You can’t have nice things, sorry.

A momentary lull in the gentle shower that is my Thanksgiving. Alan, who has to work in a few hours, is spackling downstairs. I’ve made a sweet potato pie and make-ahead mashed potatoes for my friends’ feast in about three hours. I worked a little, now I’m writing a little.

This story caught my eye today.

Martin O’Malley, former governor of Maryland, was spending Thanksgiving eve at the Dubliner, a popular Irish bar in Washington D.C. Pretty sure I went there with my friend Adrianne when we had a girls’ weekend in D.C. It’s where Barack Obama would be photographed drinking a pint of Guinness on St. Patrick’s Day. And on Thanksgiving eve, it’s an unofficial all-class reunion for Gonzaga grads.

So there’s O’Malley, and in walks another ‘Zag, Ken Cuccinelli, current acting secretary of the Department of Homeland Security. Then this happened – a “shame-invoking tirade” by O’Malley, aimed at Cuccinelli. The DHS secretary turned on his heel and left. O’Malley later explained:

When he saw Cuccinelli, he unloaded his frustration at the Trump administration’s separation of migrant children from their parents and detention of immigrants in chain-link enclosures at the southern U.S. border.

“We all let him know how we felt about him putting refugee immigrant kids in cages — certainly not what we were taught by the Jesuits at Gonzaga,” O’Malley texted.

In another text, he called Cuccinelli “the son of immigrant grandparents who cages children for a fascist president.”

I haven’t checked the usual suspects on Twitter yet, but I imagine the hand-wringing has started already. Where is civility, etc. When did we become so alienated from one another? And so on.

Three years ago, I might have…not agreed, but acknowledged the point. You’re not going to convert Ken Cuccinelli by yelling at him in a bar. Although I notice something, now that it’s happened a few times: The Trump people never stand their ground and argue. They do what Cuccinelli did. They run.

Don’t make too much of that. It’s easier to attack than to defend your position. And sometimes the opening salvo comes from management, like when Sarah Sanders was asked to leave that restaurant a while back. But it’s noticeable, just the same. Bars are made for arguing, and a crowded Irish pub would be an ideal place to do so with a fellow ‘Zag alum. Why didn’t he stay and defend the policy he is, after all, carrying out voluntarily?

Guys, I’m gonna go with “because it’s indefensible, and they know it.” And I’m also going to call O’Malley one of the good guys. When the history of this era is written, he’ll be able to say, “I objected to one person in a position to do something,” which is more than most of us will ever get the chance to do. Why should these people be comfortable in public, if the public despises them? If he wants a pat on the back, Cuccinelli could go to Mar-a-Lago with the boss. Make small talk with Barron in his tuxedo. Or he could go to Trump country; I’m sure they’d love him in Alabama. But if he wants to hang in his college town, with his college crowd, there will be music to face.

Terrible people who expect to be treated like decent people remind me of Kelsey Grammer. My friend Lance Mannion has written a couple times about the irony of Grammer, an actor whose entire career would be impossible, if not for the liberalism he claims to despise:

Grammer doesn’t live as if he believes in his own political views. It’s not just that he travels in circles where gay people and their spouses aren’t just tolerated but welcomed without a second thought. He clearly isn’t homophobic himself. And it doesn’t stop there.

Grammer doesn’t live anything like a Republican-approved lifestyle. He lives the life of the sort of big city liberal Republicans affect to despise. And as far as I know he’s quite happy with that life and has no plans to change it. He’s not about to move to any place Republicans regard as part of the “real America.” He’s not leaving Hollywood or New York for Topeka, Biloxi, or Wasilla. He’s not about to give up acting to start an oil company, become a hedge fund manager, or a cattle rancher. I don’t know if he goes to church and I don’t care, but it’s pretty hard to imagine him in the front pew at St Patrick’s, although it isn’t hard to imagine him leading the choir at the nearest Baptist mega-church—but that’s Frasier I’m seeing bouncing around in a purple robe and singing it joyfully. Grammer himself? Religion doesn’t seem to be something he’s given much thought lately, an odd thing for a Republican these days.

