Tuesday, February 14, 2017

Happy Valentine's Day

I am Her Doctor, and Her Friend.

Read, over at MiM.

Monday, February 13, 2017

Accepting Limits

I remember the moment I decided to give up on skiing. Vividly - it was last year during Spring Break. One minute I was on the verge of a tiny snow hill, one long conquered by my kids and then boyfriend, heart beating rapidly. The next moment I was lying on the ground in the snow, my body in an awkward X shape like a dead body police mark, buried skis making it seem impossible to move without breaking a kneecap. I stared up at the sky. "This is actually relaxing," I thought. "I could stay here forever, and never have to try to run a blue to impress my kids." I didn't stay there forever, but it was a good 20 minutes before I even tried to move.

Nevertheless, I tried. The year before I ponied up for group lessons, to no avail. Last year I ponied up even ridiculously more for individual lessons. Still I couldn't stay the anxiety that kept me moving in slow horizontal terror down a vertical slope, kids smiling and racing in front of me, beating me to the mid-blue hill restaurant by almost a half hour. "But I can scuba dive," I wanted to scream. "I can name cancer on 5 cells. I'm a badass in other arenas." But not this. Maybe not ever.

It's calming, to relinquish the desire to achieve in areas your kids pressure you to. There are other activities to do in snowy weather. Today, I signed up for a two hour guided snowshoe tour - one that my Facebook path friend lauded. She was at this conference a few years ago, and was giving me tips on messenger. "I only do greens and easy blues. I take beta blockers."

"I've taken beta blockers for many situations, but never skiing. Good idea. But maybe next year - I'm taking a break this year. And I've gotta convince my kids that I'm never going to be as good as them, and they will have to accept that fact and let me be happy with my greens."

This conference starts at 6:30 am and is over by 11:00 am everyday, so everyone can hit the slopes. Not me. I'm hitting the salon for a pedi and massages, and snowshoe tours. Planning to go to Aspen one evening - ACES (Aspen Center for Environmental Studies) does free lectures on Naturalist Nights. There's one on Wednesday by a Professor at Colorado State University about energy development impacts on wildlife. They sponsor the 2 hour snowshoe tours in Snowmass, and I can hire a naturalist guide to do an even longer one later this week. That's about my speed.


Friday, February 10, 2017

Gross Room

Me: So what's up with this new hat everyone in the OR is wearing? It's so crazy. Tall skinny floral chef hat. Combined with the scrubs and the clogs, it's not good.

Female PA: I think they put their hair under it.

Me: They would need a helluva lot of hair to fill that hat. Who do they think they are? British soldiers gone Mad Hatter? What happened to the chill square version of the do-rag?

Female PA: And they are all so skinny, those nurse anesthetists. Don't they get cold back there in the OR?

Me: Yes. I was walking behind one, on my way here, and I was trying to find the contours of her butt through her skinny scrubs while she was walking. A personal challenge. No dice.

Female PA: We need to help them. Sweaters and cheeseburgers!!

Me: LOL! I agree. And a freaking stylist. So what are we doing?

Female PA: Ovarian cancer. Pretty obvious. I'm cutting now, will have it ready in a minute or so.

Male PA, working at another grossing station: Who would name their daughter Nympha?

Me: Really? That's her name?

Male PA: Well, it's spelled different, but still.

Me: How old is she?

Male PA: 40 ish.

Me: Well at least she made it that far.

Male PA #2: I'll bet she was invited to all the dances.

Me: I'm guessing she wasn't the wallflower.

Female PA: Frozen is ready.

Me: You were right. Ugly. I called, gyn/onc is sending the other ovary, he says it's the same but he's cool with no frozen. Thanks a bunch.


Thursday, February 9, 2017

BHEC QRC

Pronounced B-heck QRC. Affectionately. Stands for Baptist Health Extended Care Quality Review Committee. I've been on it for over a year. And I missed the last two, for kid stuff, so I needed to be there last night. We mostly talk about the long term patients, their CAUTI's and CLABSI's first: the infection nurse leads the meeting.

If you are feeling left behind with the acronyms you are not alone. When I first got on board I needed to get up to speed. Catheter associated urinary tract infections. Central line associated blood stream infections. The entire meeting is a check on the system; comparing it to national norms. They are earnestly trying, against all natural odds, to serve the patients as best as they can. They put more effort into it than I could imagine, and despite all the crazy standards they are held too, more often than not they succeed.

After infection control left last night - she leads then heads to her church group - we moved on to pharmacy. There were a lot of new procedures to approve. We got to one called "Unresolved Discrepancies."

ID doc: That sounds scandalous.

Pharm: It's just that when a controlled med goes missing, we can always track it. Figure out why. But not this time. We couldn't find the source of the problem. So we had to create a new policy to report missing meds that aren't accounted for.

Me: Sounds like an inside job.

Laughter.

Pharm: Yeah, you are probably right. I can think of a few people that might target the narcotic bin, especially late at night. Next policy.

Television monitor at the front of the room: Sedation Monitoring.

