What I Learned This Week

There is a limit in my ability for forgiveness.

This is significant for me as my taking shit wall, as others have often pointed out to me throughout my life, is about 100 times too high. I'm not sure if that came out right. I can take a lot of shit, and come back smiling.

Not this shit.

I drew a line today, a brand new one, and there is an individual on the planet that is on the other side of that line.

Adversary. Foe. Enemy. There is a first for everything.

Good news is - the week is over, my side of the story is out there, and I can sleep again. Hopefully I will never see this irksome adult again. Time to move on. I have never in my life so looked forward to going back to work after a vacation. Work is going to seem like a vacation. Luckily I have the weekend to get over this nasty sinus infection that surfaced when all the stress and insomnia completely disarmed my immune system. Now everything tastes like phlegm. Yuck.

Time to go tuck Sicily in. She just sneaked in the kitchen for her ice pack, which she has named. "Mom, I call it Power Pack. It is like one of my stuffed animals now, so familiar to me it deserves a name! It gives me the power to sleep." I'm glad she has found the secret at such a young age. Wonder if anyone has ever tried to market chiropractic ice packs as sleep aids.

Girl's Night!

Well, I wasn't the only one who didn't sleep last night. My ex, Caitlin, and my mother joined me in my all nighter - all our heads were spinning without sleep until dawn. There is strength in numbers. Mom is back in LR - we ate dinner tonight. There is a plan. The truth shall prevail. Some people are stark raving lunatics - half-cocked. I feel like I need to say this has nothing to do with my divorce. Way worse. I punched some walls. Anger so strong it cannot fit into a haiku. If it took form and shape, it would rival the destruction unleashed on Pompeii by Mount Vesuvius. And that's all I am going to say about that.

Jack is spending a delightful evening with his dad and a Harry Potter movie. So Sicily and I had a girl's night! It started off with these amazing chocolate coated ice cream cones Sicily picked out at the grocery store today called FunDaze Sundaes. After mom went home, Sicily turned to me with glee. "I get to plan the evening, OK mom?"

"All right." I was a little scared.

"First, we'll play chase. Then we will make friendship bracelets. No, maybe anklets - way cuter, right? Then, music and dancing time. Finally, I get to go to sleep in your bed."

We did it all, and bedtime stretched to 10:00 p.m.

As she was falling asleep, she said, "You know what I am most excited about? You know the slow poison you told me about earlier?"

Earlier, she had filled a toy bubble, you know - one of those 50 cent toy containers in the machines at the grocery store, with water. She tried to tell me it came out of the machine like that, and I warned her not to taste it because it was probably poison. She smiled, stuck her finger in the water, and put it in her mouth.

"See, it didn't kill me."

I told her, "Well, that is because it is slow poison. In the middle of the night, over at dad's (the original plan was her there and Jack here but she switched it up at the last minute), you are going to grow horns, turn purple, orange and green, and grow a bunny rabbit tail." She giggled, and concocted ways over the next half hour or so to get the poison in my mouth (hey mom, your tongue is bleeding - ha! I touched it with slow poison!), until I was going to grow six horns, turn into a rainbow, and have three bunny tails.

I told her yes, I remembered the slow poison. She said, "Now, I get to watch you get all poisonous in the middle of the night."

I smiled. If I was a better mom I'd paint myself and make horns and bunny tails. Instead I'm just going to read my novel. I'm freaking exhausted.

Good Ole Radiohead

Did I Tell You?

It's been awhile, since I talked about how wonderful my 7 year old daughter Sicily is.

I nixed the push-ups at bedtime, because that was generating too many endorphins, and we all know how stimulating those endorphins are. I know I need mine - screw the chiropractor's advice - I've been running maniacally, especially when I have weeks to myself like last week. Running is addictive and mind-numbing. It's been a couple of days - I need a good long run tomorrow. But we've been doing lots of stretches and yoga at bedtime, and that has been fun. She's determined to do the splits, and I've been stretching so much with her, I might just get there again myself, for the first time in twenty years.

While we are stretching, she talks about how much fun she is having at her LRCC day camp with her friend Phoebe, where she delights in being introduced to tennis (Mom! I made it over the "fence" finally, it was really fun), winning Aloha Bingo two times in a row, and being introduced to track dogs and tree huggers. I'm off this week, and she had a delightful sleepover last night with her friend Charley from her new school.