Now, I don’t believe that any Republican should have to go live in Topeka, Biloxi, Wasilla, or anywhere else on Sarah Palin’s short list of places that count as the real America. But I do believe that happy and contented East and West Coast elitists like Grammer—and conservative members of the punditocracy in Washington—should stop talking as if they believe that the lives lived in places like Topeka, Biloxi, and Wasilla are more “authentically” American than lives lived in Brooklyn, Brookline, Chicago, Seattle, San Francisco, or San Antonio and that the people in the one set of places are more American than the people living in the other.

And it’s probably too much to ask, but could they acknowledge that the lives they live in the most decadent parts of decadent Blue America have been made possible for them by liberalism?

Yes, it’s too much to ask. Lance wrote that in 2010. At the time I agreed with him 100 percent. Now I think maybe Grammer should move to Wasilla. Why should he enjoy the blandishments of Broadway, of Hollywood, of the artistic life he so enjoys, if he doesn’t recognize how they got there?

So anyway. Enough whining. Happy Thanksgiving to all. Here’s an inspiring story about a double amputee making his way back from a devastating injury. It’s not depressing at all.

Let’s finish with some pictures. Food pix, but today is a food holiday, so there. First, the aforementioned pie. I wish I hadn’t tested it with the knife; if I’d trusted my gut, that surface would be perfect:

And just for the hell of it, today’s breakfast, because I’m experimenting with Portrait mode on the iPhone:

Yum yum eat ’em up. Back on the weekend.

Posted at 1:01 pm in Current events | 43 Comments
 

Dreaming of the northern lights.

I had the house looking pretty damn good, although we’re not hosting Thanksgiving this year; Kate is staying in California until Christmas and Alan has to work, so I’m going stag (doe?) to a friend’s. I dusted, vacuumed, straightened and plumped all the pillows, so of course today Alan said it was a good day to start painting the family room and now that is what he is doing.

Sigh.

As for me, I spoke to Kate earlier. She locked her bike somewhere on Venice Boulevard yesterday and came out to find it missing both wheels. They’re special sizes, so it may well be easier for her to just get a new bike than try to track down replacements. That someone or many someones likely saw this happening in broad daylight and did nothing to stop it only underlines the essential pitilessness of the adult world for this new member of it.

Ah well. In another month she’ll be home, then probably staying home until mid-February, when the album she recorded for her senior thesis is released, and the band starts on first a U.S. tour (including SXSW!) and later, on to Europe. I keep pointing out she’s doing just fine and not to get so stressed, but then, my bike wasn’t stripped of its wheels, either.

A peaceful weekend, other than the cleaning. Ran into a good friend at the Eastern Market, and we went for coffee. He told me about the book he’s writing. It’s gonna be great, especially if he takes all my editing suggestions. Seriously, he’s a great writer and has a deep understanding of his subject (Detroit) and knows it better than almost anyone. I can’t wait to read it. And he inspired me to get back to work on something I’m writing. Not a book, but a longer essay/column I’ve been picking at for a while. Stay tuned.

Man, night comes on quickly these days, and we haven’t even seen the worst of it yet. Every so often I daydream about spending some unspecified future winter in Reykjavik, just renting an apartment from Halloween through the end of February and settling in for the hygge. I think I could do it, once I got used to it: Swim in the morning, soak in the hot tub, then tank up on coffee and wait for a couple hours of dim sunlight before it sinks again and the long night commences. There would be sandwiches. There would be pickles. There would be lots of reading and DuoLingo and meandering writing like this. The aurora borealis overhead so often it becomes routine. I think it’d be pretty great.

But this is just fantasy. Because of course we live in a hellscape, where the president intercedes to pardon/restore the rank of a war criminal. Where so-called moderate Republicans are silenced in the GOP of m-f’ing Wyoming, for god’s sake. Where a former Fox News exec tries to drum up followers for his allegedly “center-right” political news aggregator by employing Macedonian teenagers to whip up the proles and other media illiterates, on both sides (for once!).

