Tag Archives: Creative Nonfiction

Crashing Into The Digital Age

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Thanks to Trudy’s cousin, Pud Kearns, I now have a website. With the release later this month of my book, Carrying The Black Bag: A Neurologist’s Bedside Tales, it was important to increase my visibility. So much publicity these days is online whereas before it was done more by book signings and lectures.
To my amazement within the first 24 hours of a new FB page, over 100 likes came in. Wow, that’s an impressive reach- so many people and so quickly.
I look forward to answering questions and interacting with readers. And now I have a convenient and fast way to do it. This digital stuff is pretty impressive. Book out toward the end of the month. Hope to hear from you.

HITLER’S MALADIES AND THEIR IMPACT ON WORLD WAR II

Early Praise for Carrying The Black Bag: A Neurologist’s Bedside Tales

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Wow, I’m really pleased by this early endorsement of my book due out in November. The following  review recently appeared on Goodreads:

Carrying the Black Bag: A Neurologist’s Bedside Tales by Thomas Hutton, M.D. tells the human side of medicine. Hutton’s warm storytelling will draw you into his book as you learn about what it’s like to become a doctor to practicing medicine. There are some truly heartwarming stories and some truly funny stories too. Last night I read the chapter about Hutton’s Dalmatian, Dice. Dice is not the brightest nor best-behaved dog on the planet, according to the author, as Dice managed to get tossed out of obedience school (a first I think) for his bad behavior. Dice and Dr. Hutton took a road trip, which Hutton carefully documents in his book. The chapter about the road trip is worth reading and will have you laughing. At least I was quietly laughing, as I did not want to wake up my husband who was sleeping next to me. (I love to read books in bed every night before heading off to dreamland.) Dice managed to save the day during their road trip, but you’ll have to read the book to find out how.

Hutton has other delightful tales such as the veteran who had a go-round with arsenic; there’s his tale of a Parkinson patient who played Pinochle every afternoon with his canine buddies (a hallucination probably caused by medication, according to Hutton’s book); or how love is lifelong under the most trying circumstances. You will also read about a mild mannered engineer who turns into a true Mr. Nasty thanks to a medical disorder.

Overall, this is a heartwarming book that illustrates the human side of medicine.

If I could give this book 10+ stars I would.

Highly recommend.

Review written after downloading a galley from Edelweiss.

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Man and Dog- A Special Relationship

When primitive man walked onto the pages of history, a dog no doubt trotted amiably by his side. And while the strength of this ancient bond has not diminished, the nature of the relationship between man and dog has evolved from those early days.
After wolf/dog allied with man, together they secured meat, provided mutual protection from predators, and shared body warmth during cold Stone Age nights. Man has since voyaged from caves to the moon, but this special bond, like no other between man and animal, remains.
While dogs may still fetch newspapers, retrieve downed birds, and guard against intruders, a visit to a neighborhood park nowadays reveals the main role of dogs is companionship.
Jon Katz in his book, The New Work of Dogs (Random House) depicts dogs as filling expanding roles in peoples’ lives, loves, and families.
Our lives have become increasingly private and relatively more connected digitally than by face-to-face contact. A headphone wearing skateboarder, on-line shopper, or P.D.A punching subway commuter could compete as icons of our modern age.
Diminishing direct contacts have created newer and unexpected roles for pets. Irrepressibly affectionate and endearing, our pooches provide emotional props for our lives. Our pampering, caressing, and crying over departed pets demonstrate our need both to nurture and be nurtured. Our behavior exposes, if we dare to admit it, a reciprocal dependence on our canine companions.
Many of us work from home offices foregoing daily commutes to busy workplaces. We sit at our computers, delivering services (while scratching our Canis familiaris under the desk), rather than heading off to tailor suits or hawk vacuum cleaners.
In recent years, family sizes have shrunk with less opportunity for sibling interaction. Dogs now, more than ever, serve as playmate, best friend, and protector. The Darling family, as depicted in “Peter Pan,” illustrated this point with Nana, their English Sheep dog guarding the children and serving as playmate.
Martha, a friend of mine, tells a childhood memory of having regularly been sent outdoors by her parents to play and undoubtedly to provide a rest for her parents’ ears. Lobo, her German shepherd, was always sent along with Martha who was still a toddler.
Martha and Lobo would chase and play ball in the unfenced yard that lay adjacent to a busy thoroughfare. When Martha would totter close to the street, Lobo would scamper after her, sinking his teeth into her diaper and hauling Martha back to safety into the yard.
Lobo, like the fictional Nana in Peter Pan, served as both playmate and trusted baby sitter.
The nature of friendships in modern society has evolved or devolved depending on your point of view. Some cultures today and many earlier ones held lifelong friendships as nearly sacrosanct. With modern mobility and inevitable relocations, such filial attachments have diminished. Often before indelible bonding can occur, a friend up and moves away. Such abrogation of nascent chum-ships prevents lifelong friendships from years of shared experiences from ever forming. Nevertheless, our societal mobility affects our canines not in the least, as they accompany us willingly, as we move about from place to place.
Changing personal traits may have also diminished the quality of our human contacts. Don Chance, a Louisiana State University finance professor, blames an increasing sense of entitlement among his college students on the late Fred Rogers. In an article written by Jeff Zaslow in the July 5, 2007 issue of the Wall Street Journal, Professor Chance describes what can be called the “Mr. Rogers effect”.
The late Fred Rogers, a Pittsburgh Presbyterian minister, for years hosted a popular children’s TV program-“Mister Roger’s Neighborhood.” He possessed a gentle and affirming nature and aimed to make young viewers comfortable with their circumstances and improve their self-esteem. Toward this end, he affirmed them, by saying that he liked them, just the way they were.
Unfortunately, many parents, teachers, and much of intelligent humanity saw a yawning need for improvement in the decorum of many of these pint-sized reprobates. Along with improved self-image according to Zaslow, Fred Rogers contributed to leading generations of youth toward a finely tuned narcissism.
“If I am just fine the way I am, why should I improve or interact better with others? Why worry about the needs of others, as the kindly Mister Rogers likes me just the way I am?”
Obviously Fred Rogers cannot be solely blamed for excessive doting on our offspring. He undoubtedly meant well, instilling self-confidence in his youthful viewers. However, Mr. Rogers epitomizes a phenomenon among some young adults today of increasingly impolite and solipsistic behavior.
Despite our insular ways and self-centered behavior, many of us remain emotionally starved. Along with our 36-ounce drinks, we seek and need over-sized dollops of affection. If we fail to receive succor from large families or long-term friendships, then we look elsewhere, but where in modern life might we find it?
For the family pet, an opportunity has developed; one for which Fido has proves far more skillful than in retrieving the newspaper. But how can dogs communicate their support?
I know my dogs, Bandit and Mollie, patiently listen to my shtick. They have no difficulty making their wants known. For many lonely people, dogs represent their best, and sadly, only willing listener.
What about you and

Man's Best Friends

Man’s Best Friends

your dog? Let me hear from you.

