Tuesday, December 29, 2009

Band Practice #2

Just finished a three hour session, after three scheduled practices were interrupted with duck hunting (not me), family, and work. It is amazing how much better I felt after just trying for the first time earlier this month. I needed two glasses of wine and a beta blocker (no, I don't take those often, just had a leftover prescription from when I was on TV for the swine flu earlier this year). I felt so self-conscious, that first night, internally self-berating that I had never learned a musical instrument, cause he was so good. Still falling short. I think I need to accept the fact that I will never feel like I measure up to anyone. And just quit worrying about it. Doesn't everyone feel this way?

At a party a couple of weeks later, my friend's wife laughed. "Chet said that all singers are like that in the beginning. You will do better next time." In the interim, I learned a few new songs and found myself singing better to car CD's - not comparing myself to all the singers and feeling like I was falling short (again), but finding where I could sing well within my range and (gasp) do better. My own voice.

Tonight, a couple of cups of coffee and a giant Powerade prepared me, and I got through the long practice with just two beers. GD, blues, etc. My friend and his wife were encouraging. He played great - so incredibly talented - he could just pick up a song on his guitar he didn't know when I sang it. We mastered about four or five songs and played around with a bunch more. He played some amazing original stuff I want to try to write to. We planned to try to meet again next week. It is so fun to have something non-work related to look forward to.

Excuse me, I've got to go write my Grammy acceptance speech (hee hee just kidding).

Sunday, December 27, 2009

Newest Addiction

Fingerless gloves. I love them. I bought a cheap pair of gloves in Chicago earlier this month, and became frustrated when I was trying to take a picture of the snow for Facebook. I couldn't do it. Quickly realized the gloves were the impediment, and slid my nose across to open the phone, belatedly acknowledging the fact that using my nose to go in and actually take the pic to upload to FB would prove too much. So I begrudgingly set down my Christmas present shopping bags and took off my gloves to snap the photo.

The next day I went to Eileen Fisher in the mall to present shop for my mom. I remember my mom taking me to Eileen Fisher when I was a teenager, California or New York I can't remember, only being in the store and picking out a sundress that was apricot-colored, with soft, luxurious light fabric, draping almost to the floor - this didn't happen a lot with me and dresses once I hit puberty. I love that dress. I still have it - good quality lasts a long time.

As I was running around the store quickly taking in colors and images to get ideas, I happened across a stand with these amazing bronze and charcoal-colored fingerless gloves. They were thin, soft wool, and had tiny bronze and silver beads in different patterns - just a few so they were elegant, not gaudy. My search was over. Iphone gloves - bronze for me and charcoal for my mom. There was a little story behind the gloves on the back of the tag - someone had made them for Eileen Fisher for Christmas last year and she loved them so much, she was selling them in her stores this year.

Of course I couldn't wait until Christmas - I wanted my mom (and me) to be able to wear them to all of her holiday parties and get use out of them immediately. I get compliments on them wherever I go. So does she. People laugh when I call them my iphone gloves - someone in a tiny shop in the Heights supporting local artists said, "Hey! We should get our knitters to make those! What a great idea!"

My mom loved them so much when she came across a pair at the mall - soft, fluffy ones with pastel rainbow stripes, she bought me a pair. Now I can mix and match and accessorize.

Last week as I marched into work one day through transcription area, everyone looked up and I suddenly felt self-conscious. I was in a black overcoat - the Gandolf one, according to Mellificent in residency - my hair still slightly damp from my shower. I was slumped over from carrying the giant black leather bag I bought in residency to house diapers that is currently sheltering my Christmas card project, the book I am reading (The Year of Magical Thinking - Joan Didion - big winner), a cd project for the kids that may or may not happen, recipes for cooking projects with the kids when I am off this week, and various menus and receipts, in addition to my wallet, lip gloss, and press powder. My laptop rendered my slouch symmetrical. I was wearing the rainbow fingerless gloves. I did not have on the beautiful, cozy bright blue slippers with the flowers on them (a present from Dr. Styles), the ones I noticed were still on my feet on the way to work, quickly turning around on Evergreen cause they just screamed crazy lady (in my defense, that's a first for this year. I did it twice last year. If you had such cozy slippers, you would accidentally almost wear them to work, too), but I looked down because I suddenly worried I still did. That I looked like a bag lady. Then I just laughed. Who cares?


