Thursday, December 1, 2016

Dinner Conversation

"Mom I'm so excited I got a part in the 5th grade Christmas play."

"You did? What is your part?"

"I want it to be a surprise. I didn't get the part I really wanted, the lead Benjamin."

"Who did?"

"The music teacher's son."

She's the one that does the programs. "Nepotism!"

"What's that?"

"Well, it's when you give a job or role to a family member over other qualified people, but don't tell them I said that. It's kind of a mean thing to say. Anyway, he's a good actor too."

"Yeah, he's a good actor, maybe better than me, but I'm a way better singer."

"Oh, try not to compare. You are both good actors. And yes you are a very good singer remember how everyone was talking about your performance in the class opera last year? It was amazing. And next year you will have the new drama teacher in middle school. His kids are way younger than you, no competition there."

"Did you ever try out for a play?"

"Me? Yes! But not until 10th grade. I was so shy. The first year I got a part in Oliver Twist. It was a small part, selling roses on the street. I had a solo. Want me to sing it for you?"


"Will you buy my sweet red roses two blooms for a penny."

"I like that."

"Then my part got stolen from me. There was this girl, she was a senior and very loud, and she wanted my part. Next thing I knew a few days later I was the girl selling strawberries singing Ripe! Strawberries ripe! That was her part. I figured she complained to the director, who was really just a nice art teacher. It was a bit of a stretch for me, because I'm not a soprano."

"Yeah, I like the other part much better. Weren't you mad?"

"A little, but I was excited to be a part of the production, and I really didn't want to deal with any drama with this girl. It wasn't worth it. I just sang the part I knew I got in the shower, on the way to school, etc."

"Were you ever in any other plays?"

"Oh yes! I had a much bigger part the next year in the fall musical. It was The Music Man. I played Eulalie Mackecknie Shinn. She wasn't the lead, but she was the mayor's wife, kind of the comedy role. I got to dress as the Statue of Liberty and pop out of a Grecian Urn! It was so fun. Everyone was very surprised. Even my school headmaster came up and praised my performance. He told me he thought of me as the girl always looking at her feet in the school hallway not a stage ham."

"I want to watch that musical. Did you ever do any others?"

"You should YouTube some of the songs. No, I didn't. My senior year I did other stuff. We'd better get to the play downtown. Opening night of A Christmas Story."

By the Spring of my junior year I was in a rebellious mood. It's kind of tough being a rebel when you are a white girl in an elite public school, but you cannot help the situation you are born into, and I was determined to rattle the cages as best I could. I started by plotting a coup. I and all my friends had been on the Pom Squad or cheerleaders for the last three years. It's what you did there. Being gravity challenged, I was on the Pom Squad. I enjoyed the fellowship and the dance routines - I was good at it, but all the extra duties were beginning to grate on me. Helping the cheerleaders cheer during basketball season, when there were so many games. Making posters and care packages for all the basketball and football players every homecoming. I like to show off my bubble letters as much as any teenager, but what about me? I showed up at every game. I never got a sign or a care package. Screw this gig.

So I started talking to my friends. "It's going to be our Senior Year! Last year of high school. Do we want to spend half our nights and weekends cheering and traveling when we could be partying and going to the movies? I'm quitting. Please join me." My insidious plot worked. I decapitated the senior leadership from the Pom Squad and managed to get one of the most popular girls in our class to quit cheerleading. The coaches were livid. I received some lectures. "All the Moms are so angry with you. I'm so disappointed in you." I smiled sweetly, told them I was sorry, and thought I don't really care.

By Senior year, I was wanting to replace Pom Squad with a different sport. Me and four of my guy friends - all of us had hating team sports and loving academics and art and music that was not on the radio in common - decided to start a swim team. We found a place to swim and a couple of coaches and carpooled each other to the practices. A few months in, one of the guys pulled me aside at my locker. He told me he was feeling really uncomfortable and had to tell me that the junior coach was making very lewd statements about me during practice to all the guys. They hated it. They didn't know what to do, but thought I should know. I was so angry. I knew just who he was talking about - he leered in the worst way. I stewed on what to do for a couple of days.

The next practice came around, and I told my friends to count me out. The next morning they rallied around me and tried to persuade me back. "You are the best one on the team. Please come back. You are our only chance of winning. The head coach said he would do anything to get you back." I told them sorry but no chance in Hell. I thought winning is not nearly as important to me as not being made and object. I'll swim alone.

Later that Spring, I was publicly tapped with the homecoming queen to spearhead a Just Say No to Drugs campaign for the entire school. They called us up at assembly and handed us green Just Say No ribbons. This didn't settle well with me - the admin didn't even ask me. Four days later I made an appointment with the vice principal. I sat in his office and told him I had to decline. I hadn't done drugs, but would feel like a hypocrite being an ambassador to a campaign I didn't fully support. I told him I believed some drugs are ok, even illegal ones, and I hadn't ruled out experimenting someday. He respectfully accepted my resignation, and another student was named to fill my place.

I didn't tell Jack all of this, but someday I will. When I graduated in the Spring of 1990, even though I pissed a lot of people off, I felt good that I had stuck to my principles, rather than maintaining the status quo.

Wednesday, November 23, 2016

Gross Room 4:35

What are you all still doing here? Go home! I sent other AP doc home two hours ago. And cytology. CT is dead. Bronch room and OR too. There are too many of you and looks like not much work to do. How will Friday be?

P.A. #1: Maybe around 100 blocks. Full day, but not too crazy. Gyn/onc surgeon doing three cases.

Ugh, he's going to want frozens. But we will be here. So go home. Too many P.A.'s spoil the um, organ.

