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New Patient Exam ($100.00)
Includes a full history, chiropractic, orthopedic, and neurologic examination. X-rays may be ordered if indicated and treatment performed if no contraindications.
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Chiropractic adjustment with physical therapy.
Kinesio Tapeing ($10.00)
Application of Kinesio Tape to 1 to 2 areas
Sports Physical ($25.00)
A brief exam required for participation in many school sports activities. Includes completing necessary forms brought in by patients.
Business Information
Mon8:00am - 3:00pm
Tue8:00am - 6:00pm
Wed9:00am - 1:30pm
Fri8:00am - 3:00pm
Labor Day
Sep 4, 2017
Dec 25, 2017
New Years Day
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MCM® Program - Providence, RI
The MCM® Program is a unique and practical 2.5-day class that offers hands-on training for insurance regulators and insurance industry professionals on how to manage an effective and efficient market conduct examination. The course facilitates an information exchange between regulators and industry, offers advanced certification, and furthers professional standards and ethics in insurance regulation.
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8:00am on Wednesday, August 16, 2017
1:00pm on Friday, August 18, 2017
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See map: Google Maps
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11:59pm on Wednesday, August 2, 2017
Cancellation/ Refund/ No-Show Policy
Your registration fee minus a $25 cancellation fee will be refunded to you if IRES receives written notice at least 30 days prior to the event. No refunds will be given after that date. However, your registration fee for this event may be transferred to another qualifying registrant. No-shows will be billed for any unpaid registration fees.

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Java Karaoke
The Java Karaoke project is implementing Karaoke players in Java, using the JMF and javasound APIs
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Plarpebu is a java karaoke player that runs on any architecture that can run java. It plays both midi (.mid and .kar) and mp3+cdg files. Check project web site at : http://miageprojet.unice.fr/twiki/bin/view/Fun/ScreenshotsPage for full info.
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All-in-one MIDI musical instrument with Arpeggiator and MIDI / MIDI Karaoke Player. Allows to play piano on PC keyboard, play with any MIDI file and sing at the same time. Works with any hardware or software synthesizer installed in your computer. Includes "basic" Java Soundbank, which can be...
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Try a hip and highly customisable java tree applet with funky animated 2D mouseovers, 3D button mouseover, 3D popup text mouseover effects, customisable image-based scrollbars, and customisable colors, fonts, background, and icons. Different icons can be displayed for default, mouseover, and...
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Now Blaze Audio MIDIMaster Karaoke not only lets you play, mix, and orchestrate both MIDI and Karaoke files - the brand new performance feature turns your PC into a karaoke recording studio! Set the tempo you like, find the right key for your voice, adjust the mix and instrumentation of your...
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Spice up your site with animated buttons, menus, navigation schemes and other Java applets using this easy-to-use tool - you can even add sound. Just arrange your buttons in a WYSIWYG window, press 'Build Java' and 1CBT creates all the java and HTML.
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CredibleXML 1.0 (Java Edition) is an IDE that generates Java libraries to parse and transform data into a fully defined XML format. The generated Java object oriented framework gives the programmer easy access to manipulate the resulting XML output. The generated code also outputs DTD, W3C Schema...
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Apycom Java Menu Applets is a collection of highly configurable java applets that allows you to create cross-browser drop down menus, bars, and buttons for your Website. These applets provide feature-rich, fast-loading menu navigation systems to make it easy for your visitors to find their way...
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Karaoke-to-Text-with-Chords is a program intended for extraction of the texts of songs from karaoke files and determining of chords for them. Here its major features:
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Karaoke Sound Recorder is a recording karaoke software: You can select a popular song (MIDI, WAV,MP3,KAR) and sing along with the song. It records your voice while singing, process your voice with real time voice effects.you can edit your voice and change effects ,balance and mix it . has 4...
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Java Help is a swift Java API lookup program. Designed to be invoked from a text editor, Java Help lets you search multiple APIs with a single keystroke. Place the cursor on a word you want to search for and press a key; Java Help comes up instantaneously with a list to choose from. Most popular...
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Karaoke Builder Studio is designed to let you create karaoke tracks, using the most widely used karaoke format in the world - CD+G. When you sing along at a karaoke night you'll be singing to a CD+G track.
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An incredibly powerful and easy to use Java menu-maker. Spice up your web-site with animated buttons, expandable menus, floating navigation and other interactive Java applets.
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MJS is a fully parametrable java slideshow applet. It can work in the middle of a web page, in a pop-up window or in fullscreen, with crossfading. MJS can display .jpg and .gif files of any size and will use the available place the best way. very easy to set up, takes a list from a .txt file or...
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JDDM is a drop down menu java applet, is browser-independent and highly-configurable.
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Are you tired of writing java programs with MS notepad? This is a very small program that helps you working faster when programing with java, So Avoid Hassle and start using it Now.
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ObjectDB for Java/JDO a powerful yet compact Object Database (ODBMS) for Java, written entirely in Java, and compliant with the Java Data Objects (JDO) standard developed by Sun. ObjectDB for Java/JDO is designed to handle efficiently databases of various sizes, ranged from a few KBs to hundreds...
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JWTM is a professional java tree Web Menu applet, a comprehensive solution for website navigation. JWTM is browser-independent and highly-configurable, it could be easily customized to fit your website needs and to achieve an unlimited variety of menu appearances. JWTM let you generate tree menus...
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Cycling Holidays
- Catalonia Discovery
- Coastal Cycling in the Algarve
- Essence of Slovenia
- Châteaux of the Loire
- 'Flat Out' from Amsterdam to Bruges New!
- Lake Constance - Three Countries on Two Wheels New!
- The Golden Pass Line
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- Alsace and The Rhine Valley
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- Bavaria's Allgäuer Alps
- Cycling the Istrian Peninsula
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- Lake Garda, Verona, Soave and Venice
- Côtes du Rhône in Provence
- Garmisch & the Romantic Castles
- St. Moritz and Lake Como
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EBike Holidays
Bike and Boat Holidays
The Sicilian Experience
7 Day Family Cycling Holiday - ItalyMake an enquiry
The beautiful island of Sicily has some of the most varied and dazzling landscapes in Europe, cultural gems, ancient history and some of the best culinary delights in the Mediterranean.
