Heart Only

     Christmas Eve was quite a day it started off at CARTI tumor board at 7 Diane had so many cases to present cancer doesn't rest on the holiday. On the way over to Baptist autopsy doc texted me a consent and I replied this is not my job contact Jessica. Well he was probably feeling bad so he had his resident contact her that guy was really nice and she texted me a little after 8 that the consent was legit and we would proceed with the procedure in an hour.

    Got my cases triaged and went downstairs to the morgue. We all get in a tizzy and bitch and moan about autopsies but there is something so sacred and serene about the performance. Jessica and Evans were recording the external exam as I walked in - noting the scars and the details about her nails and I would describe it to you in better detail but it seems like sacrilege. We do a U shaped incision on women instead of Y for obvious reasons. As Jessica was getting into the chest someone from Central Processing accidentally wandered in, and jumped and shrieked and apologized as if she walked in on someone going to the bathroom.

    She opened the door back up a minute or two later and asked if she could watch. I said I had no problem with that and asked Evans and Jessica if they objected they did not. As we opened the rib cage and started to dissect the heart from the surrounding vessels - Jessica and I had to use a lot of suction to clear the area of blood for better visibility - she swooned. "I was having such a bad day, week really, and to see this - I feel like I am the luckiest girl in the world. This is so amazing. Thank you so much." I told her a little about the history and what we were going to look for and her awe was infectious. 

    It was a short autopsy since it was heart only. Evans weighed it and cut into the ventricles a little so it would get adequate fixation when we gross it in week after next. It will be easy to answer docs question and I told him that the autopsy went well it should be signed out in a couple of weeks. So I got my easy autopsy after all.

    Got home a little after 3 and prepared the catered meal from Boulevard. When you have a little one - Rennie - things start and end early and I was grateful for that I was exhausted. Rachel watches It's a Wonderful Life with the kids every year S and I have never seen it so we started it on Christmas Eve and ended it on Christmas morning it's so long I'm surprised the kids sat through it Jack only remembered a few key parts when we discussed it Christmas afternoon. It came out in 1946 years before any one of us was born. 

    S and J and C and Woody all got tested for Covid when I went to work today and I was proven right - they were all negative. You pray for negativity sometimes - cancer margins and Covid tests. It's nice when your prayers are answered and you can travel and visit loved ones in relative security that you aren't a threat to them. Since I had the vaccine I didn't get tested. Thinking despite not yet receiving the second dose I'm ok too. Christmas on the couch in yoga pants and comfy t-shirt was lovely. Hope yours was too. Much love, Elizabeth.

Ocular Migraine

     I suppose I will be filling you in on more of the day sleep is eluding me.

    At about 2:45 I ran to get my afternoon coffee and water and visit Sean and Avery and Kim for emotional sustenance and as I was walking back I started experiencing sharp pains in my abdomen. Damnit, I thought, I don't have time for this. I got back to my office and held my fan in my lap and blew it directly on my face and knew that there was only one thing that would work.

    Melody knew I was in the weeds - I had been telling her about autopsy request doc and trying to save 33 yo dude in another town and cases had piled up and were threatening to keep me as late as on Tuesday. She had offered her help earlier but she's CP I'm AP and I'd already done all my surgicals I only had cytology left (she can't do that) but her recognition of my stress was honestly enough. It's so nice to have female partners male ones seem to avoid tough emotion.

    I called Melody after I closed the door of my office and said let me take you up on that offer for help please come to my office. A couple months back she was on the verge of passing out after giving blood if I remember correctly and I ran to the gift shop to get her a Powerade she let me in so I figured we reached a new level and I can do the same. She opened the door and shut it and noticed aloud that I was on the floor and asked me if I fell or if it was on purpose. I told her I was having sharp abdominal pains it was on purpose. She said that happens to her do I need some GasX she keeps it on hand. I told her yes please I used to keep it on hand but this doesn't happen to me as often anymore and I've gotten lazy about it.

    I was lying on my right side chewing the cherry flavored tablets - she adjusted the fan so it was blowing right on me - and she was wondering aloud if I was ok with cherry flavored I told her I was. Then she started talking about abdominal migraines I assured her in my experience with my body this was probably just gas even though it felt like I needed to have an appendectomy or a cholecystectomy. She told me that in med school she used to have a lot of ocular migraines. I looked up from the floor at my angel savior and said what is that I've never heard of that.

    She demonstrated with her hands. It starts like a fleck. In front of your eye. I guess it always happened in my right eye. You doubt it's existence. I was really lucky to only have the visual and not the pain. Then it grows larger, like a ring, and the borders of the ring get fuzzy like electricity. At this point you cannot ignore it. If you are talking to someone, you cannot see them bc the center of the ring obscures your vision but the periphery is really weird. The ring gets bigger and bigger and eventually goes out of your peripheral vision and goes away. But the sequelae is what I always dreaded it's like postictal.

    Well I've never had a seizure so I have no idea what postictal sequelae is. I wondered if it was like pre-panic attack or fugue state for me when I start tingling all over my body like electricity is happening. She said it's like you've just run a marathon you have to sleep it off so it was always exhausting to experience it knowing you are going to have to deal with the aftermath.

    I thanked her for the GasX and she left. Thankfully, bc the GasX sped up the process and I started belching. And we won't speak of what else happened in my office when I finally got off the floor. My ex-husband, when we were first dating, gave me one of my favorite compliments on the planet. In the company of someone else I cannot remember he said Elizabeth doesn't fart, she blows rose petals. 

    And of course despite my backlog I google imaged ocular migraine and WOW. I asked Melody how long they lasted she said 20-30 minutes. They, like fugue states, are exceedingly rare. Then I hammered out my cases and when Evans texted me that Sims was sending margins - it's like crazy we have 12 to 3 o'clock 3-6 o'clock all the way around the clock we mark one edge blue and one edge green to orient it and the deep margin is black Sims came in to make sure we got the new margin (duh) and they were so long I became practiced in giving him a breakdown. Your 7:30 to 9 is full of basal cell but your 6 to 7:30 is clear send another in that area. He trained at Mayo he's super sweet expecting his first kiddo Jan 3 so hard to get frustrated at him I want to help. When we finally got the all clear I called the OR on the bat phone and we all cheered.

    Well I just hugged Jack and I'm outlasting him that's a bad sign he can sleep in all day I gotta work. Hope you are sleeping better than me. Much love. E

    

Avoiding Awfultopsy on Christmas Eve

     Oh God today is like 10 blogs. Or ten days. Jessica agreed. This is like the worst Christmas call ever. I would tell it all but I need to space it out or I would be blogging all night.

    After I visited my chiropractor, Darren Beavers, for the third time in three days I got a call from Jessica. An autopsy. We are too reactive around them - they don't happen very often - and we tend to ignore them until they ruin our world. Jessica gave me the name of the doc I didn't know at a different hospital (Baptist serves like six now I think) in a different town and I was determined to divert it. I had some other shit going down - there was a thirty something year old in another town with wall to wall pneumocystis on his BAL and that was more important I was trying to get in touch with the docs there bc it was obvious on Epic they had thought of everything except AIDS. Pneumocystis is a hallmark presentation, like Kaposi's sarcoma. But you can't see it like purple birthmarks bc it is on the inside. The offices were closed and the secretaries couldn't find them so I took drastic measures to get their cell phones and relay the information to treat and turn it all around.

    In the meantime I called autopsy doc. He was super sweet and excited to the point of mania. He shared articles with me in text. I managed to get him to limit it to heart only. Thing is, he let the body go to the funeral home before he got consent so I told him he needed to get consent and he assured me his resident was on it. We had the body transferred to Baptist LR from small town. At 11 Jessica called him but four hours later she still hadn't heard from him so she called again and when he didn't have consent on paper she told him it would not work. He said he would mail the paperwork to the husband who consented to someone he knew and they would mail it to us. It doesn't work that way, she said, and he got a little belligerent and asked to talk to her boss. 

    I learned this bc Sims was doing late frozens on a scalp basal cell that had been previously removed with positive margins on Moh's. Evans is on call with me but Jessica stayed late to help bc Sims. I was like why didn't you tell me she was too busy and angry to be treated that way. I texted doc with autopsy request and said we cannot do an autopsy without consent in hand it's against the law. He texted it will be mailed to you when husband signs he agreed to it. I texted we will not break the law to do an autopsy sorry. Then he called and with his moderately Spanish accent (it was honestly lovely) and tried to talk me into doing it without consent, he said "medicine is flexible" like a Spanish surfer dude well damnit the law is not and I started getting angry and he said you are obviously stressed I'm going to go and hung up on me. Well that pissed me off even more I texted him I'm not stressed I'm angry you are pushing us. A lot of the frozens were positive and so more were sent and I was telling Evans and Jess what he said to me and Evans said I'm surprised then he didn't ask you if you were on your. I laughed period? F you asshole I haven't had one in 15 years sorry Evans that's TMI but he is nice he texted me in a group text at 5am Baptist was giving us hell about getting vaccine for our employees who are separate and we fixed that today by going to admin. So Evans has my back.

