On Becoming a Surgeon!: Do You Have What It Takes?

By Ian Smallman MD FRCPC

The novel starts with some Canadiana and then goes from birth through some retail, medical school, and the internship of a young man and some related adventures he has had: fights, erotica, events in medical practice, and then what happened on the day Ms. Libby Zion died (March 5, 1984)that was when many teachers and professors of medicine and surgery said that American medicine, as they knew it, had changed forever. And there are a couple of wars. There is also all the medical/surgical activities: CPR, malpractice, triage, and acuity. The way the ER should be run and much more are all updated to 2018. Through aphorisms, experts in various fields give running commentaries, and while much of a medicos (medical student/intern/young doctor) experience is described, the book comes neither with an MD nor a fellowship in surgery!

• Language: English
• Publisher: Xlibris US
• Release date: Mar 15, 2018
• ISBN: 9781984510945

Ian Smallman MD FRCPC

This might be A retired medical/surgical specialist living in Canada, with a long interest in professional journals, what happens in medical/surgical offices and ORs, teaching and the history of the two professions!

Book preview

Copyright © 2018 by Ian Smallman MD FRCPC.

Library of Congress Control Number:      2018902374

ISBN:                  Hardcover                      978-1-9845-1041-9

                            Softcover                        978-1-9845-1040-2

                            eBook                             978-1-9845-1094-5

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

This is a work of fiction. Names, characters, places and incidents either are the product of the author’s imagination or are used fictitiously, and any resemblance to any actual persons, living or dead, events, or locales is entirely coincidental.

Any people depicted in stock imagery provided by Getty Images are models, and such images are being used for illustrative purposes only.

Certain stock imagery © Getty Images.

Rev. date: 03/15/2018

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The novel starts with some Canadiana and then goes from birth through some retail, medical school and the internship of a young man and some related adventures he’s had: fights, erotica, events in medical practice and then what happened on the day Ms. Libby Zion died (March 5, 1984) and why that was when many teachers and professors of medicine and surgery said that American medicine, as they knew it, changed forever…. And a couple of wars…. All of the medical/surgical activities: CPR, malpractice, triage and acuity, the way ER should be run and much more are all updated to 2018. The rough aphorisms, experts in various fields give running commentaries and while much of a medico’s (medical student/intern/young doctor) experience is described, the book comes neither with an MD nor a fellowship in surgery!

A retired medical specialist living in Canada, Only prior writing has been medical articles in professional journals, a long interest in what happens in medical offices and ORs as well as history.

Professor Mark M. Ravitch (1910–1989), an American surgeon, historian, author said:

• No patient is too sick to have his life saved

• Never give up in acute disease

• If you are not sure, it isn’t

• Cut with the scalpel, don’t scratch

• The progress of disease is not suspended between 5 PM and morning rounds

• You cannot diagnose a condition if you do not think of it

• If you cannot figure out a patient’s problem, perhaps someone else can

• Operations can make people worse

• Just because an operation is feasible, doesn’t mean that it should be done

• All anesthetic agents are poisons – thus, the fewer the number, the smaller the dose, and the shorter the exposure, the better

• Great intelligence, and high position in a patient bear no relation to his understanding of medical problems

• The basic guideline is Would you have this done to yourself, your wife, your child, your parent?

• People have the right to die; people also have the right to die with dignity

Acceptance is the answer to all my problems today. When I am disturbed, it is because I find some person, place, thing, or situation—some fact of my life—unacceptable to me, and I can find no serenity until I accept that person, place, thing, or situation as being exactly the way it is supposed to be at this moment. Nothing, absolutely nothing, happens in God’s world by mistake.

CONTENTS

Chapter 1     Spring ’76/TYDFE/28th Anniversary/East Ontario/Canadiana/Polite/WWII/Bras/Retail

Chapter 2     July 1, 1976/Gastric Dilatation-Volvulus (a.k.a. Bloat)/Cold Hard Steel/Surgery/Change

Chapter 3     Early Spring ’78/London/London University/Japan WWII/So-called Surgeons

Chapter 4     Sept ’79/London, Ontario/Medical School/Thalidomide/C-section/Bareback

Chapter 5     Fri Jul 1/83/First Day of First rotation/intern/ER/St. Mary’s Hospital/John Milton

Chapter 6     Sat, July 2, 1983/Second Day/Triage and Acuity (Level of Care)/ Hysteria/Babinski/ER

Chapter 7     July 3, 1983/Third Day/ Flail Chest/Epilepsy/ Gonorrhea/Christmas Tree/ER at SMH

Chapter 8     July 4, 1983/Fourth Day/Picture/Koro/Jehovah’s Witnesses/GI Bleed/The ER at SMH

Chapter 9     Thurs Jul 14 ’83/Libby Zion’s death changed American & Canadian Medicine Forever

Chapter 10   Sat July 16/83/Suturing/post-operative surgical wound infections (POSWIs)/Veronica

Chapter 11   Aug-Dec ’83/The Institute/GSTP/Miss. Waters/Syphilis/Banned from ORs/Erna Dumont

For my four wonderful lovely ladies:

D, S, D, and J!

Chapter 1

Spring ’76/TYDFE/28th Anniversary/East Ontario/Canadiana/Polite/WWII/Bras/Retail

1. The power of life and death!

2. Rosebud was the name of a sled from Kane’s childhood—an allusion to the only time in his life that he had been truly happy. It is seen at the end of the movie, and because it was thought to be junk, it was being burned in a basement furnace by Xanadu’s departing staff.

3. A medico is a medical/surgical doctor or a medical student.

4. A future event referred to as having happened is called prolepsis and is like precognition and future sight and is used here so that the details of various things: cardiopulmonary resuscitation (CPR), the assessment and treatment of found-unwell individuals, the malpractice situation, and much more—will all be updated to 2018 so that the reader will see those things/facts updated to 2018!

