Thursday, July 7, 2016

Metal Chutes and Stars and Ladders

I arrived at my office at around 8:15 am, after CARTI tumor board. There was a tiny amount of water on my office floor. I looked up and saw that the bloom of water on my ceiling one of my partners pointed out to me yesterday was growing. No active leak, but I was scared. This partner is currently a hobo, traveling among empty offices. His is under reconstruction after several heavy floods that have damaged his books and journals. We wandered in his office yesterday and noticed new water stains on the new ceiling. I apologized to him after I took the Lord's name in vain, he is super religious. He replied, "No worries. Holy Hell."

I asked the transcriptionist to send a request to maintenance - you cannot call them anymore, which frustrates me. The temperature in my office is always 5 degrees hotter (with extra humidity) or 5 degrees colder than what I set it to be. I have learned to regulate my temperature with water - cold from the water fountain outside my door or room temperature - and coffee - hot or cooled to room temperature - based upon the whim of my office.

As I was looking at a stain I ordered yesterday, polarizing it under the light, a familiar maintenance man wandered in. I bumped into him in the hall yesterday.

Me: "When you asked me about my office temperature, and I said it was OK, this hadn't happened yet."

Him: "I'm going to set up a ladder. I hope that doesn't bother you."

Me: "Not at all. At least you aren't drilling brick walls in my ear. That happens a lot these days."

I returned to my casework and five minutes later he surprised me.

Him: "Can you walk up this ladder in those shoes?"

Me: "Are you kidding? Yes. I have three pairs of these heels. Gold, silver, and gunmetal black. I could climb Pinnacle in these shoes."

Him: "I want you to see what is going on here."

I climbed the ladder and observed a large amount of condensation under a square metal conduit. I loved seeing the bowels of the hospital that resided right above my head. "Can we put a towel there?"

Him: "Not sure. Need to call my superiors. I'll let you know. They don't like to use towels as a stop gap because we forget about them and they mildew. Can I tell you about this system? It's old. Your heat and air at your house? It runs on gas and electricity. It's dry. This one runs on water. That's why you see all that condensation. I believe all of that construction out front is drawing in warm air, that's why this is happening."

Me: "The hospital where I trained? There was this one toilet I used in fellowship. A single one. It had really hot water in it. In the bowl. It was so steamy I could feel it when I sat down. Very weird I've never experienced anything like that. Do these old units explain that?"

Him: "Um, no. I've never heard of anything like that. I have no idea what caused that."

Me: "This is my home (hole)? I can remember to change the towels. In two months I'll call is that OK? We can change them. I had what I thought was allergic rhinitis all through residency and when I came here it disappeared. I think I was having a reaction to something in that building. Maybe a mold. So don't worry, I'm on top of it."

Him: "Well my superiors just Ok'd what you recommended. Where's the nearest place to get towels?"

Me: "ED. I've got code to the back door want me to let you in?"

Him: "No, no get back to your work! Don't worry about this anymore. I'll take care of it."

I turned back to my scope. Excitedly pulling out the lever to polarize. Gout doesn't get biopsied much these days, but occasionally a clinician will be surprised. This was soft tissue around an olecranon - they thought it was bursitis. I knew when I looked at it last thing yesterday it would light up like a Christmas tree with the Shidham's - careful, our new Chief told me years ago - they don't get that stain request very often and it sounds like Shit them. I only see it once every couple of years. I've never seen so much of it. It overwhelmed and thrilled me. I balanced my iphone up to the scope, and carefully captured an image.




 Uric Acid Crystals, Bird's Eye View (4x)





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