Ólafur Ólafsson

When running an inpatient surgical ward there is a constant struggle to get the patients home after operations. There is, of course, some reasonable length of stay needed for serious matters etc. However, from my point of view some of my patients could go home sooner than they themselves wanted. There were all kinds of ploys used to hasten their discharge, but the opposition had some tricks up its sleeve, too. For instance, when I would do the rounds on Monday, I expected that someone would be able to go home on Wednesday. So, I would suggest discharge on a Tuesday. Then when the patient began to balk I would suggest: „Well ok Wednesday then,” and everybody was happy. The hospital had a library and the patients used it in their convalescent period (Icelanders are a literate bunch). Then I had the following rule to lighten the atmosphere in the wards where there were a number of patients together. Of course, the patients preferred the romantic genre of books, for example, the Red Series (Fabian bare chested, etc.). The rule: Whenever a book like that was spotted on a patient’s nightstand, they would be unceremoniously discharged (or an attempt would be made on the basis of the evidence).  If you can read that stuff you are ready to go home, right? And It would happen that this did not go over too well.

Ólafur Ólafsson

Ólafur Ólafsson

At that time, we had a Surgeon General of Iceland Ólafur Ólafsson, who was and still is a crusty old guy. He sported bushy white hair, and his equally bushy eyebrows were in the Santa Claus class. He was at the tail end of his career at that time. His voice was deep and gravely, and had he been an American he would have been reading the voice overs in the Whiskey and Cigarette commercials. He probably would have put James Earl Jones out of the voice work. As Surgeon General he has a great sense of humor and the ability to see the absurd and funny in just about any setting. He was always a champion for the patients and their rights, and was never a tame tool for the politicians – he was a very unconventional civil servant. He gave me invaluable advice: “Jonas, just be yourself.”

Contrast him with the Suits and apparatchiki that we have met through our lives.

https://www.urbandictionary.com/define.php?term=suit

Author‘s addition to the definitions: A Suit – a civil servant totally devoid of any charm, humor or even a face.

Ólafur could be a handful, especially when he called in the middle of the night (he is a night owl) to discuss some pressing issue. You are fast asleep in some happy dream and then “It is Ólafur” and you began thinking – it must be some damn volcanic eruption. When he was still working, his offices were next to the square where the homeless and unfortunate souls of Reykjavik congregated. To his credit, he always kept a protective eye on his neighbors and tended to their needs. When he retired he palmed them off to another humanist doctor. I just love this guy for lots of reasons.

Now, one of my patients got offended by my Red Series comment and made a formal complaint to the surgeon general. Such a matter needed to be resolved and resolved it was.

I got a formal reprimand letter from the Surgeon General’s Office stating (loosely translated):

 

Ólafur Ólafsson landlæknir
Reprimand letter

—————————————————————————————————————————————————–

Reprimand

It has come to the Surgeons General’s notice that you have been joking around with your patients during the morning rounds.

It is decided by the Surgeon General that you are not to joke around with your patients.

Signed

Ólafur Ólafsson

P.S. Unless they have the same sense of humor that the Surgeon General has.

P.P.S. It is forbidden to divulge the content of this letter.

—————————————————————————————————————————————————–

I contacted Ólafur on my last visit to Iceland and he released me from the ban.

I am sure that governments and especially the populations the world over are be better served by persons such as Ólafur as compared to their empty, talking Suits.

Ready to go

Icelandic Medical Association centennial – fly casting course

In the fall of 2017 I got an email from IMA’s president asking me to teach a fly casting course to Icelandic doctors. The IMA is celebrating its centennial this year, and the president thought it a good idea to introduce some play into the pomp. I was all for it and started to organize the course. Indoor or outdoor is the first dilemma. Outdoor is a better option generally if we could have some other weather than Icelandic, but it is the only one we have there in the subarctic.  There is a near constant area of low-pressure area at our latitudes called the Icelandic low.

https://en.wikipedia.org/wiki/Icelandic_Low

We Icelanders never use that word or acknowledge the low’s existence because it is just too damn depressing. Denial is a robust defense mechanism. However, all phone calls between Icelanders start with “How is the weather?”

So, outdoors was not feasible. To get anything done in Iceland it must be before spring (if there will be one that year at all). When the days get longer, and temperatures get into double digits (Centigrade) the natives go nuts. It is impossible to plan anything because now everyone is so busy living and enjoying life – scheduling a course then would be utter folly. In the summers it is even worse to get together a group of people. So, March indoor it was. We secured a good size gym and announced the course, and all the spots we had available were promptly filled. Forty-five persons booked and 42 showed up. What I was most pleased with was that 15 ladies participated. Some of them were intermediate and some beginners at fly casting. Unfortunately, fly casting gatherings can get to look like a Trump rally at times. We need to attract young people and more females into the mix.