5. An aphorism is an original thought, spoken or written in a laconic (concise) and memorable form. And while the first aphorisms were made by Hippocrates, Mark Young’s hands down favorite will be from another Mark: Professor Mark M. Ravitch (1910–1989), an American surgeon, historian, teacher, and author. And Mark knows nothing of this—at least not yet!

6. Sam managed bras in sizes from 28AA through 36 triple D to 52F.

7. The Canadian Dairy Commission is a Canadian Crown (government) corporation created in 1966 and was mandated to provide efficient producers of milk and cream with the opportunity to obtain a fair return for their labor and investment and to also provide consumers of dairy products a continuous and adequate supply of dairy products of high quality.

7.1 This is called supply management and is a monopoly or socialism—or maybe even communism?

7.2 And because of the Canadian Dairy Commission, Canadians pay twice the amount that Americans pay for dairy products!

7.3 On April 19, 2017, in Wisconsin, President Trump will complain that Canadian dairy farmers and their supply management/monopoly is hurting American dairy farmers.

7.4 Canadians will get similar price increases in the 1970s and ’80s when poultry and egg farmers will each get their own monopoly and because of that, Canadians will also be paying twice the amount that Americans pay for all these goods!

8. The connection most Canadians have with their cold wintry landscape is well expressed by Québécois singer-songwriter Gilles Vigneault in his 1964 song entitled Mon Pays. It starts with Mon pays ce n’est pas un pays, c’est l’hiver. (Translated: My country is not a country, it is the winter.) It is a key chanson in the Québec canon and has political significance. And while Benoît L’Herbier in his book La Chanson Québécoise describes it as a Québec anthem, if there is one, Vigneault repeatedly denies having intended to compose a Québécois anthem!

9. Three centuries previously and in France, Voltaire had much less positive thoughts about Quebec/Canada—that

9.1 it was and will remain an unproductive and useless piece of frozen wasteland,

9.2 it consisted of a few acres of snow,

9.3 and that when you write your name in the snow, you say nothing!

10. Other Canadians, and mainly Anglophones, many who spend their winters in Florida, say about the weather in Canada, Ten months of winter and two months of poor sledding!

11. While Canada is often portrayed as being north of the 49th parallel, that is only half of the story: the western half that is!

11.1 The eastern half is the Great Lakes and a line just south of the St. Lawrence River.

11.2 An estimated 75 percent of Canadians live within 160 kilometers (100 miles) of the Canada-US border.

12. The Glasgow Coma Scale is a reliable, objective way to record a person’s level of consciousness, both to start and for followups assessments.

13. While Canada’s sacrifices and contributions to World War I changed its history and enabled it to become a sovereign nation,

13.1 Canadian soldiers/airmen/sailors in World War II showed the world that Canada was and still is a nation-state.

14. How the other half lives!

15. A retractor is a surgical instrument used to separate the edges of a surgical incision so that body parts in it can be operated on.

16. Time magazine will have a full edition on July 17, 1989, that will document and show a picture, if possible, of all the Americans who had been killed with firearms in the previous week and will call this the Seven Deadly Days! In that ordinary week, 464 Americans will have been killed with firearms, and times 52 means ~24,000 Americans/year are being killed with firearms, and usually for no good reason!

16.1 Time magazine will say about that week: In the end, there is a sense of embarrassment, even shame! How can America think of itself as a civilized society when, day after day, the bodies pile up amid the primitive crackle of gunfire across the land?

16.2 A similar issue about a week of deaths caused mainly by firearms had been done by Life magazine on June 3, 1969 – a twelve-page article with the names, some details, and sometimes a picture of each of the American soldiers who had been killed in Vietnam in the previous week. North Vietnam and the Viet Cong had killed 212 Americans during that week, and Americans had become quite upset about that!

16.3 And then, in that week, a couple of decades later, when more than twice that number (464 Americans) will have been killed with guns by their own citizens, nobody was seemingly that upset! And then and, because nothing was changed, nothing changed!

16.4 And in 2013, the latest year for which the Centers for Disease Control and Prevention (CDC) will have data, it will be shown that more than 33,000 people (more than 635 a week) in the United States will have died from gunshot injuries that year and that more than 84,000 will have survived with such bad injuries that many of them will require ongoing care for both physical and mental health problems!This is a very large number of individuals becoming invalided/crippled: 84,000/52 means more than 1,615 a week!

16.5 The NRA will be saying, The only thing that stops a bad guy(s) with a gun is a good guy(s) with a gun!

17. The potato chip salesman will say that a buy-in is a necessary first step in being able to do things with/to/for someone else! And that means that the other person(s) is agreeing/concurring/accepting (i.e., buying-into whatever is to be done). David Novak—in his 2012 book Taking People with You: The Only Way to Make Big Things Happen—stressed the importance of the buy-in.

18. The price point is the price at which the demand for a given product stays relatively high versus being too high; and because of that, not much product is being sold.

>>   Now eighteen years of age and for the previous two years, Mark Young has been working toward the goal he had set for himself, and he has already accumulated $55,000. He has a couple of accounts with a brokerage firm in Toronto, and the smaller of the two holds his more conservatively managed money; and in the other, he does day trading. And while he now mostly beats the market, his first year had been very brutal and quite expensive for him; but in the end, it had been a valuable bit of schooling for him. Mark has always been a good student, and he learned much from those lessons and so that he now mostly makes money with any of his day trading!

Mark always liked the idea of money—having more than enough to live well: to be independent and to be able to do whatever, whenever, and wherever he might want (i.e. the power of being rich). And if he had known that by 2018 the top wealthiest 1 percent people on the globe would possess more than 50 percent of the globe’s wealth, he would have known that he was heading in the right direction (i.e. towards more money and more power).

And then one day, Mark heard a strange expression in his head; he had been thinking about the power of money when he heard the power of life and death! Mark didn’t know where in hell those words had come or what they really meant!