    Autopsy request doc sent me two more texts and I was so riled up and busy I didn't look at them for a half hour while I was reading the frozens. When I finally did I realized he relented. He said he will not push he will stick with the law instead of science and that he understood. I texted back thanks so much we cannot put our professional licenses on the line and subject ourselves to liability Merry Christmas. Then on the way home he asked let me try tomorrow? I said if we have a consent in hand we can do what he wants. I wanted to reprimand him for yelling at Jessica but I refrained just told him he would have to work through her she is a seasoned professional and my gross room supervisor. (hopefully he got the hint that I knew how he had treated her). The great thing is if he does get the consent prob too late for tomorrow and we don't do autopsies on Xmas or over the weekend and I'm off next week going to visit fam so autopsy avoided (but heart only is pretty sweet sad to miss that in the autopsy queue).

    I've been pretty upset bc partner Brian had third hospitalization in a month he tested positive for Covid and was hospitalized for that I was so scared I've been a little depressed. But Ginger texted today he was going home best Christmas present ever I was elated mid morning. I've got tumor board in the morning should probably wind down. Hope you are doing well. Much love, E

Object Permanence

     One of my first memories from childhood was having an existential crisis. I was four or five maybe, and I was in the kitchen my parents were so excited my dad had been interviewed he was going to be on the news they both were my mom had been with him. I probably expressed this dread as one of those adorable things adults think kids say like, "If you are going to be in the TV then how will you be here to take care of me and Sara" but believe me I was dead serious. I thought my parents had to physically disappear and I wasn't sure they would make their way back to me from that small box did they shrink them to get them there? What if they didn't come back to normal size things needed to be done around here like cooking and driving to work and school. I couldn't handle all that myself yet I was just learning to read for God's sake. My relief was palpable when they were not in fact aired on the 5 o'clock story or six they weren't on until 10 pm I was long asleep by then and they were there when I woke up in the morning so it was a non-issue by then and I could go back to worrying about normal kid things and not abandonment. They of course do not remember this. Just like I don't remember things my kids bring up and say MOM HOW COULD YOU FORGET?

    I was so fascinated by the idea of object permanence when I first learned about it in college. My advisor Tim Maxwell was young and he brought his son in to demonstrate it - the first time the kid didn't look for the hidden object but a few months later he was crying and grasping when Dr. Maxwell hid the toy. Talk about hands on learning. I of course was well  beyond that stage at 4 or 5 but not having any concept of recording or airing or how all that worked threw me into outer orbit.

    I had another minor existential crisis this morning when at 5 am I tried to get out of bed and could not. Luckily I had peed in the middle of the night because my lower back was like nope. I waited until 6:30 to ask my husband to get me a Coke Zero and an Ibuprofen (or three). While he went back to sleep (I'd been in bed since 5:30 pm so none for me) I stared at the negative space between the branches of the tree outside my window and conjured images and wondered if I would eventually need a bedpan. I did not anticipate this being a part of my life for at least thirty more years. He woke at 7:30 and still could not get me out of bed so I called my ex. My first muscle relaxer, Flexaril, and steroids are in my future and I promised chiropractor ASAP and did some stretches in bed my husband smartly suggested and triumphantly arose a little after 8. Whew! Bedpan averted.

    We got this gift on our porch yesterday - I think it was for the former owners but I don't know them and it was a bag of pretzels I didn't think it was worth tracking them down but it was this kind I have been putting in Stephan's lunch for about a month Dot's Homestyle they are everywhere Fresh Market and Kroger. I decided to have a gluten fest and try them - it's the original seasoning have not yet tried the Southwest - with a couple of nice thick slices of cheddar cheese for lunch and OMG they are amazing. S said they are even better than Nacho Flavored Doritos and that's a lot from him those are his fave. Something about the texture too as well as the flavor they are perfect. I won't be doing that again today because as soon as I was  back on two feet I spent some time in the bathroom in between cooking breakfast and I was thinking between my GI stuff and my back and the fact I've been wearing the same outfit for the third day in a row I am becoming that person they say needs to be put out to pasture. 

    I'm going to spend all day on the couch watching TV but a shower must happen at some point. And given the fact that I'm taking a steroid and I haven't done that in four years I'm hoping to sleep as good as I did last night. Jupiter is moving into Aquarius today it changes once a year. That's significant because Jupiter is the biggest planet and has the magical quality of expanding everything it touches. There's a bunch more I signed up for Astro Butterfly's weekly e-mail after I read about the Age of Aquarius the other day. If you think I'm silly for being fascinated by all this you can blame my mom she read me my horoscope every day until I was a teenager. It was so fun. Happy Saturday - much love, E

Midnight Mass

     One of my favorite memories of Christmas is midnight mass. I passed the church today on the way back from getting my hair done and thought about my 7 year old self lined up out front at midnight waiting for entry. My grandparents were orthodox even though my parents weren't. Same same with my ex - his grandparents were orthodox Jews and I remember meeting and staying with them in Greensborough SC at their home. We walked outside - we weren't allowed to stay in the same room. A few months later she perished by fire. 

    But Catholic church redux I still love to attend the ceremonies it brings back amazing memories despite my issues with the politics of it all. Communion is one of my favorite things - I still hesitate to take it because you truly need to believe and I'm still in the skeptic category. The smell of the incense and the repetition of the liturgy though I swear I will seek out ceremonies in new cities to re-experience my childhood. The pomp and circumstance is so beautiful.

    It's nice being off but I feel like I'm in this weird state I should not indulge in. Like I don't deserve to relax. Even though I know I really do. I'm on call next week, and I'm hosting Christmas Eve, and Rachel texted me today and said, "Who all is there should I dress up or can I wear yoga pants.?" I definitely said yoga pants it's just us our small blended family I am working all week it's gonna be hell. But I ordered a beef tenderloin with horseradish sauce from Boulevard and a smoked salmon platter and egg nog bread (JACK) and chocolate ganache pies it will be a wonderful pandemic Christmas.

    Did you know we are entering the Age of Aquarius on December 21? I didn't either Lisa told me last week I had an amazing session where I wasn't even journeying but I did and the first 3D thing that popped up on my floor was sturgeon. Turns out the last sturgeon moon was August 20 2019 that's my fing bday and the Native Americans used it to harvest spawning prehistoric amazing fish. One fed many.

    So I googled the first historic age recorded was Leo they worshipped the sun. Every 2000 years it changes. I laughed when I learned my ex, an Aries, a literal bull in a china shop, was the ruler of the Iron Age. I'm excited to enter the Age of Aqauarius it sounds lovely. Celebrating diversity and letting go of individualism to greet collectivism. It's about fing time. Much love, E

Joseph

     When I was twenty I graduated from college and worked at Turning Point - an inpatient child and adolescent psychiatric unit at Arkansas Children's Hospital. It was there that I met Joe - a psych nurse. He was in his thirties, was short and sturdy with a pockmarked face and a long dark brown ponytail. Avery and I - she's another barista at Boulevard I count as a friend - were reflecting today on crushes Joe was a huge one. He had been a first responder to Columbine and was so adept at counseling. He had a history of cocaine addiction and was in recovery. Flaws are appealing to me in a person. Perfection, not so much.

    My divorce therapist, Diane O'Rourke, taught me that you are usually attracted to people because they have something you desire for yourself. Joe had amazing powers of empathy. He once told me in an evaluation that I should not go into psych because I didn't have good boundaries. I was powerfully good at it, but it would eat me alive with all I took home (pot kettle in reflection). He married the head nurse Penny, we used to all hang out together (she had a wicked British accent) and I was so jealous. I wanted him all for myself. 

    Diane's observation made me reflect. I was attracted to my first husband Mike because he was a doctor and I wanted to be one. He is also lighthearted and fun and I enjoy watching the kids experience this - we get along a lot better now that we aren't married and although I sometimes wish I had the emotional maturity to go back and fix that I wouldn't change Rachel and Stephan and Rennie for the world. I was attracted to Stephan because he was humble and had a circumferential route to his current path - he was a starving artist then an architect. His OCD was also appealing. He is a caretaker and he doesn't know or acknowledge his own worth despite my adoration. But he's getting there.

