Dolly

No one didn't like Dolly Parton. She was Sara Lee cakes. "No one doesn't like Sara Lee." She was one person whose music I didn't have to download because they passed away. It was already on my iPod. (Yes, I still have one. Several in fact.)

The name Dolly automatically makes everyone like you. Dolly Madison, President James Madison's ebullient wife, who was so popular throwing White House parties that they eventually named an ice cream after her: Dolly Madison ice cream. No one doesn't like ice cream.

Frank Sinatra's mother was Dolly Sinatra, the queen of Hoboken, leading in all the town's parades. She was the go-to person in Hoboken to go to when you needed help. She wasn't an elected official. She was better than that.

And then there's Dolly the sheep. Dolly was of course a cloned birth of a sheep born to a surrogate mother sheep. This particular Dolly had a face only a mother could love, but of course it was a mother sheep.

Chap GPT tells us:
How they made Dolly.

 Scientists took DNA-containing material from three sheep.

An adult Finn Dorset ewe — they took a cell from her mammary gland. This provided the DNA that Dolly would inherit.

A Scottish Blackface ewe — they took an unfertilized egg cell and removed its nucleus, getting rid of that sheep's DNA.

Another Scottish Blackface ewe— served as the surrogate mother.

The researchers then:

—Fused the adult mammary cell with the enucleated egg.
—Used an electrical pulse to make the resulting cell begin dividing as an embryo.
—Implanted the embryo into the surrogate mother.

The remarkable part was that Dolly was genetically almost identical to the adult Finn Dorset sheep that supplied the mammary-gland cell. It demonstrated that the nucleus of a mature, specialized cell still contains the complete genetic instructions needed to create an entire animal.

And the name?

The scientists jokingly named her Dolly after Dolly Parton because the DNA-containing cell came from a mammary gland. Dolly lived for about 6½ years, had six lambs, and died in 2003. She was preserved and is now displayed at the National Museum of Scotland in Edinburgh. 

The Dolly experiment was enormously important because it showed that an adult cell's nucleus could be “reprogrammed” back into an embryonic state—a fundamental idea behind later stem-cell and cellular-reprogramming research.

Dolly gave her name to science.

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I remember Dolly on the Johnny Carson show one night when she was discussing how long it took her to put her face and wig on: "I need a good hour. It costs a lot of money look this cheap." Carson of course fell down.

I don't know if that was already a Dollyism, but at that point, on national television, it certainly became one.

Dolly in front of a Dollywood Replica of her Birthplace

At about the time the movie '9 to 5' was in the theaters, Jane Fonda, who co-starred with Dolly in the movie, was on another Carson show and said that when they were filming the movie Dolly took her on a tour of rural Tennessee where Dolly was from. At every turn in those hills and hollows of the Smokey Mountains, Dolly knew everyone, and everyone knew her.

When I saw the movie 'Best Little Whorehouse in Texas' I knew her song 'I Will Always Love' You was a mega hit song.  It's played at the part in the movie when she's got to part from her boyfriend sheriff, Ed Earl Dodd, and move; the do-gooders are putting the brothel, and Miss Mona, Dolly, out of business.

I didn't know then that was written to Porter Wagoner whose show she was leaving to go off on her own. Whitney Houston of course made a huge recording of it. I remember that Dolly was in Carnegie Hall and she commented on Whitney's version, and said she loved it. 

Of course I knew she wrote songs, but 3,000, 1,000 of which have been recorded? Insane. She said she writes all the time, even in the bath. One day wrote 10 songs.

I once caught part of a country music awards show on TV, and there was Dolly, introducing the latest country heartthrob, Randy Travis. Dolly started flirting ever so slightly with him on stage and Randy just forgot everything he was going to say or do; he was smitten and blushing. His composure did return.

'I Will Always Love You' is a great song, and became the massive headline in yesterday's New York Post: We Will Always Love You. American Icon Dead at 80.

I didn't get the Daily News, but Dolly's death certainly hit the trifecta of New York papers as her image appeared above the fold in the Wall Street Journal AND The New York Times.

When the news broke on Tuesday of Dolly's passing, I wondered how the NYT was going to acknowledge her passing. Front page for sure, maybe part of the obit above the fold is what I was expecting.

I was as pleased as I was astonished to see her obit front and center, above the fold, with a huge picture of her early in her career: Rhinestone Studded Superstar Who Lit Up Millions of Hearts. Wow!

President Trump ordered flags to be at half-staff for a week. The only other entertainer to get a half-staff honor was Bob Hope in 2003, and he got a day. (He was, after all, born in England.) 

Saratoga was playing her music before the first race yesterday. The Empire State Building went pink at 9:25 P.M. Get it? 9-two-5, like the movie.

The cupolas at Churchill Downs were lit in her colors.

Someone cleverly altered the FULTON STREET sign in the NYC subway station to PARTON STREET. 

An airport will be renamed.

I always liked Dolly Parton. 

I just never knew so many other people did as well.

http://www.onofframp.blogspot.com

Beavers Are...What?

Every so often the print edition of The New York Times is well worth whatever discounted price I'm paying for home delivery. The newsstand price is $4.00, but no one in New York pays retail.

My wife continuously makes fun of me (and we're married over 50 years) for reading that "pinko Commie rag." She gets that opinion of the paper from her father growing up in the 50s and 60s who, like many adults of  that era, considered the paper to be connected to the Communist Party.

This stems from their notorious reporter, Walter Duranty, who in the 1930s filed glowing reports about life under Stalin. It became a big deal in journalism, and resulted in efforts to yank the Pulitzer that was awarded to Mr. Duranty. That never happened, however.

