Methodical Madness

Oh No! Mr. Elf!

2011-12-21T21:07:00.000-06:00

Read it: at MIM.

Topic Week

2011-12-15T22:08:00.002-06:00

It's Topic Week over at MiM! So I was forced to break my dry spell, which has been induced by the holidays, work, and cocooning with the kids. And too many novels to count.

Read it: HERE.

Fan Mail

2011-10-31T06:00:00.001-05:00

I've had a handful of readers over the past couple of years e-mail me to ask me questions about pathology and advice about medicine but no one, until last Thursday, has ever prefaced their question as "Fan Mail." I was tickled pink. A first year medical student from a far away institution asked this, and kindly allowed me to answer in a post:

"My question for you is, are there times when you wished non-pathologist physicians remembered more about histology? What would you like them to know?"

The short answer is this: NOTHING. That's job security, right there, in an age where everyone is stepping on everyone else's toes. Radiologist doing surgeon's jobs, interventional cardiologists threatening the cardiothoracic surgeon's lifestyle, general surgeons delving into plastics, etc. etc. Nothing makes me happier than when a radiologist peers into the scope while I am doing a wet read on a lung biopsy and acts like it is all voodoo. Or when a gastroenterologist comes to the lab to look at a biopsy and I can tell, even when they act like they understand what I am describing to them, they really haven't a clue. I'm certainly not claiming superiority, here. When a patient starts to hemorrhage during a lung biopsy, or when it comes to treating the many diseases that I diagnose, I haven't a clue. That's not my job, and I am not interested in any of it unless it helps me help the patient. I like to know the implications of my call, that is very important - if I upstage this cancer what will it mean for the patient? Extra chemo? A grimmer prognosis? But beyond that, I have little interest in the details, I have my own wide scope of practice maintain current knowledge in, and that already stretches me to the limits.

In a subsequent e-mail the first year is lamenting over an upcoming histology test, but simultaneously pleased with her status as a first year med student - we were all happy miserables, in med school. I hated first year histology. It was one of my few B's in medical school. Those old neck-breaking 1960's scopes with blurry eyepieces staring down onto old, overused slides - that was a nightmare. My first month of pathology residency confirmed that I retained nothing - I used to take random slides from my autopsy cases to test myself on normal histology. I still remember mixing up the pancreas and the pituitary gland. I think the first couple years of med school are important - but especially the first year seems to be a test of endurance, much of it is not really applicable to daily practice. Biochemistry about did me in, especially since I was a psychology major in college. Since I have graduated from my med school, they have re-vamped the curriculum to a systems-based approach, which I hope is less abstract than our disjointed basic science review.

My second year of medical school was better - everything seemed more practical. That is where I realized I had a talent for pathology. I was an "upper quarter" student, but was rarely at the top of the class. This changed when I took pathology - a two semester course. There was a bulletin board where all of our grades were posted next to our "super top secret" numbers that designated us, a number known only to the individual. The Wailing Wall. I still remember how long it took me to find my own number on the first pathology test - searching for my grade. After many frustrating, anxious minutes I finally found it - at the top. I was standing in a throng of med students. Someone said, "Who is that? Who made the highest grade?" I smiled quietly, still in utter shock and amazement, and slipped away. I was never at the top before, but it was consistent for me, in pathology. So although my route was circuitous - I had an ophthalmology residency in the bag, I was glad that I came to my senses because this is clearly my calling, and I am happy.

Thanks much for the "Fan Mail." It made my day! And good luck on your histology test, J! It is a means to a, hopefully wonderful, end. You never know. You might have a knack at it.

Happy Halloween Eve

2011-10-30T20:14:00.006-05:00

Who needs a costume when you can just artfully arrange a towel and channel a vague Star Wars-like character?

Waffle fries make the best vampire teeth on the planet.

Thanks to talented neighbors, Ce-Silly has been decked out in seasonal style with blinking pumpkins on her skirt. Hope everyone has a safe and happy Halloween.

Sober Driver - Dengue Fever

2011-10-27T23:31:00.002-05:00

It's been too long since I posted music. Been listening to this old one all week on the way to work.

Floaters

2011-10-26T21:45:00.003-05:00

The other morning I was looking at a prostate. I love getting prostates - it is a huge chunk of work that normally sails by. Not the biopsies, they can be excruciating - it is easy to miss a small tumor gland so perseverating inevitably sneaks up on you, whiling away the time. But whole prostates are nice. Certainly you have to note the important things - apical margin, base margin, peripheral margins, extracapsular extension, seminal vesicle involvement - but overall it is generally pretty easy.

Floaters require a little explanation. I always thought it was funny that floaters on glass slides carry the same name as the slang term for dead bodies found in the water. I don't see floaters very often in my practice - our histotechs are very good. After the techs cut the thin slice of tissue embedded in wax after overnight processing, they float the wax/tissue square in a cold water bath prior to placing it on the glass slide with forceps. The water is changed regularly and very clean, but occasionally a stray piece of tissue from another case will find its way onto your slide. Most of the time it is so obvious that we just circle the stray tissue on the slide (thyroid in an endometrial biopsy??!!??) and write "floater." If it becomes a diagnostic dilemma (does this cancer really belong here!!??) it is easy to check the wax block and do a recut if necessary - the floater will not be there the second time around.

Floaters can be so anomalous to what you are doing at the time, and such a surprise, that your brain is sent into a gentle tailspin until you wrap your head around it and realize what you are seeing. I was looking at the prostate, following my little mundane protocol, and I picked up the urethral (penile) margin. No cancer, but what was that fuzzy pink stuff off to the side? Was that brain? Just as I realized it must be a floater I grinned from ear to ear. I ran into my partner Michelle's office.

"This is the best floater in the history of floaters. This is a penile urethral margin in a radical prostatectomy."

She threw it up on the stage, and started laughing so hard she almost fell off of her chair. I joined her, and when we finally caught our breath, I said, "Maybe I should send it around? Show everyone?" She looked alarmed. "Not the guys." I said, "OK, just the girls, then."

A few minutes later she came in my office. "Maybe most of the guys. Not all of them." We were both thinking about a senior member of our group. He can definitely take a joke, but he has an air of decorum about him that rebuffs tasteless humor. I said, "Let's try it out on Rex." She agreed, and we wandered to his office next door with the slide. I gave him the intro, and he was quiet for too long, while Michelle and I were unsuccessfully suppressing giggles, like junior high school girls. I looked at her, "Maybe he doesn't get it."

Rex said under his breath, peering down into the microscope, "Yes, I get it."

I said, "Oh," as he handed back the slide. Gave a sideways glance at Michelle. "Well, he was our test guy. It didn't go over too well. You were right, maybe we should just show it to the girls."

Later in the day, Rex came into my office to render his opinion on a breast case I had consulted him about. "I'm not sure why you want my opinion since you called me a dick brain earlier." I smiled. "Not you, Rex! It is a joke about the male species in general." He wasn't supposed to take it personally. Just enjoy the wonderful pathology spin on the age old joke. I have enjoyed the license to call him a dick brain, the last couple of days, and I think he has mellowed since the original presentation. I can't wait until my parter-in-crime, Dr. Woods, returns from vacation. To see his response.

A Day at the Arkansas State Fair

2011-10-24T09:12:00.000-05:00

Read it, over at MiM.

Yippee! Look at Me!

2011-10-19T23:08:00.007-05:00

I'm on Kevin M.D.!

Read it (again, if you already have): HERE.

I'm excited. I poured a lot into that post. Kevin M.D. picks a MiM post once a month to generate to a wider audience. I remember when I wrote it, I was thinking it was Kevin M.D. worthy. I have not had a post picked up by him in over a year - last one was Disillusionment. I made a half-hearted attempt to find it on MiM so I could post a link, but oh well. I'm tired. Oh wait. Google disillusionment and MiM and: HERE.

Been reading a lot of books, lately. Some are worth mentioning, some are not. If you can't say anything nice, don't say anything at all, right? Here are the good ones:

The Lacuna, Barbara Kingsolver - think I mentioned that I read this one. A gift from a good friend. It was a fabulous historical fiction period piece. Think Diego Rivera and Frida Kahlo and Joseph McCarthy all rolled up in the background of a great story about a very unassuming author. The current Occupy Wall Street movements are oddly reminiscent of the government protests going on during that time.

Delta of Venus Erotica, Anais Nin - I had about given up on non-cheesy erotica. Another gift, this one. It did not disappoint. The first half was pretty disturbing, but good reading, nonetheless. The second half was nothing short of incredible. Highly recommend. Saw she wrote another erotica - Little Birds, maybe? Can't wait to check it out.

A Spot of Bother - Mark Haddon. I was excited to get this as a gift - I remember reading The Curious Incident of the Dog in the Night-Time when I was on maternity leave with my son. I enjoyed this one even more. There is nothing more comforting and escape-worthy than reading about other's highly dysfunctional families. When it makes you laugh out loud more than once, even better.

I'll finish with a video. Honey is my favorite accoutrement on the planet. Not just the physical form, although it is great on eggs and Morning Star spicy black bean burgers. Daily eats, for me. Honey is the antithesis of venom, and I tell my kids over and over, they will get much more out of life by using honey rather than venom.

Blood Bank Halloween

2011-10-07T08:18:00.000-05:00

Read it over at MiM.

Click here: Blood Bank Halloween

And I Thought My Mom Was Crazy

2011-10-02T20:35:00.004-05:00

The kids and I flew in from a week long vacation late last night. Their dad picked them up from the airport, and it being my first night without the kids in over three weeks, I went home, unpacked, drank wine, and trolled the internet. Party!

I scheduled the bulk of my getting ready for the week for the morning so I could relax this afternoon. Finished grocery shopping, got gas, washed car, bought coats for kids and colander at Target (finally threw away the hand me down I got from my parents when going off to college 22 years ago - no more metal flakes in the kid's pasta!), and bought some new toner - mine had exploded on the plane.

I was pleasantly surprised that the weather heated up to 72 degrees by mid- afternoon - perfect for laying out in the sun and catching up on the last three Rolling Stones that had been piling up on my console. I spent a couple of hours squeezing the last bit of bikini weather sun out of the Arkansas Indian summer and staring out over the River. Read about everything from pedophile Catholic priests to nefarious Wall Street shenanigans to the life of George Harrison post-Beatles (I loved The Traveling Wilburys - forgot he was in that band). Changed back into pants and a long sleeved shirt to head home - it is cool in the shade and wind - and felt warm, sunny-skin drunk as I drove, sunroof open, windows down, radio blaring. Ready to see my kids again.

Suddenly, I felt a large winged creature in between my shirt and my shoulder, frantically buzzing and trying to beat its way to safety. Before I could register my panic, it slid its way down my scapula, halfway to my underarm. I could see no way of getting it out easily - if I widened the neck of my shirt it might just crawl on my neck and get stuck in my hair, a possible course of events that's appeal rivaled death. I grabbed it with my left hand to get it away from the skin on my back - now it was loosely cupped in my palm, wings flapping against my shirt. I didn't want to squish it - not that I was feeling charitable toward the insect world at this point - but I really liked this shirt and I didn't want to get bug guts all over it.

Now that I had the matter under control, I returned my focus to the road and drove like a race car driver to the nearest parking lot - weaving in and out of traffic, trying to block out and ignore the, I was sure if this by now, Prehistoric Monster Insect that was attacking me. A minute of driving like this stretched out into infinity, but I finally saw a parking lot and pulled in behind a building. I jumped out of the car, tore my shirt off, and shook out a small, unobtrusive winged creature - it must have been the spawn of the Prehistoric Monster Insect that escaped my notice as it flew away. Just as I finished jumping and flapping, finally feeling relief, I looked up and realized that I was dancing next to a dumpster in my bra, behind a church, in broad afternoon daylight. This song was blaring from my radio:

I laughed as I stretched my shirt back on, jumped in the car, and hit the road. Can't wait to tell that one to the kids. They love my Crazy Mom stories almost as much as they love hearing about what their Crazy Cat - Katybell a.k.a Katy Lady a.k.a Crazybell does when they aren't around. I'll leave out the song, I think.

That Was A Crazy Game of Poker

2011-09-22T22:22:00.004-05:00

One of the great things about care packages from friends, is that they send mixes with songs you forgot existed. I can't place exactly where I was when I first heard, enjoyed, replayed this song over and over, but it must have been college - because it seems like the memory emerges from a foggy beer haze. I remember singing this part especially loud.

So I said Johnny whatcha doing tonight?
He looked at me with a face full of fright
And I said, how bout a revolution?
And he said right.
I say of, you say a
I say revolution, and you say jah
I say of, you say a
I say revolution, and you say jah jah jah
Jahova!

I thought it was jah. This lyric youtube version above says die.

No beer today, I was working, but I enjoyed listening to it from big hospital to GI clinic and back again, over and over. Sun and rain.

There is no better care package - we do them twice yearly, than ones from my friend. Where else to you get multiple good mixes for me and kids, whoopie cushions, elegant Chinese fans, The Lacuna by Barbara Kingsolver (100 pages in and it is eclipsing The Poisonwood Bible for me) and penguin fruit chews. The kids and I were over the moon. I know you don't read this blog, but thanks, Jessica! Ce-silly already has a great big pile of gifts for you and Ella in return.

What A Difference A Year Makes

2011-09-21T22:53:00.002-05:00

Today is the one year anniversary of my official divorce. Not that I was looking forward to it - just realized it when I wrote the date down at work this morning. Put me in a reflective mood.

My mental health - so tenuous last year - is infinitely stronger. For that, I am grateful.

Kids are doing so well. Transition to new school was stressful for me, but went wonderfully for them. I went to parent-teacher conferences this morning. All praise.

Ce-silly's teacher was over the moon about my daughter. Her husband, a guy that works in film, hearing about her and seeing her pose in school pics, thinks she will be a famous actress. Her teacher told him, "You can't have her yet, she's mine for now." She is doing well in her studies - so much more confident in math and advancing in her small groups. Her teacher is impressed with her outgoing behavior and her lack of issues around the divorce - teacher is a product herself, so has much to compare with. "Your getting along with your ex is really good for your kids. We had a project in class one day, where we talked about our community. The children were supposed to describe their community on a post-it. Ce-silly raised her hand, and asked for two post-its - one for her mom's house and one for her dad's house. No shame at all. It was very touching." She also mentioned that Ce-silly is a great writer - conveys her thoughts very well on paper. I think my love for reading has been passed along and the writing is a nice by-product.

Jack's teacher was similarly impressed with his behavior and studies. I worry more about Jack - he is much younger and still in magical thinking mode, around his reality/environment. When we were moving last year, same week as divorce, he asked if his dad was moving back in with us. One day on the kitchen sink - he was helping me cook - he asked if I was going to divorce him. My heart shattered, but I picked it up. "That doesn't happen, Jack. Parents don't divorce their kids. Dad and I both love you tons, and you will always be our son." He seemed reassured, and I was happy to hear his teacher compliment us today in creating a kindergartner who has "obviously been read to. He is wise in his surroundings, in a way that so many his age are not. He's going to do very well, already is."

I'm better, they are better. Their happiness and success is daily validation that the right decision was made. Mine, too. A very old cliche, but true. What a difference a year makes.

Pseudonyms

2011-09-21T13:38:00.001-05:00

Read it here: at Mothers In Medicine.

Trouble

2011-09-16T23:48:00.004-05:00

It's been a little while since I posted music.

Here's Jessica Lea again.

Tears fell in Boerne

And stuck to your breath
Blew up to the sky
And landed on a cloud
Your heartache made the cloud sad
And it started crying
The cloud's teardrops froze
'Cause my heart is so cold

Now the clouds are crying snow
Here in Ohio

The words give me goosebumps, up to this point. But I can't relate beyond. Lots of lying and cheating. No judgement, just can't empathize (yet? Alas, no. Personalities tend to stick in quagmire, for better or for worse.).

Here's another - kind of scary in an OCD way, but catchy and mesmerizing nonetheless.

Swollen

2011-09-13T22:54:00.002-05:00

The full moon rests hea-

vily between smoky clouds

Resigned to black fate.

Team Work

2011-09-10T23:00:00.001-05:00

Last Monday night, I was invited to a block party to meet neighbors. I realized the other day I have been in this neighborhood for almost a year, and I was a little shocked. Time flies.