I hosted a five hour play date today with Jack's best friend Jack, and their shared name caused some pretty funny situations. When Jack H.'s mom was about to come pick him up, I heard water in the bathroom and became concerned about a mess. Wandered in and saw them standing on stools, looking in the mirror, and using foam hand soap, water, and a comb to create funky, spiky hairstyles. One Jack said to the other very seriously, "Who looks more like Airbender, you or me?" Very picture worthy - the Jacks. They played so well together I got a good chunk of my book read - despite sitting with them at lunch, making Lincoln Log houses, and playing Hot Cross Buns (the best I can do, after four years of piano) over and over on the piano.

Sicily is making the best of this rough summer - she is old enough to have empathy for everyone involved and it pains my heart to watch her growing up and having to exercise it all a little too early. She has a hard time shutting down at night (don't we all) and stretching is one solution - also reading. She reads voraciously. She has taken to sleeping on a chiropractic ice pack under her head. I just tucked her in - she fell asleep finally after wigging out over a large bug outside her window and a microscopic spider on her piggy bank.

Today was an awful day. I can't say that every day, but this one took the cake. Perilous head spins threaten to keep me up late - I see more insomnia on the horizon. I told Caitlin, "I've never taken a Valium, or a Xanax, or anything like that - never wanted to - but if there was ever a day I needed one this would be it." Luckily Mom's flying back from Montana early to help me weather the next few days, which promise to be pretty challenging. I hate being so cryptic, but there are things so painful, people say things so egregious, you just can't blog about them.

Did I tell you how wonderful Sicily is? Sleeping quietly now. Golden brown skin stands out shockingly against her white sheets with little roses. Caterpillar eyelashes settled atop her chipmunk cheeks. Her ice blue frozen ice pack peeks out under her silky straight chocolate brown hair. She breathes evenly in sleep, finally settled from her day. Tomorrow will be a new one for us all. Hopefully a better one.

Go Run

Don't Google Eel Porn

Last night was my one night with the kids this week - I get them back Sunday night. So it wasn't a great night to receive the above admonition in an e-mail from a blogging friend that I hadn't heard from in six weeks. It wasn't really related to anything we were talking about, it was sort of out of the blue.

I shook it out of my head and dove into a make believe world of ogres and burglars (Ogre Burglars! Say that ten times fast) and magic powers. We were each allowed four, said Sicily. Hers were Freezing, Flying, See Through, and making herself Invisible. Wait, we could all make ourselves Invisible. I can't remember her fourth. Jack's included Lava and Bug Guts. He gave a fabulous performance of what would happen to an Ogre Burglar that happened to walk into the path of bug guts shooting out of his finger. Sicily approved of my powers - she tried to steal Spontaneous Combustion but ultimately decided she didn't want a power unless she could easily remember what it was called.

Bedtime took a little longer than usual, which is not so bothersome during the summer when you haven't put your kids to bed in a few nights. Jack was pretty riled up about the Ogre Burglars - despite the fact that we killed the very last one about a hundred times, he kept insisting there was another out there. Sicily announced to me during her one on one time that she wanted to be able to do the splits like her friends Charley and Haley, so I taught her some simple stretches to do every night and told her she would get there soon - limberness should be in her genes.

As I was kissing Jack good night, I was surprised to hear grunting and counting from Sicily's room. I asked her what the heck she was doing and she said "push-ups Mom! I saw them on TV! I did a hundred! I'm going to try to do more!" I told her that she had to do them quietly and get settled for bed, and decided not to go check her form - she couldn't be doing real push-ups if they were happening that quickly.

When I was settling into the computer and responding to e-mails and blog comments, Sicily came out again. "Mom, I did three hundred!" She was covered in a sheen of sweat so proper form or no, she was getting some exercise. I told her she needed to quit generating endorphins and get to sleep - Jack had been out for almost an hour. Then I started thinking about googling eel porn. Admonishments are reverse psychology invitations. I think she knew what she was doing when she said that. Evil friend (you know who you are).

