Thursday, February 2, 2023

Ice Storms and Right Knees and Orgies

     Good god it's been a couple of weeks. I thought January couldn't get worse than December but my foot is officially in my mouth. Last Tuesday I went and got a much needed pedi after work. It was raining, I was thinking to myself all day. Great time to go. Won't be crowded, no wait. Well that was true. When they put the flimsy pedi flip flops on me they warned. Careful. It's wet, these can be slippery.

    I've been wearing these flip flops for over 20 years and never slipped. Asphalt, fine. Pebbly driveway, no problem. When I pulled up into the driveway I noticed the lights in the garage were on. It was raining heavily. I asked S to open the garage so I didn't have to walk in the rain all the way to the front door. That was my death knell.

    As soon as I hit the smooth cold 1969 concrete garage floor I wiped out hard. So much so I almost passed out and had to lay down for 10 minutes before I could get up - I was seeing stars. When I went to get my ruined front toes repaired the next day (they do this for free, so nice) the woman working told me she always tells her clients to take them off if they are wet in the car before they go in the garage. I had one client break a hip! She said. So PSA to all your loved ones that enjoy pedis. 

    It was functioning, no need for ED, but it hurt so bad. Why don't you take Advil. S said. Good idea, I never think of that. I take it like once or twice a year. The bruise is EPIC. When we checked into the Marriott Courtyard for the ice storm Monday night (one night is best, two ideal, but the third night you kind of go stir crazy and the OR NEVER DIES so I had 11 frozens on Monday and 7 yesterday and I'm not even on call!) I went out the patio door to the non-existent patio to watch for ice and guess what. Fell on my right knee coming in again. It was a soft fall, but I laid there in shame for a few.

    So imagine how terrified I was to walk in the actual ice. Tam and Shay in the Dr Lounge were oohing and ahhing over my bruises from the garage the other day. If I fall this much without ice? My demise seems imminent. I did crack some docs up about my story, so there's that.

    We were coming back to the house today and I checked the mail and a notoriously super cute but creepy vascular surgeon's name was on the envelope. I exclaimed in shock. His wife worked in the dean's office when I went to med school and there were tons of rumors of their escapades. They came to med student parties I hear (I was married to Mike) and recruited marginal women and men for orgies. 

    I told S I think this house was used for orgies. They had destination orgies, Cancun and stuff was rumored, but when I asked about him recently to another vascular surgeon she said that he had moved to another city, new job. This shit is more common than you think. One of my attendings who is now in Michigan said she had to fend off another doc who was preying on her husband. They get the husband, then they get the wife. He was clueless. Her mom had warned her appropriately. 

    I have some fantasies, but orgies are not on the list. We saw Infinity Pool last weekend and it was nuts. Seeing that vascular surgeon's name after so many years made me think of the drug fueled orgy scene. Mia Goth is my new fave actress - her wine fueled diss of her prey on the hood of the car was Oscar worthy. But who recognizes horror. Or minorities. Not the Oscars. You just gotta go with it and keep creating. Even if you feel like you are screaming into a void.

    Also recommend The Lodge (Jack's rec) and kind of brain candying on this stressful week with You People and Dead to Me. Reviving book club this weekend with Amanda and Kewen at Sky on Saturday. Had wonderful reunion bfast at The Root with Carrie and Annika and Jack a couple of Sundays ago we plan to do it again soon. Gonna do a Eureka redux on the 10-12 (last one sucked). Allsop and Chapple is really good - Melody recommended it. That's all I've got for now. Happy Thursday, much love, E

Monday, January 23, 2023

Medical Executive Committee

     I hadn't been in a while in person. Autopsy was virtual bc dry heaving and in person presenting don't go very well.  Missed the Christmas party at Yaya's due to ED visit. So it was nice to be there. A lot of financial stuff that makes my mind drift, and the cheesy admin goals that made Ward Gardner pop off so bad Wendell had to check him. Ward was Mike's classmate, I've known him for a long time. He's  a hothead, but he's smart - Chief of ENT. His observations and challenges were astute, but a little disrespectful. I think he forgets he's the only one in the room who isn't under contract with Baptist and gets paid in RVUs. Baden in radiology (they are having as hard a time as we are finding docs), myself, surely the new Peds chief Barr I haven't met yet, all have a little animosity but you gotta play the long game. 