Stefán keeping an eye on Gunnar - Guðbjörg doing fine

Stefán keeping an eye on Gunnar – Guðbjörg doing fine

Gubjörg bringing the rod tip too far back i.e. wristing

Gubjörg bringing the rod tip too far back i.e. wristing

I have discovered that it is far easier to teach females to propel the fly than males. Females do not resort to brute strength and are much more limber. They also listen better than males and pay attention. There are some great female casters, and Joan Wulff was the best of both sexes for a spell – her accomplishments were not built on power (Ms. Wulff is still teaching, and her books are great). Usually it takes up to an hour to break down a male and get his attention.  Starting out they use far more power than they ever need, and the speed they use is excessive. So, the first hour goes like this: “Slow down – slow down – are you deaf – slow down. God dammit, slow down. Less power – less power – have you got a seizure?” I do not know for certain why males behave this way – I think it might be the testosterone marinade that we males live in. However, when they slow down and go gently a big smile is usually our reward. “Wow I could feel that.” – is the refrain – meaning they felt the rod unload in their hand (a bent rod straightens and counter flexes and then straightens again – you will feel a slight kick in your hand – called unloading). The term casting is perhaps inappropriate. There is no follow through of the hand as when we throw a stone, and we stop the rod tip high – it is the rod tip that propels the line forward – the caster only bends the rod tip with his motion.

Gunnar and Stefán

Gunnar and Stefán

Þorgerður doing the triangle exercise

Þorgerður doing the triangle exercise

Many ways to skin a cat

An old friend of mine Stefan B Hjaltested was a co-instructor, and we got along very well. He did teach differently than I do, but we both got the same results in the same amount of time. He did not use any technical terms – do this – no do not do that etc. – was his way. His approach is “teach them like they are children.” This only proves that there are many ways to skin a cat.

All in all, we taught for 30 hours and we hope that our students had as much fun as we had.

We also hope that all our students learned a lot and will diligently practice new tricks before their future fishing trips.

Pictures – Davíð Valdimarsson

Berlin Airlift

As a boy I vaguely remember reading about the Berlin airlift (Berliner Luftbrücke­­­ – i.e. airbridge).

https://en.wikipedia.org/wiki/Berlin_Blockade

That was when the russkies were naughty (they still are), and ­­when they wanted to mess with Europe they just squeezed its balls, i.e. Berlin. To get vital supplies to Berlin after the roads and railways were closed (by the russkies), the Allies resorted to a massive airlift to keep the city running.  I found this utterly fascinating and subsequently had a brief obsession with airplanes. One of my casting students (a retired pilot) actually flew on those missions via that corridor [via one of the three permitted air corridors]. But I am just rambling, so I will get on with it.

https://en.wikipedia.org/wiki/West_Berlin_Air_Corridor

During the tail end of my Med School days, I got the opportunity to do a locum (relieve some doctor who needed a break) in general practice out in the sticks. This was very welcomed since we med students got paid, and it was a learning opportunity for us. What the patients thought of it is not clear, but I guess they thought it better to have someone manning the shop, albeit an inexperienced medical student. It was deemed prudent by the authorities to send two med students to relieve one experienced doctor. So off we (I and my colleague) went and wound up in the farthest district from Reykjavik on the shores of the Arctic Ocean.

That month turned out to become very eventful, and we were very busy. At this stage in your journey as a doctor everything is just so damn interesting and stimulating. We for instance had a patient who developed a sudden onset of pain in one eye! What the heck can that be? So, dive into books (remember no internet), and if we needed more, a corded telephone was our best ally. We treated cardiac arrhythmia, overdose, urinary retention and even plucked shot gun pellets from the derriere of the local police officer. Plus, all the other more routine ailments. It turned out that the organ specialists in Akureyri (closest big town) and Reykjavik, whom we repeatedly had to consult, were very helpful. They probably remembered their own bygone locums, so the system worked – if you had the sense to ask for help. We both were keenly aware off our limitations, and relatively free of hubris (that came later) – but when I reflect on that period I realize that we were so ignorant of all the ways things can go caput [go to hell in a handbasket] in medicine, that we just happily forged on with our trusted ally, the telephone. When I gained more experience I never encountered a situation that I could not make substantially worse by untimely intervention or the wrong one. So, make sure your indications for doing anything in medicine are solid before proceeding.

To give you a glimpse of the Zeitgeist  I can share the following story. We got a call from a farmer who had some pain in his chest. “A stick  fell on my back” was the story. “Can you come out here and have a look?” When we arrived at the farm, we met the family, and then we were invited to a meal. There was no examining until after. After that and conversations about our family trees (yup, that was the social norm) we got to have a look at the farmer. This was the typical attitude of those people in those days. Tradition dictates a certain decorum, and it is to be observed even if you had a “stick” fall on your back.

Driftwood

Driftwood a.k.

As it turned out, the “stick” was in fact a large driftwood log. This farm owned a stretch of beach where you could harvest these logs. Such logs drift from Siberia to Iceland’s shores and were through the ages extremely valuable as there were no big trees in Iceland for construction purposes.

Transpolar current bringing driftwood to Iceland

Transpolar current bringing driftwood to Iceland

Furthermore, they were salt impregnated after their journey in the ocean and thus rot resistant. The farmer had his ribs on one side broken with air under the skin (subcutaneous air). When you encounter such air, it feels like the crunch of newly fallen snow under your fingers. The lung was punctured, but the farmer was stable so we sent him off via airplane to the nearest hospital in Akureyri.