But enough about that, other than to establish that I've been reading the paper for many years, and don't care about my wife's opinion, or believe I'm reading propaganda from the Kremlin. If it's there, I dance around it.

Where else but in a Saturday edition can one read about Canadian beavers? And not just tucked away deep inside. Page 1. Saturdays are slow news days, especially during the summer when the movers and shakers have either not reported in on Friday, or have left early for the weekend.

I've noticed this Saturday trend for many years. Mondays, too. You can usually count on a story that is of human interest, or in this case, of animal interest.

You might expect a story about beavers to actually carry a picture of one. No. There is some sort of Page 1 aerial view of what is described as beaver built dams blocking water flow, and inside pictures of scientists who are tracking the little fellas with what else, drones. But no picture of a beaver. Were that they hard to find? The aerial shot looks like a very bad case of foot fungus.

And here is one for a future Jeopardy clue. What are people called who study beavers? Castorologists. Turn it into a typo, and you've got the study of a deceased Cuban dictator.

When I was a lad in short pants in the 1950s, there was a toothpaste called ipana. The commercials were cartoonish, led by "Bucky Beaver", whose prominent two front teeth glowed after brushing with ipana. The jingle went: "brusha, brusha, brusha, with the new ipana."

It's only now I'm wondering, how did they come up with the name ipana? Was it an acronym? According to my new-found buddy, ChatGPT, there is no evidence that ipana was an acronym. Bristol-Myers had been making ipana since 1901. There is no one alive now who can tell us anything about the origin of the name.

(Unrelated, I once knew there was a maître d' at New York Racing Association, NYRA tracks, Manny Pana, who ran the dining rooms and who was always willing to accept a $20 gratuity for a good table on the glass near the finish line. The NYRA execs hated him because he was making more than them. Eventually, Manny was replaced by an uncorruptible staff trained in Walt Disney hospitality.)

ipana. Madison Avenue at its best. So who wouldn't want teeth as bright as a beaver's? This, despite the fact that beavers have reddish/yellow front teeth due to a high iron content beneath the enamel. Like steel-toe  reinforced work shoes, a beaver's teeth are reinforced. Perfect for gnawing those tree trunks and making dams.

It wouldn't do ipana toothpaste sales any good if Bristol-Meyers admitted Bucky Beaver was a rodent. Bad publicity. Couldn't show iron stained, plaque teeth as what the toothpaste was good at removing. Today that would be called "bad optics."

ChatGPT:

No—not literally. Beavers do not have metal teeth, but their front teeth are extraordinarily well adapted for gnawing wood.

Their incisors contain a high concentration of iron compounds in the outer enamel, which gives the teeth their characteristic orange-red color and makes the enamel exceptionally hard and wear-resistant. The softer dentin behind the enamel wears away faster, keeping the incisors self-sharpening.

So, in a sense, beavers have iron-reinforced teeth, not metal teeth. 🦫

And their incisors never stop growing, which is why they need to keep gnawing.

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And its those damn dam builders that have the good folks in Umiujaq, Quebec, a seaside community 700 miles south of the Arctic Circle, hard by Hudson Bay, scratching their heads. The Arctic char, a fish that is a staple of the Inuit's diet, cannot leap over the beaver dams like a salmon can. Therefore, the char do not reach this tiny enclave, and the residents are experiencing "food insecurity." Yes, even Inuits can have "food insecurity."

Despite the size of a char being nothing close to being a tadpole, it is not a pole vaulter. And those damn damming busy beavers have built dams as big as school buses that prevent the fish of getting to where the Inuits can fish for it. 

Of course, Global Warming is behind the trend of the beavers seeking colder waters and swimming further north than they used to. Up to now, there is nothing that I found remarkable about the story. However, there on Page 1, leading off the 6th paragraph are the words I never expected to read: "The Furry Pyriform rodents..." A showstopper sentence.

Capybara

What? A beaver is a rodent? You mean like a rat or a mouse? Apparently so. The genus of the beaver puts then in the rodent family, and they are second in size to the largest rodent, the capybara, that resembles the beaver. Nice to know. 

Beaver pelts were once all the rage to make coats out of. John Jacob Astor made a fortune providing beaver pelts to the swells of the late 18th and early 19th-centuries in the Gilded Age.

I wonder how popular the pelts and fur pieces might have been if it were widely known that the beaver was a rodent. "That's a nice rodent you've got on today."

When the Interborough Rapid Transit (IRT) subway system was burrowing under 4th Avenue in Manhattan (Yes Virginia, there still is a 4th Avenue, below 14th Street.) into what is now the 4, 5, and 6 lines and it passed through Astor Place, there were mosaic designs placed along the station's wall to identify to the immigrant population that perhaps couldn't yet read, that they were going through Astor Place because of the beavers portrayed on the walls. Astor equaled beavers. Simple. If you know, you know.

The mosaics are still there, as are the ones showing a locomotive for the 42nd Street Grand Central stop. There are others along the line. Subway lore.

I'd be remiss if I didn't include two stories about beavers from the 50s. The first is the obvious one: the 'Leave It to Beaver' 1950s TV-family of dad Walt; pearl-wearing mom, June; oldest son Wally with a varsity high school sweater, and of course the younger brother who the show is named after, Beaver.

All lessons in life come from this family. Dad is a briefcase toting office worker; Mom runs the house. Wally is always trying to explain things to Beaver, and Beaver is sometimes confused, but he's cute.

Beaver's birth name is Theodore, but when he was born, Wally was but a tyke himself, and he couldn't pronounce 'Theodore.' It came out 'Beaver.' Well, that's what they say.