Want something beautiful to read instead? It’s 7,000 words, so it’ll take a while. It took me one bus ride home, last Friday, but it stayed with me all weekend: “The Jungle Prince of Delhi,” by Ellen Barry in the NYT. I hope to one day write a sentence like this:

The door swung open, and before me stood a man in tiger-print pajamas.

Until then, I write here. Ah well. Have a great week ahead, all.

Posted at 5:33 pm in Current events, Same ol' same ol' | 79 Comments
 

Raise your right hand, Ambassador.

It’s going on 8 p.m. as I write this, and the hearings are still going strong in Washington. Nunes is still a barking twit. It seems important to tell you this.

And I’m sorry, but even if you believe all the dire stories about a tuned-out public and the needle not moving at all, blah blah blah, I can’t really believe this isn’t making a difference. I mean, even laying aside my personal beliefs in this case, I see one Trumper after another tripping over his own feet. Surely this isn’t playing well in the suburbs. Surely this is making a difference with people who have two or more brain cells to rub together. I have to have more faith in my countrymen, because otherwise I will have to sell everything I own and wander the world for the rest of my life, never returning to this brain-damaged country.

Wednesdays seem to come earlier in the week than ever, which may be a function of the quickening pace of the end of the year, or just my own approaching end of the road. When you’re 12, a week lasts five years. Then you have kids and they grow up in 20 minutes.

What’s going on in your world this week? Returning to the above mega-topic, i.e., the Disgrace of This Administration, I see DUI Steph stepped in it again, claiming the outgoing Obama staffers seeded the White House with nastygrams and “Obama books.” A stupid lie that was more or less immediately debunked.

To give the girl credit, though: She’s probably never seen a book in her life, and just assumed that the ones left behind must have been “Obama books,” whatever that is.

Meanwhile, I got a message from a distant acquaintance, informing me that the “classical school” movement has set up shop in my old Indiana neighborhood, and one of its administrators, also an editor for the Federalist, is living on my very own ex-street. Here’s one of her recent columns, Stop Turning Your Yard Into a Hellscape for Halloween:

Within a few blocks of my house are yards full of severed heads, decomposing corpses, positively demonic-looking witches, goblins, and ghouls, and moldy skeletons coming out of the ground (some even shake!).

One entire nearby neighborhood decorated all of its streetlights with hanging severed heads that have blood running out of the eyes. Some people have fog machines and motion detectors that emit noises from Hell every time a mom walks by with her preschooler and baby, or kids of all ages go past on their way to school.

What is wrong with these people?

This upsets her children, she writes: “Only fools make light of evil. Hell isn’t a joke.” OK, fine. I wonder what her position might be on my personal pet peeve from when I had a young child: The anti-abortion protesters who would show up on “procedure day” at the local clinic in Fort Wayne, which happened to be across the street from the library. We spent a lot of time at the library in those days, and I believe procedure day was also Storytime Day, so I had to carry a 3- or 4-year-old past their poster-size blowups of fetal body parts. After the first time, I learned how to park to avoid most of it, but sometimes it was unavoidable. My guess is, that would be A Difficult Truth We Must Not Shrink From, or some such.

Well, if I know my old neighborhood — and I may not, anymore — she’s an anomaly.

OK, time to hit the showers and get ready for the day. Gordon Sondland, up next.

Posted at 8:36 am in Current events, Same ol' same ol' | 99 Comments
 

Video on demand.

I went to a meeting on Tuesday. One of the women there had just had a birthday, and a friend had gifted her with “a Cameo by that guy from the Fyre Festival documentary,” Andy someone. We all watched this thing, a roughly 30-second video in which Fyre Festival Guy called her by her name, specifically mentioned the big milestone (40) and her two kids, then threw in a Fyre Festival joke to wrap it all up.

“What is this…Cameo?” I asked, and got the usual answer: It’s an app.

Boy, is it. It’s an app (and a website) with dozens of photographs on it, along with prices, of individuals ranging from basically unknown to mid-level-oh-that-guy celebrities. For the price quoted, you can hire them to record a brief personalized video. A birthday greeting, congratulations, whatever. I haven’t dived all the way into the site; I assume all this has to be a mutual agreement thing. You can’t put any old words into…Charlie Sheen’s mouth. But that you can get Charlie Sheen at all is kinda amazing, when you think about it.