Cecelia and Jack and I decided to walk, it was only about a half of a mile. It was around 5:30 in the evening, and weather here has turned so nice that even taking out the garbage is a pleasant experience. We admired houses and plants. When we arrived, early set-up was taking place at the end of a cul-de-sac. Fold out chairs, tables for appetizers, and coolers. Cecelia located her friend Sydney in the middle of a Magnolia tree. Jack watched the older kids climbing. As soon as they were distracted by electric scooters, I watched him eye the tree challengingly and jump for a low limb. He immediately crashed to the ground, guarding his hand. I ran over to him. "Jack, are you ok?" He turned over his hand to glance at his palm, which was bleeding profusely, sending him into freak out mode. He had managed to graze a small, sharp twig of wood on the limb, gouging his hand.

I eyed my EMT friend who invited me, and she rushed to my aid. We ushered Jack down to the nearest house and he sat on my lap in a bathroom in front of the sink. We convinced him to place his palm under water, to try to visualize the damage, but the pain sent his psyche into the stratosphere. Even trying to shine a flashlight onto the wound seemed to create new agony. I looked over at her. "I know you have had experience, here. If there is something I should do, tell me." She looked at me sympathetically, while Jack was crying. "Splinters are tough. My son Colin had one recently. It's pretty awful territory, for a kid. You might have to take him to the ER to get a block in order to get a good look at it." Jack said he just wanted to go home, so I carried him to her car and she drove me.

Jack was pretty quiet in the car, but as soon as we got to the house he howled with new emotion, guarding his hand like a wounded paw. "It stings so bad, mom." I called my dad, who was luckily not working or I would have headed straight to the ER, and he agreed to come right over. I turned on the TV, a SpongeBob movie was on, and settled Jack into my lap. When he was calm enough to laugh at the television, I told him, "Jack, we need to get a good look at your hand. Grandpa is coming over to help. We might have to go to a doctor, we need to figure that out by looking. If there is wood in your hand, we need to get it out. If we can to that here, with your movie, it might be easier than going to a doctor's office. Grandpa and I are both doctors, we can probably take care of it, if it isn't too deep."

"Why do we need to get the wood out of my hand, Mom?"

"Well, if it stays in there, it might cause infection. That would make your hand worse. It has to come out. It might not be in there, but we need to find out."

"I know it is in there, I saw it. But I'm scared. Mom, can you go to your computer so we can look at that Harry Potter wand?"

We had been surfing this online wand store, Alivan's, for a few weeks, and he was familiar with all the wands and the woods and their powers. I obliged. He went to his favorite, The Elder Wand. Strong, protective powers. "Mom, I really need that wand. I need something to keep me safe." I'd been stalling him for a long time, these were real wood wands, and they cost around $40 bucks - some went into the hundreds, but Jack liked the simple ones. He picked the right time to hit me up. I worried he would be disappointed if it didn't create the same smoky magic as his Harry Potter Spells app on his itouch. "Mom, I know that the magic won't work until I turn 12." Six years to stall, so I bit. "Jack, remember the magician at your birthday? The one who knew magic? He said he learned by studying books, in the library. I think the magic will start working for you when you can study and learn about it."

Dad came over, and Jack shut down again. We got him to turn his hand over first in the dark, then with overhead light. Jack was right, the wood was there beneath the congealing blood and extruding soft tissue and fat, but it looked pretty superficial. Dad left to gather supplies.

He returned with betadyne, numbing cream, antibiotic cream, and wound dressings. We got Jack to soak his hand in a bowl of betadyne and water - he dribbled some on his hand first to test it. After 20 minutes of numbing cream, during which I cooked Dad a grilled cheese, Jack was ready for us to take a look. Luckily the wood practically jumped out at us, and further probing revealed that there wasn't more. Depth of the lesion was borderline, but we decided it didn't need stitches, so we dressed it and Dad went home. Jack and I went back to the party to pick up Cecelia, and he loved telling his story to kids and adults and spent some time on a trampoline, so I decided he could probably go to school the next day.

The experience reminded me of Jack's birth. Jack was six weeks early - wimpy white male - and since my dad was a neonatologist I was granted liberal privileges, being in his kingdom. Jack never went to the nursery at night - I was allowed to keep him at my side, nursing. Despite being 5 lbs., he went home pretty quickly, and I managed to double his weight in six weeks by his due date. When he became jaundiced, Dad smuggled home a bili lamp to prevent a trip to the hospital.

While I was cooking dinner Monday night, I looked over at Dad, calmly convincing Jack to take each new step in wound care and probing, making him feel like he was in control the whole time so he wasn't scared. My dad's brand of stoic empathy boosted Jack's bravery. I recognized it well - it has boosted my own bravery throughout my life. I thought about what a great team we all make. I am so lucky.

SPECIMEN IN BEDPAN

2011-09-02T22:11:00.004-05:00

Today I was looking at a urine. Dirty, junky urine. Catheterized. Surepath preparation. Lots of red blood cells, uric acid crystals, inflammation. I saw some atypical cells, and looked down at the paperwork, hoping maybe there was a bladder biopsy accompanying it that might help me figure it out - it would have gone to a pathologist covering surgicals and I could just call them up and ask them for correlation. I looked down - no bladder biopsy, but there was a pending case that had gone to a colleague with a source I have never seen in my 6 years of training and my three plus years of practice. It was in all caps, and it made me laugh out loud. SPECIMEN IN BEDPAN.

I called up my colleague whose name was on it - he had not yet gotten to the case so I got to break the news of what was buried amongst his stack of endometrial biopsies, breast biopsies, lung cases, etc. etc. He laughed. "Unbelievable."

Later he brought it to me - I was busy on the phone with a clinician, but he left it to me for correlation, not that it was necessary to correlate a specimen in bedpan with a urine, but we were in this thing together now. After I got off the phone and ran to read some thyroid smears, I threw the slide on the stage and looked at his sign out.

"Degenerative acellular debris with bacteria and small amounts of polarizable foreign material."

I took it back to his office and laughed. "That's the fanciest sign out for shit I've ever seen. Now I'll know how to sign that out if I ever get some."

He asked what I thought about the polarizable foreign material. "Maybe they were looking for something the patient ate?" I remembered the gross description I read, waxy yellow balls, and wondered if they just wanted to know what it was. "Who knows what they are looking for, here. Didn't some of that polarizable material look like vegetable matter? But does that even polarize?"

He shrugged his shoulders and I returned to my office. Next case.

Just Another Manic Monday

2011-08-30T06:23:00.001-05:00

Read it, over at MiM.

Click: HERE.

Monarch Butterfly

2011-08-21T11:18:00.004-05:00

Orange and black wings

Fluttering, cloaking branches

Poised in the sunlight

My good friend Ramona Bates is hosting the next Grand Rounds and I have been puzzling over what to submit for a few days now. The theme is changes. This is something I wrote on a bedside table in a hotel room in Monterey CA back in 2008, after visiting the Monarch Grove Butterfly Sanctuary. I was at a pathology conference by myself, and just starting to blog. I haven't posted it before, but I think it fits. It reminds me that we all, no matter how old we get, have the potential to find something new within ourselves and soar.

To all my friends on the verge of something new, I wish you the best.

Last Day of Summer

2011-08-14T22:39:00.003-05:00

Was dream-like.

Kids and I slept in and had a fabulous breakfast of crispy bacon, flaky layers biscuits (C's fave!) with melted cheese on top and egg white omelets. We hit the pool at Mom and Dad's afterwards.

Jack's main goal was to tump me off of the raft. I had a friend visit this past week - old Montessori friend who is a breast pathologist at Harvard. She heard me use the word "tump" and rejoiced. "No one in Boston even recognizes that word. It is so unique to the South." Anyway, I am 145 lbs. on a good day (5'9"), and Jack is only around 50 lbs., so it was tough for him. I was goading him and delighting in his failures, all in good fun. Finally, he stood up on the raft between my legs and started jumping up and down, yelling "Tump! Tump! Tump!" Surprised me by working. He was so proud.

Then we started races with different strokes - Breast Stroke, Free Style, Back Stroke, and my Dad demonstrated the stroke he held a state record for in Memphis years ago - the one the yielded him a full ride to Big Ten swimming school in Iowa. The Butterfly. He still does it so beautifully and powerfully at 60 plus, it is an amazing sight to behold, especially in an infinity pool on the Arkansas River. I love it when the pool and the River look the same color. It's like glass.

After lunch we played Life - Mom and C had bought it at Wal-Mart the day before. I laughed at doctor's salary - $100,000 - great but not the same as it was in the eighties. I hadn't played Life in over 20 years. Jack wimped out after 20 minutes and went to play Plants vs. Zombies on his itouch. But the rest of us hung in there, and C was delighted. She named her spouse Johnny, and her son Stevie. Twin girls were Haley and Bailey. I laughed so hard when she said, of the light blue identical pegs, "Doesn't my son look just like my husband? It's hard for me to tell them apart!"

After delivering b-day present to sis-in-law Annie, we headed home to cook dinner. I turned on TV for kids so I could finish labeling clothes and get everything organized for first day of school. It was nice to have a babysitter come to house all summer so I could just crawl out of bed, sometimes run, and head to work, but I am looking forward to the breakfasts together before school that I have missed. Good times - talking about dreams and day ahead. Jack starts first day of Kindergarten tomorrow at new school. Big deal! And C is hitting Third grade. Life goes on. Too quickly sometimes.

Hope everyone has a good summer to school transition.

Willing to Give

2011-08-10T22:08:00.006-05:00

Could not embed. It was disabled. Here is the link:

California King

"Does it count as a feeling?

If you wish that you could feel?

My evil's my discretion

And I can make anything seem unreal."

The genius continues. Add to the 171 page views. She deserves it.

I will move on soon, promise.

Sexual Harassment in the Workplace

2011-08-10T06:35:00.001-05:00

Read it, over at MiM. Click: here.

A Book Review!!

2011-08-04T05:41:00.001-05:00

Read it, over at Mothers in Medicine. Click: here.

Uri Geller

2011-08-02T22:59:00.001-05:00

Do what you love. When you love your work, you become the best worker in the world.

I freaking love my work.

Another Blond Moment

2011-07-30T23:33:00.003-05:00

So the kids and I went to Atlanta last weekend, to visit my brother, who is in law school, and my sister and her husband and two kids. It was an amazing weekend. The Atlanta Aquarium is breathtaking.

I drove - something I haven't done on the way to Atlanta in a long while. Took a plane for the last few years. I remember driving solo when I and sis were still single, many years ago. This is awful to admit - I would read on the long drive - holding the book up on the steering wheel and jumping my eyes back and forth from the book to the road. I still remember having to pull over one time because I was so upset by the turn of the novel I was reading that I had to cry.

Don't do that anymore, too dangerous. But I bought the kids itouches this year - highly recommend - so I was actually able to listen to my own music on the long drive.

We passed some graveyards. I do a funny thing when I pass graveyards - I hold my breath, and encourage the kids to do the same. Tell them that we are protecting our bodies from the bad souls that haven't passed on - the ones that might try to inhabit us. Don't think I really believe in this, but it is fun and exciting.

I also hold my breath when I go through underground tunnels. Something leftover from childhood - Mom encouraged it. So I was excited to travel through an underground tunnel in Alabama - kept telling the kids about it. We were driving on I-78 - soon to be renamed the I-22 corridor. It was well extended past the point that it was the last time I drove to Atlanta. Beautiful interstate.

We reached Birmingham - and I had been touting the tunnel and the ships on the ocean for many miles. Somehow, we missed them. I wondered aloud to the kids if we had bypassed them on the new I-78 route. They were disappointed.

Halfway to Atlanta from Birmingham I finally realized my mistake. The tunnels and the ships were in Mobile, not Birmingham. On the way to Florida, not Atlanta. Duh. What a directional dumb ass. I told the kids about my mistake, and they cringed and scolded me.

To my credit, we only got lost once - for about an hour on the way out of Atlanta Sunday morning. Sis helped me get back on track, and her advice got me through Memphis on the way back.

Cheers to getting your cities straight. I think I've finally got mine.

Jessica Lea Mayfield II

2011-07-29T22:29:00.005-05:00

There's never too much of a good thing.

Two other songs of note to share:

My favorite line:

Your actions they push me away
Into the dark where sleepless I lay
But I'm not alone, I have company
An internal void that won't let me be

I swear sometimes I think this girl crawled into my brain and took notes. Uncanny. Here's another:

Where did my mind wander off to
Found myself yammerin' all to you
Thought I'd never let those things outside my head
Probably should've kept 'em locked away instead

But I ain't gonna change for nobody at all
I'm starting to like this new love I have found
I don't wanna let this dark companion go
I would rather run myself into the ground

When I bumped shoulders with her the other night after the show I wanted to ask her about her dark companion. Regret that I chickened out.

Hope everyone has a wonderful weekend.

Jessica Lea Mayfield

2011-07-28T21:27:00.007-05:00

Robert Bell of the Arkansas Times says it better than I can. Whatever happened to John Tarpley, by the way?

Jessica Lea Mayfield is one of those wise-beyond-her-years singer/songwriters who might cause nonbelievers to reconsider reincarnation.

Ruling out the influence of past lives, Mayfield must have either had a string of painful breakups by the tender age of 21, or else she has a powerful imagination and the ability to synthesize real, grownup heartache to a degree so convincing that it doesn't matter whether it really happened.

A native of Kent, Ohio, Mayfield kicked off her recording career with a homemade EP that fell into the lap of Dan Auerbach of The Black Keys. Auerbach helmed both of her full-lengths, enveloping her songs in a sparse yet rich production, particularly her most recent album, "Tell Me," a set dominated by ruminations on relationships that border on the morose.

On lead single "Our Hearts Are Wrong," Mayfield feigns aloof circumspection, but reveals her underlying vulnerability over simple acoustic guitar strumming and a gently thudding Casio beat. She's got a smoky, restrained voice and an appealing Midwestern twang (yeah, Ohio folks can have an honest-to-God drawl; have you ever heard Robert Pollard talk?) Her music is a sort of gothic country-pop that, while not exactly bleak, is pretty dark.

I discovered her a few months back when I got a free single off of a download. It blew me away.

I downloaded the album, Tell Me, to my itunes, and listened to it over and over. Morose and dark is right. She reminds me of David Lynch - imagine she would be peppering his film soundtracks, if their paths ever cross. She is monotonous and lovely. "I'll not let hate be the one to make me naked for you." Love that line.

Her album is an endless source of fantastic lyrics. Here's another good one.

My favorite line in that one is "i did not ask to be born with these eyes, eyes that always speak for my mind."

Anyway, I was ecstatic to learn she was playing at Juanita's in LR last night - haven't been to the new venue downtown. Grabbed a musical friend and went to the show. Ferraby Lionheart opened up - very impressive voice and musician. When she wandered in around 10:30 - my friend said, "There she is."

"No, that's not her." I was expecting the shaggy bleach-blond pixie hair I had seen in all the videos I'd watched on YouTube. This girl had dark brown hair - blunt cut mid-forehead bangs with long uneven tendrils pulled partially unsuccessfully into a ponytail. Turns out it was her. She's a changeling.

The show was incredible. She played until almost midnight - both with a band and solo. Her live voice beat the hell out of her recording. Her sweet, demure "Thank you" after each applause was heart-wrenching, tying a nice bow on the dark, entrancing lyrics. Her occasional banter was intelligent and humorous.

I hope she returns soon.

I Am Disappeared

2011-07-20T21:54:00.001-05:00

Baby, I Will Leave You In the Morning

2011-07-19T21:33:00.001-05:00

Safe Landings

2011-07-15T06:30:00.002-05:00

New post over at MiM.

Click here: Parasailing

16 Bars

2011-07-07T23:02:00.001-05:00

Fizzy's Grand Rounds Part 2

2011-07-05T16:10:00.002-05:00

Yippee! Grand Rounds again from the funniest, most honestly wonderfully sarcastic MiM Fizzy. You can check it out at her blog, which is way more popular than my own, considering maybe she writes things that people actually have time to read, and she is brilliant. Click on link below to enjoy:

A Cartoon Guide to Being a Doctor

I can't wait to read it myself.

In other news, I finally got successfully migrated new MacBook Pro, so am able to actually keyboard type rather than just pecking away on phone for the first time in a couple of weeks, which feels like someone just bypassed a clogged carotid. Wheeee! More later.

Happy Tuesday.

If I Go

2011-06-15T23:36:00.001-05:00

Rites of Passage

2011-06-13T13:58:00.001-05:00

Read it, if you want, over at MiM. It might make you laugh. That was my intention, anyway.

