Thursday, January 27, 2011


That is what you get to do, when you leave your old life behind. Start over! When I go to Hawaii for a CME (continuing medical education) conference in a couple of weeks, that's the plan.

I'm staying at a resort on the best beach on the Big Island, right on South Kohala coast, which is where the conference is located. But the wonderful thing about this conference is that it only lasts 1/2 a day each day, leaving plenty of time for exploration.

I booked two adventure tours earlier this week. Both require hiking shoes, jeans, warm pullovers, parkas, and gloves. I know you're thinking, "Didn't she say she was going to Hawaii?" And yes, I'm bringing some bathing suits for lounging and snorkeling, but the adventures require warm clothing.

First off, Kilaueau Caverns of Fire. I was so excited, sitting at the GI office scope the other day, when my phone rang. I answered, "Hello?" and they said, "This is the Caverns of Fire, returning your phone call." How cool is it to get a phone call from the Caverns of Fire? They consist of a cavernous basement underneath the world's largest active volcano, and if you are feeling adventurous, like me, you can book the three hour spelunking tour, exploring the caverns and lava tubes with a miners hat. I didn't even know that lava tubes existed (thanks, Fodor's)! In addition to conventional cave formations, lava tubes boast lavacicles, pictured above. I've heard of stalactites and stalagmites - both of which I will also see in the 500-700 year old lava tubes and caverns, but never lavacicles. Spell check doesn't even recognize that.

When I was talking to the guide on the phone, he recommended the lava flow nearby at nighttime. I inquired as to what it was, and after he learned that I would be two hours from my hotel, he said, "You may not want to do the lava flow - you won't get in until after midnight." The lava flow is an area where active lava flows into the ocean, best observed at sunset. I agreed with him sagely and responsibly then hung up the phone and shook my head. 7 a.m meeting or no, when the hell am I ever going to get a chance again to see lava flowing into the ocean? It's kind of a no brainer. It's been a while, but I've been known to party all night, and I'm thinking lava flowing into the ocean is a much better reason to stay up late than drinking too many beers. I'll be loading up on Kona coffee for that experience.

The second adventure involves traveling with a group to the top of the "white mountain," Mauna Key, where snow falls year round. Temperatures average 30 degrees, and it is often windy. The mountain houses the world's largest astronomical observatory, reputedly the best place on Earth for viewing the night sky. Tough to get to by rental car, so I booked a tour that provides travel, hot cocoa, dinner, gloves, and jackets. Sunset on the summit followed by a trip to the observatory, which houses fancy telescopes that are hands off for the lay public. There is also an amateur room with dummy scopes and nightly stargazing sessions. The unique atmosphere promises clear skies year round to see galaxies at the edge of the universe. Space geek utopia, I'm thinking.

So in addition to boning up on breast and thyroid pathology (I'll search for hot science guys and cabana boys in my copious spare time), I'm plotting a reinvention. Promised my kids I'd bring them back some lava. Shouldn't be too hard to keep that one.

Monday, January 24, 2011

Amnesty Hour

Read it, if you want over at MiM.

Friday, January 21, 2011

Small Suspicious Minds

I received a call at around 3:00 in the afternoon.

"Dr. N, Dr. M wants to send a patient over for a parotid needle. Is that OK?"

Normally, it takes a couple of hours for a patient to come over from a clinic and check in to the hospital for a needle. "You had better OK it with the call person, in case it runs late."

She called me back a couple of minutes later. "I've scheduled it for 9:00 tomorrow morning."

The next morning, while I was triaging cases, the tech came into my office. "I've consented the patient. She is ready in fast-track room 27. Come when you are ready."

I finished my tray and headed to the ED. Typed my physician code into the keypad to gain entrance into the ED. Fast track doesn't get moving until around 11:00 a.m., so all was quiet and dark. I walked into room 27. My patient was sitting on the hospital bed - a 60 plus year old woman. Her companion sat in a chair by the bed. He was husky, not obese - dressed in a khaki hunting jacket. Despite his age, he still had a full head of hair and a stylish beard. The hair was slicked up with grease in a style better suited to the 1950's. As I walked across the room to introduce myself to the patient, he stated in a gruff manor, "Huh. I wasn't expecting a woman."

I glanced over at him to see if he was joking. He wasn't, and reiterated his previous statement with emphasis. "Nope, I really wasn't thinking you would be a woman." I crossed over to the counter to check the consents, and said lightly, "Well, what exactly were you expecting?"

"Not a woman."

I resisted my urge to tell him that this was his lucky day. Instead, I introduced myself to the patient and listened to her story, about the nodule on her parotid. It had been there for about a year and despite being treated with multiple bouts of antibiotics for a recent bout of pneumonia, it had grown a little in size. Her PCP wasn't worried about it, but she was. I usually introduce myself to my patient's companions, but his gruff manor had put me off, so I wasn't sure if this was a friend or husband. Neither person acknowledged each other's existence during the procedure, so I assumed they had been married for a long time.