Buddy

I love Border collies. This statement will never be called into question by those who know me. Not only do they make great pets, they have proved valuable in herding our cattle at Medicine Spirit Ranch. Especially impressive have been feats of herding involving our well-traveled bulls to neighboring, overgrown ranches. Without Border collies, the bulls might still be AWOL.
The story that follows is about Buddy. Please give me your feedback as I plan to submit this piece either to a contest or possible publication. It needs to be as good as it can be.
In its initial form the story had a middle portion showing Buddy’s incredible herding abilities. In this shortened story, I skipped the middle portion in the present version in the belief it took away some of the punch. I look forward to your comments.

 

Buddy

Impatiently, he waited for me to stop the pickup, piercing the night with excited, high-pitched yips. His succession of barks resounded up and down the hill through sheening groves of moonlit juniper.
Once the pickup had nearly stopped, I watched in the side-view mirror as my border collie burst from the bed of the pickup like a cannon shot. I pressed hard on the accelerator, attempting to outdistance Buddy to the garage a quarter of a mile ahead- a tiny victory, long sought after in this our nightly contest, but one not yet realized.
In the darkness, I could only make out the white “shepherd’s lantern” at the tip of Buddy’s tail. It appeared and quickly disappeared, as he sprinted through low brush, behind trees, and into gathering shadows.
I silently lauded his long strides as they gobbled up the gray ribbon of our ranch road. His youthfulness and agility made me a little envious as they contrasted with my increasing years and diminishing physical abilities. Age may have certain advantages but flexibility and speed are not among them.
The road bent away from the house in a semicircular direction while Buddy took a shortcut across a field of native grass. Before our paths diverged, I caught a glimpse in the headlights of the determined black and white collie, with ears back, charging confidently ahead. During this final sinuous stretch of ranch road, Buddy would typically overtake me, given his ability to out corner my hoary Dodge pickup. I galumphed over a rusty pipe cattle guard and plunged down the driveway toward the waiting garage and faux finish line.
Minutes later after parking the old truck, I looked for my competitive canine. I was surprised not to find Buddy waiting on the driveway with his usual smug look pasted across his muzzle. I waited a minute…. and then another, but he failed to arrive. I walked out onto the front lawn. The smell of newly mown grass and honeysuckle wafted over me. I breathed deeply, enjoying the scent. More minutes ticked by. My surprise became worry, giving way to eventual alarm.
I jogged awkwardly across the yard, searching the gloom of night for his familiar silhouette. What I spotted took several long moments to register. Slowly, like a photograph developing in a darkroom bath, it became clear, frighteningly clear to me. When it did, it filled me with an inky dread.
My normally agile Buddy moved oddly. I hurried closer to gain a better look. I was shocked by what I saw. My heart sank because Buddy with great effort was hauling himself along with his powerful forelimbs, his back legs lifelessly trailing behind. The significance crashed over me like a cataract over a broken dam. Oh my god, he’s paralyzed!
Within minutes I placed an urgent phone call to our veterinarian. Thankfully he responded immediately and said he was still working in his office and immediately to bring Buddy in. My wife, Trudy, and I gently lifted Buddy into the car and rushed back down the ranch road and across town. Red lights exasperated our progress, as did the sated, unhurried diners departing restaurants on Main Street. I felt additional tension welling up within me. On arrival at the one story, white stone veterinary clinic on the east side of town, I gathered Buddy in my arms and carried him through the double glass door Trudy held open. Within moments of Trudy ringing the bell on the counter, Dr. O’Neill appeared behind the main desk and proceeded to lead us down a darkened hallway to the first examination room. The clinic had a faint odor of wet dog mixed with an astringent smell.
Our vet flipped on the overhead light and asked me to place Buddy on the exam table. Following a quick examination of Buddy’s back, checking for movement in the limbs, and determining if Buddy felt a pinch to his hind foot, Dr. O’Neill gave an audible exhalation and said, “Mmm.”
“What do you think?” I asked.
“Well, Buddy needs an MRI–scan and may even need back surgery.” The weight of those words, while sympathetically uttered by the kindly, square-faced veterinarian, struck home like a hammer.
“Oh no!” Trudy cried out, her words echoing through the vacant halls of the clinic building.
The meaning of his words was all too clear, but I was flummoxed as to how Buddy had injured himself and what might be done to reverse it. “But, but what happened?” I asked while stroking Buddy, who lay quietly on the stainless steel examination table. His trusting, liquid eyes repeatedly searched our faces for an explanation for all this fuss.
“Sometimes these athletic dogs can explode a disc from their spinal column, causing weakness of the hind limbs,” Dr. O’Neill replied. He tenderly ran his hand over Buddy’s furry black and white head and gave his ears a fleeting scratch. “I’ll call ahead to an all night veterinary surgical center in San Antonio, let ‘em know you’re on your way and ask them to kick-start their MRI. Awfully sorry about Buddy, really am, he’s a fine dog. Sure hope they can help him.” His voice trailed off, containing traces of both hope and lament.
Shortly after and at high speeds, we hurtled southeastward through the deep Texas night on a winding U.S Highway 87. Overhead I viewed the blurriness of the Milky Way and Orion. Silvery moonlight fell between tree limbs and lay on the ground in shattered pieces. I switched the headlights to high beam to probe the uncertain darkness ahead of us.
We soon turned onto the four lane and divided Interstate-10 in the direction of San Antonio. I noticed eighteen-wheelers, heading at high speed in the opposite direction toward El Paso and, no doubt, the West Coast. Ahead of them lay over a thousand miles of desert with limited access to assistance should they break down. I, on the other hand, was headed east toward similar uncertainty. In the backseat Trudy cradled Buddy’s head in her lap, saying little.
