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November 29, 1994

Ask Dr. Salvo

Dear Lawyer, wherever you may be:

One of the most endearing passages in Porgy and Bess is the part where the self-ordained itinerant lawyer (jail house variety) complains to his lady client as follows: "It very hahhd to get deevorce for lady what ain't been married!"

This is both true and prophetic, as it seems to foreshadow the sexual mores of the 80's and 90's, so wild and free as to require drug-resistant V.D., and tragically -- AIDS to slow them down. To require, you ask? Yes to suggest we put on the brakes! And pause to think things over. Is it worth the cost to be so macho or so Mata Hari? Not thus far, we must reply.

The remark about the deevorce recalls more recent chestnuts such as, "If it ain't broke, don't fix it," and Meador's Maxims of Medicine: "If what you're doing works, keep on doing it. If it doesn't work, stop doing it. If you don't know what to do, do nothing. That is, don't do something, just stand there." This no doubt stems from Old Hippocrates' minimalist remark about how to practice medicine: "First, do no harm."

Some years ago there was a surgeon strike in California. For something like a week, no elective surgery was performed. That is, the surgery had to be the only remedy for an emergency of life and death dimensions. To the great enbarrassment of the medical community, the death rate during this period of grace dropped to its lowest levels for many years.

I guess what these ruminations lead up to are some recent observations about the Physicians' Ruination Network, or P.R.N.

For example, their box-score over the past several years: One resident and one professor lost to the Department of Pathology. (A big lawsuit scored.) One resident and one professor currently shot down in the Department of Psychiatry. Another of that Department "turned" into a zealot and true believer. Several members of the Anesthesiology Department -- some of them left town! The PRN has generated 3 known lawsuits, and soon there'll be several more. None of these rejected and discarded physicians was ever properly diagnosed, i.e., shown to be impaired such that they could not practice medicine with reasonable safety for their patients. Imagine our score had the doctors really needed fixing! Also, by meddling, Big Brothering, and encouraging squealers and stool pigeons, PRN has ruined the Caduceus Club.

Finally, a more serious development: The residents in Psychiatry now warn off any applicants they interview. What do they warn against? Inadequate teaching for the second and third year level, and no protective concern for the welfare of the residents. (This lets Salvo know he did not imagine this was the case.) They specifically lack faculty support against the PRN.

The only consolation is that several of these travesties of justice will lead to a variety of lawsuits which PRN and USAMC will most likely lose on grounds of violation of the civil rights of the accused physicians. And, by the way, 4 or 5 excellent law suits are just waiting to see how "Salvo vs. M.A.S.A." turns out.

Meanwhile the hubris, contempt, and outlandish stupidity of PRN as to what civil rights are all about, continues to amaze and amuse us, the plaintiffs. Oh, by the way, much support and info is being gathered daily by way of the Compuserve network. Why do I address this to lawyers? Because it is a bigger gold mine than malpractice suits, and it will take tought smart lawyers to bring these medical rogues to heel.

Cheers,
Salvo



Dear Salvo,

Frankly, your account of the washerwomen sailing through the backyard in a cloud of steam and hot fat and woodashes -- failed to set my pulse pounding. What I had hoped for was a whiff of old time Mobile cooking. Do you cook, too?

Yours,
Waiting patiently



Dear W.P.,

"First you make a roux" was what popped up in my access system when I read your request. Of course I can cook, having spent a large part of childhood in the kitchen tasting, smelling, stirring and doing the critiques so much in demand from my mother and a long succession of cooks. Through protracted apprenticeship I became convinced that I could cook anything, although I didn't ever actually cook. But just try me -- if it begins with a roux I can do it. I do recall, a few years back, capturing a 2-3 pound octopus on the shingle at Virgin Gorda, Virgin Islands. I proposed to cook and eat it but the captain said, "Octopussy is poisonous." Therefore my wife cooked it in a fine red roux, and we devoured it while captain and wife dined on sardines, rum and cocacola.

Since ingredients were not plentiful, what did that fine girl do? She took 4 tablespoonfuls of flour and 4 tablespoonful of oil and gently simmered them on low heat. When the mixture was dark brown and smoking, BUT NOT BURNT, she poured into it about a pint of the seawater in which the little octopus had been simmered. Turn up the heat a little, what you're about to do is a holy mystery to the infidels and unannointed who languish in ignorance as to the great question of all sauciers: How to bind the oil to the water by means of the flour. Every careless and ignorant cook is constantly trying to fake this process by adding flour to the broth alone, or adding cornstarch to thicken a thin sauce aleady made etc., etc. (The list of sins is too long, I quail.)

Now we have a dark caramel heavy soup boiling away and into this we add garlic, salt and pepper, chives, and 3-4 bay leaves. Maybe more liquor, and you see your soup or sauce is now become red. This is perfect for shrimp, octopus, squid, fish, etc. Indeed, it would become a very creditable crab gumbo if you had substituted for tomato a TBSP of gumbo file (in the winter) or a cup of chopped Okra (for the slime factor). Now we're sliding into gumbo, remember this:

Make the roux very dark -- the gumbo should turn out almost black. Not much, if any, tomatoes in the gumbo. Plenty of celery, spices, garlic etc. Boil about 16 crabs for 20-30 minutes for 8 guests, and save the liquor they are boiled in. It will be spicy aleady from CRAB BOIL and from a BOUQUET GARNI of various herbs.

You can let the intrepid pick the crabs in their gumbo, or you can pick it for them. It is noiser, sloppier, and more intimate to do it with your hands. Gemutlichkeit Gulf Coast!

My mother freely confessed that she made the best gumbo in the world. I agree. I only regret I never turned loose the poem, poetry and science on a dish of crawfish bisque! This is a salute to Mama, and a thank you -- I'm sure she made this rag!

Salvo

P.S. My research associate, Tim, just bit me on the ankle. I knew at once what he meant: Don't forget the Times Picayune Cook Book! I did not, have not, will not -- because this is serious. That book is comparable to the Quran or the Epic of Gilgamash. That is, if you are a serious gourmet, gourmand, or four-plus gobbler.

It embodies the canon of haute cuisine francaise, or creolaise, and it has no rivals. Where else would you be instructed to amble down to the French Market and pick up a brace of mallards, half a dozen becasse (woodcocks) and 10 pounds of green turtle? And if you tried to follow such instructions, how would it all work out?

Never mind the question. I was just giving you the ambiance, the je ne sais quoi, with which you could try to explain why this holy writ of gastronomy never mentions -- the roux!!!

Whoever would like to explain this will be given plenty of space.

Salvo

-- November 29, 1994


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