Godzilla vs. Kong

Musing, as usual, on Boston's neighborhood makeup, I thought of the 1962 classic film "King Kong vs. Godzilla." Where am I going to go with this? I'm still not quite certain but I'm sure we'll find out, also as usual, by essay's end.

In a city of neighborhoods, Dorchester is obviously the 800 lb. gorilla in the metropolis, covering the most area and holding the most population. It is no eighth wonder of the Hub of the Universe, however. It is jumbled together in a weak rogues' gallery of complacent characters.

I've been to West Roxbury twice in almost two years, both of times fairly recently. West Roxbury is one of Boston's neighborhoods but few people think of it when they think of BOSTONIA, condita A.D. 1630. Dorchester falls into the same league though it is a very different kind of place. I've been to Hyde Park more often, and I know it's part of Boston too, a little farther removed and nothing like downtown. The only commuter rail line that runs entirely within city limits serves Hyde Park and points in between it and South Station.

Roxbury itself (not West Roxbury, which is to the south) is certainly urban and has been connected to downtown Boston for centuries through commerce and Washington Street. It has been connected municipally for over a hundred years, but few people think of Roxbury as Boston either. Even mailmen deliver envelopes addressed to Roxbury 02119, not Boston. South Boston gets to be called part of Boston, the part furthest to the east, and East Boston is also a part of Boston, the part furthest to the north.

There is no Kong in Boston, but there is a Godzilla. Just as metro Boston dominates the Commonwealth's business, the image of Boston proper, downtown and its edges, dominates the fringe neighborhoods that also belong to the entire civic body. Allston and Brighton and Charlestown are all parts of Boston. The mayor, who is quite savvy, is well aware that the neglected border frontiers of the city vote for him, but others take a myopic view of what Boston is. It is a city of many parts, all of them Bostonian even if they are not fashionable.

In the movie "King Kong vs. Godzilla" the giant ape is smarter and more human than the atomic-powered dinosaur. Kong taunts Godzilla during the fight scenes and makes rude gestures. This looks familiar as Godzilla just lumbers along, trampling whatever is in his path, be it vital or defunct. Boston is an old city. Though full of tree-lined, walkable streets, it is powered by an energy that cannot be described by commonly understood physics. It is that spark, like a hydrogen bomb dropped on an iceberg, that keeps one part of the city dominating the other parts. Like nuclear fission, it is the product of many smart brains. Like the Cold War it produces a stalemate affair that occupies a lot of attention when all involved could be working together for mutual betterment rather than struggling to keep up at cross purposes.

A city is made up of many neighborhoods and many component parts and constituencies. When one gets the upper hand, through an accident of history or by design, the status quo lives on past its useful shelf life. What is Boston? It is Dorchester and West Roxbury and Hyde Park and Roxbury and Charlestown and Allston and Brighton, as much as it is the Back Bay and South Bay and South Boston and the Fort Point Channel and the North End and what remains of the West End and East Boston. What does Boston have in common besides the Common? A lot, but most of that is swept under the rug, lost in the tug and the bombast of gorilla versus dinosaur.

So does Kong beat Godzilla or does Godzilla beat Kong? I don't want to ruin the ending for anyone who hasn't seen the film yet. Let us just say that Castle Island is no Skull Island and leave it at that. If you are interested.....

School without a science teacher

I have volunteered to conduct science experiments with fourth grade students at a local elementary school. The school doesn't have a science teacher. This is in Boston, a city known for its progress in biotechnology, the Massachusetts Institute of Technology, a science corridor of high-tech companies along the Route 128 beltway. I will be volunteering at a private school but a public school, a block away, is in the same straights and relying on volunteers from the same program to expand their science curriculum because the public school also doesn't have a science teacher on staff.

I am more a romantic, intuitive dreamer than a hard-nosed analyst. If I am teaching science to youngsters, something must be wrong with the system. I would prefer to lead field trips wandering around the neighborhood appreciating abandoned buildings and well-crafted brickface facades, but that is an indulgence that comes secondary to productive, deductive thinking. I understand how electricity works and how density allows for flotation and the biological food chain and whatever else our experiments are supposed to prove. With that background, I have the leisure to appreciate the more ephemeral aspects of my surroundings.

