May 2018 – Before I Forget…

May 30, 2018May 30, 2018

My Very Own Court Martial

One of the dangers of war is that daily you realize that the enemy may not be your worst enemy. When you return from a war zone, it is amazing to see the handwringing done in the nightly news over casualties from friendly fire, when we who were there knew that about half the stuff flying past our heads was from our own misdirected guns and bombs. Teenage soldiers racing their supply trucks run them off cliffs, heavy boxes being swung in nets from helicopters break loose on people below, and a guy who had just returned from patrol slaps his rifle down on the table. The gun goes off, and shoots his best friend in the belly. In a war zone, negligence is everywhere.

In early 1969, we’d just been reassigned from sleeping in the mud at night and smelling burning excrement in the morning and being glad at all times when the pop-pop of gunfire was happening somewhere distant on our hill. My last shower had been weeks ago, in a jury-rigged system consisting of a poncho catching rainwater overload and punctured to create small streams so you could wash yourself with a minimum of water. We’d been bargaining at dinner time for specific cans of the usual rations with the peaches and the pound cake, and passing the Tabasco sauce which flavored everything savory from those cans. A good bar bet now is on the contents of these C-rat packs that we ate over and over again until their variety was a tasteless routine.

However now, because we were reassigned to a ship, we were given silver napkin rings. Oh yes, silver napkin rings! Containing white linen napkins! How cool was that? They escorted us Marine officers to the Junior Officer’s Mess on the Iwo Jima, a helicopter landing craft which would a few years later pick up the lucky, resourceful astronauts from the ill-fated Apollo 13 mission. On this day, of our first meal afloat, the naval officers sidled down to their (clean) end of the linen tablecloth because our camouflaged clothes were worn and torn and were very grimy from the bush. They tried to make polite conversation and we tried to avoid wiping our mouths on our sleeves out of habit. Filipino mess stewards served us soup with silver ladles from fine china tureens. In those days the Navy did things this way. Oh, I guess we Marines were part of the Navy, but they didn’t look too glad to have us. We were Special Landing Force Bravo, reconstituted from a shot-up battalion. We would be doing helicopter landings, hopefully by surprise, to help out when large scale shit sandwiches inevitably developed somewhere onshore in Vietnam. But meanwhile we were sitting 10 miles out on calm seas…safe and so big out here you could not feel the ship rock at all.

Real beds with real mattresses and little reading lights. And a desk. And my first hot shower in months. This was almost like R &R…until it wasn’t. I had a communications platoon this time, and much of my work shipboard was getting radios reconditioned and batteries inventoried and check-listing the hundred important little things. Important, because if certain tasks are left undone, no one can call for help. Radios could make sure everyone was where they ought to be. Without radios no one could replenish food or ammunition…what you had you had until it was gone (, and soon thereafter, you may be gone). And without radios, you were sometimes at the mercy of shouting distance in a storm of surround-sound. At battalion HQ, we practiced the radio checks, to be done every 15 minutes. Radiomen had little pads with duplicates to rip off when their radio check had been made. I thought it was a waste of time, but my gunnery sergeant told the men their ass was grass if they didn’t do a radio check every 15 minutes and so I didn’t make any contradictory statements. Chapter-and-verse is often a way for sergeants to maintain order and stifle a thousand pesky questions.

The Brigade even introduced to us a portable ground-surveillance radar with which an operator in the bush could sweep a quarter mile area at night and by listening to the length of the pings back he could tell if someone was out there. It was very much like submarines and destroyers use to detect each other by sonar waves, but this was on land and this could be carried on someone’s back. Later, onshore, we tried it out once. We were out looking over some area at twilight to set up this for a test, and we started getting some sniper fire. We didn’t like to get caught out like that, with night falling. Anyway, we lay low while this operator pinged around, sweeping back and forth in the night, and finally he told us where the pings seemed most interrupted. I called in mortars from back in battalion on that place on the map where no one was supposed to be. The sniping stopped. The next morning they found blood trails away from that spot. The only person I ever killed that I knew about…and that was just a maybe. Strange feeling nevertheless.

So anyway, onboard with our first Special Landing Force there was fair amount of preparation work, but also a fair amount of leisure. The men were in tight but comfortable rows of racks below. One guy in my (intelligent) communications platoon was a chess hustler, and won thousands of dollars off the Navy sailors who thought no Marine could be that smart. At night, our battalion commander had the whole battalion out on the (small) carrier deck in red lights running laps of about a quarter mile each. Helicopter landing ships weren’t as large as the jet carriers by any means, but they were not small.

When the word went out, we had about an hour to saddle up and line up combat-loaded for the eight-person helicopters which would take us into Vietnam once again. As I remember, we were hoping to surprise a North Vietnamese Regiment that had some Army regiment pinned down. If they did not know we were coming, we could land and step off and skitter untouched to assembly points in the trees. That was ideal…a cold landing zone. If they knew we were coming, they would probably be shooting at us all the way in, and create a virtual screen of fire across the flat landing zone which might or might not explode the helicopter before it touched down – with us in it. So as we lined up eight hundred men through the winding passageways below deck, to emerge and run to waiting choppers on deck, nerves were pretty intense. It helped a lot that Joe Namath won the Super Bowl that day.