I decided not to google it on my laptop - better to hit the viral PC desktop. I don't use the computer for porn imagery (which would be obvious to anyone who wanted to look at the history), and the last time I curiously googled a porn star who was dating someone I knew a few years back the PC died completely, which was lesson enough. I googled "eel porn" and this came up: "Japanese Anal Eel porn" with a link to a video. Oh my gosh. I just had to see what the heck that was. I couldn't help it. I shut the blinds in the computer room (what if someone saw me??) and clicked.

I started the three minute video, which involved two naked Japanese women, a funnel, and a bunch of baby eels. I was nauseated and horrified, but it was like a train wreck - I couldn't stop watching. I became fascinated that this behavior could turn anyone on. Then I started feeling sorry for the baby eels, and wondered if anyone called PETA when they watched this stuff. The images during the last few seconds have been haunting me all day. Complete lunacy.

Don't google eel porn. Really. Just don't.

Jumping Ship

Adios AT&T. I've headed back to Verizon. Got my new phone today - a Motorola Droid X. And if I thought my iphone was a lot of smartphone to handle, I'm now officially in over my head. But I'm learning.

I did a lot of research to find out what phone I wanted next. I even surfed around on tech blogs, looking at the features of everything available out there. Phone comparison on tech blogs is like reading a giant pissing contest. This camera has more megapixels! That one links e-mails better! This one has more free medical apps! That one has a bigger screen! It was mind-boggling. I did learn what HDMI cable output means (my phone has it!), and that I'm not the only one jumping ship. Hopefully I can learn a fraction of what my phone is capable of before it gets stolen again. No more leaving phones on the paper towel dispenser in a public restroom, even if for only ten minutes.

I can finally text again! I had a temporary free Samsung with limited capabilities, and I do not understand how anyone on Earth texts without a keyboard. I did not send one legible text in five days, and each one I sent took ages longer than just picking up the phone to talk. My summer nanny Caitlin was highly amused by what I came up with - she taught me how to make spaces between the words (I resorted to the number 0 as a space marker). She told me I could get a program to help me text faster but it would take me two weeks to figure out how to use it efficiently, and I was hoping to get my Droid in before then. Thank goodness it arrived in the mail today.

I played with the camera today, which is light years beyond the iphone I had - lots of settings for motion, dark, and sunlight, as well as a flash and zoom. You can automatically change the color of your pic to black and white, red tones, green tones, sepia, negative, and lots of other hues before you even take the picture. This makes it worth the purchase alone, as the iphone had become my primary camera and it's limited capabilities were limiting me.

I was worried I would not know another soul who had the Droid, so I was delighted to learn that my techie food scientist brother and his wife have the Droid Incredible. They are busy at a food science conference in Chicago this week, trying to avoid parachuting Transformers on Michigan Avenue during filming of the third movie, but I'm looking forward to picking their brains next week on the best apps to get in Android Market.

Other cool features I've encountered in less than 24 hours: The cute robot that teaches you how to add and move apps. The simultaneous tone/vibration that occurs when you type in phone numbers. The dizzying speed with which the phone adds every singe friend you have in Facebook and contact in your gmail account to your contacts (yikes, I'm going to have to make a favorites folder quick). The cool robot default sound that occurs when you receive a text. I'm already hooked.

I'm mad that you have to pay an extra $2.99 per month (I haven't decided to do this yet) to get the easy access voicemail display features that came with the iphone. In order to access your messages, you have to dial up and enter a password. Old school.

Overall though, so far, I'm pleased. I think I've got every bit as much phone, and more, as I did with the iphone (and no more dropped calls!). I can't speak to the iphone 4, but it sure is getting a lot of bad press. I forgot to mention all the perks and discounts I get from going with my group's phone service provider. I'm going to be saving tons of money with my new Droid. So maybe the stolen iphone was a blessing in disguise, after all.

Disillusionment

Read it, over at MiM.

All You Ever Wanted

My newest obsession. The Black Keys.

Attack & Release.

The Big Come-Up.

Magic Potion.

All You Ever Wanted.

Cosmic Creepers

Wow! What a bummer I've been lately.

The kids are back and all is right with the world. We enjoyed a splendid evening cooking breakfast for dinner, having water balloon fights on the trampoline, and watching Bedknobs and Broomsticks - their first viewing. They enjoyed it thoroughly (I forgot how long it was!). It was funny watching the types of special effects that earned the movie an Oscar.

