Tuesday, September 28, 2010

Marital Bliss!

I know what you are thinking. I just got divorced last Tuesday after a 13 year marriage! What the hell am I doing? But I'm headed down the aisle again. The big day is Friday. I am so excited - I think I might change out of my scrubs and wear something nice. Maybe a skirt.

It's me and Dr. Woods - we've known each other since med school, been partners in crime for 13 years.

What? No! I am not marrying Dr. Woods. That is preposterous. He is happily married to a gorgeous girl, her dad's a mayor and she's a lawyer/SAHM of three beautiful kids. Mrs. Woods is tall and slender with large brown doe eyes and silky dark straight hair. Here is my favorite story about her, one that Dr. Woods told me in residency.

"One day Josie decided on a whim to go to one of those talent searches - what's the name of that modeling company? Ford?"

"Yeah, I think that's a pretty big one."

"Yes, well it was in one of those buildings downtown - it was a week long search and Josie kept making the cut. Finally when they got to the end, she was told she was the top finalist. She was real excited, until she found out what it meant."

"What did it mean?"

"They were going to fly her to Paris and start photo shoots. She said, 'Oh no! I can't go to Europe! I just got married and he's a doctor and I'm going to have babies and all - Paris might ruin all that. I didn't realize what all this meant. I just wanted to see how far I could get. Sorry to have wasted your time.'"

I laughed. I could just hear her sweet Southern drawl and see her turn around on an opportunity like that. I love Josie stories.

But Dr. Woods and I are getting married - to the group! I'm officially a partner (pod-nuh) this Friday. I'm planning to take mom and dad to a fancy dinner - maybe Ashley's - and cooking up a blow out with as many friends as I can muster afterwards.

Three more days! I finally get my carrot. We'll be marrying 11 people - people that we have gotten to know rather well over the last three years and three months, and I guess they kind of like us. It's never too late to become a polygamist - probably useful in business transactions.

Going to the chapel and I'm / Gonna get married . . .

Saturday, September 25, 2010

Running in the Attic

I’ve had some pretty big changes in the last week.

I’m divorced. Scandalous, I know. Something that has been in the works for ages finally materialized downtown in the courthouse on Tuesday morning. One minute I was answering inanely simple questions in front of a judge and the next I was waiting for my lawyer to file the paperwork as I was chatting with my friend/witness in front of a bust of Casimir Pulaski.

“Here you go. Here’s your copy. You are divorced.”

I went home to wait for the gas guy, the one who was supposed to come the night before between 8:00 and midnight. He never showed, but I got so worked up on the treadmill at 10:00 p.m. thinking about the prospect of a strange man coming to my house at night I had my mom and dad on stand by to come over after I received his 30 minute heads-up call. I never got it.

Yes, I was on the treadmill at 10:00 p.m. And again last night. I want to say this is healthy adapting, but I have in mind the story I know of a woman who ran on the treadmill in the attic after her husband and kids were in bed. She also jumped rope. She ended up in the hospital for severe anorexia.

Well, I am a far cry from severe anorexia. And my spot upstairs with a view of the trees is a much better than the former in a concrete basement with brick pillars and an empty wooden tool rack. Every time I looked at the tool rack, while I was running, there was a blurry spot. I imagined that it was an apparition, but it never progressed from the foot radius fuzz into something more spectacular. I wondered if I needed to have my eyes checked – it lasted for years. But there is no parallel experience here in my new place on the second floor, so I guess it will remain a mystery.

Experiencing a move and divorce, all in one week, was not planned. That’s a lot of stress. But the kids and I weathered last weekend well, even had fun despite the fact that the movers were around until almost midnight and the house was swarming with moths and mosquitoes. Both kids were up half the night itching, but it was worth it watching Jack dance around the moving truck and help carry stuff in. The movers were so kind – even let him help put his bunk beds together. I tipped them heavily.

It’s my first weekend in my new house alone. I had a fabulous dinner last night with my friend/hair stylist and her 10 year old son Felex. Gifted him a book I just finished – The Hunger Games by Suzanne Collins. Gave her some brain candy from a couple of weeks ago – the autobiography of Jenna Jameson - How to Make Love Like a Porn Star. I needed some brain candy (boy was it!) after Michael Chabon’s Amazing Adventures of Cavalier and Klay and Marcel Theroux’s Far North. Both great reads.