    The other day I was putting up Christmas decor and I pulled out the nativity I put up every year that my mom bought 40 plus years ago at Tipton & Hurst. One of the figurines crashed on the brick floor of my keeping room and smashed to smithereens. I wondered if it was a wise man or Jesus and Stephan hilariously commented, "I don't know much about the Bible, but I'm pretty sure Jesus was the baby in the Nativity scene. Oh, I was thinking of grown Jesus he was right. It was Joseph who perished. My cleaning guy Charles (he's amazing a future blog upon itself) found a part we hadn't it was Joseph's hand on the staff. I put it in the Nativity Scene to commemorate the loss.

    When  I was a med student I bumped into Penny - she was a head nurse on an onc ward at ACH. We  caught up. Turns out she divorced Joe he relapsed and eventually overdosed. I burst into tears. Sometimes the people we admire the most and learn from aren't good self caretakers. 

    It's much easier being sleepless when you don't have to work the next day yay!!! Music time happy Thursday much much love take care, E

 

Deadly Dump

     It's my Friday tomorrow (no today) and I was really hoping to have a full night sleep but it is what it is.

    In PMG pathology today someone asked for help filling out a death cert for a woman found dead on the side of the toilet. Lots of people chimed in, some advocating for autopsy, others talking about their expertise in this niche area. One said it is common for elderly to have PE (pulmonary emboli) while taking a dump and her husband wrote about this and presented to his hospital he titled his talk "The Deadly Dump."

    Another bragged about her article on commode cardia - she literally wrote the paper on death by valsalva maneuver her name is Amanda Fisher-Hubbard you can totally google it she sarcastically bragged "I'm so famous." LOL. Everyone was chiming in on ruptured berry aneurysms and determining COD (cause of death) and someone posted a link to a skit called Toilet Death Ejector on SNL which I had never seen and OMG I just had four needles back to back and I was sweaty and hungry but I laughed so hard I was thinking the secretaries probably thought I lost it.

    Speaking of sweaty my office is hot as shit. I've always been a chilly space heater girl but not this year others have pointed out to me it's like ten degrees warmer in my office than the rest of the hospital. I bought a fan at Walgreen's this summer and I still get iced coffee in 28 degree weather. Melody is having the same problem next door we commiserate. Today I had a nice morning then I had like five needles in one hour I was running around like a chicken with my head cut off. I told the secretaries don't be surprised if I show up tomorrow in my bathing suit I am so fing hot. 

    My partner Brian was readmitted for post surgical complications and it's hard to type this without crying. I know he's in good hands bc the people taking care of him saved my dad but I'm having PTSD and I was texting Ginger last night about how amazing rad Ken Robbins is (he's doing procedure on him today) about how he has two daughters and they love the Kardashians so he jumped right in and followed them around the world and when Marie Osmond came here for a fundraiser a couple of years ago he hosted her and was starstruck. He gets the best damn cores on the planet I was telling him yesterday the young ones need to step it up we need more material for molecular studies. 

    I guess I'd better check out and listen to music and go back to bed my daughter is good she signed up for guitar lessons and my new best friend Sean is good I need to pick him up tomorrow so all my people are good so I can relax and listen to music and  chill hope you are having a good week. Wanted to do yoga last night Matt shared a Zoom link but dry heaving took over and hopefully soon but not now. Thinking of everyone in my inner circle and loving and supporting. Much love, E

Midnight Snow

     Last night I fell asleep early and woke at 11 pm or so - went outside and it was snowing! So magical. I danced in the courtyard and watched for over an hour and failed to take pictures oh well. It looks like it's getting so cold we may get more. 

    OMG Lindsey was lovely. Melody came and picked me up Sunday evening and we took her out to dinner and I toured and interviewed her this morning. She was a contemporary of Annie, my sister-in-law, so I was texting her seeing if she was as good as she appeared. She is from Fort Smith and seemed to have a connection to every single person I mentioned or ran into. "Brandon Walser? He's out on quarantine? I grew up with him in Fort Smith." We bumped into my ex when I briefly showed her the Dr. lounge - a place I've been avoiding for the past few months bc it seems like there is a new Dr. out with Covid every week. Bravo, Abochale, the list goes on. She not only knew one of my ex's partners she was staying with her last night and she lived three doors down from where me and my ex last lived before the divorce on S. Lookout - such a small world. She cooks  biscuits from scratch. She idolizes her nieces and nephews. She is the oldest of four - just like me. She even knows my mentor Gene Singleton and his family they have a connection. She's dermpath fellowed and working in Nashville and wanting to return to her roots. Three amazing candidates in three weeks I wish we could hire them all.

    After huddle yesterday I bumped into Krista I used to buy fresh eggs from her a while back but her chickens were mass murdered (her daughter accidentally left the gate open and I think a dog or wolf got them I can't remember correctly) then she moved and the new place is not in a raising chickens zone. God those fresh eggs were amazing. She is a secretary for the lab and I told her RESOUNDING YES from me I really want the vaccine (we were supposed to tell her yes we wanted vaccine or no we didn't) and she said I was not considered a lab worker since I was from PLA. GRRRR. I told her that I heard over the weekend from my friend Jauss at CARTI that active medical staff could get the vaccine and she said not through me you had better contact admin to see how that works. So frustrating but I'm determined so I'll figure it out. 

    My son called last night wanting privileges to my blog for some sort of secret I have no idea what the password is I haven't used it in years but I gave him a couple of options we will see what this is all about in three to four weeks he promised me. I'm off Thursday and Friday so excited looking forward to hair and massage and therapy and buying more masks from my amazing hair stylist she's selling out on her website she can barely keep up I'm so happy for her. So happy Wednesday:). Much love, E

Panic Attacks

     Yousef teaches me that there are some people that are reactive and there are some people that are proactive. Reactive people like to please everyone but when you try to please everyone you end up pleasing no one you just accommodate the latest person that talked to you and if you don't follow through you can't build trust. This is poignant - I can apply it to my own circle.

    Rex Bell once told me that when people in our department want change they are loud about it. But not you. You make change sneakily. You are insidious. Yousef says that I'm not insidious, I just don't need the credit, and I realize that if I want change it is better to create the impression that others are responsible because then they can own it. Big egos need credit, some people don't need the credit they realize that the change is more important. I think that is the biggest compliment I have ever received, but I still don't own it. 

    I hate this time of year because you are driving to work in the dark and you are coming home in the dark. I think it overwhelmed me after this crazy call week because after I was getting on the on ramp and reflecting over the fact that frozen ENT guy was starting a laryngectomy at 5:30 pm and probably didn't need me but might I started to do this thing (Yousef calls it dissociation - I call it panic attack) where I was freaking out about the rain and the night and my body was tingling and I realized I could not handle the interstate. I pulled off onto John Barrow and went left across the bridge and BRIDGE OMG I was going 20 miles an hour in the left lane. Was silently apologizing to all the people passing me in the right lane I could not EVEN I was looking for a place to pull over should have put my hazards on. Finally pulled over in Burlington parking lot and called my husband he and my daughter rescued me and my car from my imminent panic attack (second one this year it always happens while driving) and Christy talked me through it.

    Funny because on my way to my first appointment with Yousef in three weeks I was driving way over the speed limit on the interstate listening to Lithium at full blast. He said he was proud of me for expressing my anger (I tend to stuff emotions and took this praise like one from a parent I was so pleased). I was red and angry for over two hours raging at inequity and hurt and pain. I would have been embarrassed by the color that keeps me from talking publicly and exercising in public and general introversion but somehow he doesn't make me feel ashamed by it I talked through it and became un-red. 

    I've got to work in the morning but my cytotech Tony told me it was looking light fingers crossed Hal got brutalized last weekend. Bestie Laurie on call with me made it home ok I made her text me projecting my own stuff. We've plans to get a Christmas tree up tomorrow afternoon and I signed up for that blasted Boulevard Christmas cocktail class at 6:30 again on call hoping the one in Jan finds me better rested. I was joking with Tina - my head transcriptionist - that it seems like every other house is just too Christmas or not at all. She was sharing a pic of her husband's pic (It looks like Charlie Brown but at least he did it himself) of a tree and we were laughing and loving. She said her neighborhood is the same it needs to even out.

