Monday, March 27, 2017

Your Audiology Tutorial: Tuning Fork Tests

That steel, two-pronged fork that you may have seen in your ear,  nose, and throat doctor's office is used for some pretty quick and efficient diagnostic tests.  In other contexts, of course,  it may be used to tune musical instruments.  Tuning fork tests can be used to determine if a patient's hearing loss -if in fact there is one- is conductive (middle ear: eardrum, Eustachian tube) or sensorineural (inner ear: cochlea, cranial nerve).  In many ENT clinics, a 512 Hz fork is utilized.

There are four type of tuning fork tests, each named after a German otologist:

1. Weber:  After lightly striking fork against hand, the examiner places the stem on patient's forehead. The patient is asked if the resulting tone lateralizes to either ear (is heard louder in one or the other). If heard equally loud in both ears, the test is considered negative for hearing loss.  If the tone is heard in the ear reported to be worse, the loss may be conductive. If heard in the better ear, sensorineural.

2. Rinne: Patient is asked to put finger in the opposite of the ear being tested.  Stem of fork is struck by examiner and first placed on mastoid bone (just behind your pinna, or outer ear).  The patient is asked to respond when he or she no longer hears tone.  The stem is then placed in front of, but not touching the outer ear. The patient is asked to report if the tone was heard longer/louder.  If so, this can indicate a conductive hearing loss.  If heard louder on the mastoid, the loss may be sensorineural.

The following tests are less commonly performed:

3. Schwabach: Stem of fork is placed on patient's mastoid, then examiner's, alternated until one of them no longer perceives the tone. If patient hears tone longer than examiner, it may be conductive. If patient hears tone for shorter time, it may be sensorineural.

4. Bing: Stem is placed on mastoid while patient inserts and removes finger at entrance of ear canal.  If patient reports that sound alternated in intensity with finger in and out, loss may be sensorineural; if no change, conductive.

You can imagine that there are several confounding factors to these tests.  Certainly the patient's lack of understanding of procedure and the examiner's possibly sloppy technique (especially during the Schwabach) should be considered.  What if the examiner has a hearing loss?

Audiologists don't usually do tuning fork tests, as testing air and bone conduction (with different transducers) with an audiometer will confirm the nature of the hearing loss.

Thursday, March 23, 2017

The Challenge

When THE CHALLENGE was released in 1982, I was quite obsessed with martial arts epics.  Not just Bruce Lee movies but also the more obscure kind of things that have been shown on the El Ray network.  While I didn't own any of the associated props, I did mess around with my (even more obsessed) friend Paul's Chinese throwing stars and (rope and chain) nunchucks.  I regret to report that I did not take any karate or ju jitsu lessons, never got my black belt.  And why didn't that bratty thirteen year old catch this movie at the Cross County 8 or wherever it was playing?  I think it came and went too soon, lost among many big releases of the time.  And it just didn't seem distinguished enough.

Regarding the talent involved, I was wrong.  Recently, I actually sought the film out for its pedigree.  John Frankenheimer directed, Scott Glenn had the lead, and John Sayles co-wrote the script.   Surely this mix would produce something beyond the typically low grade actioner? While I'm not exactly singing its praises, I wasn't disappointed.   Sayles wrote several scripts for B-fare during this time period, movies like ALLIGATOR and THE HOWLING, which were several notches above the usual manure.  THE CHALLENGE essentially is a B-movie, albeit one that is just as fascinated with East/West culture clash as with swordplay that may or may not conclude with someone's head being split vertically into two halves.

Glenn plays a slow witted L.A. boxer named Rick who is approached by a wheelchair bound Japanese man named Toshio and his sister.  Rick is to smuggle a rare sword to Japan for a few grand.  As his life is apparently without many prospects, he almost immediately accepts, without voicing too many suspicions.  This proves to be regrettable as soon after landing Rick is ambushed by the Toshio's brother who appropriates the sword and informs the American that it is in fact, a fake.  Rather than kill Rick, he gives him the option of infiltrating his uncle's (Yoshida) martial arts academy, where the real sword remains separated from its twin, owned by his father, Hideo.  The opening scene of the movie sets the stage with a backstory dating back to 1945.