On arrival at the San Antonio location, I hurried out of the car and opened the back door to gather Buddy into my arms. I rushed him across the asphalt parking lot into the nondescript emergency veterinary clinic. A diminutive and surprisingly young veterinarian approached us with a confident stride. She had high and well-defined cheekbones, a reassuring smile, light brown hair pulled back in a ponytail, and an air of quiet competency. After a brief exchange, she took Buddy, and with his added weight waddled away down the green tiled hallway.
I noticed Trudy had a frightened look on her face. I felt helpless to reassure her, fearing the worst possible outcome for Buddy. We lingered in the dimly lit waiting room that was filled with about a dozen worn, inexpensive chairs, a few marred wooden side tables, and a single TV that blared a documentary on the destructive nature of feral hogs. I tried to ignore the booming TV and paced restlessly, my mind full of thorns.
The petite veterinarian soon reappeared. Her green eyes darted about and her face expressed concern. “Dr. O’Neill was right. Looks like your dog herniated a disc fragment from his spine causing his paralysis. A disc can shoot out into the spinal canal like a bullet from a rifle. Your dog’s spinal cord received a pretty good wallop.”
“Can Buddy recover?” asked Trudy.
I saw the veterinarian drop her gaze and pause for several long moments before responding. She shrugged her shoulders, raised her head, evidencing a furrowed brow. “Time will tell. Whether the fragment still compresses the cord can be determined only by an MRI-scan. You’ll need to decide if that’s how you want us to proceed.”
If the disc still compressed the delicate cord, I knew de-compressive surgery would be required, and soon, to prevent permanent paralysis of Buddy’s back legs.
“I need to go check on a Labrador who decided to tangle with a pack of coyotes. The poor old boy got chewed up pretty good.”
I made a sympathetic comment regarding the Lab but my real concern lay with Buddy.
“Will check to make sure the MRI is free, that is if you decide to proceed that way. I’m leaving Farah here to answer any questions you may have,” said the veterinarian. She turned on her heel and with purposeful strides and ponytail bobbing strode away in the opposite direction. My gaze trailed the retreating veterinarian down the hallway like a lonesome puppy. I saw her pass through the door at the end of the hall and close it with such finality that it made me wonder if I would ever again see my collie alive.
Grief and fear overwhelmed me. Trudy’s cheeks glistened and I heard muffled sobs coming from her. We embraced, knowing not what else to do. The sad look on my wife’s face would have brought a tear to a glass eye.
The veterinarian had left behind a young, spherically built vet tech to answer questions. The plain-faced assistant appeared to have three chins and reminded me of the stolid, hardy pioneer women who, along with their men, had settled the Texas frontier in the 1800s.
What followed next was an unexpected and wholly different kind of trauma delivered by the no nonsense vet tech: “The cost of the MRI-scan is $2200 upfront,” Farah piped up in her flat, broad Texas drawl. “This is in addition, of course, to the afterhours clinic charge and veterinary expenses.” She said this while smacking her gum and fingering the stethoscope dangling from her side pocket. Farah had an unblinking expression, lacking in emotion or empathy.
Guess this is where she does the wallet biopsy to check our ability to pay.
She next rattled off costs for surgery including anesthesia, medicines, and rehabilitation. Exorbitant, I thought. Would Buddy really need weeks of pool therapy to recover? Somewhere in the conversation I confirmed her conjecture that Buddy had actually cost us nothing, being born to Mollie, our Border collie bitch.
This could end up running $3000, maybe $4000 even without the surgery! With surgery just no telling the final cost!
“Even with surgery, no guarantee this dawg’s ever gonna walk again,” she said. Her drawn out words seemed to hang in the air like a slowly dissipating puff of smoke.
I avoided her laser-like gaze by glancing out the window, viewing a faint glow in the east following the long and broken night.
The technician drew my attention back by saying, “Need to consider what kinda life a paralyzed dawg would have, especially a working dawg like your border collie.” I heard her talking but her words were slow to penetrate my thinking because of my great affection for Buddy.
“Might just wanna euthanize the dawg? Sure ‘nuf be a whole lot cheaper,” said the vet tech, impatiently looking back and forth at Trudy and me as if watching a lantern swinging in a windstorm. I noticed her cheeks and chins wobbled with the excursions of her head.
Neither Trudy nor I responded to her indirect advice, all gussied up and impersonating a question. I glanced at Trudy’s face, mirroring my own dismay. I slipped a supportive arm around Trudy, trying to steady both my wife and my own rocked emotions.
The course that the vet assistant advocated was, I knew, based on sound economics for a working dog. It was just as when a rancher makes treatment decisions based on price/expense ratios for his livestock. After all it didn’t make sense to do a thousand dollar surgery on a five hundred dollar steer. Wasn’t the same rationale also true for a working cow dog? To do otherwise invited financial loss in an already challenging vocation with a very narrow profit margin. I was new to this ranching bit, but I somehow felt differently about my dog. But I also knew the wrong decision could doom Buddy to a dreadful life of paralysis. My mind was dizzy with conflict. I felt a terrible resignation wash over me.
“So what you wanna do? Want us to just put the dawg down?” Each word struck like an icepick. Time passed as if in slow motion. Trudy took a step backward and slumped into a chair. She buried her face in her hands and sobbed. The TV assaulted my ears with its cacophony of inchoate sounds. I failed to respond to the technician’s awful query, my mind in fitful desperation having by then escaped to a fonder memory of Buddy during cheerier times.