Low Road

2011-06-08T23:04:00.001-05:00

Magic Man

2011-06-04T22:50:00.004-05:00

Jack is 6!

We had a fabulously magical birthday today - full of excitement and magician fun.

I made a CD for party favors this week.

Puff the Magic Dragon - Peter, Paul, & Mary

Magical Mystery Tour - The Beatles

Magic Dance - David Bowie

Magic Chicken - The Aquabats!

The Sun Is a Very Magic Fellow - Donovan

Magic Carpet Ride - Steppenwolf

Magic Bus - The Who

Magic - Pilot

A Kind of Magic - Queen

It's Magic - Doris Day

Every Little Thing She Does Is Magic - The Police

Do You Believe in Magic? - The Lovin' Spoonful

We've been listening all week in the car.

Jack asked for a Medusa head from the magician - he made balloon animals/aliens/bugs for all the kids. He said it was his first Medusa head. Considering he's been doing this for 13 years, that's pretty exceptional. Jack asked for a red velvet cake with royal blue icing - campy as hell and tasty, too.

Happy Birthday, Jack!

Hanker for a Chancre?

2011-05-24T21:15:00.004-05:00

Case of the century.

I received a consult for a GI biopsy recently. Only history was ulcers in rectum. The biopsy looked like chronic active colitis - architectural distortion, cryptitis - probably ulcerative colitis or Crohn's. History fit for UC. It was signed out as such.

The GI doc called back. "This doesn't make sense. It is a young person, but there is only one ulcer. And they have HIV."

Well, that certainly put a spin on the case. UC and Crohn's usually rat out the colon - they don't create a solitary ulcer. And with the patient's immunocompromised status, a bug hunt was in order. I threw on a silver stain for fungus, an AFB for mycobacteria, a Giemsa to hopefully highlight the mucus blebs that might be Cryptosporidium, and a Steiner for syphilis.

The bug stains were all negative. I have not yet performed a Steiner since I was in private practice, and they are tough stains to read. Dirty as hell - ochre yellow and muddy brown spattered in black paint. I didn't think I could see any spirochetes, but I sent the entire case to a GI expert for review. They agreed with me. I called the GI doc to give him our update, and he said, "Well, there is some new information. The patient has syphilis. So that could be a chancre. That would be a first, in our group's history."

I called the University and learned that there is a new, cleaner, much more sensitive stain for syphilitic spirochetes - an immunostain. I had the histo lab cut some unstained slides of the biopsy and sent them over. A couple of days later, I got an e-mail. "The immunostain is positive for spirochetes. What a great case - thanks for the consult."

Sometimes things that seem straightforward aren't, and it takes some extra phone calls and digging to get your answer. I jumped up excitedly and ran to the office next door. Two of my partners were discussing a refractory platelet patient. "Guess what!! I had a rectal chancre this week!" One of them said, with a lascivious smile, "Really, you did? Can I see it? Wait, let me get my iphone camera!" I smiled at him, glanced backward over my shoulder in the direction of my backside, and managed to look cheerfully confused. "Um, that might be tough?"

"Oh yeah, you said rectal." He tucked his iphone back in his pocket. "Oh well."

As I started to blush, my other partner said, "Giz, you walked right into that one. Now tell us about the case, that sounds really interesting."

Speaking of chancres, I had an oh so promising romantic interest at a concert I attended last Wednesday night. My friend and I were sitting down, and I looked over at her curiously. "Are you getting drops of liquid on your head?" She said, "Yeah, drops, but on my shoulder." I looked up. The ceiling was pretty far away for an air conditioner malfunction. I rubbed my finger on my head, and much more was now spilled on my shirt as well. "It smells like beer. Oh well, they say that is good for the hair, right?"

When the lights came up for intermission I glanced behind me, and there was an obviously drunk guy, sitting next to a ten year old. He slurred, "What! You got something to say to me? I'm just trying to show my son a good time here!" I turned around, reluctant to engage in any further interaction.

Later, after my friend and I had picked out t-shirts, I bumped into a pediatrician/ED couple I knew, and stopped to chat. Spilling beer guy was chatting with someone they were with, and I don't think he had any idea that he had ever seen me before. He lumbered over, and it was unclear whether he was talking to me or his friend. "I'm telling you, she's happy with her husband. Are you happy with your husband? I'll bet you are. With my luck, you are happy with your husband." I glanced down at the new t-shirt I had wrapped around my left hand, disguising my ringless finger. I smiled at him. "Yup, I am really, truly happy with my husband."

He walked away, and mumbled at his friend. "I knew it! Darn my luck."

And they say single life is fun. Be wary of chancres - both societal and rectal.

Small Pot

2011-05-20T22:24:00.006-05:00

I don't usually share funny links, but I found this on the Arkansas Blog tonight, and I was laughing so hard I had tears running down my face. I had to stop at page 20 because my kids couldn't sleep and I almost gave myself a hernia.

The comical recipe: Here.

The wildly hysterical comment thread: Here.

Enjoy.

Is There a Doctor in the House?

2011-05-17T23:48:00.000-05:00

Read it, over at MiM.

Jumping On the Bandwagon

2011-05-14T22:26:00.004-05:00

Adele. Adele. Adele. I'm addicted.

This reminds me of when I finally bought Amy Winehouse.

Nothing could be good if it is so widely recognized. I was soooo wrong.

Even Cecelia is enthralled. A sure sign of excellent music.

Happy Mother's Day

2011-05-08T21:31:00.001-05:00

You can read it if you click here: MiM

Nail In My Coffin

2011-05-08T00:08:00.003-05:00

Song of the Month - this whole album is incredible I am no better at this than you are Unfinished business maybe, do love I can't change myself into you dear What you are to me is far too unclear Quit being a nail in my coffin and I don't need another one Quit being a nail in my coffin and lord knows I ain't ready yet Quit being a nail in my coffin and I don't need another one Quit being a line I'm crossing and I am never gonna get back from Oh oh oh oh oh Oh oh oh oh oh Oh oh oh oh oh Oh oh oh oh oh I am no better at this than you are Loneliness never truly leaves me alone I have made mistakes I can't take back home I love you just not the way you want Quit being a nail in my coffin and I don't need another one Quit being a nail in my coffin and lord knows I ain't ready yet Quit being a nail in my coffin and I don't need another one Quit being a line I'm crossing and I am never gonna get back from Oh oh oh oh oh Oh oh oh oh oh Oh oh oh oh oh Oh oh oh oh oh Oh oh oh oh oh Oh oh oh oh oh Oh oh oh oh oh Oh oh oh oh oh Quit being a nail in my coffin and I don't need another one Quit being a nail in my coffin and lord knows I ain't ready yet Quit being a nail in my coffin and I don't need another one Quit being a line I'm crossing and I am never gonna get back from Quit being a nail in my coffin and I don't need another one Quit being a nail in my coffin and lord knows I ain't ready yet Quit being a nail in my coffin and I don't need another one Quit being a line I'm crossing and I am never gonna get back from Oh oh oh oh oh Oh oh oh oh oh Oh oh oh oh oh Oh oh oh oh oh

The Sleepover

2011-05-07T23:03:00.004-05:00

I helped my daughter host one last night. I promised her for her birthday, which was a whopping two months ago, so it was time I cashed in on it.

I don't do these very often, as it throws me all out of whack and can be overwhelming. I just basically worked two weeks in a row - having had call last weekend with a record number of marrows, and lots of tissues to boot. It makes me feel good that a weekend like that would have sent my GI tract into hyper overdrive a couple of years ago and now I can take it all in stride.

I had my tarot cards read about a six weeks ago, by the Mom of one of my great friends. It was pentacle after pentacle after pentacle (or was it oracles? I'm not too tarot card savvy). Anyway, it was about work. She remarked at one point during the reading, "You might think there are no more pentacles in my deck of cards. But with you they seem to be multiplying. You must be doing really well in your job." I replied, "Yes, I'm doing great. Bonuses are rolling in. I made partner last fall. I feel really good about what I do." She said, "Sometimes these readings aren't so much a prophesy for the future, but simply a validation." I guess it is nice to be validated every now and again. No cups, unfortunately. Sigh.

Anyway, Cecelia and I picked up her friend after I got off work, around 5:30. These are some new neighborhood friends - she and my daughter are in dance together and it was a bonus to find that they live a block away. Mom is a transport EMT and dad is a cop - not just any cop, but a special one that works at the Governor's mansion. This kid is obviously more worldly than my own daughter, but I like that she is extremely polite, ordered lots of veggies at dinner, and kept centering plans around me when C just wanted to whisk her away for herself.

This one cracked me up. "Cecelia, let's spin for your Mom." She started spinning, and spinning, and spinning in the living room. I was settled into the couch with my book and my SOBE water. Cecelia joined her for about five minutes, then said, "Sydney, I'm sick of spinning. Why don't we just go upstairs and dance?" She said, "No, I want your Mom to know that I can spin. I once spinned for 25 minutes straight." I told her, "It's Ok, Syd, I believe you - you can really spin."

"No, I want to show you." She kept spinning. C rejoined her. Sydney said, "Do you think you could give your cat a wedgie?"

I looked over at Katybell, then at Cecelia. C's mind was whirring with her body. I said, "I don't know, Syd, I don't think a cat's butt would work too well for a wedgie."

C said, still spinning, tripping over my big feet, "Yeah! And they don't really even wear underwear! And their butt is just so, um, circular. Circular butts can't get wedgies." They both giggled uncontrollably and collapsed on the floor.

A couple of fashion shows later, they corralled me into YouTube. Sydney was much more computer savvy than C, and was working my laptop like a pro. "I want to show you ET, by Katy Perry. But we can't watch the video, because the guy is n-a-k-e-d. Just look at the lyrics, they're ok." Later on, when C was playing "Imma B (sp?)," Sydney barged in on me while I was brushing my teeth. "Um, there have already been three bad words. We didn't listen to the whole thing, but I think we had better stop." I asked her, "Would your parents let you listen to it?" She said no. "Then don't." Despite the fact that she knew the bad words, and could spell them for me - B-I-T-C-H and S-H-I-T - I know C has no idea about these words - she was still checking in, which was good in my book.

They had lofty plans to stay up until 1 or 2 a.m., but they fell asleep at 11:00, thank goodness. They were being so rowdy in the room right next to mine that I almost sent them upstairs, but I liked to listen to their rowdiness, with all of its wonderful eight year old innocence. As I alternately read my novel and berated them through the wall for being too loud, I thought that maybe I could do this again, before another year. Because how much longer is it all going to be so innocent? So full of giggling about cat wedgies, and playing games, and listening to music without too many bad words on itouches, and falling asleep with the anticipation of morning cinnamon rolls and water balloon fights. Not much longer, I imagine.

Another Blond Moment

2011-04-28T20:59:00.003-05:00

I like using hair color as an excuse, anyway.

I was heading to the chiropractor around noon today - missed my appointment Monday because I lost track of time while I was interviewing a candidate for a possible future job. Luckily she was able to reschedule me - I don't know what I would do without that interferential current, traction, and adjustment. I went a few months without it and got all crooked. I've been going about every two weeks for the last couple of months, and even though I don't feel like I need it anymore, it's kind of like exercise - addictive.

I notified the secretaries I would be out of my office for about an hour and stopped by my partner Dianne's office to let her know I was leaving - she agreed earlier to cover me for clinical calls. She is tall and lanky and like every other pathologist I work with, looks about 15 years younger than her chronological age. I'm telling you, this is the life. She has short brown hair and chunky black stylish glasses that complement her uber-intelligence. Her office has a window (jealous!) that oversees the entire clinical lab, so she has her finger on the pulse of the activity - she knows when a new marrow is coming from radiology by the sounds she can hear on the other side of the glass.

"Dianne, I'm headed out."

"Can you smell that?"

"What?"

"That banana, in my trash can. It's overly ripe, and it stinks."

"Well, I can't smell it, but I know what you mean. I can't stand the smell of overly ripe bananas - they make me nauseated. If it was by my desk, I would have to take it to the bathroom trash - I couldn't work."

"That's what I think I am going to have to do."

Our conversation got me thinking about bananas. I keep bananas around the house constantly - I eat peanut butter, banana, and honey sandwiches at least once or twice a week. Jack also likes them. I asked Dianne, "What is up with bananas these days, anyway? They get overly ripe so fast! I buy them green as I can and a couple of days later they are attracting fruit flies. I can't stand it. I used to make banana bread all the time, but now I usually just throw out my bad bananas."

Dianne said, "I know what you mean. I have a banana tree, but they still go bad all the time."

Wow, I thought. Dianne, the self-proclaimed non-cook like myself, had a banana tree? I imagined her traipsing out to her back yard plucking them off in bunches to slice with her morning cereal and yogurt. And it sounded like her banana tree was so prolific, that no matter how many she picked they still went bad. I imagined a banana tree weighed down with too much fruit, an exasperated Dianne perspiring in a heap at its base with a basket full of bananas, no end to her work in sight. Just how many feathers, I wondered, could fit in her cap? Wasn't it enough that she could make a difficult lymph node or bone marrow report sound like poetry, such that I frequently sought her counsel and hung on her every word? Really, a banana tree? I said, "Well, that's really impressive! A banana tree! I just go to the store to get my bananas."

She looked at me querulously - in retrospect, I think she was trying to determine if I was serious. "Um, Giz, the banana tree is in my kitchen? It is something I hang my bananas on to keep them fresh longer?" She made each explanation a question, still doubting my belief in her banana tree. Finally a light bulb went off in my head, and I started laughing uncontrollably. Luckily she joined in. When we both gathered ourselves, she said, "Boy, Giz, I'll bet I could convince you of anything, couldn't I?"

"I was wondering how you managed to have a banana tree, what with this Arkansas climate and all. Yes, I have been known to be pretty gullible. I like to think of it as part of my charm, rather than stupidity, but I guess it could go either way."

She grinned. "You know, I've got this diamond mine in my back yard and I really need some investors. . . "

"Ha! I've got to get to the chiropractor."

"Thanks for the laugh, Giz - I really needed that."

I have a feeling this is not the last I will hear about the banana tree.

Foo Fighters - Another Round

2011-04-23T21:47:00.004-05:00

Since my friend bought us tickets for next month, I decided I might need to listen to them.

I like this song.

The Romany Rye - Untitled (Love Song)

2011-04-22T22:36:00.003-05:00

Star Student

2011-04-20T21:48:00.005-05:00

It's Jack this week! And Cecelia was "Student Helper" a couple of weeks ago. I have a new line on my CV - carting pets up to school for show and tell.

I asked Jack the other morning if he wanted to bring Katybell, our cat, or Spotty Dangerous, the snake. He said, "Mom, everyone already believes that I have a cat."

"What Jack? Some people in your class don't believe that you have a snake?"

"Uh uh. Aidan doesn't."

"Well, we'll fix that."

So in between breast conference, fat pad aspirate in fast track ED, surgical cases, and GI clinic, I'm bringing the snake and some cookies up to school tomorrow around noon. Spotty was a little rambunctious when we got him out to play tonight, so I'm going to feed him a big mouse. Hopefully that way he won't be hissing at the kids.

Oops, there's the oven timer now. No silly, not the mouse, the cookies. The mouse goes in the microwave.

Rosie the Rooter

2011-04-12T21:54:00.003-05:00

Last Saturday I discovered that my kid's toilet was stopped up. They were with their dad, so I wasn't sure about the probable etiology, but assumed they had let it not flush long enough to get clogged with paper - the usual issue. I ran upstairs to get the plunger. I consider myself pretty savvy with a plunger - I've had lots of practice. If there was a Toilet Paper Anonymous, I would be the first to sign up. I certainly wouldn't preach abstinence, but a little moderation would help. I'm all for being green and recycling, but when it comes to hygiene maintenance, there is no reasonable limit for me. I like to create a mountainous barrier between my hand, and, well, you know. It's a problem, I'll admit it. My ex used to posture that I used a toilet paper roll like a fishing line. I beg to differ. You reel in a fishing line.

Anyway, I tell you all of that to set the scene. I am a master with the plunger, and I've got a good one. But I attacked the toilet for 20 minutes - flush, plunge, flush, plunge - and the blockage did not budge one bit. This has never happened to me, that I can remember. It is like getting an A on an academic test. When I set my mind to clear a stopped toilet, I can make it happen. I decided to let it sit for 24 hours, and tried again Sunday night. The kids were home by then, and enjoyed watching me take the toilet to task, with all of the accompanying water splashes and slurpy gross noises. Once again, I failed. Cecelia rushed off to make a note for the toilet "Do not use the toilet or toilet will splash on you." I read it questioningly and looked at her. She started laughing, "Oops, mom, I meant to say water!" I said, "Well, your message is much more of a deterrent. Good mistake." We put a towel over the closed toilet lid, placed her note on top, and started bedtime routine.

