The Neuro Critical Care Society meeting in Vegas Nov 1-3 was just great. Everyone who’s anyone in Neuro Critical Care was there, most gave talks and the quality ranged from good to awesome. Naturally, the CODES blew the crowd away on Friday night. More on that later. My primary focus in really on trying to give you some sense of Las Vegas.

In order to put the phenomenon of Las Vegas into perspective, one must read the first essay in: The Kandy-Kolored Tangerine-Flake Streamline Baby, Tom Wolfe’s first collected book of essays, published in 1965 and “Fear and Loathing in Las Vegas, a savage journey to the heart of the American dream” By Hunter S. Thompson in his golden age, 1971.

The “Writer with x-ray eyes”, Wolfe cut right to the chase in his analysis of Vegas. “A place built by and for gangsters”. A place where the usual propriety and civility of society is suspended. A place where gangsters can retreat and relax in their element after a hard day of murder, larceny, grand theft, extortion and breaking kneecaps. Even the architecture is unique, termed “free form”, specifically designed to be as garish and gaudy as possible, flying in the face of convention, in keeping with the sensibilities of your domestic gangster at home.

Bugsy fell out of his limo in 1946 and had an epiphany. If gangsters could be comfortable at home here on this barren slab of desert, why couldn’t the concept be profitably expanded to a general public always on the lookout for Walter Mitty fantasy (from a safe distance). An adult Disneyland. The public at large might very much like to dip a toe into an alternative style of living not exactly illegal, but not exactly mainstream civil either. Skirt the ethos of gangster ethos for a few days, then go back to humdrum with a knowing smirk. What happens in Vegas stays in Vegas.

But, alas, the dream vanishes in the harsh light of the Nevada noonday sun. Scratch the surface of Vegas and you see………façade. Nothing in the entire city of any substance, all smoke, mirrors and clay. The huge pyramid of the MGM grand only houses massive waves of slot machines. The reproductions of the Chrysler Building and the Empire State Building at New York, New York are just big models in a sea of garish colored lights. The Eiffel tower presides over nothing more than empty hype, glitz and …….. free form architecture. Form and substance signifying nothing but a n enticement for more money into the coffers of wolves and foxes in sharkskin suits.

The Strip stands out like Emerald City in the middle of a sea of poverty, mediocrity and urban decay. So much for the revenue from gambling benefiting the un-anointed. The Vegas Airport far too small to contain all the true believers. Three hour waits from taxi to lift off are common. Huge far-as-the-eye-can-see building projects (new casinos) to accommodate those ever eager to take money out of their pockets and deposit it into the pockets of wolves and foxes in sharkskin suits. Prime time entertainers appear in huge ballrooms, but prime seating vanishes into the shadowy realm of high rollers and special interests, leaving available seats for the public only at the nosebleed elevation. Yet the illusion persists.

The illusion of stepping into a slight naughty world vanishes when it becomes apparent that everyone in the collective is silently watched by wolves and foxes in sharkskin suits from hundreds of remote cameras. Watchers watch the public, watchers watch the watchers, and watchers watch the watchers watching the public. There is no trust anywhere in the system when this volume of cash is involved. The slightest hint of “out of line” (a broad definition in a casino) is greeted by stealthy suits gently but firmly taking a real or potential offender by the arm for a chat in a secure area. An impromptu foray into the “real” world of gangsters.

Watching gamblers is an endeavor everyone should do at least once in their lives for their general education. And they’re hard to miss. Sitting in front of slot machines with glazed eyes, mechanically pulling the lever, even ignoring the occasional win for the next pull. Wild-eyed optimists convinced they have the skill to outwit odds of winning so infinitesimally small they can only be measured with a lot of zeros after the decimal. Like an ant farm, literally thousands incoming daily to deposit their load of money to smiling wolves and foxes in sharkskin suits, then a steady stream of out goers with empty pockets, already planning the next trip. Nonstop streams coming and going, a constantly expanding, self-perpetuating ecology feeding on a limitless supply of greed, optimism and availability.

Somewhere Bugsy is smiling.

References:

“Open up the door…let the shark men feed”

James Taylor

“We were somewhere around Barstow on the edge of the desert when the drugs began to take hold. I remember saying something like “I feel a bit lightheaded; maybe you should drive…” And suddenly there was a terrible roar all around us and the sky was full of what looked like huge bats, all swooping and screeching and diving around the car, which was going about a hundred miles an hour with the top down to Las Vegas. And a voice was screaming: “Holy Jesus! What are these goddamn animals?”

Hunter S. Thompson

“For a loser, Vegas is the meanest town on earth”.

Hunter S. Thompson

“Las Vegas is the only town in the world whose skyline is made up neither of buildings, like New York, nor of trees, like Wilbraham, Massachusetts, but signs”. ~

Tom Wolfe

“Las Vegas has become, just as Bugsy Siegel dreamed, the American Monte Carlo-without any of the inevitable upper-class baggage of the Riviera casinos. At Monte Carlo there is still the plush mustiness of the nineteenth century noble lions…. There are still Wrong Forks, Deficient Accents, Poor Tailoring, Gauche Displays, Nouveau Richness, Cultural Aridity-concepts unknown in Las Vegas. For the grand debut of Monte Carlo as a resort in 1879 the architect Charles Garnier designed an opera house for the Place du Casino; and Sarah Bernhardt read a symbolic poem. For the debut of Las Vegas as a resort in 1946 Bugsy Siegel hired Abbot and Costello, and there, in a way, you have it all”

Tom Wolfe.