Cycling through this seductive island is the best way to see its highlights and hidden treasures, arriving into Catania with Mount Etna to greet you and passing through historical Baroque towns such as Noto and Syracuse.
You will also glide through nature reserves, ancient ruins and enjoy swimming off the Mediterranean and Ionian coasts. You will also be rewarded by the flavours of Sicilian food such as seafood, almonds, tomatoes and ricotta.
This holiday is also available as a 7 day/6 night version and with extra night stays in Caltagirone or Syracuse on request.
What not to miss
- Visiting the Baroque towns of Noto, Caltagirone and Syracuse
- Admiring the Vendicari Nature Reserve and taking a swim from one of its beautiful beaches
- Enjoy the local Sicilian cuisine and red wine, Nero d'Avola
What's included
- Hotel Accommodation
- Bed & Breakfast
- Luggage Transfers
- Transfers from Caltagirone to Piazza Armerina and from Comiso to Modica
- Bikes and panniers
- Route maps and instructions
- Assistance whenever needed
This tour is operated by our preferred local partner


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I am Mochamad Hikmat Gumilar, a sworn translator for English to Indonesian translator under the Decree of the Jakarta Governor No. 1765/2006, also Certified Translator from HPI – Himpunan Penerjemah Indonesia or Indonesian Translator Association and a member of ATA – American Translators Association. I live in South Tangerang in Indonesia.
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The FallacyInternal WarfareNostalgiaGuilty DemeanorKarmaThis Is The TimeIncentiveLong Lost LoveMemoryRequiem For The IndifferentStay The CourseStorm The SorrowDeliriumMonopoly On TruthTwin FlamesAvalancheDeep Water HorizonDeter The TyrantSerenade Of Self-destructionLingerFacade Of RealityLiving A Lie (Live In Miskolc)Natural CorruptionThe Second StoneChemical InsomniaOriginemUnchain UtopiaCanvas Of LifeThe Essence Of SilenceBanish Your IllusionOmen - The Ghoulish MaladyReverence - Living In The HeartDies Irae (Live In Miskolc)Follow In The CryAdyta (the Neverending Embrace)Cry For The Moon (the Embrace That Smothers Part 4)Veniality (orchestral Version)Seif Al Din (the Embrace That Smothers Part 6)Victims Of ContingencySense Without Sanity - The Impervious CodeUniversal Death SquadThe Phantom AgonyThe Last Crusade A New Age Dawns Part IMartyr Of The Free WordNever EnoughDeath Of A Dream The Embrace That Smothers Part ViiBlank InfinityBurn To A CinderQuietusWhite WatersIllusive ConsensusConsign To Oblivion A New Age Dawns Part IiiDance Of FateForce Of The ShoreSolitary GroundReplicaMother Of Light A New Age Dawns Part IiSemblance Of LibertyMenace Of VanityTides Of TimeTrois ViergesUnleashedThe Divine ConspiracyVeniality Previously Unreleased Orchestral VersionAnother Me In Lack'echThe Obsessive DevotionSancta TerraDeconstructResign To Surrender A New Age Dawns Pt. IvBeyond BeliefThe Price Of FreedomFools Of Damnation The Embrace That Smothers Part IxDesign Your Universe A New Age Dawns Pt. ViRun For A FallSensorium
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Related Information for Epica There is more than one artist known as Epica:ONEEpica formed in the Netherlands. They are a symphonic metal band, founded by guitarist and vocalist Mark Jansen, subsequent to his departure from After Forever. Their songs largely deal with philosophical topics, including science, religion and world events.Official Website: Twitter: Facebook: 2003, Epica's debu.. read more


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Article by Saharnaz Mirzazad
What You Should Know About Home Automation Technology
Home automation technology refers to a remote-controlled network that can connect lights, appliances, electrical outlets, heating/cooling systems, and shades. Home automation provides a wide variety of potential benefits, including:
- Energy efficiency: Reduce your environmental footprint and lower energy bills.
- Increased convenience: Keep your home in its most comfortable state without having to think about it. System can learn from you and use pre-programmed settings to save you time and effort.
- Safety: Have you ever worried whether you turned off your oven before leaving the house? Automated systems enable you to control your home appliances remotely.
Energy and Water Savings
Home automation has revolutionized energy and water conservation in buildings. New technologies can take conservation principles one step further by offering self-programming, remote access, and real-time data tracking features. For example, if you usually turn down your thermostat before going to bed, a smart thermostat can learn your preferences and program itself to follow them automatically. A smart thermostat can even use your phone to track when you leave home and turn off the system when you're away, saving you energy and money. The remote access features allow you to turn your home appliances, lighting, and heating/cooling systems on and off as needed. In addition, this technology collects real-time energy and water use data to help you understand and manage your cost. This is important in helping you and other Southern California Edison residential customers transition to Time of Use (TOU) rates next year (see our next newsletter).
Space heating and cooling are the largest energy users in residential buildings, but home automation can reduce unnecessary heating and cooling. According to a survey conducted by Coldwell Banker Real Estate and CNET, 45% of Americans who use home automation technology average over $1,100 savings annually.
The energy saving potential varies by technology which include smart thermostats, lighting controls, smart shades, usage data analytics and smart irrigation systems.
Smart thermostats (cost $50-$500):
Internet-connected thermostats save energy by reducing heating, ventilation and air conditioning run time using control techniques that are more sophisticated than the manual and programmable thermostats commonly used in U.S. households. Smart thermostats are able to optimize temperature settings and energy usage based on the weather and the household's current occupancy. One of the most widely used smart thermostats, demonstrated 10-12% energy savings from heating and 15% savings in cooling in homes with central air conditioning (Nest Lab).