The next beaver association is when I was in the back seat with Billy Gabler, in a car driven by his father, with my dad in the front passenger seat. (We didn't have a car.) For some reason, the game was to see who could be the first to see and call out on seeing a station wagon on the road and yell "beaver." I swear. I don't remember keeping score, which was almost as unusual as calling out "beaver."

We weren't the only car-trip tykes passing the time this way. This was a recognized game known to others. It is now after writing this that I'm wondering how did the word 'beaver' come to be associated with a station wagon sighting?

Say what you will about AI, but ChatGPT offers a cogent explanation: station wagons of the 50s were often 'Woodies.' wood paneled cars. Since a beaver chomps wood, seeing a station wagon required acknowledging it with a yell of "beaver."  We were not selective. Any station wagon counted as a beaver sighting to us. Our rules.

So, at 77, with the help of AI, there's a possible explanation for why "beaver" got called out when seeing a station wagon. I'd love to share this with Billy Gabler, but I can't find him.

http://www.onofframp.blogspot.com

Death By...?

As the song 'American Pie' starts off...

"...long, long, time ago, I can still remember, when..."

It might have been 2002, and I was at an NHCAA conference in San Diego in June, perhaps. NHCAA stands for Nation Health Care Anti-fraud Association, I was there with another co-worker.

This is the annual convention and draws people from all types of fraud departments: State Insurance, Federal Law Enforcement, Commercial insurers, and from companies like mine Blue Cross Blue Shield plans across the nation. I think it runs 4 days.

Birds of a feather flock together, and after one day or so of presentations, a group of us from us went to one of the malls, Fashion Mall, I think.

It was accessible by the trolley, which is part of San Diego's mass transit system. There was trolley stop right behind the hotel,

San Diego the, and maybe still, uses an honor system fro paying the fare. You buy a ticket and show it, if asked to an enforcement individual, who might be on the trolley, or asking you for the ticket as you get off. But there not always there.

There are no turnstiles like the N.Y.C. subway. The trolley runs at ground level, powered by pantograph wires overhead. The ride is as smooth as a baby's bottom, because I think the trolley's wheels are rubber.

The station stops are almost sidewalks. You can walk across the tracks to the other side with no chance of any danger.

Being the New Yorker, I am I marveled at the system, especially the honor system for fare collection. I felt proud of myself when I was confronted at a bus stop for my ticket by uniformed fare enforcers. They almost seemed surprised I had one. I wasn't playing the wise guy, conniving New Yorker to beat the fare.

So, here we are at the Fashion Mall, and I can't get over the trolley and the ability to walk across, or along the tracks. 

Being who I am, I envisioned getting killed by a trolley. Further, I wondered how they would code the accident using the ICD-10 manual, International Classification of Diseases: Death by trolley? Death by trolley going uptown? Downtown? Electric trolley? Diesel powered?

I kept this patter up as we went to and from the Fashion Mall. "Death by trolley." A woman from the Louisiana Blue Cross Blue Shield thought this was quite funny. They don't come across many New Yorkers whose accent make then sound like a gangster, thinking out loud on how to code an unusual death. We can he a handful. We stayed in touch. Somewhat. 

Don't laugh, the ICD-10 manual is thick with codes to uses for all kinds of diseases. Toward the back are a series of alphanumeric codes that attempt to assign a code to an event causing death that is not a medical death. Maybe something like a car accident.

But the codes can be quite granular, and an event might need several codes to capture the cause of death, as we will see. 

The world runs on statistics, and having a uniform coding system for cause of death allows for research into causes. Medical reasons are understandable. Other types of events that might cause death are varied as well: violence, suicide, accidents by all sorts of conveyances, crime, there is quite a list.

There was quite a bit of teeth gnashing on how to code the deaths from the World Trade Center, the Pentagon, and Shanksville, Pennsylvania. Hijacked 767s not using a runway to land causing death was a coding challenge. Did NYC have a sudden surge in homicides? Oh boy.

I immediately thought of the investigator from Louisiana (who is now a manager of the unit) when I was putting the posting together about the assistant night club manager who was crushed to death by a piano that was accidently hydraulically lifting itself to the ceiling while he was on top of a stripper making whoopee. The assistant manger was crushed to death, and the screaming stripper was found the next morning with bruises, but otherwise not physically hurt. A janitor discovered the scene the following morning when he came in to start cleaning.

Being stuck for hours under a corpse on top of you while you're on a piano pressed against he ceiling, had to leave some mental damage. Eventually, more coding.

The woman from Louisiana was still working for the Blue Cross Blue Shield plan, which made me wonder how young was she when I was going on about "death by trolley?" No matter.

We connected via LinkedIn. I linked her to the blog posting about the assistant night club manager killed in a very unusual manner, and asked her if she'd use the ICD-10 book and code the event for me. The book is expensive and I have no need to have one.

She admitted she was not a coder (there are certified coders as a profession) but took a stab with T14.8, crushed, severe, unspecified site. Certainly fits.

I also asked her if she could also code the Central Park carriage accident where a young man fell out of the carriage attempting to help his mother when the carriage was tipped over because the horse felt a charge of stray electricity in its hoof from the pavement, and ran off. The young man hit his head on the pavement and died. Lots of news there. Louisiana passed on that one, but was a bit astonished that I still brought up "death by trolley" after all thee years. 

The coding of unusual deaths still niggled in my brain. It got me thinking. How would they code that? Why not ask AI? Well, ChatGPT reveals how much can go into capturing all the elements of a death precipitated by a horse feeling a stray electrical charge in its hoof and running off while tipping the carriage over, causing a passenger to fall out and fatally crack their skull on the pavement. You got to admit, a lot went into having a very bad day.