"The power of life and death!" might actually be like the word "Rosebud" in Orson Welles’s 1941 film (spoiler alert) Citizen Kane, which was said early in the movie. And while the word was said throughout the film, it was only in the final scene that attentive viewers were shown what Rosebud was … and so what it really meant!

>   Mark is the main person in this story, and the story will be in part the education of medicos (medical students and young doctors) and will use prolepsis (a future event referred to as having already happened) and is like precognition and future sight. And so the details of various activities, such as cardiopulmonary resuscitation (CPR), the assessment and treatment of found-unwell individuals, the malpractice situations, and much more will be updated to the year 2018!

>   Each chapter starts with a preliminary page written in smaller print and is like Coles Notes in Canada, CliffsNotes in the US, and York Notes in the UK. It is a peek at what is to follow; and after that chapter has been read, it is a summary of much of the information that had appeared in that chapter. These pages don’t have to be read to fully understand what is happening in that chapter.

A >> and a ">" are used frequently and indicate a big or a less big change in thought or story line.

>   Mark’s abilities to study and learn present him with bits of information that he uses to go through his various situations; and while some are just facts, many are aphorisms, which are original thoughts, spoken or written in a laconic (concise) and memorable form. And while the first ever medical aphorisms were made by Hippocrates (460–370 BC), Mark’s hands-down favorite will have been expressed by Professor Mark M. Ravitch (1910–1989), who is a surgeon. But Mark knows nothing of this, at least not yet!

>   It has been a good year for Mark and his family. It is early spring of 1976 and the twenty-eighth anniversary of The Young Dairy Farm Enterprises (TYDFE)—a large family-owned and run dairy farm and dairy produce–manufacturing enterprise. They have hundreds of acres almost all overflowing with pastures and crops on the many farms that they had bought up from other farmers who had then been seemingly heading to better situations—actually, many of them had been dairy farmers, and that had mostly happened before 1966. That was the year when the Canadian government established the Canadian Dairy Commission that mostly gave dairy farmers a monopoly (socialism or maybe even communism)—i.e. the key to the billfolds of all the dairy-produce consumers in Canada! The Canadian Dairy Commission also started charging large tariffs and duties on all milk products, and because of all that, Canadian dairy-product consumers pay more than twice what Americans (who don’t have a similar monopoly) pay for their dairy products south of the 49th!

TYDFE had actually been a fairly profitable business even before 1966, and many of the farmers whose farms they had bought weren’t!

On their homeplace, the Youngs have many huge barns and other farm buildings and a staff of fifteen-plus employees doing the farming: the fields and crops along with the feeding, managing, and milking of more than a thousand cows twice a day.

The processing takes place in another set of buildings on a farm next door (one that they had bought early in their expansion). It is an on-site factory with a skilled workforce of about twenty, and they make more than twenty different quality dairy products there, including milks, cheeses, ice creams, yogurts, and butters. These are then sold through many retail outlets that include local variety and grocery stores and in stores in and around Ottawa and in a few other communities further afield, like London, Ontario.

TYDFE is located in Eastern Ontario, 80 miles southwest of Ottawa, Ontario, and 550 miles east-northeast of London, Ontario.

London, Ontario, is the Young family’s home community, and a couple dozen Youngs still live there.

>   Jim Young had been a sergeant in the Canadian Army in WWII, and after the war, he brought Betty, a Glaswegian, home to Canada as his war bride.

Mark remembers his mother telling him that the first time she had ever visited anywhere outside of Glasgow was when her Canadian soldier had taken her off to Edinburgh and how worldly he seemed—like when he told her that Glasgow’s and Edinburgh’s latitudes were both 56° North. And as such, they were much farther north than any major Canadian city (Montreal, Quebec; St. John’s, Newfoundland; Halifax, Nova Scotia; Fredericton, New Brunswick; Charlottetown, Prince Edward Island; Quebec, Quebec; Toronto, Ontario; Winnipeg, Manitoba; Edmonton, Alberta; Regina, Saskatchewan; Ottawa, Ontario; London, Ontario; and Vancouver, British Columbia) and that all those Canadian cities have much more significant winters than Glasgow and Edinburgh—i.e. many months of significant subzero temperatures and much snow. In fact, the two main differences between these Canadian cities are (1) how much lower the temperatures had been and (2) which had gotten the most snow that year—except for Vancouver, British Columbia, which usually has next to no subzero temperatures or snow. But in the winter of 2016–17, and likely thanks to global warming, it will get months of both.

map%20%23%201.jpg

Details of Canada; Find 55th parallel (north) at left middle edge and follow it back through Canada: Glasgow is located just north of this parallel

At some point in their relationship, and having to do with latitudes, Jim had found a world map showing latitudes and longitudes (that will be ever so easy to do when the internet will finally arrive), and that map made his educating of Betty so much easier!

The connection many Canadians have with their cold, wintry landscape is well expressed by Québécois singer-songwriter Gilles Vigneault in his 1964 song Mon pays:

Winters in Canada have long been known to be a factor in the life of the people who live there, starting even three centuries previously and in France, when Voltaire had expressed some very negative thoughts about Quebec/Canada:

1. it was and will remain an unproductive and useless piece of frozen wasteland;

2. it consisted of a few acres of snow;

3. and that when you write your name in the snow, you say nothing!

Other Canadians, mainly Anglophones and many who spend their winters in Florida, say about the weather in Canada, Ten months of winter and two months of poor sledding!

Even Edmonton, Alberta (the most northerly major city in Canada), is more southerly at 54° North than Glasgow and Edinburgh and most all of the other major cities in Canada: Montreal, Quebec; St. John’s, Newfoundland; Toronto, Ontario; and London, Ontario are all at 50° North or more southerly, mind you, the capitals of Canada’s three territories: Yellowknife in the Northwest Territories at 62° North; Whitehorse in the Yukon at 60° North; and Iqaluit in Nunavut at 64° North are all more northerly than Glasgow and Edinburgh.

