We Did “The Dells”

We went to Wisconsin Dells last week for a one-week family vacation with our kids. This was everyone’s first visit, so we discovered “The Dells” together, and had a great time.

From the moment we planned the trip, to the day we arrived and grabbed fists full of attraction pamphlets and brochures, I had a nagging question in the back of my mind, that I was sure sometime during the week would be answered to my satisfaction. What is a Wisconsin Dell?

I knew about “hills and dales,” and about “the farmer in the dell,” but I wanted to know what a Wisconsin Dell was. There were the Upper Dells, the Lower Dells and the famous Dells. I kept my eyes open all week long for a look at one of these interesting Dells, whatever they might be.

I will summarize our week of activities and adventures with a montage of words and phrases that will evoke images and emotions in the memories of the participants, and will give anyone else a flavor for the week’s content. If any particular detail peaks curiosity, a question about that item could draw out that specific story.

This reminds me of the old joke about the prison inmates that assigned each joke they knew a number. An inmate would call out a number and the other inmates would laugh at the joke as they recalled the joke from memory.

The punch line to this old joke comes when a new inmate arrives who doesn’t know what the numbers mean, just that when someone calls out a number, everyone laughs. One day, the new inmate decides to give it a try. He calls out a number, but there is dead silence. No one laughs. Chagrined, he asks his cellmate what went wrong. His cellmate replies, “Some people just can’t tell a joke.”

Here are my “joke numbers,” so to speak:

Evan driving, sexy GPS voice, Chinese all-you-can-eat buffet, rubber ducky whirlpool bubble bath, leaky plug, pine trees, timeshare sales pitch, discount coupons, Lumberjack Paul Bunyan all-you-can-eat, fudge stores, candy stores, T-shirt stores, 1920s old-time photo, 500, progressive rummy, laptops, The Prestige, Star Trek, naps, more naps, dirty sheets, wet towels, hot tub, noodles, horror house, shock chair, spinning walkways, Indian lunch, Dad’s Coke-in-the-lap, humus, Dad washing dishes, upside-down Top Secret White House, upside-down Top Secret White House refund, Bulgarian exchange students, Animatronics Pirate Show, Crabby’s all-you-can-eat crab legs, the wench, the Chicago Dinner Theater, the Charleston, flirting dancers, indoor waterpark, flying off the family waterslide backwards, sore back, go-kart racing, the Trojan Horse racetrack, gyros lunch, wooden rollercoasters, Hades, Hades again, rollercoaster headaches, Matt and Evan 4-G swing, 10,000 Middle-Schoolers, grilled brats, rain, more rain, wet firewood, wet hammock, gas station “you’re dead to me,” inflatable kayaks, tier two, canoe Nazi, cranes, turtle golf, picnic ducks, chamber of commerce picnic photograph, mushy watermelon, River Dinner Cruise, hole-punched casino cards, pepper jack cheese snacks, sunset, Noah’s Ark, 47 waterslides, The Anaconda, splash in the face, The Point of No Return, The Time Warp, The Time Warp again, Matt fell out, Cowabunga, wet suits, Matt did everything, Kristin did The Point of No Return, with her eyes closed, truffles, 10,000 Middle-Schoolers again, amphibious Wisconsin Ducks, driving in water, the Duck driver’s lame jokes, $4.00 souvenir, Japanese grill chef, onion volcano, tempura fried ice cream, Uno pizza, missing credit cards, Knocked-Up, House on the Rock, Infinity Room, bizarre stuff, naked hairless flying manikins, wedding drop-off.

Notice what is missing from the list, anything about a Dell.

The dictionary says a dell is a small, usually wooded valley or hollow. But what are these famous Wisconsin Dells, The Dells? Are they unique geological formations? We saw some. Are they unusual examples of landscape wreckage left over from the ravages of the glacial Ice Age period? There are lots of those.

Maybe the dells have something to do with the abundant and beautiful Wisconsin River related grottos and Potsdam sandstone fashioned pinnacles, crags, chasms and fissures? Only two other places in the world are anything like it. Nope, none of this rare beautiful stuff turns out to be dell material.

The Dells? They're just small wooded valleys or hollows, nothing special. Somewhat anticlimactic, really. My advice, though, if you haven’t done the Dells, is--do the Dells. We had a great time. Just don't spend a lot of time looking around for any mysterious "Dell." Oh, and skip the upside-down Top Secret White House, it's a total rip-off.