ChatGPT:

"If you mean the scenario you describe is unusually specific, but it actually fits the transport-accident classification quite well. The key external-cause code

"The best fit is:

"V80.02XA — Occupant of animal-drawn vehicle injured by fall from or being thrown from animal-drawn vehicle in non-collision accident, initial encounter.

"That category specifically includes an overturning animal-drawn vehicle without a collision, which is essentially what happened when the horse bolted and tipped the carriage.

"For a death certificate/mortality coding, however, the coding works somewhat differently. The CDC says that transportation accidents are classified primarily according to the victim's mode of transportation, and the underlying-cause code is generally selected at the three-character level rather than using the full clinical 7-character injury code.

"So the mortality coding would likely center on:

V80 — Animal-rider or occupant of animal-drawn vehicle injured in transport accident

with the circumstances further described in the record.

"But there is another important part

The actual cause of death would be the fatal head injury—not the horse's electrical sensation. For example, if the medical examiner determined that the passenger died from a traumatic skull fracture and brain injury, the medical cause would be something along the lines of:

Fatal traumatic brain injury due to skull fracture from fall onto pavement

and the V80 code supplies the external circumstances.

"The electrical charge that startled the horse is an additional causal circumstance. ICD-10 mortality coding is designed to capture the chain of events, and the CDC specifically notes that when transportation is involved, the transportation accident is coded as an external cause.

"So, in plain English, your hypothetical could be represented as:

Horse receives stray electrical shock → horse bolts → carriage overturns → passenger is thrown/falls from carriage → strikes head on pavement → fatal skull/brain injury.

"ICD-10-CM external cause: V80.02XA (for the injury encounter)
Underlying mortality classification: V80 (animal-drawn vehicle transport accident)

"One wrinkle: because you specifically said “death precipitated by a horse feeling a stray electrical charge in its hoof,” there may be an argument for separately coding the electrical event. If you're asking this because you're trying to reconstruct how an actual historical death would have been coded, I can dig into the ICD-10 Index and show exactly how the electrical shock → runaway horse → overturned carriage → skull fracture chain would be coded on a death certificate.

"Factoring in the electrical charge causing the bolting:

"Yes — the electrical shock is a separate part of the causal chain, and I would distinguish it from the carriage accident.

"If the horse itself received an accidental electrical shock from, say, a live wire or electrified rail, the ICD-10-CM external-cause category for the human victim is not simply “electrocution.” The passenger was not electrically shocked; the electricity caused the horse to bolt, which caused the transport accident.

"So I would code the chain approximately as:

"Electrical current → horse startled/bolts → animal-drawn carriage overturns → passenger thrown out → fatal head injury.

"The passenger's principal external-cause code would remain in V80, for an occupant of an animal-drawn vehicle injured in a non-collision accident. The ICD-10-CM classification specifically has V80.0 for someone injured by falling from or being thrown from an animal-drawn vehicle in a non-collision accident.

"But if you're asking what code describes the electrical event itself, that's where it gets interesting. The appropriate electrical-current code depends on what supplied the current—for example, a power transmission line, electrical wiring, railway equipment, etc. ICD-10-CM has separate external-cause categories for those circumstances.

"And there's an important distinction:

• Person receives electric shock: an electrical-injury code such as W85–W87 may apply, depending on the source.
• Horse receives shock and a person is subsequently killed: the electrical event is an antecedent circumstance, while the person's injury is the consequence of the animal-drawn-vehicle accident.

"The CDC's mortality guidance emphasizes that the external-cause classification follows the circumstances that produced the fatal injury, and transportation accidents are separately classified.

"If this is for the historical death you have in mind, I can go one step further and find the exact ICD-10 code for “horse struck by electric current” and then construct the complete death-certificate causal sequence.

"Horse struck by electrical current makes it:

"Ah — if you mean the horse itself was struck by an electrical current, rather than the passenger, then I would not use an ICD-10-CM “electric shock” code as though the horse were the patient. ICD-10-CM is a classification for human morbidity/mortality.

"For the human death, however, the electrical event can be described as an antecedent circumstance. The ICD-10-CM Index identifies “Exposure — electric current” as W86.8, with the more specific W86.8XXA being “Exposure to other electric current, initial encounter.”

"But in your exact scenario:

Horse's hoof contacts stray electrical current → horse bolts → carriage overturns → passenger is thrown → passenger sustains fatal skull fracture

"I would not make W86.8 the principal external-cause code for the passenger, because the passenger wasn't exposed to the electricity.

"The most natural coding description would be:

V80 — occupant of animal-drawn vehicle injured in transport accident

with the electrical current recorded as the precipitating circumstance.

"And I think this is what you were getting at originally: “death precipitated by a horse receiving an electrical shock”, rather than “death by electrocution.” That's an important distinction."

WOW! You can see there are a lot of events, and sequence of events, to consider. I watch some of those British detective shows and there's one called 'The Coroner' where a verdict comes in: "Death by misadventure."  How boring. 

---------------------------------------------

Okay, perhaps the most unusual death ever is the woman in NYC who opened her car door and fell into a manhole because the cover had been dislodged. She fell to the bottom of the manhole and was scalded to death.

ChatGPT

"On May 19, 2026, a 56-year-old woman died after stepping out of her Mercedes-Benz SUV and falling 10 feet into an uncovered manhole on East 52nd Street near Fifth Avenue in Midtown Manhattan. 

"Incident Details: Dislodged Cover: Surveillance video reviewed by Con Edison and the NYPD showed that a multi-axle truck turned onto the street and drove over the manhole cover roughly 12 minutes prior to the incident, unseating and dislodging it.