In the divorce decree I decided to take my last name back. It’s a pretty unique and awkward one, one that I spent the first half of my life longing to get rid of, but it is strange how I feel drawn back to it desperately like an old familiar coat. I know it’s going to take months, even years maybe, to fully convert based on conversations with friends - and there are all these legal issues with cases - but I enjoyed trying it out on the dictation machine and love seeing it on the vacation and call schedule. I reveled in explaining the pronunciation to lab and office staff all week long. “On the last part – just remember I’m rude.” One of the transcriptionists laughed. “You aren’t rude. You cannot be rude.” I said, “Well, there’s always time to change, right?” She said, "I think I'll just call you Dr. Gizabeth."

New house, new name, new me. I think I need to spend the rest of the weekend alone washing my brain out and cutting off all my old associations and addictions. I need a nice strong disinfectant – preferably one with alcohol. Wine should do nicely. A cab would be perfect.

Breast conference at the University today. It was wonderful seeing old attendings and getting up to snuff on the latest developments in the breast. Papillary lesions. Columnar cell hyperplasia with atypia is now lumped in with flat epithelial atypia and columnar cell hyperplasia without atypia is no longer an entity. Things change so fast. I gained new insight into borderline cases. Nothing I had yesterday was borderline – it was all in-your-face cancer. Clear diagnosis makes a quick, easy day. I am grateful I don’t have to meet the patients.

I’m really excited about starting over. I have felt so much stronger since the separation in February, but I know I've still got a long way to go before I feel normal again. The kids and I are great, but busy. Yes, I’m still happy, Ramona!

Adios from the crazy divorced doctor mom running in the attic.

Friday, September 17, 2010

Happy Girl

I am a homeowner! I won oops own my very own winning home.

Last night I attended my groups yearly stockholder's meeting. I love the stockholder's meeting - we meet at a country club and have a wonderful (ownderful) meal. I had shrimp skewers with an amazing spicy as hell sauce and caramel bread pudding. And I got to taste my partner's paradise pie. We talk a little business, but the evening is liberally doused with fun.

The business manager usually fills the beginning of the notebook with cartoons. This year, there was an additional page with medical chart mishaps. Michelle and I laughed out loud at number three.

"Exam of the genitalia reveals that he is circus sized."

One of my other female partners pointed out that circus sized can span both ends of the extreme, small and large.

Here are some of the other entertaining ones:

"She stated that she had been constipated for most of her life until 1989 when she got a divorce."

"Rectal exam revealed a normal size thyroid."

"Both breasts are equal and reactive to light and accommodation."

"She can't get pregnant with her husband, so I will work her up."

"The patient has no past history of suicides."

"The patient refused an autopsy."

"Between you and me, we ought to be able to get this lady pregnant."

The above was listed under a page called Advanced Training for the Future Physician. I truly love my group. Darn it, I can't figure out why the entire cartoon doesn't show well in my post - it looks just fine in preview. You can google it if you want to see the rest - you really aren't missing too much.

Tonight after I closed on my house I went to my parents to pick up my kids. Sicily was swimming with my dad and Jack was playing my parent's now month-long obsession - some iphone zombie game - with my mom on the couch. After I cooked a grilled cheese, I drove home with the kids - sunroof down (although Jack was constantly cautioning us about witches and zombies). When we pulled into the garage, Sicily asked if we could just listen to music and sing for a while. So we did.

Last night in this house. Kids are so excited to spend the moving day with their summer babysitter Caitlin, and judging from the number of texts I received from Cait today - she is pumped as well. Jack and I lounged on Sicily's bed while she acted/read her latest chapter in her new book - she is on a writing obsession since she completed her twelve week reading goal in three weeks and can do whatever she wants during accelerated reading class (yes, I'm bragging about my daughter. She's pretty awesome).

I love her grasp of language. Chapter 2: New Edvenchures. Now that is exactly how that word should be spelled. Go C. "Lily and her unicorn met Princess Ariel, and she sent them on a quest. To find the lost crown. Ariel said that it was lost."

