Sunday, August 28, 2016

Sunday Morning

Ants crawl across wooden planks
Industrious and oblivious
To the human form
Studying, smoking, observing
Half-torn between their plight
And the recesses of the sky

Thursday, August 25, 2016

Blue

Is my favorite color. I know, I'm not alone.

I was signing out an oligodendroglioma today - I don't do that very often. So I had to consult the books. Peter Burger is by far my fave in this arena. He reminded me of why today.

Microscopic features: Like pornography, in the observation by Supreme Court Justice Stewart, the oligodendroglioma is easy to recognize but may be difficult to define. Although there are objective histologic features that aid in recognition, only one or two may be found in a given microsection.

We had all the features of WHO Grade III. Nuclear atypia, hypercellularity, and rare mitoses.


Isn't it beautiful? Fried egg nuclei. Arcuate capillaries. This isn't my case, I stole it off of the internet. Sent off for characteristic LOH (loss of heterozygosity) for 1p and 19q. Will be surprised if it isn't positive.


ICD-10 is going to be the death of me.

Tumor Board this morning was only remarkable for its obscure chemo meds and stellar radiology shots. But no worries, tomorrow The Nightingale is having a tumor board party at her home on Edgehill. I cannot wait. Book club follows. Did anyone else cry as hard as I did? Dunno (ha accidentally typed Cujo). Emotion is so individual.

I read an article about Halsey a year or so ago but just started listening to BADLANDS this summer. Wow. Love it all, but Colors is by far my favorite.








Wednesday, August 24, 2016

Disjointed

It's been a busy week full of brain frozens and surprise important micro meetings so I feel all over the map.

My new pulmonologist friend invited me to the group Style MD and it is my new addiction. Docs take selfies from Target outfits to Jimmy Choo's. "The criteria is stringent," she assured me, "you cannot get in unless you are an female M.D."

This post took me by surprise this morning.

NAME YOUR VAGINA by using the name of the last movie you watched!!

The fun lasted throughout the day and continued into this evening.

Miracle on 34th Street
Popstar!
Bad moms (that was a frequent one, and my last movie, but I chose to list my favorite one The Resurrection - that got a few likes)
Spooky Buddies
Finding Dory (lots of Millenials here I'm past this)
Zootopia (Despite being past this I LOVED this movie)
The Jungle Book
Pete's Dragon
Suicide Squad
Anthropoid
Equity
The Secret Life of Pets (LOL! Someone commented - the secret life of your kitty-kat?)
The Hangover
Home
Frozen . . . Damn. Rough month at my house. Poor hubby.
Vacation
Olympus has Fallen (commenter: ya your vag took him down!)
Daddy's Home
God's Not Dead 2
Ice Age
Air Force One
Unstoppable
Hell or High Water
Independence Day
Monsters University
Wolf on Wall Street . . . I need a wax
Hunger Games
My King
The Usual Suspects
Now You See Me
The Martian
The Big Short
Central Intelligence
Eddie the Eagle
Nine Lives
Free Willy
Deadpool
Bad News Bears
Bladerunner
Sausage Party
The Revenant
The Last of the Mohicans
Big Ass Spider
The Boat That Rocked
Mary Poppins
Star Trek Into Darkness
X-Men - perfect for the lesbian
Batman vs. Superman
Red Riding Hood
Everest
Kikis Delivery
Maya the Bee
Monty Python and the Holy Grail
The Boss
Matrix Revolutions
Diamonds are Forever
Mission Impossible
Kubo and the Two Strings???
Harry Potter and the Chamber of Secrets
Pretty in Pink
Where to Invade Next
War Dogs
The Enterprise
The Terminator
Outbreak

I think you get the idea. I'd type in funny comments but that would take all night.

Very few things make me cry really hard. I can count on one hand in adulthood. My sister tells me I bawled hysterically on the last day of our yearly family vacations to Navarre Beach, Florida, but I don't remember doing that. I remember losing it for the first time in college when I heard the Bruce Springsteen song "Johnny 99." Surprised the Hell out of my boyfriend Snake, who was driving my Jeep. It's still one of my favorite songs.

I also remember losing it in residency when my brother was really sick. Driving around and crying so hard I really should have pulled over on the side of the road. Crime Lab rotation did me in. I told the guys one day I was leaving early and headed to the River to cry all afternoon. No one wants to hear about that shit, you have to just suck it up and deal with it. I remember my ex stopping me the first week, telling me it was too much. It may be too much, but it's still there.

But since then, nothing more than a moist eye and occasional tear. So imagine my surprise when I read the last chapter of my book club book last week, The One in a Million Boy, and major waterworks. I had to rush over and lock the door of my office it was so ridiculous. Tears flying out of my eyes all over my skirt. When I collected myself, after 20 minutes or so, I texted the one who picked the book. "Have you read it yet?" "Yes." "Did it do that to you?" "No."











Tuesday, August 23, 2016

Picture Perfect Words



One of my Facebook friends, breast surgeon I think - maybe he is distantly related to her, posted this at the beginning of the summer. I listened, and I'm addicted. He's pretty prolific, and he's from Arkansas! All the songs are good, but I think this one is my favorite.