That children who attend schools adjacent to the Longwood Medical/Academic Area don't have a science teacher doesn't pass the smell test for a well-rounded education. Mission Hill and Roxbury are lucky to have responsible corporate neighbors with deep pockets who can pay their employees to lend a helping hand and provide staff, however marginally qaulified, to guide students through a few, pre-packaged experiments. Do Dorchester schools have the same resources available to them?

I assume the corporate entities in Longwood employ more college-educated persons than the businesses in Fields Corner. I don't think Tedeschi Food Mart or Mad Rag are offering their employees to help out at that neighborhood's schools.

Something is broken and that something needs to be fixed. I don't have the answer but I will do my part to shed a little light of enlightenment and the miracles of critical thinking about natural facts for one hour a week in Mission Hill. I can only hope someone else is doing the same in the thick of Dorchester's school system. Boston, and the world, needs more children who will grow into adults, who grasp the basics of the universe's mechanics.

Intensive care

The owner of a particular hair salon in Savin Hill asked that no revealing details be told in this report. We respect his wishes. By naming the shop's neighborhood we are not letting any cats out of any bag. Like everywhere in Boston, Savin Hill is flush with hairdressers as well as barbers, manicurists, convenience stores, pizzerias and Chinese take-out joints. To say that one catagory of establishment is in any broad jurisdiction is not a secret; there are dozens within blocks of each other.

The salon in question doesn't have any remarkable features if one looks through the front window. It is clean and stylish enough to entice women and metrosexual men to stop in for a hair cut. The receptionist at the desk looks welcoming and unintimidating enough. There is a special room in back, however, that maintains its sterility through positive air pressure, where a few special clients are admitted access. As the owner told me, "We don't like to advertise our services. We already serve clients beyond capacity and, really, the facilities are for emergencies only."

Before we started our tour his cell phone rang. He listened intently and barked a few questions: "How long has this been going on?...Mmm hmmm...How rapid are the contractions?...Mmm Hmm...Do you feel you can drive? Should I call an ambulance?...Okay. Get here as quickly as you can." Then we started our tour.

I was ushered past the chairs and mirrors and sinks and that make up the main salon through a locked, panel door that opened with a whoosh that blew my forelock back on my scalp. What greeted me was what may be Boston's premier intensive hair care unit. It was empty at the moment and this allowed the owner to show off and demonstrate all the equipment. The room is about the size of a typical pantry and most the wall space is lined with shelves holding bottles and polystyrene bags of exotically colored gels and small, mad scientist-style machinery. At the rooms center is a typical barber chair covered with a foam, egg crate mattress to prevent clients from developing pressure ulcers while they undergo treatment.

We proceeded clock-wise. The owner explained, "Here we keep our nutrient protein-enhancers and on this shelf we store the collagen formulae. Down here are the coco butter and lanolin for easy access at hip level in the case the patient, I mean client, goes into split arrest." He directed my attention to a device that sprouted a kaleidoscope of telephone wire tipped with alligator clips. "This is our follicle defibrillator," he said, "And over here is our parenteral conditioning unit." His tour was full of descriptions about micro-sebaceous pumping mechanisms and trans-dermal vitamin infusions and cytogenetic dye spectrometry. I have to admit I didn't follow most of it but he seemed to know what he was talking about.

As we wound up my visit a young woman wearing a turban burst through the front door. "You have to help me," she exclaimed, "I'm going to a party tonight and I can't go like this. I tried to do a touch up job bleaching my roots and now my hair is falling out!" The hair stylist on call took her pulse for thirty seconds and then fetched a flashlight out of his pocket to check her pupils. He turned to me and said, "I have a serious case here. Do you mind if you show yourself out? I'm going to be very busy for the next hour or so and I can't be disturbed. Lock the door behind you, if you don't mind." I said I understood the gravity of the situation and I did as he requested. As I closed the door I heard the stylist call to his assistant, "Fire up the autoclave. We've got a case of acute, achromatic alopecia here!"

Matta-pannus

This story is bizarre beyond being believable, but here we go anyway. Someone has to tell it and I was present and accounted for.

I received an email recently from an agent of the Massachusetts Executive Office of Health and Human Services. It read, "Mr. King, We understand you are familiar with events occurring in Dorchester that may not be followed by the usual news media or government agencies. We request a meeting to discuss some unusual, medical occurrences that have taken place in Dorchester and would like to learn your insight on developments concerning a demonstrable uptick in back alley surgical procedures. [italics mine]." This certainly seemed like my bread and butter so I agreed to an interview on the eleventh floor of One Ashburton Place downtown.

