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.