Monday night, after hauling down the trash and the recycling (I over-recycle to make up for my excess toilet paper usage - promise!) I decided to attack the toilet one last time. I was not optimistic - I have never had a three day blockage before. I dreaded calling the plumber the next day - not only would it cost an arm and a leg, I was going to have to find the time to meet the guy or pay someone to meet him for me - something I occasionally have to do these days. Cecelia saw me head into her bathroom and followed me excitedly. "Mom, I'm going to jump in the tub so I don't get splashed! I'll watch and cheer you on!" I smiled at her. "Thanks, C."

I attacked the toilet for the last time with gusto and to my surprise, after a couple of minutes, it cleared. I looked up at Cecelia in wonder. She asked, "Did you fix it mom?" I said, "Yes! Hooray for Super Plumber Mom!" I flexed my muscle like Rosie the Riveter and turned to face Cecelia in the mirror, posing as a superhero. She scooted over right underneath me on a stool, imitated me, and looked at me happily and challengingly back in the mirror, "If you're Super Plumber Mom, I'm Super Plumber Daughter." I looked down at her chocolate brown hair framing her olive face and dark, sparkling eyes, a lopsided grin showing off a gap in her front teeth that could only be rivaled by mine at her age. I told her, "You've got a lot to look forward to in life, you know that?"

Only If You Are a Pathologist

2011-04-04T22:11:00.003-05:00

This afternoon, I was headed out of my office to grab my afternoon coffee. I ran into a histotech, who had a slide tray in her hands. She stretched her arms out and handed it to me, beaming, full of official importance.

"Doctor, here is your herpes! It is finally ready! I can give it to you now, if you want it."

She was referring to an immunostain I ordered on an active esophagitis.

I doubled over with laughter. "I do, I do! I have been waiting for someone to tell me that my whole life!"

I know. I'm not very funny. It's a Monday following a vacation week. I'm sure you can think of a lot better responses. Still, I love that my job creates moments like this.

Cinderella Man

2011-04-01T23:58:00.001-05:00

Run like hell, and enjoy it.

The Snake and the Pussycat

2011-03-31T07:55:00.001-05:00

You can read it - click here: MiM.

Is There Intelligent Life on Mars?

2011-03-23T08:08:00.002-05:00

Read it, if you like, over at MiM. (Click on that last MiM).

Another Like You

2011-03-18T22:10:00.002-05:00

Kilauea Caverns of Fire

2011-03-15T22:38:00.007-05:00

Whew! I finally found my attachment so I could upload pics from my new Nikon.

Here's a fabulous secret - no one in Hawaii knows about this adventurous lava tube spelunking tour. After arriving in Hawaii and finally unpacking at 3:30 a.m. Little Rock time, I had a couple of glasses of wine in the lounge and slept soundly before my trek to Kilauea in the morning. Driving down the highway in my rental Chevy Malibu listening to island tunes on one of three local radio stations was liberating. I was a little early (as usual) for the 11:00 tour, so I stopped along the way to take in scenes like the one on the left. Breathtaking, right?

I was a little worried about finding the tour base, but arrived without trouble 15 minutes early. Plenty of time to chat with the movie star family that was responsible for leading the tour - tall, dark, handsome Hawaiians - a father, two sons, and a daughter. Mark, Mark, Hector *swoon,* and Selena. Since the Philadelphian manager of a team of financial advisers and his wife were hopelessly lost, eventually requiring Selena to find them in her pickup truck and lead them to the site, I got to know the locals well. I was especially excited when Hector volunteered to help me plan the rest of my day - pulled out my map and pulled up a chair (close) to plot my quest for lava.

Hector left to lead the basic tour, leaving the two Marks, the other couple, and I to gear up in our hardhats, hand-held giant flashlights, gloves, and knee pads. We hiked to the entrance of the cave, and climbed down a forty foot ladder to enter.

Here is what the entrance looked like (sideways). Taking pictures was pretty difficult with the gloves and holding the flashlight, but I got a few. I was surprised at how strenuous the tour was. Within about 15 minutes of the three hour trek my jeans and t-shirt were soaked in sweat. It seems that in the lava tubes, the roof caves in periodically, creating a mountain of rubble that requires surmounting prior to getting to the next leg of the tour. At times we would be climbing through mountains in caverns, at others we would be shimmying through small crevices.

The most surprising thing about the lava tubes was the color of the formations. Being from Arkansas, I am used to cavern delicacies - namely soda straws, stalactites, and stalagmites - looking mostly brown and yellow in the light from the installed floodlights. Here, there were no installed floodlights. In fact, I'm not sure our tour guides had been into the caverns more than a couple of times. They kept saying things like, "Isn't this cool?" and "Let's go here, I don't think I've ever been here before." I became slightly nervous but was reassured when the dad told me that no roofs had caved in during the last big earthquake, despite the fact that half of our flashlights were dead and abandoned within an hour and the dad and son were arguing over what types of batteries they should have bought.

Here in the lava tubes, everything was gunmetal grey and sparkly silver. A wonderland of color. Mr. financial advisor manager said, "This looks like a great place for an ATV chase scene in a movie."

I've been scuba diving, spelunking, and mountain climbing, but this was like nothing I've ever seen before.

I met a ton of pathologists on my trip - from L.A., Virginia, etc. Even the one who has been attending this conference for 17 years had never heard of these lava tubes. My pal from L.A. actively sought the tour out with the multitudes of tour guides in the lobby, frustratingly to no avail. She told me she finally learned that they are keeping it a secret so it remains pristine. The other couple found out about it in the same guide as me - Fodor's.

Needless to say, I felt special for having the chance to experience the surroundings and micro climate. And sore as hell the next day during lectures. More about my afternoon quest for lava in future installments.

Happy Birthday Eve!

2011-03-09T21:10:00.002-06:00

To my almost eight year old daughter, Cecelia. I'm going to try to outlast her tonight so I can decorate the house - but she burns the midnight oil with books, so it's going to be tough.

I'm planning to get the kids up early for breakfast and take them out for donuts for a treat. We have never done donuts for breakfast, but she's been exposed to them at school, so she already has her two favorites - chocolate and glazed. Not that I'm opposed to donuts, I've just never liked them, myself. Luckily I think they have egg and cheese biscuits.

Tonight we celebrated in my new bed. I spent hours trying out every mattress in town in December and January before I finally made the purchase. It is a Tempur-Pedic. They sent out a delivery team last week and the electrical team was at my house until nearly 9:00 last night hooking up the Prodigy electronic base. One guy said, "I've never seen a model like this! This must be the top of the line. Your bed is like the Jetsons."

I'm pretty crazy about all things created to protect my back - when it is out of whack I'm not too happy. The first thing I bought with my CME money three years ago was a fancy chair for my scope and then a new scope with an adjustable headpiece. Some people buy jewelry, cars, or clothes when they get their first bonus after a divorce. My ex bought a Mustang convertible. I bought a new bed.

It was too late last night to play with the remote, so tonight I promised the kids after dinner and bath we would hit the new bed. We cranked up the head, raised the foot to top levels, and upped the vibrate mode to full power. The kids laughed while I hummed - it sounded like I was talking into a fan. Then they took turns somersaulting off of the foot and dancing, while I rested on the side unaffected by all the activity (which was a lot more than my bed had seen in . . . never mind. TMI.). It really is like the commercial with the wine glass sitting undisturbed while someone is tossing and turning on the other side.

The remote even has a clock and alarm - you can wake up in vibrate mode (kinky!) or alarm mode. I wonder if that means my whole bed will vibrate me awake. Kind of like my pager, only much bigger. Maybe just the remote vibrates. Guess I'll find out in the morning. It's set for 5:00 a.m.

Cecelia wants to re-decorate her room for her birthday. Since I was planning to do that anyway, it works out well for both of us. We've been picking out beds, bedspreads, and paint colors all week. She has been actively de-cluttering her room and drawers every evening (finally! At 8! I knew my neuroses would surface in her eventually without my prompting if I was just patient) - her room looks fabulous. Just in time for her third of four birthday parties this Saturday (she had two with her dad last weekend). I think she is enjoying one of the fruits of divorce - double the holiday and birthday celebrations.

I think the page-turning has stopped. Time to decorate.

I've Got Friends

2011-03-05T22:59:00.008-06:00

If you haven't yet guessed who helped me with my blog by looking at the addition to my admin on the top right corner, it is the Duchess of Cookies, a.k.a. DC. The designer formerly known as Prince. I mean Cat Stevens. Nope, Domestically Challenged. That's it. You can check her blog out here if you didn't already when I linked to it in a recent post.

When she agreed to take me on as a charity case a few weeks back, she had all these intelligent questions about me as a person and my interests which left me flummoxed. I began to google around and sent her random pics throughout the weeks. I was a little obsessed with lava, what with my upcoming trip to Hawaii, but we weren't able to make that work. Another site I am addicted to is the Nikon Small World Contest winners. If you've never visited that site, I suggest you check it out here. Scientist or no, you will have to agree it boasts some of the most amazing darkfield microscopy, brightfield microscopy, and polarized microscopy pics imaginable. I love to make my daughter try to pick her favorite (she can't). The one of many I sent that she converted to wallpaper is Roland O. Marsh's 1987 4th place winner - a 50x darkfield image of an Obelia medusa. It is a simple aquatic marine organism in the class Hydrozoa found in oceans throughout the world. Of the different wallpapers DC eventually created and sent for me to choose from, my kids and I were unanimous on this one.

I think I also mentioned somewhere in an e-mail way back that I like toe tags? DC took that idea and not only ran with it, she broke the sound barrier, don't you agree?

Thanks again, DC!!!

Going Live

2011-03-04T23:07:00.002-06:00

It happened today while I was drowning in marrows, antibody work-ups, lymph nodes, lee-vurs, and Factor deficiency work-ups.

It's beautiful, isn't it?

More later, namely on what the hell that thing is floating on the side and gratitude.

Blood, Sweat, and Tears

2011-03-03T21:44:00.006-06:00

One of my New Year's Resolutions was to redesign my blog (wait, wasn't that last year? Oh well, NY resolutions do have a way of haunting us year after year). This week, in contrast to most NY resolutions, this one is on the brink of being realized. I engaged a friend who understands fancy computer words like "HTML" and "code."

After weeks and weeks of grueling work - well, to be honest, my lead designer did have a two week visit from her in-laws and then I had to plan a trip to Hawaii, so we've been mostly just e-mailing pics and joking and sharing ideas. But this week, we - well, she mainly, I'm the cheerleader at this point - have been getting scirrhous. I mean serous. Oops - no - serious! Blah! Call weeks warp the mind. Forgive any craziness over the next few days while it is under construction.

Stay tuned for sheer greatness. I got a sneak peek of the layout minus finishing touches, and I nearly swooned out of my chair. I can take very little credit - only the flaws (if you can find any) belong to me.

Full disclosure of my partner in crime is forthcoming.

The Rainbow

2011-02-25T23:15:00.005-06:00

"Strange, what a void separated him and her. She liked him now, as she liked a memory, some bygone self. He was something of the past, finite. He was that which is known. She felt a poignant affection for him, as for that which is past. But, when she looked with her face forward, he was not. Nay, when she looked ahead, into the undiscovered land before her, what was there she could recognize but a fresh glow of light and inscrutable trees going up from the earth like smoke. It was the unknown, the unexplored, the undiscovered upon whose shore she had landed, alone, after crossing the void, the darkness which washed the New World and the Old."

The Rainbow - D.H. Lawrence, page 476 of 478.

I read this passage eating breakfast on my last day in Hawaii, after a brutal, all night, uncharacteristic thunderstorm on the South Kohala Coast. There was a rainbow. I didn't have my camera - stole this pic off of the web. The one I saw was, if you can imagine, more amazing. It made my spinach and Swiss omelet with smoked salmon, onions, and capers seem trite.

I'll be blogging more about Hawaii in the weeks to come. It was too much to cover in one blog. From spelunking through undiscovered lava tubes to being caught in a vicious snowstorm at an altitude of 13,796 feet above sea level (over 33,000 from the ocean floor) - I experienced at least 13 of the 15 micro climates that the Big Island boasts. I only spent a total of three hours of my six days on the beach - most of which I was swimming in the ocean. I'm trying desperately to put back on a surprising amount of weight I lost from endless activity - which is fun, but shouldn't take long. I can't wait to go back.

Thinking Outside of the Box

2011-02-18T07:50:00.000-06:00

Read it, if you want, over at MiM.

Happy Valentine's Day!

2011-02-14T20:35:00.005-06:00

I love Valentine's Day. I was going to try to google around and find a cool pic to post, but I opened up my friend DC's blog in my reader, and she so beat the hell out of what I could hope to do that I'll just post you a link - click below:

Another Day in Paradise

She has the most artfully decorated blog I know, and she changes it seasonally.

Today I was sitting in my partner's office jealously listening to her stories of her meeting in Vegas last week. A female barbershop quartet was in the transcription area crooning something barbershop quartet-ish, "Let me Call You Sweetheart," I think. Or something similar that worked OK with the gender transposition, those songs all blur together for me. I could see another pathologist - not the sender's husband - he happened to be working in Conway and I guess the wife forgot or didn't know - smiling encouragingly at the four singers, but obviously a little embarrassed to be the unwitting recipient of the misguided song-gram. Flowers decorated most of the transcriptionist's desks. I asked Michelle,

"She does this for him every year?"

"Yes. This is the same song as last year, I think."

"I've never heard it, I guess because I'm out in the hall."

"Every year. Since I've been here anyway."

I think she's been here seven years. That's quite a tradition. Suddenly she looked me in the eye. "Is it hard for you?"

I was completely confused. "Is what hard?" Vegas? The case I brought to show her? What was she talking about? Suddenly it clicked. "Oh! Do you mean Valentine's Day? No! Not at all." I smiled. Being single? Finally feeling independent after struggling in a doomed marriage for years? Happy, well adjusted kids despite everything we've been through lately? Wonderful civility in dealings with my ex, which seems to be improving as he and I both move on in our own lives? Nothing to be sad about on this Valentine's Day.

She laughed. "Well, obviously not!"

Hope everyone is having a blissfully Happy V-day.

SNOW!!!!

2011-02-09T21:19:00.002-06:00

That seems to be the hot topic, around Arkansas today. Around the country, I know, but we don't get much here, so we are reveling in whiteness.

Driving to work wasn't such a big deal - it had just started and was gorgeous - the swirls of snow on the interstate looked like ghostly veins that alternately appeared then dissolved in swirls of smoke. Driving home was a little dicier - full blown blizzard with only a handful of cars on the road - there was even less traffic than last Friday at rush hour, which was like navigating through a ghost town. My adrenaline rush from snow driving is dissipating this year, but I don't want to jinx myself - I've got to get to work again in the morning. I've learned something interesting about driving in a snowstorm - the lack of landmarks is strangely disorienting. The roads blur into the background landscape and until you see a road sign leading you to your exit, a tiny bit of anxiety creeps in and saturates your mind (at least mine), making me wonder if I am in the right state. On the right planet. Oh, there's my exit. Thank goodness.

I arrived home to my sitter and her mom - invited them to spend the night but they declined and thankfully made it home OK. Cecelia and I put in another hour on her dinosaur project - she is studying the Allosaurus. I have learned more about the Allosaurus in the last week than I have snow driving in the last two months. The Allosaurus is a carnivorous dinosaur that held the place of the most fierce dinosaur until it was usurped by the T. Rex in the early 20th century. It was the star of the first motion picture to feature dinosaurs - an adaptation of Arthur Conan Doyle's The Lost World. It shed its teeth continually, so there are lots - you can get one yourself online for only around a hundred bucks. There are many theories about the hunting patterns of the Allosaurus. Most say it managed to bring down prey much larger than it's own average 28 foot long self - such as Stegosaurus and Brontosaurus, by ambushing them and using its mouth like a hatchet. My favorite theory is about Allosaurus as "flesh grazer" - taking bites out of living sauropods sufficient to sustain its own well-being and leaving the live, injured dinosaur to heal and be prey for another Allosaurus. Over and over, until the giant sauropod succumbed to repeated injury and bacterial contamination. Thus saving the energy required to outright kill the large beast. Cecelia thought that theory was kind of gross. I have been glad to have the dinosaur project to balance out the efforts of the Valentine's projects. I was talking to a friend the other night - we came to the conclusion that there is a lot more hands-on, at home work than there was when we were growing up. Whether this is good or bad, I'm not sure. For me, probably good.

