NEW ENGLAND JOURNAL OF MEDICINE CHRISTMAS

Unique Case of Aerial Sleigh-Borne Present-Deliverer's Syndrome 

Source: North Pole Journal of Medicine, vol 1 no.1, December 1997 Author: Dr. Iman Elf, M.D. 

On January 2, 1997, Mr. C, an obese, white caucasian male, who appeared approximately 65 years old, but who could not accurately state his age, presented to my family practice office with complaints of generalized aches and pains, sore red eyes, depression, and general malaise. The patient's face was erythematic, and he was in mild respiratory distress, although his demeanor was jolly. He attributed these symptoms to being "not as young as I used to be, HO! HO! HO!", but thought he should have them checked out.

The patient's occupation is delivering presents once a year, on December 25th, to many people worldwide. He flies in a sleigh pulled by eight reindeer, and gains access to homes via chimneys. He has performed this work for as long as he can remember. Upon examination and ascertaining Mr. C's medical history, I have discovered what I believe to be a unique and heretofore undescribed medical syndrome related to this man's occupation and lifestyle, named Aerial Sleigh-Borne Present-Deliverer's Syndrome, or ASBPDS for short.

Medical History: Mr. C. admits to drinking only once a year, and only when someone puts rum in the eggnog left for him to consume during his working hours. However, I believe his bulbous nose and erythematic face may indicate long-term ethanol abuse. He has smoked pipe tobacco for many years, although workplace regulations at the North Pole have forced him to cut back to one or two pipes per day for the last 5 years. He has had no major illnesses or surgeries in the past. He has no known allergies. Travel history is extensive, as he visits nearly every location in the world annually. He has had all his immunizations, including all available vaccines for tropical diseases. He does little exercise and eats large meals with high sugar and cholesterol levels, and a high percentage of calories derived from fat (he subsists all year on food he collects on Dec. 25, which consists mainly of eggnog, Cola drinks, and cookies).

Family history was unavailable, as the patient could not name any relatives.

Physical Examination and Review of Systems, With Social/Occupational Correlates: The patient wears corrective lenses, and has 20/80 vision. His conjunctivae were hyperalgesic and erythematous, and Fluorescein staining revealed numerous randomly occurring corneal abrasions. This appears to be caused by dust, debris, and other particles which strike his eyes at high velocity during his flights. He has headaches nearly every day, usually starting half way through the day, and worsened by stress. He had extensive ecchymoses, abrasions, lacerations, and first-degree burns on his head, arms, legs, and back, which I believe to be caused mainly by trauma experienced during repeated chimney descents and falls from his sleigh. Collisions with birds during his flight, gunshot wounds (while flying over Chicago) and bites consistent with reindeer teeth may also have contributed to these wounds. 

Patches of leukoderma and anesthesia on his nose, cheeks, penis, and distal digits are consistent with frostbite caused by periods of hypothermia during high-altitude flights. He had a blood pressure of 150/95, a heart rate of 90 beats/minute, and a respiratory rate of 40. He has had shortness of breath for several years, which worsens during exertion. 

He has no evidence of acute cardiac or pulmonary failure, but it was my opinion that he is quite unfit due to his mainly sedentary lifestyle and poor eating habits which, along with his stress, smoking, and male gender, place him at high risk for coronary heart disease, myocardial infarction, emphysema and other problems. Blood tests subsequently revealed higher-than-normal CO levels, which I attribute to smoke inhalation during chimney descent into non-extinguished fireplaces. He has experienced chronic back pain for several years. A neurological examination was consistent with a mild herniation of his L4-L5 or L5-S1 disk, which probably resulted from carrying a heavy sack of toys, enduring bumpy sleigh rides, and his jarring feet-first falls to the bottom of chimneys. Mr. C. had a swollen left scrotum, which, upon biopsy, was diagnosed as scrotal cancer, the likely etiology being the soot from chimneys. 

Psychiatric Examination and Social/Occupational Correlates: Mr. C's depression has been chronic for several years. I do not believe it to be organic in nature - rather, he has a number of unresolved issues in his personal and professional life which cause him distress. He exhibits long-term amnesia, and cannot recall any events more than 5 years ago. This may be due to a repressed psychological trauma he experienced, head trauma, or, more likely, the mythical nature of his existence. Although the patient has a jolly demeanor, he expresses profound unhappiness.