    I saw Mackenzie for the first time in a while and told her that I'd heard the gross room was being completely redone. Jessica already has a shoot for the moon wishlist, I told her, and even though it might not be financially feasible she agreed you should always shoot for the moon. I learned that Angel from Heme (new lab director in LR don't want to short her she's super kind) and Paula lab director are touring the country to look at other tissue labs? I need to be a part of that. They don't know tissue labs like we do. Shaver has already ok'd PTO for this. I am the director of it, among other things. Don't exclude us, I asked Mackenzie. She said I'll keep you in the loop.

    Crazy Monday - cleaning up call cases and fielding a bunch of new ones I think I have calcifications in my neck muscles. We have had such an uproar in our practice family in the past few weeks - more than in my entire tenure here. It's horribly stressful. My therapist said I need to widen my circle back to pre-pandemic. So, to start off, Jack and Annika and Carrie and I met at the Root for Sunday brunch it was lovely to catch up it's been years. Jack and Annika weight lift together and have been trying to make it happen for a few months. I finally took the reins (never give teens the reins) and we had so much fun we plan to do it again soon.

    Also starting a book club back up - we meet February 4 to plan. Starting off small - Amanda Ferrell and Kewen Jauss and Laura Sanders and Kandi West. Kandi was texting a couple of weeks ago - she's the best reader I know - she bought Wordsworth! One of my faves. Carrie Mensik said she is building a new house at the end of Foxcroft Road and wants to start a book club too. Maybe if I can get my health in line I can resume yoga and hiking. Baby steps.

    This weather not weather maybe weather event tomorrow night is stressing me out. Jessica presented a new inclement weather policy in QA last Thursday makes sense and makes things more fair. But I'm getting ready, got gas, got brandy, Jack got food since Med Exec popped up on me unexpectedly. Will get hotel near Baptist if necessary. Cancelled Paula for the immediate future. 

    Unplugged on Sunday on the couch and watched X, which was freaking amazing. The origin story Pearl was a little slow for me but the cinematography was incredible and Mia Goth? Big time acting chops when she did the soliloquy to the sis in law it reminded me of the beginning of My Town. I thought she must be the muse of Ti West but turns out she is married, divorced, and married to Shia LeBouf so they are just collaborators. So hard to find good horror these days, I told Savanna in the gross room this morning. We desperately need new content. There is a new horror movie with Mia in it coming out this weekend - I might just have to make it to the theater. Oh and The Meal - highly recommend. Happy Monday (not on call) much love, Elizabeth

Tuesday, January 17, 2023

Back to Baseline, Sort of

     Well, we moved Cecelia and her million pounds of stuff into Hendrix Sunday. I told her that people were probably watching and marveling from their dorm room windows. She got assigned to the Dickinson House, which didn't exist when I was there. It's named after my Dickinson family who got their money from a rock quarry in Pine Bluff maybe? It built most of the roads in Arkansas. I was charmed to see the plaques with Uncle Haskell and his dad Tyndall and mom Carrie on the outside of the building, and flabbergasted to see the portrait of Mama Carrie and Tyndall elevated above a common room that was like an atrium. That portrait was in the house Haskell and Peggy (dad's little sis) live in now, the one Mama Carrie and Tyndall used to live in on Palisades. I grew up looking at that portrait when we would go for Christmas or pool parties or birthdays or whatnot. It felt like a homecoming.

    It is right next to the Browne house, which I didn't know existed until I went to Hank's life celebration a week from last Thursday (slide show). Mary and I don't keep up regularly these days, but we go way back to Aldersgate when we were 15 and first met. At a surprise coincidental pedicure visit a few months back we caught up and she told me he was suffering from glioblastoma but had managed to live a lot longer than anyone expected. She looked elegant at the Clinton Library in a tailored skirt suit and as I waited in the slipshod receiving line to give her a hug I admired and squinted at the sun setting through the window of where I had my wedding reception in 2016.

    You look like a Madonna, I told her, the way the sun is framing your face as you are talking to people. Can I get you a glass of wine you are empty handed and this is so packed. I feel like a president's wife, she quipped. And no but thank you, I'm not going to drink until I get home then I'll get shitfaced. No judgement there at all.

    Speaking of Aldersgate, Cecelia called me today ecstatic. The last time she worked there was a couple of months ago, a respite weekend. There was a girl who was 9, Rennie's age, in her last week or two of life due to brain cancer. When Cecelia learned this she devoted her entire weekend to the girl, singing and laughing and playing with her. M was wheelchair bound, and struggled at this point to voice her thoughts. Cecelia devoted time in her Hendrix application essay to M, and the lessons she learned, so I became quite invested. The mom was so thrilled with C she got her cell from Katie, the director of something at Aldersgate, and called C the next week to thank her effusively.