Lighting controls (cost $1.15-$4 per square foot):
Recent advances have moved lighting control beyond the conventional infrared motion sensing, manual dimming, and timer switches. Newer technology includes networked LED lights that "talk" to each other and are equipped with advanced photosensors and controls that adjust light brightness continuously according to current indoor ambient light levels. These advanced lighting technologies have the capability of 44% energy savings with a payback of less than five years.
Smart shades (cost $15-$61 per square foot):
The California Energy Commission estimates that about 40% of a typical California building's cooling requirements are due to sunlight coming through windows. Smart shades can automatically control the amount of light and heat entering a building, using sensors to measure indoor and outdoor temperatures and the sun's position and radiation. These systems can save up to 43% of the energy spent on indoor heating and cooling.
Energy and water analytical systems (cost varies based on function):
Energy analytical systems can reduce a building's overall energy use by 5-10%. These devices usually plug into a breaker panel and provide real-time data on energy consumption through a mobile app or website. The homeowner can see when and where their energy is going and take actions to reduce use or increase efficiency. These kinds of tools are commonly included when homeowners go solar.
Smart sprinklers (cost $50-$250):
Smart sprinklers use the weather forecast and sensors to detect soil moisture and calculate the amount of water needed for each planting zone in your backyard. Some smart sprinkler systems have reduced household water usage by 40-70%. Currently, some of the Property Assessed Clean Energy (PACE) providers in Thousand Oaks are providing smart sprinklers to their customers.
Free Home Automation System Opportunity
California Energy Commission has provided a grant to Universal Devices to conduct a study on the impact of home automation systems on energy use. As a result, the company is able to offer FREE devices in exchange for you sharing your energy use data. If you are a local SCE customer interested in taking part in this study and receiving free devices including a smart home controller, smart thermostat, pool controller, and motion, temperature, humidity and lighting sensors, contact the company representative: Orly Hasidim; Email: email@example.com; Phone: 818.489.7672
Click here more information on Energy programs on the City's website.
Pie Chart is obtained from The National Academy of Sciences, 2017
Chart shows the typical breakdown of energy use in homes across the U.S.
Photo Credit: NXP
A smart lighting network can be controlled through a phone app
Other credits: Energy saving potentials and costs are obtained from King, J., & Perry, C. (2017). Smart Buildings: Using Smart Technology to Save Energy in Existing Buildings. Washington DC: American Council for an Energy-Efficient Economy.


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The Misconception of Cinco de Mayo The Story of Cinco de Mayo - Injected the Mexican people with pride and patriotism. 5 de Mayo in the U.S. Mexican Troops defeated the French army on May 5, 1862 at the Battle of Puebla Significance: - The Battle of Puebla was viewed as hope for victory of the Union during the Civil War in the American west. "Drinko de Mayo" Cinco de Mayo is an American holiday. The holiday is viewed as a casual day, except in Puebla. Cinco de Mayo in Mexico The EndFull transcript


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*Please join Rose City Reader every Friday to share the first sentence (or so) of the book you are reading, along with your initial thoughts about the sentence, impressions of the book, or anything else the opener inspires. Please remember to include the title of the book and the author's name. *Taken directly from Rose City Reader's Blog Page.
"When people find out what I do for a living their first question is always about the most horrendous case of child abuse I've encountered. I can be at a backyard barbecue or at a New Year's Eve party or in the waiting room at the dentist's office, or my husband's baseball game."
SWEET WATER by Christina Baker Kline
It is a wonderful read. Review is in the book's title.
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Detailed Forecast
This AfternoonShowers likely. Cloudy, with a high near 79. Southeast wind around 6 mph. Chance of precipitation is 60%....
Hoot Owl Closure is in effect which mean that the river is closed to fishing between 2:00 pm and midnight.
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- *
An earlier draft of this article was presented at the Federal Reserve Bank of Chicago Conference on Bank Structure and Competition, May 2003, when the author was serving as a member of the President's Council of Economic Advisers. The author is deeply indebted to Cindy Alexander, without whom this could not have been written.
This paper develops three basic economic principles for effective corporate governance: (1) information accuracy and timeliness, (2) management accountability, and (3) auditor independence. Accuracy and timeliness of information is critical to providing market participants with the data necessary to monitor and evaluate managers. Management accountability focuses on strengthening the incentives of managers to act in shareholders' interests and on increasing the likelihood and magnitude of punishment for wrongdoing. Auditor independence reduces the incentives and likelihood that auditors would give managers more leeway to undertake fraudulent or questionable acts.
The author provides a preliminary assessment of how well legislative reforms, such as the Sarbanes-Oxley Act, regulatory changes at the SEC, and private sector responses such as those from self-regulatory organizations like the NYSE and NASDAQ, conform to these economic principles. The paper concludes by commenting on current proposals from the SEC on "shareholder democracy" and emphasizing the importance of balancing private and public regulatory responses.


text:
© Transport for London
Enlarge image
Buy photographic reproduction
For Christmas plays, by Albert Rutherston, 1923
- Published by Underground Electric Railways Company Ltd, 1923
- Format: Double royal
- Dimensions: Width: 635mm, Height: 1016mm
- Reference number: 1983/4/1586
Related themes:
The range of entertainment on offer in London provided countless vibrant and enticing subjects for transport posters. Rather than advertising specific venues or events, posters usually promoted general activities such as shopping or going to the theatre. Many aimed to encourage travel to the city in the evenings and at weekends. Others encouraged regular commuters to stay in the city after work, rather than travelling home at rush hour. In the 1930s, posters were also issued with listings of specific events scheduled for that week.
Show all records with Entertainment theme
Theatre & cinema
London's West End was often promoted by the Underground for its numerous theatres and cinemas. Posters encouraged passengers to travel there in the evenings and weekends. Others encouraged commuters to watch a film or see a show after work, rather than travelling home at rush hour. Theatres on the outskirts of London, such as Kingston and Hammersmith, were also occasionally advertised. At Christmas, London Transport issued posters specifically to promote seasonal pantomimes. These were particularly popular in the 1950s.