Jim also said that in Canada and just north of 56° North (Glasgow’s and Edinburgh’s latitude), there is the small community of Churchill, Manitoba (59° North), where the Churchill River flows into Hudson Bay and where the Inuit build igloos and mostly hunt and live off the land and where, before ice has formed on Hudson Bay and after it has melted away, many polar bears roam through the city. And in the future, and because of global warming, the ice in Hudson Bay will form later in the fall and disappear earlier in the spring; and so even more polar bears will be in that town for longer periods of time, and that will make Churchill, Manitoba, the polar bear center of the world—at least for tourists! And because of the thousands of beluga/white whales (nicknamed sea canaries for their strange high-pitched whistles, clicking, chirping and other underwater vocalizations) that inhabit the waters coming out of the Churchill River and into Hudson Bay, Churchill could also be called "the beluga whale center of the world"!

>   Jim explained that the reason why none of that happens in Glasgow and Edinburgh is the relatively warmer temperatures in Great Britain compared to in Canada at that same latitude, and that difference is caused by the Gulf Stream and its northern extension toward Europe called the North Atlantic Drift. Starting near the tip of Florida, this powerful warm current comes up north from the Caribbean, follows the eastern coastline of the United States and then of Nova Scotia and Newfoundland, Canada, before crossing the Atlantic Ocean. And so it makes Great Britain and Western Europe somewhat warmer than Canada at the same latitudes.

And even when her Canadian sergeant had taken Betty to London, England, on their honeymoon, he had told her that London, England, at 51.5° North is also more northerly than most major Canadian cities!

>   And while maybe not meaning to, Canadian soldiers swept many Glaswegian females off their feet! And while these Canadian soldiers were like Mark’s and his friend Sam’s fathers and had had next to no regular scholastic education, save maybe for some geography and map-reading skills, math, and the ability to write and read English, they had been very able and handy at getting things done or at least keeping things going, and that included carpentry, painting, plumbing, roofing, heating systems, and the like.

And that was what Canadian soldiers mostly did for the British people until they were sent to mainland Europe to fight—either in Sicily/Italy starting on the tenth of July 1943, as had happened with Mark’s father, or on the sixth of June 1944 in France for D-day, as it had with Sam’s father!

Early in Jim’s time in Britain, his squad had been sent to Glasgow to teach the locals, including Glaswegian women like Betty, how to shoot Germans with a rifle—if the war would have gotten that bad. And at the time, who knew?

Betty had been such a bad shot that Jim swore that he would never let her shoot any of his guns ever! And since Betty didn’t like or want to shoot guns, that was how and what she had just very successfully done!

>   When Jim and Betty came home after the war, they knew that they wanted to be dairy farmers and have a big farm, and so with some government help, Jim and Betty bought their first farm in eastern Ontario and at a very good price. Mark—their self-proclaimed money man—was much impressed with the deal his parents had gotten. Jim and Betty had been very happy and were very ready to work right hard, and they did!

>>   Jim had worked on that mostly-dairy farm for three years before he joined the Canadian Army in 1939. Actually, when Jim had started working there, the farm had been doing a bit of everything: a so-called mixed farm and did next to nothing really well, and that included some dairy.

And while the dairy part had been a problem for the farmer—neither of his sons wanting to get up to do the 5:00 a.m. milking—after Jim’s arrival, that wasn’t a problem anymore. And thanks to the father’s experience and knowledge and Jim’s enthusiasm to learn from him and other farmers and do the work—like milking twice a day—the farm then mostly became a fairly successful dairy farm with a little bit of a few other things thrown in.

Near the end of those three years, that farmer’s wife caught her husband easily and for himself alone, accepting praise for how well his dairy farming was doing; by that time, his farm was producing the largest amount of milk per cow and had the highest milk butterfat levels in the community. It had actually been one of the neighbors who had told Jim that feeding cows a consistent and constant diet was a good way to maximize milk volumes and butterfat levels. And so that was what Jim had been doing, and it worked!

>   Actually, those three years had been a vocational school for Jim. And while that farmer had been pleased with Jim’s work during those three years, he was then also so very pleased that Jim was going to war and his sons weren’t, that he promised to help get Jim get started if and when he might come back and wanted to farm! That farmer and his family had lost many family members and friends in the previous world war—the so-called "Great War" (a.k.a. the War to End All Wars) and in the end just called World War I—that they didn’t want to lose anybody more to any war, especially not their two sons!

While the farmer’s two sons had seemingly wanted to join the army, they weren’t allowed because farmers and their families were required to work their land for foodstuffs as part of Canada’s war effort, and anyway, their parents wouldn’t have let them!

That farmer and his wife had memories of the slaughter that had been WWI for Canadians; more than 68,000 Canadians were killed, and so many others were terribly crippled—the guns, the gases (disabling chemicals, such as tear gas, to lethal agents like phosgene, chlorine, and mustard gas), the conditions in the trenches and on the battlefields, the mano a mano fighting and the almost constant machine-gun fire. And so this farmer and his wife were wondering whether Jim would survive his time in the Canadian Army and in this world war—or not!

>   Jim did; they did and in a big way. That farmer sold the farm to Jim and his new war bride i.e. the farmer and his family liquidated all their assets in order to raise money to invest in something else, and it seemed that the sons must have heard and believed the song by Reuben and Rachel—the one that had been published in Boston in 1871 and then became popular again starting at the end of World War I and was entitled How Ya Gonna Keep ’Em Down on the Farm (After They’ve Seen Paree)? because even before Jim had come home from Europe, the sons had already been eyeing life in the nearby big city of Ottawa, Ontario. And when they got the money for their farm, they quickly moved and bought into a couple of businesses there.

