Thursday, December 29, 2016

Tuesday, December 27, 2016

Narrow Misses, Part 4

When I left for college I was ready to end my relationship with my high school boyfriend, but I was only 16 so I did it somewhat vaguely. Muttered a bit about wanting to date around, maybe too under my breath. He wrote me long letters and called but I didn't answer either for a couple of months. Thought this sent a clear enough signal.

He came to my college one weekend and partied with a high school friend. I happened to be in the same guy's dorm that night hanging out with some friends. I bumped into him and was startled. He was obviously inebriated. He pleaded to continue our relationship, I said I really didn't want to talk to him and it was over. Next came a string of female four letter invectives that sent me running into a room and climbing on the top bunk. He came after me. Luckily it was so loud four other guys rushed to my aid as he was screaming and cursing. They tried to reason with him, to no avail. He had to be dragged away by a cluster of men. I shakily climbed down from the bunk, called a girl friend, and we went to the grocery store. I needed to do something mundane, in bright lights, to clear my head.

I'm telling these stories not for pity, I'm long over them, but because this Fall I'm doing some clearing of attic clutter. And it feels good, but it's hard too. I'm reframing past experiences in a whole new wonderful lens. You see I blamed myself for not breaking up right. But it wasn't my fault. Adolescent kids don't always break up right - there is no couples counseling we are just feeling things out. My lack of interaction over months was a clear signal, and I didn't invite that violence from someone I loved. He was in pain, I get it, pain induces rage. But it's no excuse. I've forgiven him. He came to my wedding last month, and I was happy to catch up with his parents there too.

When I approached a male partner, my work brother, a conservative, in anger over Trump's remarks when they had just leaked out about grabbing girls in the pussy he said, "Oh that's just locker room talk. Girls are just as bad." I said a few choice words and then backed off. I cannot change this mentality. No, girls are not as bad. Girls can talk pretty salty, but they don't brag about assaulting men. They don't drug them, rape them, and then laugh and egg each other on. I'm pretty sure that a guy wouldn't be much use after a roofie, but most girls wouldn't dream of doing that. There are exceptions, I know, but it's not all pervasive.

When I broke up with my college boyfriend for the second and almost final time, it was after a winter formal. We all went to a separate location, had a formal dance, and stayed in a hotel room in the facility. He was getting too drunk and no fun so I started dancing with a platonic male friend - fast only, no slow dances. I noticed he was missing so went to try to find him in our room. When I walked in he was shaking and threw me up against the wall in a state of rage. Accused me of cheating. I was so mad I slept curled up in a ball on the floor.

His last girlfriend had cheated on him, and I was a victim of that projection off and on for two years. That was the only time he physically assaulted me, but there was plenty of verbal shit. In college between our Freshman and Sophomore years it was particularly awful when we were apart. I remember my parents pleading with me to talk to him because if he didn't know where I was he would call the house phone until 3 am over and over. The happy bespectacled Kid Rock could turn on a dime, like Dr. Jekyll and Mr. Hyde. Now I am Facebook friends with his wife, and enjoy watching him grow older. He's going bald and has a little gut and has two beautiful children. I'm happy he's settled down.

I read a story a few years back - can't remember if it was an article or a short story or a novel, but it has stuck with me because it was so heinous. A woman told of a bad marriage. Her husband was no help when her kids were a toddler and a baby, he moved downstairs. She was doing everything with them at night and working a full time job. He became addicted to bad porn. She knew this because she had to go downstairs every morning before the nanny came to close it out on the computer and clean up the chair. She begged him for a new computer chair, one that wasn't full of his stains, but he was a tightwad. He only regarded her with anger and disdain. Then when Viagra came out, he obtained it for him and his friend, she overheard a phone conversation. At some point he decided to shift the party from downstairs to upstairs. He knew she wouldn't agree, so he decided to drug and rape her. A handful of times. He wanted to try out the new drug.

As I read I thought, what a fucked up, distorted mind. What a completely fucking idiot. Utter lack of respect. Who in their right mind would do that to their wife who they made vows too, the mother of their children? It took her 2.5 years to put it all together, he left clues. She finally developed a vague sense of something wrong, and confronted him in couple's therapy. He vaguely acknowledged, and promised to never do it again. She stood up with a level voice and told him to find another place to sleep, she was calling a divorce lawyer.

It would be another month or two before all the pieces fell into place. Minds are curious and wonderful things, they wait until you are ready to confront your demons. I didn't even know him, but I was ready to gnash his guts out with my teeth and feed the intestines to the pigs. I know rage, and I imagined the cad who might confront her from behind in a dark alley. He would probably get his eyeballs ripped out, she enjoying it gleefully, maybe even eating them maniacally.

This happens. Women blame themselves over and over for this shit. I know, because I have a lot of girlfriends, and they've been through some awful things. Things I would never repeat, because I was told in confidence, but things that would curl your hair. But women are not to blame. White male entitlement is to blame. I know, because I was smart and I worked damn hard. Twice as hard as the lazy dumbass next to me, but he was still regarded in a higher light.

I'm flying to Washington, D.C. next month, during the inauguration. I'm going to the Women's March on Washington. I've already agreed to lead the Sunday School afterwards. Me!! I can't wait to do it, and to tell them all about it. For women, life can be like Groundhog Day. Physical and sexual assault are ubiquitous. But we remain kind, good, and full of action and warmth.

"Out of suffering have emerged the strongest souls; the most massive characters are seared with scars." - Khalil Gibran

Monday, December 26, 2016

Narrow Misses, Part 3

When I was in college, hell, no different from now, I listened to music in my car at a very high volume. It's a nice private space where you can sing at the top of your lungs and no one will shush you or act embarrassed.

There are a lot of train tracks in Conway, AR. So it was not uncommon to sit on one waiting for a light to go green. Once I was sitting in my Jeep, music loud, singing, and all of a sudden there was banging on my window. Startled, I turned the music down and opened the window. It was mid-afternoon, broad daylight.

"Get the hell out of the way! There is a train coming!"

Sure enough, I missed the warning sounds because I was lost in the music. I could see it rapidly approaching and gunned the accelerator right before I missed an impending doom.

There was a girl who worked at a restaurant in Conway, the one with the good cheese dip. I forget the name. Everyone asked, "What happened to her?" She wasn't well enough to wait, she just bussed tables. "She got hit by a train. Lucky to be alive, but severely compromised."

I was glad that random stranger saved me from her fate.

Friday, December 23, 2016

Thursday, December 22, 2016

Tumor Board

The Nightingale: I've got another case. She's in her 70's, she's frail. There it is. The radiology. See those three lesions? It's BAC. What do I do with that.

Bronchoalveolar carcinoma. Slow growing, and insidious. In pathology, we call the growth pattern lepidic. It grows along the alveolar parenchyma like a butterfly.

Rad: Is she a smoker?

The Nightingale: Yes, but. Her son blamed her condition on her smoking. I tried to tell him it's more complicated than that.

Ancient thoracic surgeon that smokes cigars in the doctor's parking lot: She's not going to die of that. Tell her to keep smoking. I'd keep smoking if I had that diagnosis.

Rad: I only worry about her lung capacity. You say she is frail. These things can percolate for years, then they get bigger.

Ancient surgeon: Yeah, I'd follow her every six months with radiology.

Rad: Is she a candidate for SBRT?

Stereotactic body radiation therapy.

The Nightingale: I could offer her that. Absolutely. But right now, watch and wait, right? That's the consensus? Next case?

Wednesday, December 21, 2016

Diva Cup and Zombies

I left my office today and got sideswiped. There were hordes of people in the lab hallway.

My office is separated from the other pathologists, the clinical lab, transcription, and histology by this hallway. About three months ago the entire hospital traffic from the main hospital to the food and gift shop was re-routed for 10 weeks due to major construction. We were warned, we were prepared, but it was still Hell. Every time I left my office I had to check both ways to ensure I wasn't flattened by a wheelchair or trampled by a listless patient in a nightgown. Traffic varied - it trickled, it was steady, there were hordes. The worst was getting called to a rad needle or a frozen section and being hampered by what we eventually all dubbed zombies. And I thought it was over for good.

I stormed into transcription. "What is going on?"

"They have re-routed to tile."

"And that takes like one day right? Why weren't we warned?"

"It's going on until January 6."

As if that wasn't enough, the construction started and the sounds were vaulted directly to the ceiling above me. I might have to buy some more earplugs tomorrow.

I left around noon to meet an OB/GYN friend. My son had left some presents for me in her car when he was at a sleepover with her son last weekend. I had seen her office a few months ago, pre big time renovation, and wanted to see the finished product.