I got lost, scrolling through the possibilities. Stormy Daniels, $250. Gilbert Gottfried, $150. Tom Arnold, $100. OMG Tomi Lahren, $70!!! (Like anyone would pay that. Even Heidi Montag and Andy Dick fetch more than that.) It’s hilarious, proof that even the nominally famous are not immune from money-grubbing for a few $20s. Sooner or later, this shit will bring on the revolution, and I welcome it. Before it does, though, I’d love to get Stormy to record a birthday greeting for my boss. I’ll even write the script.

So, today. The hearings. I had a lot to do, which meant I could only pay attention here and there. I tried to keep it on in the background, but once Nunes started talking, I simply couldn’t keep my wits about me. I swear, the last three years have taken 10 off my own life. This can’t be good for me. So I muted it and checked in via Twitter from time to time.

My takeaway is that this is going to be bad for the Republicans, but only in the long run, and not as bad as it should be. Anyone stupid enough to put their faith in this moron are unlikely to be moved.

By the way, the snow that fell the other day? It overperformed. We were supposed to get five inches, but it ended up being closer to eight. Because the autumn leaf pickup was only about half over, much of the equipment that would normally clear it away was still fitted with leaf-collecting stuff, not snowplows, and some streets remain kinda rutted because they were only salted, not plowed. Then there was this phenomenon:

Leaves falling on top of snow. It’s unlikely to melt for at least another week, too.

One more link? Sure: A serious book-critic’s review of the Anonymous book:

More often in “A Warning,” actions are not taken; they are almost taken. In a particularly dire circumstance, several top officials consider resigning together, a “midnight self-massacre” that would draw attention to Trump’s mismanagement. “The move was deemed too risky because it would shake public confidence,” Anonymous explains. At any moment, the author writes, there are at least a handful of top aides “on the brink” of quitting. (The brink is a popular hangout for Trump officials.) Anonymous also wonders if Trump’s response to the Charlottesville protests in 2017, when the president drew a moral equivalence between white nationalists and those opposing them, would have been the time for such a gesture. “Maybe that was a lost moment, when a rush to the exits would have meant something.”

It’s like “Profiles in Thinking About Courage.”

Good one. OK, must run. Time to pull in the latchstring and think about Thursday.

Posted at 5:04 am in Current events, Popculch | 61 Comments
 

Who’s that girl?

I have about 20 minutes this morning, so let’s get moving. More Morocco, anyone? :::cocks ear to room, hears silence::: OK, then!

Storage lockers at the port, Essaouira:

This was basically a composition exercise. That one, or this one?

Can’t decide. I’m leaning toward the first.

We’ve been back for two weeks, and I suppose we’re fully re-integrated now. Last night I watched the last thing that dropped on Netflix in our absence — “El Camino,” the Breaking Bad movie. I liked it. I thought it struck the right balance between playful fan-pleasing, a rewarding extended encore for Aaron Paul and just being an OK movie. I’m thinking, again, how much I love Vince Gilligan’s work, and want to see more of it, but I guess “Better Call Saul” is still months away. Sigh.

As the credits were rolling, my phone beeped: The Anonymous book dropped, and oh my stars and garters, it turns out the president is a venal, greedy, petulant (add 1,000 more unflattering adjectives) bastard. WHO KNEW?!?

And I’m putting my bet, today, on Kellyanne Conway as the author. Someone make a case for someone else, but something about the dad-running-around-with-no-pants stuff sounded like it came out of a female brain.

My heart has hardened against every one of the adults in the room. John Kelly, just recently, lamented that if he were still in charge, the president wouldn’t be facing impeachment:

“I said, whatever you do — and we were still in the process of trying to find someone to take my place — I said whatever you do, don’t hire a ‘yes man,’ someone who won’t tell you the truth — don’t do that. Because if you do, I believe you will be impeached,” Kelly said Saturday at the newspaper’s political conference in Sea Island, Ga.