"Legal and Official Response: City agencies and Con Edison opened joint safety investigations, and the victim's family subsequently filed a lawsuit regarding the hazardous, uncovered condition of the street.

"If you mean how I would code this event in ICD-10-CM I would treat the fatal thermal/steam injury as the principal injury with the fall into the manhole as an external-cause code. The exact burn code cannot be finalized from the narrative alone because the anatomic burn sites and degree of burn are not specified. For 2026 ICD-10-CM, the CDC guidelines say burn codes should identify the site and degree, and that separate codes should be assigned for separate burn sites. Likely coding structure: Coding element ICD-10-CM approach Primary injury coded to the documented body site(s) and burn degree. Add T31 if the percentage of total body surface area burned is documented/needed Steam exposure— exposure to ignition of highly flammable materials / hot vapors/steam category should be verified against the final 2026 tabular listing. 

"An appropriate W17/W18.- fall code depending on the documented mechanics of the fall Cardiac arrestI46.9 may describe cardiac arrest, but it generally would not be the underlying cause of death when the arrest resulted from the fatal thermal injury assuming the medical examiner determined this was an accident. The CDC's ICD-10-CM index specifically recognizes burn from steam as a thermal burn and directs coding according to the burn site.

"If this is for a death certificate that's slightly different from hospital ICD-10-CM coding. Based on the facts you supplied, the causal chain would conceptually be: 

"Underlying cause: Accidental fall into an uncovered utility manhole → exposure to extremely hot steam → severe thermal/scald burns → cardiac arrest → death,. not code “cardiac arrest” as the underlying cause simply because she went into cardiac arrest. Cardiac arrest is the terminal mechanism; the fatal injury that precipitated it is what matters for the causal sequence. Also, I would not assign a specific T20/T21/T22/T23/T24/T25/T26/T27/T28 code from this narrative alone, because doing so would require knowing where she was burned and the documented degree. The CDC specifically cautions that T30 (unspecified body region) should rarely be used when the burn site can be determined. 

"If you want, I can also turn this into a complete ICD-10-CM code set (principal diagnosis + secondary diagnosis + external-cause codes) and identify the most likely specific codes for the steam exposure and 10-foot fall using the 2026 code set."

That's okay. I don't blame Louisiana for taking a hard pass on that one. They did however come up with a code for the next one.

Yes Virginia, there is one more.

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Now, for the cherry on top. The pièce de resistance: How would ChatGPT ICD-10 code the horny assistant manager who climbed on top of a piano while having sex with a stripper underneath him, who accidently (we think it was his foot) tripped the "on" switch with his foot, and was oblivious to the piano rising to the top, crushing and killing him against the ceiling, and leaving the stripper in hysterics until the morning?

The description of the circumstances of the death were described to ChatGPT as stated above. Initially, the little AI guy thought I was pulling their leg—thought it was fiction. On no, mon ami, this actually happened. ChatGPT thought I was writing a screenplay:

ChatGPT:

"If this is for a fictional story, the cause-of-death certificate version could get considerably more darkly funny while still sounding authentically medical."

No, this happened. Not fiction Thus, I got:

"Ah—understood. If this was a real death, then I should treat it as an actual medical-coding question rather than a fictional scenario.

"For the circumstances you describe, ICD-10-CM would not code him as “horny,” nor would the fact that he was having sex be the principal diagnosis. The coding would center on the fatal traumatic injury and its accidental mechanism.

"The exact code depends on the injuries documented by the medical examiner/autopsy. For the external cause, the scenario sounds particularly consistent with caught/crushed between a moving and stationary object. ICD-10-CM specifically has the W23 category for being caught, crushed, jammed, or pinched between objects; the classification distinguishes moving/stationary-object circumstances.

"So, in plain English, the death certificate/coding narrative might be along the lines of:

Cause of death:

Multiple traumatic injuries due to crushing/entrapment between a mechanically elevated piano and the ceiling.

Manner of death:

Accident (assuming the medical examiner concluded that the activation was unintentional).

"The piano rising while he was on it is an unusually important detail because the external-cause code should describe what actually produced the injury, rather than simply calling it an unspecified accident. CDC describes ICD-10-CM external-cause codes as a framework for classifying both the mechanism and intent of injuries.

"And I wouldn't assign a psychiatric diagnosis from the word “hysterics” describing the stripper's reaction. Nor would I infer intoxication, sexual disorder, or anything else unless the actual medical/legal record establishes it.

"If you give me the actual injuries listed in the autopsy or death certificate (you can redact names and identifying information), I can tell you much more precisely how I'd map the case to the current FY2026 ICD-10-CM codes. The CDC has the FY2026 code set and official coding guidelines available."

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I followed up with stating the cause of death was getting crushed by the piano against the ceiling. I offered that my Blue Cross Blue Shield contact suggested: "T14.8, crushed, severe, unspecified cite." Would this fit?

ChatGPT:

"Yes— T14.8 is a defensible description of the injury if all you know is “crush injury, unspecified body region.” The ICD-10-CM inclusion terms for T14.8 explicitly include “crush injury NOS.”

"But there are two important qualifications:

1. “T14.8” by itself isn't a billable ICD-10-CM code. For a clinical encounter, it expands to something such as T14.8XXA (initial encounter), T14.8XXD, or T14.8XXS, depending on the circumstances.
2. It isn't the best description of the mechanism of this particular death. ICD-10-CM has W23.2 — “caught, crushed, jammed or pinched between a moving and stationary object.” A person crushed between a rising piano and a stationary ceiling is remarkably close to that wording.