I texted her from the seventh floor. "There is no 770. I'm in neurosurgery. Help."

"You are in the wrong tower."

When I made it to the right tower she excitedly greeted me in the waiting room.

"I just got a whole shipment of this lubricant! All natural. Isn't the bottle lovely?"

"What is that for?"

"Um, sex?"

"I know, I've just never used it."

"It's more popular with the post-menopausal crowd and breastfeeding moms. And women who hate their husbands."

I met her partner who I had helped out with a case of pinworm on the cervix earlier this year. We laughed about posting pics in our relative PMG fields on Facebook. They started talking about this revolutionary thing for menstruation, called the Diva Cup.

"What is a Diva Cup?"

"You don't need to know, if you have been on IUD for ten years."

"Yes, but for my daughter. I want to know."

"It's this cup, you put it in in the shower in the morning. You don't have to change it for twelve hours. Beats tampons and pads by far. Might not want to have sex with it, but maybe you can."

"I would think it might get bumped against."

"Girl, you only had two kids. We both had three. Big difference. It's like a cavern in there. Diva cup won't affect anything."

Party Post

KC posted about my wedding over at MiM today! Squee! Check it out.

Celebrating with Gizabeth

Sunday, December 18, 2016

An Ode to the Bralette

When my daughter asked me to go with her to the mall the week before Christmas Eve I felt like I had been asked to be waterboarded.

"Ok, anything for you sweetie."

We headed there and luckily, as a native of Little Rock, I knew the back roads and could find a decent parking spot.

On the way up the stairs to Dillard's she was telling me she wanted to find a bralette.

"What's a bralette?"

Eye roll. Go figure.

We made it to Airie on the third floor and I settled down to being the Mom who looks at her daughter and approves clothing. But I was still curious about the bralette. How, I wondered, was it different from the bra?

While she was trying on clothes I decided to ask the sales clerk.

"I'm a 36 C, or B. C now." Weight gain has its perks. It's universal. But I'm still determined to get back into the jeans I could wear back in the Spring, ones I have worn for most of my life. No rush. I've stopped getting on the scale daily. I'm going to take it slow. It's not that I don't love how I look, it's just I'm a little bit frugal. It might be expensive to buy all new jeans. I'm only about 8 pounds away. Not really sure. I stopped getting on the scale. I vow to enjoy the holidays.

"You need a large. That's my size too."

I went over to the 50% off bin and grabbed about 10. Tried on three, and fell in love. Screw more trying on, if the rest doesn't fit, I'll just donate to Goodwill. I'm done with the dressing room.

Epiphany. I haven't had such a comfortable bra since my night nursing bra. It was white and cotton and elastic and wonderful. But these were lacy and racy and beautiful. And they didn't have the ridiculous padding and shaping that I had tried to escape for the last 20 years. Even if bras are designed by women, they must have been controlled by men. The only ones I love I bought 15 years ago and cannot find, despite much research. Ones that still have wires, but no crazy padding. These bralettes were a cousin of those. A superior cousin, one that didn't gouge and bleed me as it was falling apart on a plane or at work. I felt like I was in Heaven.

I told the sales clerk: "I feel like this is the day I learned to ride a bike. Or drive a car. These are amazing. I have my underwires, but I cannot imagine I will ever use them again."

Meanwhile, C was texting me. "Where are you? I'm at Forever 21."

That was on the bottom floor. The mall was hot and crowded. I was sweaty and uncomfortable. I looked for stairs, and found them to the second floor, but not to the first where she was. Escalator was stressful and out of the question. I found the elevator and rode it with old women and women with strollers.

I met C in the food court. "Mom, what took you so long?"

"Well, escalators stress me out. I have an irrational fear. I can face it, but didn't feel like it today."

"What? Really? Escalators?!!"

"Um, yeah. I could have handled it if you were with me. The ones in the main mall are so out in the open. I feel like if I step on one I will  be riding into oblivion. It's so crazy, I know. These are nothing in comparison to the DC Metro. They are ten times as long. I was sweating and shaking the whole time. I think I will be fine on the ones at Dillard's." And I was.

I'm wearing bralettes for the rest of my life, I think.

Narrow Misses, Part 2

When I broke up with my college boyfriend for the third and final time, I was done with dating, apart from a couple of unsuccessful forays, for five years until I met my first husband.

My friend Jen would get me through the last two years of college. We did everything together. Ate meals, went on group camping trips, studied until the break of dawn. Once we were headed to some apartments to party on a Friday night with a 12 pack of beer in the back seat of my Jeep, each of us sipping a cold one in the front seat. The apartments were less that a mile from the dorm, but somehow I managed to garner attention from a local cop.

Our "Oh shit" buzzer went off when I noticed the blue lights in my rear view mirror. I raced to cover the cooler in the backseat and we buried the two open beer bottles in the console as I pulled over on the side of the road. We were only 18.

I rolled down the window and smiled at the officer sweetly. "What were we doing wrong?"

"Do you know what a California stop is?"


"You just did it. It's when you pull up to a Stop sign, and instead of stop, you just slow down and go right through."

"I am so sorry. I'll never do that again."

"That's all right. You girls stay safe. And pay attention to the Stop signs. You stop a full three seconds, count them, before you make a turn."

"Ok, we promise. Thank you."

Friday, December 16, 2016

Friday Morning Baseball

Not my term. Cid Vicious. I know nothing about sports. But I get it. This day was crazy.

Parking lot 7:45 a.m: Headed to bronch lab. You are on standby for CT.

In between needles I triaged 8 cancer cases.

Bronch lab: You've got it. It's malignant. (Go Cid. He's so refreshingly fast).

CT: I think it might be lymphoma. History doesn't fit - multiple liver lesions, but get flow. I'll tell CP call doc.

Bronch lab: More blood and B9 bronchs. Hopefully it will be in the cell block. Not on smears. (Sorry Cid).

CT: Lymph node? I guess maybe follicular lymphoma. That's what we usually see in the abdomen. But get flow. This isn't obvious high grade lymphoma. Flow will tell if it's clonal.

Rad: Did I tell you I was moving to Atlanta? Not until March. Marietta.

Me: What??!! You haven't been here that long. But good luck, I love Atlanta. Sis is a P.A. at children's hospital Scottish Right. Bro is a criminal defense lawyer. I've been there a lot. We will miss you, but you are going to a good place.

4:00 - There is this doc, on the phone. He wants to bring you fruit.

Me: I remember him. Cleared him on an autopsy a few years back. He talked to me about spirituality and Buddha for a half hour. Not ready for that today. Last batch of fruit was rotten. Take a message. I've had a day, and I'm done. I'm ready for the weekend.

Thursday, December 15, 2016

Tumor Board

Dr. Owl: I'd like to present a patient. Can you pull him up?

Radiologist types in name and retrieves MRI for the big screen.

Dr. Owl: This guy has cancer, it ate up his entire face. Wait. What? That can't be him. Before therapy? No, oh! You have the wrong name.

Radiologist: Oh! Heh Heh. Funny how two wrong letters can do that. And the fact that the other guy also had a head MRI? Weird.

Dr. Owl: I threw chemo. And chemo. More chemo. And chemo. It kept coming back. And coming back. And coming back. And coming back.

Me: What type of cancer was it?

Dr. Owl: Squamous cell carcinoma.

Radiologist pulls up correct scan, and a collective gasp arises from the 25 or so doctors in the room.

Dr. Owl: Yes that's it! Impressive, huh? You could put a fist through that hole in his head. I started him on OPDIVO, a year ago, back before you had to do a PDL-1 to get approved. No progression. Stopped it dead in it's tracks.

The Nightingale: I'm from Texas, and a couple of years ago a Texas researcher started going on about immunotherapy, and everyone was like Pooh! But now look at this. It's amazing.

Dr. Owl: So do I just keep him on it? It's been a year. He's doing great.

The Nightingale: We don't have long term follow up studies. It's too new. I would keep going with it.

Me: I had a case like that in residency. It was basal cell carcinoma. He ignored it until it ate half his face. Went to his liver. Only time I've grossed half a face.

Swagger and Sagacity: Yes, stay on OPDIVO. And get him a bathroom scale from Sears. Better than any follow up PET or MRI. If your patient is gaining weight, you are doing the right thing. Are you going to get a plastic surgeon on that?

Dr. Owl: That's out of my hands. I'm leaving that up to Dr. ENT.

The Nightingale: Next case?

Wednesday, December 14, 2016

Cher - Just Like Jesse James

Narrow Misses, Part 1

There are many times in my life that I should have been killed, or at least gotten a DUI. But the gods intervened in my favor. Too many to tell in one blog post, so this will be a series.