Years later, it was I who suffered from a back injury. I lay prone in my bed with my right leg frog-legged out, suffering from a ruptured disc in my low back. For six weeks I had assumed this awkward position, popping pain pills as if they were popcorn, and dreading the real possibility of impending surgery. For hours on end through the window I watched the flitting and swooping of barn swallows. I saw them disappear under the eves to their protected nests with morsels in their beaks for their hatchlings.
Along with her usual workload, Trudy had assumed my routine ranch chores. Her activities required prolonged absences from the house and this along with the remoteness of our ranch house forced an unanticipated silence in my life.
No longer was the opportunity for introspection competing with the demands of vocation, meetings, or ranch responsibilities. Following my retirement from a hectic medical practice, Trudy and I, as if compelled by habit, had become immersed in ranch work, volunteering, getting a new home in order, and establishing our presence in a new community. We had sought a reordering of our lives in a community, ripe with exciting opportunities. All my activities had earlier been put on hold weeks due to my injury.
It occurred to me, as I lay there hour after hour and day after day, that my existence before the injury had been like standing mere inches from a TV screen, unable to clearly make out the flickering images. Only now during my inactivity was I able to back away and see what was really taking place.
My new mental and physical distance from the hectic life had also brought about a sharpened awareness as to what was truly important. While travel, work, and professional accomplishments were important and had offered a degree of satisfaction, what seemed really important were the personal relationships and the imprint that love in all its forms had firmly stamped upon my life.
I lay there recalling the exhilarating intoxication of amorous love, the assurance and satisfaction that accompanied mature love, the quiet wonder of family love with the caressing voices and company of openhearted children and grandchildren. I thought of the nurturing love that comes from expanded knowledge and from my personal search for wisdom. I pondered the spiritual and devotional love that relinquished self to a greater good. I also recalled the unconditional love between pets and their humans. When thinking of pets I thought of Buddy. Love with its many faces had invigorated my life, comforted me through challenging times, and had fed and nurtured my spirit.
While convalescing from my ruptured disc, I frequently recalled Buddy’s tragic back injury so many years earlier. I assumed his back injury had been as painful as my own, but he had braved his injury with great courage and without pain medicine. I relived the mental anguish over that night at the veterinary clinic in San Antonio when presented the persuasive but repugnant option of euthanizing him.
At least there hasn’t been any talk of euthanizing me. I chuckled out loud. My long-standing feelings of hurt over Buddy resurfaced once again- a sickening mental all-time low in my life that just then co-mingled with my back pain.
I remembered during the darkest nights at our new ranch, walking behind Buddy’s white tipped tail and him leading me home. Like a beacon his shepherd’s lantern had always stood out, signaling both his movement and the path I needed to take.
As if controlled by an alien force, my hand stole out behind me and blindly searched the bed covers. I felt the coolness of the cotton sheet as my hand swept from side to side like the pendulum of a grandfather clock. And there it was. I felt moist breath on my hand, followed by a distinctly wet nose, and whiskers that tickled my hand.
I scratched behind the soft, furry ears of my now elderly Buddy. His tail began to thump happily against the bed. I cocked my head around to see him gazing at me with expressive and soulful eyes, his head cradled on his paws. From his position of recline, he slowly and mechanically stood, his back abnormally humped. He gingerly approached me. Buddy then circled three times and he lay down. His gait and actions had slowed but he showed no hint of complaint or surrender to the circumstances life had dealt him. Buddy had not required surgery and with time and home therapy had largely regained his strength in his hind limbs.
Buddy’s life had been complete with joyful forays around the ranch. He had nimbly herded our cattle, frolicked in fields festooned with bluebonnets and Indian paintbrushes, and had cared for his humans. I had no doubt he felt contented.
For weeks Buddy and I had lain beside one another in the quiet bedroom. There we shared our common sense of community. How unifying it all seemed. We two beings had been apportioned a common fate– suffering similar infirmities and growing older together.
I found Buddy’s presence comforting. Having witnessed his defiance of his injury gave me both increased strength and augmented my limited store of patience. Buddy’s tolerance for his diminishing physical abilities had imparted a life lesson not soon forgotten.
Just then, as if to show thanks and demonstrate his devotion, Buddy gave my hand a languid, velvety lick.

Am I In The Publishing Backstretch Yet?- Part V

I labored under the impression that an advantage of a traditional publisher over self-publishing was that marketing and manuscript processing would be done for you. Wrong!!! All publishers these days must suffer from financial pressures as they ask authors to perform as much of this work as they can. Limited budgets and limited staff time are the explanation I have heard.

I was asked to format the accepted manuscript according to Tech Press specifications. This consisted of converting the accepted manuscript into a form that was easier for the publishing process. Secondly, a lengthy marketing questionnaire instantaneously arrived via the internet, but required much longer for my research and completion of it. The standardized questionnaire asked how and where Tech Press should advertise and many other questions related to book promotion (now those were tricky ones and likely my thoughts will not prove very helpful).

Also I was asked to obtain permission for images to appear in the book. This seemed quite reasonable but was a challenge. Researching where the image first appeared and by whom can prove difficult. In my case I mainly sought pictures of Adolf Hitler held by various European museums and the Library of Congress. Gaining permission for using these for my chapter on the impact of his Parkinson’s disease represented new and unfamiliar ground for me to till.

Once this identification phase was completed, I contacted the museums or individuals holding copyright and, in some instances, paid to use them in my book, Carrying the Black Bag: A Neurologist’s Bedside Tales. This proved a time consuming slog.

The Tech Press questionnaire also asked me to pen promotional copy for the back cover and to provide a brief bio and picture. I admit, self-promotion is awkward and hard for me to do. Nevertheless with the help of my publicist and marketing gurus at the publisher, brag I did!

I completed each of the thirty-five queries. As it turned out the process forced me to shrink my conceptualization of my book down into sound bites. I had previously found “the elevator presentation” hard to manage.Every author needs to describe his/her book in simple declarative sentences that weave a strong argument for buying it. To be sure, completing the questionnaire helped me with this effort.

Feeling like this guy?

Feeling like this guy?

 

Winding my way through the publishing maze has at times made me feel like the mouse in this cartoon. It is doable but at various points in the process-confusing.

I hope my experiences will interest some and help others attempting to publish their books. Who knows what lies ahead? Publishing is not for the faint-hearted!

Agents, Publishers, and Editors, Oh My!– Part IV

Seeking an agent is, of course, optional. Nevertheless, sending your work “over the transom” to publishing houses frequently lands it in their circular files. Publishing houses say they do not have time to review every manuscript they receive. But even finding an agent can be challenging. So what are ink-stained minions to do?

Various books such as Literary Digest exist with the names and locations of agents. These can be sought out and agents identified willing to review material from new authors as well as their expertise in the genre you write.

For me, I found two potential agents at the Harvard Medical Writer’s Conference. The conference had  distilled down the pool of agents to those interested in doctor stories. I submitted to these two and, to my surprise, both wanted to represent me. This represents the only time the time frame of the publishing process was shorter than anticipated. I know my ease in finding an agent is not the norm. Good luck!

I quickly learned from my experienced agent, Don Fehr, at Trident Media in NYC that publishers did not buy books, they only buy well-written and compelling book proposals. While I had labored mightily to complete my book proposal, Don with his knowledge had several suggestions that helped it. I lengthened the proposal to seventy-five pages, bolstered several sections (especially the comparative literature section), and cut off one sample chapter. An agent possesses knowledge about to whom the proposal should be sent. I didn’t have a clue about this and the fifteen percent fee charged by my agent seemed entirely reasonable.