The agent and I sat at an empty conference table while nibbling catered sandwiches delivered from rebecca's cafe (lower case for proper nouns dictated by rebecca's corporate HQ). The agent asked me what I knew about illicit, unlicensed surgeries being performed in Dorchester. I admitted that this development hasn't registered on my radar.

A little back story: Over the past few years Mass Medicaid has been approving and paying for gastric bypass surgery for beneficiaries whose overall health is threatened by morbid obesity. As one would expect, rerouting a person's esophagus more directly to the small intestine is an expensive affair, even at government rates. The surgery is generally successful in alleviating the condition it is supposed to cure. Patients on average lose between 65% to 80% of excess body fat very quickly. This rapid weight loss often results in the patient acquiring a pannus about the patient's midsection.

Pannus is the Latin word for cloth though in this case it may be more properly translated as 'apron.' The patient's skin cannot contract as quickly as the excess fat being lost and hence an apron of empty skin develops that, in some cases without the underlying support, can hang almost to the knees. The Health and Human Services agent informed me that rumor on the street is that Mass Medicaid considers removal of this pannus after gastric bypass surgery isn't covered by the program since it is considered cosmetic surgery rather than therapeutic. I could see the reasoning. After all, I don't see any supermodels with an apron of excess belly skin strutting the catwalk, not even at Boston fashion shows.

The agent explained that some panniculectomies, as the surgical removal of this apron is called, are medically necessary. The underside of the pannus is often subject to dermatitis either of the fungal kind because of difficulties in keeping these deep folds clean and dry, or of the mechanical kind due to excessive rubbing against other surfaces. She emphasized that when medically justified the surgical removal of excess belly skin is a covered service under Mass Medicaid guidelines. This sounded reasonable to me.

The agent leaned in so close that her hair was in my egg salad, "Do you know, Mr. King, that we have seen a twenty-seven patients at Boston hospitals who are suffering complications from panniculectomies performed for private payment in unlicensed operating theaters in the Dorchester area?" I admitted that didn't know that. She continued, "Most of these beneficiaries are eligible for coverage under Mass Medicaid rules from contracted providers but they don't go there because they've been told the Commonwealth is cutting back on reimbursement for this procedure. They are going to unlicensed surgeons to correct their deformity and paying out of pocket. Granted, it's a reasonable fee considering the work being done, but it often much more than what Mass Medicaid has determined to be the proper reimbursement rate. Naturally, providers not certified by the Commonwealth don't always adhere to the standards we here at the Executive Office of Health and Human Services beleive to be in people's best interest. The system is starting to see the consequences in post-operative infections and sponges being left in the wounds." It was all news to me.

She said, "Do you know where most of these operations are performed?" I knew the answer already before she said it, "Mattapan."

Of course, Mattapan, that neighborhood where all sorts of trickery hatches without breaking egg shells. Mattapan...Where truth and falsehood exchange hats and every passing face is an enigma that asks. "How do you do?" Mattapan... Where fake IDs are passports. Mattapan... Where every shyster and accountant and hedge fund manager proudly hangs a store-bought diploma behind his desk. Mattapan... Where the best hot dogs are served, where best suits are tailored, and where the most well-attended churches make room to shelter their congregations. Mattapan.... Sweet, trusty, shady, sparkling, sparking Mattapan, the part of Boston that is most a'glow with unbridled opportunity. Mattapan...

The agent asked me if I could shed any light on the department's statistics. I said no and I thanked her for the sandwich. Exiting onto Ashburton Place, I looked at Boston's skyline looming and stretching to the south. I was only a few miles from Mattapan but I was a world away, slender and stylishly dressed in a bespoke suit and a shirt sporting folded-over cuffs. I get my tailoring done in Mattapan by an unlicensed tailor. If I needed a panniculectomy, I might consider the unlicensed neighborhood surgeons headquartered in that part of Boston. It is a place known as much for its bargain quality as for skirting around regulations. The two go hand in hand. Let the buyer beware and do due diligence. Any sawbones with a paring knife and a bottle of rubbing alcohol can hang his or her shingle in Mattapan but so can any respectable surgeon. You roll the dice for relief and the chance to improve your condition. You take your chances but there are worse places than Mattapan. There aren't any statistics for all the successful operations.