I’ll always remember that first landing, because the upstart New York Jets from the upstart American Football Conference were playing the old established Baltimore Colts of the old established National Football Conference. Joe Namath, a colorful quarterback at all times, at this time predicted the impossible, that his new upstarts would beat the Baltimore Colts. The world waited breathlessly for the outcome, and it came when we were in line for our first Special Landing Force mission to bail someone out of deathly trouble onshore. The whisper started when some Navy guy picked up the final score on the radio: “Jets won…Namath did it.” Those phrases were repeated mouth to ears throughout the catacombs of the ship where men and weapons stood in line to face death, and a little cheer swelled up. It happened! Somehow Namath beating the Colts made the whole day right, uplifted us all…

On the way to a mercifully cold landing zone, bullets from below went “pop” through the skin of the helicopter. We all pulled radios or other boxes, anything at all, to put under our seats to keep from the bullets coming up from below. Out the front of the helicopter we could see the beams of machine gun tracers 500 meters apart. Those guns had a tracer every 4 rounds so they could see where they were shooting. 500 rounds per minute. The tracers formed a moving crisscross in the sky ahead, and we were flying right into the “X” of it. With experienced reflexes the pilot moved up and down to avoid the total concentration of fire as we clung to our seats and marveled at his skill. I suppose this is in some computer game now. Maybe it would not be as thrilling as an oaf with a chainsaw, but it was thrilling enough. We were all very glad to touch ground, even though we had no idea if our situation would be better or worse in the next minute.

During the week we set up and dug in and coordinated with the Army unit which had been in trouble, we set up radio operators with command and the companies. We used code names. For instance, Command was Mystic Circle and the companies would be Mystic Circle Alpha, Mystic Circle Bravo, and Mystic Circle Charlie. We referred to each other remotely by those names and not by real names, if we knew them. This way if one operator went down and someone took his place, that station was still the same name. Sort of interchangeable parts.

On the other hand, the Army merely handed the radio to whoever was doing nothing else at the time. When we needed to coordinate with an officer, they said they would go get Larry. I kid you not. The troops called their officers by their first names. Some might consider that egalitarian, but experienced military called it deathly. One can only wonder if this breakdown in decorum led to the breakdown in discipline that led to Mi Lai and other ghastly mistakes. The military chain of command is not just there to make riff-raff fall into line and obey orders they may not wish to. The real chain of command is unspoken but realized through the sternly dedicated examples of officers seen all the way up the order of things. This command example empowers troops, clear down to the lowly private, to take initiative within the lines of proper decorum. It is one of the unwritten rules of war.

I recount this in such detail because it was at the roots of the time I was almost court martialed wrongly. A few years before, Korean Marines had laid a minefield in a certain area and then were pulled out without deactivating the mines, or even completing a detailed map of where they were located. The villagers, however, were watching closely when the Koreans placed the mines, and so knew exactly where not to walk. They wouldn’t let their kids play near these areas. They wouldn’t even let dogs run wild in these areas, because any shrapnel form an exploded mine travels a long way at high speed. The villagers knew where the mines were. However, they would not always be kind enough to tell a new generation of Army soldiers or Marines where the minefields were. It was not entertainment. It was loyalty to a family member who might be Viet Cong. And there were a lot of those.

One company of Army soldiers was planning on going into an area already secured and evacuated months before, and the wise thing to do was to find out from the previous Marine units where the mines were. The Army company was in a hurry and whoever was supposed to coordinate the minefield locations did not. Four soldiers lost their lives when they went on the wrong side of a village, and two more lost their legs. They wanted to blame that on the Marines for not getting them the information. Apparently they wanted to say they had no contact because our radio net was down when it should have been up.

As the Marine officer in charge of the communications platoon it was my duty to set up and maintain a radio network with all surrounding parties and maintain that net through all 24 hour periods. I was called to a meeting in the Army compound two weeks after the unfortunate minefield incident. They would send a Huey Cobra helicopter to pick me up. Before I got on the chopper, my gunnery sergeant handed me a stack of duplicate radiocheck forms. They were about 3 x 4 inches, roughly the size of cards people used to make card files out of, before computers. I shoved them in the top of my camouflage shirt. “They may be after your ass,” he said. ”I’ve seen the Army work like this before. They’re trying to hang this on someone else.”

So the meeting loomed more than just a curiosity to me. Sure enough, I was brought into an Army tent, and three senior officers were sitting at the table, including my Battalion commander. “We need to have your testimony on the maintenance of your battalion radio net on March 27 of this year.”

“Yes, sir, we maintain a radio net at battalion 24 hours a day.”

“Well,” said the Army colonel. “We need to know specifically about the afternoon of the 27^th. Some crucial information did not get to one of our units, and they say your net was not operative.”

My battalion commander squirmed a little, and said “I communicated over that net several times that afternoon.”

“Ah, but was in operation all the time, or were there significant lapses of hours, when we needed the coordination?”

I could see right now that they were trying to narrow me into a corner where I had to say I honestly did not know if the net was up and running that whole time.

“I was in and out of that area, but we always have someone manning that station.”