Kelly, a retired Marine Corps general who was chief of staff from July 2017 to January 2019, said he told the president he needed someone to keep him within the bounds of his authority to avoid impeachment. Kelly said he believed the president wouldn’t be facing an impeachment inquiry had he stayed in the job, a thinly veiled shot at Mick Mulvaney, the acting chief of staff who replaced Kelly.

“It pains me to see what’s going on,” Kelly said, according to the newspaper.

It pains him. Poor baby. In other words, if he were still in charge, everything would be unfolding more or less exactly the way it has for the last four years, which he presumably is OK with. So fuck that guy. Fuck all the guys, plus the gals, and save a special one for Kellyanne Conway, grifter queen extraordinaire.

When this is all over, I do look forward to Stephanie Grisham’s next drunk-driving arrest.

Twenty minutes is nearly up. Gotta hit the showers, maybe slurp up some more coffee. Have a good weekend, all.

Posted at 8:26 am in Current events | 52 Comments
 

What just happened?

Now that. Was an election.

Like many of you, I’ve been watching the results come in for the last 12 hours or so, marveling. There’s Kentucky, but there’s also my little home suburb here. The most overtly conservative candidates for city council, one an incumbent, finished last and next-to-last in a five-way race for three seats. (Which is to say, neither one will be raising their right hand at the next meeting.) That’s Grosse Pointe Woods, reliably red. In G.P. Park, which has been trending blue for some time, there’s now a progressive majority on their council, with two conservative incumbents sent packing. G.P. City elected a progressive mayor (a woman, no less) and an actual progressive lefty gained a seat on the G.P. Farms city council.

All of this would have been unthinkable just four years ago. Everything is changing.

One of the losing candidates in the Woods was a young man who ran a campaign right out of the 2004 playbook. He promoted his degree in public administration from Liberty University. He used “family” in his campaign tagline. He said he works in federal law enforcement, but when I asked him directly which branch, he refused to answer, pleading the Hatch Act. OK, then! Moving on!

Local elections are the ones where I have almost always crossed party lines, and ours are nonpartisan. Competence in running a small city — or in our city-manager system, overseeing the running of a small city — can be found across the political spectrum. But when you blow all those dog whistles, I am outta there. And the Hatch Act? Please. As a friend of mine commented when I told her this, “If they haven’t thrown Kellyanne Conway in prison yet, I think he’s safe.”

So, a good day for Dems and non-Trumps of all stripes. Someone at 1600 Pennsylvania Avenue has to be sweating right now.

I was also interested in what happened in Fort Wayne, which I see Alex covered in the comments on the last thread. You may not have seen this column by the publisher of the morning Journal Gazette, though, an open letter to a council candidate who eked out a tight win:

Your large postcard featured you gripping a baseball bat and included, in capital letters, the phrase: “BEAT THE MEDIA.” There were four references to The Journal Gazette, the only media identified by name.

So yeah, invoking newsroom violence in a tight-knit business community? Sure, that’s just fine. More:

During the election cycle, the editorial board does make recommendations in local races. It is always our intent to inform and share our insights based on both our news-side coverage of the candidates, our observations and research, and our interviews with them.

This year, you did not respond to multiple requests to meet with our editorial board before the May primary election and, again, before the general election. You also did not respond to calls from a news reporter preparing an election preview story. All were opportunities we provided you to identify the issues you considered most important and to explain to our readers, many of whom are avid voters, your plans for addressing those issues.

Don’t show up for your endorsement interview, don’t return reporter calls, then send a mailer like that. These people are simply awful.

Health care is a winning issue. I think that’s the takeaway.

What happened in your neck of the woods?

Posted at 9:57 am in Current events | 26 Comments
 

A quickie, and a snapshot.

I set a goal to clean the entire house yesterday and pretty much accomplished it, but it sapped my energy at blogging time and so, no Sunday-night blog.

But fearing that interest in the last thread may be flagging, here’s a new one. Some things to consider:

E. Jean Carroll is suing the president. For defamation.

Can you imagine, in some not-so-distant past, hearing that the First Lady of the United States would be visiting your child’s school, and that announcement causing a flipout/meltdown? Of course, this is no ordinary FLOTUS, either.