Oops. After a breakfast of cinnamon rolls and a thorough, intensive grooming of children - mainly focusing on fingernails and rat's nests (J and C respectively, I mean S, whatever), I accidentally let the cat out of the bag. Sicily was re-connecting with Spotty, and I casually and absent-mindedly let it slip that Spotty I got away. She blew up in drama, wanted to know all the details, and quizzed me about our search efforts.

"Sicily, it happened long ago. We've had Spotty II for so long, you really know him better. He's like Spotty I."

"Poor Spotty I! I liked him better!"

"No, you didn't. When we got the new snake, you thought the markings on his skin were beautiful and wondered how he got so bright. We told you he just shed for the first time."

She looked at me, suspect. I think she understood I was sparing her feelings at the time, and I decided she finally became satisfied after I launched a lengthy campaign assuring her that Spotty I was living a happy, carefree life in the woods across our street chasing live rodents and meeting a mate.

She rolled her eyes, "Yeah, right mom, he probably got eaten or died somewhere in the basement."

She's only seven. I've already lost all my magic.

Then she became excited.

"Hey, Mom, since this isn't really Spotty, we need a new name. Do you think he will get confused if we change his name?"

I watched her gazing down at him fondly and lazily moving her hands to keep up with Spotty's slithering and curling. "I think you will be all right, Sicily. If it was a dog, I'd worry. But I'll bet Spotty will adjust."

"What was the name of that cat in the movie last night? I loved that name."

"Oh! Me too. Cosmic Creepers." It wasn't really a cat, just a spooky robot cat that looked like it had the mange.

"Let's name him Cosmic Creepers."

"Make sure Jack is OK with that." Oops, I mean John. I like Jack. Sicily and Jack. I'm changing his name. It's name changing day, for the boys in the house.

The eternally accommodating Jack agreed that Cosmic Creepers was a better name, and we tried it out and played with him until he pooped on my bed. Jack ran away in horror and disgust and Sicily started dry heaving. I grabbed Creepers as he was slithering under my pillows, cleaned up his hairy fecal matter, handed him to Sicily (who had recovered), and put the bedding in the wash.

I asked Sicily, "What shall we call him for short?"

"Cosmic? Or Creepers? Which do you like better, Mom?"

"I think Creepers."

"Me too."

Beautiful Mess

This was one of my favorite albums in college. Good luck finding many of the songs on YouTube or song lyrics sites. So I apologize in advance to the band if I made any mistakes.

I Get So Scared

I've had dreams

Where everything goes right

I've been that kind of high, yeah

Where life is just a ride

But it's only for a moment

It only lasts for a moment

And then I get so scared

Well I get so scared sometimes

Yeah I get so scared

That I don't know

I've been alone

I slept all by myself

And the bed seemed so bare

And I seemed so small

But it's only for a moment

It only lasts for a moment

And then I get so scared

Well I get so scared sometimes

Well I get so scared

I don't know

Yeah I don't know

Which way to run

Which way to run

And that's why, when you look, in my eyes sometimes

You can see, just how scared, just how scared I get yeah

Well just the other night

While I watched a star was born

I thought how beautiful and innocent, yeah

And all my fear was gone gone gone

But it was only for a moment

Yeah it was only for a moment

Then I get so scared

I get so scared sometimes

Yeah I get so scared

That I don't know

I don't know

Which way to run

Which way to run

Well I get so scared

Yeah I get so scared sometimes

Well I get so scared

I get so scared sometimes

Fecalith

I walked into the gross room this morning and was greeted by Bob, whose look of surprise ("I haven't seen you around here in a while, doc!") melted into a broad smile. He gave me a quick rundown of today's cases.

"You've got a couple of big ones, doc! Guess what? There was an 8 centimeter fecalith!"

I looked up at him, not sure if I was hearing right. His navy scrubs hung loosely over his large frame, and silver hair ringed the lower half of his cranium. "What?"

"Yeah, doc! I've never seen one that big in my career. Can you imagine? It filled the whole cecum. There was a great big abscess - they had to take a big chunk of the colon to get around it."