>   At that time, dairy farming was not making anybody rich. In fact, that was yet another reason the old farmer was quite happy to sell his farm. The story for dairy farmers—actually, for many Canadian farmers at the time—was that if any one of them had won a hundred thousand dollars (1976 dollars), they would have used it to keep on farming for a few more years until they had, and maybe finally, run out of money again!

In 1966, a bright new future for dairy farmers started—the Canadian government created the Canadian Dairy Commission, a Canadian government Crown corporation under the Canadian Dairy Commission Act. It made dairy farming in Canada a monopoly, with the prices mostly being set by dairy farmers themselves!

On April 19, 2017, and while in Wisconsin (dairy farming country), President Trump will complain bitterly about Canadian dairy farmers and their supply management (a.k.a. monopoly); he will say that what Canada has been doing to US dairy farmers is a disgrace and a disaster and that he will correct that, and very quickly!

As of early 2018, he still hadn’t!

>   The Canadian government will then do the same thing for poultry and egg farmers. They will each get their own monopoly—the Canadian Egg Marketing Agency in 1972, the Canadian Turkey Marketing Agency in 1974, the Chicken Farmers of Canada in 1978, and the Canadian Broiler Hatching Egg Marketing Agency in 1986. And at the same time, the Canadian government will also put large tariffs and duties on all chickens, turkeys and eggs coming into Canada, such that Canadians pay more than twice what their neighbors south of the Canada-US border do for all these goods!

>   Once back and safe in Canada, Jim taught Betty even more about latitudes; that roughly 3,500 kilometers (2,175 mi) of the Canada–United States border had been intended to follow the 49th parallel north from British Columbia to Manitoba on the Canadian side, and from Washington to Minnesota on the US side, but that the definition of latitude was/is a little loose in that the actual marked border wanders north and south of that latitude over a band of about 100 meters wide. That is the western side and the eastern side is the Great Lakes and a line just south of the St. Lawrence River.

And while it is called the world’s longest undefended border, that is true only in the military sense, as civilian law enforcement is present.

It is illegal to cross the border outside border control stations, and it will be in the winter of 2016–17 that Canadians will first face the situation of many refugees from various hard spots in the world, starting with mainly from Somalia, illegally crossing that border. Once in Canada, they can request asylum in Canada and will be housed and fed over the next half dozen months while their request for asylum is investigated by the Canadian government! If these individuals had tried to cross through any of the border control stations, the guards there would have just turned them back.

>   This is a situation that the US has had for many years on its southern border with Mexico and not only people from Mexico but also from other Latin American countries.

That will mostly start big-time in about 2010 for Europe—so many refugees (in the millions) coming from the Middle East and Africa.

>   Now, 1976 and a quarter century plus after Jim and Betty’s coming home and while most all of the dairy farmers in Canada and in Eastern Ontario are doing quite well, mainly thanks to the Canadian Dairy Commission, the Youngs are doing even better—actually, very much better. The five owners of TYDFE include Jim and Betty and their three children—all boys. Douglas (and not Doug) is twenty-four years old, muscular, and blond; and he looks like Jim. Jake is twenty-three years old, medium built, and has brown hair and looks much like his mother. The youngest is eighteen years old. Mark is red-haired, tall, and almost gangly, and doesn’t look at all like either of his parents. And from early on, he seemed to know right quick what he really didn’t want to have that much to do with; that started with the farming and its cattle and ended with the on-site factory, but the bookkeeping and the making of money part seemed to be to his liking.

>   And while the older two sons were born in the late morning and so interfered with the dairy activities of only one of the parents (Betty), each had settled quickly after their delivery, and each had seemed a little unhappy for the bother they had caused by their delivery. The youngest son, Mark, arrived at 5:00 a.m. and so kept both of his parents from doing their parts in that morning’s milking. And while her first two boys had settled quickly in the evening and slept all through the night and had to be awakened for cares and feeds in the morning and matched Betty’s thoughts on how and what Canadians were like (polite and nice), her youngest was demanding from the get-go. He rested only for several hours at a time, and it seemed to take him a really long time to accept any new situation in his life, and that started with the fact that he was out and alive and not still warm and comfortable inside his mother’s stomach/belly!

Every time Jim and Betty will hear the Bill Crosby monologue about the birth of two of his children—the very good one and the very bad one—they remember how much Mark had been and still is very different from their other two boys. And when Betty says something about it to Jim, he agrees and then sometimes, when the devil is in him, he jokingly mentions the single farmer two miles up the road who is a real go-getter and is tall and redheaded, a little gangly and so looks a little, if not a lot, like Mark in appearance. But Jim doesn’t do that very often or for very long, and then he usually says that he is sorry, that he hadn’t meant anything bad. And when he does that (be nice and apologetic), Betty recognizes that she had indeed married a true Canadian!

And then in 2015, the Young family will throw all their Bill Crosby albums out when Mr. Crosby’s sex scandals and the charges against him will become known to them!

>   Having lived in the rough and tough streets of Glasgow, Betty had been really struck with how polite, apologetic, and kind Canadians were compared to some of her fellow Glaswegians, especially the Canadian soldiers and that specific sergeant whom she married, except maybe when her Canadian sergeant jokingly mentions that single, tall, redheaded farmer.

Glasgow%20Coma%20Scale_GS.jpg

The scale is composed of three tests: eye, verbal, and motor responses. The three values are separately considered (as well as their sum). The lowest possible GCS (the sum) is 3 (deep coma or maybe even dead), while the highest is 15 (a fully awake person who can move and is oriented).

>   A few years later—and Mark doesn’t know this yet—he will tell his mother that her Glasgow was and still is one of the most violent, if not the most violent, city in all of Europe. And so it was no wonder that the Glasgow Coma Scale (GCS) had been developed in there. It is a scale of three neurological signs (eye, verbal, and motor) that gives a reliable, objective way of recording the conscious state of a person—and not only for an initial assessment but also for subsequent assessments. i.e how badly a poor sucker had been beaten up or whatever and then whether he is getting better or worse. And seeming to demonstrate that Glasgow is still that way, Betty will tell Mark a Paul Ferris story.