P.A.#2: Sorry, but that can be taken in more than one way.


P.A.#2: My mind just goes there.

I love it. I'm on call, will take care of everything. Go home. Enjoy the holiday.

P.A.#1: I've got thirty minute drive. Going to take you up on that now.

P.A.#3: I'm on call with you. I don't like the use of your word dead. OR settled, not dead.

Ok, yes. Settling down for a long winter's sleep. I'll take that.

P.A.#4: It's going to be a long winter.

Friday, November 18, 2016

A link

Please read this powerful anonymous guest post over at my other blog, MiM.

Our scars are our torches

I'm chilling with my med school bestie in Jonesboro, status post lab inspection, with wine and kids and birthdays. Hope you all are having a good weekend.

Wednesday, November 9, 2016



"I wish it need not have happened in my time," said Frodo. "So do I," said Gandalf, "and so do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given us."

Newton's third law: For every action, there is an equal and opposite reaction. That was my mantra, that got me through my workday.


Homemade meatballs. Kids fave. Celebratory dinner turned comfort dinner. We talked politics and positivity.


Donate. Arkansas Food Bank. ACLU. Planned Parenthood. Etc. Just a beginning to a long four years.

5:30 am. question (after telling my daughter on text that I'm sorry, I was wrong, it will be ok, we have family and friends and that is what is important): Can you impeach a president that hasn't yet been sworn into office? (No, I think).

Tuesday, October 25, 2016


Dr. Music: Yes, S.E.?

He calls me S.E. Cupp, ever since I got my blended bifocals in February for presbyopia. I don't have cable, had to google her.

Me: Help. Endobronchial lesion. Bland as hell. Ordered some stains, no hits. I'm stumped.

Three hours later. Most consults like to tell you what they think. This guy likes to play attending. I'm used to it. His expertise is almost worth it.

Dr. Music (barging in my office): So what do you think this is?

Me: Well not sure. Bland endobronchial lesion. Obviously ruled out carcinoid and low grade adeno, my best thoughts. What do you think?

Dr. Music: It's obviously prostate cancer, and he has a history.

Me: Um, well, I guess that fits histologically, but I've never seen it metastasize there. History? Oops I missed that. Had like 8 diagnostics this morning. I'll throw on a PSA and PAP. Surely you saw the history before you figured that out?

Dr. Music: No. I thought of prostate cancer right away. (Barges out the door).

5 minutes later phone rings.

Me: Hello?

Dr. Music: Didn't you have Dr. Ancient at the VA? If you paid attention you would have known what this is.

Me: Yes I had Dr. Ancient.

Dr. Music: Dr. Ancient taught us that there are three cancers that metastasize as endobronchial lesions. Melanoma. Renal cell carcinoma. Prostate adenocarcinoma.

Me: Well, but . . .

Dr. Music: You would have known what this was right away if you were paying any attention at all in residency.

With all due respect to the great Dr. Ancient, by the time I was his resident he was Dr. Over Ancient. For example, once he gave an unknown conference where every single unknown for the entire hour was small cell carcinoma. We residents vacillated between alarm, amusement, and pity. But Dr. Music didn't let me get a word in edgewise to tell him about that.

Me: I've never seen any of those cancers manifest as endobronchial lesions. And I doubt I'll see it again in the next 15 years. But don't worry, you are burning it into my brain today. I won't forget.

Dr. Music: Good! You'd better think of that next time. I've done my duty here.

Next morning PSA (prostate specific antigen) and PAP lit up like a Christmas tree. I didn't text Dr. Music to let him know he was right. He's already a megalomaniac, as evidenced by the nickname given to him by the secretaries.

Friday, October 21, 2016


Secretary: Dr. Shyder a woman called and wants you to look at her mom's case. She needs an expert.

Me: No, what? Are you sure? She probably wants her mom's case to be sent out to be reviewed by an expert. Did you get her mom's name? A case number? How do I look her up?

Secretary: No. She was talking so fast. I only got a number.

Secretary #2: I'll call the number and try to get more information for you.

Me: Thanks. Weird. No rush on that.

Later in the afternoon.

Secretary #2: Dr. Shyder you're not going to believe this. She's from another state. Her mom's death was ruled a suicide. She googled and found you as the expert. She wants you to review the case because she believes it was a homicide.

Me: ?? Give me a little bit of time to figure this out.

Post in PMG pathology. Get lots of advice. Most pertinent:

I'm Priya Banerjee. Please refer her to me. I'll evaluate the case, and even if she doesn't like my assessment I'll be objective.

Me: Secretary #2 will you please call her back and tell her I'm not an expert in forensic pathology but this doc is and she can call her for a second opinion?

Glad to know there is someone out there I can use if I ever have trouble with a death and need an independent evaluation.

Sunday, October 16, 2016

Infection Control

Head nurse #1: It's the food! It's a big problem. Not the patients, but the families. I walked into the SICU the other day and Subway everywhere! Hello people, would you eat out of a toilet? No! So don't eat in an intensive care setting.

Head nurse #2: I fielded a complaint the other day from a guy who said his wife got C.Diff. from our hospital. She wasn't even a patient here.

Head nurse #3: Was she visiting someone?

Head nurse#2: Yes, some in-law.

Head nurse #1: I'll bet she brought in Subway!! Not our fault.

Head nurse #4: It's a shift issue. One person will acquiesce, and the family will think they can bring in food all the time. We are very strict about it in the NICU.

Head nurse #1: It should't be just a nursing issue. They need to get the guest service representatives to help us reinforce the rules.

Head nurse #2: I also got a complaint from a guy who said his wife had to sleep on the bathroom floor. That's a choice, in my opinion.