Needful of a Negroni Cocktail?

Balance

Balance

I have been drinking Negroni cocktails recently.  The Negroni presents three virtues: it contains gin, it is bitter and it is simple to make (equal parts gin, Campari and sweet vermouth).  Its simplicity makes it superior for quiet mixing at home or when one is faced with modestly-adept bartenders, as noted by Kevin Sintumuang in the Wall Street Journal:

“That’s it?” Yep. Boozy, bitter, bold and built right in the glass, the Negroni has become a steadfast sidekick for me when I need a proper cocktail at a not-so-proper bar, from dive to airport. And when I’m mixing at home, there’s no other drink that produces so much satisfaction with so little effort.

Read the article here: The Only Negroni Recipe You Need


One place to start for a little history is Conde Nast Traveler:

Iconic bartender Gary Regan, a Brit who now makes his home in the Hudson Valley, is the go-to man for Negroni history. He recently published The Negroni: Drinking to La Dolce Vita,which traces the drink back to Florence in 1919. According to reliable lore, the cocktail was born when an Italian bartender responded to a customer’s demand for a stiffer riff on an Americano cocktail (a much-tamer mix of Campari, sweet vermouth, and club soda). The patron, Count Camillo Negroni, had picked up a taste for strong liquor while working—true story—as a rodeo clown in the American Wild West, and gave his name to the resulting concoction. Today, Regan estimates that the drink appears on “about 300 percent more cocktail lists than 10 years ago.” One caution for the uninitiated, via Negroni fan Anthony Bourdain: The drink will “hit you like a freight train after four or five.”

After four or five?  True.  Read the entire article: How The Negroni Became Today’s It Cocktail 

Watch that twist.

Watch that twist.

Here is a post by Vince Keenan, and an even more detailed article from Difford’s Guide

It’s even possible to dive into literary theory:

So I have to conclude that like the novels of F. Scott Fitzgerald, or the paintings of Henri Matisse, the Negroni has become a symbol of an older iteration of the modernist idea. Its pedigree comes with the passage of time. Just as how Matisse and his cohorts were once denounced as fauves, the insult became a badge of honor, before becoming a simple historical descriptor. The cocktail is no longer a “barbaric horror,” a bucking of antique tradition, but a part of that antique tradition itself.

It’s easier just to drink the thing and then fix another, but here’s the full post from the Subject/Object blog: On the Negroni.

Another instructional video, this time from Liquor.com:

With regard to the Negroni and films, here’s an excerpt from a post by Trevor Kensey:

“There is a thirty year age difference between us thought Mrs. Stone. Then she was ashamed of herself and by the time Paolo had emerged from the bathroom she had mixed two negronis and placed them on the glass-topped table on the still sunny terrace with a bowl of olives between. Paolo came outside with an air of abstraction. He paid no attention to the drinks, but left her sipping hers while he wandered over to the balustrade and looked moodily down into the little piazza at the top of the Spanish stairs. Mrs. Stone thought to herself, This is a time to lie low. And so she made no comment. She sipped her drink with her eyes on his grey flannel back and she thought of the night when the flannel would not stand between them.”

– Page 31, “The Roman Spring of Mrs. Stone”, Tennessee Williams.

Even its most ardent fans, myself included, must admit that the Negroni is not always enjoyable at first contact. It is a near-universal first time sipper experience that can often block one from falling in love with this stubbornly seductive cocktail. Stick with that drink and what begins by leaving a bad taste in your mouth becomes a complete joy by the time you finish your inaugural glass. By your third you will be well on your way to a lifetime of full Negroni enjoyment.

Read the full article here: The Negroni Cocktail .

If you want to see more of Mrs. Stone [Vivien Leigh] and Paolo [Warren Beatty], here is the 1961 trailer:

Let’s close with a quote by F. Scott Fitzgerald, a man who knew a good bit about cocktails:

The bar is in full swing, and floating rounds of cocktails permeate the garden outside, until the air is alive with chatter and laughter, and casual innuendo and introductions forgotten on the spot, and enthusiastic meetings between women who never knew each other’s names.

–F. Scott Fitzgerald, The Great Gatsby

The great American novel. And, cocktails.

The great American novel. And, cocktails.

 


Electronic Medical Records and Federal Criminal Prosecution

Bedside manner.

Bedside manner.

Electronic medical records (or “EMR”) were supposed to be a boon to the provision of healthcare.