My agent submitted the proposal serially in three lots. I learned from observing these acts of literary commerce that all publishers are not necessarily timely in responding, even from agents whom they know well. Months became years. The waiting time for me crept by like a caterpillar with sore feet.

The initial responses when they finally arrived consisted of “we do not have experience or expertise with this kind of book,” or “we are having to limit ourselves to only a few publications this year, or similar “passes.” “Passes”, hell, each and every one felt like a searing, bald-faced rejection, a real punch in the groin. So what if thirty-three rejections occurred before the final ACCEPTANCE? How sweet the acceptance.

Texas Tech University Press received my proposal with enthusiasm and asked me to submit the full manuscript. Another six months unfortunately slipped by when the then Director of Tech Press unexpectedly retired and failed to pass my book to a colleague or to even download it into their system. When eventually the error was discovered, my submitted book took flight, winging its way to two external reviewers. Both mercifully provided prompt and strongly positive endorsements.

My wonderful editor at Tech Press, Joanna Conrad, made several deft observations and tactful requests. I worked for three months responding to her requests that consisted largely of personalizing the manuscript more. What had been a combination memoir and medical narrative became a stronger physician’s memoir. After addressing her edits, the manuscript was re-submitted and was better for the extra effort.

A final editorial committee (you just knew there would be a committee at a university publishing house somewhere) gave the book a big thumbs up along with a positive recommendation from the Editor at Texas Tech University Press. Voila! I am at last to be published! Praise the Lord and pass the champagne!

At this point I thought my portion of the publishing process was largely completed. Again, my assumption would be proved wrong.

 

So You Want To Write-Part 2: The Early Days

I suppose for years I’ve harbored the desire to write for a popular audience. A strange visceral need to be sure, but after it strikes, it’s hard to deny.

While practicing medicine, I would cubbyhole an interesting case file or article to later return to for inspiration. Some dramatic experiences in medicine simply demanded more processing time than my busy medical practice would allow. These records, by the way, helped me develop the stories for my forthcoming book, Carrying the Black Bag: A Doctor’s Story.

Not long after retiring from neurology, I signed up for popular writing classes at the Texas Tech University Higher Education Teaching Site in Fredericksburg, Texas. A retired writing professor who had relocated from a faculty at Houston university taught these courses.

At the time I felt I had a reasonable understanding how to write for a popular audience. After all, I had edited some five medical books and authored over 100 scientific articles and chapters. Wow, was I wrong!

Not only did my scientific writing skills not help, in some ways they impeded my progress toward  writing for a popular audience. I would never have suspected this.

Scientific writing must be concise. The space available in scientific journals is precious indeed and editors are maniacal in their attempts to excise excessive verbiage. This results from more worthy articles being submitted than there is space to print them.

I had also mastered the unfortunate but well ingrained habit of using jargon and passive voice. I had earlier been discouraged by journal editors from using popular writing devices such as similes, metaphors, and alliteration. Colorful description in scientific articles was absolutely verboten.

This painful lesson I learned early on from a irritable editor. (In an earlier draft I used the term dyspeptic editor, resorting again to a term not commonly understand. Over learned writing habits are hard to break as I just proved.) The jargon impedes communication to a popular audience to be sure, although it shortens the description necessary-a cardinal requirement for scientific writing.

When writing for a popular audience, I found having to monitor my word choice closely to avoid this insidious habit of using jargon. Lets face it–scientific writing is dull reading and impenetrable if lacking the professional jargon.

Scientific writing also follows on from studies for which data and methods exist. Popular writing has less rules and demands greater creativity. The guideposts are less obvious for popular writing. Any of you with an MFA in creative writing feel free to differ with me on this point.

I remember one day in class being given a general topic to write on and having a devil of a time being creative enough to write a story about it. The idea seemed to come out of no where and lacked context. There had been no experiments, no case file to review, and no scientific literature from which to begin. Ah, the terror of a blank page reared its ugly head! Needless to say, my class offering was short in the extreme.

Naturally, I became most comfortable writing about topics about which I knew something–experiences from medicine and my new found retirement to a Texas cattle ranch. Nevertheless, i have over the years learned to dabble in fiction and occasionally to venture further afield from my comfort zone. While my fiction is of poorer quality than I desire, my attempts as they have unspooled at least have loosened me up.

At the conclusion of my writing classes, I realized I was having such a good time that I did not want to stop. I suggested to several of my classmates (old friends at this juncture) we form a writer’s critique group. Just because our instructor had decided to stop teaching did not mean that we had to stop meeting. This venture soon proved a helpful exercise about which I shall write next. Critique groups are extremely useful but certain precautions are needed. My opinion springs from having experienced both positive and negative outcomes. More later.

My Book Will Be Published

Good News: I’ve had a book accepted! The title likely will be Carrying the Black Bag: A Doctor’s Story. My editor currently has me rewriting four of the eighteen parts of the book, a task that has lately consumed much time. Nevertheless, my editor was spot on and the book will be better for the effort.

My book will come out next fall. It will tell of my life as a doctor and of especially memorable patients who demonstrated unusual courage, humor, and bravery in the face of sometimes life threatening illnesses. The stories are inspirational and useful for anyone who knows someone with a serious illness or who will someday develop a serious illness. Well, that is just about everyone, I suppose. I also hope it will speak to health care professionals about our very special roles in caring for others.

The patient stories I tell were so important to me that I spent years writing, rewriting, editing, and reediting them. In most instances I am the last person standing who can relate these often poignant stories about special people who trusted me not only with their medical care, but also with their private thoughts.

In all likelihood I will divide this blog into two parts: book related and ranch (retirement) related. I am thinking about adding a second category of Views From the Black Bag to parallel Views From Medicine Spirit Ranch. What do you think? Please let me know.

I plan to share in upcoming posts my long process of unlearning scientific writing skills and learning popular writing skills. This has been tougher to do than I ever imagined. It’s as tough as trying to get rid of belly fat. And it’s not just all about losing the jargon either.

I will keep you posted as to the process and progress of this exciting writing venture.

Intruder

The major transition points in life, e.g. retirement, have similarities to the boundaries of a ranch. It is at these dividing lines in life or geography that  stressful but often memorable events occur. The story below happened shortly after I retired from medicine  at the boundary fence of our ranch. The players are two rookie Border Collies, Bandit and Mollie, and one rookie, newly minted rancher, me. There is also one VERY large intruder. I hope you enjoy the story.