"So I'd distinguish them this way:

What you're trying to code	Likely approach
The injury itself	T14.8 can encompass an unspecified crush injury
How the injury happened	W23.2 is much more specific
Underlying fatal injuries	Specific S-codes would be preferable if the autopsy identifies the injuries (e.g., skull, chest, abdominal, etc.)

"And there's a subtle issue with your contact's wording: “T14.8, crushed, severe, unspecified cite” isn't the official long description. The official-style description is “Other injury of unspecified body region,” with crush injury NOS as an inclusion term.

"So if you're asking, “Was the Blue Cross contact completely off base?” — no. T14.8 does encompass an unspecified crush injury. But if you're asking, “Is T14.8 the most informative ICD-10-CM coding for a man who was specifically crushed between a rising piano and a ceiling?” — probably not. The mechanism and the specific injuries would ordinarily allow substantially more precise coding.

"One other distinction: if you're dealing with an actual death certificate, rather than an insurance claim/clinical diagnosis, the medical examiner's cause and manner of death are a separate matter from selecting an ICD-10-CM diagnosis code for billing."

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ChatGPT has done an admirable job of dissecting the events that lead to the death. They are a talkative little guy. They accorded my Louisiana contact an "E" for effort, but basically tell them to keep their day job. Which is fine. A manager of Fraud Investigations is an important role in society.

Paul Simon has sung, "there are 50 ways to leave your lover." There are waaaay more ways to code your demise.

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Pittsburgh Phil

Pittsburgh Phil/George Smith

If everyone thought racing was on the up-and-up, what fun would that be?

The X Universe is alive this morning with good observations on betting patterns and outcomes. An intelligence agency would call it "lively chatter." Thoughts of conspiracy and shenanigans follow like a sunrise.  A catchy name has even emerged: 'The Fair Hill Five.' The name mimics the great British WW II spies in the U.K. that were double agents for the Soviets: 'The Cambridge Five.' I love it.

There is a difference. The Fair Hills five is not five people, but rather 5 horses that ran at two tracks on Sunday—Monmouth and Saratoga—that won from two obscure trainers, sporting workouts at Fair Hill Training Center in Maryland.

The training center is a combination of a spa, retreat, workout center, and rehab facility for thoroughbreds. It boasts of a lot of horses who have passed through it and gone on to do great things, or are coming from great things and want to get back there.

Fair Hill is not unique. There is Payson Training Center in Virginia; a similar facility devoted to getting a horse in top shape. Workouts are published in the Racing Form when they come from these facilities: "Fai"; "Pay" are the initials. Sort of like airports. There are other training centers as well. 

What has got the X people jumping is two horses, trained by Ernesto Ochoa, who won races at Saratoga on Sunday, with ease, sporting fairly lousy looking past performance form and coming off significant layoffs, but showing workouts at Fai.

In Saratoga's 4th race, Classic Rock went wire-to-wire after last racing November 7, 2025 at Churchill Downs. Classic Rock won the $35,000 maiden claiming race by nearly 9 lengths with Ricardo Santana riding, paying $18.68 to win for $2.

According to some people on X, the workouts at Fai are reported on an "honor system." That would imply there are no Daily Racing Form, or track clockers at this facility timing morning workouts. Thus, a workout might be reported, but the timing concocted; or, there can even be a workout that goes unreported. 

There was a legendary gambler, horseplayer, Pittsburgh Phil, who was really George Smith, who made over a $1 million betting on races in the 19th and early 20th centuries. Phil was the first human Racing Form, acquiring statistics on horse that no one was paying attention to. In horse racing, like the stock market—both played at by the same individuals—information is king. Google tells us:

"Pittsburgh Phil," born George Ellsworth Smith (1862–1905), was America's greatest and most methodical Thoroughbred horse racing handicapper. He won an estimated $1.7 million (a massive fortune at the turn of the 20th century) by treating the racetrack like a precise business rather than a game of chance. 

He was the first Quant of racing. He compiled all the information, and more, that is now available in a past performance. He made his own past performances, when no one else did.

In Saratoga's 7th race, also a maiden claiming, this one for $85,000, M Bs Melanie Cares also went wire-to-wire with Ricardo aboard, paying a plump $27.70 for $2 to win. They last raced January 4, 2026 at Gulfstream Park.

At Monmouth's 3rd race on Sunday, in a maiden claimer for $25,000, The Great Amira took the lead after the ¼ pole and won by 9 lengths with C.D. Lugo aboard, and trained by Angel Quiroz, a trainer with few starts and only $70,645 in earnings for the year. The Great Amira was coming off a layoff, and last race February 8, 2026 at Gulfstream Park, paying a very nice $37.20 for $2.

The 4th race at Monmouth, an open claimer, thus not a maiden race, was for a $16,000 claiming price. Tepeyac took the lead in the stretch after moving up through the field, and won by 1½ lengths with C.D. Lugo, also trained by Angel Quiroz, with only 20 starts this year. Another lightweight. Tepeyac was coming off a bit of a layoff, not having raced since April 5, 2026 at Gulfstream Park.

There is such a thing as "Rolling Daily Doubles", meaning starting with the 1st race and 2nd race; there is also a Double that starts with the 2nd race and links the 3rd race, and so on.

Consider the second daily double on the card at Monmouth, consisting of the 2nd and 3rd races won by horses that paid $9.20 and The Great Amira's $37.20, and you've got a $101.00 Daily Double payout for $2. 

