side of
the tree where he’d deepened the long cuts in each of the three trunks weeks
earlier. He gasped, looking upwards at fist-sized tears of smoky yellowed
frankincense coating the trunks like irregular clumps of grapes; smooth,
hardened tears upon tears of a translucent gold dripping from each cut. Never,
in his forty years, had ever seen such a sight, and all through the day he
worked carefully, separating the tears of hardened resin from the tree. The
saddlebags on either side of his camel were so laden that he feared the
addition of his own weight would be too much for his old friend, and so he led
it down the trail. It was many hours into the night before he reached Moscha,
the road lit by a brilliant night sky, including a bright star just to the
north of west he’d not noticed before.

He had never traveled further than Moscha his entire life,
until then. He continued on to Shabwah the following day where his frankincense
was sorted, graded, and one fifth taken as a tax. Knowing that he would be
vulnerable to bandits, he joined a caravan of hundreds of camels. Each day he
traveled north, passing through towns that before had been only names of far
off places, and each night, the bright star seemed closer.

After many days the caravan met another from the west on the
great trade route known as the Silk Road. The two caravans stopped to trade;
the old man’s from the south of Arabia with frankincense and myrhh, cinnamon
and spice for the gold, silver, jewels and wine from the caravan out of the
west.

The night star now lay to the east. On the second night, a
group of magi, sent by Herod, approached the old man because it was said that
he had the finest frankincense of all the caravan. They told him of the birth
of a new king, and that they would give him gold for all the frankincense that
he carried, but because of the weight, they asked him to join them as they
traveled east. The magi told him it would be only one or two days more.

The old man fell into the end of their procession, and on
the second night, under the star, by a stable, one of the magi came to him, and
filled an ornamental vessel with yellow tears. The magi smiled at him. “A King
is born,” he said.

And when they were come into the house, they saw the young child with
Mary his mother, and fell down, and worshipped him: and when they had opened
their treasures, they presented unto him gifts; gold, and frankincense, and
myrrh.
 Matthew
2:11

 ***********************

For some reason, this month seemed harder than most to derive a suitable monthly topic after nearly three years of what I hope were suitable montly topics. At first, I thought about holiday nuts; walnuts, pecans, hazelnuts and almonds piled high in glass bowls sitting on coffee tables with a nutcracker sticking up in the center like a spade in the dirt. And, I thought of writing about diverticulitis because it’s so common and I see it all the time; but, then I thought of the colon and the obvious involvement of stool in that particular discussion and abandoned it.

Then I thought of cinnamon, because I like it and because I figured there’d be something unusual and interesting about it, and for some reason, I thought that Sinbad might have had something to do with cinnamon, and I remembered Sinbad from when I was little. Unfortunately, when I looked up the seven adventures of Sinbad, I didn’t notice cinnamon in a one; although I did find that cinnamon was the inner bark of a tree.

Then, last weekend when we decorated for Christmas I was tasked with plugging in a light bar behind the nativity setting that Sue had set up on top of the entertainment center. As I was threading an extension cord down the hole in the shelf, way in the back, I noticed the magi off of Joseph’s left shoulder and wondered…frankincense? Hmmm…

Well, I slipped into the wormhole of Frankincense for a few days, which involved maps of ancient Egypt, zoroastrianism (which I didn’t use), Antony and Cleopatra, Herod, the Magi, and all sorts of stuff having to do with both frankincense and myrrh, it’s just that I only had 700 words to spend and so I focused on the former.

I started to write about all the facinating things about frankincense and what it was used for, and how it was harvested and etcetera, etcetera, and quickly became bored, like I was a sixth-grader writing a report from the “F” volume of the Encyclopedia Brittanica, flipping the sentences around so that I could claim them as mine own.

Anyway, I tackled the topic more like an exercise in historical fiction, which seemed a better way of disseminating the information.

 

 

 

 

 

 

Onion Ring Week

My October contribution to the NWTC Newsletter, What’s Cooking.