The song I listened to last night reminded me of one time. I was status post college, living in an apartment down by the Arkansas River. Two of my best friends from college, Jon and Brandon, lived in a condo down on Main Street. Main Street wasn't developed like it is now. But Jon's apartment was incredible, a true testament to his calling. He ditched his doctor job for decorating. That was the future though. At this point, he still had his eyes on the doctor prize.

At the time I was working three jobs - DNA researcher by day - with a Jack White look-a-like Ph.D. candidate teacher. Psych counselor on nights and weekends. Taking classes at UALR to get into medical school when I could fit it in. Weekends were spent with Jon and Brandon. We would pre-drink until after midnight. It was beer back then - I didn't develop a taste for wine until my late twenties. So I was still pounding the beer.

One night I went to their place to ring and couldn't remember their apartment number. Didn't want to random alarm all the guests, so I decided to go call and ask from a pay phone - this was pre cell phone days. I found one on Main Street, about a block away from Juanita's. Just as they gave me the number to buzz, I was startled by a policeman who pulled up between me and my Jeep and the pay phone. He got out of his car and dressed me down.

"What the hell are you doing out here at this time of night? If you were my daughter . . . Did you know there was a guy about to do something to you? I pulled up at just the right time, and he ran away."

What could I say? Thank you officer.

Later at Jon and Brandon's I did what I did most nights before we headed to Discovery for a night of dancing and watching drag shows. I sang. Mostly Cher. My fave was Just like Jesse James, and they thought I sounded just like her. So much so that 20 years later at my cousin's birthday party - it had a mystery guest theme where they taped a name of a famous person to your back and you had to try to figure out who you were - I was flummoxed. Finally Jon told me - you are Cher. Don't you remember?

One night I was at Disco with another friend - a cool nurse at the psych unit who looked like a platinum blonde 1950's pinup. I was enamored by her, but she wasn't a reliable partner in crime. I discovered, around 3am, that she had abandoned me for some guy. I was a little alarmed, because a creepy guy had been stalking me all night and I was over it. No more dancing until sunup. I needed to leave.

As soon as I left, I heard him behind me. Fuck, I thought, and started to run. Back in those days, when you pulled up to disco at midnight, you had to park a football field away. I ran harder and faster than him, and was thankful I had my hardtop instead of my soft top on my Jeep, but my heart still pounded. As I climbed into my Jeep and started the ignition, he started pounding on the doors. "I just want to talk to you!" Hell no. I pulled away.

Jon and Brandon would have never abandoned me. They kept me safe, and often climbed in bed with me in the wee hours of the morning, making me feel safe and happy in their completely platonic love for me. I feel lucky to have had them in my life back then.

Tuesday, December 13, 2016

Wednesday, December 7, 2016


Police officer: So the only thing of value was a rock? Tell me about the rock. When was the last time you saw it?

Me: It's a rare rock. I bought it this summer and was transporting it to my office. I left my car unlocked, accidentally and uncharacteristically, overnight. When I left for work at 7:15, my car had obviously been ransacked. I don't expect to find the rock, but when I posted in Foxcroft neighborhood it was apparent to me that many other cars were ransacked last night.

Police officer: It happens in every neighborhood. What is so special about this rock?

Me: It was named after the founder, I think it was in 1976. He named it for his daughter, Larissa, and the Spanish word for sea, Mar. Larimar. You can find more on Wikipedia. It's only found on one square mile of the Earth. A perfect storm of sea and copper. It's beautiful. Here's a pic I found on google images.

My rock is not as big as this, it's about the size of a lime, but less round. It cost around 600-700 dollars. The one I really wanted was 3K. Too much. There is only one rock dealer for this rock, that I know of, in the US. They are based in Colorado.

Police officer: When I hear the words rock dealer, I usually go in a different direction, in my head.

Me: Yes, some girls collect jewelry, other rocks, but I'm a fossil and rock collector. This is the most I've ever spent on a rock. I know I'm not going to find my rock, I've already given it up to the Universe. But I wanted to report so you could maybe step up night patrol around here. It's a problem.

Police officer: Yes, it is in every neighborhood. One guy in the Heights caught some of them on deercam. We arrested them. Your stretch is very dark - you need more motion lights. There aren't enough street lights.

Me: Yes I've noticed that. Tried to exercise before dawn, and got so scared I went back home to the treadmill.

He was very nice. We chatted about kids and pets: geckos, snakes, cats, dogs, and ferrets. We both agreed spiders were not an option: me relaying my freak out pull over on the side of the road if a miniscule spider falls from my visor - him telling me about shooting a tarantula because he was afraid to get too close. He talked about how beautiful my house was, and wanted to know more about a mural in the living room.

Me: Oh that's my cousin Eleanor. She's super talented - traveled the world and trained in printing in Knoxville and in advertising in Atlanta at Portfolio. She's hiked Machu Picchu. I think most of this is Turkey. 

Police officer: Check pawn shops and Craigslist. But I doubt you will ever see your rock again.

Two minutes later the doorbell rang.

Police officer: I'm glad you told me it was in a white box. I think I recovered your rock in the drain next door.

Me: Can I give you a hug? Is that ok? Thank you! I'm so excited. Happy holidays to you.

Now all of Foxcroft neighborhood knows me as the crazy rock lady. I'll own that.

Thursday, December 1, 2016

Dinner Conversation

"Mom I'm so excited I got a part in the 5th grade Christmas play."

"You did? What is your part?"

"I want it to be a surprise. I didn't get the part I really wanted, the lead Benjamin."

"Who did?"

"The music teacher's son."

She's the one that does the programs. "Nepotism!"

"What's that?"

"Well, it's when you give a job or role to a family member over other qualified people, but don't tell them I said that. It's kind of a mean thing to say. Anyway, he's a good actor too."

"Yeah, he's a good actor, maybe better than me, but I'm a way better singer."

"Oh, try not to compare. You are both good actors. And yes you are a very good singer remember how everyone was talking about your performance in the class opera last year? It was amazing. And next year you will have the new drama teacher in middle school. His kids are way younger than you, no competition there."

"Did you ever try out for a play?"

"Me? Yes! But not until 10th grade. I was so shy. The first year I got a part in Oliver Twist. It was a small part, selling roses on the street. I had a solo. Want me to sing it for you?"


"Will you buy my sweet red roses two blooms for a penny."

"I like that."

"Then my part got stolen from me. There was this girl, she was a senior and very loud, and she wanted my part. Next thing I knew a few days later I was the girl selling strawberries singing Ripe! Strawberries ripe! That was her part. I figured she complained to the director, who was really just a nice art teacher. It was a bit of a stretch for me, because I'm not a soprano."

"Yeah, I like the other part much better. Weren't you mad?"

"A little, but I was excited to be a part of the production, and I really didn't want to deal with any drama with this girl. It wasn't worth it. I just sang the part I knew I got in the shower, on the way to school, etc."

"Were you ever in any other plays?"

"Oh yes! I had a much bigger part the next year in the fall musical. It was The Music Man. I played Eulalie Mackecknie Shinn. She wasn't the lead, but she was the mayor's wife, kind of the comedy role. I got to dress as the Statue of Liberty and pop out of a Grecian Urn! It was so fun. Everyone was very surprised. Even my school headmaster came up and praised my performance. He told me he thought of me as the girl always looking at her feet in the school hallway not a stage ham."

"I want to watch that musical. Did you ever do any others?"

"You should YouTube some of the songs. No, I didn't. My senior year I did other stuff. We'd better get to the play downtown. Opening night of A Christmas Story."

By the Spring of my junior year I was in a rebellious mood. It's kind of tough being a rebel when you are a white girl in an elite public school, but you cannot help the situation you are born into, and I was determined to rattle the cages as best I could. I started by plotting a coup. I and all my friends had been on the Pom Squad or cheerleaders for the last three years. It's what you did there. Being gravity challenged, I was on the Pom Squad. I enjoyed the fellowship and the dance routines - I was good at it, but all the extra duties were beginning to grate on me. Helping the cheerleaders cheer during basketball season, when there were so many games. Making posters and care packages for all the basketball and football players every homecoming. I like to show off my bubble letters as much as any teenager, but what about me? I showed up at every game. I never got a sign or a care package. Screw this gig.