Double pools are separate from win pools, but should reflect either the high or low payouts of the horses in the double, paying $101.00. A $9.20 horse, and a $37.20 horse linked in a Double paying $101.00 sounds about right. The trainer for the winner of the 2nd race was Antonio Arriga and the rider was Ruben Silvera. Thus, the winning trainer of the 2nd and 3rd races was not the same.

The rolling daily Double for the 3rd and 4th races, comprised of the Fair Hill trained winners, paid $25.60 for horses that paid $37.20 and $$9.60 to win, almost identical in payouts for the previous Double, that included The Great Amira at $37.20, and Johnny Hockey in the 2nd at $9.20 for a Daily Double that was a not eyebrow raising $101.00.

Thus, the 3rh and 4th races rolling double paying $25.60 is less than the payout for one of its legs. This is unusual, and speaks to a Double pool skewed to the two winners. You can get the justifiable feeling that someone has put "one over" on the public. It is not impossible.

I can't find my Pittsburgh Phil book right now. It is filled with his axioms, one of which was maybe the best one: never play a horse (especially a favorite) that is trying something for the first time, a distance, carrying weight, or a change of surface, or condition of that surface..

The voluble Andy Serling on the Fox racing broadcasts once attributed this to Harvey Pack, a legendary racetrack bettor and personality. Well, if Harvey said it, and he probably did, he got from Pittsburgh Phil, although not personally, since Phil lived from 1862-1905.

(After Serling quoted Harvey as coming up with that bit of advice, I X'd Andy and told him Pittsburgh Phil said it first. No response from Andy. None expected.)

I like to think that if Pittsburgh Phil were around today, he would know if something was up with Fair Hill trained runners and their reported or unreported works.  In his era, there would have been no rolling Doubles, only Win, Place and Show bets and maybe one Double at the start of the card.

$18.68 and $27.70 win scores are nothing to sneeze at. Phil would have been smiling.

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Sharp Force

"Sharp Force." The book? Not so sharp.

I took a chance of reading this book because of he Scarpetta miniseries on Prime Video starring Nicole Kidman and Jamie Lee Curtis.

Initially, I wouldn't recommend the series to anyone, but I've since revisited it after reading "Sharp Force" and find it worth the bother if you can get past Jamie Lee Curtis and her wrinkled breasts trying to escape from the hardly age appropriate clothing she's wearing. Kay, played by Nicole Kidman, is her sister, and has basically retorted that Dorothy is just plain "cock-happy." Oh boy.

I just finished a book and was looking for another to read. I got the book in hardcover, which I prefer, for around $14 on Amazon. There is one thing about a best-selling author, even hardcover books are cheap.

The Scarpetta miniseries helps in identifying the characters in "Sharp Force". The miniseries rocks back and forth though time, necessitating another actress to played the younger Kay Scarpetta, the Chief Medical Officer of Virginia

There is a long-running BBC series called Silent Witness that's been playing out for decades with a female forensic pathologist headlining the cast. Lately that's been Emilia Fox, playing Nikki Alexander as the pathologist who we see doing the cadaver cutting, extracting and weighing of organs as they are placed dripping on a handy scale.

:Silent Witness: is a great series. The author of the Scarpetta series of book is Patricia Cornwell, who worked in a chief medical officer's office in Virginia. She wasn't a medical person, but was certainly in the room when bodies were examined.

"Sharp Force" is basically a straight narrative starting on Christmas Day in what can be described as a day in the life of Kay Scarpetta. It's easy to follow, and there are just enough characters that you don't get confused as to who's who.

The arc of the story will challenge your sense of reality when the "Slasher" is following their victims with a drone that produces a hologram that goes through walls and doors to torment the victim.

This is not a science fiction book. It is a crime mystery will all the bells and whistles of what we read about every day: AI brought to life.

Kay Scarpetta's niece is Lucy, Dorothy's child who lives with Kay and her husband because, well, Dorothy is a "shit mother." Kay and her husband have no children.

Lucy is a lesbian who is a cyber special agent and technical expert for the F.B.I., and is mourning the loss of her wife, who she has replaced with an AI agent avatar, Janet, who is Wi-Fi'd into seeing and hearing everything Kay and her husband do, in the house or even in their Tesla car, and who they consult online for background checks.

Lucy can fly the Bureau's helicopter and chases away the news drones from the pain-in-ass news personality, Dana Diletti, who has also been personally threatened by a hologram, that has flooded the sky over the murder scene, a psychiatric hospital on the fictional Virginia Mercy Island with great views of the Potomac, near Ronald Regan International Airport.

Lucy's AI avatar, Janet, is so realistic that she talks and moves as if she's in the same room, listening to the background conversations. Janet has a soothing British accent in the miniseries. Benton, who is a Secret Service profiler, even asks Janet to complete an assignment to get the background information on an individual. Result? "Thank you Janet. Please download your complete report to me and Lucy." I kid you not.

The book is 384, and it's not until Page 246 that Kay and her husband reach to scene of the murdered psychiatrist, Georgine Duvall, who lives in a house on the fictional Mercy island that also has a psychiatric hospital on the grounds.

Georgine is known to Kay, and it turns out was Lucy psychiatrist when Lucy was having trouble in there early college years adapting. In addition to that connection, the house where Georgine was killed is one in which Kay and her husband Benton were looking at to buy when Kay was moving back to Alexandria, Virginia.

Along with Georgine, the Slasher's victim is another person who was in the house at the time and who was nearly killed by the Slasher, Zain Willard, a young man who was staying with the psychiatrist. No sexual relation there apparently, but Zain in the nephew of Senator Calvin Willard, an expected nominee for president.

Pete Marino is first on the scene with the police and the F.B.I. Marino has seen the hologram float outside the victim's house. It is real, and not a product of the imagination.