Sicily said after she read it, "Oops, that doesn't sound right. I repeated myself."

I cracked up. "No, I love it! Make it comedy. Go figure. The lost crown is lost. Who would have guessed that?"

So we did. Acted it out over and over in fits of giggles. Jack joined in, even though he didn't really get it.

Happy kids. Happy moving day. Happy me. Happy girl.

Saturday, September 11, 2010

The Internet Gods Have Spoken

They gave me wireless on my home laptop for a few months, inexplicably, after I bird dogged the problem for months to no avail. Monday night they decided that I have no business having a night time Internet social life because I need to be packing. Since I move in a week (yikes!) it makes no sense to try to troubleshoot again. I wasted enough time in the spring trying to control the uncontrollable.

The call gods, while not benevolent, weren't brutal either. I was bestowed: 4 bone marrows, 5 lymph nodes, 1 spleen, 1 apheresis, a smattering of assorted body fluids, and a peripheral blood smear. I'm about to get out of here for more fun packing. I'll need to come in tomorrow for another apheresis procedure and to look at some immunos, but it certainly won't be another 8 hour day.

Highlights of call Sat.:

I hadn't had a case of lymphogranuloma venereum in a while, so I google imaged it. I was looking for histology, not gross pics. Ewww.

Discussing with the L&D nurse whether or not we could get viable cytogenetics from a 2 week IUFD.

Showering the apheresis nurses with chocolate (my two faves who went to Afterthought with me in the spring were working today).

Getting this valuable piece of information on a bone marrow requisition form: Previous bone marrow biopsies. Note to clinician from small town where I have absolutely no access to previous path or clinic/hospital records - this is not very helpful. Especially when I see normal marrow elements. Are you looking for minimal residual lymphoma? A low grade MDS? These cells will be dead on Monday when I can call and get clinical - so I am forced to initiate flow and molecular work-up (that I can cancel or remove charges on if necessary) because I have no idea where to go. And if the patient has had previous bone marrow biopsies, that implies a history of an abnormal process in the marrow. You've got to give me a little more to go on. Even cryptic abbreviations would be preferable to previous bone marrow biopsies. Uh oh. I've been reading too much Dr. Grumpy.

On to the moving gods. Weather looks good for next Sat. I'm keeping my fingers crossed.

We won't talk about the divorce gods. Ten more days, I guess. Strange to start negotiations two weeks out, when we started this whole process six months ago. Everyone tells me how fast mine is going. Goes to show you everything is relative.

Friday, September 3, 2010


More than a ripple. He made a big damn splash. Thinking of you, cousin Tommy. Can't wait to see you again someday, in the afterlife.

Irrational Fear and Blond Moments

This month is shaping up to send my global stress level through the roof. I'm packing to move in two weeks and my divorce trial is in 2.5 weeks. I've got a lot on my plate.

I have watched a couple of close friends go through divorce so I should have been more prepared for the irrational fear that develops soon after a split. One friend was terrified of the Avian Flu - remember the bird one that came before the Swine Flu? It wasn't even local, but she was voicing her fears constantly - stockpiling and planning for the apocalypse. When I brought it up to her soon after my split (she has been divorced a few years now), she was like, "Yeah, that was really weird, but I was going through a divorce. That really messes with your head." Another friend seemed overly clingy and depressed, but she has her head back on her shoulders in a new marriage in another state (not that a marriage will straighten you out from divorce - but she's a lot happier). Back then she was following my book advice like gospel, now I am depending on her e-mails and care packages for each new novel - she has fabulous taste.