    I'd better wind down with music S and kids do a much better job than me I was venting about work stuff tonight and I'm wired as hell. Hope you are all more relaxed. Much love, E

Bullet and Skull

     I've had lots of specimen types in my years as a pathologist. Appendices, lung lobes, breasts, but never ever until this week have I had bullet and skull. Jessica even equivocated in the gross - we usually don't take bullets, there were no police to receive it - the neurosurgeon insisted firmly. Apparently she was homeless, transferred from another small hospital, accidentally shot herself in the head. Hell no something is missing here. When they tried to follow up after discharge guess who didn't answer the phone.

    This call week has lasted a year. When I went into the gross room yesterday to check on things before I went home to Christmas shop online with my daughter I got a great story from my good friend Laurie. Her brother in law - Wendy's husband - has worked at Con Agra for 40 years. Wendy is over a decade older than her so kind of like a second mom. They pulled him in on Monday and told him, I shit you not, that he would be replaced by a college student to save money and starting January first he would be responsible for training his replacement. He's paid fairly well but 40 years. He's in quality control. He called in sick on Tuesday and landed a job two minutes from his house in Adkins AR as a plant manager - a bit of a pay cut but he's only really in need of the insurance for five more years Wendy retired from her lifelong school teacher job last year and he's not far behind her. Wendy called Laurie on Tuesday so happy Laurie thought she was drunk. But it was Karma. Her husband called his lifelong employer on Wednesday and told them he got a new job, he was taking four weeks vacay and he wished them luck in training his successor he would not be helping out. Sick burn. God I love Karma.

    What else? Nothing enlightening been doing lots of frozens and kind of in a tizzy over something I can't really talk about online but I'm trying to take over another department to fix dysfunction. Work people are like family. Sharing dysfunctional stories is not gossip it's rooting out dysfunction. If everyone doesn't feel supported no one can work as a team, no matter how much money you throw at them. I fixed the gross room, I'm working on transcription, now it's time to tackle histo. It takes time, for me I get angry things seem to move at a glacial pace, but I need to relax and breathe and plug in. It's not appropriate to ignore the mentally ill elephant in the room anymore you have to acknowledge and tackle it. 

    My partner Brian is doing great we sent him flowers and we got a pic of him next to them I've been sharing happily and profusely. A transcriptionist Jan said something that made me LOL "He looks a little pensive." I imagine he was a reluctant poser of the photo Ginger probably insisted. Nevertheless it's heartwarming to see him in full recovery.

    Good news in huddle yesterday Baptist is the first hospital in AR to receive the vaccine and it's happening next Thursday and there is a complicated algorithm on who receives it when I'm sure lab is not the first on the list but they will start giving it out on a week from Monday Hallelujah. I know I won't be first on the list - I'm scared as shit and haven't been to Dr lounge in two months - but hoping to get it before Xmas. Seems like there is a new Dr. every week falling to Covid thank God I work in the lab. 

    Happy happy 3 am music time here hope you are doing well I am surviving kind of a hell week but it's coming to a close thankfully. Much love, E

    

Rectal Foreign Objects

     I should not be writing at 3am but I cannot sleep and it seems smarter than slamming drinks, I've got ENT tumor board at 7am, so here goes.

    We are hiring two pathologists, and we have already interviewed two for one of the slots and will interview a third for the same slot next Monday. All women. I wish we could hire them all, because they all are amazing but the one today (yesterday?) grabbed me so much that I called my friend Becky at St. Vincent's and told her she had to interview this girl because my desire for her to land in a good position supersedes my desire to have her for myself. I was honest - told her what she was up against and that it wasn't entirely up to me we have to make the decision as a group based upon our needs. Selfishly I'd hire her in a heartbeat - her accomplishments include fellowships at Mayo and MD Anderson and I want to learn from her but I love the other too and Melody's good friend is coming next week - anyone Melody loves must be amazing so I'm just going to leave this one up to the Universe and hope everything works out.

    Natalya, the woman I interviewed and toured and lunched with today, is from the Ukraine, but she is a citizen here and has been here for twenty years so she counts the US as her home. She is beautiful and soft spoken and I cannot ascertain her age but she doesn't have kids and seems not to plan to but maybe I'm wrong on that I just intuit it. She loves to read and told me when she was in med school at the University of Iowa (that is a kick ass med school) there was a library with books in Russian and she would read the Russian and the English version. I told her about my mom's volunteering work in Russian orphanages and how she brought her translator Sergei over and put him through Hendrix. She marveled at how unusual of a story that was. I told her that I used to lament that Sergei (he was super cute) would never go out he studied all the time and in my youth I failed to realize the magnitude of what he was trying to accomplish. He was learning to learn in a new language and studying psychology and he didn't have the time to indulge in frivolities granted to me by my privilege. I follow him on Instagram - he's a social psychologist in CA who works for ad companies - and am happy to see he now has time to enjoy travel and fun.

    One of my best friends from residency - Kadria Sayed, is from Syria. She came to the US when her husband did ophthalmology residency and learned English by watching soap operas and retook her boards over here to qualify for a residency position. She is tall and majestically beautiful and one of five daughters she has two herself. She always pumped me up about how smart I was but I balked. I was born at the same hospital I trained at it was like intellectual incest. I was lucky to have some greats pass through but hell I didn't tackle another language. She ended up going back to Syria she was born of great privilege there and frankly wasn't treated very well here and missed that. She told me she used to have to ask her patients if they could afford/wanted her to perform immunos on their cases that shocked the hell outta me. When Syria fell apart she moved to Dubai. When she learned I was getting married she said, "Lizzie, you need to honeymoon in the Maldives and stop over in Dubai to see me." Well that didn't happen but I googled the Maldives and it seems like a good idea for the future.

    When I took Natalya to meet the gross room staff today Jessica was puzzling over something I was like what the heck is that. She said it's a rectal foreign object, we haven't quite figured out what, they seem to self manufacture things a lot. I laughed and said don't drive Natalya away I like her. A new hire who was absent today is named Savanna she is like 4'10" and when my chief Shaver met her he said, "There's a new mouse in the house!" and that's probably not very PC but hilarious my friend Laurie at 5' held the former title. Savanna is tough as nails and Jessica told me she's the new identifier of sex toys she used to work at Adam and Eve. A few weeks ago Jessica was puzzling over something submitted for gross only and Savanna strode over after watching her and said, "It goes like this. This is how it works." Like a boss.

    So Jessica is saving the RFO for Savanna to ID and I asked my doc mom book club last night if I could invite a non-mom to join when we resume post Covid and their overwhelming response was YES. There is a Christmas tree in the front yard of 18 Tallyho to add ornaments to to remember Deborah so I plan to shop at the Baptist gift shop tomorrow (today?) it is my fave place to shop on the planet. Hope you all are sleeping better than I am. Much love, E

Bathrooms and Elevators

     I've talked about my work bathroom on Instagram but quick recap - 1960's, doesn't get cleaned, trash often overflowing, toilet once flushed for hours, tar once bubbled from the drain. There are also a bunch of lockers for the lab techs so there's lots of traffic flow even by those not using the bathroom. Very little privacy. So when I was walking back from a frozen about a month ago and the secretaries told me that they made the boy's bathroom boy/girl and put a lock on the front door (there are two doors so even though I've worked there for years I've never even gotten an accidental glimpse inside) I volunteered to be the guinea pig and check it out.

    It blew my eyes out. 1990's decor,  no lockers, clean, two stalls and a urinal, updated way more than ours. Privacy. I used it once or twice then the third time there was pee all over the seats and that's what happens when you let the boys in so yuck I haven't been back. But I still rage at the inequity of it all.

    I also mentioned on Insta that they are starting to socially distance at the elevators in Med Towers 1 and only allow two on at a time. I was getting cash at the ATM nearby last week when the elevator door opened and a dozen people spilled out I reflexively turned my head and thought what. is. the. point. if you don't practice the same guidelines going down. But when I was up there later in the week (guaranteed all access private nice updated clean bathroom) I noticed some people had good sense and that made me happy.

    Not so much in Big Baptist. There are NO elevator rules there. My partner Hal said he was on his way to do a frozen  last week and thirty people were shoulder to shoulder waiting. Many had on those blue gowns you wear to go into infected people's rooms did I mention we have ninety Covid pos patients at Baptist the ICU is full they are creating spillover ICU's in pre-op and other plans are being made it's truly emergent at this point. Hal stood there wondering how to get through and put his arms out in a t shape to silently communicate PLEASE SOCIALLY DISTANCE and guess what everyone just laughed. He said it took all of his self-restraint to not verbally play teacher to a crowded pack of adult toddlers.