The small knot on the right side of her face was mobile, which was a good sign. As I steadied the needle in the gun, her male companion asked, "So are you a foreigner?"

Had my distinctly Southern accent thrown him off? I answered, "Well, in fact I was born at UAMS."

"So does that mean you are a foreigner?"

He had me confused. He wasn't smiling, he wasn't flirting, he was dead serious. I asked, "What exactly is your definition of a foreigner?"

"You know, someone born in India, or China, who is practicing medicine here in U.S.A."

Every bone in my body was itching to engage him in heated discussion, but the rational part of me knew it would end badly. So I said, "I was born in Arkansas. I've lived here my whole life."

"So how do you pronounce that foreign name?"

"Oh! Well, it is Norweigan. Like I've told everyone my whole life, I live in a nest and I'm rude. That's how you pronounce it."

He wondered aloud, "Are you really rude?"

I looked at him and smiled. "No, I'm not at all rude." Nothing like you, I thought to myself.

I stabilized the mass in front of my patient's ear, and hit it on the first stick. It was cystic, so I was able to reduce it to almost nothing, draining the fluid into the syringe. The tech prepared the fluid for me to look at under the scope. Nothing surprising, nothing alarming. Mr. anti-woman/foreigner walked over to my scope and stood next to me during my evaluation.

"So are you like CSI? I watch that show. This looks like CSI."

"As a matter of fact, yes. Would you like to look in the scope?"

I adjusted the eyepiece for him. He was in complete awe. "What is this stuff that looks like hair?"

I told him, "It's not hair, just degenerated cellular material. But I don't see anything bad, which is a good sign."

His female companion was ecstatic that I had reduced her year-long lesion to almost nothing, and the tech escorted them both to the ED exit. When he returned to the room, we both laughed - a long awaited catharsis to a very strange experience. I read about these people - but never think they really exist. Or that I will ever encounter them. Guess I am wrong.

Tuesday, January 18, 2011

High Level Conspiracy

Read it, if you want, over at MiM.

Thursday, January 13, 2011

Moving On

Life is so weird.

It takes you on all these incredible tangents - highs and lows. Ups and downs.

I'm coming to the conclusion that certain things happen for a reason. Connections, real or imaginary, are made just to pull you out of your miserable status quo. And maybe that's the reason? For the connection? To drag you out of your stupor, make you face your own demons and conquer them so you can move on. Attention is a powerful motivator, especially when you aren't getting any.

But at some point, I've got to stop Waiting for Godot. It gets a little ridiculous. I'm relatively young, and single, and the ex has been dating for months, so I suppose it's time for me to take the plunge.

But how? My sis tells me I need to get professional photos taken and join a computer dating website. I can't tell you how much the idea of this fills me with nausea. E-harmony? Blech. My stylist told me today about a website that advertises to married couples, claiming confidentiality and promising a marital tryst ("To restore and revitalize your own marriage!") within six months or your money back. It's real. She investigated it. Sounds pretty disgusting to me.

I'm planning a trip to the Big Island of Hawaii next month - good reason to shed those holiday pounds (that I really didn't gain) and stay on the treadmill. So I look good. For myself, right? My friend Trish tells me I need to find a Hot Hawaiian Surfer Dude and have a fling. I'm not really sure how to do that. Another friend encouraged me to have a tryst with a cabana boy. While I have a vague idea of what a cabana boy is, I wanted specifics, so I googled it. Wikipedia says this,

A cabana boy is a male attendant (boy in this sense) performing 'personal services' to the guests of a hotel or a large private estate, operating from a nearby cabaƱa (American Spanish for cabin; compare cabin boy), notably on a beach. A pool boy performs the same duties at a swimming pool. Cabana boys are typically viewed as scantily clad attractive young men who cater to their clients' every whim.

Sounds pretty good, right? If they really exist. I've been doing more research on green sand beaches and underground volcanoes than cabana boys, but I guess if one comes along, I might be game. My own little week long Eat, Pray, Love - no wait, I hated that book - more like Drink, Play, F$#&. I'm not sure how these guys writing the books can swing three months and stay gainfully employed. I'm going to have to cram it all into one week.

Last fall after the divorce, to my own personal surprise, the old self-esteem sank to guttural levels. Not that it really ever wanders far from the gutter, but I had a glimmer of hope. Which was dashed.

The New Year brings it back. As the old saying goes, time heals all wounds. I am happy on my own, and am dying for something new, but also dreading complications that it might bring. So maybe I'll just hang out here for a while and see what happens. Here's hoping that a heavily tattooed, singularly empathic guy materializes (No I don't, Yes I do have one in mind). I could use a little company, right about now.