A Man I Didn’t Know

A man I didn’t know staggered onto a dusty street. He was a small man, haggard, ill kempt. His frame was skeletal, clothing hung from him, loose and baggy. Tottering, nearly falling with every step, he lurched and weaved along a seemingly random course as he struggled to cross to the opposite side.

Brutal blasts of gusting wind lashed at the man as billowing clouds of debris rolled around him, nearly swallowing him up. His eyes squinted until nearly closed as dirt and grit pelted his face. The severe withering midday heat bore relentlessly down on him. Nature herself seemed to be conspiring against him. His inebriated reckless stumbling was no match.

I was entranced by his visage as he passed before my view, I could not take my eyes away. The urgency of his effort, his desperation was compelling. This shell of a man was in that drastic and extreme place where one risks everything, gives all, reserves nothing and is utterly spent. He either prevails, or comes to his end. It was a decisive moment.

Looking him over, I see no cause for hope. Alcoholic, drunkard, trapped in a life and death struggle against forces beyond him, he was lost with no one else but himself, and with nothing else to do but the best he can and he is losing. I think to myself, it’s tragic.

I felt pity, sadness, remorse, then in a flash of an instant, I judged. I judged him to be pathetic. Yes, I decided that he was pathetic, which means I decided, in some way, that he was responsible. Likewise, in some way, that he was deserving of his fate. Therefore, I wrote him off, so I could walk away, I suppose, less guilty, less connected.

Then he fell. He simply caught his toe on the ground, pitched forward and ended up sprawled out facedown in the middle of the street. He lay there, motionless at first. Come on, I thought to myself, get up. Any cars coming would not see you lying there. I shifted in my seat, uneasy, fearful for him.

Then, he stirred. He started to push himself up by his arms. Slowly, with painful effort, he lifted his head, then his shoulders. He hovered for a moment above the ground, and then crumpled back down in a heap. After another pause, he stirred again. With considerable effort, he pushed his head and shoulders up again and then stopped. For an agonizing moment, trembling, head swaying side-to-side, he lingered, then, he dropped. I waited. There was only stillness. It was over. He was finished, defeated. He never moved again.

I stared in disbelief. My heart was wrenched. I was not prepared for such a profound capitulation. I wanted to scream out, but I couldn’t breath. Tears filled my eyes. Was I thinking a moment ago that he deserved this? No! No human being should suffer such horrible cruelty, dignity so thoroughly ravaged.

When at his extreme, at his utmost end, when he was beaten, he was little more than like an infant child that had fallen and could not get up. He lay bare and exposed, prostrated in the middle of a public street, his weakness and failure forever etched into the memory of those who witnessed an enduring disgrace.

My last view of him was a close-up of his grimy face pressed unnaturally hard against the coarse surface of the street, his greasy tangled hair dancing about, tossed by dusty gusts of cloying wind. The lights came back on in the classroom. The documentary film was over. I felt hollowness in my gut, sitting in the High School Sociology class, watching a film on the Alcoholism epidemic among Native Americans in the American Southwest.

I was seventeen then, searching for purpose and direction in my life. I asked God to reveal his personal plan for me, to reveal my mission. I wanted God to give me a calling. I was so powerfully moved with compassion at the end of the documentary film, I was convinced that God answered my request by issuing me a call through what I just experienced. I thought God was calling me to dedicate my life to reach Native American Indians.

After that day, I went on to college, medical school, postgraduate training and twenty-two years of medical practice. In all that time, I never had the occasion or the opportunity to become involved in ministry to Native Americans. I even forgot about that moment of epiphany in the classroom, that day of intense emotion when I was so certain God had placed a call on my life. What happened?

I have a new job as Medical Director of Jackson Recover Centers, the proverbial second career. I have wanted to go in that direction professionally for a while now. I attended the American Society of Addiction Medicine’s National Scientific Conference in Miami a few weeks ago as part of my training to become certified as an Addiction Medicine specialist. This was actually the first time I have been at a gathering with such a large number of peers that are Addiction Medicine specialists and what a great experience.

I was saturated with the culture of the specialty, its scientific foundations and scope, the intellectual challenges and depth. I discovered how thoroughly passionate and enthralled I am with the subject matter, the people involved and the whole prospect of spending the rest of my life pursuing this new career. I literally felt like I came home. As if I finally found my true place in the world of medicine. There I was in Miami, surrounded by these wonderful, brilliant, smart people, my new colleagues, and it felt magnificent.