He reports anger at not receiving royalties for the widespread commercial use of his likeness and name. Although he reports satisfaction with the sex he has with his wife, I sense he may feel erotic impulses when children sit on his lap, and I worry he may have pedophillic tendencies. This could be the subconscious reason he employs only vertically-challenged workers ("elfs"), but I believe his hiring practices are more likely a reaction formation due to body-image problems stemming from his obesity.

The patient feels annoyed and worried when he is told many people do not believe he exists, and I feel this may develop into a serious identity crisis if not dealt with.  He reports great stress over having to choose which gifts to give to children, and a feeling of guilt and inadequacy over the decisions he makes as to which children are "naughty" and "nice".  Because he experiences total darkness lasting many months during winter at the North Pole, Seasonal Affective Disorder (SAD) may be a contributor to his depression.

Treatment and Counseling: All Mr. C's wounds were cleaned and dressed, and he was prescribed an antibiotic ointment for his eyes. A referral to a physiotherapist was made to ameliorate his disk problem.

On February 9, a bilateral orchidectomy was performed, and no further cancer has been detected as of this writing. He was counselled to wash soot from his body regularly, to avoid lit-fire chimney descents where practicable, and to consider switching to a closed,  heated, pressurized sleigh. He refused suggestions to add a helmet and protective accessories to his uniform.

He was put on a high-fibre, low cholesterol diet, and advised to reduce his smoking and drinking. He has shown success with these lifestyle changes so far, although it remains to be seen whether he will be able to resist the treats left out for him next Christmas. He visits a psychiatrist weekly, and reports doing "Not too bad, HO! HO! HO!".

Conclusions: Physicians, when presented with aerial sleigh-borne present-deliverers exhibiting more than a few of these symptoms, should seriously consider ASBPDS as their differential diagnosis. I encourage other physicians with access to patients working in allied professions (e.g.Nightly Teeth-Purchasers or Annual Candied Egg Providers) to investigate whether analogous anatomical/ physiological/psychological syndromes exist. The happiness of children everywhere depend on effective management of these syndromes."
http://www.dezert-rose.com/humor/christmas/ 

THANKS FOR READING ALL YEAR LONG

AND

MERRY, MERRY CHRISTMAS

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FEET OF CLAY

I think it might be the most important two feet of clay in the entire world, 14 inches of clinging, grasping wet sticky ooze that made Teddy Roosevelt a two term President, inspired the effort that created the American century, and offers a lesson in the history of the world we live in - that we all have feet of clay.

The two feet had to be clay because clay holds water, and this particular clay was created over thousands of years by limestone being eroded by the dark acidic waters of a lake surrounded by a dense forest, such as in today’s Wisconsin Dells (above). This particular ancient dell has been called  "Lake Chicago", and if the clay it produced had been less than two feet high, then the clay would not have mattered.

If it had been thicker, then in 1674 Lois Jolliet (above) would have returned from his exploration of the Mississippi by a different route. Two feet was just thick enough to be difficult to overcome, but it could be over come. And although Ms Jolliet was the first European to see the clay, he did not really see it. 

Jolliet wrote his superiors back in France that there was a simple way to travel from the great lake now called Michigan with the Mississippi River  "We could go with facility to Florida in a bark (canoe), and by very easy navigation, " wrote Jolliet.. "It would only be necessary to make a canal by cutting through but half a league of prairie."  But Jolliet had arrived at the edge of the ancient "Lake Chicago" when most of the clay was hidden from view by the spring runoff. So the obstacle and the advantage of the clay would have to wait over a century to be revealed.

In the summer of 1818 fur trader Gurdon Hubbard, retracing Jolliet's route for the American Fur Company, made his first trip up the south fork of the ‘Shikaakwa’ (or skunk weed) River from the village of “Chicago” on the western shore of Lake Michigan (above) . 

Hubbard followed the river upstream until the open water gave out. From there, unlike Jolliet,  Hubbard was forced to  portaged for seven miles. Because Hubbard was traveling in the summer, when the water was low.

“Our empty boats were pulled up the channel," wrote Hubbard, "...until the Mud Lake (above)  was reached, where we found mud thick and deep, but only at rare intervals was there water….”

