Wednesday, April 1, 2009

The Keith Conundrum

"I only get ill when I give up drugs."
Keith Richards

There is simply no accounting for protoplasm.

We used to have a catch phrase in medical residency when we were signing over patients to each other at the end of each shift; we would refer to our sicker patients as possessing either good or bad 'protoplasm'. To a resident on call that phrase means that the doctor taking care of him or her for the last shift had a gut feeling about how the patient would fare for the upcoming shift. A typical summary might sound like this, "Mr. Brown should do okay for you tonight. His kidneys are in bad shape and he has just come off dialysis but he is good protoplasm so you should not get any calls."

We would all agree that the undisputed King of Protoplasm in the history of the world would have to be Keith Richards, guitarist for the Rolling Stones. Keith wakes up every morning of his life trying to think of a new way to introduce as many toxins as he can into his body. He has done this his entire life and still gets around the stage and navigates (although somewhat warily) his way through halls and rooms, his creaking lungs breathing in and out with complete disregard for his bodily functions and systems. There ought to be a medical journal dedicated just to the marvels of Keith Richards. He is a one man cohort.

Lesser men and women have crumbled after sustaining only a fraction of the abuse that Keith has subjected his body to. Kurt Cobain (drugs) Jimmy Hendricks (drugs), Janice Joplin (drugs and alcohol) all must bow from their heavenly (not-so protoplasmic) thrones to the Mighty Keith, their toxic cachectic god. Elvis came close to Keith but ultimately died (multiple drugs). Mama Cass avoided drugs altogether except for some pot and wine and still did not make it to 50 (ham sandwich). If we doctors were to develop a Protoplasm Scale we would put Keith at the top and Mama Cass at the bottom.

Medical Resident, "Mr. Brown is a 7 on the ProtoScale but look out for Mrs. Smith! She is a 2 so you better go right up and check on her."

There's no accounting for protoplasm.