Paul Ferris is a famous/infamous Glaswegian gangster who had then became a journalist and an author. The story was that Ferris had taken the handgun that wouldn’t fire from an assassin who had been paid and given that gun to kill Ferris with, and then Ferris physically beat that man to death with it!

Funny, but there is a seemingly somewhat similar story about bringing a knife to a gunfight and who should/would win that fight!

And while Portland, Oregon isn’t known to be a rough place, in 2006, a man will hire a hit man to kill his wife, and the wife will then end up killing the hit man with her own bare hands.

The sergeant in the Young family will also have a Glasgow story to tell—that in the 1980s, rival ice cream truck drivers in Glasgow, Scotland will be selling drugs and shooting at each other from their trucks in something called the Glasgow Ice Cream War!

>   The Youngs had gotten to be so good at it all—the dairy, and then the processing—that they had money and started buying up farms and more farms in the area and then gave some of these farms to their sons as properties each owned outright.

The Young Dairy Farm Enterprises frequently gets visitors from other places in Canada, south of the 49th parallel, and even from countries a little farther afield and who had come to learn and then to mostly copy some of TYFDE’s ways.

>>   Jim had been born in London, Ontario, into a family of fundamental Christians who wouldn’t do any unnecessary work or play on Sundays: not even reading, except for the Bible. And then at the age of sixteen, Jim had been hired by that farmer up near Ottawa, and that family didn’t have Jim’s family’s fundamental religion and beliefs. And then three years later, in 1939, he had joined the Canadian army and had fought in both the Italian and then the Dutch campaigns and had just crossed the Rhine River into Germany when Germany surrendered. Jim had been noticing that while some of his fellow Allied soldiers seemed quite religious—they carried Christian bibles, prayed almost every day, and attended church services whenever possible—that there were also well-used Christian bibles written in Italian and German that had been carried by some of the dead, wounded, and captured Italian and German soldiers. And so it seemed to Jim that the Christian God was fighting and killing on both sides, and so, no matter which side won, the Christian God would be on the winning side!

Strange, and while working those three years on the land back in Canada, Jim had sensed something much bigger than himself, something spiritual, something that he had never felt on Sundays with his family—neither in their small church nor in their tiny parlors. And then during the fighting in Europe and after having seen more than just a few deaths and being in strange, different countries, almost took Jim to a somewhat similar spiritual place that he had experienced when he had been working the land back in Canada. His world had become so much bigger and more different than his previous life back in London, Ontario. And then things and words from his family’s religion came back against him, words like parlor! And even his son Mark, who had not really spent that much time in London with Jim’s relatives, found that that word also gave him somewhat unpleasant feelings and not just expressed in the English language.

It is strange how things in childhood can somewhat cause certain activities in adulthood and how parents unconsciously influence their children. In his adult years, while Mark will do almost anything on Sundays like work a job, cut hay, play cards, or do surgery, he will never cut his lawn on Sundays. It would be an unnecessary thing for him to do on a Sunday, and if he did it, it and he would have been out there in everybody’s face doing it. And then, when looking at houses in Paris, France, and when he will see that one has a "petit salon," he will have such bad feelings for that house that he and his wife will not even go to see it. Petit salon is French for the English word parlor!

>   Talking about Europe and spiritual places, Sam Jackson, Mark’s best friend, will tell stories about his working and becoming more knowledgeable during the summer of 1975, and that will have happened to him in a brassiere manufacturing plant in London, England. The company will be Lovable, and a relative of his in Britain will have gotten the job for him.

When Sam had first come over to tell Mark and Mark’s mother that he had a job working a summer in England, and before giving any more details, Betty said something strange; she had actually previously said that their fathers had both gone to Europe as soldiers/warriors and had helped saved Europeans—actually, people from all over the world—from what had been a very bad situation in something called World War II and that some of the forefathers of those Canadian soldiers had done the same thing when they had gone to Europe in 1914 to fight in what is now known as World War I. And she said that those two wars, especially the first one, had been a big step in Canada finding its identity as a sovereign nation, and she thought that some of Sam and Mark’s generation would likely return to do even more in that part of the world. And funny, none of them was seemingly thinking the obvious: World War I, then World War II, then World War …? But when Betty then learned that Sam would be sorting and packaging bras (from size 28AA through 36 triple D to 52F) and shipping them to retail outlets, she looked at him and said that that wasn’t one of the "even mores" that she had thought that they and their generation would also do in Europe, and they all laughed.

Betty continued that both of the world wars would always be with them, that they had been well educated in school as to what had happened over there and that many Canadian soldiers/sailors/airmen had fought, and many of them had paid the ultimate price with their life. And then, when Betty suddenly realized that she was sounding a little more profound than was usual for her, she smiled and whispered something in Sam’s ear that Mark didn’t quite hear—something that sounded almost flirtatious/sexy, and then the two of them laughed! Mark thought it was something about bras or maybe panties, and since he was already a little embarrassed by the whole situation, he didn’t ask his mother to repeat what she had said because it would have likely embarrassed him even more.

>   Mark’s mother’s remarks about the world wars were very true; and while the two boys had been well taught and had learned a lot about those wars in school, but and like most Canadian households, neither of them had ever heard much from their fathers about their part in WWII. Mark had tried a couple of times by asking his father a few questions about his being a Canadian soldier fighting in Europe—once when he was about ten years old and then it had been to know about how many Germans that his father killed and while his father could be a quiet soul, he was an even quieter one that day and so the conversation hadn’t really gotten off the ground.

The second time Mark asked was when he was fourteen years old, and he had just learned in school about the Canadians fighting the Battle of Monte Cassino (17 January–18 May 1944), and he asked his father if he had been there.