Most of my irrational fear was poured, to some extent it still is - into my financial situation. After depending on my ex to collect and dole out our salaries for years, I realized that I had become - granted I was busy with residency, pregnancy, and nursing babies - completely ignorant of finances. It got to such a ridiculous point that I was infantilized (spell check says that's not a word, but I'm making it one), to a large degree. I look back at how little I knew back in March and how much I have learned - within a couple of short months I became the primary accountant in our split because I was better at it and more organized. I keep track of the bills and make sure that we are both contributing equally not only to this house, but to his new place and all of the accompanying utilities. Lately, with my offer on a new house, I have been depending on advice from my accountant, my realtor, my mortgage guy. I've been shopping for house and car insurance. I no longer check regions.com on an hourly basis, because I am gaining a good sense of income vs. expenditures. Last night, the mortgage guy and I were texting at 10:00 p.m. about a situation with the house. This morning, I was on the phone with my accountant for 30 minutes troubleshooting taxes, the IRS, and deductions (three separate issues). The other day, my lawyer proudly noted from my bank statements that the only large sums of money that were taken from my account since February when I opened it were my car payments. No trips to Vegas. I am being responsible. I have not built up any significant new credit, nor had to borrow from dad. Yeah, I know, I'm 37 years old. Most people get here a lot sooner. But I'm kind of proud of myself.

So I'm blond. And I have the capability to perform in a way that justifies all the jokes - always have - I guess it's part of my naive personality. I've got a great excuse with all the stress this month, but it has gotten a little ridiculous in the past couple of days. For instance - we had a little buyer appraisal square footage issue earlier this week - they were all in a tizzy and wanted to come over to measure while I was home yesterday packing. I noticed the yard developed some yellow patches over the last few days and decided it had some dreaded fungus that would cause the buyers to back out the door. I called the lawn care company and left a frantic message on their answering machine detailing my worries. On the way home from work Wednesday, I looked at all the other yards. They all have yellow spots. The season is changing.

Yesterday, I left my packing for an hour or so to pick up boxes at the liquor store, get gas, and run into work to finish up a cling on breast case. At the gas station, I noticed a sign that said if I enter my local grocery store ID I could get a discount. I tried to enter it four or five times and it didn't work. It was pouring rain and I finally got fed up and decided screw the discount I'm going to just put in my debit card so I can get out of here. Apparently my repeated insults to the digital display had rendered me an idiot incapable of any further transactions outside, so I had to go inside and get help from the clerk.

He was a thin, middle-aged man with a black shirt, single gold chain necklace, pockmarked skin (from acne or burn scars - anyone's guess), and a mask of indifference. He had a thick, Middle Eastern accent when he told me, "Just get the gas and come back in and pay."

About three hours later, when I was on my way to pick up my kids, I realized horrifically that I never went in to pay. I was mortified - I had never done anything like that before - except the time I was 10 and I broke a Cinderella in the Disney World gift shop and put it in my pocket because I was afraid I was going to get in trouble. Later I sobbed to my dad in the hotel room that I had stolen a Cinderella, and he took me downstairs to straighten it out with the nice, slightly amused gift shop worker to whom I confessed tearfully. But the gas wasn't even intentional - I just forgot.

I explained to the kids what happened and why we had to stop by the gas station before Jack's soccer practice. They worried about me getting in trouble with the police, and I too wondered if they had cameras and would I be getting a phone call that evening. Unfortunately, it was a different worker, but when I explained what I had done he found the charge in the computer after I gave him a time window. "Was it $46.90? At about 12:30 p.m.?" I said, a little breathlessly, "Yes, that sounds about right. I filled the tank. It was almost empty."

"It says here it was a cash charge. Do you have cash? You have to pay in cash."

I was a little stymied. "Are you sure you can't take my debit card? I don't carry cash."

"Sorry, you have to pay in cash."

"Well, I only have $20. And I have to take my kid to soccer practice. I can run through the money machine after I drop them off for school in the morning and give you the rest. $26.90."

He looked at me suspiciously. "Are you sure you will come back?"

I looked back without speaking. My eyes said, "I'm here, aren't I?"

He laughed. "You are a good girl. You will be back."

This morning after I dropped the kids off at school, I did just as I promised. The original guy was working, and looked surprised when I walked in. I marched to the counter, muttered apologies, and looked him in the eye.

"I believe I owe you $26.90."

His mask of indifference had strangely melted into incredulity and glee. "You know, when you drove off yesterday, I thought to myself, - I will never see her again. She probably thought she payed with the card."

"No, you made it clear that I needed to come back, and I just forgot. I feel really bad about it."

He smiled at me and said, "You know, this is the first time this has happened in, I don't know, 5 or 6 years. You are the first to come back."