    I was on my way down the elevators in Med Towers last week bumped into Amy Wiedower she's a cute ob and when I just googled to get her name right Amy Winehouse came up she actually kind of reminds me of Amy Winehouse she's quite angular visually. Anyway we talk twice a year but she's always got a good story she said her daughter had a golf cart roll over on her a few days ago. I made her repeat that I misunderstood the first time bc mask. She was just off the phone with the guy that read the MRI he said she had a fracture in something maybe tibia I forget. The funny part is that she told her daughter she was fine and made her play in two basketball games since the event with a broken leg. I laughed and said, "Doctor's kids - they never get any sympathy right?"

    I had big plans to cook and shop but I've abandoned them bc Sunday shopping with Covid sounds scary and even though I slept until 3 pm yesterday I'm still needing more couch time I'm on call next week and the week of Christmas. With Covid and a partner down and people trying to meet their deductibles it's gonna be batshit crazy I need my rest we can do Bite Squad all week. Or soup. Jack's fancy Ramen came in he will be so excited when he gets here tonight he won't miss the cooking plans I never told him about. My friend passed peacefully on Saturday morning so sending lots of love to that family and planning gifts to drop off on the porch. Man that was fast, knowing how bad that looks under the scope I shouldn't have been surprised but I was. My partner is doing well. So that's good news. 

    Highly recommend the Euphoria Christmas special that guy needs an Oscar. Hope you all are having an equally lazy Sunday. Much love, E

Blog Review

     I'd like to welcome a new reader today my son Jack has been expressing interest in reading the blog and I told him no rush he's got his whole life and it's quite a lot to read. Today he asked me to send him a link to this one and MiM, so I did, and about twenty minutes later I got an I love them already I just read two of them! text and he doesn't exclamation point in text so my heart melted. Then he texted, "I feel like I am reading a profound author. Your vocab is great!!! Had to look up a word to fully grasp the meaning." Then I got worried and texted, "Some older ones embarrass me but I decided to keep them as is like a record. Also I used to obsess over minor typos and errors but recently I'm using it more as a journal so I don't reread and obsess anymore." He expressed his approval and I smiled with pride as I returned to my cases thinking if that's the only review of my writing I ever get I will die happy.

    I had breast conference this morning and there was a new format I hadn't been assigned to cover yet it's called Oncolens it's very confusing and I had to call out the rad onc's secretary a few months ago bc the platform was sending daily email 😀😬😁😂😃😄😅😆😇😉😊🙂🙃☺️😋😌😍😘😗😙😚😜😝😛🤑🤓😎🤗😏😶😐😑😒🙄🤔😳😞😟😠😡😔😕🙁☹️😣😖😫😩😤😮😱😨😰😯😦😧😢😥😪😓😭😵😲🤐😷🤒🤕😴💤💩😈👿👹👺💀👻👽🤖😺😸😹😻😼😽🙀😿😾🙌👏👋👍👎👊✊✌👌✋👐💪🙏☝👆👇👈👉🖕🖐🤘🖖✍💅👄👅👂👃👁👀👤👥🗣👶👦👧👨👩👱👴👵👲👳👮👷💂🕵🎅👼👸👰🚶🏃💃👯👫👬👭🙇💁🙅🙆🙋🙎🙍💇💆💑👩‍❤️‍👩👨‍❤️‍👨💏👩‍❤️‍💋‍👩👨‍❤️‍💋‍👨👪👨‍👩‍👧👨‍👩‍👧‍👦👨‍👩‍👦‍👦👨‍👩‍👧‍👧👩‍👩‍👦👩‍👩‍👧👩‍👩‍👧‍👦👩‍👩‍👦‍👦👩‍👩‍👧‍👧👨‍👨‍👦👨‍👨‍👧👨‍👨‍👧‍👦👨‍👨‍👦‍👦👨‍👨‍👧‍👧👚👕👖👔👗👙👘💄💋👣👠👡👢👞👟👒🎩🎓👑⛑🎒👝👛👜💼👓🕶💍🌂GOD that's the third time it's done that and I'm too tired to erase it again cannot figure out how to prevent it sorry. Anyway Melody already warned me not to try to upload the pics into Onclens like they want you to bc it's way too hard and it doesn't look good in the Zoom-ish meeting (no one uses their camera). She makes a Power Point and shares her screen I tried to do that this morning at 6:30 a.m. but couldn't find Power Point so decided just to put the pics on my desktop and share my screen how hard could that be. Everyone was very welcoming and indulgent and helpful when I tried seven or eight times to share my screen when I presented the first patient's pathology and I finally said, "Look guys I'm just going to describe it we need to move on I'll work on it for next time. Lobular carcinoma is like Medusa. It has tendrils like snakes and it goes everywhere it is a bad actor." Jerri Fant wondered how it could be so metastatic when it was low grade and I chimed in. "I don't believe the Bloom-Richardson Nottingham grade system should be applied to lobular. It doesn't fit. You never see low grade ductal go all over the place, hell even high grade ductal, I've seen low grade lobular in the small bowel, in the ovaries, in the uterus, it's so sneaky." Rad onc agreed, "It doesn't quite fit the paradigm."

    About halfway through the meeting at a break in patients I said, "Guys, I need to tell you if you don't already know my partner Brian Quinn had semi-emergent bypass surgery yesterday seven heart vessels he is going to be out for a while." Two of the doctors, Fant and Wilder gasped they are quite close to him a lot of clinicians are he lives at work he's a genius he's who I named this blog after. They wondered what happened and long story short he was symptomatic over the weekend before Thanksgiving and had a cath and then yesterday. The breast conference discussion ended with lots of thoughts and prayers and we moved on. I was using my ex as an inside connection to see what was going on why the surgery was taking two hours longer than expected (almost 7 hours) at the behest of Rex and I had this sweaty PTSD reaction and almost fell apart. My dad. That's a story for another blog. But luckily he made it through ok I'm sure the recovery will be slow and as a group we are stressing and worrying and praying and towing the line and it's all a little much but isn't that typical of 2020.

    I read a headline at lunch today that made me LOL Covid superspreader event at a freaking swingers conference in New Orleans I had to click. Apparently there's an annual convention "Naughty in N'awlins" that drew 2000 swingers last year but only 250 this year but that was still enough to create a problem. The head of the convention expressed regret in the article and then said "We didn't have a dance floor but I know from Footloose that you cannot prevent dancing" so I questioned his sincereness. That reminds me of an article I read last Friday in the Huffington Post it's a long read but well worth it the author obviously did their research and it took some time. Dr. Opioid just googled found out it was published October 28. Forget the Frye Festival and the Tiger King and that cheerleading one where the plucky boy got famous then turned out to be engaged in pedophile activity or tweenophile activity whatever you call it he fell hard. If this was made into a documentary it would eclipse them all. It was full of doctors and motorcycle gangs and opioid diversion and divorce and strippers. My favorite line was when the doctor got the strippers posing as patients for opioid diversion addicted to Xanax and they would come in asking for more and he said, "A blue for a blow." And they complied. Disgusting but intriguing. That article was bawdier than an entertainment lounge at a brothel.

    Ok that's all I've got in me again welcome Jack to my 25 readers (now 26!) and happy Tuesday to you all. Much love, E

    

Landlord

     I never thought I'd add that to my resume at the ripe old age of 47 but our house has been on the market since March and hasn't sold so when an acquaintance texted in distress three weeks ago - her house sold in a week and she had to be out before Thanksgiving - to see if we would consider renting I jumped on it. Double mortgage since July sucks. My financial advisor told me to look up rent on Zillow and charge 200 bucks less good renters are priceless. Her cousin lives down the street, she only wants six months bc they have their eye on a FSBO on 2 acres. He's a farmer and wants lots of land, she's a busy SAHM of three girls. 

    She called me this morning and told me she didn't want to bug me over Thanksgiving but two things, one, there's a black rat in the cupboard in the kitchen (we killed a baby white rat in the Spring and were worried there was another one) and Dow, her husband, was testing all the lights and the one on the back porch sparked scarily so she called an exterminator and I called an electrician and I hope I passed my first test as a landlord with flying colors because she is really amazing and I want to count her as a friend. She's agreed to deliver the meal I plan to cook for my friends two doors down on Wednesday - I'm stuck at work - so I plan to bring her a housewarming and thank you gift when I drop off the food tomorrow night. After family pictures take two. I hope she shows up I was originally off tomorrow but a partner is having emergent surgery so I agreed to come in.

    Don't recommend The Nest the woman was an interesting character but overall it fell flat. Big wishes that his next is as good as his first. That cult one has lingered.