THE CHALLENGE spends much time in Yoshida's school as Rick slowly becomes indoctrinated to the ways of Bushido.  He will sample their cuisine, consisting of often still alive seafood, and be tested by remaining buried up to his neck in the sand outside for five days.  None other than Toshiro Mifune plays Yoshida-san, a sensei given to meditation and old school weaponry.  His presence certainly elevates this movie from the usual muck of ninja dramas, and he is fun to watch.  The drama of the two brothers' battle to reunite the swords is to honor a centuries old tradition, no matter how much arterial spray must be shed in the process.  Hideo represents Western excess with his million dollar deals and arsenal of machine gun toting minions.  Rick will be tested by both sides for his loyalty and allegiance.

Sounds standard, and certainly is for the most part.  The screenplay, co-written with Sayles by Richard Maxwell and Marc Norman, covers most of the bases of the genre.  For good measure, a subplot involving Rick's mentoring of a little boy at the academy is woven in, though it feels gratuitous, as does an obligatory sex scene. Frankenheimer, who made an interesting assortment of films during his career, frames everything competently.  The dialogue in this movie is a bit sharper than in say, REVENGE OF THE NINJA, likely due to Sayles.  I found it interesting that the evil cousin (son of Hideo) talks like an American, complete with vulgarisms like "hide the salami", certainly in line with the modernist culture to which he's been exposed.  I wonder also if it was Sayles' idea to stage the final battle in an office, where in addition to the precious swords a stapler becomes a key weapon.

Monday, March 20, 2017



You have probably met a guy like Bernie Tiede, especially if you've ever lived in the South and attended the local Baptist church.  He stands out from other males his age in such environments: eternally single, keen interest in the performing arts and travel, deft with interior design.  He is also unfailingly polite, charming, active in said church, serious about his work, and honest.  Even after he kills the local widow.

Well, not right away.  He leaves her body in a freezer for several months before the authorities discover her.  He does not deny his crime when apprehended by the police.  Bernie, an assistant mortician, calmly explains through genuine tears that he was waiting until he could properly prepare her for burial.  He truly believes that his falsehoods to the residents of Cathage, Texas were means to an appropriate end.

2011's BERNIE recounts this true life story, complete with interviews with the actual folks who knew Bernie (Jack Black) and his friend Marjorie Nugent (Shirley MacLaine).  Director and co-screenwriter Richard Linklater scatters their Q and A as punctuation throughout the story, one that could've easily merited one of those tacky "true crime" docs you see on cable.  Instead, Linklater creates an engaging bit of Southern Gothic (with frequent use of old hymns on the soundtrack) that never feels lurid 'cause, dammit, that Bernie was such a nice feller.  

And Black's performance is so on the money that we are smitten with him too.  Some viewers may agree with all those townsfolk who refuse to think Bernie is guilty, even if they know he did it.  But how could he do such a thing?!  Nugent was a contemptible old snake and she deserved it, you see.  Fact, Bernie was her only friend.   He spent quite a bit of time dining, going to shows, and traveling with her.  But she became possessive, demanding all of his time.  Even a sweet soul like Bernie can have a breaking point after months of nagging and abuse.

Makes one wonder why Bernie's lawyer did not play the temporary insanity card (Did Bernie think maybe Satan whispered in his ear or something)?  How would that have affected Danny Buck Davidson's (Matthew McConaghey, clearly enjoying himself) - the local D.A.-  strategy?.  He does recognize that a jury pool from Cathage would be unfairly biased, that a conviction would be impossible there.  Davidson successfully has the venue changed to a town fifty miles away.  A place the residents of Carthage think is filled with morons.  One interviewee unapologetically explains that he thinks Bernie's jury all shared one brain.

Bernie was convicted for life, but his demeanor, although saddened, remained as sunny as ever.  He even becomes a teacher and encourager of his fellow inmates.  Watch those closing titles.

Thursday, March 16, 2017

The Color of Money

Pool hustler "Fast" Eddie Felson was a character who warranted an update.  Many fictional characters really don't, either due to their inherent lack of interest or that their previous story was quite sufficiently wrapped up. As seen in 1961's THE HUSTLER, Felson was more than your average fresh faced hood, and left in a world of pain by the time he shook hands with Minnesota Fats one final time.  He walked away and perhaps viewers mused on what ten cent game he would join next, or even if he would live another few months. 

In 1986's THE COLOR OF MONEY twenty five years have passed and we find Eddie (Paul Newman, reprising his role) has become a wizened sixty-something, now a liquor salesman who's done well for himself. He's still hanging around smoky billiard halls and organizing bets with younger hotshots.  It seems he rarely picks up a cue these days.