“We’ll need proof, Captain.”

And then I remembered, and felt for the stack of receipts my gunnery sergeant had handed me.

“I don’t believe the Army uses our radio net method,” I said. “So in the Army it would be difficult to have proof of constant operation.” The Army Colonel nodded, a bit smug, I thought, as I pulled out the stack of receipts. I showed the top one which was a 10:15 radio check from the pad.

“But in the Marine Corps we have radio checks noted by the station every 15 minutes, traffic or not. This is the day you want, I think,” and I began to lay the radio checks out on the table in front of the investigation board. The Army colonel’s eyes were big. My battalion commander’s smile was bigger.

“So you see,” I continued, slapping down the pieces of paper one after another. “We were not contacted by your people on March 27.”

The Army colonel waved his hand in despair, meaning the meeting was over. Many months later, back in a small ceremony in the States, they pinned a couple of medals from Vietnam on me. To no one’s surprise, one was a Navy Commendation with a combat “V.” However, to everyone’s surprise, one was an Army commendation medal, undoubtedly due to their political embarrassment.

Some days are actually fun.

May 27, 2018November 9, 2018

Travels with a Baby in a Suitcase

Certain people are always offering stale advice like “Do what you love and you will never work a day in your life.” Pretty easy blather to throw out, when even most popular singers and movie stars end up working more for the money than for love of their material. However, hopefully there is a point in life for most people where they feel like what they are doing is for a larger benefit than personal applause or maintenance of a family, as worthy as those may be. Some say that kind of work has “psychic benefits.” At that point the product you present takes on a newer, higher, better life. You are not seen as just “trying to make a buck,” but appear be making the world a better place.

I arrived at that point somewhere in the CPR saga around 1982. All of the political bridges had been crossed: if it could be done, let’s do it. So we did it and proved it and the Pittsburgh Health Sciences Group (one of the top in the nation) made an excellent study of the effectiveness of this CPR system compared to standard live instruction. 33% more effective. And the Long Island Rescue establishment tested it and said that because the CPR Learning System created such a high standard, firefighters who tested on that CPR system had to qualify only once in two years rather than every year . And the Canadian Armed Forces bought our second system.

The CPR Learning System, with its hands-on simulation of a heart attack victim, started to win random media awards, because nothing close to it existed to show the possibilities of interactive training and testing. Thus it started to get written about. Shortly thereafter, I spoke at education conferences at Harvard and computer software conferences at M.I.T. The U. S. Congress’ Office of Technology Assessment was heavily influenced by Harvard and M.I.T., and on their say-so put the CPR System up for Congressional Testimony to show the possibility of such leading edge medical certification.

For all of the interest, it was not feasible to drag the whole system – manikin, computer, display screens — to every show, but I was fortunate to have done it on a few early trips. Luckily, a few news agencies generated excellent quick stories that I could could show with high credibility. For instance, when I showed the system to a Congressional committee on New Technology, a CBS news crew was next door in the Sam Rayburn congressional hearing room for the Abortion hearings. They were trying like mad to find a visual angle to describe that dilemma, and a few of them wandered over at 9:30 to see this me — in a suit, on my knees on the floor — hooking up a manikin to a computer for the 10 o’clock session.

Instantly the CBS news producer saw that our CPR simulator was going to be a visual story. They quickly got permission to tape my appearance with the system rather than slog through the Abortion hearings. Ordinary people cannot believe the whirlwind efficiency of these national TV camera crews, large cameras being placed, close ups taken of the screens for later editing in, cables rolling out around me to all corners of the room. It dawned on me that this had a history, that theaters clear from Shakespeare’s time had employed sailors to handle all the rigging of the curtains, just as they had sails in commerce and war and exploring the world. Now the ropes were cables and the sailors were TV crew, and rather than travel the world on explorations, what they explored here with their cameras would be going out across the world. Diane Sawyer made it a feature story on her evening newscast. (Just let Diane Sawyer do the talking….)

As a consequence, I was invited to make talks for all of the year 1982. Medical conferences wanted to see medical simulation; Computer conferences wanted to see a realistic simulation controlled by a personal computer; Training conferences wanted to see the teacherless training; Education conferences wanted to see the future of education; and Consumer Electronics wanted to see what this interactive stuff was all about. During 1982, I really chalked up some flyer miles. I was flown to some conference about 2-3 times a month to show (a little) and tell (a lot) about this new system. People were quite interested for their several reasons, but I had an underlying pressure.

What lay underneath these public forays was the need to find someone to take this orphan on. I was made the Director of Advanced Technology Development for the American Heart Association, and now I had to find a secure home for this phenom. I wrote a patent on it, but someone had to fund commercial development and sell it to the public. Someone had to continue testing and publicity and all of those things a glittering new project needs to sustain itself past the first “Wows.” The AHA could not run a small business – or so they were advised – and so we had to find a business partner to carry the CPR System forward. My dual purpose, then, was as an evangelist for this kind of interactive simulation learning, and as a rainmaker to keep the project from dying prematurely. That meant hitting the conference circuits while the invitations were hot. Popularity Based Marketing, for lack of a better term.