Now it was my turn to be surprised. "Really? Well good for me, I guess!" I walked out feeling happy that he wasn't angry with me.

Man. It is only September 3rd. This is going to be one long month. But I've got another full day alone packing and then pool and lake plans with the kids Sunday and Monday. A nice three days to - not check regions.com (I can't promise this), not worry about work, and not stress about my next two weeks. Well, I can't promise that either. But I'm relaxing tonight after a great dinner at Acadia with my friend Laurie - cumin-encrusted tuna (rare of course) with rancho risotto, sauteed vegetables, and amazing red velvet bread pudding. It's finally deck weather, and the deck was full of people dining and enjoying a long-awaited fall. Now it's time to thaw the mouse and feed Spotty.

Thursday, September 2, 2010

The Fine Line

I'm not sure why it is that whenever I am off for a few days, I think of my GI office - the one where Michelle and I currently are the only pathologists who hold privileges to sign out. Two of the other pathologists have pending privileges, and if I knew how I would sabotage the bureaucratic paperwork because a) it is really fun to drive around and go off site even though keeping up with caseloads at two different locations - GI office and main hospital - can be hairy at times b) I do not have to cover an OR or cytology or apheresis procedures so I can occasionally go out to lunch or run an errand and c) the staff are cool and different.

Take the head honcho - "GI doc." I was telling my friend from work the amazing stories about the young women who dressed up in leather minis and wore garter belts just to try to hit on him during a procedure, and how the wild and red-headed nurse would send them home to change. I told her the story with shock and amazement. She looked at me strangely. "Duh, Giz. He is hot as shit." I looked at her, surprised. "Really? I never noticed. I'll have to study him a little more carefully."

He is sort of an African-American equivalent of Matthew McConaghey (sp? too lazy to check). He is so nice and down to Earth and family-oriented - I never considered his appearance. Our first interaction consisted of him apologizing profusely for some commotion that had occurred next door in the procedure room that I hadn't heard. I guess I was so intent on what was going on in the scope that I didn't notice the screams from the patient undergoing a colonoscope. "They usually don't go on like that. Our sedation is more than adequate. I hope it didn't disturb you." No worries there.

My GI office is about four times larger than the one I inhabit at the main hospital. It also has a (squee!) window, which proved to be exciting in May but a little frustrating in July and August when the temperatures hovered above 100 - the office is not well ventilated. Keeping the blinds closed and running a fan were enough for me to maintain ambient temperature - luckily I am cold-natured and was happy not to have to run a space heater all day.

In addition to a large table that houses the scope, which is a Nikon - a nice change from my Olympus - the optics are mildly superior - there is another table with a computer monitor and a bunch of puzzling technical equipment. One day GI doc came in and sat down at the table and turned on the monitor. He was working quietly, and I became curious.

"What are you looking at?"

"I hope I am not disturbing you (love the Southern hospitality theme going here). I'm just reviewing the gross findings in a patient's small intestine. This is from a pill endoscopy."

I scooted closer in my chair. "Oh wow! That is incredible. I've read about it - a patient swallows a pill that functions as a camera, right? So you can see places where the scope won't take you."

"Exactly. Look here - these erythematous patches are a little worrisome. And I can find masses that might need to be sampled. I am puzzled by this patient's symptoms and I am trying to find out if there's something I'm missing."

He was trained elsewhere, and accordingly he samples an area of the duodenum routinely - the bulb - that I am not generally familiar with. Michelle and I joked one day about the duodenal bulb.

"The lamina propria is so jazzy! Don't you just want to call it active duodenitis, until you have looked at 30 of them and realize that is the norm for the bulb?"

Michelle agreed. Strange to have to go back and hit Sternberg after you have been in practice for a couple of years to avoid overcalling active duodenitis.

The last time I was there, a couple of weeks ago, I was fighting sleepiness in the warm sign-out room. Suddenly I heard moans. Lots of moans. Tough to ignore, now that the new place was old hat. All of a sudden I wasn't in the GI office, I was in a motel listening to nocturnal activity through paper thin walls. And I smiled, because I realized what a fine line there is between agony and ecstasy. If you can't see what is going on, it's hard to tell which one it is.