The first job I ever had lasted two days. I made $36.80. I was sixteen years old and my dad asked me if I was absolutely sure that I wanted to work because once I started, he said, I’d never stop. I told him that I wanted to earn my own money; but, he was right. The night before that first day of the rest of my life Randy said, “Better dress warm.” He was the friend who recruited me for Albrecht’s Frozen Foods.

It being mid-July, leaving the house that morning in a thick cotton Tee, flannel shirt, and jeans tucked into snowmobile boots seemed, if a bit of overkill, at least consistent with the boy scout motto of always be prepared. I could already feel the sweat crawling down my back like trails of ants converging on a sweet morsel lodged in the top of my natal cleft.

I was nervous. Who wouldn’t be, on that first day? Randy was waiting for me outside and we walked in together where he introduced me to “Mabel,” and then slipped away to some cool place having to do with storage and boxes and incoming product. Mabel was in her early sixties I’d guess. She had shoulder-length, curly grey hair held down by a worn red cap that said “Built Tough” above the bill. Her face was square, ruddy, and she had a gap in her front teeth that made me think of Ernest Borgnine from The Poseidon Adventure. She just stood there looking me up and down like I was a piece of livestock she was thinking of bidding on at the county fair. “Big,” she said. I think with approval. “Follow me, son.”

It was onion-ring week. Mabel put me towards the front of the line.

It worked like this: some guy dumped fifty-pound bags of white onions into the bin of a machine that chopped the onions into slices, somehow perpendicular to the concentric rings; from the other end of the machine, sliced onions cascaded into twenty-gallon tubs filled with water; then the raw sliceswere spilled (this is where I came in) onto a grated table that was the origination of a three-foot wide black conveyer belt that carried the separated onion rings on a circuitous course through various stages around a large hot room, eventually terminating in some colder area on the other side of a wall, where they were packed into white cardboard boxes with red lettering, and stacked like bricks on metal shelves that could be rolled around on black castor-wheels.

My job was to lift the tubs up to the table, spill the onions out, toss aside the tub, and then take each of the slices and poke the rings out with my thumbs, separating each ring into however many single rings each slice was composed of and place each ring on the conveyor belt so that none touched the other. It was smok’in hot. My body felt like an extension of the onion chopping machine behind me, grinding chopping… lifting, separating…crying. I lost the flannel shirt, then the tee-shirt. I couldn’t tell if the water in my boots was from the tubs or sweat, and my eyes cried like a four-year-old sent to his room for hitting his little sister.

You might call this unskilled labor, but there is a specific aspect of the onion’s anatomy that does require, if not skill, at least a mindless persistence; and that is the fine, inner-most skin of each individual ring. That translucent, barely existent film is the reason the onion slides out of the breading when you bite into an onion ring—if that inner skin isn’t there, the onion ring bites cleanly in half. At least that’s what Mabel told me, demonstrating with a raw onion ring. She flicked the slimy remnant off her finger like a booger, “I don’t expect you to get every one,” she said before disappearing down the line.

Two hours…break…two hours…lunch…two hours…break…two hours…home. I was ready for my first break, until I got to the break room. I could barely find the clock to punch out through the thick fog of second-hand smoke, progressively thickening with each collective consecutive exhalation such that after ten minutes I couldn’t pick out faces on the other side of the table. For lunch I went outside and threw up. I skipped my second break, wanting to quit, thinking is this it?…For the rest of my life?

On the second (and last) day of onion rings Mabel asked me if I was coming back for shrimp the following week. I told her that I’d applied for a position at a grocery store, but that I appreciated the opportunity. She nodded, “You can pick up your check next Wednesday.”

I felt like I let her down. As I walked away I felt her eyes on my back and imagined her thinking…Big…and soft. Doesn’t have what it takes.

So, the next time you bite into a mass produced onion ring, and it snaps cleanly in half; know that someone, somewhere, in a hot factory far away, did a good job on that day and an angel up high, called Mabel, smiles.