    The funny thing about the rat is that they heard it and thought it was in the attic - but her youngest Virginia was like no I hear it it's in the kitchen. And they had heard their alcohol bottles clinking around at night - Dow put them in the cupboard above the stove. They are used to country living - so not afraid of animals - but not in their living area I agree. She told me that they once had rats in their garage, the reason they like they alcohol bottles it that they pry the labels off for their nest. I thought that was lovely, honestly. I would never have guessed that in a million years. 

    Just finally emailed/figured out the senior ad thing. I found a quote that made me cry when I originally read it - Neil Gaiman's Blueberry Girl. Don't tell Cecelia she doesn't read this and it's a secret. If I recall correctly he loved Sarah McLachlan's music so much he wrote it for her little girl. I read it at Barnes & Noble and quickly introduced into my daughter's nightly queue. It is one of my favorite children's books I've ever read I need to get it for Rennie.

    Busy day, nice to be relaxing, hope you are too - much love, E

Lazy Sunday

     I've just been helping my daughter with college scholarship essays - she really doesn't need much help I just edit and discuss and give suggestions. She's been writing college level since early high school - one of her papers on human trafficking won best in the region at Model UN in tenth grade. She has so many accomplishments - Student Body President at Central and National Merit Semi-Finalist (I never got close to that) but I'm most proud that she has good core values. She wants to follow in her mom and dad's footsteps, despite the fact that I've told her on many times when supporting her through life that I don't care if she is a greeter at Wal-Mart as long as she is happy I am happy. Putting those essays together - meeting new prompts with old content - is like playing word Jenga. But you get used to it, it gets easier as you go along.

    Before that I was lazy as Hell been having a Sean Durkin fest after reading about him in the Atlantic this morning. I meant to watch Martha Marcy May Marlene when it came out nine years ago but it slipped my mind and so I watched it this morning it was amazing, definitely some rough scenes to watch but the psychological study of being a cult leader was so on point there were these amazing clues in every scene not just out loud but visually. In the middle of the Nest now it's equally as jarring a psychologic picture of horror but this time wealth, not a cult leader, is the villain. 

    I've also been reading some Anthony Chekhov stories of women - a great thing about moving is discovering books that you have that you never got around to reading and I've got hundreds of paperbacks. Not sure when I picked this one up but it's a gem. It's funny how people have the same problems and feelings and stories that travel time. I really liked Wretchedness. I've had trouble reading lately but I just ordered ten copies of Mitch Albom's The Magic Strings of Frankie Presto - my hair stylist lent it to me (if you call ponytail a style lol but that's my fault not hers) and it is my favorite book of the year so I've got to gift it. I googled him after I read it he's quite an amazing person he uses his gift to give and I admire that quite a bit.

    And, like everyone else on the planet, I watched Queen's Gambit it is so good she is amazing those eyes can say more by looking than anyone could ever say out loud. And of course I loved that her name was Elizabeth but she goes by Beth I've never done that. 

    I'm off tomorrow gonna grocery shop and try to figure out this Senior ad thing that is a mystery to every parent of a Senior at Hendrix we lament about it in a Facebook group. It's due Tuesday. I was commenting to follow the other day and I saw my therapist comment I felt like I won the jackpot and Facebook stalked - just his cover photo to see his wife and kids. 

Hope you all had a restful weekend - much love, E

Fugue States

     Man I'm so tired but this stuff is literally swarming my brain so I'm gonna run with it. 

    My new psychologist Yousef, who I started using at the beginning of the pandemic based on a friend's recommendation, is brilliant I can tell. I feel like I have a sixth sense about brilliance. We had about six or seven phone meetings before I met him in person. I do this thing with people I admire, I deify them, so much so that it is a detriment to me and them. I imagine a lot of people do this, but with me it's very intense. It was really intense with Yousef because he was like this disembodied voice imparting wisdom from the Heavens and he makes himself available to certain clients for after hours sessions and I used that a lot in the Spring - not only pandemic but was having kid crises and work stuff was really stressing me out. I thought I had graduated from therapy after the divorce but nope, here I was again seemingly back again at square one. 

    Once we met in person it got better - he was less God-like. He told me that when I called him sometimes in crisis he could tell I was in a fugue like state. He asked if I remembered the late session at Beaver Lake when 45 minutes into the session I realized I was on the phone with him and was confused how I got there. The last time I did it I was on the back porch of my house and I started normal but ended fugue and woke up in my bed thinking, "Well that was a waste of a $200 session." I googled fugue. It's not very common. It happens in times of deep crises. I do realize when it happens and I get really embarrassed, like what the hell did I do or say it's non-recoverable.

    When I was little, I sleepwalked. I wonder if this is related. I'd wake up on a couch in the house far away from my bed and wonder how I got there. My sister would recount entire conversations we had that I had absolutely no memory of. I researched the pathologic version, maybe dissociative disorder - but I'm not that bad it usually only happens when I'm really stressed out and it's not like I wake up in another state wondering how I got there it's usually only a few minutes or an hour or two and I'm back. I told Yousef that I wanted to meet with him weekly until I stopped and he complied. That was a couple of months ago. I recently went three weeks without a session. He agrees I'm much stronger now than I was in the Spring.

    When I met Jesse McKenney I had another strange sense of brilliance. I soaked up every moment I had to learn from him because I realized he was just starting out but was going to go far. But when you put people really high on a pedestal you are putting yourself down it doesn't work out too well. Plus, they eventually fall, we are all human. With Jesse it was one time when something nasty and political was happening in the department - I was a resident - and I vented to him and wanted him to take up my cause and support me - start a freaking revolution. He balked. I realize in retrospect this was self-protective and smart - academics can be brutal and he didn't yet have enough experience and power to wield. But I was so disappointed it was like he fell from the Empire State Building and I drop kicked him into another dimension, that's how intense it can be. 

    And take Rex Bell, my partner. He is retiring in June I'm already beginning to mourn. When I first met him I was dazzled. I say knowledge is sexy but musical talent and quick wit are a close second and third and he had all three. I love his wife and mean this to be complimentary not weird. I'd wander into his office and he would be being interviewed by NPR based on his accomplishments as a jazz pianist. When I was telling him today about my weekend with my husband on the porch in the rain with drinks and Fritos and bean dip he said "So you got gassed and gassy." I swear it comes so fast I can't keep up. Once a few years ago we got into a tiff about a billing charge he was checking I made and error and I took it too personally and exploded. I got him so out of sorts he sent another partner to tell me if I had a billing error for FOUR years he is just now comfortable with me again. Except that incident this Summer. For a future blog. I really can have a temper. And I love that despite all of his accomplishments and talent he still wears his heart on his sleeve.

    Recently Jesse and I were sharing kid pics on texts and comments about new crazy ass lung cancers. He is at the Cleveland Clinic - career pinnacle. So impressive, and I take a little pride in knowing that I predicted it. So human mistakes are recoverable. But my experienced outtake - sliding into 50 like an anonymous bad DM, is that I need to quit deifying and start having enough confidence in myself to being equal to even those I admire. Like pretend I'm sitting in a room with Obama and have a not weird normal conversation and not sweat. Because we all sweat and have anxiety and sit on the toilet. No matter how accomplished we are, anonymously or publicly.

    I've been winding down to Dave Chappelle at night. I was in residency when his show came out and missed all that. It's kind of fun reliving the Bush years and he is so funny I LOL that is the best medicine after a long day of cancer. Happy Monday. Much love, E

Near Death Experiences

     One of my favorite questions that my husband asked me when we first started dating was, "I like your sunglasses. How long have you had them?" I almost LOL'd. Smart right? Like a thinly veiled "Can you keep up with your actual shit?" I appreciated this, considering my ex loses his iPhone about every other month, which is an endearing trait the kids and Rachel and I laugh about now that I'm no longer at odds with him. I proudly announced I'd kept up with them for years. We were still in the honeymoon phase  where you can't really let your guard down - it took me months to even be able to take a shit around him. Which made for a very awkward trip to New Orleans - I'd held it in for awhile so excused myself at the aquarium and was totally prepared (and inwardly triumphant) when I emerged from the bathroom and he worried, "It was taking so long." I replied, "Oh, you know women's bathrooms. The line was eternal."

    S and I spent a few summers vacationing at a dude ranch with the kids. One year I wanted to go white water rafting while the kids were at their day camp, it was a blast. So much so that Cecelia wanted to do it with me the next year. Since S had already done it and Jack and boats don't get along - he can't even watch a 3D movie without getting a massive headache - C and I embarked alone on the three hour journey to the raft site one day. It was the same tour and frankly not really scary at all there are hardly any rapids but a lot of great scenery and the guide was a grizzly old guy with campy jokes. The spotter in the back was a PA who did this on her off days. If I recall C and I were the only other ones on the boat. 