    Cecelia told Katie that she wasn't going to volunteer this weekend because she needs to plug into her new college. Her suite mate is cute as a button, Sophie from Greensville SC and premed major Spanish minor. C got a call from Katie today and the girl, don't want to violate her privacy by naming her but it's an unusual beautiful name, is going to be there this weekend. She entered a clinical trial and is doing fantastic. She hasn't been this healthy in 6-7 months. C and I both ugly happy cried on the phone together this afternoon around 1. I drew so much attention Kimberly and Tina came to check on me.

    Who knows what the future brings but you take the good and you process the bad appropriately and move on. I'm on call, and had a late frozen yesterday (if you call 4:15 late LOL). Stern was doing a direct laryngoscopy on a patient with a large laryngeal mass and a shit ton of big lymph nodes. He needed a diagnosis. Lindsey cut the frozen. We looked at the gross (think 2 mm of WTF). It was pink, and fleshy, and we worried about lymphoma so she saved half for flow. Turned out to be run of the mill squamous cell carcinoma. That directs treatment. If it was lymphoma, stop. Squames need to be excised. Happy Tuesday, much love, Elizabeth


Saturday, January 14, 2023

Happy Weekend!

     Good god. Why does life continue to throw you shit to fragment your mind. Oh well. It doesn't work. Well, to be fair, almost. 

    Nothing new here. Going to be on call on Monday, back to the grind. Not a bad thing. Oh! Looking forward to dinner tomorrow night with Christy and her new beau Jerry and his father who is suffering from Alzheimer's. Kemuri west. Christy knows the owner. We have a 4:30 reservation. Old folks time. He always comps her drinks or apps. Looking forward to meeting him. Might be a good contact.

    Hopefully S will test neg for Covid tomorrow - he had it back in February with horrible sequelae. Alopecia, requiring derm intervention. I told Melody I think I must be Covid immune. Exposed twice, and never symptomatic. So I haven't ever tested. When S tested at 4 am yesterday I was surprised. It's like a pregnancy test, I told him. Looking for the lines.

    Excited to move C into Hendrix on Sunday - she is going to come over tomorrow to start packing. Mike and Rach are having a weekend in NOLA so they are taking care of Rennie. I've done enough of her laundry to last a lifetime. Just checking in. Happy January. Much love, Elizabeth.

Wednesday, January 4, 2023

Comparison and Confidence

     I've noticed something weird about the guys in our group, I've talked to Melody about this before. Women are more communal, guys tend to approach us like aliens - trying to compare and make sense of us. Rex, for example, would compare me to Diane and marvel at the differences. Once Shaver, years ago before I got divorced, came into my office. He told me about his relationship with Carlisle - a co-resident of his who works in Fort Smith. We played practical jokes on each other all of the time. It was really fun.

    Something in his voice made me wonder if he wanted that with me - another practical joke player. Maybe I was reading into it, but at the time I was not in a situation to be that person. I gave him a blank stare and smiled fake. That's nice, I said. When Melody was hired, one of the guys, can't remember who, marveled to me that Melody was different from me, she likes sports. Again, I thought in my head, it's because we are different people. 

    I'm not trying to make this a gender thing, I've seen more OCD partners get frustrated when their male counterparts aren't as OCD as them. A big fight erupted one call weekend a decade ago. The AP person called me in free fall. It's ok, I told him. I make typos too. When the CP person vented to me, I told him that guy is different than you. Certain things don't eat at him like they do you. It doesn't make you or him any less or more, just different. 

    But women do communicate more. A lot of the hubs of Bad Mom Docs piggyback on our posts, with the wives permission. They wish they had a similar space, to laugh and vent about their spouses long shits and their tendency to start long inane projects five minutes before they are hosting a party or leaving for vacation (although those are guy things - they would need something different to make fun of, of which I'm sure there is plenty). I like the funny posts - the Christmas pic fails etc. But there are a lot of anonymous trauma dumps, and people get into that - leaving hundreds of supporting comments and reality checks. I occasionally participate, but for the most part I need a laugh in my day, not a trauma dump.