Wednesday, January 12, 2011

Monday, January 10, 2011

See, Ramona, It Really Is My Fault. I Always Get Lost.

The kids and I set off for Mount Magazine early Saturday morning. Well, not so early - we slept in until 8:30 and grabbed breakfast on the road after running a couple of errands. The person I booked the suite with gave me directions and told me it would take two hours to get there. Above all, I was admonished not to use my GPS - she told me countless families have been hopelessly lost trying to find the resort by GPS. Her directions seemed simple enough for even me to follow, so I wasn't worried.

We set out west on Highway 10 around 10:30 a.m. - putting us at the resort in plenty of time to hike a short trail and relax around the room before enjoying the indoor pool, restaurant, and arcade. The kids and I got lost playing the alphabet game, 10 guesses, and singing at the top of our lungs. I became briefly worried when I crossed back over I-40 headed to Morrilton, but stuffed it and kept on driving. About 2.5 hours into the trip, I became more worried when I reached Clinton. Wasn't Clinton the town that we stopped at on the way to Blanchard Springs last Spring? Wasn't the mountain supposed to be in the Southwest corner of the state? I decided to stop at a gas station and ask for directions.

It was a bad sign when not one of the 15 people at the gas station had heard of Mount Magazine, except for one older man that said, "Isn't that Southwest?" I went back to the car and called my dad. He got off the phone with me to research for 10 minutes, and when he called back, I was already back on the road headed in the opposite direction.

"Giz, I think you need to take 65 South back to Conway. Then head to Russellville on I-40, and take 7 from there." He went on until I said, "Well, Dad, I'm already back on the road, and you seem to have a lot of instructions. Can I just call you when I get to Russellville?"

"Sure, I'll have my phone on and I'll help you from there."

"Most importantly, how far out am I? How much longer until we get there?"

"About 2.5 hours."

Ugghh. Well, I might have made it in 5 hours if I didn't get a ticket for going 63 mph in a speed zone in Damascus (Sorry officer, I was a little heavy-footed and distracted by the stress of finding out I was 2 hours lost from my weekend destination - "It's OK - you haven't had any moving violations in over 8 years - after you pay this ticket I'll recommend you for probation.") and if the kids and I didn't need a 30 minute food/leg stretch break in Russellville. We finally made it to Mount Magazine at 4, and despite much whining from Cecelia about me being the worst trip planner on the planet and her having a worse Saturday than if she had been in school (really, C? A road trip is worse than school? She is such a drama queen), we had a blast. She entertained everyone we met with my asinine direction radar, and a lodge worker helped me discover my error - Hwy 10 and 9 briefly converge and instead of noticing that I had to turn to stay on 10, I kept heading North on 9. An honest mistake, I thought, given that our storytelling in the car had evolved to caves, flying foxes, talking mice, and purple penguins. How can you pay attention to road signs with all that going on?

The indoor pool was amazing - it seemed to be under a glass chapel in the sky, and we played until our eyes were so red we looked like vampires. After dinner, Cecelia declared our chosen dessert - Chocolate Confusion Cake - the best thing she ever tasted on the planet. It was a layer of chocolate cake, chocolate mousse, chocolate brownie, chocolate syrup, chocolate icing, and baby chocolate chips - we polished the entire slice off quickly with two scoops of vanilla ice cream, and giddily pretended to be launched into a state of perpetual confusion for the rest of the night. We had the arcade to ourselves and played air hockey tournaments until 10:00 p.m. - C quickly mastered the "mom's distracted by Jack so I can slip in a goal" maneuver and kicked my butt two times. We finished off the night with spooky bedtime stories and I was the last to fall asleep by only a minute or two. I was long forgiven for my gross direction error, and you know how the way back from a trip always seems a lot shorter than the way there? Well, that was exacerbated 10-fold, in this instance. After a hearty breakfast and a quick trip to the gift shop, we were home by a little after noon to wait for the impending snow storm.

I can't wait to book a room for the butterfly festival. C told me she dreamt of sharing Chocolate Confusion Cake with her second grade teacher. "Mom, I gave her a bite, and she tasted it, and she said it was so wonderful." A sure sign of a great dessert - one that permeates your dreams and is shared with your loved ones. See Ramona? It's not just Oklahoma. It's me. I always get lost. Take it or leave it - it's always an adventure. I spent an hour tonight planning the next one.

Thursday, January 6, 2011

Death by Chocolate

I discovered this song on an album that my partner Rex gave me for Christmas. The cover, with his jazz trio in the background, is amazing. Kasie Lunsford is the cover artist, and you can find it over at his studio Infrared Records.