Thursday, December 24, 2009

Fragile

This is another one of my favorite songs. I remember listening to this album over and over, when it first came out. Been listening to this all week in the car. Merry Christmas Eve. Please fall asleep, sweet Sicily, so I can play Santa!





Kind of fitting, considering we are trying to survive a flood, this Christmas Eve. Listening to all of the lab workers and transcriptionist's heart-breaking stories about trying to get to the hospital to work, even though
interstates were closed, was tough. Listening to their anxiety about getting home for Christmas Eve was even harder. I fought the urge to save everyone. I have my own family. I work with a truly incredible group of people.

I don't know why I can't control the font or the spacing, suddenly, on my blog. But I am tired of trying to fix it. So you'll have to accept my post, flaws and all. Hopefully my stupidity will make you smile.


Wednesday, December 23, 2009

Christmas Miracle II

Damnit, I couldn't help it. I am just so happy. Here it is.

A Christmas Miracle

Well, my daughter's art is pretty miraculous. She called this one "Potato Penguins." I asked her a couple of months ago, "Why potatoes?" "Potato stamps, mom. I used potato stamps to make them. It was easy." I had never heard of those, but loved her penguins so much I vowed to save them for the Christmas card. Then I used kid pics instead, so here are the penguins in a Christmas Eve Eve post.

But that's not the miracle I'm talking about. It deserves a long, wonderful post, one that I will write eventually, when I am not wrapping presents and setting the table for Christmas Eve dinner, and readying myself for a final day of work before Christmas vacation. For now, a few words will have to suffice.

Welcome, welcome to the newest addition to the Gasper family, Lorelei Ruth. She is a beautiful 4lb. 5oz. bundle of peacefulness and serenity that I had the privilege of meeting this morning in the NICU. I cannot imagine what it is like to find out at noon you will be a parent, meet your daughter, sign the papers, and learn you will probably take her home on Christmas Day. After a long wait, what a tremendous amount of body-rocking and mind-blowing emotion to experience during the holidays. I got to watch her dad and mom take turns holding her and telling her amazing story - the beginning of their journey. I could hardly work today because I kept thinking about them and getting choked up.

She is ravishing. She looks a lot like her adoptive mom, Courtney. Luckily, she doesn't favor her adoptive dad (hee hee just kidding Brent) but I hope like hell she adopts his enormous compassion, humor, and intelligence. What lucky parents. What a lucky little girl. I can't wait to see her again tomorrow.

By the way, guys, I am dropping off a very un-festive collection of Kroger sacks filled with essentials on your front porch on the way to work tomorrow. Congratulations, you three!

Monday, December 21, 2009

John Doe



That's the name of the candy bar I got my partners for Christmas this year - I had fun playing Santa today. It is the creation of Bloomsberry & Co., a chocolate company originating from New Zealand that now sells in the U.S. I received one from my creative sister-in-law and brother for Halloween, in my work mail. I was wondering how I could top the Giotto's rocket blaster I got last year for everyone to clean their scopes, and was glad that someone else did the legwork for me.

Every chocolate bar offered has amazing cover art and clever sayings, tailored for all holidays. Some are incredibly racy, like this one:


Others are sweet:


Anyway, you get the picture. It's fun just to look. There are tons of them. And at $5.00, it won't break the bank. Fortunately the quality of the chocolate lives up to the packaging. I was happy to find the quintessential pathologist's candy bar in the John Doe - death by chocolate. How delightfully morbid.

I also ran around to different departments passing out Killer Pecans and White Trash snack mix, two of my favorite food gifts. I was so happy to see Killer Pecans back on the shelves at the gourmet food stores this year - I couldn't even find them on a website last year and I have mourned their absence for two to three years. Pecans laced in sugar, butter, cayenne, and cumin - oh my god they are incredible. I kept checking to see if histology opened their tin so I could sneak some. I got a tin for my house for Christmas Eve dinner snacking.

Almost as fun as giving was receiving - someone from the blood bank made some incredibly gooey lemon cookies (I got the recipe), someone from the gross room made homemade smoky, chili powder pecans and peanut butter fudge. I could go on and on, like the ever expanding size of my stomach capacity. The biggest hit for the kids was our business manager's Oreo cookie truffles - I got the recipe for this, too, and instructions to vary with Nutter Butter's. Hopefully if I am brave enough to attempt cooking next week it will go over better than last Christmas. Well, re-reading that post made me realize I didn't properly describe the angst and severe five minute couch depression of the failed candy experiment. I never tried again -- needed a year to recover.


Playing Santa makes me so happy. Work is done. Now on to the kids later this week.