After that we headed to the large hill/entrance to the neighborhood with the toboggans their dad dropped off last night. So many kids, families, and dogs around - our combined hand signal efforts drove away a snowplow/sander that threatened to spoil our fun. Fearless Jack joined a band of teenagers and was going so fast he "caught air" a couple of times - I cringed a little when a mom remarked judgmentally, not knowing he was my son, that he was going to bite his tongue off or hit a car if someone didn't slow him down. I checked in. He was happy, not scared. That's a good thing in my book, so I gave him the green light to be as adventurous as he liked. No broken bones.

I love my new neighborhood! I joined a progressive party, with the aid of an old friend who has many acquaintances. Missed the hot chocolate hour, but who cares? I got invited to the happy hour, where they were serving snow margaritas (yum!), warm chex mix, salsa and chips, kettle corn, and wine. All the kids shed their outerwear in the garage and there was an interesting game of boys against girls developing amongst the children while the adults chatted. I met a girl who looks exactly like Indina Menzel. I kept expecting her to turn green and belt out songs from Wicked. She laughed when I told her so, and said, "It is probably the braids. I never wear them. My boys were flabbergasted. They said I looked like a girl. I told them I was a girl, and they said no, I was a mom." It wasn't just the braids, it was the high cheekbones and the green eyes as well. But the braids helped.

We walked home. After dinner, bath, and bedtime stories the kids crashed hard. I peeked in on them just now and smiled. I have been so happy, despite all this crazy weather stress. Life is pretty wonderful right now. Looking forward to escaping the cold in Hawaii, but I'm glad I'm not missing their experience of this. And mine.

The Cave

2011-02-03T22:36:00.001-06:00

This is one of my favorite running songs, right now.

tête-à-tête

2011-02-01T21:44:00.005-06:00

I saw this when I walked into the GI office restroom this morning. My mind raced through possible scenarios.

- Do some people actually find it easier if they put their feet up?

- If a guy stands on a chair, is it more challenging? Like a solitary sport event?

- Comfortable puking? It would beat kneeling around the bowl.

- Is there something that happens after a colonoscopy that I need to know about for the future? Something requiring a coach/partner?

It kind of reminded me of potty training my daughter - she got number 1 easy but number 2 required much hand holding - there was definitely a fear factor going on. Thank goodness when she finally conquered the fear there was no going back. But this is an adult GI clinic, not a pediatric behavior clinic.

I guess I'll never know. Maybe it's better if I don't.

Reinvention

2011-01-27T21:34:00.004-06:00

That is what you get to do, when you leave your old life behind. Start over! When I go to Hawaii for a CME (continuing medical education) conference in a couple of weeks, that's the plan.

I'm staying at a resort on the best beach on the Big Island, right on South Kohala coast, which is where the conference is located. But the wonderful thing about this conference is that it only lasts 1/2 a day each day, leaving plenty of time for exploration.

I booked two adventure tours earlier this week. Both require hiking shoes, jeans, warm pullovers, parkas, and gloves. I know you're thinking, "Didn't she say she was going to Hawaii?" And yes, I'm bringing some bathing suits for lounging and snorkeling, but the adventures require warm clothing.

First off, Kilaueau Caverns of Fire. I was so excited, sitting at the GI office scope the other day, when my phone rang. I answered, "Hello?" and they said, "This is the Caverns of Fire, returning your phone call." How cool is it to get a phone call from the Caverns of Fire? They consist of a cavernous basement underneath the world's largest active volcano, and if you are feeling adventurous, like me, you can book the three hour spelunking tour, exploring the caverns and lava tubes with a miners hat. I didn't even know that lava tubes existed (thanks, Fodor's)! In addition to conventional cave formations, lava tubes boast lavacicles, pictured above. I've heard of stalactites and stalagmites - both of which I will also see in the 500-700 year old lava tubes and caverns, but never lavacicles. Spell check doesn't even recognize that.

When I was talking to the guide on the phone, he recommended the lava flow nearby at nighttime. I inquired as to what it was, and after he learned that I would be two hours from my hotel, he said, "You may not want to do the lava flow - you won't get in until after midnight." The lava flow is an area where active lava flows into the ocean, best observed at sunset. I agreed with him sagely and responsibly then hung up the phone and shook my head. 7 a.m meeting or no, when the hell am I ever going to get a chance again to see lava flowing into the ocean? It's kind of a no brainer. It's been a while, but I've been known to party all night, and I'm thinking lava flowing into the ocean is a much better reason to stay up late than drinking too many beers. I'll be loading up on Kona coffee for that experience.

The second adventure involves traveling with a group to the top of the "white mountain," Mauna Key, where snow falls year round. Temperatures average 30 degrees, and it is often windy. The mountain houses the world's largest astronomical observatory, reputedly the best place on Earth for viewing the night sky. Tough to get to by rental car, so I booked a tour that provides travel, hot cocoa, dinner, gloves, and jackets. Sunset on the summit followed by a trip to the observatory, which houses fancy telescopes that are hands off for the lay public. There is also an amateur room with dummy scopes and nightly stargazing sessions. The unique atmosphere promises clear skies year round to see galaxies at the edge of the universe. Space geek utopia, I'm thinking.

So in addition to boning up on breast and thyroid pathology (I'll search for hot science guys and cabana boys in my copious spare time), I'm plotting a reinvention. Promised my kids I'd bring them back some lava. Shouldn't be too hard to keep that one.

Amnesty Hour

2011-01-24T22:14:00.000-06:00

Read it, if you want over at MiM.

Small Suspicious Minds

2011-01-21T22:55:00.004-06:00

I received a call at around 3:00 in the afternoon.

"Dr. N, Dr. M wants to send a patient over for a parotid needle. Is that OK?"

Normally, it takes a couple of hours for a patient to come over from a clinic and check in to the hospital for a needle. "You had better OK it with the call person, in case it runs late."

She called me back a couple of minutes later. "I've scheduled it for 9:00 tomorrow morning."

The next morning, while I was triaging cases, the tech came into my office. "I've consented the patient. She is ready in fast-track room 27. Come when you are ready."

I finished my tray and headed to the ED. Typed my physician code into the keypad to gain entrance into the ED. Fast track doesn't get moving until around 11:00 a.m., so all was quiet and dark. I walked into room 27. My patient was sitting on the hospital bed - a 60 plus year old woman. Her companion sat in a chair by the bed. He was husky, not obese - dressed in a khaki hunting jacket. Despite his age, he still had a full head of hair and a stylish beard. The hair was slicked up with grease in a style better suited to the 1950's. As I walked across the room to introduce myself to the patient, he stated in a gruff manor, "Huh. I wasn't expecting a woman."

I glanced over at him to see if he was joking. He wasn't, and reiterated his previous statement with emphasis. "Nope, I really wasn't thinking you would be a woman." I crossed over to the counter to check the consents, and said lightly, "Well, what exactly were you expecting?"

"Not a woman."

I resisted my urge to tell him that this was his lucky day. Instead, I introduced myself to the patient and listened to her story, about the nodule on her parotid. It had been there for about a year and despite being treated with multiple bouts of antibiotics for a recent bout of pneumonia, it had grown a little in size. Her PCP wasn't worried about it, but she was. I usually introduce myself to my patient's companions, but his gruff manor had put me off, so I wasn't sure if this was a friend or husband. Neither person acknowledged each other's existence during the procedure, so I assumed they had been married for a long time.

The small knot on the right side of her face was mobile, which was a good sign. As I steadied the needle in the gun, her male companion asked, "So are you a foreigner?"

Had my distinctly Southern accent thrown him off? I answered, "Well, in fact I was born at UAMS."

"So does that mean you are a foreigner?"

He had me confused. He wasn't smiling, he wasn't flirting, he was dead serious. I asked, "What exactly is your definition of a foreigner?"

"You know, someone born in India, or China, who is practicing medicine here in U.S.A."

Every bone in my body was itching to engage him in heated discussion, but the rational part of me knew it would end badly. So I said, "I was born in Arkansas. I've lived here my whole life."

"So how do you pronounce that foreign name?"

"Oh! Well, it is Norweigan. Like I've told everyone my whole life, I live in a nest and I'm rude. That's how you pronounce it."

He wondered aloud, "Are you really rude?"

I looked at him and smiled. "No, I'm not at all rude." Nothing like you, I thought to myself.

I stabilized the mass in front of my patient's ear, and hit it on the first stick. It was cystic, so I was able to reduce it to almost nothing, draining the fluid into the syringe. The tech prepared the fluid for me to look at under the scope. Nothing surprising, nothing alarming. Mr. anti-woman/foreigner walked over to my scope and stood next to me during my evaluation.

"So are you like CSI? I watch that show. This looks like CSI."

"As a matter of fact, yes. Would you like to look in the scope?"

I adjusted the eyepiece for him. He was in complete awe. "What is this stuff that looks like hair?"

I told him, "It's not hair, just degenerated cellular material. But I don't see anything bad, which is a good sign."

His female companion was ecstatic that I had reduced her year-long lesion to almost nothing, and the tech escorted them both to the ED exit. When he returned to the room, we both laughed - a long awaited catharsis to a very strange experience. I read about these people - but never think they really exist. Or that I will ever encounter them. Guess I am wrong.

High Level Conspiracy

2011-01-18T22:37:00.001-06:00

Read it, if you want, over at MiM.

Moving On

2011-01-13T22:01:00.006-06:00

Life is so weird.

It takes you on all these incredible tangents - highs and lows. Ups and downs.

I'm coming to the conclusion that certain things happen for a reason. Connections, real or imaginary, are made just to pull you out of your miserable status quo. And maybe that's the reason? For the connection? To drag you out of your stupor, make you face your own demons and conquer them so you can move on. Attention is a powerful motivator, especially when you aren't getting any.

But at some point, I've got to stop Waiting for Godot. It gets a little ridiculous. I'm relatively young, and single, and the ex has been dating for months, so I suppose it's time for me to take the plunge.

But how? My sis tells me I need to get professional photos taken and join a computer dating website. I can't tell you how much the idea of this fills me with nausea. E-harmony? Blech. My stylist told me today about a website that advertises to married couples, claiming confidentiality and promising a marital tryst ("To restore and revitalize your own marriage!") within six months or your money back. It's real. She investigated it. Sounds pretty disgusting to me.

I'm planning a trip to the Big Island of Hawaii next month - good reason to shed those holiday pounds (that I really didn't gain) and stay on the treadmill. So I look good. For myself, right? My friend Trish tells me I need to find a Hot Hawaiian Surfer Dude and have a fling. I'm not really sure how to do that. Another friend encouraged me to have a tryst with a cabana boy. While I have a vague idea of what a cabana boy is, I wanted specifics, so I googled it. Wikipedia says this,

A cabana boy is a male attendant (boy in this sense) performing 'personal services' to the guests of a hotel or a large private estate, operating from a nearby cabaña (American Spanish for cabin; compare cabin boy), notably on a beach. A pool boy performs the same duties at a swimming pool. Cabana boys are typically viewed as scantily clad attractive young men who cater to their clients' every whim.

Sounds pretty good, right? If they really exist. I've been doing more research on green sand beaches and underground volcanoes than cabana boys, but I guess if one comes along, I might be game. My own little week long Eat, Pray, Love - no wait, I hated that book - more like Drink, Play, F$#&. I'm not sure how these guys writing the books can swing three months and stay gainfully employed. I'm going to have to cram it all into one week.

Last fall after the divorce, to my own personal surprise, the old self-esteem sank to guttural levels. Not that it really ever wanders far from the gutter, but I had a glimmer of hope. Which was dashed.

The New Year brings it back. As the old saying goes, time heals all wounds. I am happy on my own, and am dying for something new, but also dreading complications that it might bring. So maybe I'll just hang out here for a while and see what happens. Here's hoping that a heavily tattooed, singularly empathic guy materializes (No I don't, Yes I do have one in mind). I could use a little company, right about now.

Bad Weather Driving Music

2011-01-12T21:46:00.003-06:00

See, Ramona, It Really Is My Fault. I Always Get Lost.

2011-01-10T21:54:00.007-06:00

The kids and I set off for Mount Magazine early Saturday morning. Well, not so early - we slept in until 8:30 and grabbed breakfast on the road after running a couple of errands. The person I booked the suite with gave me directions and told me it would take two hours to get there. Above all, I was admonished not to use my GPS - she told me countless families have been hopelessly lost trying to find the resort by GPS. Her directions seemed simple enough for even me to follow, so I wasn't worried.

We set out west on Highway 10 around 10:30 a.m. - putting us at the resort in plenty of time to hike a short trail and relax around the room before enjoying the indoor pool, restaurant, and arcade. The kids and I got lost playing the alphabet game, 10 guesses, and singing at the top of our lungs. I became briefly worried when I crossed back over I-40 headed to Morrilton, but stuffed it and kept on driving. About 2.5 hours into the trip, I became more worried when I reached Clinton. Wasn't Clinton the town that we stopped at on the way to Blanchard Springs last Spring? Wasn't the mountain supposed to be in the Southwest corner of the state? I decided to stop at a gas station and ask for directions.

It was a bad sign when not one of the 15 people at the gas station had heard of Mount Magazine, except for one older man that said, "Isn't that Southwest?" I went back to the car and called my dad. He got off the phone with me to research for 10 minutes, and when he called back, I was already back on the road headed in the opposite direction.

"Giz, I think you need to take 65 South back to Conway. Then head to Russellville on I-40, and take 7 from there." He went on until I said, "Well, Dad, I'm already back on the road, and you seem to have a lot of instructions. Can I just call you when I get to Russellville?"

"Sure, I'll have my phone on and I'll help you from there."

"Most importantly, how far out am I? How much longer until we get there?"

"About 2.5 hours."

Ugghh. Well, I might have made it in 5 hours if I didn't get a ticket for going 63 mph in a speed zone in Damascus (Sorry officer, I was a little heavy-footed and distracted by the stress of finding out I was 2 hours lost from my weekend destination - "It's OK - you haven't had any moving violations in over 8 years - after you pay this ticket I'll recommend you for probation.") and if the kids and I didn't need a 30 minute food/leg stretch break in Russellville. We finally made it to Mount Magazine at 4, and despite much whining from Cecelia about me being the worst trip planner on the planet and her having a worse Saturday than if she had been in school (really, C? A road trip is worse than school? She is such a drama queen), we had a blast. She entertained everyone we met with my asinine direction radar, and a lodge worker helped me discover my error - Hwy 10 and 9 briefly converge and instead of noticing that I had to turn to stay on 10, I kept heading North on 9. An honest mistake, I thought, given that our storytelling in the car had evolved to caves, flying foxes, talking mice, and purple penguins. How can you pay attention to road signs with all that going on?

The indoor pool was amazing - it seemed to be under a glass chapel in the sky, and we played until our eyes were so red we looked like vampires. After dinner, Cecelia declared our chosen dessert - Chocolate Confusion Cake - the best thing she ever tasted on the planet. It was a layer of chocolate cake, chocolate mousse, chocolate brownie, chocolate syrup, chocolate icing, and baby chocolate chips - we polished the entire slice off quickly with two scoops of vanilla ice cream, and giddily pretended to be launched into a state of perpetual confusion for the rest of the night. We had the arcade to ourselves and played air hockey tournaments until 10:00 p.m. - C quickly mastered the "mom's distracted by Jack so I can slip in a goal" maneuver and kicked my butt two times. We finished off the night with spooky bedtime stories and I was the last to fall asleep by only a minute or two. I was long forgiven for my gross direction error, and you know how the way back from a trip always seems a lot shorter than the way there? Well, that was exacerbated 10-fold, in this instance. After a hearty breakfast and a quick trip to the gift shop, we were home by a little after noon to wait for the impending snow storm.

I can't wait to book a room for the butterfly festival. C told me she dreamt of sharing Chocolate Confusion Cake with her second grade teacher. "Mom, I gave her a bite, and she tasted it, and she said it was so wonderful." A sure sign of a great dessert - one that permeates your dreams and is shared with your loved ones. See Ramona? It's not just Oklahoma. It's me. I always get lost. Take it or leave it - it's always an adventure. I spent an hour tonight planning the next one.