Show all records with Theatre & cinema theme
London's calendar has always been full of public events. These range from large scale annual events and one-off festivals, for which thousands of Londoners take to the streets, to smaller exhibitions held at a variety of specific venues. Transport companies have always taken the opportunity to promote travel to such events through their posters. On public holidays, when there were no scheduled events to promote, posters encouraged Londoners to travel out into the countryside or to explore the city.
Show all records with Events theme
Public holidays
Public holidays meant that less people were commuting. Keen to fill empty seats on buses, trams and the Underground, London Transport used posters to promote the opportunity for leisure travel. Every Easter, Whitsun and August Bank holiday the public were encouraged to take outings to London's surrounding countryside, towns and villages or to explore the delights of the city. At Christmas many posters promoted shopping, while others simply offered their passengers festive greetings.
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text: You smash a window and go for it. You don't even hit the floor. SPLAT! You have been impaled on a church. That has gotta hurt... I can't believe a church killed me! 2 DOH DOH DOH DOH DOH! 1 Why couldn't I have landed on a pillow factory... 8 The poll was created at 20:55 on January 14, 2008, and so far 11 people voted. Please wait, submitting your vote... Retrieved from "http://runescapefanfiction.wikia.com/wiki/Alternative_Timelines/17?oldid=71712" Ad blocker interference detected! Wikia is a free-to-use site that makes money from advertising. We have a modified experience for viewers using ad blockers Wikia is not accessible if you've made further modifications. Remove the custom ad blocker rule(s) and the page will load as expected. Categories: Alternative Timelines Add category Cancel Save


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The Impact of the Reformation"The Reformers' forensic understanding of justification ... the idea of an immediate divine imputation [of righteousness] renders superfluous the entire Catholic system of the priestly mediation of grace by the Church." -- (Bruce McCormack, What's at Stake in the Current Debates over Justification, from Husbands and Treier's "Justification", pg 82.) If you'd like to submit an article on a topic important to the Reformation, please contact me, johnbugay [at] gmail [dot] com.
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Tag Archives: natural law
The Gospel, Immigration, and Racial Reconciliation: Properly Framing the Issues
(I) The Gospel contains unique precepts concerning immigration and racial reconciliation for the civil (not ecclesial) community. (A) If (I), then these precepts … Continue reading
Posted in grace, Uncategorized Tagged gospel, grace, immigration, natural law, racial reconciliation
Complementarianism and Why Natural Law Needs a Community
In the past few weeks, a few Christian bloggers (mainly from the Reformed camp) have engaged each other in a discussion on complementarianism. The discussion has missed, to my mind, a key element and requirement in natural law practical reasoning. … Continue reading
Posted in Carl Trueman, Reformed Writers Tagged Carl Trueman, complementarianism, egalitarianism, natural law
Reformed Natural Theology – Part 1 (Calvin)
This is part 1 of a series on natural theology and reason in the Reformed tradition. See Part 2. Before directly discussing Calvin's thinking on natural theology and reason, we must lay some theological groundwork. In particular, we will have … Continue reading
Posted in Calvinism Tagged calvin, natural law, natural theology, reason 2 Comments
Natural Rights and the Calvinist Political Tradition (1)
In the last couple decades, many scholars have recognized the contribution of Calvinist theologians and political theorists to the formulation of natural rights. Prior to this, largely due to Leo Strauss, Calvinists were lumped in with the pre-modern notions of … Continue reading
Posted in Calvinism, Medieval Thought, Middle Ages, The Reformation, Uncategorized Tagged calvin, Calvinism, Leo Strauss, natural law, natural rights, political theory, politics, reason, Reformation, reformed, strauss, witherspoon
Calvin and Winthrop Between the Ages: Medievalism, Hierarchy, and Modernity (Part 2 of 4)
This is Part 2 of a series on Calvin and modernity. This post covers Calvin's two-kingdom theology and his theology of work. I show that Calvin's thought cannot be the foundation of modernity and that his thought is a modification … Continue reading
Posted in Calvinism, Justification, Medieval Thought, Middle Ages Tagged already-not yet, calvin, Calvin's Institutes, eschatology, faith, hierarchy, natural law, politics, spiritual kingdom, two-kingdom, Wolterstorff, work 4 Comments


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CHRISTMAS ROSE | Carol Scott-Conner
At her Christmas visit, my daughter comes to me with the handkerchief.
"Mother," Freya says, "What the hell? What IS this?"
"It is one of Sven's old hankies. That is all."
"It's got blood on it."
So it had. Lots of little tiny blood spots, each the shape and size of the raw area that recently spread like small rose petals on my left breast. Blossomed just in time for Christmas. My Christmas rose.
Sven has been dead for a decade now. After he died, I gave most of his clothes away to the Salvation Army, all but his hankies and his long underwear. He had these really soft old hankies, they don't make them anymore. And his long underwear was pure silk. I could not give it away. Nice and warm. I turned up the cuffs with those little stitches, just like Nana taught me when I was a girl.
"It is just a little blood. I was going to wash it. Give it to me. A little cold water, you soak the hankie, the blood comes out. Not hot water – that sets the stain. Always cold water." I take the hankie back and start off for the back porch, to set it to soak in my wash basin. Beautiful day today, I would hang it out back to dry in the sun. The cold wind would freeze it solid and it would become even softer.
Lately, I had taken to putting one of Sven's old hankies in my bra, to catch the little bits of blood. So the bra wouldn't stain. Freya didn't need to fret. I wouldn't let the bra get stained.
There was really nothing to worry about. Hadn't I seen Doctor Chen just two months ago? Such a nice young doctor. Always feels my pulse, listens to my heart and lungs. He never makes me take off my blouse, just loosens the top a little. Keeps me decent. Keeps me warm. He said I was as healthy as a woman half my age. If there was something wrong, he would have found it. He is a good young doctor.
I hear Freya on the kitchen telephone. "Doctor Chen? This is Freya Helversen. My mother is your patient. I just came home for Christmas and she has this bizarre growth on her breast. Like an ulcer or a dog bite or something. Or a… cancer? She won't tell me how it started and…it's bleeding. Yes. I know it's the holidays, but please, can I bring her to your office?"