I remember when American Airlines put the CBS story (about the CPR system in Congress hearings) with their short subjects preceding the inflight movie. I was living in Dallas, but I would get calls from drunk friends across the country who had been on coast-to-coast flights and awakened to see me in front of their faces. That footage also came in handy when I was giving keynote talks in faraway places, but did not want to travel with the whole shebang. After the Congress show I almost never took the Resusci-Annie manikin, because the airlines wanted to charge for an extra seat, or extravagant onboard shipping which would cost almost as much, with those heavy crates. Diane Sawyer’s short news story was enough to show gist of the system, but people wanted to see a bit of the real thing. Enter the baby…

Luckily, we did have an Infant Resuscitation model and I could carry this Resusci-Baby and an Apple II computer in my baggage, along with hookups for TV monitors. I needed to show how the manikin interacted with the computer through a special serial card to give instant feedback on the monitor, so we made a dedicated program just to demonstrate how the sensors from parts of the baby gave feedback that you would see on the screen as a computer graphic. The baby created some special challenges for us, since you could hold its small body in your hands to do some of the rescue work. When it had an Airway Obstruction, for instance, you were supposed to have the head down and feet up and to gingerly slap its back to free the airway obstruction. (A Hiemlich maneuver would, of course, injure this small a person.)

To sense this Airway Obstruction maneuver, the computer had to know the baby’s position in space, and whether its back had been slapped just enough to dislodge any obstruction, but not so much as to hurt the child. The computer could sense this impact. We had much of the positioning of the baby sensed by a series of mercury switches, which sloshed around in a circle when the baby’s head was down correctly. However, believe it or not, one of the main problems we came up with was how to end of the lifesaving procedure, when all the moves had been made and breathing had been restored and the little heart (with air puffs pulsing through its artificial veins) was beating just fine. A happy ending doesn’t just happen by magic…

Then what? How do you clear the screen and start over? We thought of adding a button. On the light pen touch screen (full model) you just touched a box that said “Quit.” But with this traveling model we needed a quick and easy way to start over and let interested spectators try a little hands on after the presentation. We tortured with how to do this, and then one afternoon it became obvious — to someone I think was the janitor. He was cleaning up and watching us go through our mental gyrations, and just blurted: “Shake the baby.”

Of course, Shake the Baby…and the program starts over. A lot of people who saw the demo in public thought that was — AHA! — a brilliant and elegant solution. Some cell phones’ flashlight features start now by shaking and it is probably the same kind of mercury switch. To think: this slightly awesome feature of smartphones today may have actually come from a bystander 30 years ago seeing us Shake the Baby to clear the screen. Conference attendees talked as if we must been geniuses. Little did they know.

As I’ve mentioned, this traveling setup called for me to carry a videotape clip of the whole system (thanks to Diane Sawyer), plus the Apple II computer and the actual baby manikin. It was always possible to have a monitor or screen provided wherever I spoke, if their A/V people could follow specifications, and there were only a few emergencies there. And then there was me carrying my baby in a suitcase…

Possibly the most fun on almost every trip was carrying the baby in a suitcase, setting the case on the conveyor belt, and watching the eyes of the security people when the X-ray displayed its contents. In many cities, the security guards pulled me aside to open the case for them, and a few times they called for backup, I guess in case I was a serial pedophile killer. Some security guys in San Francisco slammed me against a wall and began frisking me, causing the person standing in line behind me to say, “Wish I’d said that.”

I actually began to look forward to that return part of each trip. Visiting each new city brought forth a new set of reactions: some unique like nearly falling from a chair, some vocal (Holy…this or that), some clandestine like pushing a red emergency button with a straight face, and quite often gathering other security personnel to make a group decision on what to do about this threat. However, as they say, you can go to the well too often.

And then there was Dallas, where I lived and worked for the American Heart Association. Leaving on one trip to New York, with my practiced nonchalance I placed the suitcase containing the baby manikin on the conveyor belt. And watched out of the corner of my eye for it to appear onscreen, and, hopefully, disturb the tranquility of this routine job. A black security lady was on top of it. And me. In a very laid-back manner she said “Is them things wires, or veins?”

Tough question. I gritted my teeth: “Veins.”

She smiled, not quite the Mona Lisa wryness. “Well that’s OK, we just don’t want any of those bombs with wires in them going through here.”

Veins were apparently OK.

May 19, 2018May 19, 2018

Adios to a Continent

Our trek through South America quickened its pace when I finally had a guaranteed job at in September. This meant we had an actual schedule and an actual itinerary to see the southern end of South America from June through August…Not a breakneck pace, but one with a beginning and an ending. What did not seem to change was the ever presence of paramecium. It was in all the water that washed all the fruits and vegetables, and we inevitable got a helping of those bugs once a week, though we tried to eat only raw fruit like mangos and bananas and things with skins. Fresh vegetables were harder. We only occasionally peeled carrots and all vegetables had to be washed and therein lay the presences of the paramecium. I started out at 180 pounds and ended up at 159, svelte and fast but afraid of the most nutritious foods. Sure they made fresh potato chips and donuts, fried in grease right there on the street, but most meat and cheese and eggs were always suspicious, meaning we could eat none of those with relish and no risk.