It had been after supper, and no one else was in the house, and Jim nodded a yes and went on to say that Monte Cassino had been the historic hilltop abbey founded in AD 529 by Benedict of Nursia—and with the emphasis on had been. The Allies had bombed it to hell because they had been concerned that the Germans had been using it to see what the Allies were up to and would possibly use it as a place from which they could shell them. It turned out that the Germans hadn’t been doing any of that, and the abbey has since been rebuilt.

Jim had then said that while the fighting in Sicily and southern Italy hadn’t been that hard—the Germans had not been fighting that fiercely such that when the Allies put some pressure on a position, the Germans would usually retreat. But things really changed when the war arrived to an area just south of Rome, where the Battle of Monte Cassino was fought. It had actually taken the Allies four different battles (attacks) to finally break through the German Gustav Line. Jim said that by that time, the Germans were fighting much more vigorously and weren’t retreating as easily or as quickly as they had in Sicily and southern Italy, and the Allied generals were also a little different in that there were fewer free days between attacks and that these Allied generals seemed to want an almost continuous pressure on the Germans.

Jim explained why there had been changes:

1. While the Germans had initially been trying to stop an invasion of an ally (Italy), by the time they got to Monte Cassino, the Germans knew that they were now fighting to protect the Fatherland.

2. And as for the Allied side, the generals back in England were getting ready for the D-day invasion into Normandy and wanted as many Germans as possible elsewhere in Europe i.e., fighting in Italy.

Funny, but Mark will get several good aerial looks of the rebuilt Monte Cassino in a few years—actually twice a year for several years!

>   A few months later, another war story brought Mark to talk with his father. It concerned a nice Dutch family he had just met. The family had just immigrated to Canada and had moved into the area. The mother had told Mark about the Dutch famine of 1944, and she used the word hongerwinter, which she had translated to hunger winter. She said the Germans had caused it by cutting off food shipments to 4.5 million Dutch citizens living in the cities from the surrounding farm areas, and that the Germans and the starvation they had caused killed about 22,000 civilians and had made millions quite unwell.

The woman had said that the Allied forces, including Canadians, had stopped their advance into that part of Holland in the early fall of 1944—just down the road and so, not too many miles from where the German-engineered starvation was killing Dutch civilians and causing many of them to be in such bad straits that they sold/traded anything and everything they had, and even themselves, to get food. The Allied/Canadian forces didn’t liberate this part of Holland until May of 1945; and while it had been really hard times for the Dutch in that area for nearly eight months, the Dutch were so very happy to finally see the Canadians arrive and drive the Germans out that even by that battle’s seventieth anniversary in 2015, it will be very difficult for anybody wearing a Canadian military uniform to spend any money there—everything will still be totally free for any and all of these individuals!

The woman mentioned that she had met the actress Audrey Hepburn. She had been in the area during that time and had said that because of that winter of next to no food, that she suffered from a degree of continuing ill health that includes anemia, respiratory illnesses, edema, and depression—and all the while, the Canadians had been camped just down the road, and they hadn’t done anything!

>   Mark’s question to his father was this: Why didn’t the Canadians liberate the area sooner? So many were terribly sick and some died!

His father agreed that the Canadians knew about the starvation, but it was their commanders who hadn’t ordered any attacks or military operations any sooner than they had. Mark could sense a feeling of sadness in his father, and the conversation stopped. Mark will only more fully discuss World War II with his father after he will have flown over the rebuilt Monte Cassino.

>   The Dutch mother did say that at least one good thing came out of it, and that was that one of her sons had gotten the diagnosis and a treatment of a terrible condition mainly because of that period of starvation. Before the war, that son had been the scrawniest of her five children and had had frequent bouts of diarrhea. During the starvation, wheat had been in very short supply, and that son had then started to look a lot better than he had been previously and was having no diarrhea. And then, after the Canadians had liberated that part of Holland, and when he again started eating food made from wheat, he again became sick with terrible diarrhea, and it was the famous Dutch pediatrician Dr. Willem Dicke who had then told this mother that her son had celiac disease and that it was caused by an allergy to the gluten in wheat and that, in big part because of that starvation, he had been able to demonstrate in many young people that gluten allergy was indeed the cause of celiac disease. And after that, her son hasn’t tasted any wheat ever again and has become her biggest and strongest son, and for that, she is ever so glad!

>   Sam’s situation with his father and the war happened quicker—much quicker. And in the end, he will have asked only once and that was when he was about twelve years old. He had asked specifically about Juno Beach. His father’s response was two days of anger and continuing foul language, and shortly after that, his mother quietly asked Sam to not ask any more questions ever about the war. And he didn’t—not ever!

>   The summer Sam had worked in Lovable was with >300 seamstresses who mostly worked on their sewing machines in a huge hall, and a big part of his job was to put the bras they made—from size 28AA through 36 triple D to 52F—into appropriate packages, and then put these packages into boxes and ship the boxes to retail outlets that were mostly in the US.

While on the job, Sam met Joan, one of the seamstresses and a Londoner and while Sam had already been to Scotland and Ireland, Joan had never been anywhere else in Britain except for a couple of beaches in the south of England and never on the continent. And then one day, she told Sam and her fellow workers that she was going to France to see how the other half lives.

That statement confused Sam a bit, and Sam was usually not easily confused. If France is the other half, then Britain is likely the first half; and so where in the hell does Canada and he fit in?

Joan did take a ferry across the English Channel to France and camped for three days at a place called Juno Beach, and while there, she had visited a couple of small villages, but not any towns and certainly not Paris. And when she came back to London, she said that France wasn’t any better than England; in fact, there were nicer beaches in England than Juno and that there hadn’t been much to do in Juno, just the sand dunes and the water and some monuments about which she hadn’t learned anything—at least not until Sam educated her!

>   Sam knew! He had always liked history, and he knew that 369 Canadians helping to defend the rest of the world from Führer Hitler (and Emperor Hirohito) had been killed there on June 6, 1944. Sam knew a lot about Juno. He had been told that his father’s personality had dramatically changed there, and that on that day, he had gone from being a really fun-loving and friendly guy to an angry and bitter solitary man.