My Freya – my strong, strong Freya – sounds like she might cry. I go make her a cup of tea, sit her down. She just looks down at the tea cup.
Well, the second day after the New Year, I found myself in this cancer clinic at the University. Freya is talking a mile a minute to this woman in a white coat. A lady doctor. Good for her, I think. This lady doctor must be strong, like my Freya. She must be smart, to be a doctor.
"She has this growth on her breast," Freya says. "I don't know how long it's been there. She never showed it to Doctor Chen. She never showed it to me. Mom – what were you thinking?"
Well, I know when to keep quiet. So, I just look at her. The doctor smiles at me. She seems young, but she has some gray hair. That is good.
Freya turns back to the doctor. "I live in San Francisco now. I only get home on holidays. If I hadn't seen the blood stains…" She spreads the fingers of both hands, like she is asking the doctor to forgive her.
Freya, I want to say, this is not your problem.
The last patient of the day was listed simply as "Helversen, 89-year-old woman, breast cancer." The note from her family practitioner had said that her daughter came home from a long absence and accidentally caught a glimpse of a strange growth on her mother's breast. The mother denied any problem, but finally agreed to go see her doctor. The doctor confirmed a fungating mass on the upper surface of Mrs. Helversen's left breast. Mammograms and a biopsy revealed an underlying breast cancer, a diagnosis which Mrs. Helversen had chosen to ignore. Daughter and doctor then strong-armed Mrs. Helversen to come in to see me. It was up to me to persuade her to undergo care for her cancer. Mrs. Helversen was alert, oriented, and competent. Nothing could be done without her consent.
I see a couple of these cases every year, often around Christmas. Cancer of neglect, we call it. Typically, these tumors have been growing slowly for a very long time. And we generally see them in older women. No one knows exactly why these women choose not to seek medical attention. I've conjectured that they've considered the alternatives, and that they figure they will just drop dead of old age before the cancer ever gives them much trouble. I suspect that often the tumor grows so slowly, so insidiously, that they are seduced into believing that they will get away with it. Often the pivotal event is bleeding, as the center of the tumor outgrows its blood supply and dies. Sometimes it is the odor. Having concealed the problem for so long, they become even more secretive. Then someone, usually a daughter, comes home for a visit and they are (as one daughter said to me) "busted." Brought to medical attention.
When I was a young girl, I was a rock hound. There weren't very many interesting rocks in the New Jersey neighborhood where I grew up, so I slowly acquired a few very special specimens as gifts, from my parents and their kind friends. One of these was a barite crystal formation called a "desert rose." Its reddish crystals had formed among hot sands or an evaporating salt basin, slowly taking the shape of a rose with flat petals. The illusion was pretty realistic until you touched a petal. Flat, sharp, crystalline edges covered with a light crystal dust, rather than soft coolness. These tumors, red and firm against the pale softness of a breast, sometimes reminded me of that old barite rose.
Unyielding stone against frail flesh, as if a cosmic game of scissors-paper-rock were being played out. How would you score it? Flesh wields scissors, flesh folds paper, but rock bruises flesh. Or is it – scissors cut flesh, paper wraps flesh, but flesh holds rock in the hand? No matter how you played it, the perfect Escher-like symmetry of the original game was lost. And yet…well, my patient was waiting.
I knocked on the exam room door, records in hand.
Mrs. Helversen was a small, slender white-haired woman with powerful gnarled hands, a broad gold wedding band, and an erect posture. Her blue eyes were milky with age, but her steady gaze reminded me uncomfortably of my high school principal. I resolved to ask her what she had done in younger years. Her daughter was large, angry, fierce, protective, scared.
I had barely introduced myself when the daughter started in. I logged into the computer, and maintained eye contact with her as I touch-typed the history into the electronic medical record. I'd fix the typos later. It was an efficient system, almost a direct conduit from my ears to the record, and her story was familiar. But then Freya said something that caught my attention.
"And at one point, she said it was her rose. I asked her what she meant, and she just repeated it – it is my rose. I asked Doctor Chen if this was… you know… and he said not a chance, she's mentally sharper than I am."
"Your rose?" I said, looking straight at Mrs. Helversen. Was it my imagination, or did a slight smile broaden those sun-splotched lips? She stayed silent. Well, I'm used to that. Often these women just clam up. We call it playing possum. The instinct to give away as little as possible.
The rest of the history was easily filled in. Mrs. Helversen was basically quite active and healthy, and might easily live for another five or even ten years. All bets were off in her age group.
I wanted to hear Mrs. Helversen's side of the story, so I asked the daughter to step outside while I did my examination. Reluctantly, she agreed.
"May I check your breasts?"
"Of course. That is why I am here."
I gently exposed one breast – normal – and then the second, taking care to keep her covered with drapes and the faded lilac-colored clinic poncho as best I could. The tumor growing through the skin of Mrs. Helversen's left breast had raised red edges. It was maybe the size of the last digit of my right thumb. I carefully measured it, and ascertained that it was not fixed to her chest muscles and that there were no palpable lymph nodes. Good.
She had plenty of skin. I looked at the breast, and sized it up. What would the easiest surgical approach be? Her breasts were small and only very loosely attached to the chest wall. A mastectomy would be easy, quick, and maybe even less traumatic than a lumpectomy. I could maybe even do it under regional or local anesthesia. It might even be possible to do it as an outpatient procedure.
She called it her rose. It did look like a rose. More like a rosebud, by size. Maybe she thought it was a flower, miraculously blossoming there. Wasn't there a saint who, caught carrying bread to the poor against her husband's prohibition, said she had roses in her apron – and, behold, her apron was full of roses?
So here was her rose. She had kept it covered with a clean white handkerchief under her bra. The handkerchief was stained with some oily substance and spotted with small crescents of blood, but the tumor itself was clean.
"I have been putting vitamin E on it," she said proudly. I nodded.
"It's nice and clean. The problem is, it's a tumor," I said.
"When did you notice this?" As soon as I asked the question, I regretted it. Typically women say it just popped up. I usually don't even ask. But Mrs. Helversen was different.