After becoming the Ambassadors of English in Peru, we headed by train across the continent to Lake Titicaca and an overnight boat on that huge inland lake, to La Paz, Bolivia for a few days, and then flew back to Arica, Chile. We rarely took flights in South America, but occasionally it made sense to save time and trouble, especially when the local airlines were less than the cost of a hotel room. There was a reason for that. First of all, many South American nations used their Air Force as a commercial airline. This drove down costs for all carriers and was kind of cute in the way the crew stood at attention as the passengers made their way across flat dirt airstrips and up the flip-out stairways in old two engine DC-3s. Secondly, these airstrips doubled as lower division futball fields, undoubtedly to the surprise of pilots and/or players if the schedules became confused.

When we landed in Arica, Chile, our taxi driver took us to his uncle the street banker, and he gave us four times the bank rate for our American Express traveler’s checks. Then we got on a bus that took us 24 hours across the northern Chilean desert. We stopped a few times in what looked like a state park barbecue shed, and drank exquisite white wine with the other passengers from a huge clay vessel, suspended by ropes so that you could tip it into your cup. Then at night we stopped at a small fishing village and tried the Congor Eel, its large diameter cut in steaks of flakey meat. Fresh fish and white Chilean wine, all for about a dollar.

What we were about to find out – first from rumor, of course –was that Chile was a bargain if we used our Chilean money, escudos, there in Chile. Because of some political and economic skullduggery, our absolute haul of escudos would become almost worthless when converted to Argentine pesos. After scoring big time on our traveler’s checks through the Mercado Negro in Arica, Chile, we ended up with cash that would drop 75% in value when we finally crossed from Santiago to Mendoza, Argentina. Funny, that was possibly the value we started with when we entered Chile.

We got off the bus in Santiago and started calculating. We needed to stay just a week in Santiago because we were on schedule to make it back to Oklahoma. It was the early part of July, and my first college teaching job started in a little over a month. We’d approached South America with some leisure up to that point, but now we were more like tourist, on a timetable, than nomads following the seasons. If we did not spend our pile of Chilean escudos here in Santiago, in a week, they would be worth only a quarter of the buying power we had right now. It was logic inescapable. We would have to blow that money here in Santiago. Holding our two pieces of luggage, we asked our cab driver to recommend a hotel.

“Barato?” he said, also as an assumption as he looked at our cloths and somewhat ragged bags. They were used to Gringo wastrels asking for a “cheap” hotel.

“No,” I said. We pointed out the window to a tall building on the skyline of Santiago. “Is that a hotel?”

It was a hotel. The best in Santiago. Taking us there, I knew he would expect more of a tip than he first estimated from us. When we stopped, he took our threaded bags from our laps like they contained precious glass crystal, and made the doorman take extra care stowing them on the roller cart.

The desk attendant in this very best of Santiago hotels was about to tell us that they had no rooms available, and then he saw our wad. “We do of course have the Presidential Suite,” he said, sure that we would not be able to afford that. “But,” he said, “It even has a grand piano for entertaining, and a small dance floor leading out to the balcony.”

“Who was the last President to stay here?”

“Strossner.”

“I guess we’ll take it.” I said. Strossner was the ex-Nazi who had taken over as dictator in Paraguay and ruled with iron tentacles around the whole region. The desk manager was shocked.

“You didn’t ask the price.”

I laid down a wad of escudos. He nodded. We who had been riding dirty buses and chasing rats out of small pensiónes and drinking only soda pop were now turning the tables. Tough life…but you understand, we had to spend the money.

It was a gorgeous view of the city. We dropped our bags in this vastness of luxury. Couches, bars with real liquor. Tapestries on the walls. Carpet inches thick like walking on cloud in heaven. I, who had who had learned the boogie-woogie in two years of teen piano from an always tipsy local piano teacher, was fastest to the piano, and started giving it the boogie-woogie workout as the bellman waited for his tip. Brenda, who had won school contests in piano, waited patiently to take over with Beethoven’s 9^th.

There were real showers and bathtubs with gold fixtures. The toilet had a telephone extension on the wall beside the commode, which told us that powerful people never slow down. We found later that this suite had another bedroom and another bathroom, but unfortunately we knew no one in Santiago to invite. The ultimate party suite and no one to party with.

We had questions for the concierge. What is the best place to eat in Santiago? (He got us reservations) Where are the best clothing stores? (He made a list of streets where we should go shopping.)

So we ate…well. And we walked down the streets of Santiago’s boutique clothing stores like masters in need of regal drapery. Brenda got a green trench coat made of goat leather. I got a blazer and slacks and shirts (which, because I was so malnourished at that time, I could not wear after 6 months back in the States). That experience of buying anything you saw, staying at the top of the town, walking around expensive streets with money to burn…This should be accorded every human being once, so that it will never be an aspiration that exceeds family and community and real personal accomplishment. That’s what I think, anyway.