When Eddie sees Vincent (Tom Cruise), skilled but undisciplined and cocky, he begins to instruct the young man how to scam larger amounts of dough from small timers.   Vincent has some innate ability but is a bit slow on most things, especially the idea that a con involves scaling back, pretending to be an average player.  Eddie plans to mold Vincent into perhaps a more savvy younger version of himself, and finds that using Eddie's girlfriend Carmen (Mary Elizabeth Mastrantonio) to inspire jealousy can be effective.

Like its predecessor, THE COLOR OF MONEY is really not attempting to milk suspense from high stakes contests, at least not the ones on the felt.  The shadowy figures who drift through dank parlors, guys like Julian (John Turturro) and Amos (Forrest Whitaker) are playing games at every moment, waiting to snare their prey.  They'd as soon do it with three card monte or some other trick if nine-ball wasn't their preference.  Richard Price's hard boiled script, based on Walter Tevis' novel, mines the psychology of the players, their bleak surroundings. Often very effectively.  It's also a film of atmosphere, and director Martin Scorcese provides the grit and seediness almost as vividly as in TAXI DRIVER.  The soundtrack is filled with Robbie Robertson's moody scoring and a few more uptempo tracks, including Eric Clapton's "It's in the Way That You Use It".

Scorcese fixes Michael Ballhaus' camera on faces as much as fancy pool shots (some of which are very close-up).  Newman's face is seen from multiple angles in a series of fades that tells us his thoughts before he actually explodes in frustration. The actor's Oscar winning performance really is perfect, even if the film around him isn't.  THE COLOR OF MONEY meanders and often seems to lose interest in its story, allowing the low key vibe among the characters to become near catatonic. I found the events in the climactic moments of the movie to be lacking, though realistic. Many viewers will be frustrated by the final scene's inconclusiveness.

Cruise, becoming a big star by this time, does convincing work as a wet behind the ears kid.  Mastrantonio is also fine in her quiet sultriness.  But this is Newman's picture all the way, a Star Vehicle I can get behind.  Scorsese lends his visual magic but it's all there to service his lead actor, and that's just fine.  I wouldn't have even minded seeing another chapter, to see how "back" Eddie Felson really was.

Monday, March 13, 2017

West Side Story

At once very dated and to the moment relevant, 1961's WEST SIDE STORY, an adaptation of the Broadway hit, is unique among Hollywood musicals for many reasons.

While many of the NYC locations are created on soundstages, the film has a distinctive faux real urban texture.  Tenements, streets, basketball courts, underpasses, etc. all have a lived in, somewhat gritty feel.  While we are entirely aware of the pageantry at hand, director Robert Wise has a good sense of the way such a story on the West Side of the city might play: artificial yet convincing enough to be plausible fakery.  Put another way, we always know that the drama involving the turf wars between the Caucasian Jets and the Puerto Rican Sharks (and the lovers caught in between) is updated Shakespeare yet within these confines it's still convincing.  There is a sense of menace and urgency but examined closely, these youths are really just a few degrees more threatening than the Bowery Boys.

The astonishing choreography, by co-director Jerome Robbins, is distinguished by step work done in time with Leonard Bernstein's elaborate scoring, often incorporating unusual time signatures.  The result is a jerky, perhaps less polished round of dance that suits the action.  Not just street brawls and knife contests.  There's a vibrancy throughout, a real sense of life, but also a nervous energy.  An uncertainty.  This is a tragedy, after all.  Witness the post brawl number "Cool",  one of the most complex exercises of its type I've ever seen on film.  It apparently was quite a bear to pull off. 

While many critics deride leads Richard Beymer (Tony) and Natalie Wood (Maria) for their lack of charisma, not being fiery enough, etc., etc.  I think within this artifice they do just fine.  Are just right.   Each perhaps represents that eternal pie in the sky hope that we can all just get along.  That romantic dreams can come true.  That love can conquer all within in urban nightmare of racism and poverty.  There to level this utopia are Oscar winners Rita Moreno as Maria's friend Anita and George Chakiris as Bernardo, brother of Maria and lover of Anita.  They are the voices of (sad) reason, with no illusions of their environment.

And the plight of the unwelcome immigrant infusing WEST SIDE STORY is still as potent as ever.  Some of the corny dialogue actually holds weight, and the signature tune "America" nicely sums up what it meant to be Puerto Rican in their new land in the '50s and '60s, and what it means to many others today.   

Friday, March 10, 2017

Respect the Stoagie

I haven't partaken of a cigar in close to twenty years.  I was never fond of the taste.  Maybe I didn't smoke enough of 'em.  Maybe I still remember, all too vividly, that time in 1994 when I did things rather incorrectly.