One more Morocco picture. We were walking around the port in Essaouira, I was trying to frame this gull, and said, “Hey, gull, look over here,” and it did. Just then, one of its colleagues flew through the frame as the shutter fell. Like I said: Hard to take a bad picture over there.

Posted at 12:33 pm in Current events, Same ol' same ol' | 40 Comments
 

Here, kitty.

If you all will indulge me a little longer, another photo post from Morocco. Today’s subject: Cats.

Feral cats are common in Morocco, and elsewhere; I recommend a charming documentary about the cats of Istanbul, called “Kedi.” (Kitty, get it?) It’s not exactly the same in the Moroccan cities we visited, but similar — cats are everywhere, entirely wild, not entirely pleasant to consider what their lives are like.

They’re skinny, dirty, some with mange or eye problems. No one pets them, although some soft-hearted souls might feed them from time to time. One rubbed on my shins at a shop, but most kept their distance. We saw more in Fez than in Marrakesh (I theorize most had been run over by scooters). The Essaouira cats proliferated by the dock and port, where they competed with the gulls for fish guts.

If you’re a cat lover, you’ll get lots of pictures. But don’t try to touch them; they’re not that kind of cat.

But like cats everywhere, they were excellent photo subjects:

They were silhouetted in every alley in the medina, it seemed:

I saw this one early, on the way back from the patisserie. He was breakfasting on a fish head:

Lots and lots of kittens:

They walk in and out of the businesses, most of which are open-air in some way or another. So you’d turn around and see something like this:

I really was hoping you’d order the shrimp, lady. We were sitting on the roof level of a cafe, and he was a little higher. He watched us for a while, then disappeared.

At our last place, in Essaouira, our host told us to close the door to the riad balcony at night, because otherwise they’d come into the apartment. He told a story about a woman who was staying there alone, and called in a panic her first night. “Someone’s trying to get in the door,” she whispered, frantically, and he ran over, only to find the front door locked. He let himself in and flew up the stairs, where she pointed to the balcony door: “No, there!” It was a cat.

Sure enough, that night, the balcony door rattled with something that sounded exactly like a paw, knocking, along with the usual plaintive meowing. No dice, kitty, but I fed fish leavings to a couple in the port the next day.

Maybe it was this one; this was in the alley outside our riad:

This place is so picturesque it’s ridic. I’m not even a very good photographer, either. It’s just hard to take a bad picture in Morocco.

And what happened on this side of the Atlantic? Just the president’s allies attacking a Purple Heart recipient because he speaks a second language. Just another day in the greatest and richest country on earth.

Here’s to Wednesday.

Posted at 8:41 pm in Current events, Same ol' same ol' | 48 Comments
 

So, so ready.

Alan lurched through the door last evening and pronounced himself ready for vacation, if only to get away from the country in a more or less constant constitutional crisis these days.

Couldn’t agree more.

What else, today? Not much. Just a to-do list a mile long. Why is it so hard to get out of town for a couple weeks? Of course, it doesn’t help that there’s a strike going on, which has blotted out the sun in Alan’s world for a month or so. It’s just hard to slip the surly bonds of earth, even for a little while. But stuff is getting ticked off the list, and one way or another we’re getting on the plane.

As to the constitutional crisis.

I’m so damn tired of all this stuff. The bonkers communications, the horrible family, the idiot enablers, the First Sex Worker, all of it. And this sort of thing, as well:

“Pathay.” Or maybe it’s “pathé.” I guess that’s fancy talk you learn in fancy-talk school.

And now we’re going to be seeing more of Trey Gowdy. Another reason to be so, so glad I gave up cable TV.

You guys can post the links today. Alas, I have to tackle this to-do list.

Posted at 9:23 am in Current events | 37 Comments
 

His brand is chaos.

The other day I said to someone in the office, “You remember when we would say, on Friday, that something happened on Monday and it seemed like six months ago? Now something happens at 9 a.m. and by 3 p.m. something else has happened and it’s like, ‘oh, that’s so 9 a.m.'”

