I've been away for a while, but I have not been idling away my hours. I got married and went on a honeymoon--a pre-honeymoon really--to Japan. Pictures to follow. Last night at work I got called up to the ICU to intubate a guy. Fine. The patient big COPD/sleep apnea guy who was grunting to death on CPAP. I ordered up the meds and examined the intended target oropharynx. I was out of my league. Thick neck, no jaw excursion, zero thyro-mental distance. Fat tongue and, for that matter, pretty clenched. I realized that if I put this guy down there was no way I could get the tube in. A sure cric, and with that think neck a certain death. I pulled back, called for anesthesia, and let them make the attempt. I'm really happy with the pull-back. I could have really hurt that guy; I'm glad I realized it before going in. U-561