Like Jim, Tom had signed up to fight in Hitler’s war, but instead of fighting in Italy, as Jim had, Tom was in the Third Canadian Infantry and landed on Juno Beach on the sixth of June 1944 as part of the D-day invasion of France. Tom had joined the army with a couple of close friends; they had trained together, had had fun together, and they had been booked to fight together on Juno Beach. Everybody called them the three musketeers: see one and the other two were usually close by.

Juno was to be their beach to play on. They were in the first assault, but within minutes of hitting the beach, Tom’s two friends had been shot dead by German machine-gun fire. Sam had learned that each Canadian soldier in the first assault had a 50/50 chance of being killed—such was the potency of the German machine-gun fire. Since his friends had been on either side of him and had been killed, Tom couldn’t understand why he hadn’t also been killed. He lay on the sand beside them, seemingly wanting to die also. But he didn’t, and he wasn’t afraid –he just wanted to be with his friends wherever in heaven or hell they were!

His sergeant came back and practically dragged him farther up on the beach, and that was when Tom realized that the enemy—the people who had just killed his two best friends in the world—were the German soldiers who were shooting their machine guns down at them from fortifications high in the sand dunes at the back of the beach. And that this was France, and the French had not invited the Germans into their country; and when the French had told them to leave, they didn’t!

Tom then applied some of the learning he had gotten and had become so skilful at using; and while he would later say that he didn’t have a death wish, he did rush and help destroy two German machine-gun nests with grenades—a machine gun in one or the other of those two nests had killed his two friends!

He then successfully got through the German lines and was killing Germans left and right from behind. The Germans had never thought that they would be attacked from behind their line, and so their response after one or two of Tom’s bullets had hit them was to be mainly dead. It was only when there were no Germans still alive and holding a rifle that Tom stopped shooting. It took Tom a bit of time to settle down, and everybody was congratulating him for what he had done. And while Tom was told that he had killed nineteen German soldiers that day, Tom was quietly saying to himself that that wasn’t an acceptable exchange for his two buddies—at least not yet!

>   Later that week, Tom was given twelve German prisoners and a machine gun and told to take the prisoners to an area a couple of miles away where prisoners were being kept; but halfway there and at the bottom of a gully, such that no one could see what was going on, there was thirty seconds of machine-gun fire. And when Tom came up from the gully, he said that they had all turned on him and he had no choice but to kill every last one of them!

>   After that day, a couple or more soldiers in the Third Canadian Infantry who wanted to come home alive started travelling with Tom—actually travelling well behind him and his deadly weapons! Tom was armed to the teeth with things that would mostly explode—a machine gun, a sniper rifle, and several handguns that included a Luger he had found on a dead German that first day and at least ten grenades. And not only did he kill with bullets and shrapnel, but he also dispatched a few Germans with the blade of his ten-inch hunting knife that he carried on his belt!

Tom would often see Germans on the horizon that the other Canadians with him couldn’t, and he would usually prove that by shooting one of the Germans, and there was always a dead German there showing that he had been right. The Canadians who travelled with him—but a little behind—carried replacement grenades and ammunition, set up his camp, fed him, did some work on his Luger, and guarded the camp overnight while he slept.

The Canadian commander knew a good thing when he saw one; he said that Tom was a scout and used him and his few associates to help protect one or the other of his flanks, usually the one with the most risk of having problems. He would just let Tom go hunting, knowing that wherever he went, all the Germans there would soon either be dead or captured!

>   Tom had been an only child, and maybe he had been born with a rifle in his hand; his delivery had been such a long and painful one that his mother thought that he must have been carrying a rifle when he finally did come out. And after that, and while she said that she didn’t want any more babies, she actually would have loved to have more, it would have been the deliveries that would have really, really bothered her!

At a young age, Tom had joined his father in running the farm: ploughing, cutting and trashing the grain crops with horses and by hand versus with the machinery that farms will be using in the future.

The Jacksons also sold services to their community to increase the farm income in that while farmers and their families mostly ate quite well and were usually warm and reasonably well clothed, they did not have that much money "to buy things" with. One of the services the Jacksons sold was the clearing of properties and buildings of rats, and since the main rat poison (warfarin a.k.a. Coumadin) will not be invented until 1948, they used ferrets and their excellent shooting to do that!

>   The province of Alberta has had a somewhat similar program for clearing rats for decades. Old World rats, a.k.a. black and brown rats, are not indigenous to North America (nor Europe), and with a combination of rat poisoning and rat-shooting on their east border, permafrost to the north, and the Rocky Mountains to the south and on their west border, Albertans are proud to say that Alberta is the only province in Canada that is totally rat-free!

>   The Jacksons would arrive at the site in the morning and, with their rifles off safety, let their ferrets loose and watched as their ferrets scurried around and under the bigger buildings, keeping an eye for any rats their ferrets would put the run to. And remembering the saying "the only good rat is a dead rat," they would shoot any escaping rats dead with their rifles. They would then tip the smaller buildings and shoot anything that popped its ugly little head out.

In clearing a property of rats, it is important that all the rats be killed because if just one pair of rats is still alive after all the other rats had been killed, that pair could/would quickly repopulate the area with rats—many rats. And even rats that had escaped the property/buildings and had gone into the woods would often come back and repopulate the area, and so the killing of rats heading for the woods was also very important.

The Jacksons had learned that their ferrets really liked chocolate, and so when the day was finished and after they had hung a couple of pieces of chocolate in their cages and did something like what the Russian physiologist Pavlov had done, and which he called "conditioning," ring a bell, that would bring the ferrets quickly back and into their cages to eat the chocolate.

The Jacksons had a standing offer of a second day of killing rats at no additional charge if rats had repopulated the property/buildings within