Ironically, my daughter loves bro country. It's what I'm subjected to whenever she is in the car. She loves good country too - but it's the current radio that she is most addicted to. So I listen. And am marveled that singers like Blake Shelton and all the others I don't know the names of are topping the charts and this guy has less than a thousand hits on Spotify; because his songs are amazing. I encourage you to listen to all of his albums. If he's not going places, this country is on crack.

Monday, August 22, 2016

Chinese God Factory

At the culmination of a weekend full of debauchery I headed to my friend's mother's house in Harrison, AR for shrimp and grits and cornbread waffles with butter and syrup and chocolate waffles with local blueberry compost and cream. I have great friends. Med school and having kids derailed this. It's nice to rekindle the friendships.

Her dad died suddenly of a heart attack in March. So devastating. He was a staunch Democrat - spent his life in public service. So nice to see the pics of them attending two Clinton inaugurations and an Obama one on the wall of his well preserved office.


Both Hillary and Bill Clinton called to express their condolences.


Yes this was going on in the office. While I'm indulging in hangover food. But the thing that really intrigued me was this.


Chinese war gods, from a Chinese war god factory. Here's a factory pic. They had them shipped from China, and had to hire movers to get them into the house.



The factory belittles it, doesn't it? A little. They had a wonderful life. Although I didn't know him well, this is  a blunted testament to his soul. For Christie.

Friday, August 12, 2016

Tumor Board

I walked in 5 minutes late. The Nightingale patted a seat beside her at the front of the room, beckoning me to join.

I sat down after getting breakfast (greek yogurt, almonds, blueberries, water, coffee) amidst the din of cases being presented. Feeling guilty for being late.

As I settled in I noticed Cid Vicious. Decided to text him.

"I woke up at 6:50." My alarm originally went off at 5:30, but I fell back asleep. When I woke up I startled and got ready in 10 minutes. Skirt. Blouse. Wash face. Drive to CARTI.

He texted back. "I woke up at 4 - I have seen 11 ICU patients, put in 3 central lines, intubated and bronched so far this AM. I am going to Chicago at noon and have to get outta here."

"Are you calling me a slacker? What's in Chicago?"

"Nothing in particular. Just going up there for baseball, eating, drinking, etc."

"At least I'll get EBUS relief." Amid more talk of patients.

"You call non diluted cases with the peacock relief?"

He had a poker face. I could not. Kept silently laughing from the front of the room. I was jealous.

"Aren't you taking her with you?"

"Yeah, we usually travel together, my wife thinks it's weird but we really enjoy each other's company."

I've met his wife, in the Kroger parking lot. Super sweet and adorable.

"Traveling with the peacock would make a really good SNL skit."

Then I presented. It went over pretty well. I even had the hard nosed thoracic surgeon engaged. Can't wait to present next week.

I was trying all day to think of texts that might have broken Cid's poker face.

"It's a good thing my leg hair is blond because I've got two days growth going on."

"My ponytailed look is not styled by product. It's grease from lack of showering."

I'll have to try harder next time. Good to have goals.

My partner at work who missed tumor board was incredulous that I didn't have time to shower. "It looks like you took an hour to get ready."


This is a granular cell tumor. It was in the arytenoid cartilage. 30 ish year old. Very subtle on frozen section, but I called it. Looks like macrophages. Never seen it in the larynx. Has a 3 (or .3?) percent malignant rate - most are B9. The clinicians were fascinated, gave lots of good advice. I've only seen it malignant once, in Conway, in the soft tissues of the buttocks. I think this one is B9, but local recurrence is a concern. The hard nosed surgeon wants a full laryngeal resection. None of the radiation oncologists had any idea of what it's response to radiation therapy might be, it's so rare. I'm not so sure I agree with resection, but it's not my granular cell tumor.

Saturday, August 6, 2016

Absorbing

I fell today, on a walk. It wasn't raining when I left the house, but a steady rain accompanied me as soon as I got going so I decided to cut it short, thirty minutes instead of forty-five. The road back to my house is steep. In retrospect I should have taken a different route. I debated taking my walking shoes off, but decided to trust them. I lost my footing about thirty seconds later. Skinned the hell out of my knee.

It bled. All the way back to my house blood and rain mixed in rivulets down my leg. I laughed at my situation (who falls on a walk?) but as soon as I got to the house the adrenaline that propelled me there exited my system and I got woozy - saw stars. First sat in a chair, then laid on the carpet. Still, it bled.

When I was finally coherent enough to move, I was surprised it was still bleeding. I've never had a cut bleed for more that a half hour. It bled while I changed the laundry. It bled while I had a whiskey to beat back the pain. It bled while I read a book. It bled while I took an hour and a half nap on the couch; it stained the couch. It was still bleeding while I finished the book. I cringed while I showered to get ready for my Uncle's 70th birthday party.

I catalogue the wounds of the dead - they don't bleed. So I am unfamiliar with live blood. I applied gauze and band-aids because it was still bleeding five hours after the injury. Not profusely, just oozing. And dripping. Must have been pretty deep. Wonder I made it home.

I used baby wipes to absorb the blood. I also finished a body of work that has interrupted my planned summer reading. It was a lot to absorb. Enjoyable, but sometimes when you read you learn something about yourself that precipitates a psychic crisis. But no matter the shock, somehow your soul absorbs, and you continue.

So I continue with new knowledge. Hopefully there will be no more bloodletting. I tread carefully. Trepidatiously. Fool me once, shame on you. Fool me twice, shame on me.