"I noticed a little prickling, almost like a thistle, and then last Christmas, this rose came. A little bud, and then it bloomed. It did not hurt after that. I have kept it clean."
I finished my examination.
"Do you know what it is?"
"I know that it is cancer. Dr. Chen told me. He took a piece off this edge here. It bled for a while. I put more vitamin E on it and it healed right up."
"We need to treat it."
Mrs. Helversen just shook her head.
"It is a cancer. You doctors always want to treat cancer. I have known that it was a cancer for a year, before Dr. Chen and his biopsy. My younger sister died from breast cancer. She was only 30. That was so many years ago. They cut off her breast and she died. So now it comes to me. I am 89 and Sven is gone from me for ten years now. Do you want to cut off my breast?"
It had certainly crossed my mind. In fact, I had been sizing up the breast like a butcher assessing a prime cut of meat. Again, I felt like a small child, caught passing a note in class. I temporized by following her into her world, asking the questions that I never ask. "Why do you call it your rose?"
"Sven would bring me a rose when he came courting. Always a red rose. From his mother's garden. He grew up on the farm next door. His mother grew these wonderful wild climbing roses, all around her kitchen window. He always brought me a rose. And now I have a rose again."
"But you know this is a cancer."
"Yes. But it does not hurt me. It is small, it is clean, and I do not let it stain my bra. I am careful. I use Sven's hankies. He left me plenty of them."
I stalled for time by moving to another part of the physical exam. Carefully felt under her arms and over her clavicles and in her neck. I couldn't feel any lymph nodes, and that was a very good sign. I was hopeful that she had one of those tumors that is content to grow where it started, slow to metastasize and spread. Possibly just doing a lumpectomy would be enough.
"We need to treat this tumor, so that it doesn't grow larger and bother you." I resisted calling it her rose. I hoped that by focusing her attention on this as a problem that we needed to treat, rather than a gift from her childhood sweetheart, we could move forward together. I knew, as Mrs. Helversen probably did not, where this was all heading. She was basically healthy and might live for another ten years. During that time, the tumor, untreated, would continue to grow. As it grew, the center would become necrotic, would die and grow black and ulcerated. Bacteria would grow on the surface. It would smell, despite her best efforts. It would become impossible for her to "keep it clean." All of Sven's old handkerchiefs would no longer be enough. And it would probably become painful. All of this could happen before next Christmas came around. Maybe she did know this at some level. After all, roses droop, fade, and die too.
I finished my exam, reassured Mrs. Helversen that everything else was normal, and told her to go ahead and get dressed.
"May I have your daughter join us?"
"Yes. Freya may come in." I thought I heard both uncertainty and resolve in her voice.
"I'm going to tell her that it is up to you," I said. "You have some options here, and I want both of you to hear them. But ultimately, it is up to you."
She nodded.
Freya was lurking right outside the exam room door. I had anticipated this, so I left the room with a lot of forward momentum, said, "She's getting dressed. I'll be back in a few moments to speak with both of you," and kept moving down the hallway before she could respond and try to corner me for a private conversation. It helps to pretend to be both very busy and slightly deaf at this point. I'd had practice.
I'm old enough that I can remember the old paternalistic days when the family and the physician would confer separately, as if their collective wisdom was more important than the patient's own judgment. Now patient autonomy is respected, and the family is involved only to the extent that the patient empowers us to involve them. Unless, of course, the patient is not competent to make medical decisions and has designated someone else to do this.
The work room that we all use between patients is cavernous and noisy. Small carrels with computers are fiercely fought over. Medical students, having despaired of getting a chair, stand uneasily waiting for the resident or attending surgeon to recognize their presence. I had staked out my carrel early. I always used the same one, and one of the nurses had put a sign with my name on it over the computer. As usual, no one had usurped my seat. I opened our electronic medical record and added the physical findings to Mrs. Helversen's note. I added a paragraph summarizing our discussion. I did all the necessary "busy work" of creating a complete note – pulled in the review of symptoms form she had completed in the waiting room, and so on. It didn't add much to what I already knew. It took all of 5 minutes. Time to bring this visit to some sort of closure.
As I worked on her chart, I'd begun to formulate a plan. Sometimes all you can do is keep things moving forward. I doubted we would be able to reach a decision today. In fact, if I forced the issue, Mrs. Helversen would simply say no. So the trick was to delay that decision point.
Back in the room, I summarized the findings from her chart and my exam for both of them. Speaking directly to Mrs. Helversen, I concluded, "Thus, although the cancer is growing through the skin of your breast, it is still small and there is no clinical evidence of spread to the lymph nodes. I'd like to send you for an ultrasound examination of your lymph nodes. If that is negative, it provides additional evidence that the tumor is not trying to spread.
"I want you to see one of my colleagues in Medical Oncology, to see what alternatives she might be able to offer you. She may want you to have some additional x-rays or scans." I paused, turning back to the computer screen to give Freya and Mrs. Helversen an opportunity to absorb what I had said. Not too long a pause, however; I heard Freya's indrawn breath as she prepared to launch into her questions and I forged ahead. Experience had told me that this whole discussion usually worked best if I kept my focus on the patient, spoke directly to her.
I looked at Mrs. Helversen and said, "When your sister was treated, mastectomy was our only option. Sometimes a mastectomy is the quickest and easiest way for us to treat the cancer and let you get back to your life at home. This may be what you choose. Sometimes we just do a lumpectomy. Some women are treated with radiation. And some women just take a pill, like Tamoxifen – have you heard of that?" I figured that was a safe question – I wasn't going to put her on the spot, force her to decide right this minute.
I don't fish, but this part of the process always feels to me a bit like playing a fish on the line. They say you have to feed the line out and reel it back in carefully; if you pull too hard, too early, the line will snap and the fish will swim off with the hook in its jaw, never to be seen again.
Mrs. Helversen nodded in response to my last question.
"Do you have questions?" I asked her. Mrs. Helversen just looked back at me. Her gaze was clear-eyed and steady. It gave nothing away. She had gone back into "possum" mode. Had she noticed that "Let's just do nothing" was not on my list? I felt certain that she had.