Then it hit me, seemingly out of nowhere. An intense memory of a staggering man, a blistering sun, an unrelenting wind, an intense memory that I had forgotten for more than thirty years. The memory came flooding back, all those years ago sitting in a High School Sociology class, watching a documentary about the Alcoholism epidemic among Native Americans and being so sure that God was giving me a call for my life, and finally realizing now that he was.

Had I missed the point? Maybe, but it doesn’t matter. God has brought me along anyway. What was my calling; is my calling? It is to reach alcoholics, to treat victims of the diseases of addiction, the patients, their families, all those affected by the devastation caused by these dreadful life and soul killing diseases. To be sure, there is more than hope; these diseases are eminently treatable, and I am at the perfect place in my life to do so.

I have been blessed by being given a wonderful gift of compassion for the victims of addictions. God first bestowed it on me that day those many years ago in that classroom. Today the memory of it is a sign in my life of his providence.

Long ago, I had to watch helplessly through the lens of a camera; what I would give to actually have been on that dusty street, when a man I didn’t know attempted his fateful crossing. Today, I hope God takes me to similar dusty streets, where by his grace, I can be used to help save others from the misery and anguish caused by addictive diseases.

Medically Unbelievable Edits

The agency that processes Medicare claims, the Center for Medicare and Medicaid Services (CMS), came up in 2005 with a computer system designed to lower the number of claims paid out to fee-for-service providers that are paid in error. For example, if a doctor submits a claim for performing an appendectomy say, and accidentally a typographical error is made on the claim form—hey, come on, it can happen!—and, for example say, a two is put in the box for the number of procedures done instead of a one, well, CMS wants a way to catch that kind of error before sending a check out paying a doctor for doing two appendectomies on the same patient on the same day.

They initially named this project “Medically Unbelievable Edits” (MUE). Kind of a humorous name, I think, when you think about some of the mistakes that the system might uncover. Apparently though, they ended up changing the name last spring after they got "into it" with some providers at a feedback meeting last spring. Now they call the project “Medically Unlikely Edits” (MUE). How clever, they don’t even have to change the initials of the acronym.

When I reflect on the name change, I can see the logic in it. While it does seem unbelievable that an individual patient could have two appendixes that would need removing on the same day, anyone that has practiced medicine for any length of time knows that you can never live long enough to see everything there is to see. The human being and this world in general has just got some awfully strange, unusual, and let’s face it, occasionally downright bizarre things in it. Never say never, unlikely is a better word than unbelievable.

Personally, what I find unbelievable is that Medicare has been sending checks out to doctors when obvious typographical errors have been made on the claim form. I mean, sending out a check for taking out more than one gall bladder, or appendix, or uterus, or whatever is, well, unbelievable to me. Obviously, no one looks at these things.

Now at least they are getting a computer to do it. The problem with that is, since the computer doesn’t have a brain, it is going to end up thinking a mistake has been made when it really hasn’t and then deny paying a doctor when the doc legitimately should be paid. Too bad a real person can’t just do this stuff, it seems like it would be so much simpler.

At any rate, I’m glad the term “Medically Unbelievable” is gone. No one who actually does medicine thought that one up. If you have been around long enough, you know there is nothing medically unbelievable. I guess that’s one of the many reasons I like medicine.

Addicted to Marriage?

In my new role as Medical Director of Jackson Recovery Centers, I have become a member of ASAM, the American Society of Addiction Medicine. I am currently studying the massive textbook “Principles of Addiction Medicine” as part of my educational program in preparation for the certification exam, which ASAM gives every two years. I am hoping to take the exam in December of 2008.

As I plow through this ponderous academic tome, it has occurred to me that particularly interesting pearls of wisdom and factoids of information are just too juicy and too interesting not to just drop everything, run out, find someone and tell them. Maybe it’s just me.

So I thought from time to time I would leave something interesting I have learned here on my blog just to see what you think about it. I don’t know, it might just all be ho hum, but I’m going to give it a go. Here’s something I learned today.

According to a study in 1991, individuals in stable marriages had the lowest lifetime prevalence of alcoholism (8.9%), as opposed to cohabiting adults who had never been married (29.2%).

But wait, there’s more.

According to a study in 1992, individuals who lived with a significant other but had never married had the highest lifetime prevalence of drug disorders. Cohabiting unmarried men had a 50.2% lifetime prevalence of an illicit drug disorder, compared to a 3.6% prevalence for married men. Cohabiting women had a lifetime prevalence of 19.9%, compared to 1.8% among women with a stable marital history.