So I started talking to my friends. "It's going to be our Senior Year! Last year of high school. Do we want to spend half our nights and weekends cheering and traveling when we could be partying and going to the movies? I'm quitting. Please join me." My insidious plot worked. I decapitated the senior leadership from the Pom Squad and managed to get one of the most popular girls in our class to quit cheerleading. The coaches were livid. I received some lectures. "All the Moms are so angry with you. I'm so disappointed in you." I smiled sweetly, told them I was sorry, and thought I don't really care.

By Senior year, I was wanting to replace Pom Squad with a different sport. Me and four of my guy friends - all of us had hating team sports and loving academics and art and music that was not on the radio in common - decided to start a swim team. We found a place to swim and a couple of coaches and carpooled each other to the practices. A few months in, one of the guys pulled me aside at my locker. He told me he was feeling really uncomfortable and had to tell me that the junior coach was making very lewd statements about me during practice to all the guys. They hated it. They didn't know what to do, but thought I should know. I was so angry. I knew just who he was talking about - he leered in the worst way. I stewed on what to do for a couple of days.

The next practice came around, and I told my friends to count me out. The next morning they rallied around me and tried to persuade me back. "You are the best one on the team. Please come back. You are our only chance of winning. The head coach said he would do anything to get you back." I told them sorry but no chance in Hell. I thought winning is not nearly as important to me as not being made and object. I'll swim alone.

Later that Spring, I was publicly tapped with the homecoming queen to spearhead a Just Say No to Drugs campaign for the entire school. They called us up at assembly and handed us green Just Say No ribbons. This didn't settle well with me - the admin didn't even ask me. Four days later I made an appointment with the vice principal. I sat in his office and told him I had to decline. I hadn't done drugs, but would feel like a hypocrite being an ambassador to a campaign I didn't fully support. I told him I believed some drugs are ok, even illegal ones, and I hadn't ruled out experimenting someday. He respectfully accepted my resignation, and another student was named to fill my place.

I didn't tell Jack all of this, but someday I will. When I graduated in the Spring of 1990, even though I pissed a lot of people off, I felt good that I had stuck to my principles, rather than maintaining the status quo.

Wednesday, November 23, 2016

Gross Room 4:35

What are you all still doing here? Go home! I sent other AP doc home two hours ago. And cytology. CT is dead. Bronch room and OR too. There are too many of you and looks like not much work to do. How will Friday be?

P.A. #1: Maybe around 100 blocks. Full day, but not too crazy. Gyn/onc surgeon doing three cases.

Ugh, he's going to want frozens. But we will be here. So go home. Too many P.A.'s spoil the um, organ.

P.A.#2: Sorry, but that can be taken in more than one way.


P.A.#2: My mind just goes there.

I love it. I'm on call, will take care of everything. Go home. Enjoy the holiday.

P.A.#1: I've got thirty minute drive. Going to take you up on that now.

P.A.#3: I'm on call with you. I don't like the use of your word dead. OR settled, not dead.

Ok, yes. Settling down for a long winter's sleep. I'll take that.

P.A.#4: It's going to be a long winter.

Friday, November 18, 2016

A link

Please read this powerful anonymous guest post over at my other blog, MiM.

Our scars are our torches

I'm chilling with my med school bestie in Jonesboro, status post lab inspection, with wine and kids and birthdays. Hope you all are having a good weekend.

Wednesday, November 9, 2016



"I wish it need not have happened in my time," said Frodo. "So do I," said Gandalf, "and so do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given us."

Newton's third law: For every action, there is an equal and opposite reaction. That was my mantra, that got me through my workday.


Homemade meatballs. Kids fave. Celebratory dinner turned comfort dinner. We talked politics and positivity.


Donate. Arkansas Food Bank. ACLU. Planned Parenthood. Etc. Just a beginning to a long four years.

5:30 am. question (after telling my daughter on text that I'm sorry, I was wrong, it will be ok, we have family and friends and that is what is important): Can you impeach a president that hasn't yet been sworn into office? (No, I think).

Tuesday, October 25, 2016


Dr. Music: Yes, S.E.?

He calls me S.E. Cupp, ever since I got my blended bifocals in February for presbyopia. I don't have cable, had to google her.

Me: Help. Endobronchial lesion. Bland as hell. Ordered some stains, no hits. I'm stumped.

Three hours later. Most consults like to tell you what they think. This guy likes to play attending. I'm used to it. His expertise is almost worth it.

Dr. Music (barging in my office): So what do you think this is?

Me: Well not sure. Bland endobronchial lesion. Obviously ruled out carcinoid and low grade adeno, my best thoughts. What do you think?

Dr. Music: It's obviously prostate cancer, and he has a history.

Me: Um, well, I guess that fits histologically, but I've never seen it metastasize there. History? Oops I missed that. Had like 8 diagnostics this morning. I'll throw on a PSA and PAP. Surely you saw the history before you figured that out?

Dr. Music: No. I thought of prostate cancer right away. (Barges out the door).

5 minutes later phone rings.

Me: Hello?

Dr. Music: Didn't you have Dr. Ancient at the VA? If you paid attention you would have known what this is.

Me: Yes I had Dr. Ancient.

Dr. Music: Dr. Ancient taught us that there are three cancers that metastasize as endobronchial lesions. Melanoma. Renal cell carcinoma. Prostate adenocarcinoma.

Me: Well, but . . .

Dr. Music: You would have known what this was right away if you were paying any attention at all in residency.

With all due respect to the great Dr. Ancient, by the time I was his resident he was Dr. Over Ancient. For example, once he gave an unknown conference where every single unknown for the entire hour was small cell carcinoma. We residents vacillated between alarm, amusement, and pity. But Dr. Music didn't let me get a word in edgewise to tell him about that.

Me: I've never seen any of those cancers manifest as endobronchial lesions. And I doubt I'll see it again in the next 15 years. But don't worry, you are burning it into my brain today. I won't forget.

Dr. Music: Good! You'd better think of that next time. I've done my duty here.

Next morning PSA (prostate specific antigen) and PAP lit up like a Christmas tree. I didn't text Dr. Music to let him know he was right. He's already a megalomaniac, as evidenced by the nickname given to him by the secretaries.

Friday, October 21, 2016


Secretary: Dr. Shyder a woman called and wants you to look at her mom's case. She needs an expert.

Me: No, what? Are you sure? She probably wants her mom's case to be sent out to be reviewed by an expert. Did you get her mom's name? A case number? How do I look her up?

Secretary: No. She was talking so fast. I only got a number.

Secretary #2: I'll call the number and try to get more information for you.

Me: Thanks. Weird. No rush on that.

Later in the afternoon.

Secretary #2: Dr. Shyder you're not going to believe this. She's from another state. Her mom's death was ruled a suicide. She googled and found you as the expert. She wants you to review the case because she believes it was a homicide.

Me: ?? Give me a little bit of time to figure this out.

Post in PMG pathology. Get lots of advice. Most pertinent:

I'm Priya Banerjee. Please refer her to me. I'll evaluate the case, and even if she doesn't like my assessment I'll be objective.

Me: Secretary #2 will you please call her back and tell her I'm not an expert in forensic pathology but this doc is and she can call her for a second opinion?

Glad to know there is someone out there I can use if I ever have trouble with a death and need an independent evaluation.

Sunday, October 16, 2016

Infection Control

Head nurse #1: It's the food! It's a big problem. Not the patients, but the families. I walked into the SICU the other day and Subway everywhere! Hello people, would you eat out of a toilet? No! So don't eat in an intensive care setting.

Head nurse #2: I fielded a complaint the other day from a guy who said his wife got C.Diff. from our hospital. She wasn't even a patient here.

Head nurse #3: Was she visiting someone?

Head nurse#2: Yes, some in-law.

Head nurse #1: I'll bet she brought in Subway!! Not our fault.

Head nurse #4: It's a shift issue. One person will acquiesce, and the family will think they can bring in food all the time. We are very strict about it in the NICU.

Head nurse #1: It should't be just a nursing issue. They need to get the guest service representatives to help us reinforce the rules.

Head nurse #2: I also got a complaint from a guy who said his wife had to sleep on the bathroom floor. That's a choice, in my opinion.

Wednesday, October 12, 2016

Enterobius Vermicularis

Secretary: You have a call from OB.

OB: Can I talk to you about this case? What I saw?

Me: Oh yeah, there's some foreign material in your cervical biopsy. I was wondering if it was plant? I mean weird, never seen that, but I've heard of people sticking veggies up there?

OB: No this was a white spot on the cervix. It was wriggling around. Freaked me out. I've been consulting and googling all week. Could it be pinworm?

Me: Oh. Not sure. Only seen that once in appendix in residency. I'll pull the case and google image. Can I text you?

OB: Please. If it is pinworm, I need to treat her.