Fighting off schools of leeches and clouds of mosquitoes, it took Hubbard three days to cross the 7 miles of clay and mud before reaching the clear flowing water of the Des Plaines River on the other side of the Valporaso morraine.  But as Jolliet had said, the Des Plaines River ran into the Illinois River, which joined the Mississippi River, which carried Hubbard and his bateau’s 12 tons of trade goods into the very hinterland of the continent. And perhaps this might be a good point to pause and explain why this was where the clay surfaced.

Three times over the last 300,000 years glaciers have ground southward across North America, successively plowing the landscape bare and then recreating it on their retreat. When the penultimate of the glaciers paused here 25,000 years ago, they bulldozed a 10 foot high north-south ridge of clay (above, foreground) from the bed of the  ancient Lake Chicago into the “Valparaiso Terminal Moraine”. 

Chicago writer Libby Hill has noted this moraine is not a mountain range, but  "a very slight rise of maybe about 10 feet that...in times of low water... would be a subcontinental divide"(above).   The  24 inch high clay was the cap on the moraine ridge which kept the present Lake Michigan from draining to the west and south down the Des Paines River into the center of the continent.  Instead the waters of Lake Michigan were forced to find a another path to the ocean , eastward,  toward the Saint Laurence River, and giving birth 12,000 years ago, to Niagara Falls.  But from the moment Hubbard clawed his way through the sucking, engulfing clay, Americans were anxious to dig through it. 

The dream of breaching that moraine was first achieved by the 96 mile long "Illinois and Michigan Canal", begun 1836, discontinued in the panic of 1837,  and not completed until 1848. It drained the Mud Lake and provided locks (above) to lift the narrow canal boats and their 100 ton loads 35 feet up to the level of the Des Plaines River at Jolliet.  

From there another series of locks provided an easy journey so Michigan apples could be sold in St. Louis and New Orleans. That first canal established Chicago as a transportation hub.

But the growth of Chicago presented its own challenges. By 1867, the 300,000 citizens of Chicago had so fouled their Lake Michigan shoreline that to reach clean drinking water they were required to tunnel two miles out under the lake. 

The success of such a "big government project", like the water tunnels and the "Illinois  and Michigan" canal encouraged the locals to dream of breaching the moraine in a more grand fashion,  and of converting Chicago from a mere lake port into a seaport. 

To sell the plan to conservative voters, politicians  also pitched the idea of reversing the flow of the Chicago River, to carry Chicago’s waste away from the lake, which was the source of the cities’ drinking water. Pumps would draw lake water into the Chicago River, and then send it up and over the "Valparaiso Moraine" before sending it down the new "Sanitary and Ship Canal". 

So on Saturday, 3 September, 1892,  Frank Wenter, President of the new Metropolitan Sanitary District of Greater Chicago, turned the first ceremonial shovel of earth in the village of Lemont, Illinois (above), which was to be the central point of the Sanitary and Ship Canal, because it was the highest elevation between the rivers and a good source of stone, for lining the canal.

The new canal, built in the name of progress and “clean water”, would excavate 44 million cubic yards of clay and stone...

...to create a passage 28 miles long, 202 feet wide and 24 feet deep, which would terminate, for the time being, in a dam and the first in series of locks at a new town named Lockport, Illinois. These locks could take ships and barges up to 600 feet long and 110 feet wide. It would take eight years to finish the initial work and the final cost of this version of the canal would prove to be $45 million.

The New York World newspaper examined the social changes this ‘progress’ brought to the sleepy village of Lemont (below). Out of the town's 9,000 residents, wrote the paper,  “…4,000 are gamblers, thieves, murderers or disorderly women. There are 100 saloons, 40 gambling houses, 20 dance houses and three theaters…Everything is running wide open and licensed...Within three months 30 dead bodies have been found…and no one has been punished…"

The paper then added, "Every Sunday excursions of the worst classes go to Lemont from Chicago.”

The Mississippi River town of St. Louis had already lost the race to become the rail center of the nation to Chicago, and now the new canal would allow Chicago grain and livestock markets to set prices for Missouri farmers. When the Missouri business interests finally awoke to the threat,  they realized a purely monetary argument against the canal lacked a sense of urgency.  So, as the Sanitary and Ship Canal got ready for an official opening in the spring of 1900,  Missouri threatened a lawsuit, claiming, to quote the Missouri Attorney General  “The action of the Chicago authorities in turning their sewage into the Mississippi River for the people of St. Louis to drink is criminal, and Chicago knows it.”