Sunday, December 20, 2009

Love

I've been reading some psychological and spiritual mumbo jumbo lately. I'm pretty callous so I'm not proud to admit this, but sometimes it's what we need, in our lives.

My mom gave me this book called "How to be an Adult: A Handbook on Psychological and Spiritual Integration," by David Richo. They recommend that it is read slowly, in order to digest the teachings. So of course I sped-read it in one night. It's pretty short.

Two quotes struck a chord, so I'll share.

"We discover the gift dimension of the music and feel it in our bodies. We find out why it has survived the ages: it shows love and helps us receive it. 'We are put on this earth a little space, that we may learn to bear the beams of love,' says William Blake."

"Then we know that music is what love sounds like, and art, drama, and dance are what love looks like. When something still has the power to move us, it must have been love all along, since love moves the earth and other stars."

Reminds me a little of a quote I love by Gabriel Garcia Marquez. Of course I gave away Love in the Time of Cholera - it is no longer on my bookshelf - I usually give away books I love the most quickly. And of course when I tried to google the quote I couldn't find it. It has something to do with actualized love and unrequited love. How actualized love is quiet, and unassuming. But unrequited love is the love that moves the earth, and powers the world. Makes men (and women) great. Realizes potential. Furthers civilization.

Back to fiction now. The gut-wrenching, heart-stomping, wonderful kind that helps you escape and handle reality.

Somewhere Over the Rainbow

Friday, December 18, 2009

Don't Put Your Hands On Me

Fluidity

Sometimes I wonder if the more experienced a pathologist I become, the hedgy-er and weirder my sign-outs will get. I start to see mistakes that people make, and the culmination of past history makes me hesitate more and more with my diagnostic words. This is vague, I know. I'll try to make it a little more clear.

When you first come out of residency, you have a nice set of rules to work from. A follicular lymphoma is a follicular lymphoma because it looks like this, it marks like that, and the flow cytometry fits perfectly. So you type that into your diagnostic line (or dictate it for the transcriptionists). Follicular lymphoma, grade 1 or 2 or 3. Depending on the rules you read in your fancy book. The ones you memorized to take your boards.

But then life gets messy. People are messy. They don't always follow the rules. There are articles you can find on pubmed to deal with the messiness - ones that people publish about these five cases that don't quite fit the rules but we are going to call it this. You read the well-known academic author, and feel confident in following their lead. Sometimes you send it to them to get their name on it, pay lots of money for back-up. After all, you want to get the proper diagnosis for the patient, so they can get the proper treatment.

Then, a few years into practice, a new book comes out, and come to find out that thing you used to confidently call this is no longer considered this. New molecular information has come to light, and now they call it that. You squirm uncomfortably in your $1200 chair, the one you purchased with your continuing medical education money to prevent slipped discs and chronic pain issues you have seen your partners deal with. You think of all the cases you used to call this, and wonder how in God's name you could ever go back and call them all that. You look at partners that are good, solid, hard-working people, and understand all the quirks and strange habits they have developed over the years to help them sleep at night. You wonder, two years into practice, what you will be like ten years down the road.

This week, I was asked by a medical oncologist to review a case I signed out last December. It was a simple question, "Can you grade this lymphoma?" I had the case pulled, but didn't have time to review it for a couple of days. We were slammed with record high block counts all week long, everyone trying to get in their surgeries before the holidays and new year. Add in trying to rearrange schedules to make it to my kids amazing Christmas programs, and John's febrile illness that finally peaked in the middle of the night last night, and wow. I love having tough days, because work is stimulating, but it is nice to balance out hard days with light ones. Hopefully next week will oblige.

When I finally got around to looking at the biopsy, I was mortified. I won't bore you with the details, but I had confidently called a GI biopsy this, and I didn't feel so confident about my diagnosis in hindsight. I sounded like I knew the patient had already had this diagnosis, but failed to explain anything about past history or clinician communication in the comment I made. I told my partner I shared it with, "This isn't like me. I am not that much of a cowboy, on a first time diagnosis. Something is missing."

I was further alarmed to read in a GI note I had faxed from a clinic that the patient did not have a pathological diagnosis, prior to mine. He was being treated presumptively, based on radiology, according to the note. I searched his history in the archives on our computer. No previous. What have I done.

I resolved to call the oncologist and explain the situation. I talked to her before - she is based in another town, and she seemed reasonable. I would tell her we needed more tissue to make a diagnosis. Maybe I jumped the gun. I should have called it suspicious. Hopefully it would all be OK. Unfortunately, she takes Fridays off. I talked to her nurse.