During the Cold War the Americans had built a radar station on the top of a nearby mountain and ran it from 1954 to 1968.

Driftwood and the mountain

Driftwood and the mountain

To service it there was a small airfield on the shore running from east to west. To be able to land there, a radio beacon had to be turned on.  The airfield manager (and only personnel) turned the beacon on after receiving a call from Keflavik. ”Can you turn the beacon on Mr. X?” to which the answer was “Whiskey?” “No damn it – no whiskey.” “No whiskey no beacon.” They could get by with few words.  If the negotiations were successful, the beacon got turned on, and the airfield manager was happy. The way alcohol is sold in Iceland is through state monopoly shops. Sweden has the same system, for instance, and it is rumored that the people living on the Faroe Islands only get to buy their liquor if their taxes are paid. The state shops in Iceland are called “Der Reich” (The state) and exist only in the bigger towns. The population with no “Der Reich” makes a phone call, and the merchandise is delivered with the next post delivered by flight. It was thus imperative to receive the post on a Friday. On Friday the airfield manager had radioed in the local weather conditions on which the pilot made his decision to fly or not. The “terminal” at our local airfield was the bridge cut off from a decommissioned trawler.  Yet it functioned well.  We were in the terminal once waiting for some medical supplies when we witnessed another interesting exchange on Friday afternoon:  “You reported the local weather – visibility unlimited – calm – no clouds” came the voice of the pilot from the radio. Then we could hear the drone of a plane from above, but it was totally overcast (clouds 600 feet), wind from the north 10 mph (crosswind). “Yes – it is amazing how the weather on the arctic ocean can change in a heartbeat,” answered the airfield manager tongue in cheek. Now the calm voice of the pilot was heard – “I am going to kill you Mr. X.” “Well, you have to land to do that” was the logical answer. The bush pilots are very good, so nothing untoward happened despite dicey weather. We got our supplies, and the village its vital necessities.

Casting Clinic February 2018

My local fly club is called FFNWF (Fly Fishers of North West Florida). Now that is a mouth-full without vowels but still not quite Hebrew. We just love our abbreviations here, but I can tell you that it takes a while to understand them. Especially if English (American?) is your third language. Some abbreviations are simple and ubiquitous like the OMG! exclamation that is now being used even in Icelandic parlance. What the heck does POS mean? Or NYOB – PAWS and on and on. So, here’s my advice to the natives – go easy on those abbreviations when talking to a non-native. But I digress.

Casting Clinic February 2018

Casting Clinic February 2018

When I first saw the term “Casting Clinic” in our monthly newsletter I was not sure what it referred to. Casting could refer to fly casting, but it could also mean shaping a plaster of Paris cast. The clinic part implies some medical endeavor in my understanding. But what I discovered, was that it means club members get together and wave their rods. The idea is that we supposedly teach each other, especially those who are starting out. Then we can show off a bit by banging out long casts with sharp pointy loops (Yup – guilty as charged). As I have been sucked closer and closer to the black hole of teaching fly casting, I realize that this way of preaching probably is not a very effective way of converting beginners to intermediate casters or intermediate casters to good ones (to become a great caster you need private lessons!).

Casting Clinic February 2018

Casting Clinic February 2018

So, this year we are running an experiment. I plan to introduce one special fly casting drill/exercise every clinic during the year. The February clinic was devoted to the pick-up and lay down cast. We had a good turnout – around 20 casters with several new faces, which was heartening. When we commenced I got up on my soap box and explained the basics of the cast to the group. Then we divided the group into subgroups of two, with one experienced caster in each, and set off to practice. I was a libero (soccer speak – for a player who is undisciplined, so he gets to roam around) and went from group to group running my mouth and praising technique or correcting small errors, etc. We focused on just this cast for half an hour, until it became apparent that the group was starting to lose focus. Then we reassembled in the larger group and went through the components of the cast. I was rather pleased with this first lesson and I hope that the next clinic will have a good turnout of students, especially new ones. These clinics are open for all comers.

Casting Clinic February 2018

Casting Clinic February 2018

The pickup and lay down cast

This is a basic fishing cast, and we will break it down into its components.

Its purpose is to unstick the fly from the water surface (the lift part) and cast the fly out again (the subsequent parts). We start casts by lifting the rod tip until the casting hand is at breast height. We do not rip the fly line from the water surface since that will scare the fish. When we lift the rod tip you will notice on the water that the fly line clears the surface and runs away from you to the leader. That is when you commence the casting stroke. Pay attention! If you wait too long the fly line will sag again to the surface. The idea is to have just the leader in the surface.

We start with fly line (30´ – 35´) and leader (7,5´) straight. There should be no slack in the line.

The Pick-up and Lay Down Cast

  1. Rod´s tip down and lift gently to shoulder level (peel)
  2. now we flick the line over the rod tip upwards and backwards (pluck)
  3. and pause for the line to straighten (pause)
  4. now we flick the rod forward (pat) and stop the hand at 10 o’clock. The line and leader straighten, and we let them gravitate/float down to the surface and let the rod tip follow.