These numbers raised my eyebrows. I feel smarter already.

Ta ta, for now.

To Boldly Go

All doctors will eventually take on the role of patient themselves. I have found that my own experience being a patient has most likely made me a better physician. I gained insights and awareness as a patient that I would not have learned any other way. As a result, I believe I am a more compassionate and understanding physician. It only makes sense.

My most recent experience was inevitable and one I dreaded. The fifty-year-old screening colonoscopy. Yuck. I don’t even like to say the word. All those related words are yucky too. Colon. Yuck. Rectum. Yuck. Digital exam. Double yuck, yuck. It just conjures up all kinds of nasty connotations that I have preferred to avoid most of my life. But the day would come, I’ve always known it would, and it did, and it has. The colon examination. Yuck.

Now, as a doctor, I have been recommending, admonishing, cajoling, threatening, scolding, sweet-talking, convincing, fast-talking, pushing, nagging, guilt-tripping, explaining, asking, begging, reminding and forever doing it all over again getting my patients to get their colon exams done since I was in doctor diapers. Over the years I have literally led thousands of innocent souls down the path to colon exploration. It’s a wonderful thing. Many lives have been saved.

But, and it’s a big but, when it’s my actual butt were talking about, it’s an altogether different matter. I am not nearly as interested in the prospect of the anal probing (yuck, yuck) as I have encouraged everyone else to be over the years. When the shoe is on the other foot, so to speak, it doesn’t fit so well. So comes the value of taking on the role of patient sometimes. The experience sheds unique light on the matter. And in this particular, I’m in for a lesson.

Well, I did it. It’s over and done with. I had my colonoscopy yesterday and it all came out fine (yuck). I have to admit, I wasn’t too fond of the laxatives. I knew I wouldn’t be. Who wants a case of the runs? But looking back on the whole event, that was the worst part. Hard to believe, but it’s true. All of my worry and fear and nervousness and hesitation and all that crap that was keeping me from getting this done, turned out to be all for naught.

Here’s why--drugs. Yup, wonderful, modern, well-designed, well-tested, well-applied, marvelous, incredible drugs. I knew they were good, I’ve watched them work, I’ve told people about them, but there is nothing like first hand experience, ho boy! The last thing I remember was the nurse holding the syringe in her hand; the next thing I remember is the nurse asking me if I would like a ride in the wheelchair out to my car. For all I knew, I had just dozed off and napped.

In fact, I felt so fine, I have to literally totally trust them that they did anything at all. I mean, how do I know that I wasn’t just scammed out of $1,000? My butt’s not sore, my stomach doesn’t ache, I don’t have gas, I don’t remember anything! What a rip off! Oh god, it’s so wonderful! I just might do this again sometime!

I can’t believe I just said that.

Well, I hope I can help my patients better by giving them a first hand account that is reassuring, and then get them in to get their colonoscopy done. It really is a piece of cake.

How about you? Are you due for a colonoscopy? If you're not sure, then ask. As far as I’m concerned, the only thing standing between you and getting it done is a case of the runs and some good drugs. Go for it.

Final Floor

Finished, it is fantastic! My wife is a wonderful lady. What a great idea. What a great project. What a great result. I love it.


Elmo shows off the results. He kept us in stitches during snack breaks. If you have not seen the newest version in the Tickle-Me-Elmo series, you have to see it. It is a major hoot. Guaranteed to crack you up.


New paint, new floor, new furniture, new curtains. Almost perfect. I know. How about a new plasma TV with theater surround sound? Did I mention that I was patient?


That's it. My photo essay of our do-it-yourself kitchen-floor weekend nightmare, ahem, project that turned out so well that we will never ever do it ever again. Thank goodness for the thirty year warranty. All's well that ends well.

No, really, we're happy, really we are...

I want my TV.

Self-Made Floor

Putting the pieces together wasn’t so bad. It was all the cutting. To get it to fit around all the corners.



At the end, the little hallway was the hardest. We had to fit around five doorways.



Evan had to leave by a certain time on Sunday. He got faster the later it got on Sunday. Was it the deadline? Was he just getting really good at it? Maybe both.



Soon to be finished, the light appears at the end of the tunnel. When all of the volunteers have left, late Sunday night, Cindie and I toil to the end.