Intruder

 

For no apparent reason, my dogs’ ears suddenly pricked up. Their muscles tensed.  Mollie began to quiver and emit plaintive moans.  Wet snouts pressed forward, panting moist and warm on my neck. Just moments before Bandit and Mollie had been sitting in the backseat, calmly peering through the windows at the passing Texas Hill Country landscape.

We were traveling along a wash-boarded caliche road. The pickup shimmied down a steep hill, passed by a stock tank, and galumphed across a rusty cattle guard. Aggressive treads on sixteen-inch tires made crunching sounds on the limestone roadbed.

Twenty minutes earlier Bandit, our six year-old male Border Collie, had been relentlessly pestering me. His impatience had taken the form of mournful whimpering and pleading golden brown eyes. From a brief glance in the pickup’s rear view mirror, I thought I could detect a smug look across his whiskered muzzle.

From years of experience, I realized Bandit’s insistence could not be resisted for long. He had a history of inexorably wearing people down with his limitless canine shenanigans.  Nevertheless, a show of male gumption had seemed necessary on my part. As the steam rose from my coffee cup, I muttered to no one in particular, “What nonsense, it’s my ranch, I’m in charge, not that house demolishing, canine nut case!” Finally, as was typical and of no surprise to Trudy, my wife, Bandit succeeded in mobilizing me out of my chair and out of the house.

As we rode along that morning, Mollie applied furtive, staccato-like licks to my neck.  Was this her expression of appreciation?  In contrast to the more languid licking Bandit, Mollie, our three year-old, blue-eyed Border Collie demanded less attention and was far less demonstrative. While Bandit would nudge, paw, and connive to make his wants known, Mollie would usually sit a few steps away, studying every nuanced human behavior– Yoda-like through half closed eyes. 

Mollie loved to ride in the pickup. Mere mention of a trip would provoke frenzied barking and a skittering of paws on hardwood floors. Her fondness was largely anticipatory, as Mollie’s greatest delight in life was herding.

We had previously lived in the city of Lubbock where Mollie and Bandit, lacking livestock, had herded whatever moved. At times this had included groups of neighborhood children who chose to play in our yard, largely unaware cocktail party guests who surprisingly would realize they had all been rounded up in a tight knot, and most especially slow to move, human family members. An insatiable instinct to herd had over the centuries been bred into Border Collies and, as a defining characteristic of the breed, proved second only to an amazing intelligence.  I sensed Mollie had permanently tasked Bandit with the rallying of family members, a job Bandit seemed to relish even more than a juicy steak bone.

            My doggy road crew and I meandered along in the “Old Gray Goat”- a nickname Trudy and our two grown children had given my aging Ram pickup. After the dogs had alerted, they remained fixated on whatever excitement it was that lay ahead. I could see in my rearview mirror how their eyes stared at a distant spot, as if their gazes like matter were drawn into a black hole.  Then Mollie gave an ear-splitting yelp and began climbing into the front seat. 

While forcing Mollie back and navigating the Gray Goat around a clump of Live Oak trees, our herd of cattle came into view.  My growing concern began to gnaw more deeply, but I lacked an explanation for my anxiety. The dogs then became still more agitated and began to race back and forth in the backseat.  A disquieting sensation arose in my gut that something was very much amiss. But what was it?  After several moments of visually searching, the answer gradually became clear, like finally achieving focus with a pair of binoculars. 

“Awwwww shit,” I yelled to no one except my already aware canine companions. With my fist, I pounded the steering wheel in frustration.

He would have been hard to miss. The white bull was huge and contrasted sharply with my herd of smaller black cows.  He possessed a massive, shaggy head accented with black ears, black nose, and curiously black-rimmed eyes. In excess of a ton, the bull’s size alone would have made him stand out from the others, as he was at least twice the size of my Black Baldy heifers.

I looked for the small Black Angus bull that was supposed to breed the heifers but found him nowhere in sight.  Almost immediately I realized the behemoth before me would produce large and undeliverable calves. This mammoth bull had to be removed and the heifers protected, but how? 

Panic began to flow over me like a cold, breaking surf. The unfortunate reality was that the welfare of these young cows depended on me– a recently retired city guy and newly minted but largely clueless rancher.

I swung hurriedly out of the pickup and forcefully shoved two intensely interested Border Collies back into the truck cab. Unmistakable disappointment appeared on their muzzles. These rookie dogs, if unleashed, I thought, might cause a stampede and in any event would only be in the way.

I glanced to my left and spotted a mangled section of downed fence.  Barbed wire dangled from broken cedar posts that had snapped like matchsticks.  The ground nearby was gouged and scraped, as if by spring tilling. This area, I realized, was the scene of an unsuccessful defense put up by the smaller Angus bull.

In an attempt to learn something about ranching, I had read several books on the subject. What else would you expect of an educated city guy? Bulls, I had learned, were intensely territorial. The resident bull would usually confront an interloper at the fence line and ferociously defend his domain.  The gouged ground before me spoke to how the smaller Angus had made such a vain attempt, but given the size difference, he would have had no more chance to repel the huge white interloper, than would a destroyer pitted against a giant battleship.

On impulse I picked up a small limb and proceeded to strip off its smaller branches. I then pressed ahead in the direction of the great white bull. My hand repeatedly gripped the stick’s rough bark, as if milking it of a plan for expelling the pale intruder.

My intense concentration distracted me so that I failed to see an exposed tree root. My body hit the ground violently. As I landed, a hot, searing pain exploded down my leg and into my lower back. My head next hit, smacking into an unfortunately placed cow patty. I felt dazed and momentarily disoriented. As I gathered myself and slowly pushed myself up from the ground, the pungent smell of dung assaulted my nostrils.  My initial embarrassment was replaced by a seething rage that rapidly welled up within me. I distractedly scraped cow dung from cheek and glasses and began to limp onward, my anger overcoming the pain. 

“I’m coming to get you!  Can’t sneak onto my ranch!”

What I expected to accomplish by making such a patently hollow threat was unclear, but lacking a plan, bravado was all I could summon– outrage having swallowed common sense. As I saw it, the bull threatened my kingdom and challenged my role as protector of the yearling heifers.  Bulls, to be sure, were not the only territorial animals on the ranch that day. 