"Can you fax me all of his records in the chart, please?"

Two hours later, a transcriptionist came into my office. "Here is your book." I laughed. "You are right, she faxed me an entire tree."

I pored through the history searching for old path. Luckily, it was there. Five years ago, two people in my group had good tissue with good flow. I must have had this information a year ago, and forgot. I was so hell bent on figuring out what I did wrong, and the GI note really threw me off. Because the path was in the small town, it wasn't easy to find in our computer records. I sighed with relief. Suddenly, my cowboy, slipshod sign out made sense. I did the right thing. The diagnosis had already been made, as was evident to me in my sign out, but I had to play detective to find it out. I resolved to make more all inclusive sign-outs in the future.

Last night, I was up until midnight addressing Christmas cards. I just ordered more online, because I ran out. I looked at the pictures I took frantically in front of the tree last week, when I started receiving cards and realized I hadn't done mine yet. I was very proud of the ones I chose - the kids look great, happy and real - not posed, just having fun. I thought of how my past experiences with them shape the way I deal with them currently. My set of parenting rules is constantly shifting and changing based on new information. Life has so many parallels. I hope they don't think I'm hedge-y and weird. Fluidity is probably a good trait, in work and life.

Sunday, December 13, 2009

Word Cloud

I got this idea from the person who accused me of making a statement in a comment that can be interpreted as racist. We're OK now. We hammered it out. I learned something. She had her one year anniversary, on her blog, and got a word cloud from Wordle. This website takes the text from your blog and features prominent words that you use.




Wordle: Gizabeth Shyder


I am sure there is a way to make this bigger. I just don't know how. It looks bigger on the website. And it is still really cool. Except I wondered, where the heck is my son?? Have I not mentioned him lately? Do I not talk about him as much? And work words are way bigger that words like "shopping" and "party." Not good.

Pot of Gold

Check it out, if you want, at MiM.

It is really out there now. It was removed briefly to put up a few more "Day In the Life" posts.


Friday, December 11, 2009

Art Part III

I opened up Sicily's glittery heart folder from her pink backpack last week, and saw a memo from the teacher.

"Please bring 15 gifts on December 15th to share with the classmates. Examples in the past have been Golden Books, stickers, etc. Do not spend a lot of money."

I cringed. 15 gifts? To go in a stocking? My child was going to come home with 15 gifts before Christmas break? Whew.

I decided to embrace the spirit of the endeavor. I would not run to Target at 9:00 at night to buy 15 plastic objects made by children in China. This was going to be about Sicily. So the next day, we were running through ideas.

"Here are the examples, Sicily -- what do you think?"

"Well, mom, we could go to Michael's and get some of those wind-up toys we got for the Halloween party."

"What about a CD?"

"Yeah! I'll make a song list right now."

She made one, and I stuffed it in my purse so I wouldn't lose it. I was going to have to buy a couple of the Polar Express songs on itunes, but oh well. Still a pretty cost-saving idea - one that she could make hers. One night last week on the way home from work, I stopped at Office Depot and found some CDs with great art - they weren't there the last time I picked up a big batch. I was so excited. I couldn't wait to show them to her. I was a little stressed about finding the time to make and label the CD's, but I was off the next week, so I figured I would work it in somehow.

Last night in the car on the way home from my mom's, Sicily was vying for attention over the music and her brother.

"Mom, listen to me. I have an idea. Do you have pictures of my classmates? Like in the yearbook? We could cut them out and put them on the CD's."

"No, Sicily, that won't work, if we glue them or tape them on the CD's it might mess them up when they put them in the CD player. We could maybe put them on the cover - the one we label. You can decorate them."

She answered emphatically. "No, mom, that's not my idea. There's not going to be music anymore."

I thought the music idea was so good, I initially tried to dissuade her. She had other ideas.

"I want to make the CD's Christmas ornaments, for their tree. We can get some great ribbon to tie through the middle. I want to decorate them with my classmate's pictures."

What a fabulous idea. And less work, for me. "I'll stop by my office tomorrow and check for pictures in the directory."

Unfortunately, there weren't any pictures in the directory. When I broke the news to Sicily today in the afternoon carpool line, she wasn't dissuaded. "It's OK. I have those wonderful scraps, from your friend Ramona. I think I know where some pink ribbon is. We have lots of stuff around the house. I'll make it work."

