I love this fantastic and hilarious piece which was written by a friend and fellow medical colleague who has requested anonymity.  Enjoy!

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I knew a guy who was simply an unequivocally reliable asshole. From day to day, his demeanor varied depending on what he intended to leach out of those around him, but, over the long-haul, he was consistent. Given enough time (and toilet paper), he always proved his assholedness. Some described him as a narcissist—he undoubtedly was—but he was also a class-A (and you can imagine what that A stands for) asshole. 

A friend listened once as I described my acquaintance to another person. I called him a narcissist. My friend, who knew the big brown eye, said, “Nah. He’s just an asshole.” How refreshing is that? Not that one’s ass should be an air freshener; but it’s refreshing when a person just calls something—or someone—as it is. No apologies or feigned political correctness: just unabashed candor. 

Sometimes I think of certain people as having an asshole titer. A titer is an objective measure of concentration. An antibody titer, for example, quantifies the concentration of antibodies in a person’s blood: the higher the titer, the higher the concentration. It’s not speculation or guessing; it’s a measurement, free of judgment. 

A titer might express a person’s exposure to a certain trigger, like hepatitis; or their immunity to an infection, such as mumps. In a broader sense, among those comfortable with the lingo, the word is used more casually. A woman with a high granola titer, for example, has Brillo Pads in her armpits and a particular propensity for tree-huggedness. 

Wouldn’t it be nice if we could measure a person’s asshole titer—an objective measure, that is, of one’s assholery. At present, calling someone an asshole implies judgment: as if we can’t make an objective, unbiased observation. One isn’t questioned or scrutinized for saying Dolly Parton has big breasts, or that Kareem Abdul-Jabbar is tall. They’re just observable facts. One might be judged if they said Gary Coleman was short, but that depends on context and tone. If we’re not being pejorative, it’s just an observation. That’s the way it should be with assholes. We should be able to call them what they are without accusations of being judgmental. And doing so would be a lot easier if we could simply measure one’s asshole titer. 

If we could measure asshole titers, we’d remove guesswork and tiptoeing. We wouldn’t have to pretend everybody’s nice while waiting to find out otherwise. We wouldn’t have to ignore that little warning itch on our ass when we meet someone we know is malevolent, even if they haven’t yet proven it to us. (Believe me, they’ve proven it to others.) A good friend might have an asshole titer of five, but a ninety-five could be kept at arm’s length when sober and avoided altogether on weekends. 

As an aside, for the sake of completeness, we should note that titers are not percentages; they are measures of concentration by way of dilution. They do not stop at one hundred. They can soar into the thousands. We all know a person whose asshole titer rivals the national debt. But, for this discussion, let’s just say that a titer of one hundred is a complete and total asshole—also known as an asswhole (a homonymous designation that only works in print). Notice I didn’t say big asshole, as if size mattered. No. It’s the quality that matters. Over the years, the asshole in my life has proven that repeatedly. He is consistent and accomplished at it. 

Even better than just measuring an asshole titer, what if the number were tattooed on a few foreheads? Just think how much frustration and angst we could avoid. We could enter a room, instantly assess the asses—or the average assholedness of the gathering—and head for the door. Maybe we’d rescue the poor seven at the bar on our way out, but we wouldn’t waste time trying to be nice to the eighty-and-above crowd. They could massage one another’s egos (and wipe one another’s butts, for that matter) while we move on. We’d know up front where to spend our time and what to expect. Wouldn’t that be sweet? 

Some titers are good. Some are bad. It’s not fun, for example, to have an unusually high titer of rheumatoid factor. There’s a cadre of titers one would rather not have at all, like an HIV viral titer. On the other hand, it’s nice to have a high antibody titer against polio, especially in some areas of the world where polio is making a comeback. 

Titers change over time. When I get the measles, my titer shoots up as my immune system pumps out more antibodies. Ten years later, my titer may wane. That’s why the ER doc asks about my tetanus shot. I need a high titer to step on rusty nails and still avoid the lockjaw. The same is true with rabies. 

And that brings us to another idea. Wouldn’t it be great if we could generate an anti-asshole antibody? Now that would be a valuable titer, though the immunization might be a shitty experience. Antibodies gobble stuff up, bind things together, inactivate them, and get rid of them. Perhaps the rabid, rusty assholes would be more tolerable if we just had enough anti-asshole antibodies. 

There are all kinds of assholes. Everybody knows the run-of-the-mill asshole: irascible, obnoxious and temperamental. But there are also specialty assholes: the ones with particularly ironic twists. There are the assholistic health-food nuts, preaching the benefits of sprouts and antioxidants in between their cigarettes. There are the asswholesome hypocrites—mostly politicians and preachers—who are closely related to the assholier-than-thou crowd. They have a penchant for placing themselves on pedestals; so proud of their own humility, they often stumble while patting themselves on their own ass (or, more often, patting someone else’s younger, shapelier ass). 

Twenty years ago, Dennis Leary sang the Asshole Song. It went like this: “I drive really slow in the ultrafast lane | While people behind me are going insane | I’m an asshole | I’m an asshole | I use public toilets and piss on the seat | I walk around in the summertime saying, ‘How about this heat?’ | I’m an asshole | I’m an asshole | Sometimes I park in handicapped spaces | While handicapped people make handicapped faces | I’m an asshole | I’m an asshole.” 

You may not like the words, but you have to admire a guy who owns his assholedness. At least that gives you a chance to acknowledge and avoid. 

Be careful, though. If you avoid polio and its vaccine altogether, you’re vulnerable. You have to be exposed to be immune. That’s why an asshole immunization stinks. On the other hand, you don’t want too many antibodies, or antibodies of the wrong kind. That’s the problem with Lupus, anaphylaxis and multiple myeloma. One needs a balanced exposure to assholes, but the burden of maintaining that balance falls on you. One not-so-endearing quality of assholes is their lack of moderation. Given enough time, they’ll shit on everything. 

Here’s the rub: If we have too many anti-asshole antibodies, we could end up with an assholeless life—and that could be a problem as well. (An imperforate anus is a serious medical problem, but that’s not my point.) I’m talking about the color, texture and variety the assholes bring us, if only to remind us how much we hate them. Yes, assholes are people too—unwiped, perhaps, smelly and pimpled, but people nonetheless. My asshole—a person, separate and distinct from my anus—has brought me a few things; like caution, mistrust, self-preservation and, ironically, a healthy dose of CYA (cover-your-ass). And those, my asshole-hating friends, are necessary elements to surviving and thriving in a world of assholes. 

Perhaps the day will come, as with small pox, when we won’t need anti- asshole antibodies because all the assholes will have been eradicated. Until then, we need to be prepared. We may never be able to measure an asshole titer, but we all have a gestalt about these things. You know when something stinks. Trust your nose. And be grateful for the shit in your life that prepares you to deal with the assholes.