A stone of shit. Well, that is a fitting case to start off the day. That pretty much defines the latter half of my week - having my phone stolen, owing a boatload of money to the IRS, missing my kids (they are back tomorrow!) and trying to sort out the most economical next move to make, phone-wise. House is not even being viewed, anymore. I'm getting lazy about forgetting to run around and turn all the lights on (it's expensive, and it's not working). But what the hell do I have to complain about? At least I don't have an 8 centimeter stone of shit lodged in my colon. Thank god I don't have to look at it under the microscope - we grossly identify these things and move on. I'll check a few colon slides to identify margins and confirm the abscess. But we do not section fecaliths.

"And your other big case is a 7 centimeter breast cancer. It's a day for big stuff! Can you believe a breast cancer got that big? I guess she must have been in a nursing home or something."

Or she was so well-endowed, I thought to myself, that it was hidden well. Then I wondered if that was really possible, and decided no. Surely not. Bob's explanation was more likely - nursing home, maybe with a touch of Alzheimer's. I would hope, however, that in a care facility someone would have noticed the nipple retraction and peau d'orange (orange peel skin) that was surely grossly noted by Bob the day before (it was, I checked his description) - I could see evidence all over the slides of nipple involvement and even foci of pagetoid spread in the skin. Sometimes it's better not to know how these things happen.

Like the time I was training and I got half a face to gross in. Actually it was a little bit over half of a face - have you ever taken sections for margin evaluation on half a face? It is hell. The removed portion of the face (jaw, mouth, cheek, nose) was being eaten away by a common slow-growing skin tumor. I was shocked to learn the face belonged to someone who was not only married, they also had a job working at a meat-packing plant. I would have thought someone around him would have tied him up, stuffed him in the back seat of a car, and taken him to a doctor. It must have taken years for it to get so bad, and could have been nipped in the bud, when it began, with only a tiny skin scar for evidence.

Oh! I just got more cases. Time to get back to work. Hope your day is as full of big stuff as mine is. Watch out for stones of shit. Mine just hit.

Am I the Only One (Who's Ever Felt This Way)

Guilty Pleasures

Just posted, over at MiM.

Immuno Junkie

"Rex, I need a third pair of eyes. It looks like in situ, but the immunos are telling me it's invasive. How much of this is invasive cancer? Is it invasive? How do I measure it?"

He came into my office an hour later.

"Multiple choice test. There are three things that a simple H&E stain can tell you. It's way more powerful than any immunostain."

He recited them:

"A. Looking for Helicobacter pylori.

B. Looking for microinvasion in a breast cancer.

C. Looking for microinvasion to sentinel nodes, in a breast cancer.

D. All of the above."

An immunostain takes advantage of protein interactions between specific antigens and targets in the tissues. In looking for subtle invasion in breast cancer, we look at the myoepithelial cells surrounding intact ducts and lobules. P63 and calponin light up these cells. A lack of expression suggests invasive over in situ tumor cells.

"OK, I get it. You favor the H&E, in all of the above. What does that have to do with my case?"

"E - you didn't need immunos. Your calponin is fooling you. Your p63 sucks."

"Well, p63 is pretty weak this week. I told Rick, he's going to work on it. It doesn't always suck this bad."

"Yes it does. It always sucks. Actin worked all right, but that's in the past. You don't need your immunos."

"I do. I'm a junkie. I trained on immunos."

"What did you think before you did the immunos?"

"I thought it was all in situ. They confused me."

"This breast is a mess. If you want to favor microinvasion, you can. I'll support you. Based on the H&E, I favor retrograde extension in ducts and lobules. It's crawling around in the sclerosing adenosis. I really don't think it is invasive."

"Point taken. I just want to do right by the patient."

Rex is old school. Sometimes, like now, old school is better. This was a FLK - funny looking kid. Funny looking DCIS - lots of weird clear cell change.

"In my opinion, you should lean against invasion. Look at the stroma."

"It looks OK. In the places where I am worried about microinvasion, there is no desmoplastic change."

"No promises. This is an ugly cancer, and it's all over the margins. I see, by your dots, that you noticed that. She needs a mastectomy. But we haven't yet proven that it is outside of the box."

Sometimes new tools confound the nuts and bolts. Sometimes, you don't need fancy supplemental tests. You just need a good pair of eyes.