Me: Help consult. Weird story. (I relayed as he looked at slide - told him I was thinking carrot maybe?).

Dr. Music: I agree. I would have thought plant too. But yes, this is pinworm. I'm guessing why you are thinking of carrot. Personal experience, maybe?

Me: Hell no. I've heard of it but . . . not that I will ever convince you.

Dr. Music: I hesitate to say this but. With the carrot. Are you ever thinking, What's up doc?

Me: Post to PMG pathology. Get smart path girls take.

Much ewww and vomiting emojis.

NB: Love this! We see pinworm in vaginas all the time in peds path.

Me: Yes I can see that from poor wiping hygiene, but adults? Never.

Path girl#1: Anal to vaginal intercourse maybe?

Me: I guess, double dipping?

Path girl#2: They come out at night and party in the perineum. The drunk ones accidentally return through the wrong hole.

Path girl #3: I was a med student in Miami. Labor and delivery. Tons of pinworms coming out during delivery.

Me: NO! My moving parasites memories consist of only maggots on BKA! If I knew that knowledge would have resulted from this post I would have refrained.

Enterobius Vermicularis. If you google image Pinworm, it fits. I wonder if the cervix is as itchy as the anus purportedly is. Scotch tape test might be a little harder to do way up there.

Friday, October 7, 2016

Just Because

Public Service Announcement: Do not drop a Yeti cup on your big toe, unless you enjoy it being blue, purple, and yellow.

I weigh daily religiously. Lifelong habit. Somehow I stopped in May and didn't again until September. I GAINED 21 POUNDS!! Where did you put it? Asked my partner. I don't know! But my pants sure don't fit. Or the shorts I bought last Spring. How does anyone gain that much weight in one summer? I guess, as the old saying goes, fat and happy. But I'm not buying all new clothes so I'm determined to lose it. I'm down 7 lb. from my high point, but still not even halfway there. Dieting is hard! I researched macros and read Thinner Leaner Stronger but I just cannot pay that much attention to my food - weighing and all. So I got the Weight Watchers app and researched the points of all the foods so I could know how much carbs to skip in order to get in my nightly wine. I got into some shorts today - real ones not just the only pair of workout shorts I fit into. I'm so happy. And I think this Plexus thing I've been doing for two months will help eventually once I get past the detox and the constant feeling that I have fuzzy mold growing all around my mouth (Is that a side effect? I asked Kalina. Um, not one I heard of). On the plus side, that is an appetite suppressant.

Shirley Jackson's autobiographies are like reading a 1950's housewife version of David Sedaris. Yesterday I laughed so hard one one chapter of Life Among the Savages I almost cried.

I had four days off this week, planning to get a book chapter done I haven't started on even though I've known about it since March, and it's still not happened. Well, a little in my head. But I've got until Nov. 4 deadline. I'll be out of town then, so hoping to write it next weekend when I'm on call. I never really get creative unless I've got lots of pressure.

We adopted a new kitten. One of my Facebook friends had four black kittens show up under her house and posted them for adoption. She put ribbons around their neck - pink, purple, blue and green to id them. Thursday night we adopted Pink, and the name stuck. Cecelia wanted to call her Harambe or Baby Frances after Dirty Dancing but she was outnumbered. We did agree to put Babypink on the name tag to placate her, but she's really just Pink. Love that on Breast Cancer Awareness month, which I am especially aware of this month.  She's adorable!! I rescued Katybell as an adolescent so haven't had much experience with kittens. Jack and I spent all afternoon playing with her.

Here's to lazy weekends and kittens and homemade chocolate chip pumpkin muffins (I know it sounds terrible but they are addictive, at least the two bites of one I am allotted daily) and Jack's new friend playing air hockey and the piano downstairs tonight and my awesome Halloween decorations and my currents author addiction Shirley Jackson, who is about to gain my full attention.

Wednesday, September 28, 2016

Rectal Foreign Body

Me: Call Dr. Woods.

Dr. Woods: Hello?

Me: I've got an interesting case. Guy stuck a candle up his ass. They had to convert to open. He had a colostomy.

Dr. Woods: That happened to me a few years ago! Did I tell you about it?

Me: No.

Dr. Woods: It was a teenager. They handled it under anal sedation. He came back, for the candle. It was huge! Three wicks.

Me: No.

Him: He said his mom wanted it. It was covered in feces. He was skulking around the gross room like the unabomber. Hoodie, bad affect, the works.

Me: Do you think he really wanted it for his mom?

Woods: Hell no. Who knows why he wanted it back. Cheeky lad, to get what burned him.

Monday, September 26, 2016

Purple Passion

I met a good friend at Camp Aldersgate when I was 15. She was 14. Let's call her Sunny (Urology resident I love - I've got two med students this month - their names are Sunny and Cherry. I feel like I'm at Woodstock.)

Sunny is still a good friend today - a furniture mogul. Back then she was the daughter of a blooming one. She lived in Salem, AR. I had the hardship, so would drive to her house to spend the night.

We met at Respite Weekend. We both volunteered. Respite weekend at Camp Aldersgate was different from the summers. No real categorization of disease. Just caregivers, mostly parents, dropping off their kids so they could have a weekend alone. Moderate to severe Down's Syndrome. Severe Cerebral palsy. There was even a Prader-Willi. He was almost one on one - trying to keep him away from food. I heard his parents put a lock on the fridge.

I was enamored with Sunny - she looked like a model. Her cool countenance belied her country upbringing. One night we left Aldersgate on break and went to a convenience store with the express purpose of buying a Playgirl magazine. In retrospect that store clerk must have been amused, but we were anxious, and being the older one I did the deed. Later that night back at camp we marveled over who in their right mind could be turned on by such foolish images.

I guess it was my junior year of high school. I drove to her house, and we decided to go running around with two of her guy friends. She was sweet on one, and hoped I would be sweet on the other. He was cute, kind of reminded me of my cousin, but nothing went beyond that. We drove to a cul-de-sac in my 1983 Oldsmobile Toronado convertible and shared some Purple Passion. Everyone but me drank a little too much - I was driving.

Next stop - Salem grocery store. Sunny was feeling a little queasy so I went to the bathroom with her and helped her recover. When we got back into my car we were startled by blue lights behind us. The officers searched my car and found a case of stolen beer. Seems the guys decided, while we were in the bathroom, to steal some beer from the back of the store.

After spending two hours under police questioning and stony disapproval from the store manager in the box (remember when grocery stores had those areas? Boxed in with tall plexiglass? Don't know what kind of business went down there maybe returns? Or purchasing cigarettes? For me it's just the humiliation of that night) they let Sunny and I go. The boys convinced the authorities that we had no knowledge or partnership in their plan to steal the beer.

I think I became marked, at that point, as a bad influence. Our friendship continued through snail mail, but we didn't really get close again, despite being at Hendrix together, for many years. Then she needed nanny help. Then she supported me through divorce - she'd been there. Now my daughter and her stepkid are in the same grade. So we see each other on occasion. If I ever really needed her, she'd be there in a second, I'm sure.

Thursday, September 22, 2016

Tumor Board

The Nightingale: Hey! I'd like you to meet palliative care doc. She's going to talk to us today a little bit about what she does.

Me: Nice to meet you! I've seen your name in the charts. I'm a pathologist. I love the idea of being a palliative care doc - always wanted to.

The Nightingale: You should do it!

Me: But I love pathology too . . .

Palliative Care Doc: You can come on rounds with me sometime if you want.

Me: I would love that.

The Nightingale: Ok everyone let's start. I've got someone to introduce you to. She's going to talk about palliative care. I've used her a few times and she is excellent. Not just for hospice, also for inpatient pain, depression, and dementia.

Palliative care doc gives a short spiel about who she is, where she is from, where she is located, where she trained.

Swagger and Sagacity: So tell me this. The hospitals have a reputation for sending nurses and social workers to my patients and talking them into getting hospice consults. Then they end up taking over my patient, who I have a long relationship with.  Sometimes years. Just because my patient is in a pain or  depression crisis - because hello, they have CANCER - they in no way need a hospice consult, but they and their family are easily convinced they do and it becomes such a mess for me to clean up.

The Owl: That happens to me too. Makes me so angry. I call them. I yell at them! I yelled at a hospitalist the other day who did that very thing. If you yell enough maybe they will learn.