Unfortunately, I can only link to a store where you can buy it. It is worth the purchase. They also cover John Lennon and Paul McCartney, Natalie Merchant, and Pat Benetar. Her voice plays so many tricks it is impossible to follow. I found the original artist on youtube.

It's pretty cool how a song can make you remember when you felt. Tears on the nursery floor. Panic attacks in the middle of the night. Granted, it was a long time ago, but still. Good to be reminded. Maybe someday it will come back, only not quite so painfully. If I could sing to that old person, it might go something like the above. Music is truly the best gift on the planet.

Tuesday, January 4, 2011

Absence Makes the Heart Grow Fonder

Hmmm. What does this old tried-and-true saying bring to mind, these days? Cheese dip. Red wine. Massages. Oh, and Mount Magazine.

It's been about 20 years since I've been to Mount Magazine. My college boyfriend Snake's dad had an old dilapidated cabin in the middle of nowhere. We would bring a tent for the front yard, since the cabin was only fit for twilight wanderings to get your creep on. It was teeming with insects, arachnids, and forest vermin. My favorite part of those weekends in the mountain weren't the dinners cooked by bonfire - I remember fondly learning to shoot a gun.

Snake usually brought along a .22 rifle and a .20 gauge shotgun. The .20 gauge had a little too much kick for my taste, but I enjoyed sighting the soda cans he set up on a log far away with his .22 rifle. He was a little more than peeved that I was a much better soda can marksman than he was, despite my novice status. I was secretly pleased. Despite the fact that my ex hoards a large number of guns in a gun safe, I never shot another gun in my 13 years of marriage. Not that I remember, anyway.

Wait, that was Mount Nebo. Not Mount Magazine. But I think they are in the same vicinity. So I am ecstatic to take my kids to Mount Magazine this weekend - I booked a King suite with a fireplace and two balconies - my partner assures me it is as good as any five star resort. The kids and I are pretty fired up about the indoor pool and the arcade that boasts air hockey. "Mom, what is air hockey?" I can't wait to show them.

Happy New Year - have I said that yet? It goes without saying. This year has got to be better than the last - a giant head f$%# of a year. I'm flying high off of a challenging call weekend with an unprecedented amount of difficult medical marrows. I stopped a radiologist in the parking lot last night and accused him of dragging patients off the street. He is older than me, and has a lot more holiday calls under his belt. Still, he remarked, "That was one of the worst calls I have ever had."

I took the kids back early Sat. so my ex could go hunting, so they had to trek up to work with me on Sunday to look at a couple of cases. They were over the moon.

"Mom, we get to go to your office? We love your office!"

They don't go that often, so I wandered into the lab and introduced them to one of my favorite techs. We headed to the doctor's lounge where there was one chocolate doughnut left - we also loaded up on Frosted Flakes, 2% milk, and juice from the fridge. I promised them if they were quiet while I looked at the stains from a lymphoma case and did a wet read on a bone marrow aspirate, then calling a clinician to give them results, that I had a surprise in store.

A couple of months ago I went to a science area in a kids store and found five microscope slides of an ant, a honeybee mouth, a planaria, a cross section of an earthworm, and I forget the others. I had been storing them next to my computer for an opportune moment, which was Sunday. I made them guess what they were looking at, and although C cheated since she could read the slide label, I was pleasantly surprised that Jack guessed the ant. I filled them with facts.

"Did you know a planaria can be cut into infinitely small pieces and regenerate fully? Meaning it can grow back from a tiny bit of itself?"

"Mom, I love the planaria the most. It is so pretty."

"Those eyespots are called ocelli. Can you imagine if someone cut off your fingers and voila! A new Cecelia was born?"

"Would it be another Cecelia with my exact personality?"

"Not possible, I think. You are one of a kind. It might look like you, but it would have to forage it's own mindset."

"Oh. That's good, I guess."

Then she went on to creating her own pathology notepads from mine - she crossed off my name and wrote below it, "Cecelia Ann Schneider, M.D." She stapled her work together and took it home. Meanwhile, Jack was busily decorating my notepads with my favorite blue highlighter. I have his work pinned up on my bulletin board full of kid art and normal values.

Yup, absence really does make the heart grow fonder. I missed the hell out of my kids last week and was glad to have four books (I recommend Little Bee by Chris Cleave, Inherent Vice by Thomas Pynchon, and Homer and Langley by E.L. Doctorow - and I won't mention the other because if you don't have anything nice to say don't say it, right???) to read at night and lots of work to keep me busy all week and weekend. The kids and I are counting down the days to the lodge. I hope to plan many more outings in the new year, to keep us all occupied. An idle mind is the devil's workshop. I enjoyed this call so much that I don't think I'll give up any more for the rest of the year.