Another momentous event was happening, though we had little knowledge of the particulars. Salvador Isabelino del Sagrado Corazón de Jesús Allende Gossens (or Salvadore Allende to most of us) was elevated, with his socialist party, to the leadership of Chile. All through South American the young people felt the Chileans were the intellectuals of South America, and were ever so excited about his Marxist programs which froze prices and gave living wages to the poor. Allende even nationalized copper, one of Chile’s main exports, much to the despair of our President Nixon at the time. One of the sights of a lifetime I should remember is standing at twilight on the balcony of the Presidential suite in the best hotel in Santiago, drinking aguardiente and looking out over a large hill which hovered over the city. Lights strung across the whole hillside came alive in the encroaching darkness, and in large vibrant letters in the night, they proclaimed “Cobra es nuestra.” (Copper is ours!)

It did not dawn on me then, or for some time, how ironic it was to be standing there on the balcony in the best room of the most plutocratic hotel in Santiago, capitalist pigs from the US sipping our drinks, oblivious to the fact that a vast world was changing right front of us.

Turns out the depreciating escudos still didn’t last us more than four days – four really fun days – and then we had to fly over the mountains to Mendoza, Argentina and spend like normal pobre travelers again. Mendoza brought us back to earth when the plane landed. Things once again cost what things cost, instead of a fraction of expectations. A lovely piece of Argentine beef cooked over hot coals and a glass of wine with it cost over 7 dollars. What a shock!

To follow our schedule we took the Argentine national railway 24 hours across the pampas ( which looked for all the world like West Texas) and into Buenos Aires. Funny thing about that railroad. It seemed like something in a nation’s infrastructure that would always be there. However, recently I was brushing up on my fledgling Spanish and talked to someone on the Internet in Cordoba, Argentina. Someone in their twenties, it turns out. I said we liked Mendoza and had taken the train across to Buenos Aires. He sounded confused.

“What railroad?”

“Your national railroad from Mendoza to Buenos Aires.”

“There is no railroad across Argentina there.”

“Of course there is, I rode on it.”

“There has never been a railroad there.”

“How can that be?” I said, and excused myself from what I thought was one of those many prankish exercises young people indulge in on the Internet.

He was not wrong…Well, he was wrong, but had no notion that there ever could have been a railroad there. None of the Argentina history books were allowed to cover the real story. The real story is that the railroad went on high government subsidy and was dissolved by a political party, which then handed choice lands over to developers as quickly as the railroad ties were pulled up across Argentina. Someone as old as we are may be the only ones who remember, and we are easy to ignore by a country which did not want to admit such a failure.

So we did ride the railroad, and came into Buenos Aires in the dead of winter. A beautiful city to explore with its lush parks and tango clubs, but by then we could give it only a few days on our diminishing itinerary. We bargained for some stopover tickets through a thoroughly corrupt travel agent, and plunked down nearly the last money we had on earth to get back to Oklahoma (- which might tell you a bit about our total prospects). We were able to go from Buenos Aires to Montevideo, Uruguay, whose residential streets looked like a vintage car museum. Turns out they put about a 4x tariff on any new cars, but had no tariff on car parts. So they just kept the old ones, pre-1940s, in great condition and running perfectly. The middle class teenagers who I grew up with in the 1950’s were always rebuilding cars, and they would have dearly loved Montevideo.

From Montevideo we went to Asunción, Paraguay, which had its black market bartering big Hotel Guarani on all its money rather than some political hero. The President at the time was Strossner, an ex-Nazi immigrant who took over every element of the government and created Dakotas, huge cartels which daily brought flights of Boeing 707s full of transitor radios and other highly taxed imports, to be distributed by mule back through the back trails into all major countries in South America. The Ricos (rich families) in every country owned stock in the Dakotas and profited from those, while keeping normal tariffs very high on imports because – of course – they controlled most of the government except in Chile. (That was resolved shortly after we came back, with a coup in Chile in which Pinochet brought the Army in to occupy the capital, and Allende committed suicide as his dream socialist state of South America was relegated to history’s many backwaters.)

Iquazu Falls is one of the world’s spectacular waterfalls, absolutely worth getting drenched in its volume and majesty. From there we bused to Sao Paulo, to which so many Japanese at the end of WWII had fled that it looked like a Japanese city the size of Kyoto or Osaka. Rio was gorgeous on the beach and up the sky tram to Sugar Loaf as we ran down to almost our last dimes. Brazilia was a stop along the way, a new and empty city build by the government back in the interior to be the new government of the new Brazil. I hear it took many years to fill it up, after almost being a laughingstock of one President’s vision.

Manaus was the last city we touched down in before Miami. It was on the Amazon river and had the look of a temporary encampment…but one in which they were already building an opera house. This was years before the fictional guy made the ball field in Kansas hearing “If you build it they will come.” Apparently they did come to Manaus, as it is now a city of over 2 million people on the Amazon. It now seems amazing what can happen to places in your own lifetime. You turn away and when you look back a river stop is a metropolis.

Next stop, Miami. The problem we had been wondering how to avoid was that Brenda could not come in to the States legally. As my wife, she would have to wait outside the States 4 months for a green card. We stood there in the customs and immigration line, contemplating a quick divorce. (For the rest of the story, see “Dostoyevsky Meets the Anadarko Indians” .)