Yea, maybe they did. But in response, in December of 1899, the Metropolitan Sanitary District of Greater Chicago released their own "scientific study" which "proved" all sewage had been cleansed by the river by the time the Chicago sewage  reached Peoria, even before it joined the Mississippi.  And besides, the Chicago lawyers argued, St. Louis drew most of its drinking water from the Missouri River, not the Mississippi. 

And besides that, the city of St Louis even had their own a sewage draining into the Mississippi River, above their own water intake (above on the Mississippi.  If anybody was forcing the citizens of St. Louis to drink sewage, it was St. Louis, not Chicago! 

In an attempt to present the United States Supreme Court with a faite accomplie on this issue, on 2 January 1900,  Chicago opened the new northern locks connecting Lake Michigan with the canal.  Not to be deterred, on Wednesday, 17 January, 1900, Missouri filed a request for an immediate  injunction from the Supreme Court to stop the canal from being opened at the southern end. And suddenly the Chicago lawyers and politicians did not feel so certain about their case. 

To forestall the Supreme Court, on Sunday, 21 January, 1900, the directors of the Chicago Sanitary District tried to quietly produce another fait accompli (above). The Chicago Tribune explained why that did not prove a simple thing to achieve.

“…B.A. Eckhart was the first to reach the narrow watershed at Kedzie Avenue and Thirty-filth Street...a dredge was already hard at work throwing up the clay from the cut…. Less than eight feet (of ice and frozen clay) separated the waters of the lakes from the waters of the Mississippi…It was exceedingly slow work, for the clay was (frozen) like a rock…Four large charges of dynamite were placed in the ridge…A few fugitive pieces of clay did fly into the air. But as a grand opening it was a failure…."

"Then the ambitious trustees, armed with their shovels, descended into the cut and began to push away the pieces of clay and ice which held back the lakes…With the regularity of a pendulum the arm of the dredge swung back and forth….The ice from the river rolled in and blocked the channel…"Push the ice...away with the arm." shouted the foreman…The (dredge) arm dropped behind the ice gorge and then with resistless motion swept the whole of it into the Mississippi Valley. .... "It is open! It is open!" went up from scores of throats as the water at last (flowed)…Like school boys on a vacation, the drainage officials waved their arms and shouted.”

It was done.  On 2 May, 1900 Admiral George Dewey, hero of the battle of Manila, dedicated the official opening. But it would not be until 1907 that a lock and power plant would be built (above) to control the 36 foot climb from the southern canal level at Lemont to the level of the Des Plaines  River to the north, and complete the dream of ocean going ships reaching the Mississippi via Chicago.

Within a decade after the canal opened the construction techniques for the locks used to raise and lower ships over the Valparaiso Moraine (above)....

...would be used by many of the same engineers in the construction of the Panama Canal (above). It was that endeavor, championed by Teddy Roosevelt, which ushered in the American Century. The lesson here is that no infrastructure construction, be it the creation of the Sanitary and Ship Canal, or manned space flight, or the creation of the interstate highway system, or a national Internet access system, is ever a wasted effort. It is the lessons learned from the endeavor that make the future possible. 

And the Chicago canal proved something else as well. As recorded by William C. Alden in the 1902 “Chicago Folio” for the U.S. Geological Survey Atlas of the United States (volume #81), excavations for the canal and its locks unearthed the history of the entire continent.Beneath the clay and beneath the limestone was the bedrock of Chicago; “Potsdam Sand Stones”. The bedrock of Chicago is petrified beach sands, the bottom of an ancient shallow sea. We know it was shallow because above the sandy bottoms corals grew, and left their lime rich skeletons (above) hundreds of feet thick embedded in the sand stones. Over millions of years that sea had been replaced with a freshwater lake, surrounded by trees,  whose leaves fell into the waters, turning the waters acidic, and converting the top layer of the limestone into clay.And then the glaciers had come, and scrapped across the clay, piling it up in a terminal moraine, which prevented the glacial melt waters from finding their way to the Mississippi river, until humans arrived and stood upon their own two feet of clay and thought, "I can do this. I shall do this". And it was done. It was not done without a paying a price, but there is a price required even if you decide to do nothing.

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