The Nightingale: This doesn't happen when you consult her. I've only had good experience, and she stays in close communication with me about the patient and the decision making process. But I know what you mean. Believe me. A cancer patient in pain crisis is the perfect set up to be duped into thinking this is the end. This is why we are so important. We are in charge, at this moment. We know the patients better than anyone in the hospital and we are trained to know the disease process more than the patient or their family. Everyone needs to listen to us. I think it's good that she is here, she will help to turn around this problem. Educate and care for our patients with us. See? It's good to have these conversations. We all learn why there is such a stigma around consulting hospice and how trained individuals are part of our team, not working against us. I'm really glad you came. Ok, let's move on to the patients. Who wants to go first?

Thursday, September 15, 2016

Gross Room

"I'm glad they waited until 8:15. Done with tumor board. What is the frozen?"

Requisition: "What tissue is this?"

"Are you serious? Ugh that surgeon. Histology 101. Is he crazy?"

"LOL. Where are we?"

"Um, I'm doing a sleeve gastrectomy. Am I near the stomach?"


"Ok, thyroid. He's in the thyroid. That was easy. Next frozen?"

Tumor Board

The Nightingale: She's in a lot of pain. She has pancreatic cancer. She was crying in my office.

The Bear: We can help. Celiac plexus nerve block. For those of you who don't know, let me show you. Here's the origin of the SMA. Here's where the celiac artery takes off. See this? It's the celiac plexus. They wanted us to pay $500 for 100cc of absolute alcohol. We only need 10cc. So we are looking elsewhere. That's a ridiculous amount of money.

Robbins: It's absolute alcohol. It's like Napalm. Destroys.

The Nightingale: So how long does it last?

The Bear: Forever. It kills.

Greenie: Does it work for pancreatitis?

The Bear: Not so much. We try, but results aren't good. For cancer though, it works well.

Greenie: What is it?

The Bear: Absolute alcohol. A panacea. We inject right here. Bilateral. No more pain.

Swagger and Sagacity: Can I get some of that?

Friday, September 9, 2016

Tumor Board

The Nightingale: So I've got another one. 64 year old female with a history of lobular breast cancer, ER PR positive Her2neu negative. Been managing fine for 5 years. Now picked up leptomeningeal spread on MRI scan. Asymptomatic. Healthy, doing well. What should I do?

We all looked at the meningeal enhancement on the MRI displayed at the front of the room. The radiologist pointed out the areas. Various scenarios of treatment were kicked around.

Swagger and Sagacity: I'm glad the word "Omaya reservoir" was not uttered from anyone's lips. That's like trying to rearrange deck chairs on the Titanic.

I remember seeing routine positive CSF's from a case in Conway, until we no longer covered there a year or so ago. This lady had ductal, though. The CSF's were obtained through her Omaya reservoir. When I first saw the fluid, I thought "This lady's a goner." Eight years later she was still alive. I gathered based on this conversation that she was an outlier.

The Owl: Yeah, that'll buy you two months, maybe. It's a big waste of time.

The Nightingale: Thank you all that was really helpful. I mean lobular? Chronic disease. She will be alive for a while.

Here's a normal brain MRI I cribbed off of the web. I hope her next scan looks like this.

Tuesday, August 30, 2016


Staggs walked into my office a couple of months ago, looking quite dapper.

Staggs is my work husband/brother. We went to med school together, but I didn't know him because he was on the golf course. We did residency together. We were hired at PLA together. He's smart, and inspirational in his nonchalance. But don't tell him I said that. It will go to his head.

He was upset when I wrote a blog on MiM about LGS. "Where's my blog?"

"Don't worry Brent. You aren't just a blog. You are a whole book. War and Peace. Be patient." I smoothed his ruffled feathers. "Why are you so dressed up?"

"I'm going to see BDQ win an award today at lunch."

"Oh! I'll go too."

If anyone deserves to win an award around here, it's Brian. He has a palette on the floor of his office. He lives there, sacrificing time at home to serve the clinicians. I named this blog after a quote with him in mind.

I gathered HEP and we wandered over to the award ceremony around noon.

The hostess, an admin assistant, seemed flustered at our presence. Easy to see why, in retrospect.

We have a wonderful team of doctors at Baptist and the coordination of care is exemplary when all physicians contribute their areas of expertise to a patient's needs. 
Sometimes the most important physicians on a care team, are the quiet, dedicated, hard working doctors who work in relative obscurity - apart from the busy interchange on a hospital floor or in a physician's office. 
It is these individuals, however, who provide the critical information that will guide diagnosis and treatment - the foundation of a patient's plan of care. 
You can imagine the fear and anxiety when a patient is told there is a mass or a "lesion" that is new and that needs further work up. Immediately, a patient feels vulnerable or in shock and disbelief that then turns into a grasp for hope - a grasp for a plan so that what is shocking and ill defined can turn into something that is manageable and clear. 
At that point, a patient's diagnosis is the key to formulating a treatment plan. It is also important, however, that it provides the patient with a guidepost, a transition point to which to cling until the natural resiliency of the spirit catches
Sometimes the diagnosis is clear and the path forward is relatively easy. But many times, the intricacies and the behavior of tumors or infection can impair the process of a quick determination. It is at this point that those physicians who superbly practice the discipline of pathology transcend science to invoke its art. And the art of medicine involves rising above normal expectations to diligently study, read, ask questions, communicate and research. 
Physician colleagues recognize this unique gift in Dr. Brian Quinn and Dr. Brent Staggs. We have found that these physicians deeply care about our patients, even when they've never met them. They seem to understand that the faces we are privileged to encounter in our serious discussions merit pristine data that then leads to accurate diagnosis, treatment and prognosis. 
Though our pathologist friends handle cells and tissue and things like immunohistochemical stains and receptors, they never see our patients through the prism of tissue, but rather, by their tenacity for accuracy and by their diligence of effort to understand- even long into the night and into the weekends - they prove to us that we present to the patient an army of professionals who care about them. 
It is with great admiration and appreciation that we applaud the heart, minds and efforts of Dr. Quinn and Dr. Staggs.

It was a little uncomfortable for me and HEP, as you might imagine. We walked back to our offices reassuring each other. 

"They are the faces, the ones who like to be out front. Go to the golf tournaments, and the social events. That award was for all of us, not just them."

Dr. Bell was thoroughly displeased. "We need to have black t-shirts made, for the rest of us at PLA. They should say: SUB-PAR Pathologists."

This was an award given to the two guys who discovered Tumor Board at CARTI first. Quinn sleuthed that it was The Nightingale that wrote that speech. Beautiful. A big donation to Baptist accompanied it.

Staggs was embarrassed, and sent this e-mail.  "This was for all of us, not just me and BDQ. Thanks for being my partners."

It's nice to be appreciated. But I like the black t-shirt idea. And I don't need an award to recognize the fact that I am working my ass off. Working my ass of is reward enough. It keeps me afloat on this crazy sea of life, where it is so easy to go adrift.

Sunday, August 28, 2016

Sunday Morning

Ants crawl across wooden planks
Industrious and oblivious
To the human form
Studying, smoking, observing
Half-torn between their plight
And the recesses of the sky

Thursday, August 25, 2016


Is my favorite color. I know, I'm not alone.

I was signing out an oligodendroglioma today - I don't do that very often. So I had to consult the books. Peter Burger is by far my fave in this arena. He reminded me of why today.

Microscopic features: Like pornography, in the observation by Supreme Court Justice Stewart, the oligodendroglioma is easy to recognize but may be difficult to define. Although there are objective histologic features that aid in recognition, only one or two may be found in a given microsection.

We had all the features of WHO Grade III. Nuclear atypia, hypercellularity, and rare mitoses.

Isn't it beautiful? Fried egg nuclei. Arcuate capillaries. This isn't my case, I stole it off of the internet. Sent off for characteristic LOH (loss of heterozygosity) for 1p and 19q. Will be surprised if it isn't positive.

ICD-10 is going to be the death of me.

Tumor Board this morning was only remarkable for its obscure chemo meds and stellar radiology shots. But no worries, tomorrow The Nightingale is having a tumor board party at her home on Edgehill. I cannot wait. Book club follows. Did anyone else cry as hard as I did? Dunno (ha accidentally typed Cujo). Emotion is so individual.

I read an article about Halsey a year or so ago but just started listening to BADLANDS this summer. Wow. Love it all, but Colors is by far my favorite.

Wednesday, August 24, 2016


It's been a busy week full of brain frozens and surprise important micro meetings so I feel all over the map.

My new pulmonologist friend invited me to the group Style MD and it is my new addiction. Docs take selfies from Target outfits to Jimmy Choo's. "The criteria is stringent," she assured me, "you cannot get in unless you are an female M.D."

This post took me by surprise this morning.

NAME YOUR VAGINA by using the name of the last movie you watched!!

The fun lasted throughout the day and continued into this evening.