Death by Chocolate

2011-01-06T22:19:00.003-06:00

I discovered this song on an album that my partner Rex gave me for Christmas. The cover, with his jazz trio in the background, is amazing. Kasie Lunsford is the cover artist, and you can find it over at his studio Infrared Records.

Unfortunately, I can only link to a store where you can buy it. It is worth the purchase. They also cover John Lennon and Paul McCartney, Natalie Merchant, and Pat Benetar. Her voice plays so many tricks it is impossible to follow. I found the original artist on youtube.

It's pretty cool how a song can make you remember when you felt. Tears on the nursery floor. Panic attacks in the middle of the night. Granted, it was a long time ago, but still. Good to be reminded. Maybe someday it will come back, only not quite so painfully. If I could sing to that old person, it might go something like the above. Music is truly the best gift on the planet.

Absence Makes the Heart Grow Fonder

2011-01-04T22:28:00.005-06:00

Hmmm. What does this old tried-and-true saying bring to mind, these days? Cheese dip. Red wine. Massages. Oh, and Mount Magazine.

It's been about 20 years since I've been to Mount Magazine. My college boyfriend Snake's dad had an old dilapidated cabin in the middle of nowhere. We would bring a tent for the front yard, since the cabin was only fit for twilight wanderings to get your creep on. It was teeming with insects, arachnids, and forest vermin. My favorite part of those weekends in the mountain weren't the dinners cooked by bonfire - I remember fondly learning to shoot a gun.

Snake usually brought along a .22 rifle and a .20 gauge shotgun. The .20 gauge had a little too much kick for my taste, but I enjoyed sighting the soda cans he set up on a log far away with his .22 rifle. He was a little more than peeved that I was a much better soda can marksman than he was, despite my novice status. I was secretly pleased. Despite the fact that my ex hoards a large number of guns in a gun safe, I never shot another gun in my 13 years of marriage. Not that I remember, anyway.

Wait, that was Mount Nebo. Not Mount Magazine. But I think they are in the same vicinity. So I am ecstatic to take my kids to Mount Magazine this weekend - I booked a King suite with a fireplace and two balconies - my partner assures me it is as good as any five star resort. The kids and I are pretty fired up about the indoor pool and the arcade that boasts air hockey. "Mom, what is air hockey?" I can't wait to show them.

Happy New Year - have I said that yet? It goes without saying. This year has got to be better than the last - a giant head f$%# of a year. I'm flying high off of a challenging call weekend with an unprecedented amount of difficult medical marrows. I stopped a radiologist in the parking lot last night and accused him of dragging patients off the street. He is older than me, and has a lot more holiday calls under his belt. Still, he remarked, "That was one of the worst calls I have ever had."

I took the kids back early Sat. so my ex could go hunting, so they had to trek up to work with me on Sunday to look at a couple of cases. They were over the moon.

"Mom, we get to go to your office? We love your office!"

They don't go that often, so I wandered into the lab and introduced them to one of my favorite techs. We headed to the doctor's lounge where there was one chocolate doughnut left - we also loaded up on Frosted Flakes, 2% milk, and juice from the fridge. I promised them if they were quiet while I looked at the stains from a lymphoma case and did a wet read on a bone marrow aspirate, then calling a clinician to give them results, that I had a surprise in store.

A couple of months ago I went to a science area in a kids store and found five microscope slides of an ant, a honeybee mouth, a planaria, a cross section of an earthworm, and I forget the others. I had been storing them next to my computer for an opportune moment, which was Sunday. I made them guess what they were looking at, and although C cheated since she could read the slide label, I was pleasantly surprised that Jack guessed the ant. I filled them with facts.

"Did you know a planaria can be cut into infinitely small pieces and regenerate fully? Meaning it can grow back from a tiny bit of itself?"

"Mom, I love the planaria the most. It is so pretty."

"Those eyespots are called ocelli. Can you imagine if someone cut off your fingers and voila! A new Cecelia was born?"

"Would it be another Cecelia with my exact personality?"

"Not possible, I think. You are one of a kind. It might look like you, but it would have to forage it's own mindset."

"Oh. That's good, I guess."

Then she went on to creating her own pathology notepads from mine - she crossed off my name and wrote below it, "Cecelia Ann Schneider, M.D." She stapled her work together and took it home. Meanwhile, Jack was busily decorating my notepads with my favorite blue highlighter. I have his work pinned up on my bulletin board full of kid art and normal values.

Yup, absence really does make the heart grow fonder. I missed the hell out of my kids last week and was glad to have four books (I recommend Little Bee by Chris Cleave, Inherent Vice by Thomas Pynchon, and Homer and Langley by E.L. Doctorow - and I won't mention the other because if you don't have anything nice to say don't say it, right???) to read at night and lots of work to keep me busy all week and weekend. The kids and I are counting down the days to the lodge. I hope to plan many more outings in the new year, to keep us all occupied. An idle mind is the devil's workshop. I enjoyed this call so much that I don't think I'll give up any more for the rest of the year.

Merry Christmas

2010-12-24T22:52:00.005-06:00

I'm pretty proud of my grandma Loretta a.k.a Rett for this one. There's Uncle Tom, Aunt Sheeran, Dad, and Uncle Chuck. Aunt Peggy must not have been born yet. Pretty amazing Christmas card, don't you think?

Mom, Dad, and brother Mike recently collaborated to get thousands of pictures and documents scanned onto a disc. Some of the letters from my Dad to his family when he was away at Boy Scout camp got me all teary.

Christmas brunch casserole in fridge. Kids almost asleep. Time to wait for Santa. Jack asked me to wear a necklace he made for me out of magnetic buckeyballs (sp?) and wait on the couch for Santa Claus to come down the chimney. I asked him why, and he said, "So Santa Claus will want to marry you. You look so pretty." Ha! Can you imagine scoring Santa for a stepdad? Keep dreaming, Jack.

Merry Christmas.

Christmas Eve Eve

2010-12-23T21:38:00.011-06:00

I just finished wrapping all my adult gifts - insert gift card into sack, fluff tissue paper - and am waiting for my night owl Cecelia to fall asleep. She is singing her favorite doll Pippi to sleep, and I hope she finishes soon so the "elves" can start wrapping kid gifts. I've got a huge buzz off of one glass of Cabernet - it's been a while so I'd better slow down if I'm going to outlast the nocturnal one.

Got my Christmas cards in the mail yesterday and addressed for 2 1/2 hours last night - oops! I only got 100 this year and for the first time in about five years I ran out. Oh well. Here are some pics that made the cut. Cecelia dubbed Jack the candy cane alien in the last one.

Despite a busy work week, and rolling into a big week of call starting Monday night, it's been a great holiday so far. One of the keys to surviving a week without kids over the holidays (next week for me), I think, is a batch of books from B&N, half of which I've already read. I plan to post a list with one word book reviews when I'm done, hopefully by next weekend. And lots of exercise, to balance out the already plentiful over indulgences (red velvet brownies with homemade cream cheese icing, gingerbread cookies, annual giant sack of homemade treats from the billing office, boxes of chocolates from friends, Dad's homemade toffee, peppermint bark, etc. etc.).

I had a blast today gifting my partners with soap. It's not just any soap, it looks like bacteria growing on a petri dish. My brother and his wife Effie sent some to me for my birthday, and if it wasn't for those two dishes of bacteria soap I would not have been very clean for the first week or so after my move in September - it took me about a week to locate the master bathroom box. I attached a typed greeting assuring my partners that if they received Klebsiella pneumonia, it meant that I thought they drank too much at the Christmas party last Friday (Klebsiella is the bug that alcoholics tend to get when they aspirate). Dr. Woods got E.Coli (or was it Salmonella?) with a special treatment - after all, I am the Director of the Micro lab so I have special micro treatment powers. He won't be needing his rocket blaster enema for a while (hee hee). My partner Michelle was ecstatic to receive Pseudomonas aeruginosa, which carries its real life characteristic "grape-like" smell. "I was hoping to get Pseudomonas, and I was so happy when I did!" God, we are such nerds. The transcriptionists were not nearly as excited about the soap as we all were ("Um, so what?). Here is an example - the E. Coli smells like honey - one of my favorites! You can find it on Etsy - just google cleaner science. They even have glow in the dark bacterial soap. No, I was not paid for this, I just think they are really cool. They are so life-like - as one partner pointed out, there are even divots in the agar simulating inoculation by the loop (he would use golf terminology).

Those that I worried would not appreciate the petri dish soap got food - sesame almond and rosemary snack mixes. I made sure to stick around until flow cytometry opened theirs so I could have a big handful. The buzz I got off running around gifting today topped the one I am currently experiencing from my glass of Cabernet. I love Christmas!

Hope you are having a fabulous holiday.

New Office

2010-12-17T22:23:00.003-06:00

About a year and a half ago, I was told that I needed to move out of my office. The hospital is doing a staged, multi-gazillion dollar Emergency Department remodel - and my tiny corner office is slated to become a small portion of the new lab storage closet. The ED has been slowly taking over the pathology lab for the past couple of years - toxicology has moved away, the lab break room is shrinking. I've seen the pictures - the new ED is going to be incredible. A sharp contrast to our 1950's hospital lab decor, but after all, the ED is the gateway to the public, so that is where we as a hospital need to shine. The lab is never seen, so updating our environment is not a priority. Last December, I was visited by various men in suits and construction outfits, informing me in serious tones that the move was imminent.

Back in September, nine months after this hushed meeting, the men returned.

"A major contract decision was finally reached. You will probably move sometime this month. Things are going to start moving quickly now."

Luckily, they planned to build me an office before kicking me out of mine. I had several meetings with a bigwig hospital architect - picking colors of walls, floors, and desktop formica. We decided how we were going to reconvene my current desk furniture into a new longer but narrower space. They were taking up a portion of the lab test draw waiting area, an area that currently becomes fast-track ED waiting in the late afternoon/early evening. I hoped that the walls would be thick enough to block out sound. It gets kind of loud and crazy in there.

As construction began about six weeks ago, my new office became the buzz of our small pathology world. Asbestos removal necessitated an outer wall to be built around the construction, and eventually the next door office, housing part-time pathologists like jazz pianist extraordinaire Rex Bell, was evacuated. Then the procedure room, where we perform all of our fine needle aspiration biopsies (FNAs). Procedures were turfed to the fast-track ED, which is not too far away. The pathologist performing the procedures, and cytotechs assisting, were not too miffed - after all the new rooms were much more modern clinical spaces and God forbid someone actually having a medical emergency while we were sticking a 25 gauge needle into their lump or bump - well, we would have back-up help. Not that any patient has ever done anything beyond fainting, but still. As one of my senior partners says, the last doctor you want to run into if you have an actual bona fide medical emergency is a pathologist. Shortness of breath? Get a thoracic surgeon to do a VATS and we'll take a gander at the lung wedge under our scope. GI bleed? Grab the gastroenterologist and well look at whatever he finds in his endoscope. But after a few years of living inside our microscopes we are helpless at clinical-decision making beyond common sense.

About a week and a half ago, construction abruptly halted. I was summoned one morning by one of the lab administrators. Apparently, word came down from high that my new office plan was unacceptable, for reasons which I can only guess at. It was aesthetically awkward, but that doesn't seem to stop hospital construction historically. I think maybe they needed that space for ED waiting - that cutting the waiting area even 1/3 was not ideal, since the new ED might not be ready for a couple of years. My half constructed office is now planned to be torn down, the waiting area will be remodeled, and I will move to the procedure room - since we have been doing our FNA's fine for a few weeks in the ED, we will permanently shift there.

I hope they plan to remodel the procedure room, but I'll likely not hear until at least after the holidays. It is a very small space lined on one wall by ancient metal drawers and cabinets with glass doors. The walls are cinder blocks painted aged ivory. There is an old leather clinical chair bolted into the floor in the middle of the room - reminiscent of a piece in a torture or death chamber. It can be manipulated electronically but only the most seasoned cytotechs understand the cryptic levers and buttons involved in making the patient "more comfortable." I'm always afraid if I touch them I'll send the patient through the apparently asbestos-laden panels in the ceiling.

That was the hot topic of conversation at our lab Christmas party tonight - with the Rex Bell Jazz trio playing in the background and the beautiful cardiologist nurse crooning in the marble foyer of my beautiful Hispanic partner - part-tiger, part-ballerina's home. I planned to wait until my new office was completed until I blogged about it but hell, its already been over a year and who knows when it will be done. I told someone tonight that in January, they could probably open the old procedure room door and find me sitting in the torture chair with my scope on my lap, signing out cases.

Walking in Place

2010-12-14T23:33:00.002-06:00

Big little brother Matt is back in town, and this is good because:

1) I finally have a date. Hung out with him and six of his friends tonight -- a night filled with spirits and merriment.

2) I get to indulge in my jam band side. He sent me a video he was addicted to during his law school finals last week.

The holidays have officially started. They'll hit their full groove when culinary brother Mike arrives this weekend with his fabulous sensory scientist wife Effie. I'm almost done with my Christmas shopping, and my toes are a beautiful gunmetal silver with sparkles. All set for three Christmas parties this weekend. Life doesn't get much better than this.

I hope you still smile when you're singing.

Walking the Line

2010-12-13T14:30:00.000-06:00

Posted at MiM.

Sing Me To Sleep

2010-12-09T23:10:00.001-06:00

Employee Phone Call - Don't Mess With This Guy's Dog

2010-12-06T22:39:00.003-06:00

As heard by me, while I was looking at a prostate around 11:00 a.m.

"I can't really talk about this right now, I'm at work. I don't want to start yelling." This was the only normal, somewhat discreet statement in the entire hallway phone conversation.

"Don't you dare go mess with my dog, woman! You have no business going over to my house, and you cannot mess with my dog. That's my dog!"

"He has bad hair, that's all. He's got food and water, he's fine. Don't you go near him."

"What? You'd better not! Like hell! I'll call the FBI - you just think you have methamphetamine problems now, you wait, you, I'll call the law on you!"

"Don't. Mess! With! My! Dog!"

"You will not. I'll take care of your son, if you mess with my dog. That 35 year old lazy good for nothing - I'll take care of him, you wait and see. I'll take care of him for good, if you mess with my dog."

His voice faded as he exited the building. I was glad I didn't recognize it.

Meeting Baby Beckett

2010-12-05T21:06:00.004-06:00

It has been a long time since I've been around a baby.

My best friend from medical school, Lys, delivered her second child, a son, 2 1/2 weeks ago. Her daughter Ainsley is 3 1/2 years old. I was ecstatic to plan a trip to Jonesboro this past weekend to meet him. Since I didn't have the kids, I was able to focus on her family, which was a luxury.

I spent the week picking out gifts for them all - a soft camel jacket with satin lining and a reindeer hood for Beckett, a stuffed Santa with a rainbow cap and candy glitter buttons for Ainsley, a long hammered gold necklace with variably sized chained hoops for Lys, and barley wine for Chris. I didn't even know it was called barley wine, but spent some time researching to try to find a good one - I remembered that he was well stocked. He gave me a lesson in hops on Saturday night - most of which went right over my head, but as I tasted some of his favorites, I began to glean a small understanding.

Lys looked amazing for having just delivered two weeks ago - her pre-baby jeans were hanging off of her. I laughed and warned her how skinny I got while nursing Jack. She smiled and said, "I couldn't have picked a better time to be nursing and on maternity leave - I am really going to enjoy the holidays this year." It made me remember the massive quantities I could eat while nursing - so many more calories being burned while the body is producing milk. Her husband took charge of the kids for a couple of hours Saturday night so we could enjoy Indian dinner solo, then drinks and dessert at a local restaurant/bar. I laughed watching her pack back enormous amounts of chicken vindaloo and enough naan to feed an army. Today after breakfast we ate lunch at a buffet and she had two giant plates of food - broiled shrimp, deviled eggs, veggies, fried chicken, then a large three egg omelet filled with tomatoes, mushrooms and cheese. Her hunger was rivaled only by her thirst - reminding me of sitting on the couch nursing my own kids and having that constant "I need water NOW!" feeling as if I was in the middle of the Sahara desert.

The kids were adorable. The spring in Ainsley's golden curls competed with her gymnastic legs - she is growing out of her toddler clumsiness and tumbled deftly around the house all weekend. And oh, that baby smell that Beckett exuded filled the house, but was best savored as he snuggled on my shoulder, his head resting right where I could breathe it in like a drug. I read an article in the NYTimes recently about combating bully behavior in early elementary school by having a mother and new baby visit weekly throughout the year so the children could witness and participate in the miracle of the first year of development. There is something about being around babies that brings out the good in all of us, no matter what our age. Chemicals, hormones, emotions, whatever you want to call it - it works.