Why Benson is on the scene is not really understood. He's given Kay a ride from home because she left her car at the morgue the night before and got a ride with her investigator, Pete Marino, a former homicide detective who is married to Kay's sister Dorothy. This is not a soap opera, but a group of people who have a lot of history together. Pete is Kay's investigator on the job.

Patricia Corrnwell must be a vastly popular best-selling author, because I got the hardcover edition on Amazon, new, for $14. Any more, and I wouldn't have bothered. I like a hardcover book, but I think I'm going to drop this one off at the train station when I'm done. It should go before I even get on the train.

Kay's husband is allowed onto the murder scene despite being a Secret Service officer with no apparent reason to be part of the investigation other than to give Kay a ride to Mercy Island because she has been driven home the night before because of raging snow storm by her chief investigator, Pete Marino, a former homicide detective, who undoubtedly has the hots for Kay and is Lucy's step-dad, Marino  is coincidently married to Kay's somewhat hysterical and argumentative sister, Dorothy. No, this is not a soap opera either.

A Senator's nephew was staying in the house on the grounds of the psychiatric hospital with the murdered psychiatrist, making him a possible suspect, except for his nearly fatal wounds suffered from the Slasher. There was nothing sexual going on between him and the psychiatrist. 

His uncle is a strong candidate to gain the nomination for president, and maybe this is why the Secret Service can be there. Benson has seen Zain at White House events, even demonstrating his robot. It's nice he gave his wife a ride and acts as an investigator, with uncertain authority to be there.

All those pages to get to the principal crime scene are taken up by Doc Scarpetta investigating a dead guy who went fishing off a pier at night in December and landed in the drink and died, who may, or may not be related to the bigger picture coming up. Oh, the dead guy fired two shots at something. 

I only came to choose this book because I was just finishing a book and needed another to read when I came across the Prime Video miniseries of Kay Scarpetta, via Amazon. I took in the first episode and stayed away from the rest of them because I couldn't stand watching Jamie Lee Curtis play Kay's sister, who always seems to be theatrically overwrought over something. As portrayed, Nicole Kidman as Kay Scarpetta and Jamie Lee as Dorothy, could in no way have been sisters who have reached adulthood together. Kay would have found a away to kill Dorothy and fudge the cause of death and gotten away with it before either of them was 23.

At another point, as the red herrings get introduced, Benson actually starts to interrogate the robot that the Senator's nephew has in the closet in the psychiatrist's house. Zain is a robotics expert, who has demonstrated his robot dog at the White House. Benson has seen Zain and his robot before. During the "interrogation" the robot's batteries start to run low and he goes to sleep mode. Again, I kid you not. He does prove useful though, if you can imagine that.

I will not introduce any spoilers here for you to avoid. I will tell you the ending is idiotic and is brought to a head by an escaped orangutan who glows on UV light in a greenhouse where legal pot is being grown. Again, I kid you not.

This denouement occurs at the end of the penultimate chapter. The last chapter is a week after the narrative of what has truly been a busy day. for all involved.

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Carol Double-D II

Jeanette Etheredge

I've experienced yet another example of living on a Möbius Strip. We are all connected.

Just a few days after writing about how my posting of December 1, 2015 on the passing of Carol Doda has recently surged in views—for unknown reasons—Ms. Doda's name appears in the  New York Times August 3, 2026, print edition obituary by Penelope Green, of Jeanette Etheredge, 85, a legendary owner of a North Beach San Francisco bar. 

Ms. Doda was San Francisco's most famous stripper, and maybe the most famous stripper of her time. Ms. Doda's names appears in Ms. Etheredge's obituary as an example of the eclectic, celebrity crowd of A-Listers, B-Listers, No-Listers, and likely ex-cons, who favored going to Tosca. It was the West Coast Elaine's, the famous bar, eatery on Second Avenue in New York that was hosted by the ineffable saloon keeper, Elaine Kaufman. 

Elaine's is no longer there since Elaine passed away, but Tosca remains, and now serves food. With Ms. Etheredge, there was no food served.

Ms. Doda's names is dropped: "Carol Doda—once San Francisco's most famous stripper—who in the 1960s danced at the nearby Condor Club in a Rudy Gernreich monoskin, showcasing her newly enhanced breasts, was a regular."

Rudy Gernreich was a famous fashion designer in the 1960s who designed swimwear, amongst other articles of clothing for women. He was famous for designing the topless bathing suit. (It is California.)

But Penelope Green's obit is about Ms. Etheredge, and what a backstory. It almost reads like a spy novel.

Jeanette "was born in China. Her grandparents were Armenian refugees who fled the Ottoman genocide of 1915, settling first in Manchuria, and then in Qingdao on China's eastern coast, but their community was Russian—Jeanette's first language.

"During WW II, the family was interned in a Japanese prison camp in northern China. When is was liberated by American troops, they returned home, only to be exiled again after the Communist Revolution in 1949, when they fled China and spent a year at a refuge camp in the Philippines. In 1950, when Jeanette was 9, they immigrated to San Francisco." You don't have to own a bar to be able to tell stories.

Jeanette was famous for only remembering customers' first names. Like the fictional Boston bar Cheers, everybody knew your name.

I was only in San Francisco once, in1971, when I could ride the streetcars for 25¢, and the subway BART, Bay Area Rapid Transit, was still on the drawing boards. I never got to North Beach.

The Condor Club, mentioned as where Ms. Doda danced, was the scene of her grand entrance being on a piano lowered from the ceiling. The Club, and the piano continued to be famous for a most unusual death.

Read on, McDuff. It's California.

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