I had a long lunch Thursday with a blogging friend, Ramona Bates. She is a plastic surgeon in Little Rock, and we met through a medical bloggers in Arkansas article. I've been following her blog for a few months, and we finally found the time to meet in person. I was incredibly touched that she brought quilting scraps for Sicily - I had mentioned in a comment a couple of months back that Sicily's old school liked to use quilting scraps for sewing buttons, when she wondered on her blog what to do with her quilting scraps. Her blog has the smart title Suture For A Living, and she often reviews articles and books and talks about her hobbies. She is the person that suggested I post over at Mothers in Medicine, so I am incredibly thankful to her for plugging me into this community. Her blog is worth checking out. If you like to read about reviews of nail bed injuries over your morning coffee, or 30 pound breast tumors (I thought only ovarian tumors got that big!), then you'll have fun.

Tonight Sicily grabbed her bag of quilting scraps, (my goodness she was like a kid in a candy store when she received them - so incredibly grateful and excited - "Who do you know that gave me such a great gift?? Can I meet her someday? Can we take some to Nana's house so I can sew with her on my Nana days?"), some pink ribbon, and went to town. The picture above shows some of the results. I am so incredibly proud of her creativity and work.

I loved meeting Ramona. We cut to the chase, face to face, and unloaded about business practices, dreams, regrets, and family. She's an amazing person.



Thursday, December 10, 2009

Rosemary

This is one of my favorite songs, of all time. The visuals are a little weird. Close your eyes.

I am off this week, and got to meet my daughter's piano teacher tonight, sitting in on a lesson.

"I really think you need to get her into voice lessons. She is amazing. Most kids her age are all over the map, with their voices. She is pitch perfect."

We work on it a lot. Every night. I am so proud. It's nice to hear someone recognizing our efforts.


Wednesday, December 9, 2009

Relativity

I walk into the FNA (fine needle aspiration biopsy) room, to perform a procedure. A 53 year old woman is sitting in the clinic chair - my patient. Her husband sits to the left of me, and I introduce myself to both of them. I run through the procedure, and then listen to her talk.

"It's been here for a couple of years. I wasn't that worried about it, but my mom recently was diagnosed with breast cancer, and thyroid cancer, and I decided to get it checked out."

She had a mass below the ear, a parotid mass. Slow growing parotid masses are usually one of two things - pleomorphic adenoma, if you aren't a smoker. Warthin tumor, if you are. Both benign entities. She wasn't a smoker.

I steadied my needle and performed one pass. I was confident that I got good material, so let her apply pressure and take a break while I waited for the tech to stain the slides. We chatted about her life.

"My husband and I are going to D.C. tomorrow, for a vacation. So we won't know about the diagnosis until we return. I'm going to be anxious thinking about it, the whole time."

I learned about her children, what they were doing. The slides were ready, so I looked in the scope. It was a great pass. Photo worthy. One to stash away in the files, for the cytotech students. Beautiful magenta metachromatic stroma surrounding football-shaped myoepithelial cells. A pleomorphic adenoma. We were done.

As the tech lowered the clinic chair so she could step down onto the floor, I looked her in the eye. "Have a great trip in D.C. You've got nothing to worry about."

Back in my office, I called the ENT doctor, and told him the diagnosis. "Wonderful. Thanks."

A week and a half later, I received a phone call in my office. It was a transcriptionist. "I've got a lady on the phone, and she wants to talk to you. A patient. She is really upset, and thinks you may have gotten her slides mixed up with someone else. Do you want me to take a message?"

I quickly looked her up on CoPath, saw the name and diagnosis, and remembered her. "No, I'll be happy to talk to her. What line is she on?"

I don't often get phone calls, from patients. The transcriptionist was trying to protect me. We usually leave all the interaction to the clinicians. But having a patient worried and doubtful about my diagnosis alarmed me.

"Hello, Dr. Shyder? Do you remember me?" Her voice was laced with hysteria.

"Of course. How was your trip?"

"Great, but I just went to the doctor. He told me I would have to have surgery, to remove the mass. You told me I had nothing to worry about, you thought. Are you sure you didn't get my slides mixed up?"

Pleomorphic adenomas are, by rule, benign. One in a million can be cancerous, so they have to be removed surgically. I have seen pictures in books, but never run across a malignant one. I'm a young pathologist, but I'd be willing to wager that none of my 13 partners have ever seen a malignant one, either. I'm guessing at these stats, but malignancy, in a PA, is a true anomaly. As pathologists, we don't discuss diagnosis or treatment with our patients, when performing FNA's. But on the precipice of her vacation, and with her mother's history in my head, I felt moved to console her.