    I was enjoying the day - it was cold so we were in layers. It was June in Colorado so glacier melt was still happening there was no getting in the water for a swim but we enjoyed a light lunch on the bank and stopped to see an actual dinosaur footprint. I could tell C was a little disappointed - she was only 12 but already had a thrill seeking nature and expected more. So when we hit a fun rapid the guide announced that he could turn around and do it again. As he was doing a 180 I fell from the boat and plunged into the icy cold waters. I apologize if I've told this one before but it came up in therapy this week so clearly it needs more processing hopefully with new twists and turns. 

    I emerged under the boat in shock from the cold and thinking I needed to get out from under the boat that was my single minded goal. I struggled for what was probably only a minute or two but it felt like an eternity. The guide pulled me from the water by my jacket back onto the boat and once he ascertained I wasn't in any health risk he ripped the spotter a new one. I shivered in adrenaline rush and thrill for just being alive. He got me in some semi dry clothes and towels and thirty minutes later the trip concluded. My single regret was that I lost the lens of one side of my sunglasses.

    My glasses are covered by my health insurance. So while I thrift shop and sale shop all the time for clothes I luxuriate in glasses. My current readers are Tom Fords and those sunglasses were Versace. S and I researched on the computer back at the cabin to see if we could find a replacement for the lens but they were out of rotation. I lamented and said "Let's just throw them away I'll get new ones."

    I needed reader sunglasses by then anyway so I got some cute Tiffany & Co. ones I've had ever since. S and I were conversing a few months later and he confessed that he couldn't bear to throw them away so he went on a hike we had already done where he remembered there was a hole in a tree trunk and put them there. So I like to think of them buried, like in a vault, up in Colorado where I spent all that time teaching my kids to enjoy nature and horses (them anyway horses scare the shit out of me) and hikes and gourmet food.

    Looking forward to breakfast, speaking of food. Hope you are having a lazy happy Sunday. Much love, E

Happy Place

     It's kind of nice when you plan a long hike and nature says nope I'm going to rain all day so all you get to do is eat and drink and read and write and get a massage. Just finished breakfast at my favorite new brunch place yum poached eggs over sausage with a bloody Mary reduction sauce and of course plenty of Tabasco sauce. Bombadil's. It's a little out of the way from this bed and breakfast but feels a hell of a lot safer than Mudd Street Cafe that breakfast den feels like a Covid bed and there are never very many people at Bombadil's it's kind of hipster.

    The last time I was up here we did another underground off the path cave tour and it was just me and S and a cheerful tour guide who reminded me of Mindy Kaling. We got to the end of the lighted part of the tour and she asked me to climb on a very scary boulder - the drop offs were vertiginous, and as I sat there with the point of rock invading my ass she said, "Now you are going to want to climb here and then put your foot up here." I looked up and tried to pay attention through my fear and saw that she had her foot going into another room above her head - she was already a head above me. I made a snap decision based on the fact that my foot had not been that high above my head since I was on the Pom Squad in high school. "Y'all go on I'm going to stay here." 

    As they ascended into the dark recess I realized that I was too frightened to get back on the path so sat on the scary rock for twenty minutes contemplating my fate. Luckily they emerged to go into a different part of the cave and recognized I needed help and got me down. So I spent two hours by myself in the lit part of the cave where people tour and took pictures and sang Cowboy Junkies - the acoustics were amazing and thought how lucky I was to get to do this at night with no one else around. S said I made the right decision the things she had him do were scary and not fun and there wasn't even much to see. He said the other one we did back in the summer was better that guy always gave you a safe and a scary option and the scary options were nothing compared to what Mindy put him through.

    Lisa tells me it's ok to take something from nature if you ask permission so I felt really bad because I took three tiny rocks from the cave and forgot to ask permission but hopefully if I ask I will be forgiven. They sit on my bedside table reminding me of the adventure. 

    The last time I was fascinated by religion was in college - I took a world religions class I loved from Jay McDaniel. I had a huge crush on him. I can see where college kids and professors might get in trouble  entangling because knowledge is about the sexiest thing on the planet. Throw on a Scottish accent and you get Dr. McAinsh, a history professor. Some days I had to use all my self control not to run to the podium and throw myself at him. I guess as long as you keep that shit in your head it's ok. When he came up to me on my graduation day and sought me out to tell me my final essays written for a class I forgot was the best one he ever read in his entire life I was so pleased. Dazzle em with your brains:) 

    Anyway, I became fascinated with Kali, an Indian deity, during world religion class. I even made her my Twitter handle at one point during my divorce but then I never got on Twitter which is typical. I'd kind of forgotten her but when Lisa told me to order these goddess mediation cards and read the accompanying meditation I brought them to my office and opened them up and guess who I picked. So I read the mediation and it looks really cool but it's been about six weeks and I've yet to try it. Moving. Election. Pandemic. We've discussed this. I found a Kali statue my mom brought me from India in college that was hiding in a cabinet and took her to my new house. She's important, somehow.

    Well I'm  going to go pick one of the seven books I packed to start and read until 1:00 massage. Hope you all are having a wonderful Saturday. Much love, E

Ascension Sickness

     I should tell you about Wednesday. Not really yesterday but it's past three a.m. so time is a little murky. I was off, I planned a few long weekends to unpack. I'm about 75% done but there is still much to do. We had family pictures planned so I slept in and showered and went to a salon in Hillcrest my stylist recommended to get a blowout. I hadn't had one of those since I turned 40 so it was a real treat. The stylist was super nice and gave a great head massage - we talked about the astrological signs of all the people in our lives and what they meant. 

    My histology department is in real distress. We had one out on quarantine and one is on maternity leave after bed rest and our night person quit so we aren't getting slides until around noon it's kinda crazy. Therefore I had a bunch of hard cases I had to order immunos on that needed my attention so I went into work for about three hours. I sighed as I gave a 22 yo metastatic leiomyosarcoma to her bowel mesentery and a 30 yo nurse with an upcoming wedding metastatic ovarian cancer to her entire abdominal cavity. WTF is up with cancer. It's running rampant. It's not just the virus we have a real health crisis on our hands.

    I'd had an egg for breakfast and I ate the rest of a fruit cup dumped in Boulevard ginger dressing for lunch with corn nuts. I swear I could drink that ginger dressing. I finally wrapped things up and headed to get a gift for my new friend Sean - he had a hard day at work the day before - he's a barista at Baptist Boulevard - and I was excited to see him. We were chatting outside his apartment and suddenly I had to sit down. Then I had to lay down. I was tanking and he told me I needed to come in his apartment. I scooted into the front entryway and my hands grew numb and I almost passed out. His boyfriend was on the couch - I was excited to meet him but apologizing profusely for invading their space. He was super kind and offered me a pillow. "It's clean I just washed it." I said, "I'm not a neat freak I let my kids eat mosquitos to build their immune system but I appreciate it."

    I was turning grey and Sean offered me some lemon sorbet. I ate it so fast I got a second cup and then had a cup of raspberry sorbet. I think I was hypoglycemic from lack of food - I told them both this hadn't happened to me since I was in residency I had a GI bug and grew numb and paralyzed from low electrolytes. It was supposed to be my first day on forensic rotation at the crime lab I had to call in for the first time in residency. Trent talked about a Karen incident with their adorable chocolate lab Roxie, who they were holding back until I revived and was able to sit on a chair. I told them to let her over I was feeling better and had to be at Two Rivers in twenty minutes for the family pics. They worried about me driving but I assured them I was OK.

    I arrived at the park and C called me from her car saying that the photographer had DM'd her on Insta at noon to say she had to postpone but C doesn't get notifications so she just found out. She was crying. I told her no worries we can just take some pics but she clearly wasn't in a state for pics so S and J and I wandered over to some trees and took pics of each other. I told her I'm off again the Monday and Tuesday after Thanksgiving so we can reschedule but she was in melt down mode so I supported her for 20 minutes over life and such. She worried over her dripping mascara and I told her she looked beautiful like a goth queen. They drove off to their dad and stepmom's for supper.

    Ever since this summer I've had to have a cough drop in my mouth to prevent me from dry heaving. It's super annoying. My therapist, Yousef Fahoum, thinks it might be new allergies but I googled it it's ascension sickness. I think all of our souls are ascending right now. Sometimes, like the other night, the cough drops aren't enough and I throw up. S and I were planning to go to dinner but it was put on hold as I tossed all of the lemon and raspberry sorbet into the kitchen sink. Then I needed a whiskey and Arnold Palmer - my new fave drink - I learned about Arnold Palmers from someone a long time ago at the Racquet Club. 