As two Boston-area physicians point out, EMR are anything but a benefit:

Electronic medical records, or EMRs, were supposed to improve the quality, safety and efficiency of health care, and provide instant access to vital patient information.

Instead, EMRs have become the bane of doctors and nurses everywhere. They are the medical equivalent of texting while driving, sucking the soul out of the practice of medicine while failing to improve care.

Read the whole article: Death By A Thousand Clicks: Leading Boston Doctors Decry Electronic Medical Records

We'll be right with you.

We’ll be right with you.

The additional problem for healthcare professionals is that EMR systems often auto-populate fields from the last patient visit (or even from the first patient visit).  In busy clinical practices, such systems can create technically inaccurate records that do not diminish patient care but, three years later and blown up on a courtroom monitor, can be used by the Government in a criminal prosecution under a “medical necessity” theory under Medicare or a prescription-based “not for a legitimate medical purpose” theory under the Controlled Substances Act.  (A physician may legally “dispense” controlled substances but, if he or she does so without a legitimate medical purpose or not in the usual course of his professional practice, he or she may be criminally prosecuted under the CSA.)

An EMR trial.

An EMR trial.

On the latter point, consider our White Collar Law 360 article:  Mute Oracle: The Controlled Substances Act and Physicians’ Criminal Conduct.

In particular:

Physicians continue to face two critical questions in the uncertain case law under the federal Controlled Substances Act. First, what conduct is prohibited? Second, what intent must the physician be shown to possess in order to support a conviction? Given the government’s increasingly aggressive prosecution of physicians with regard to controlled substances, white-collar practitioners who represent a physician or other healthcare professional in a “pill mill” case understand and address these issues in pretrial briefing and in preparing their trial strategy and must do so early.

 


Mute Oracle: The Controlled Substances Act and Physicians’ Criminal Conduct

 Balance in the law?

Balance in the law?

Criminal laws are supposed to give persons regulated by the law sufficient notice of what conduct, exactly, is prohibited.  Criminal laws, as interpreted by courts, are also supposed to provide clear standards for mens rea (that is, the level of intent the Government must prove at trial).  With regard to physicians and their prescribing practices, the federal Controlled Substances Act does neither.

Or, as my Lightfoot colleagues Brandon Essig, Jeff Doss and I put it in a recent article for Law 360:

With the Eleventh Circuit’s recent decision in United States v. Enmon, physicians continue to face two critical questions in the uncertain case law under the federal Controlled Substances Act. First, what conduct is prohibited? Second, what intent must the physician be shown to possess in order to support a conviction? Given the government’s increasingly aggressive prosecution of physicians with regard to controlled substances, white-collar practitioners who represent a physician or other healthcare professional in a “pill mill” case understand and address these issues in pretrial briefing and in preparing their trial strategy and must do so early.

And my mens rea is unknown, too.

And my mens rea is unknown, too.

Read the entire article: Questioning The Controlled Substances Act After Enmon


Pill Mills, Poppy Flowers, Dead Poets and the Human Resources Department

"In Flanders fields . . . ." (via Zyance)

“In Flanders fields . . . .”
(via Zyance)

Having been through a seven-week federal criminal “pill mill” trial, I think a lot about enforcement of the Controlled Substances Act and its effect on physicians.  Aggressive enforcement effects others in healthcare as well, including management:

“It’s very hard for medical professionals and those in upper management, such as hospital CFOs, CEOs, and CMOs, to see themselves as criminals,” says Jack Sharman, partner at Lightfoot, Franklin, and White, a law firm headquartered in Birmingham, AL.

“This difficulty to perceive what someone else might think merits a criminal investigation impedes judgment and slows internal response.”

While physicians might not see themselves as criminals for managing patients’ pain or making sure they had enough pills to get through a holiday, it’s not hard for others to come to that conclusion, says Sharman.

Health Leaders MediaHere is the full text of my interview with Health Leaders Media:What the Crackdown on Painkiller Prescribing Means for HR

 

John McRae (1872-1918)

John McRae (1872-1918)

If your recall for literature is not what it once was, In Flanders Field is a poem by John McRae, spoken from the point of view of World War I dead:

In Flanders fields the poppies blow
Between the crosses, row on row, 
That mark our place, and in the sky, 
The larks, still bravely singing, fly, 
Scarce heard amid the guns below. 

We are the dead; short days ago
We lived, felt dawn, saw sunset glow, 
Loved and were loved, and now we lie
In Flanders fields. 

Take up our quarrel with the foe! 
To you from failing hands we throw
The torch; be yours to hold it high! 
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.