The herd grazed lazily in a nearby paddock about two hundred yards from my abandoned pickup. When my limp-along advance had closed to within thirty yards of the herd, the bull raised his massive head from his grazing and slowly turned to stare in my direction.  His baleful eyes bored into me, halting further progress.  The bull’s unblinking black eyes projected what I perceived as surly defiance.  I was especially taken aback by the size of his massive neck. It was huge–thicker than a man’s chest.  Steeling my resolve, I foolishly crabbed forward, my eyes measuring the distance to what I hoped was a safe retreat to nearby cattle pens.

The four-stomached herbivore lowered his massive head and began to repeatedly scuff a huge cloven hoof along the ground, throwing dirt up and under his enormous belly. The intent of the bull’s aggressive display was unmistakable and once again stopped my forward movement.  I was close enough to him to observe how his dirt-caked nose dripped, and how drool streamed out of his maw. He began to make a rumbling, low-pitched sound, as if from a bass speaker. The sound was so granularly deep; it was hard to imagine it coming from an animal, but rather more fittingly from some sinister subterranean chasm.   Evolution had designed this menacing warning to frighten away other bulls, predators, and no doubt foolish, beginner ranchers like me.

The bull mercifully did not charge or I likely would not be writing this piece.  Perhaps startled at seeing a yelling, flailing, idiotic man, carrying only a small limb, he chose instead to relish the entirety of the scene by falling back.  The novelty of my hobbling charge might have given the creature pause. Alternatively he may not have even viewed me as a threat, but more of an inconvenience, like a pestering swarm of black flies. 

For the next twenty minutes, I gamely attempted to separate the bull from the herd. I ran at him yelling wildly. I threw rocks at the bull and verbally berated him. I threatened him with my unimpressive stick. All my efforts proved useless.  Despite the coolness of the morning, I soon found my shirt soaked with sweat and my legs aching. My lungs began to burn and demand more oxygen, forcing me to bend over and rest my hands on my knees.

On one brief occasion I separated the bull from the heifers, only to have him rapidly circle me and rejoin the herd. Irritation and humiliation settled over me like a morning fog.  Bulls, I learned, could move surprisingly fast to be such massive animals.

Defeated, exhausted, and still smarting from my fall, I stumbled back toward the pickup. The sun had by then climbed high above the eastern blue hills but provided no illumination as to how to evict the trespasser from my ranch.

I turned back toward the surly creature and, and just in case any nosey neighbors happened to be watching from over the fence, shook my fist in the air and yelled, “Just you wait, I’ll make you the biggest meatloaf in history, make the Guinness Book of Records, you will!” 

Despite my bluster, I felt thoroughly and unequivocally diminished. A roving ruminant had outsmarted me. Heading toward the pickup, I heard my boots scraping along the ground. I felt ashamed because with all my years of advanced education, I had been outwitted by a dumb bovine. I was exhausted, stank of dung, and ached from my unsuccessful, sophomoric effort.

As I neared the pickup, I began to hear frantic but muted howling.  When I looked up from the caliche-strewn ground, I was surprised to see the pickup rocking from side to side. I heard Bandit and Mollie’s muffled wailing, obviously demanding their release from the cab. 

I could see that Mollie had jumped into the front seat and was careening from side to side. She banged into the doors, using her body like a small battering ram.  In his frenzy, Bandit had shredded the back seat upholstery. Shredded white seat stuffing made the interior resemble a winter snowstorm. A piece of the padding still crowned his black and white head, like snow atop a mountain peak. I stood dumbfounded, looking at the swaying truck and the havoc ensuing within. I learned a valuable but expensive lesson– never leave a Border Collie in the pickup when near the cattle herd.

My dogs seemed to be demanding their chance with the bull. But realistically, how could small, inexperienced dogs from the city confront this mammoth creature? Bandit and Mollie could be hurt or even killed. The risk seemed too great to consider.  I felt anguish, torn between by fear for my dogs’ health, yet equally tormented by feelings of responsibility for the well being of my heifers. 

Many good reasons for not releasing the dogs flitted through my mind: they could be kicked, stomped, or butted.  They could stampede the herd or run off in fear and become lost. But what other possibility did I have to protect the young cows from their reproductive fate? The dogs’ frenzied desire to participate, in what seemed their Border Collie birthright, struck me as compelling. 

I grasped the door handle, but still I hesitated. Should I really open it? I had no real chance of removing the bull on my own, having already failed miserably. Certainly the dogs could do no worse than my misadventure, which had driven the intruder still farther from the breached fence line. 

Peering through the window of the pickup, I asked the collies, “You guys wanna help?”

Deeply emotive howls erupted.  Their tails beat a staccato against the seatbacks. Their eyes demonstrated a burning intensity, and their bodies quivered, as if racked by fever. I tentatively pushed the button on the door handle, cracked the truck door ever so slightly, only to have it blown open, as two yelping Border Collies erupted like demons streaming out the gates of hell. 

“Go get the bull!  Get him!” I screamed after them, my voice full of desperation.  The dogs, like low flying cruise missiles, immediately sped off in the direction of the herd.

The two dogs charged pell mell across the pasture. Mollie, the younger and more recently acquired dog, was first to reach the vicinity of the bull.  She cut her stride, dropped her head, and began cautiously to circle the herd.  When an opening arose, Mollie darted between the bull and the cows.   There she crouched, fixing an unwavering Border Collie “eye” on the giant white bull.  The bull immediately alerted to her presence and froze in place.  Mollie then hunkered down about ten yards away from him, as if awaiting Bandit’s arrival. 

And this was not long in coming and consisted of a headlong, yapping, suicidal charge straight at the gigantic bull. Bandit’s kamikaze onslaught caused the giant bovine to spin around to face his reckless attacker.  But at the last instant, Bandit veered off, barely escaping a fierce head butt. This diversion of the bull’s attention, as if by signal, prompted Mollie to surge forward and repeatedly bite the bull’s hind legs. 

The bull appeared at first startled by the nips and then perturbed by them.  He twisted his massive body around to determine the source and focused his malice on Mollie. The bull clattered a huge hoof over the rocky ground.  He bellowed a loud, deeply pitched warning, turned, and retaliated with several ferocious kicks that narrowly missed her.  My spirits sank.  Landing one of these kicks would crush a dog’s skull. 