    When Shaver told me I was Chief last Fall, based on doorway conversations, I told all my friends and family. The next day he texted us and asked everyone to vote on me being Chief. I was perplexed and disturbed. I thought this was already decided, I told Melody, I don't want to eat crow, why is he doing this? It was excruciating. A few hours later, he announced on text that it was decided. Only two people dissented, he said. Elizabeth won by majority.

    The next twenty seconds seemed like an hour of Hell. I got super paranoid. I decided quickly who those two people might be and went into emotional tailspin. How will I go on, I wondered. Melody jetted into my office and told me that Shaver planned it all as an elaborate practical joke. I told him not to do it, but since he did I came into your office as soon as the text went through to straighten things out. I warned him you might be upset, but he was like she's so confident how will she believe it? I did. Michelle was equally alarmed. Why did he do that? If I had joined in on the practical joke thing years ago I might have not gone down into the trenches, but I had not, so I did.

    Our self esteem has such a shallow veneer. Melody knew that, and Michelle, but a confident white male might not see that. I laughed and went along and forgave him. Even asked him the next day to be my co-chief. You do PLA, I said, I'll do Baptist. I can be a face and a problem solver, but I don't want to deal with the finances. It's not my forte. Michelle has her MBA and Melody is more OCD about finances than anyone I've ever seen (I mean this as a compliment) so there are plenty of checks and balances without me getting involved in matters I'm no good at and could care less about.

    So I'm in a weird headspace that I'm objectively trying to crawl out of this week. Still. But as I said last week, writing helps me process. Looking forward to Eureka this weekend - Christy is independently going with a new possible beau and I've made reservations to meet them at The Grotto Saturday night at 7:30. Reading a lot about Basque culture. Vicente Suarez, who S thought sounded like a gigolo (No, he's a very handsome very gay man who seems to be independently wealthy) wants to meet for dinner in Barcelona - I talked to him on Insta for the first time since he was a foreign exchange student at PA in high school when I was in Florida last week. 

    Bonus. I found out yesterday I get back Sunday and work Monday and then have the rest of the week off to help Cecelia get organized for her big move. And lunch and shop with Christy. At my insistence Cecelia booked us massages next Friday. And work? Thankfully half of all of December each day so far. Its creeping back up, I'm not jinxing myself, but the respite has been a nice change from what felt like a literal fire water hose of cases being shoved down your throat - you, trying not to get plastered against the wall. Swimming. Happy Wednesday. Elizabeth


Tuesday, December 27, 2022

Thankfully Back to the Grind

     Not that I had a bad holiday, but it was intense. I learned about two things that happened to Cecelia's friends, both that I know and love, that spun me into mental health instability and more GI craziness. One threw me into such PTSD it was all I could do to hang and shop and make lovely memories, which I did, but not without desperate phone calls and texts to Yousef and Paula and Kimberly. All wonderful grounding forces. It's one thing when you read about the ills of the world, which is important to do despite the unpleasantness, but another thing when it hits the young and the innocent. Ones you know.

    Your workspace is grounding as well - it's where you are in control, where you operate at the top of your game. After a day on the couch yesterday reading a novel and watching two movies (that Knives out redux was amazing and Breakfast at Tiffany's surprised me) I told S I was never more ready to return to work. It was busy, and I had a lot of BS CME Board reporting to do at the 11th hour but I managed to pull it off - almost, I still have a little more but not due until January 5 and that seems like a lot of time. To me. Melody is like Cecelia she has to get everything done in advance to stave off the anxiety. I'm like Jack - I work best under time pressure.

    I got a letter from the Patient Safety Officer tonight acknowledging my ED experience. And a text from Mike Perkins, the new Baptist LR CEO (I think? Admin titles elude me). That felt good. I assured Mike minutes ago that writing for me is processing, and based on all the wonderful experiences I have had at Baptist over the years that eclipsed that one I'm moving on. No need to sit down and talk, I told him. I said my piece. See you at the next med exec committee meeting. Enjoy the holidays and your family.

    The Shop Around the Corner was one of the most pleasant holiday surprises. While we were in Florida we were looking for a good holiday movie. Both that one and Bfast at T's had some terrible cultural appropriation but at the time? Probably misguided bc they didn't know any better. Mia, C's friend who spent her entire high school watching movies, recommended it. I will never forget Jack guffawing in my parent's living room. I shared it with S, and C and J shared it with Mike and Rachel. 

    Ugh I looked at my call calendar today and highlighted the rest of the fiscal year, through October. The reason I'm having such a gap is bc I have two weeks in a row three times in the Spring. Yikes! I've hardly ever done two weeks at once. It happens to Melody more often. But I'll buckle up and survive.