"Yes, they have to be removed. But the vast majority are benign. When I saw the slides, I was thinking of your anxiety about your mother's two cancer diagnoses, and was attempting to reassure you on that point. I apologize for any miscommunication. I realize that having surgery is a big deal, and I am sorry to have misled you. I will be happy to have the slides pulled, and will review them today, since you are worried. If there is any change in diagnosis, I will notify your clinician immediately."

Lesson learned. I won't be so quick to pacify a patient, in the future. My idea of "no big deal," isn't every one's. I'm not the one going under the knife - this week, anyway.


Tuesday, December 8, 2009

Book Club


Is this Thursday. I read the book while in Chicago. I picked it a while back, but we were having trouble finding it in stores (I think we kept getting the name confused and it just isn't out there) so we postponed it until now.

One of the first books we read, when we started book club a couple of years ago, was Eat, Pray, Love: One Woman's Search for Everything Across Italy, India, and Indonesia. I don't really remember the particulars of each adventure - I read it so long ago, but I do remember the feeling I got. I loved Eat - who wouldn't enjoy reading about a woman leaving her husband and gallivanting around Italy, enjoying wonderful food? But by the time I got halfway through the part about the Indian ashram, I became annoyed with her narcissism. So annoyed, that I don't really even remember Indonesia - it got weird and I was bored and speed-reading, to finish the book. I didn't really care about her finding love, because I didn't care about her. I can't speak for everyone in book club, but that's how I felt.

So when I came across a fictional parody response by the man she jilted, called Drink, Play, F@#k: A Man's Search for Anything Across Ireland, Las Vegas, and Thailand, I thought it would be fun to read. I floated the idea and everyone agreed. I don't know what I expected - maybe a big dose of revenge and debauchery. There was a little revenge talk, but it was respectful, especially given she was the one who did the cheating. He drank a hell of a lot in Ireland, I probably missed some of the golf and gambling metaphors in Las Vegas, and I fully expected that in Thailand Bob would be reveling in rampant sexual hedonism. But I was pleasantly surprised. He was really funny throughout the book, in a self-deprecating way. The story was highly improbable, but his "gurus" (a midget in Ireland, a personal trainer in Vegas) were fantastic and doled out wonderful philosophy in such light spoonfuls that it wasn't so painful to receive. He was such a decent guy, I found myself cheering for him and might have even forgiven him if he strayed off the moral track. But he didn't. By the time I watched him dive into the ocean away from what I would consider to be every man's greatest fantasy to find true love (I'm such a sucker for that sort of thing), I was so happy on the inside.

So if you ever get inclined to read one of them, I vote for the latter. I'm shocked that his book didn't stomp hers in critical acclaim. It was a much better read.

Friday, December 4, 2009

Week In Review

What a hell week.

I was crazy busy, on cytology. Tons of needles. And we are going live, with PCR from H1N1. I was trying to compose a fastfax, for all the doctors. One that is legal, satisfying to both the lab and the hospital. We, meaning the micro lab, are happy, because we got a badass molecular machine that will do all kinds of other things to make our lives easier.

I found out I made a diagnosis, on a patient, that resulted in the wrong treatment. I am still reeling from this one. In my defense, I made the proper call at the time, and was backed up by an experienced colleague. All the ancillary tests fit. It was the right diagnosis, with all the clinical information, but time told a different story. The clinician was cool about it. But still - I made a wrong call. I learned that this happens, in my job. It is not a perfect science. I have heard other stories, from pathologists, about mistakes. This is my first. I lost sleep.

I made a comment, on my new blog at Mothers In Medicine, that was unintentionally viewed as racist. A smart Indian-American girl called me out on it. The last thing I view myself as, on the planet, is racist. But in retrospect, I could see where she was coming from. I need to be more specific, in writing. Because you can't assume that others will always share your background experiences, and know how you stand.

I haven't run in a week.

But none of this matters. Because Wednesday night, I got together with an old friend, a particularly musical one, and sang, to his guitar playing. I've never sang with an instrument before. I was inhibited at first, even though it was my idea. I loosened up eventually, and had fun. I think he did, too. We were all over the map - Kravitz to Loretta Lynn. We made a song list to start working on. I can't wait to meet again next week.

Off to Chicago in the a.m. Looking forward to some time away.