May 7, 2018May 7, 2018

On the Outside Looking into the Insides

The history of medicine is thousands of years old, but one thing remains constant: the curiosity of the physician. Surgeons would linger around battlefields looking for open wounds in soldier’s abdomens, to get a last look at a working organ. Of course, they could see corpses anytime, but most were shriveled or putrid or rigid with formaldehyde. There are stories of men who recovered from wounds but did not have their abdomens or stomachs totally closed, and they sometimes hired out to medical schools so the students could observe the live body in action. Certain things like eating and digestion had to be managed, of course, but it was not a bad living being a unique specimen for student observation.

For many centuries, surgeons trying to understand the human body (and hopefully fix it) tried to see inside. This is where the idea of a scope came in. Doctors felt they could safely make a small hole and stitch it up later, except when they ran into a bone…or an artery. But they could not see for two reasons: They were looking for small anomalies, and there was no light inside the body. For centuries physicians experimented with channeling candle light through a straight scope, with lenses in the scope for magnification. One can only imagine that sometimes doctors got their ears burnt as their eyes tried to peer through the scope at the same time.

The age-old curiosity still persists, but now doctors can see more, and even perform procedures inside the patient, under full view, with adequate lighting. One of modern medicine’s miracle tools is the flexible scope, by which physicians can explore around in various tubes and cavities such as the stomach, lungs, bladder, and the colon. The tip of the scope has a light and a lens in it, and the user manipulates dials to turn the scope head in various directions. Spies and criminals also use these flexible scopes of course, to worm around corners in internal housing ducts, to see through air vents and hear privileged conversations, but that is a story for mystery magazines, and my experience was in medicine. Not that I was a doctor or paramedic or anything remotely medical except that I took Latin in High School and was able to pick up a lot of medical words pretty quickly. Because I could say Endoscopic Retrograde Cholangiopancreatography in one breathe I could then abbreviate it to ERCP and even medical practitioners were glad to abbreviate that.

There are other ways of seeing inside a body, of course, with x-rays and various scans, and in some cases, such as angioplasty, it is possible to perform procedures inside remote veins and arteries. These days there are jazzy illustrations drawn from CT scan “slices” and it is possible to see your insides in almost realistic fashion. Almost, but not quite. The blood is not real. The bodily fluids do not sheen their sickly green, and the organs do not writhe with the pulse of life. And few doctors would be comfortable performing remote procedures on tissue they had only seen in cartoon representation.

The endoscope however, provides a real view directly on the inside passages. Various tools and baskets can be inserted through that tube to accomplish various routine procedures in a few hours that would have been quite risky under the surgeon’s knife and would have taken weeks or months to recover from. Colonoscopies are a good example, wherein the physician can spot cancerous polyps and burn them out – cauterize then – on the spot. All of this is very routine stuff now, and yet somehow doctors have to learn how to do it on live patients. Pushing and twisting the scope inside an intestinal tract can be dangerous in the hands of a novice. Puncturing the abdominal wall means a rapid trip to the operating room, and sometimes death to the patient. Our answer was to provide simulation to novices, so that their first hands-on procedures with an endoscope were not risky to unknowing patients.

We took on a simulation project with Merck Pharmaceuticals that was at the outset merely a promotion for shows, and for doctors to work with the scope outside of a patient before they invaded the patient with the tip of their scope. We were to build not only a training endoscope, but the simulated physical and video environment through which it traveled. In some ways, it was similar to flight simulation, with the tip of the scope “flying” through the internal passages with the point of view provided on video, in the same way it happens with the actual endoscope. No one had done this before. That seems to be my problem usually. And yet somehow, the client thought I could do it.

In the feasibility study, I portrayed in a videotape what it might look like if you could insert an endoscope in the mouth of a manikin and see in live video on a TV monitor what was inside the body. Then according to my feasibility study videotape, students could proceed through the esophagus, upper esophageal sphincter, stomach, upper duodenal sphincter, and upper duodenum with smooth precise moves and the minimum of stress on the patient. There would be utter reality in look and feel. Wow! No one had ever done that. No one ever even had the chance. Almost no one thought it was possible.

Feasibility studies are like hope come to earth in demo form. They are not real. Though my client thought it showed I could do it, in reality it had no basis in reality. If I can transgress for a minute on demos, there was a joke running through the high tech community about God and the Devil getting the opportunity to woo prospects when they first die. God would show them Heaven and how everyone is calm and pleasant and singing hymns. The Angels actually looked a little boring. Then the Devil took them on the down elevator, and opened out onto gorgeously landscaped seaside resort, with golf and tennis and sailing and little carts coming around with snacks and refreshments all the time. So the prospect came back to middle earth and was given the choice of places to go, up or down. He chose down, which looked like much more fun. The Devil escorted him down again, to a second level, assuring him that he had made a good decision. The door opened and a heat blast came at them. In front of them was a vast steaming, barren, fiery top of a volcano, with people in chains writhing and moaning and hyenas laughing and nipping off pieces of their flesh. “Hey, wait a minute”,said the prospect. “This isn’t what I saw here before!” “Oh,” said the Devil, unapologetically, “That was just the demo.”