    Can't remember if I've mentioned this but we are planning a trip to Basque country in the Spring. My first ever two weeks off in a row. Barcelona, where I will see my high school friend Vicente, then Bordeaux then San Sebastian. I've ordered a ton of books on Basque history and culture, and C has amazing recs. I'm having a little panic over it. When I went to Germany to S's mom's hometown in Bad Herzfeld a few years ago there was no English speaking. It was beautiful, but I sometimes ordered a dish that was fish heads swimming in soup, accidentally. C assured me it was fine, and my brother told me that with all the advances in Google Translate I won't feel so isolated. You can take a picture of the chalkboard menu, and it will automatically translate it. Whew.

    So anyway. Happy Holidays. Looking forward to hosting C's friends this weekend and getting a little R&R the next weekend in Eureka then moving C into Hendrix on the 15th. She is so good. She's finishing her yoga instructor's degree and making all the fam look good with her thrifting at Goodwill. Jack has friends over tonight watching a movie. I'm hoping for a slow down after all of these patients meet their deductibles but who knows? I see new doctor names every day. It's a grind, but a good one. Much love, Elizabeth



Tuesday, December 13, 2022

Social Justice Crusade

     After I got back to work on Wednesday, which was Hell, I should have taken one more day off, my adrenaline from Monday crashed. But I got through it. I bought Dr. Flamik and Shelby and Katelynn, who blew my vein but she was nice, which goes a lot farther even if you are inexperienced, gift cards to Boulevard and some cookies for the employee lounge. By Thursday I still hadn't heard anything from Mackenzie, and I became worried when I talked to Jeff the security guard who said that happens more often than it should in the ED, with the nurses.

    I had a burning desire to be HEARD. I wrote an essay at 2:30 Thursday about my experience, one much more eloquent and less conversational than on the blog, and delivered it to Mackenzie and Mike Perkins and Pahls on Friday. Not in person, just in a work envelope. It felt a little like I was writing a victim's statement. Monday I had S's Christmas luncheon at his new building downtown, the Arkansas Pharmacy Association, so I had to cancel with Mackenzie but today her secretary rescheduled for 3:30.

    I've had a lot of good experiences at Baptist as a patient, and it feels comforting to see familiar faces. Chandra, head of phlebotomy, did my bloodwork. Jeff checked on me - he spends a lot of time trying to keep the ED, which can be chaotic, safe. My goal here is to educate, not litigate, I assured Mackenzie. Mike and I's goal is not to be victims here, but to try to right a wrong. Mike called me after I shared the essay for feedback Thursday night.

    I hope you aren't mad that I did something, he told me. I took a picture of you on the floor. Mad? Hell no. I felt validated. I shared it with Mackenzie. This nurse was insolent and aggressive and reading the room as wrong as hell, and refuting Mike's polite entreaties to get a stretcher. She asked if she could share my essay with the nurse manager, and I said absolutely. I told her after the weekend my urgency on the matter fell from 90% to 10%, but I didn't want to be swept under the rug.

    She agreed, and I told her I talked to my sister about it this past weekend. She is a P.A. at Scottish Rite (sp?) in Atlanta. She told me she has long been frustrated that physicians and P.A.'s get peer reviewed, but the nurses don't which allows for a lot of bad behavior. Not just insolence, but laziness. They get hired, they behave badly, they get fired. No peer review. I asked Mackenzie if nurses get peer reviewed at this hospital.

    I don't think so, she said. They get annual competencies, but not peer review. That's how we do it in my company, I told her, but we are much smaller and if there is bad behavior? Intentional or not? We root it out and address it immediately. We do not tolerate egos. Power trips. Laziness. She said I agree. I told her when you are vulnerable and someone is aggressive you doubt yourself. I did, I heard Mike doing it too. She said that is a good point. 

    So yesterday and Friday were awful. I became uncharacteristically terse with many employees on Monday and was glad to have a luncheon to go to. Shine, entertain. Get out of my own fing bad headspace. Enjoy the amazing view of the Capitol - there were obviously school carolers singing in abundance on the front lawn, I observed from the second floor which was created as an event space. The grand opening is tomorrow. 

    So if you've never seen carpal tetany I've got a pic. Of me, escaping incompetence on the ED floor. It's almost Wednesday, hump day, and I'm looking forward to a week off. Happy Tuesday, much love, Elizabeth