Miracle on 34th Street
Bad moms (that was a frequent one, and my last movie, but I chose to list my favorite one The Resurrection - that got a few likes)
Spooky Buddies
Finding Dory (lots of Millenials here I'm past this)
Zootopia (Despite being past this I LOVED this movie)
The Jungle Book
Pete's Dragon
Suicide Squad
The Secret Life of Pets (LOL! Someone commented - the secret life of your kitty-kat?)
The Hangover
Frozen . . . Damn. Rough month at my house. Poor hubby.
Olympus has Fallen (commenter: ya your vag took him down!)
Daddy's Home
God's Not Dead 2
Ice Age
Air Force One
Hell or High Water
Independence Day
Monsters University
Wolf on Wall Street . . . I need a wax
Hunger Games
My King
The Usual Suspects
Now You See Me
The Martian
The Big Short
Central Intelligence
Eddie the Eagle
Nine Lives
Free Willy
Bad News Bears
Sausage Party
The Revenant
The Last of the Mohicans
Big Ass Spider
The Boat That Rocked
Mary Poppins
Star Trek Into Darkness
X-Men - perfect for the lesbian
Batman vs. Superman
Red Riding Hood
Kikis Delivery
Maya the Bee
Monty Python and the Holy Grail
The Boss
Matrix Revolutions
Diamonds are Forever
Mission Impossible
Kubo and the Two Strings???
Harry Potter and the Chamber of Secrets
Pretty in Pink
Where to Invade Next
War Dogs
The Enterprise
The Terminator

I think you get the idea. I'd type in funny comments but that would take all night.

Very few things make me cry really hard. I can count on one hand in adulthood. My sister tells me I bawled hysterically on the last day of our yearly family vacations to Navarre Beach, Florida, but I don't remember doing that. I remember losing it for the first time in college when I heard the Bruce Springsteen song "Johnny 99." Surprised the Hell out of my boyfriend Snake, who was driving my Jeep. It's still one of my favorite songs.

I also remember losing it in residency when my brother was really sick. Driving around and crying so hard I really should have pulled over on the side of the road. Crime Lab rotation did me in. I told the guys one day I was leaving early and headed to the River to cry all afternoon. No one wants to hear about that shit, you have to just suck it up and deal with it. I remember my ex stopping me the first week, telling me it was too much. It may be too much, but it's still there.

But since then, nothing more than a moist eye and occasional tear. So imagine my surprise when I read the last chapter of my book club book last week, The One in a Million Boy, and major waterworks. I had to rush over and lock the door of my office it was so ridiculous. Tears flying out of my eyes all over my skirt. When I collected myself, after 20 minutes or so, I texted the one who picked the book. "Have you read it yet?" "Yes." "Did it do that to you?" "No."

Tuesday, August 23, 2016

Picture Perfect Words

One of my Facebook friends, breast surgeon I think - maybe he is distantly related to her, posted this at the beginning of the summer. I listened, and I'm addicted. He's pretty prolific, and he's from Arkansas! All the songs are good, but I think this one is my favorite.

Ironically, my daughter loves bro country. It's what I'm subjected to whenever she is in the car. She loves good country too - but it's the current radio that she is most addicted to. So I listen. And am marveled that singers like Blake Shelton and all the others I don't know the names of are topping the charts and this guy has less than a thousand hits on Spotify; because his songs are amazing. I encourage you to listen to all of his albums. If he's not going places, this country is on crack.

Monday, August 22, 2016

Chinese God Factory

At the culmination of a weekend full of debauchery I headed to my friend's mother's house in Harrison, AR for shrimp and grits and cornbread waffles with butter and syrup and chocolate waffles with local blueberry compost and cream. I have great friends. Med school and having kids derailed this. It's nice to rekindle the friendships.

Her dad died suddenly of a heart attack in March. So devastating. He was a staunch Democrat - spent his life in public service. So nice to see the pics of them attending two Clinton inaugurations and an Obama one on the wall of his well preserved office.

Both Hillary and Bill Clinton called to express their condolences.

Yes this was going on in the office. While I'm indulging in hangover food. But the thing that really intrigued me was this.

Chinese war gods, from a Chinese war god factory. Here's a factory pic. They had them shipped from China, and had to hire movers to get them into the house.

The factory belittles it, doesn't it? A little. They had a wonderful life. Although I didn't know him well, this is  a blunted testament to his soul. For Christie.

Friday, August 12, 2016

Tumor Board

I walked in 5 minutes late. The Nightingale patted a seat beside her at the front of the room, beckoning me to join.

I sat down after getting breakfast (greek yogurt, almonds, blueberries, water, coffee) amidst the din of cases being presented. Feeling guilty for being late.

As I settled in I noticed Cid Vicious. Decided to text him.

"I woke up at 6:50." My alarm originally went off at 5:30, but I fell back asleep. When I woke up I startled and got ready in 10 minutes. Skirt. Blouse. Wash face. Drive to CARTI.

He texted back. "I woke up at 4 - I have seen 11 ICU patients, put in 3 central lines, intubated and bronched so far this AM. I am going to Chicago at noon and have to get outta here."

"Are you calling me a slacker? What's in Chicago?"

"Nothing in particular. Just going up there for baseball, eating, drinking, etc."

"At least I'll get EBUS relief." Amid more talk of patients.

"You call non diluted cases with the peacock relief?"

He had a poker face. I could not. Kept silently laughing from the front of the room. I was jealous.

"Aren't you taking her with you?"

"Yeah, we usually travel together, my wife thinks it's weird but we really enjoy each other's company."

I've met his wife, in the Kroger parking lot. Super sweet and adorable.

"Traveling with the peacock would make a really good SNL skit."

Then I presented. It went over pretty well. I even had the hard nosed thoracic surgeon engaged. Can't wait to present next week.

I was trying all day to think of texts that might have broken Cid's poker face.

"It's a good thing my leg hair is blond because I've got two days growth going on."

"My ponytailed look is not styled by product. It's grease from lack of showering."

I'll have to try harder next time. Good to have goals.

My partner at work who missed tumor board was incredulous that I didn't have time to shower. "It looks like you took an hour to get ready."

This is a granular cell tumor. It was in the arytenoid cartilage. 30 ish year old. Very subtle on frozen section, but I called it. Looks like macrophages. Never seen it in the larynx. Has a 3 (or .3?) percent malignant rate - most are B9. The clinicians were fascinated, gave lots of good advice. I've only seen it malignant once, in Conway, in the soft tissues of the buttocks. I think this one is B9, but local recurrence is a concern. The hard nosed surgeon wants a full laryngeal resection. None of the radiation oncologists had any idea of what it's response to radiation therapy might be, it's so rare. I'm not so sure I agree with resection, but it's not my granular cell tumor.

Saturday, August 6, 2016


I fell today, on a walk. It wasn't raining when I left the house, but a steady rain accompanied me as soon as I got going so I decided to cut it short, thirty minutes instead of forty-five. The road back to my house is steep. In retrospect I should have taken a different route. I debated taking my walking shoes off, but decided to trust them. I lost my footing about thirty seconds later. Skinned the hell out of my knee.

It bled. All the way back to my house blood and rain mixed in rivulets down my leg. I laughed at my situation (who falls on a walk?) but as soon as I got to the house the adrenaline that propelled me there exited my system and I got woozy - saw stars. First sat in a chair, then laid on the carpet. Still, it bled.

When I was finally coherent enough to move, I was surprised it was still bleeding. I've never had a cut bleed for more that a half hour. It bled while I changed the laundry. It bled while I had a whiskey to beat back the pain. It bled while I read a book. It bled while I took an hour and a half nap on the couch; it stained the couch. It was still bleeding while I finished the book. I cringed while I showered to get ready for my Uncle's 70th birthday party.

I catalogue the wounds of the dead - they don't bleed. So I am unfamiliar with live blood. I applied gauze and band-aids because it was still bleeding five hours after the injury. Not profusely, just oozing. And dripping. Must have been pretty deep. Wonder I made it home.

I used baby wipes to absorb the blood. I also finished a body of work that has interrupted my planned summer reading. It was a lot to absorb. Enjoyable, but sometimes when you read you learn something about yourself that precipitates a psychic crisis. But no matter the shock, somehow your soul absorbs, and you continue.

So I continue with new knowledge. Hopefully there will be no more bloodletting. I tread carefully. Trepidatiously. Fool me once, shame on you. Fool me twice, shame on me.

Wednesday, August 3, 2016

Reading in Reverse

Something funny happened today.

