Oh No! Mr. Elf!

Read it: at MIM.

Topic Week

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

Read it: HERE.

Fan Mail

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

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

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

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

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

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

Happy Halloween Eve

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

Waffle fries make the best vampire teeth on the planet.

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

Sober Driver - Dengue Fever

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

Floaters

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

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

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

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

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

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

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

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

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

A Day at the Arkansas State Fair

Read it, over at MiM.

Yippee! Look at Me!

I'm on Kevin M.D.!

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

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

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

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

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

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

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

Blood Bank Halloween

Read it over at MiM.

Click here: Blood Bank Halloween

And I Thought My Mom Was Crazy

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

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

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

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

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

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

That Was A Crazy Game of Poker

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

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

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

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

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

What A Difference A Year Makes

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

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

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

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

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

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

Pseudonyms

Read it here: at Mothers In Medicine.

Trouble

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

Here's Jessica Lea again.

Tears fell in Boerne

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

Now the clouds are crying snow
Here in Ohio

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

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

Swollen

The full moon rests hea-

vily between smoky clouds

Resigned to black fate.

Team Work

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

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

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

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

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

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

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

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

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

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

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

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

SPECIMEN IN BEDPAN

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

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

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

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

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

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

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

Just Another Manic Monday

Read it, over at MiM.

Click: HERE.

Monarch Butterfly

Orange and black wings

Fluttering, cloaking branches

Poised in the sunlight

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

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

Last Day of Summer

Was dream-like.

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

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

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

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

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

Hope everyone has a good summer to school transition.

Willing to Give

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

California King

"Does it count as a feeling?

If you wish that you could feel?

My evil's my discretion

And I can make anything seem unreal."

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

I will move on soon, promise.

Sexual Harassment in the Workplace

Read it, over at MiM. Click: here.

A Book Review!!

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

Uri Geller

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

I freaking love my work.

Another Blond Moment

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

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

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

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

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

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

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

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

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

Jessica Lea Mayfield II

There's never too much of a good thing.

Two other songs of note to share:

My favorite line:

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

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

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

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

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

Hope everyone has a wonderful weekend.

Jessica Lea Mayfield

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

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

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

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

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

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

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

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

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

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

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

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

I hope she returns soon.

I Am Disappeared

Baby, I Will Leave You In the Morning

Safe Landings

New post over at MiM.

Click here: Parasailing

16 Bars

Fizzy's Grand Rounds Part 2

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

A Cartoon Guide to Being a Doctor

I can't wait to read it myself.

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

Happy Tuesday.

If I Go

Rites of Passage

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

Low Road

Magic Man

Jack is 6!

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

I made a CD for party favors this week.

Puff the Magic Dragon - Peter, Paul, & Mary

Magical Mystery Tour - The Beatles

Magic Dance - David Bowie

Magic Chicken - The Aquabats!

The Sun Is a Very Magic Fellow - Donovan

Magic Carpet Ride - Steppenwolf

Magic Bus - The Who

Magic - Pilot

A Kind of Magic - Queen

It's Magic - Doris Day

Every Little Thing She Does Is Magic - The Police

Do You Believe in Magic? - The Lovin' Spoonful

We've been listening all week in the car.

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

Happy Birthday, Jack!

Hanker for a Chancre?

Case of the century.

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

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

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

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

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

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

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

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

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

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

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

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

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

Small Pot

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

The comical recipe: Here.

The wildly hysterical comment thread: Here.

Enjoy.

Is There a Doctor in the House?

Read it, over at MiM.

Jumping On the Bandwagon

Adele. Adele. Adele. I'm addicted.

This reminds me of when I finally bought Amy Winehouse.

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

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

Happy Mother's Day

You can read it if you click here: MiM

Nail In My Coffin

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

The Sleepover

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

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

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

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

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

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

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

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

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

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

Another Blond Moment

I like using hair color as an excuse, anyway.

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

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

"Dianne, I'm headed out."

"Can you smell that?"

"What?"

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

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

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

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

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

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

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

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

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

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

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

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

Foo Fighters - Another Round

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

I like this song.

The Romany Rye - Untitled (Love Song)

Star Student

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

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

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

"Uh uh. Aidan doesn't."

"Well, we'll fix that."

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

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

Rosie the Rooter

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

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

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

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

Only If You Are a Pathologist

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

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

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

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

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

Cinderella Man

Run like hell, and enjoy it.

The Snake and the Pussycat

You can read it - click here: MiM.

Is There Intelligent Life on Mars?

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

Another Like You

Kilauea Caverns of Fire

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

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

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

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

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

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

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

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

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

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

Happy Birthday Eve!

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

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

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

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

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

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

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

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

I've Got Friends

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

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

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

Thanks again, DC!!!

Going Live

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

It's beautiful, isn't it?

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

Blood, Sweat, and Tears

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

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

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

Full disclosure of my partner in crime is forthcoming.

The Rainbow

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

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

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

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

Thinking Outside of the Box

Read it, if you want, over at MiM.

Happy Valentine's Day!

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

Another Day in Paradise

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

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

"She does this for him every year?"

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

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

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

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

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

She laughed. "Well, obviously not!"

Hope everyone is having a blissfully Happy V-day.

SNOW!!!!

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

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

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

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

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

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