To my surprise, my dogs, usually docile pets, had been transformed into snarling, vicious predators. They fixed wolf-like stares on the bull with lips pulled back revealing their gleaming white canines. My fear for the safety of the dogs was by then mixed with an awed incredulity at their agility.  They repeatedly darted at the bull and, at the last instant, dodged his enormous flying hooves.  I felt loathing for this unwelcome intruder, threatening the well being of my heifers and my rookie herding dogs. My heart pounded so hard in my chest, I felt it might burst.

The bull shifted his stare frequently between Bandit and Mollie, his fury-filled eyes never leaving the dogs. Lifting his massive head, the bull, to my amazement, took a few tentative steps, backward. The dogs, seeming to sense his hesitancy, stepped up their swirling, frenetic attack, an assault that left the bull uncertain and bewildered.  While the dogs appeared to be dodging and diving haphazardly, soon it became apparent to me that the dogs, working in concert, were having a wanted effect.

By then I had moved close enough to the mêlée to smell the musky aroma of the bull and to hear the growling of the dogs.  I briefly studied the situation and then hurried to station myself on the far side of the bull, opposite the downed fence.   I brandished my stick– a stick that in the presence of the dogs garnered renewed respect. Together the dogs and I, ever so slowly, edged the stubborn bull across the pasture, away from the herd, and in the direction of the breach. 

After several more minutes of the dogs lunging and my wielding the stick, the dogs and I managed to move the bull about a hundred yards in the desired direction. Then near disaster struck. Circling at full stride from opposite sides and intent on watching the bull, the dogs collided with one another full force, sending both sprawling. For an instant, my Border Collies laid on the ground, legs splayed out awkwardly.

After a moment to assess the changing situation, the bull recognized his opportunity and whirled around. He then rambled back in the direction of the herd. The giant bull swept by me, ignoring my wind milling arms, leaving me standing helplessly in his wake. He had passed by so close that, had I been foolish enough to reach out, I could have run my hand down his broad, muscular back. I began to taste not only the dust he had kicked up but also imminent defeat.

The dogs soon reacted by groggily regaining their feet. Bandit stretched a hind limb and Mollie shook her head, causing a jingling of her collar tags. Then both dogs turned, and sped off toward the retreating bull and back into the fight.

 Mollie soon closed the distance between her and the bull. She arrived directly behind the bull where she chomped full force down upon his tail.  In the next instant, I saw Mollie, attached Bulldog-style, rocketing along behind the bull, like a miniature black and white caboose behind a huffing steam locomotive.  When the bull eventually slowed, Bandit circled him and charged head-on. This time Bandit did not dodge, instead biting down on the bull’s thick, pink snout. His bite left behind a bloody gash. Bandit’s attack had momentarily distracted the bull from the tenacious, tail-riding Mollie. 

The bull, now bleeding from his nose, appeared progressively flummoxed by the two tenacious dogs.  He took a few steps away from Bandit and then proceeded to buck like a rodeo bull, tossing the still tethered Mollie high into the air. She became detached from the bull’s tail, fell to the ground, and laid motionless some twenty feet away; her back pressed awkwardly against the side of a water trough. 

My heart sank. Was she dead? Was she hurt?  Would she recover? As if to answer, Mollie sprang up, shook herself, and sprinted back across the paddock to re-engage the bull. 

The collies had been able to outrun the bull prior to his rejoining the herd.  Now the bull with collies in pursuit turned unhappily toward the breached fence. The dogs, arcing from side to side, tailed the trundling, ghost-like, massive beast, urging him always onward. The bull thundered by my parked pickup, wheeled around the corner of the dilapidated corrugated aluminum barn and hurried across the crushed limestone ranch road. Now in full gallop with an occasional desultory kick at the pursuing dogs, as if to save face, the bull headed straight for the downed fence line. From the rear of the chase, I watched the bull jump through the yawning breach and hasten off into the pasture of the neighboring ranch.

Shortly thereafter I arrived at the boundary fence. Like two sentries Bandit and Mollie paced back and forth in front of the opening, still gazing in the direction of the retreating marauder. I collapsed to my knees, and sucked in vast quantities of air. I threw my arms around the furry necks of the collies and hugged them fiercely. I buried my face in their silky coats. Bandit and Mollie had accomplished what only minutes before had seemed impossible.

From deep within these untrained collies had come an instinct to separate the foreign bull from the herd and drive him to the broken fence line. The dogs, ferocious only moments before, had abruptly reverted to their gentle mode. Their eyes shone brightly and their tongues dangled haphazardly. Bandit and Mollie seemed to comprehend the magnitude of their accomplishment, appearing alive in a way I had never before witnessed. 

Still too winded to speak, I continued to embrace my dogs.  I scratched their ears and hugged their necks, feeling the softness of their soft fur against my cheeks and the warmth of their bodies.  I felt raspy tongues licking my face.  Pride swelled within me. I felt exultant, as one whose burdens had been miraculously lifted. Bandit and Mollie, my two brave Border Collies, had provided a gift, no doubt as valued in the giving as in the receiving. 

Now looking back at this, the first herding effort of the dogs and me, I chuckle over my own incompetence. I am thankfully aware of improvements since then, especially in my own stock handling ability.

Our capacity to herd together, in a larger sense, mirrors the development of the interdependent relationship between human and dog. From the earliest times, dogs, with their keen sense of hearing and smell, warned their human companions of lurking predators. Still today dogs provide protection for their families. As mankind learned to domesticate animals, dogs provided the ability to drive them into pens and off high rocky slopes, tasks that man on his own could not accomplish. Human hunting benefitted from dogs capturing game and from retrieving felled animals from inaccessible places, such as from lakes and streams.

Mankind’s discovery of fire to cook his meat increased its nutritional value a well as its tastiness, with the leftover morsels going to the helpful dog. Whether the dog-human relationship is based on utilitarian purposes or solely on companionship, a special emotional bond has developed between human and dog unrivaled by other human-animal bonds— a special relationship well known to every dog lover. A dog’s empathy toward a human’s emotional needs and the constancy of his affection remain the principal reasons for having a dog.

Eventually my breathing on that eventful day became more normal, and I was able to speak to my dogs.  I cupped their warm, damp muzzles in my hands.  The dogs intently stared up at me with their eyes still gleaming. They seemed expectant, awaiting my voice. With my first words, I uttered the time honored, parsimonious Border Collie congratulation and stand down command.

”That’ll do Bandit.”

“That’ll do Mollie.”