I looked at Freya. She had a list of questions, which I fielded as best I could.
Back in the clinic work room, I placed orders for the axillary ultrasound and to schedule a consult with Dr. McAdams in Medical Oncology. Finally, I scheduled Mrs. Helversen to return to my own clinic after she saw Dr. McAdams. There was no hurry – the tumor had been there for a while - and I felt that if I tried to rush Mrs. Helversen she would simply refuse to do anything. So I went back into the exam room and outlined the plan to both of them. So far, so good.
Two weeks later, I had reviewed all of the new material in Mrs. Halversen's medical record in anticipation of her next clinic visit. I had been relieved to see that there was no evidence that her tumor had spread to the lymph nodes under her arm, or to other parts of her body. Medical Oncology had offered three alternatives: surgery, hormonal treatment with Tamoxifen to suppress the tumor, or radiation treatment. Dr. McAdams' clear preference was for limited surgery – a lumpectomy – followed, maybe, by radiation and Tamoxifen. It was my own preference. Mastectomy would be a simpler alternative, if Mrs. Halversen agreed.
The morning of her clinic appointment, I sat at my old wooden desk at home sipping my first cup of coffee. It was still dark outside, and through our library window I could see stars, planets, even – if I craned my neck – the waning crescent moon. Automatically, I named some of them. That would be part of the constellation Orion. There's Venus.
I thought about Mrs. Halversen and Freya. The rose-like appearance of her tumor. And then I remembered my desert rose. On an impulse, I rummaged through the small drawers and cubby holes of my old desk. I found a small hoard of rocks and fossils – a geode, a shark's tooth, some fossil coral, and, finally, deep in the drawer, my old desert rose.
My desert rose was about the size of a flattened marshmallow. The edges of the crystal were worn smooth, and so it had no value as a geological specimen. Perhaps it had tumbled for centuries in the sand of the desert in which it grew and been altered by the wind and sand. Probably, being so imperfect, it was judged a good gift for a child, and that was how it came into my hands.
I could not remember the family friend who gave it to me. I had a vague recollection of some kind man visiting our house and pulling this small present out of his pocket. I was probably around eight years old. I had kept it all these years for largely sentimental reasons, a battered reminder of my childhood here in my hand, lovingly preserved down all the decades.
This was a desert rose that one could carry in the pocket, or carry in a pouch around the neck, like a talisman. I cupped it in my left hand and thought about power; the power of the spoken word, the transfer of power, and the power of small objects. Perhaps it would give me some power – the power to persuade Mrs. Helversen to accept some form of treatment. I slipped it into my briefcase.
So, Freya and I go back to see the lady doctor. The lady doctor spends a lot of time telling me this, telling me that. She wants to cut the cancer out of my breast. Not to cut off the breast, just to cut out the cancer. She says she could just take off the breast and that would be quicker. I want to say, quicker for you, maybe. She keeps saying this operation, that operation, but I know what she means. She wants to take away my rose.
Freya asks a lot of questions. The doctor and Freya talk for a while. Me, I stay silent.
Freya turns to me. "Mother, you need to have this done."
The lady doctor holds up her hand and stops Freya with a gesture.
I start to say "No," but the lady doctor holds up her hand and stops me. She says, "Shhh." Then she does something very strange. She pulls this rock out of her pocket. She tells me it is a desert rose. She was given it as a child and has kept it safe ever since. Well, I can understand that. I still have the first rose that Sven gave me, safe in my Bible.
She asks me, "Will you trust me? Could we do a trade, my rose for your rose?" Then she holds out the rock to me. I can see that it is a very special rock. I have never seen a rock like this. I can see why she calls it a rose.
She keeps talking. She tells me how it formed in the sands of the desert. She thinks maybe someone carried it in a leather pouch around their neck. A healer, like her.
"A rose for a rose," she says. "Let me get rid of your cancer." She holds out the rock to me. I look into her eyes. She is a healer. I can trust her. She waits, holding out the rose to me.
So I hold out my hand. I take the rose from her, and fold it in my palm. I look at her again. We both smile.
Carol Scott-Conner is Professor Emeritus of Surgery at the University of Iowa Carver College of Medicine, where she is a member of the Humanities Council and serves on the editorial board of ' The Examined Life' literary journal. Her monograph, Medical Writing: Creative Writing for Clinicians, clarifies the distinction between technical writing and creative writing. Her creative work explores the intersection between surgeon and patient, and hopes to illuminate the lives of women in surgery. Her short stories have appeared in numerous small literary journals and she has published two short story collections: A Few Small Moments, and Beachcombings. In "Christmas Rose," she gives voice to an elderly woman with neglected breast cancer.


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Jaye Albright
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Expecting the Unexpected: Preparing Now to Manage a Future Crisis
- 04/12/2017
- Posted by: Mike O'Malley
- Category: crisis management, radio, social media
The past few weeks have provided strong reminders that PR disasters happen. Simply opening Facebook these days should provide you sufficient encouragement to have a plan for how you would handle a worst-case scenario. Radio is far from immune from things suddenly going very wrong: from something that aired that wasn't supposed to, to a
- 11/23/2010
- Posted by: Mike O'Malley
- Category: marketing, radio, social media
It's one thing to use social media to market to people who are aware of who you are and what you're selling. But what about those who don't yet know about you or don't yet know that they need your product? That's the subject of this Chris Brogan post, "Two Sides of Marketing," which could be a great


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Year: 2017
Category: Non-Alcoholic Beverages - Single
Title: Well Water
This is Well WaterTo put the power of well water into perspective for North Americans, we turned it into a product that can make unbelievable claims. We called it Well Water™ and rolled it out like a new player in the beverage category. Well Water™ was designed for conversation, not consumption. By deviating from a conventional charity campaign and creating a product that people would desire, Well Water™'s message broke through.