Admin: If I was a joking man I might make one about keeping you all awake during this review.

Pharm: Beats her fingers against the table in the universal culmination of a joke sound. Bah bum bum. No, this is about making sure the patients who are getting procedures get the right support.

ID doc: Not sure I understand. Explain.

GI doc: Like if you want to do a scope - GI, pulmonary, you need the right support. You can't just do it in any room. You can't have a nurse anesthetist monitor five rooms on the floor. There are only certain areas, with the right support staff, that are allowed to do those procedures.

Me: It's the Joan Rivers Rule.

ID doc gives delayed incredulous belly laugh. "Exactly!" I love inducing that.

Me: Motion to approve.

FP doc: I second.

Admin: Everyone in favor?

Collective: Aye.




Wednesday, February 8, 2017

The Quest

Mid-morning, while I'm reading my GI's I become determined to find someone else who hasn't heard of vodka tampons. I decide to call Dr. Music on the intercom.

Dr. Music (he can see who is calling): No one's home.

Me: Well that sucks, because I'm on the hunt.

Dr. Music: And I'm being hunted? Not sure if I like that or not.

Me: I'm looking for someone, besides me last week, who has never heard of vodka tampons.

Dr. Music: Vodka what?

Me: So you haven't? I finally get to explain it. (So I did).

Dr. Music: That sounds crazy. What if you don't have the right orifice?

Me: I hear from my friend that it works in the other one down there too.

Dr. Music: That doesn't make sense about the breathalyzer. Once it goes into your bloodstream, it would register on the breathalyzer.

Me: I don't know, I've never been breathalyzed so I don't know the technology. But I would think it would register less, not having been sitting in your stomach.

Dr. Music: Maybe they will make an assalyzer.

Me: I was thinking a vaginalyzer. Not too farfetched in our current political climate.

Dr. Music: Yeah I saw that pic on Facebook of you and your husband at the Woman's March. I can't believe you dragged him up there. Did you make him wear a pussyhat?

Me: Hell no. I hate them too, but you can't always choose the symbols of your movement, you've just got to run with it. There were 30-40% guys there, by the way. Way more than anticipated. And three of S's male colleagues called him to thank him for participating in the March.

Dr. Music: Well that's something.

Me: You aren't on Instagram, are you?

Dr. Music: No.

Me: I posted tons of pics. I didn't carry a sign, I just took pics of signs. I'll text spam you when I'm done with my GI's. I made a series on Instagram. I'll even send you some that I didn't post - because they were pretty salty and I know I've got a big following from C's friends. Your wife will love the pics.

Dr. Music: She will. I can't even have Trump or Trump news on the TV - she will run and attack the television.

Me: I'm trying to take it all in as entertainment. A necessary step to a better future. Helps me cope.

Dr. Music: Yes, I'm spinning it that way too.

Me: Except it's hard when people are held and detained at airports by misguided officials because of their religion. Then it's not so funny.

Dr. Music: Can't argue with that.






I took the first four, but I can't take credit for this last pic I cribbed it off of a Democratic facebook group I think? Not sure if it was in Washington or not. Ballsy chick, though.

Tuesday, February 7, 2017

Gross Room

PA: I'm cutting the frozen, it's almost ready.

Me: What is it?

PA: Pancreatic mass. Nothing in the computer.

Me: Ugh I hate pancreas. So my friend told me last week I'm the only one who hasn't heard of vodka tampons. I'm trying to prove her wrong.

PA: No luck here. Vodka tampons are all over the place. How could you have not heard of them?

Me: Living under a rock, I guess. You haven't tried that, have you?

PA: Hell no. Young girls are doing it, I hear. Helps to avoid the breathalyzer.

Me: But how do you regulate it? If you aren't sipping slowly. Wouldn't it be easier to OD? Where are the Vodka tampon rules and regulations?

PA: Yeah, it's supposed to absorb quickly; it's really vascular down there. I don't know. A new way to overdo it.

We both agreed that we certainly weren't the queens of abstinence in our younger years, method of delivery be damned.

Me: But still - tampons? Ewww.

PA: Can't disagree with you there. Here's the slide, it's ready.

Me to surgeon on bat phone: Long comment about frozen.

Surgeon: I can't hear a word you are saying on this intercom thing. Let me scrub out and get the phone.

Me: I know right? It's like Charlie Brown's teacher.

Surgeon: What do you think?

Me: Mostly chronically inflamed fibrosis. There isn't an epithelial wall per se, but some of the area that looks like lining is teeming with neutrophils. Could this be an old walled off abscess? I see atrophic acini, but no tumor.

Surgeon: So it might just be a pseudocyst? That's great news.

Me: Yeah that fits. We will look at the whole thing tomorrow to make sure.

Monday, February 6, 2017

Densus Church






This is the oldest church in Romania. I spent a chunk of the day riveted by it's limited online history (I favor the pagan theory) and that of the pagan Gods of Europe - Swedish, Norse, German, and Romanian. Much more fascinating than my morning frozens. A slow day, finally, thank God (Gods?). Last week was insane.