Expanding Floor

What a lot of work. The furniture had to be moved out. The baseboards had to be pulled off. Then we put down this blue foam stuff as a base for the planks to lie on.



Cindie is snapping together the interlocking planks. It’s simple, a piece of cake, right? Would she do it again? Nah, I don’t think so.



The garage was turned into a makeshift workshop. The new DeWalt radial arm saw is front and center. Did I mention how patient I am?



Of course the workers had to be kept going with the right kind of energy fuel, to keep up the momentum.



Slowly but surely, the new floor is taking shape. By the end of the first day we all have maybe one nerve left and are trying not to get on it. We are half way finished, but Sunday and the second half of the job looms. Maybe a few hours of sleep will refresh.

Do It Yourself Floor

Here it is. My photo essay series documenting our kitchen-floor resurfacing project. Cindie planned this for months. We had stacks of wood floor planks waiting in our laundry room since last year. She got the on sale, of course. The appointed day arrived when helpful volunteers gathered bringing with them an assortment of handy tools, a potpourri of useful knowledge, valuable experience, veritable enthusiasm and the marathon weekend of blood sweat and tears ensued.

I managed to snap a few photos to record the transformation and share it here with you. My photojournalism efforts met with a few ruffled feathers when I was accused of taking pictures that were less than flattering. But I never show cleavage or butt shots, never. They did not have to worry.

My son-in-law Evan was an enormous help, performing a lion’s share of the work. Thank you Evan.

I was worried though that the job was ever going to be done when it took him and Cindie most of the first morning to figure out how to put down just the first plank. Fortunately, the speed picked up after that.

My new DeWalt radial arm saw was perfect for the task at hand and a perfect excuse to finally get one after I’ve wanted one for nearly ten years now. I’ve been patient.

Part one in a series, more to come.

Pomp and Circumstance

Cindie and I surveyed the spectacle before us. From our vantage, we could see the more than one thousand graduate candidates stretching out across the floor of the arena sitting patiently in rows of plastic folding chairs facing our direction. Below us, facing the sea of black robed students was the raised platform of impressively regaled faculty and dignitaries and five large linen covered tables weighed heavy with stacks upon stacks of diploma covers arranged in neat rows awaiting presentation to each individual graduating collegian.

Thousands, perhaps tens of thousands packed the large sports arena to witness the event, family, friends, well-wishers, cameras, flashes, videos, tiny dots of red light, brass band, cheers, smiles and tears everywhere, it was a raucous and joyous occasion. We scanned the pages of our program and found the name of our son. There he was, listed under the College of Letters Arts and Sciences, a degree in Bachelor of Arts, a degree in English. Yes, we were satisfied, Matthew Benjamin Wolff, they had spelled his name correctly.

We squinted out at the rows of faces in the sea of black robes and square mortarboard hats with their colorful dangling tassels hanging down. My eyesight is better than Cindie’s; I could make him out first. “See where I’m pointing? On that end, the guy with the red shirt, next to him the guy with the white shirt, count four in and that’s Matthew. He’s looking to the left now, now he’s looking straight. Now he’s looking left again, see him?”

The band played the Iowa State “Fight” song. People were up on their feet, clapping to the rhythm. Anyone who knows college knows that this is an involuntary reflex. When it is invoked, one is as helpless against it as your knee is to a reflex hammer. The row in front of us sat three beautiful young people. They jumped up when the music played. Cindie and I admired them and could not help but shed a tear in gratitude for their lives on this wonderful day. Cindie remarked to me, “Our four kids are all college graduates today!” The three of them together, my daughter and her husband, sitting with my son’s new wife, with my son down below us, robed and waiting.

The moment drew near; I went down closer for a better picture. I jostled for position with other dads and moms, but everyone was polite, it was a celebration. The graduate candidates came from both sides. Deep booming voices announced the names, which then reverberated in the cavernous expanse of the massive arena. Robes went flying as the young men and women marched with pride and confidence across the platform. Their moment in the spotlight came with a handshake, a leather-covered folder and a straight look in the eye from the dean.

There he was, my son, filing forward to the front of the line, it was his turn. I was positioned, ready to take the picture. Then I heard it, everyone heard it, it sounded out, loud and clear on the impressive PA system. “Matthew Benjamin Wolff” Then he too, took the walk, advancing across the platform with purpose and poise to claim his prize. As he retreated, the sound continued to echo in my head, “Matthew Benjamin Wolff.” Announced to the world. Proclaimed. Wow. I was profoundly moved.