While Lys and I were at dinner we discussed professional challenges. I had one of the worst days at work on Thursday that I have had in my career, so my planned trip out of town was not only a fun visit, but a much needed refuge. Working in medicine carries enormous weight and responsibility - and although we constantly thrive to do our best, mistakes happen. Even when the mistakes bear no harm to our patients we bang our heads and wonder, in our 20/20 hindsight, how in the hell they could have happened. It shakes your confidence and wrenches your guts and keeps you awake at night when it happens to you. I look around at how different people cope with 15, 20 years of experience - see all the emotional quirks that develop- and wonder how much longer I can keep all of this up and still be sane. Lys is an ophthalmologist, not a pathologist, but she could certainly empathize. When there is a complication surrounding something bearing your name and responsibility, whether or not it was your fault, your head spins into such an amazingly awful place that it threatens your sense of self. Even when you can count hundreds, even thousands of successes, it is the near misses that stand out in your head like a giant flare. I guess, in a way, it is what keeps us all in check, and makes us better at what we do.

As I drove the 2 hour drive home today, anxiously anticipating seeing my own kids and tucking them safely into bed, I listened to some new country and blues that Chris burned for me last night. I felt amazingly refreshed after the weekend in their new baby home. Looked forward to knocking out another couple of hours of SAMs, which I have done, before the new work week starts. There is very little in life that can compete with being nurtured by close friends. I am so lucky.

MOC, SAMs, and CME, Oh My!

2010-12-01T15:08:00.000-06:00

Read it, if you want, over at MiM.

Big River - The Secret Sisters

2010-11-30T22:32:00.002-06:00

I can't stop listening to this song, this month.

Breakfast In Bed (But Better)

2010-11-24T21:50:00.003-06:00

This morning, the kids woke me up at a blissfully late 7:40 a.m. After rolling around in my bed and snuggling for about 20 minutes, Sicily announced, "Mom, you can't get up. Don't come in the kitchen. Stay in bed, I'm doing breakfast today.

"Are you sure?"

"Yes, you can't come in."

"So I can stay in bed for a while?"

"Don't get up until I tell you to."

Hard to argue with that. Jack and I played on the computer for about 15 minutes, but she was still busy in the kitchen.

I yelled from the bedroom, "Can I send Jack in to watch TV? Do I have time to take a shower?"

She called back, "Yes, I think I need Jack's help. You have plenty of time to take a shower."

I wondered what was taking so long - I bought a rare treat, honey buns, for the holiday, and she popped her head in earlier to ask for the 10 second microwave instructions. But I really wanted a shower, so I didn't ask.

I yelled, "You know I don't want a honey bun, right?" Too sweet for me.

"Don't worry, mom, I already knew that."

As I was washing I tortured myself with my thoughts. I texted my babysitter the night before to ask her to come help out with one of the kids for a few hours so I could run errands with the other. I didn't really need help but felt guilty for the lack of work I had provided over the last couple of weeks - she normally picks up my kids from school and takes them to activities or gets them home but I and their father had been able to cover it ourselves. I made up my mind to call and cancel and then told myself I would look stupid for being wishy washy. I was also concerned that both kids would want to go with me and that would be another battle. Oh well, I decided, I would split the time evenly between them. As I climbed out of the shower I called, "Don't turn on the stove unless I am in the kitchen."

Sicily wandered in, "Too late, mom, we've already cooked your eggs. Jack helped me, but now he is mad that I am doing everything and he won't help me cook your cheese toast. How do I work the toaster oven? Which dial do I use? Do I switch the setting from pizza to toast? I am worried that your eggs are getting cold!"

I silently laughed that my seven year old was depending on my five year old to learn how to work the various kitchen appliances. Is this girl vs. guy or personality? He watches everything I do, always wanting to help - he can even run the coffeepot. She could care less if I am making her breakfast or it is materializing out of thin air. Until today. My heart went out to her.

"Don't worry, C - you can always heat up the eggs in the microwave." I explained to her how to work the toaster oven and assured her I would be out as soon as I got dressed. A few minutes later I called, "Can I come out now?"

"Yes, please! The breakfast is ready."

When I walked out the card table we have been using since we moved was decorated with leftover Christmas trinkets we used for making her school Christmas goodie bags the day before. Tiny snowmen, snowflake, and candy cane erasers were adorning the plates. She poured our favorite juices/water into glass cups and each had a candy cane twirly straw in it. My egg and cheese toast were on my plate and she and Jack had warm honey buns on theirs. Baby candy canes were artfully arranged as a centerpiece. She even had their vitamins out. I sat down and gushed over every detail. When I reached for my absent honey she jumped up to get it from the cupboard - telling me not to get up. This was a far cry different from most school mornings when she is lying on the couch moaning over my requests to help put out napkins and forks while I rush to get the cooking done. I was overwhelmed.

I put my fork into my breakfast and noticed the smoked cheese was hiding it's paper separator, which she had accidentally cooked. I said, "Oh! Is this a little present?" She looked down shyly and apologized. I told her it wasn't something I hadn't done myself, and was easily fixed by scraping the cheese off onto the top of the eggs. It didn't change the taste, I added, of the best egg and cheese toast I'd ever had. I asked her what the hardest part of cooking breakfast was, since she made it all look so easy.

"Well, keeping everyone's meal warm enough in the microwave - it was hard to get it all ready and get people to the table on time." I certainly did not have this level of awareness about meal preparation at her age.

Later in the day, after we ran errands - my babysitter had arranged a play date with my son and his old best friend from last year that he hadn't seen in months - she is in nursing school with the mom - so he was over the moon and my anxiously anticipated battle was a non-issue - Sicily and I were making Christmas presents for her dog and her dad. She looked up at me and asked, "What about you, Mom? What do you want for Christmas?"

I smiled at her. "You already got me a Christmas present. One that I'll remember forever."

She looked puzzled. "What are you talking about?"

"Breakfast."

She smiled, clearly pleased with herself. "So now what?"

"How about another round of Old Maid?"

She happily picked up the cards, and we played.

Homecoming Queen

2010-11-19T20:28:00.007-06:00

Read it, if you want, over at MiM.

Old New Music

2010-11-17T22:41:00.002-06:00

Introducing the kids to Van Lear Rose this week. I hadn't listened to it much since 2006. Sicily's favorite song is the album title.

She loves the part where Loretta Lynn says, "You're dreamin' boy, she'll never look your way."

Jack's fave is Portland, Oregon. He calls it the Fizzy song.

I like that he loves it, but worried a little in carpool when he climbed out singing, "And a pitcher to go!!"

Perpetual Motion

2010-11-14T22:36:00.004-06:00

Having a five year old son is a unique experience. His teachers tell me that while capable of great focus and amazingly sweet, my son moves around more than any other five year old they ever knew. Even while sitting at his desk doing work, he will have legs and arms in constant silent movement. At home he is always climbing the kitchen counter tops to help me cook and shimmying up the dangerous outside part of the wrought iron stairwell to the second floor when my back is turned for a second. He is fearless.

On Saturday morning we followed Sicily's requests of making bug cages and hunting for bugs with magnifying glasses. We are reading The Cricket in Times Square by George Selden and she is a little bug crazy - wants her own cricket prodigal musician. I have to hide the chapter books I read her at night now so she won't finish them after I've left - I provide her with popular series tailored toward her age group that she loves but I don't really want to read myself. I followed Jack's fancy for the next half of the day. We recently had an electrician visit our home - I have been out of a bedroom closet light ever since I moved in over a month ago and there were a couple of other light problems. He is the husband of a friend and moonlights at night - so he was around taking apart a light fixture in the kitchen one evening last week while I was preparing dinner and Jack was fascinated. He wanted to learn and experiment about electricity.

We found a highly recommended and awarded electricity kit at a local store, and set to learning about loops and circuits. The kids were both enthralled with creating light and whirring motors with a C battery, rubber bands, alligator clips, and the provided simple motors and bulbs. We even set up a switch with a paper clip and some brads. I tried to extrapolate what we were doing with their life experiences - the train around grandpa and bapcia's Christmas tree, the lights in their rooms, etc. I was pleasantly surprised that the activity held the interest of both my five and seven year old for quite some time, and I think they learned something from it.

Today was a special day I had planned a few weeks ago. Here is a hint:

I know - 40,000 people in my state have seen this over the last two weeks, but I was really excited to take the kids. And pleasantly surprised that they handled the three hour performance rather well. Jack was in his usual state of perpetual motion, which was somewhat challenging, but I was shocked to find my best control tactic over him kicking the seat in front of him over and over or flying his stuffed flying monkey in front of his sister's face was the threat of leaving. He was loving it, even though I was a little challenged trying to keep him focused. As I sat in the balcony, I thought back to my first viewing of this musical in the Orpheum in San Francisco last fall. I was in a front row seat, no squirmy kids or whispered questions about the plot. All in all, I enjoyed this second performance much better.

Another Blond Moment

2010-11-09T22:06:00.004-06:00

I had 45 minutes to kill today before a 4:00 section meeting, and was looking for an excuse to have an "outside classroom" in the beautiful 74 degree November weather. As the head of the microbiology department, I have to sign off on 15-20 procedure manuals every year before December 31st. Last year I waited until December 20th to begin my review, and I decided to get a little head start this year so I wouldn't be so rushed. I wandered back to micro, and found the lab supervisor.

"Nothing to big or heavy. Just a couple of small ones that I can start to go through in a half hour or so."

She said, "Bioterrorism isn't too big. Here, take it, and this one too."

She handed me two identical small black three ring binders, which I assumed were both bioterrorism. Many manuals contain so much material that they have a part one and a part two.

I donned my sunglasses, grabbed a bottled water from my fridge, and headed out to a park bench in front of the hospital. After checking my e-mail and my google reader, I opened a notebook. At the top of the page in giant block letters I read:

CHLAMYDIA TRACHOMATIS AND NEISSERIA GONORRHOEAE

Oh my, I thought with alarm. Bioterrorism has changed a lot in the past year. What in the world could this be about? Where was Anthrax, smallpox, and Yersinia Pestis? I had no idea that Chlamydia and Gonorrhea were agents of bioterrorism. How could they be? It was kind of gross to think about. Then I thought to check the spine of the notebook. RAPID TESTING. Bioterrorism was the other folder. Duh.

Maybe I Need to Clarify

2010-11-09T21:21:00.001-06:00

Read it, if you want, over at MiM.

Boob Job

2010-11-08T22:38:00.002-06:00

I was in the office trying to tackle a breast case that had been interrupted over the hour with a CT needle, a visit from dad, and a call from my best friend ophthalmologist in Jonesboro. I should have known it was futile to continue. Dr. Woods, the one I walked down the partner isle with recently, came to the door.

"How's your day?"

"Great for a Monday. Kind of slow. I'm getting a lot done, and I'll probably have time to catch up on some journal reading this afternoon. I have a really cool case I've never seen - a pregnancy leuteoma. It's out for consult, but I'm pretty sure that's what it is. How is yours?"

"Ugh. Four medical livers. Nasty outflow obstruction. But other than that, fine. So do you have a hot date for the weekend?"

I laughed. He's been asking me that every week for the past month. I think he wants to live vicariously, but he's barking up the wrong tree right now. "Nope, no hot dates lined up. Laurie and I saw Hamlet this weekend, and it was wonderful."

"Is that a new shirt?"

"Yes! I got it this weekend." I was shopping at Kohl's for the kids, and I saw some beautiful long john shirts on sale for eight bucks. I bought a dark coral, an ivory, and a cornflower blue. They all have subtle but wonderful bohemian patterns - perfect for fall transition with scrubs. I debated over the medium and large, and decided to go with the large.

"It's kind of big. It drowns you. I think you need tighter shirts. And a boob job. Then the guys would be falling all over you."

I might have been offended if this was coming from anyone other than Dr. Woods, but I just laughed. "So you think I need a boob job? I know people that are happy with them, but I've also heard a lot of horror stories. Cockeyed nipples (I demonstrated with my fingers shaped like errant arrows in front of my chest and now it was his turn to double over). Open ports. Silicone busting. Nope, I think I'll stick with what I've got."

I've had the experience of bigger boobs. Double DD's, when I was nursing. And I can understand why women pay for them. They hypnotize men. I've witnessed it. I remember certain male attendings (I could have guessed which ones before I was nursing) never met me in the eye for months while I was nursing - they just stared at my boobs during every conversation. I felt like I could have asked them to buy me a car instead of when are we going to meet to discuss this autopsy and they would have just smiled and nodded. It was comical. I certainly don't judge anyone who wants one, but it is not for me. I know too many people that regret it, and friends that are naturally endowed are frustrated by the unwanted attention.

There is also a downside. They hurt! Maybe not so much when they aren't swollen with milk, but it is harder to exercise. And they cause lower back pain. To someone who isn't used to having them, they are cumbersome and unwieldy. Plus, and I've never investigated this from a medical standpoint, so I could be way off base, but I worry about nerve damage, during surgery. How that might affect things.

Dr. Woods said, "I've been trying to get my wife to get them, but no dice." I think he was joking, but I replied, "Good for her." She is about the same size as me, and we underdogs have to root for each other.

I put down my glass slide. "C'mon, I hear there are good cookies from that Ed's Bakery in Conway in the break room. Let's go get one."

"Maybe you'll find some guys around the cookies, and you can get a hot date."

I can count on one hand the number of guys I have dated, and still have leftover fingers. I've always attracted a certain overly aggressive type that plows me down with attention, and in retrospect, that's pretty telling considering how the relationships turned out. Nope, I'm not eager to go there again anytime soon.

"You'll be the first to know, I promise."

Madness, Murder, Suicide, Incest, and Ghosts

2010-11-07T21:25:00.003-06:00

I was looking forward to this past weekend for a very long time.

My house is somewhat settled on the ground floor, I didn't have a conference to attend, I wasn't on call (well, I was supposed to be, but I fixed that - remember? I'm a partner now. I can sacrifice a little money for happiness, if someone is willing to take on the work), I didn't have a weekend full of activities for the kids, I wasn't moving. The kids were headed to Fayetteville Friday night with their dad, and I had the weekend to myself.

After a moderately busy week I was looking forward to an evening alone Friday night - take out gyros (yum!), massive project of moving the one hundred addresses I correspond with Christmas cards yearly from paper to laptop, addressing moving announcements, and watching three movies. Yes, I did all of that on Friday night. I stayed up rather late - one thing nice about these weekends alone is reverting back to my high school/college clock - I never started papers or test studying until at least midnight.

The only movie I would recommend, very highly, is Winter's Bone. Just watch it, if you haven't already. I haven't fallen so in love with a heroine since I read The Girl With the Dragon Tattoo series for book club. I would have rented The Girl Who Played With Fire, but subtitles and laptop projects don't go well together, so I decided to save that for later. Luckily the other two movies were mediocre at best, so I got my project done. If they were as good as Winter's Bone, I would have been toast.

Saturday was sinful - laying in bed until almost ten reading/sleeping! I know this may bore people that don't have kids, but believe me, when you are a mom - this just doesn't happen. Unless you get a divorce. Not that I'm an advocate. I was somewhat productive the rest of the day with exercising and running errands and cleaning out/organizing Sicily's closet, not to mention buying frozen mice for poor Spotty who was a few days overdue on his feeding. I was buying time, looking forward to my evening out with my friend Laurie. Who made me a kick-ass CD I haven't quite gotten through yet.

Have you not already guessed what we did based on the title of this blog? Shame on you! Our plans were down to Hamlet vs. 127 Hours. Hamlet won. She saw the Broadway version with Jude Law a couple of years ago, and had read a review where a Wall Street Journalist claimed that this Hamlet, Avery Clark, was better than Jude Law's version. I had seen a picture on Arkansas Blog, and he was pretty hot, maybe even more so than James Franco, so Hamlet won. We had fourth row seats in the center aisle of the Rep. I remember struggling through Hamlet in high school, so I was a bit skeptical, but the three hour show went by in a flash, it was so incredible. I voiced my amazement to Laurie during the intermission - "Wow, I can understand Shakespeare - it is so much better acted well than studied!" She replied, "Yes, this guy makes Shakespeare seem conversational, and funny. Better than Jude Law, I agree."