Even if the demo looked good to everyone, there is often a point in such a project that you know you are in real trouble. Existential trouble. Trouble that means reality wants no further relation with you. In truth, I did not know about 1. Endoscopic explorations, 2. The Upper Gastronentestinal tract itself. 3. Various software that could change the video as fast as the surgeon’s hand, and 4. Video footage that could simulate where the scope should be when the hands made certain maneuvers, in and out, back and forth and in circles. Luckily a friend of Merck’s, a young gastroenterologist named Mark, was enlisted to help me. He took care of my first two ignorances, of endoscopes and the G.I. tract.

My old friend the videodisc gave me the lightning fast changes in picture that were required when the scope was inserted, or turned one direction or the other. By shooting video footage in patterns that included all possibilities of exploration at every 3 centimeters, we could cover everything that could be seen, in a realistic experiment. I set these patterns up geometrically, with a route to an outer circle that doubled back on the scope, a preferred way to look around to anomalies. Mark did the shooting perfectly, and I donated my Upper G.I. tract one afternoon one of our “models” did not show up.

Our internal landscape models were patients who agree to have their G.I. tract extensively photographed for a reduced bill. The Upper G.I. was fairly easy on the patient. Later, when we were testing a lower G.I. on live patients, we set up a scheme we called rent-a-rectum for the students to do simple endoscopies on the lower tract to compare their abilities before and after using our simulator. We would pay them 20% of their stipend for the first event, and 80% if they returned for the final one. Most returned, but had we not structured it that way, I fear they may not have offered up their internal landscape a second time.

We had to build a mock endoscope that would make signals that were sent to the computer to then present certain images, all in real time, no processing delays. The doctors could tell if there was the slightest delay between what they felt with their hands and what they saw with their eyes. Of course, most of this was a bit more than I budgeted for (another problem when no one has done it). The real problem, however, came with the manikin. “What manikin!!!” I said. I had only budgeted for a box with a hole the size of a mouth that had rollers in it to gauge the depth of the mock endoscope. However, the client had seen the CPR manikin I had instrumented a few years back, and assumed that the endoscopy simulator would have a realistic manikin on a bed with a sheet over her. I say her because I learned long ago that men are gross when used as medical models. Annie had been acceptable to all and damned if I was not going to use at least one principle that had worked before.

There comes a time in the life a business when you are impelled toward making a much more involved product than you had intended. You say to yourself, this will take almost all of my profit, but the client will be satisfied and perhaps it will win a few awards and between more business from this client and others who line up at my door, this extra effort will be worth it. Then, in the real world, the client company loves it and shows it off — and then reorganizes the company and lays off everyone involved with the simulator, while keeping the simulator as a showpiece. You collect your awards, but the line at your door is not companies with money, but students who want to do theses about this new phenomenon, and universities who feel all information should be free to them and want to allow you to present all your designs and software at their institution. There is a wonderful world of free that some people live in, I guess, but it is no reward for a businessperson which, as it turns out, I was not much of.

The doctors and the company that had enlisted their reviews on this simulator were of one voice. It had to look like a real patient on the outside. So in my real world of making simulated experience, I supposed buying a manikin from a department store could work. We could lay it on its side and carve a hole for the roller mouthpiece and put a sheet over it and a pillow under its head. Her head, for reasons explained before, and a few to come. I went to my friend Dale to see if there were surplus manikins in the movie business, and he suggested Izzy. Isadoro Raponi was part of the Dino De Laurentis Italian group that created a second, more spectacular, King Kong, and in Hollywood, Izzy and his partner Carlos Rimbaldi made the creatures in two movies for Steven Spielburg, Close Encounters of the Third Kind, and ET – Extra Terrestrial. When they broke their partnership up, Izzy moved about Hollywood with special skills in special effects. In his time at home in Italy, he helped build the Leonardo Da Vince museum in Rome. He suggested he could make a life mask to make the manikin look like an actual woman rather than a department store prop. We used Mark’s wife Martine, with her short black bangs and pleasant, undaunting face. In short, it looked like a real person with her eyes slightly closed.

Later, Mark, along with Merck, helped us to do ERCP, Endoscopic Retrograde Cholangiopancreatography, wherein we allowed the simulator user to maneuver down to the pancreas, to insert a catheter inside the endoscope with a basket tip, and to see themselves using that catheter to extract stones from the pancreas. To medicos, this was the most impressive feat, and won attention for our future projects. But at a human level, Martine made a distinct difference. Her face and hair were so real that once her young daughter mistook the manikin for her sleeping mother.

It was amazing how much better the whole project was received when the manikin, which received the endoscope through the mouth, was shrouded in sheets and laid on a hospital bed. Immediately the scope manufacturer Olympus, set up the working simulator in one of their display rooms. Mark took it to Hamburg to show off with some top medicos there, and apparently someone from the Nobel committee flew in to take a look.

I learned something valuable here. The technology may be accurate and work exquisitely, but it may fall short if there is no link to we humans at a simple level, in our case with a real face and realistic hair. The technology community must learn this over and over. Most recently a focus on human users allowed the iPhone to emerge through all the rest of the mobile phones. It worked, simply almost flawlessly, but it was also quite beautiful when it fit into people’s hands, and adorned them.