It’s about 9:30 p.m. now, and there are multiple scoops breaking all over Newsville, which makes yesterday’s astonishing press conferences seem like they happened a year ago, but come on, this picture is one for the ages:

I used to work with Chip Somodevilla. Great photographer.

Yeesh, what a week. The last 48 hours have been bananas, necessitating a drive to Goddamn Lansing in which it rained, hard, both ways. Welcome to fall, bitch, every drop seemed to say. I don’t mind an overcast, drizzly day from time to time, but it’s never fun to pass an 18-wheeler in that sort of weather. You just drive into the mist and hope the road is still under your tires as you do so. And it’s worse at night.

But never you mind that. Because anything I write now will be outdated in 15 minutes, some bloggage to take you into the weekend, then.

I read this piece by Gene Weingarten, an excerpt from his upcoming book, the other day, marveling at how well it’s written. It’s likely something you’ve read before, a story about an organ donor and organ recipient on their separate journeys, but it’s just So. Good. You want to know how to write about complex medicine? Watch and learn, kids. Here’s the moment where the donor heart is extracted from the chest:

If you’ve read about open-heart surgery or seen videos, you may have a mental image of what followed: hours of precise, delicate work on gossamer tissue and threadlike vessels, performed by beetle-browed people wearing those eyeglasses with little telescopes in them.

Discard everything but the furrowed foreheads and telescope glasses. Compared with other open-heart procedures in which Lefrak was already expert — say, coronary artery bypass — heart transplantation seems like butchery. The heart as a whole is a large, unsubtle organ, and those vessels feeding it that aren’t the circumference of a D battery are still as fat as thumbs. Edward Lefrak removed Mark Willey’s heart with a single tool: a pair of scissors not all that structurally different from what second-graders use on colored paper. There were no nurses beside him handing him tools or mopping his brow.

First he separated the superior and inferior venae cavae, the two large vessels that return blood from the body into the right atrium, and severed them. Then he lifted the organ with his left hand and cut behind it with his right, one snip on each of the four pulmonary veins that run lung to heart. He lowered it back into the chest. Below the clamp, he cut through the aorta and finally the pulmonary artery, which runs heart to lung. The heart was now in the doctor’s hands, free of the body. It felt cold, even through a latex glove.

All that detail, using both simple and specialized language, in images you can see in your mind’s eye – D batteries, a child’s scissors. And here’s the moment after it’s been attached to the recipient, before it’s brought back to life:

What happened next defied everything most people presume about the human heart. Lefrak lowered Eva’s head, cupped her new heart with his left hand and tilted the bottom of it up so it became the highest point in her body. Then he accepted from Dellinger a long 18-gauge hypodermic needle and stabbed it into the heart’s apex, clean through the muscle to the cavity of the left ventricle. From the plastic collet of the needle came a bloody froth. When that stopped, Lefrak withdrew the needle, then pushed it in again, a few millimeters away. More bubbles.

If a heart is sliced by the thrust of a knife, that is usually fatal. If it is pierced by a bullet, it is nearly always fatal. But the heart is, in the end, a muscle, and as anyone knows who has ever gotten a vaccination in the arm — or anyone familiar with the overdose scene in “Pulp Fiction” — muscles can withstand and survive a needle. They close back up and heal instantly. Lefrak repeated this unnerving stab of the needle more than a dozen times. The goal was to empty the heart of all air bubbles before reconnecting it to its prime source of blood, via the venae cavae. Air bubbles cause embolisms, and embolisms cause brain damage.

Satisfied all the air was gone — no more froth — Lefrak allowed the heart to fill with blood.

The magic phrase there is “anyone knows who has ever gotten a vaccination,” because it makes you understand immediately. Of course you can stab a heart with needles; it’s a muscle.

Alan used to be a medical writer in Fort Wayne, doing disease-of-the-week stories. He was good at this sort of explanation. Not this good.

OK, I’m going to bed. I’m going to nibble a quarter square of an indica edible, swallow a melatonin and go off to dreamland. Let’s hope we survive the weekend.

Posted at 9:59 pm in Current events | 51 Comments