Have you ever walked into a lecture mid-way through and have been a little confused? Like, damn I wish I had seen the beginning so I could understand what the hell he/she is talking about. But you are a trooper, a hard worker; you puzzle and struggle through it anyway and it is rewarding nonetheless.

The book I finished yesterday felt like that. So imagine my surprise when I opened a new book today and discovered the same characters! A prequel. Relieving and comical at the same time. "Now I get to learn what I should have known all along. All the inside jokes." By the way that was a helluva good book. Caught a few typos though. Maybe I was an editor in my previous life.

You have to take your shoes off. Feet grounded to the Earth. Trust yourself. Don't be in a hurry; you have plenty of time. Let me look at you, OH! You are a . . . "

I was going to the bathroom today, sitting on the toilet, and something sticking out of the tampon dispenser distracted me. An empty package of beef jerky. I suppose beef jerky can pass the time as well as anything else (books, Facebook, but really? Beef jerky?). I have always professed my hate of beef jerky but truth is, I've never tried it. They say you can't really judge something you've never tried.

9:30 a.m. 8/3/2016

"Can I come into your office?"

Who asks? No one. So much so that I've taken to locking my door at lunch, for a short reprieve. "No, please don't." Half joking, but only half. I had a tray of placentas I wanted to finish before I worked on my Q/A.

"So I heard you had a possible autopsy last week, when I (head gross room PA, former defense lawyer) was on vacation." Long silver hair. Pony tail. He was perusing my bulletin board. I felt a little invaded, probably because I just wanted to get some work done. This is the time to acquiesce, because it's not about me. I turned to him and smiled.

"Yeah, but I beat it back. No worries."

"What would you have done? I'm the only deaner. It was a staycation, I could have come in."

"Well, John (morgue assistant - last name Horn - such a smooth voice I made excuses to call him again and again - could hear Gunsmoke re-runs in the background) and I decided that we would muddle through it if we had to. I've never performed the deaner job before, but I've seen plenty. He's seen more. Fortunately we didn't have to test ourselves. If we did, we might have pissed off a funeral home, but that's secondary right?"

"How did you get out of it?"

"It took about ten phone calls, but eventually I did. Wasn't even ordered by a doc. Was a screwy EMR mix up. On some social worker form."

"Wow, that's crazy. Did they ever fix that other problem in the EMR? With mandatory autopsy request by nurses?"

"Yeah, we nipped that in the bud. Don't worry about it."

Friday, July 29, 2016

Case of the Week (COW)

More like case of the century. I've never seen one.

I was headed into the gross room around 9 am. J, the gross room PA, said, "I need you to look at a specimen after you do the frozen."

Another brain, ugh. I had a two hour brain frozen the day before. Was praying this was an easy metastatic carcinoma but no. I had to call Dr. Bell again, for the second time in one week. Feed the megalomaniac. Luckily I like him, and his wisdom and experience more than make up for the humiliation of needing help.

"Ok, J, finally done. What do you have?"

"It's a didelphic, diduph, di-what? Help. It's a double uterus."

"What? I've never seen or heard of that."

"Me neither. Help more experienced gross room PA?"

"It's a didelphys uterus."

I walked over to the stainless steel table to look, and was amazed. Two uteri, divided by a septum.

"Why did they take it out?" A chronic condition, one that's not too serious, but if it festers it can become dangerous. I assessed the situation visually. Two cervices. Two uterine cavities. One much larger than the other.

"There's no way this can bear children, is there?"

"Well, I saw something like this on a Steve Harvey episode."

"Who is Steve Harvey?"

"Kind of like a Jerry Springer. Afternoon talk show. She was pregnant in her bifid uterus by two different fathers. One pregnancy was farther along than the other."

Well, I guess that's plausible. I suppose one could be 9 months along, the other 5. One could deliver before the other. Later on in my office, while I was studying my cases and stewing over this, my dad walked in. I eagerly shared the case.

"Yes, that can happen. Pretty rare. The danger is that if one is growing in the smaller uterus, it can be squashed. I've heard stories about Vietnam prostitutes (human trafficking victims! - some, anyway) being pregnant with twins. One uterus, but two different fathers. Happened in the same day."

You think you know it all, but you are constantly surprised. I was excited to get that case the next day. She had borne children. Wow. Both endometriums were in the same phase - proliferative. The surgeon who removed the uterus had a late case that night. I called him on his cell.

"This is really selfish, but my dad's birthday is in two days and I am taking him out for dinner tonight. Do you need me? Late? I'm happy to stay just let me know and I'll reschedule the dinner."

"No you go. Have a big time. Tell him happy birthday from me. I don't need to know anything tonight that will change what I do during surgery."

I was grateful, had just finished a lung frozen. Was exhausted from the day.

"Can I thank you by texting you a pic of the uterus from yesterday?"

"I'd love to see it."

Kind of looks like an octopus doesn't it?All the girls in PMG pathology are as amazed as I was. That's an ariel view of the fundus. I wish I would have thought to take it in panoramic mode. To the right and left are the individual uterine cavities, opened up.

Tuesday, July 26, 2016

Girl's Night Out

Girl 1: We need to plan a trip to Eureka before your wedding this fall. A bachelorette? There's a great lingerie shop up there. Not like Dillard's - a true sex shop with lots of other fun things to look at.

Girl 2: We went there together not too long ago - it was great. We shared a couple of bottles of wine over lunch, left the kids in the magic shop nearby. I was a little nervous, but she just plowed right in. I heard an oof from the dressing room and queried in alarm, but she said the shop girl was just tightening her corset. We ended up getting outfits that kind of matched.

Girl 3: Y'all were in a different kind of magic shop.

Girl 2: Oh, and I also tried the tightening cream.

Girl 1: I wasn't really into trying the tightening cream.

Girl 4: What? There is a tightening cream? I thought only surgery could do that!

Girl 2: Yes. It really works, it's amazing. You apply it by rubbing the cream on the inside, and by the time you are done with that part you are already halfway there ;)

Girl 4: So how does it come? Like in a toothpaste tube? I've never heard of it.

Girl 2: You find it in the corner of the store. It comes in a fuck's worth.

Girl 4: What did you say?

Girl 2: A fuck's worth.

Girl 4: That is the denomination? So I guess you want to buy more than one.

Girl 5: Does it work on the guy too?

Monday, July 25, 2016


I met her this morning. She is incredibly beautiful. In profile her face boasts eyes that crinkle in smile and recognition. I can tell when she is happy, she swishes away with a mermaid/dolphin tail and splashes me with water. Her fierceness is alarming; it looks like a phantom orange/red profile of an angry ghost trailing fire and smoke. Showing strength, her torso rises from the ocean, arms stretched to the heavens. Feeling maternal, she rises on angel's wings and invites me to emerge from the ocean and dance with her in the clouds, carrying me on her back. 

Sunday, July 24, 2016

The Gordian Knot

On the last leg my summer vacation trip I was re-reading an old fave - Dress You Up in Corduroy and Denim, by David Sedaris (finally a perfect fit!). I'm a big fan, even though I still at 42 years old have to look up the spelling of Corduroy - twice argh. I saw him both times when he came to Little Rock to read some of his essays. Wasn't quite brave enough to stand in the autograph line, but I imagined what I would tell him if I was and it sounded really stupid. To me anyway.

So was that his first book? I can't remember I read them so quickly. I think it was definitely short-listed for some big award. And it was really good - read in the hotel bathroom so I wouldn't disturb anyone until the wee hours of the morning addictive, leaving myself only a couple of hours of sleep before I had to catch a plane. When I finished it on the plane today I got to a part that reminded me of others, and was a little frustrated.

See, I remember one thing about my past. I had a plan. Two plans. And they were MY plans. But somehow somebody else got to enjoy those plans (I guess? Is this really happening? What really happened?), but not me. That's not fair. Am I MPD? Am I so well versed in self-loathing that this was yet another protection mechanism to propel me to this day with my sanity intact? Or is this just those darned Gods again? (having completed a cycle of traditional Freudian psychoanalysis, he has moved on to shamanic journey work and studying the cycles of the moon. Whatever is happening to him, it feels like a Gordian Knot. I guess he's got to channel Alexander the Great. He's going to untie this damn thing, or slice through it with a sword. The latter might be more satisfying).

But I diverge. I'm taking a break now from DS to read a book I've been wanting to read, edited by an Arkansas author, Erin Wood: Scars / An Anthology. It brought tears to my eyes three times in the first 40 pages, and I've already hatched a plan to e-mail her and introduce myself. Anyone who can bring this amount of intelligence and emotion into paper form is someone I want to meet. And I've got lots left to read. That makes me happy.