In a planning phone conversation earlier in the day, Laurie mentioned how much she loved British humor. I said, "Boy, do I have the book for you. Soul Music, by Terri Pratchett." I gave it to her, with the embarrassing admission that I struggled with the humor. I wanted to love it, based on the person who recommended it, but I felt embarrassed and stupid that I plodded through it. I think it is just a British humor thing - you find it funny, or you don't. Monty Python, The Princess Bride - I just don't get the humor. I did laugh a little in places, especially when DEATH gave his drunken speech in the pub and passed out, but overall it sailed right over my head, and jumped around so much I was reeling. I can't wait to get her take on it - I may appreciate it more in retrospect. Having said all that - the first song on Laurie's CD, which I played over and over in the car today, is freaking hilarious. And I think he is British. So please don't give up on me, you know who you are.

After Hamlet Laurie and I had a midnight dinner at Ferneau - fried calamari, ahi tuna nachos, wine, fruit and cheese. It was decadent, and there is no better place to people watch while discussing Hamlet on a late night out. We agreed that Ophelia was a little stale - I remarked that she seemed the same sane as she was mad. Laurie said, "Yeah, she just looked a little more disheveled." Polonius was incredible. Claudius, who doubled as King Hamlet's ghost was good, but his occasionally muted voice made me lose a little of the text. Hamlet was a pleasure to watch - both visually and with his interpretation. Laurie told me, "Yes, he was hot, but gay don't you think?" I was shocked. "What, do you really think he is gay? Surely not." I remembered back to the spring where I went to a concert and thought a bevy of guys talking to my friend and I were gay, and I was dead wrong. I thought I was good at that sort of thing, but maybe I'm not. Marriage and the passage of time has ruined my radar. "You might be right," she conceded, but she left me questioning my judgement.

This morning was another lazy one - in bed late late late especially when you consider the whole fall back thing. Took my mother-in-law to a long overdue brunch (can I still call her this? What do I call her now? The semantics of family after divorce are really strange), grocery shopped, and finished the last of the book I was reading this week - "The Last True Story I'll Ever Tell" by John Crawford - in the gorgeous 68 degree weather down by the river. There's another weekend recommendation for you - a very readable and fascinating account of a soldier in the Iraqi War. I hate war stories in general, but each chapter told an isolated story of his year long stint. The dream vs. reality of his return home was heart-wrenching. He is no longer affiliated with the U.S. government.

I was so happy to see my kids at 5:00! Cooked Italian and then we vegged out on the couch with YouTube. They took turns suggesting searches. "The scariest thing in the world! The biggest snake on the planet!" and I happily obliged. When Jack got to a certain search, I almost fell over laughing at the result. He wanted "The scariest surprised fattest thing in the world." I told him that was a pretty detailed but general search and we might not get anything. Here's what came up.

I have to agree with YouTube on that one. The kids were cracking up at the video - we could only tolerate the first minute.

Hope everyone reading had a wonderful weekend.

Questioning Eyebrows

2010-11-04T11:46:00.002-05:00

I love this cover of The Magnetic Fields song. But where oh where are the Pine Valley Cosmonauts? Definitely better, in my opinion, than Andy Hopkins.

I got a big laugh the other morning when I interrupted Sicily's sing-along and asked her to show me what she thought "questioning eyebrows" look like. We've been experimenting showing emotions through eyebrows all week long during our short morning carpool. I love Jack's "surprised eyebrows."

My favorite line in the song is, "I see that kiss me pucker forming, but maybe you should plug it with a beer."

Don't Believe That You're Someone

2010-11-03T22:41:00.002-05:00

0:00-2:28

My Special Friend

2010-11-01T21:45:00.002-05:00

A few weeks back, at dinner with the kids, Sicily was being especially intolerable. She was mad about something, and nothing I could say or do would make it right. Despite my efforts, she was determined to get a rise out of me.

"Mom, that thing on your chin. What is it called? It's so BIG."

"It's called a mole, Sicily."

She looked at me with a wicked gleam in her eye.

"Is it your special friend?"

I was a bit taken aback, but decided not to let it show.

"As a matter of fact it is." I began to stroke it lovingly. "At night after you and Jack go to sleep, I talk to it about my day and my problems. It is my most special friend."

The look of barely veiled horror and surprise on her face was priceless. "Aw, come on Mom, you're kidding, right?" I loved that she had to ask.

"Of course I'm not kidding. You just hurt it's feelings. I'm going to have to spend some extra time with it tonight."

"You don't really talk to that thing, do you?"

The next morning in the carpool line, she was sulking over being reprimanded for goading her brother. I tried to think of a way to cheer her up before she left the car for her school day. I caught her eye in the rear view mirror and started rubbing my mole. She broke into a fit of giggles.

"You know, Sicily, some people call these things beauty marks. All of the famous models have them. That's what I was telling my special friend last night to console it."

"Mom! You are crazy. You are teasing me again. A what? A beauty mark? You cannot be serious."

"Shush, Sicily! Don't hurt it's feelings again." I stroked it with exaggerated motions, trying once again to elicit a spontaneous, wonderful smile. Ha. It worked. Still does, if I use it sparingly.

Happy Halloween

2010-10-30T21:54:00.004-05:00

Annual Visit to the Crime Lab

2010-10-29T21:42:00.004-05:00

I won't apologize for my dearth of posts lately, but let's just say that the events of last month have completely undermined my immune system and I'm still fighting off two weeks of sinus/URI crud that the kids are bringing home. I paint a pretty picture, but life is not easy right now. But the not fun stuff isn't fun to dwell on.

I was off this past week and despite lofty goals to organize all the boxes and mess upstairs, there are still lots of boxes and a big mess upstairs (but our living area downstairs looks fabulous!). Soccer games, Halloween parades, Halloween parties at school, and helping Sicily with presentations for Nature Week, coupled with our snake Spotty Dangerous AKA Cosmic Creepers week long visit/tour at the kid's school kept me busy. Not to mention meetings with accountants and financial advisers. I did manage to squeeze in a little fun - I revisited my old (well at least for a month) residency stomping grounds - the State Crime Lab.

I spent April of 2006 at the Crime Lab - becoming acquainted with the blowflies surrounding the bodies that met their ends by nefarious means. There was a rash of crime that month - it was covered all over the evening news - so I had copious learning opportunities. Unfortunately, I was trying to cram in studying for my combined AP/CP boards in June, so I largely neglected everything but the bare essentials of performing the autopsies in the morning so I could sprawl out on the warm Spring lawn and study all afternoon. The building and grounds are beautiful, and while I would have rather been immersing myself in the fascinating study of Forensic pathology than Blood Bank and Chemistry, the proportion of Forensics on the general boards is so slight that it would not have been prudent at the time. I stopped nursing my son in early February of that year, and his demands at night coupled with daily residency demands made studying absolutely impossible, so I had a lot of catching up to do.

But it's never too late to pursue sideline passions, so I like to check in with those guys yearly. I was especially excited to go this year because one of my fellow trainees, he was a year behind me, finished his Forensic Fellowship in Alabama in June and joined the staff at our State Crime Lab this past July. I feel like I have an inside connection now. This guy isn't just one of my former attendings - he's someone I sat alongside in excruciating morning conferences being pimped, and he had a propensity for party throwing so I've spent time sharing crawfish and beer with him at his abode. When he greeted me at the locked entrance after I signed in and got a visitor's badge, I felt like I was really in.

We spent a half hour or so catching up on personal life - kids, residency, his wife who is also a doctor, and life after residency. What it was like on the government vs. private side. He just got a new scope (exactly like the one I've got - he even got the free rocket blaster!). I couldn't help admiring his spacious office with the wall of windows - it was much better than my closet in the lab basement. I finally steered the subject into my intended direction - books.

After I had exhausted his library we wandered next door to another pathologist's office and I hungrily scanned the titles while he graciously grabbed post-it's and jotted down titles and authors. Then he said, "So, do you want to see a cool case?" This is the pinnacle of pathology science nerdiness - our sharing cool cases. I grinned, "Yes! Is it the Case of the Week? The COW?" He looked at my friend from residency knowingly. "No, more like Case of the Month. Or maybe the year." I sat down at the scope, briefly encumbered by the stage clips, and apologized as I pushed back his training wheels. A lot of the best pathologists I know use the stage clips religiously, but it's too cumbersome for me - I'd rather fly by my fingers. Mechanical stage lovers argue that we miss stuff in our haste. It's an internal one-upmanship. As I threw the slide on the stage, I balked. It was the heart. I never look at the heart. But the heart isn't really tough to look at - usually you are just looking for the boxcar nuclei of hypertrophy in autopsy or rejection in surgical specimens. None of which would constitute the case of the year.

"I need a hint."

"Focus on the vessels."

"Yikes!"

I'm not sure what is really kosher to reveal, especially in an ongoing Forensics case, so I'll stop there - it's pretty obscure science nerd stuff anyway, but I enjoyed reading an accompanying article in the Journal of Forensic Pathology that illuminated the rare disorder that caused this man's demise - something that I had never heard of in all of my training. My friend, the younger pathologist, expressed his awe. "I'm not sure I would have caught that." It was an amazing find.

I left with hearty handshakes and they promised to think of me when they went to their next Forensics meeting - get me lots of free stuff to read. I can't wait to dip into my CME fund and order some new books. Maybe next time I visit I'll ask to join in on Monday Morning Rounds (they don't work over the weekend - so Monday mornings are pretty exciting). For old time's sake.

There's No Going Back

2010-10-18T22:05:00.005-05:00

I guess this means that at 7, Sicily is officially over princesses. Wait, that happened at age 5.

While I wholeheartedly approve of her costume choice, I can't take any credit. I took her and Jack to the Halloween Express, and after a quick survey of the dizzying array of choices, I offered my guidance. Sicily looked up at me. "Mom, who are the workers? The ones in the orange shirts?"

"Yes, Sicily."

She cornered a perky college-aged orange shirt clad attendant, and proceeded to monopolize her time for thirty minutes while Jack and I looked over his choices. When she was done, I asked her if she wanted to try it on in the dressing room. "No, I'm sure I will look great."

And she does. I love the dainty foot sticking out at the bottom. She hated it - thought it ruined her image, and made me take another picture so it didn't show.

Jack and I had his costume narrowed down to a zombie and a pirate. Sicily said, "No, Jack, you want to be a ninja. See the cool weapons you can get? All the daggers and mom, what do you call those things?"

"Nunchucks, I think."

So Jack chose the ninja.

I have officially lost any semblance of control. It feels great.

Day in the Life of a Single Mother Pathologist On Call

2010-10-14T22:42:00.006-05:00

5:10 a.m. Alarm goes off. Hit snooze.

5:20 a.m. Alarm goes off again. Get up and run.

6:45 a.m. Dressed and ready to wake kids.

7:00 a.m. Prepare breakfast - eggs, cheese toast, waffles - while kids get dressed.

7:30 a.m. Drop kids off at school and head to main hospital.

8:00 a.m. Sip morning coffee and pay bills.

8:45 a.m. Triage first few cases. I should have known it was going to be a day in the trenches when my first three cases were "scrotal mass," "hemorrhoid donut," and "sacral and ischial pressure ulcer." Hemorrhoid donut? I've heard of colon donuts - they are the margins created by the auto anastamosis thingy during surgery - but hemorrhoid donut? Not something I really want to contemplate over my morning coffee.

9:15 a.m. Get text from histo tech at GI site - "I'll have slides ready at 10:00." All 90 blocks. Big day.

9:45 a.m. Head over to GI clinic to sign out cases. Frustratedly troubleshoot computer issues I've been having all week with our drop down diagnosis, web-based sign out which is normally a dream - saves having to dictate - but is causing problems currently. Try not to take out frustrations on the extremely nice and eager new histo tech that I already love. Resolve to surrender to computer and wait until my partner comes back on Monday to help me on the relatively few problem cases.

12:00 p.m. Hit a lull in cases and decide to run to Sears to tackle the tire pressure issue that elicited a warning light I had to look up in my car manual before I walked into work - it's been on all week and I had no idea what it meant.

12:20 p.m. Deliver divorce decree to financial adviser who is splitting my residency retirement $$.

12:45 p.m. Head back to GI clinic and wolf down frozen burger with corn nuts, Planter's chipotle cashews (Yum! Their skinless olive oil and sea salt almonds are also amazing!), and a Coke Zero.

1:00 p.m. Continue GI cases.

3:00 p.m. Run to Barnes & Noble to get a few books in a series Sicily has been begging for.

3:20 p.m. Head back to main hospital to tackle rest of cases there. Learn from partner that he successfully deflected a possible apheresis procedure. I joke with him later in the evening that he jinxed me.

5:00 p.m. Finish cases and start to leave hospital. As I am walking out the door, receive a phone call from a frantic oncologist who warns me of a critically ill transfer that will probably need apheresis. Call hematology and tell them to page me when they get blood work so I can review peripheral smear. Luckily there is a Quinton in place so I don't have to call radiology.

5:15 p.m. Run to house, get Jack's prescription bottle, and call in asthma meds. Rush to pharmacy to pick up asthma meds.

6:00 p.m. Empty dishwasher. Stuff down dinner - microwave nachos with beans and Rotel. Pager goes off halfway through eating.

6:15 p.m. Head back to hospital. Call mom to see if she can meet my kids when their dad drops them off at 7:30 and get them to bed.

6:45 p.m. Shake my head in disbelief as I look at smear. Definitely a procedure tonight. Go to ICU to meet with oncologist, see patient, then back to office to perform calculations necessary for plasma exchange. Call blood bank and dialysis nurse on call. Go back to ICU to complete consult in chart and write orders.

7:45 p.m. Lull. Waiting for blood bank to thaw necessary products for procedure. What to do? Catch up on journals? Nah. Read news. No. Head back to Barnes & Noble to buy mom gift for helping out tonight, knowing I won't be home until late. I really need to buy stock. It's my fourth trip to book stores this week - other two were Wordsworth.

8:30 p.m. Back in blood bank with techs watching dejectedly as some of the FFP busts after thaw (this is common). Jokingly blame tech I have known for many years. Go over to histology to chat with night crew. Call apheresis nurse to ensure that she has completed her dialysis procedure and is getting the apheresis machine ready. Take a picture of blood bank Halloween decorations.

9:30 p.m. Walk first bag of plasma over to the ICU so the procedure can start. She greets me with a wide grin. "Now that's what I call service!"

10:00 p.m. Head home to relieve mom. Check on kids, who are thankfully sleeping, and give kisses. Thank mom for going over spelling bee words with Sicily. Quickly memorize the four words out of dozens she fumbled so we can go over them on the way to school in the morning. "Stopped." "Barefoot." "Steep." "Without."

10:15 p.m. Troubleshoot start-up procedure problems with apheresis nurse.

10:45 p.m Check back in with apheresis nurse to make sure everything is going OK.

10:50 p.m. Settle in to blog/read and stay awake until procedure is over (in a couple of hours).

TGI almost F. Except it's a call weekend. Ugghh.

Yes, it's fun to complain. But I really love my job. Nights like this are pretty exciting, considering they don't happen all that often in the pathology world. We get emergency apheresis procedures maybe every other call. Once I was unlucky enough to have three in one week - but that was pretty strange. We pathologists like our predominantly solitary microscope lives, laced with rare moments of excitement.

The Colorful Cupcakes

2010-10-10T22:12:00.001-05:00

Check it out, if you want, over at MiM.

Only

2010-10-08T23:07:00.008-05:00

I've never been a big fan of Nine Inch Nails.

But my amazingly musical friend, the one who makes incredible mixes - Laurie, is.

So she peppers my mixes with their songs, most of which I skip.

She went to see them in Dallas a couple of years ago, and was delighted to see Trent Reznor in her hotel corridor. I'm not sure I would even recognize him, if I saw him.

A few months ago, I was listening to one of her mixes, and I happened across a song. I forgot to skip. I listened to the words, and found myself empathizing.

I've been playing it a lot lately - in my car on the way to Conway, and on the way to the main hospital after I drop my kids off. Because there is nothing like music that can drive a wedge into a feeling that you wonder if you ever really had in the first place. After a certain period of time, it starts working.

Then there's Fiona. Sweet, savvy, smart, and scathing. Her words place a sharp boundary between the past and the present.

Not many have said it better.

Now I find myself exactly where I should be, albeit somewhere I never would have dreamed. A single mother, primary custodian for two beautiful children. Slowly coming to realize that this place, although not easy, is the perfect place for me.