Voice: 416-260-7000
Website: http://www.kbsagency.ca/en/
Email: firstname.lastname@example.com
KBS Canada Chief Creative Officer: Matt Hassell Copywriter: Kate Thorneloe Art Director: Jess Carter Design Director: Bob Makinson Producer: Lauren Sharpe
Winning Website: www.thisisthework.ca/wellwater/
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The 2018 call for entry opens September 25, 2017! Check back soon for more info!


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How do YOU pronounce KRFT? I say craft. How do others say it? Crafty? Kirft? Is it simply Kay Arr Eff Tee?
Hey @alexfoxy, how do StudioAmplify say it? Inquiring minds want to know, haha!
I say CRAFT. But I've heard people call it "Kay Arr Eff Tee"..
Craft for me also as I feel like I'm actually crafting something that will be useful!
Then also I feel like I'm designing, almost like a painting!
My son calls it Kirft (rhymes with Nerft). I like it...


text: rn(a)rn - X is takenern - X takes Yirn - a takingorn - some takingsurn - some differing a takingsoirn - a group of identical a takingsuirn - a group of differing a takingsairn - a taking-ityTemplate Retrieved from "http://mochafiction.wikia.com/wiki/Idr/rn?oldid=9500" Ad blocker interference detected! Wikia is a free-to-use site that makes money from advertising. We have a modified experience for viewers using ad blockers Wikia is not accessible if you've made further modifications. Remove the custom ad blocker rule(s) and the page will load as expected. Categories: Idr


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"The story really pulls you in, and the plot is very easy to follow and fast paced, making you want to keep reading. The characters are well developed and there are lots of twists and turns to keep you engaged."I love it when readers say things like this! 'Tis a happy day! Thanks to the fine people of Orchard Book Club!
Saturday, March 9, 2013
"Memories of the Dead" gets a 4-star review from the Orchard!
Over at Goodreads, my book Memories of the Dead got nabbed a 4-star...or in their case, 4-apple...review from the Orchard Book Club! Excited is a small word for such a big feeling! Here's a quote:
Posted by Phil Hall at 1:41 PM
4 comments:
That's so great, Phil! :)ReplyDeleteReplies
Thanks, Bethany!Delete
I've posted a link to the review on the "authors" page on my blog:
Maybe it'll snd a few other readers your way!Replies
Thanks, K.R.! :) I can only hope the same! I'm very proud of the good reviews I've gotten thus far!Delete
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Off with their heads: In the Gulf of Mexico, dolphins have learned a deadly new trick
Social Justice: 250,000 people want makers of Florida shark-dragging video charged
Officials grapple with how to help young gray whale out of Newport Harbor; 'I hope it left'
Siesta Creeps: Florida 'Jackass' anglers troll social media and the law struggles to catch them
Why farming is making salmon go deaf: Accelerated growth causes hearing damage in the popular fish
Surf Fisher Dude Ponders Eclipse's Effect on Fish; 'There's three different schools of opinion'
Gulf of Mexico dead zone is 'Largest' ever recorded in U.S.; 'Size of New Jersey'
Gone Girl: SeaWorld's matriarch 42-year-old killer whale is euthanized, the second orca death to hit the marine parks in a month
Removal of Rhode Island 'Eight-legged Mystery Object' Delayed over Weather Concerns
Ship full of hammerhead sharks and endangered fish seized in the Galapagos
Baby dolphin killed by Spanish beachgoers passing it around and taking selfies
Migaloo is back! Albino humpback makes a rare appearance off the coast of Australia
Marineland Canada announces death of young beluga whale; Gia 'Appeared happy, healthy and a well-adjusted'
Report: Diver bitten by shark in Bahamas, rides back to Florida
Crazy from the heat: Drunk Florida woman bites fisherman's lure before swimming away with the rigging
Watch the heroic moment divers save four whale sharks tangled in fishing nets in Indonesia
Krill Joy: A drone's remarkable footage of the world's largest animal feeding
Chinese white dolphins spotted off southeast China coast
Invasive lionfish may be superfish hybrids of two Indo-Pacific lionfish species
Dun-dun, dun-dun... Why are we so fascinated by sharks?
Thresher shark, marlin found at popular Nova Scotia beach
Kiwi fisherman stabs himself in leg while cutting shark off line
Background information on land-based shark fishing study; posing anglers ignoring new laws
Video: A great white shark named Lucy and her brave little escort
The power of compassion: Why humpback whales rescue seals and why volunteering for beach cleanups improves your health
Brit divers remove 100kg of ghost nets from James Eagan Layne wreck in Whitsand Bay
San Antonio couple takes mermaid-themed engagement pictures
Bull: Alabama angler reels in record-weighing shark in Mississippi
Before this 'Shark Wrangler' can tag a shark for science, he first has to catch it
The Odyssey review – Jacques Cousteau biopic looks good underwater but doesn't go deep
Villagers discover gruesome remains of missing camper inside an alligator near river shore in Brazil
News you can use: Five reason why people shouldn't take fish medicine
Mexican marine biologist works to save great white sharks; 'one of the most perfect creatures in the whole world'
Ecuador navy arrests Chinese crew for fishing 'thousands' of sharks in Galapagos
Japanese surfer gets bitten by 'something' off Thai coast
Mysterious 8-legged object off to stay underwater for now; diver set to inspect legs; 'we need to tread carefully'
Again: Thirteenth North Atlantic right whale found dead near Cape Cod
It's bad: Scientists explore offshore drilling's effect on humpback whale migrations
Secrets revealed behind Ingalls-built submarine's Cold War spy missions
Airborne great white shark caught on video off Cape Cod
Fish are sniffing out plastic waste and confusing it for food
Research finds evolutionary link between 400 million-year-old fish fossil and humans


text:
I thought I would mention this, so you could share in the merriment. I got a voice mail today, and this is more or less what it said:
"Hi Krebscout, I don't know you and you don't know me, but I'm a friend of a friend. Anyway, I heard you had a foodfight for your birthday and that it was the funnest thing ever, so I wanted to copy you. I just wanted to ask how you handled things, like if you asked the park officials beforehand or anything. So if you could give me a call back, that'd be great!"
I think it has now officially passed into the realm of legend.
Another Summer Catch-Up
1 week ago