West Palm Beach was celebrating its centennial.  A group of us were downtown, pub crawling.  Cigar bars were becoming trendy at the time.  We stopped in one and spent too much money, minutes later puffing like pros in the humid night air.  I'm sure one of us grabbed a port wine to go with it.  The activity felt very grown up and refined.  I was the novice of the group, something that would really hit me about twelve hours later.  I think I smoked two stoagies that night, all the while inhaling the smoke.  I think we had a big dinner somewhere on Clematis that night as well.

I went to bed without incident. No coughing jags.  I woke up feeling fine.  It was Sunday.  I went to church. I donned the robe as usual, sitting among my choir mates in the loft in the front of the sanctuary.  The pastor was deep into his sermon.  Something became very wrong.  Like someone threw the switch on my nausea receptors.  My stomach felt as if it was distending.  I had to clumsily make my way over the knees of those in my row, racing up the back stairs to the second floor hallway.  I was close to the restroom and then it hit.  I sprayed the wall like that kid in STAND BY ME.  It was epic, my most dramatic emesis ever.  Thankfully, no one was there to witness it.  But embarrassment would've been secondary at best in that moment.

After I cleaned it up, I began wondering why the reaction was so delayed. Was some time release mechanism at work?   I knew even then that the tobacco leaves were probably cured with some chemical after harvesting. Was that it?  Maybe it wasn't even the cigar? Did I get food poisoning instead? Dunno.  Maybe someone can answer.  I know that I never inhaled cigar smoke again.  Granted, I only did the deed a few more times, quite gun shy and only puffing and blowing a few times before discarding.   I was sufficiently spooked.  I was slightly tempted that time in Vancouver, when I saw Cuban Cohibas for sale in a shop window.

My wife is happy that I do not smoke anything these days.  She is not pleased that her father still enjoys what he would call a hobby.  She might call it a habit.  I do still enjoy the aroma.

Tuesday, March 7, 2017


There's quite a story behind 1982's HAMMETT, an imagining of the life and times of pulp writer Dashiell Hammett.  The movie was produced by Francis Ford Coppola's (ill-fated) Zoetrope Studios and directed by German auteur Wim Wenders.  After photography was completed, the studio was unhappy and ordered a complete reshoot.  Wenders had filmed this neo noir on location in San Francisco, apparently going more for the essence of a detective's existence than a complex narrative.  A year later, after Wenders shot another movie, he returned to frame the action on soundstages and backlots.  There were and are many rumors that Coppola actually reshot the movie himself.

When HAMMETT was finally released, only some of Wenders' original scenes remained.  The director was quoted as saying the new version was "all story and no soul."  Given such a troubled history, it would seem that that the result would be a disaster, and many critics and fans were less than thrilled, but I find the film to be a real lost treasure, an entirely pleasurable evocation of a bygone era through the prism of patent artificiality.  I do lament the lost maiden effort (reports state the original film was destroyed), and it's impossible not to wonder how this movie played in its first incarnation.

Jimmy Ryan (Peter Boyle), an old pal, shows up at Hammet's flat one afternoon with a request to help him find a Chinese lady of the evening called Crystal Ling.  Hammett isn't really interested, especially as it smells like a ticket to his old life, working for the Pinkerton snoops.  He's been behind the typewriter of late, eking out a living composing short stories. There is a manuscript he's trying to sell.  He coughs up his lungs and nurses whiskey no matter the hour.  But a friend's a friend.

Jimmy goes missing after the pair make their way through Chinatown.  The mystery is just beginning.  Hammett, known as "Sam" to several others in this movie, including his sexy neighbor, Kit (Marilu Henner), winds his way through a labyrinth of blackmail and hired assassins.  Duplicity lurks behind the eyes of many of the characters.  Periodically we are treated to dramatizations of Hammett's writings, nicely stylized in the traditional of great, smoky noirs.

But the entire feature can be described as such, and Wenders does a fine job of conveying the spirit of yesteryear crime dramas in every possible way.  The backlot settings only add to it, in my opinion.  Ling sums it up well as she slinks over Hammet's recliner, dreamily remarking how masculine his apartment is.  It's cluttered and drab, yet far more romantic than your average bad neighborhood shithole mancave might look.  Everything clicks in HAMMETT: the reliably snappy dialogue, the astounding production design, Joseph Biroc's beautiful photography.  While Forrest (a stock company reg for Coppola) was not Wenders' first choice he is excellent in the lead role.  A well balanced mix of confidence and weariness.  Noir fans should not miss this movie.