    When I recovered S and I went to Santo Coyote - new Mexican chain in the hood - and ordered a big plate of nachos with pulled chicken and ground beef. My only complaint was that there wasn't enough cheese dip on it I'll have to ask for extra next time. The jalapeno margarita was large and plenty full of tequila but a little sour. 

    Yesterday C told me she rescheduled the pics for December 1st when I'm off. I'm kind of glad bc I want to wear a different outfit and I thought I looked a little washed out I don't wear makeup bc I don't understand it and it's an extra step to the day I'd rather avoid. She told me she would help me with makeup.

    I bought some of the lemon sorbet at Kroger yesterday it's going to be one of my new comfort foods it's so good. Trent told me that they have tried them all and strangely the Private Selections brand at Kroger is the best (I won't be going to the Heights one any fing more) even better than Haagen Dazs and Ben and Jerry's. I also got the mango and the black cherry to try. I should probably wind down and catch a few more z's before my trip tomorrow. I hope Lisa is proud I'm writing.

Much love, E

Grocery Store

     This morning I had a nine o'clock appointment with my psychic, Lisa Dawn. I don't think I've told you about her. I heard about her from my hair stylist - her mom is a psychic and in professional circles she's known as one of the best in Arkansas - she's in Eureka Springs. I met her in 2016 on a long weekend in May - I went for a Tarot reading on a lark and she said some things to me that really helped me heal my relationships with my family. I've done lots of journey work, usually on the phone in my office. Lately I've just been doing energy clearing and Reiki, because pandemic and moving and life is stressful. She told me I need to write more, because it was inspirational. LOL I don't know about that but it is something cathartic to me so I will try to be a little more of a frequent flyer around here.

    My husband asked me to go to Walgreen's today to pick up some gum and mouthwash for him. I'm off, and decided to go to Kroger instead to get some basics and try out a new soup I found on Tasty this week. It's a vegan soup I'm making for an acquaintance I recently learned it battling a nasty cancer - sarcomatoid carcinoma - it's like cancer on steroids. I'm going to make a test run on Sunday night but add Italian sausage and cheese instead of lentils. She's so wonderful and she's my age and she has kids my age and I've cried about it three times since I learned on Monday. I signed up for the December 2 meal - lasagna soup. I learned from googling that most store pastas have no animal products.

    Kroger was crowded and the lines were longer than I've ever seen them. When I finally got to the register I was making small talk with the checker until she was dogging the vaccines and how early they were coming out and I was like ugh. Who is this crazy person. When it finally came time to pay the bill it was rejecting my debit card. Then it rejected my credit card. Then it rejected my check. I checked my account and sure enough there was plenty of money to cover the bill, so I told her I wasn't leaving without my food and she called the manager. Freaking Opie walked up with slick backed red hair and a vapid face and said the machine was not communicating with my bank. I told him that was ridiculous - it's freaking Regions, and he needed to fix it so I could take my food home I'd shopped over an hour. He said, "Ma'am, I cannot let you walk out of this store with 280.00 worth of groceries without paying." I just sighed and wondered what the hell I did to deserve this stupidity and prayed as he handed me over to a cute guy from guest services to try to ring me up on another computer. 

    I worried, "Are you going to have to scan everything again?" Thankfully no, and he saw the problem was one that she made and fixed it. I paid with my debit card. He apologized for the trouble and I looked him in the eye and said "No thank you so much you are a lifesaver." I hope he told Beavis and Butthead that it was their problem not mine.

    Lisa has taught me that if animals show up a lot in your life you should google the Native American meaning because it means there is something they are trying to tell you. Back in my old house on Foxcroft we had a stink bug issue. So much so we paid a bug service to close off external entrances to our home. When I moved here I saw, guess what, a stink bug. So I googled. Turns out they have a lot to say I'd tell you but google it yourself I'm not long for this journal. My husband rescued the one from my bathroom the other day - I told him they were important - and when my cousin Eleanor came over she noticed the biggest stink bug on the planet outside of our keeping room on the screen. It looked prehistoric. So I told her about them I think I shocked her a bit. The next day there were two giant ones on the screen door if they made babies one of them showed up in my bathroom this morning. I'm going to get S to rescue it when he gets home from work as a single mom I dealt with many bugs for my kids and I was happy to pass that torch when I remarried.

    OK I feel better. My husband is grabbing brats on the way home we are going to grill in the new backyard and have a bonfire we are headed to Eureka for the weekend. I'm so excited. Won't see Lisa bc Covid but we made a phone appointment Thanksgiving morning. Talk soon. Much love, E

Lingular Tonsil

Well it's been a while. Not two years, but certainly longer than I intended. Just made it through the middle of a call week, and there are reasons to celebrate. First of all, I got a text from Melody on the way home - she texts the Baptist systemwide Covid info every day. Baptist Little Rock went from 48 inpatient yesterday, 14 in the ICU, to 37 inpatient today, 11 in the ICU. North Little Rock got two out of the unit. Hard to know if it's a trend since we've been going up for a bit, but encouraging.

I was doing late frozens tonight for John Sims - the new ENT guy from Mayo who has increased our frozen monthly count by like 25% but is so gosh darn nice (I bet his ears were burning when Laurie and Jessica and I were talking about him in the gross room waiting on the specimen) it's hard to be mad at him about it.  I simultaneously learned that an organ procurement that was going to start at 8 was bumped to midnight, yikes. John came in the gross room to chat about the case. Melody had diagnosed cancer in a lymph node but the origin he was hunting for at the base of the tongue was elusive. I told him the second specimen was also negative. "We are in the lingular tonsil right?" He replied "The lingual tonsil, yes. I'm not too worried, because I've seen 2mm primaries in this area. And it makes a difference if you find it or not, for neoadjuvant therapy. Make sure you sample thoroughly. And I want p16." Oops. I got the lingula of the lung and the lingual tonsil all mashed up in my head, LOL. I told him, "We can do the p16 on the lymph node, if we cannot find the primary. Yes of course I'll put it all in and relay this info if I don't get the case."

Two funny things happened last week I kept trying to write about. Last Monday was chaos in the micro lab. Of the 48 patients scheduled to go to surgery that day only one had a Covid result from AEL. Turns out AEL lost 40% of their testing supplies from Roche - it's happening all over with the surges. We had to re-order the tests and do them in house. On MyChart there is a place the patient can check their Covid result. It says if you have questions, call this number. The number is to the front of the lab and that person was forwarding it to the micro lab all day. So patients were calling THE MICRO LAB FOR RESULTS!! That never happens. It was so hectic trying to get all the tests done that it wasn't until mid-afternoon that director Amy sat down to e-mail the head of the lab. She started it with HELP!!!!!!! Finally they stopped that still anon to me person from forwarding those calls. Surgeries and procedures were crippled for about three days last week, but it picked back up.

Another funny phone story. Jessica was sitting down with me talking in the back room of the gross room problem solving and there was a phone call. She said, "That's HIM!! UGGHH! Room 532!" I wondered who. Apparently there was a patient that was a little demented and had been calling the gross room all day long for three days asking various questions. "Is my wife there?" "Is this the kitchen?" It was getting so crazy - this was when surgery had started picking back up - she got the nurses to take away his phone. But then there would be a shift change and he would get it back from the new nurses. "I'm going to have to talk to those nurses and get it back again. Savanna, what did you say to him when he called?" Savanna is a new hire - hybrid gross room deaner and histotech. She's amazing. "I just picked up the phone and hung it up." I haven't heard any more about him this week, so I guess he was either discharged or lost his phone privileges permanently.

Jessica texted me on the way home that the organ procurement was moved back to 5am. Yay! Now I can have a drink in peace. The nurse at the front desk in the OR told me that midnight was probably wishful thinking, because it was a full organ procurement and to get that many surgeons and recipients coordinated in surrounding states would take a lot of time. She gave me a number to call before I went to bed to check the status. Now I don't have to worry about it. Whew.

Here's to after work cocktails and more Covid decline - we need some good news around here. My kids are happy (for the most part) and healthy - Jack's at camp for two weeks and Cecelia is loving spending money she is making from her new job babysitting a former Camp Aldersgate camper. I'm looking forward to next month - two weekends in a row are already booked up with birthday fun and I've got a doc mom book club to schedule. Hope you are doing well. Much love, E

Birthday

It's my son Jack's fifteenth birthday today! A quinceanera, if he was a Mesoamerican female, which he is decidedly not - he's a tall, handsome dude, but still. It's a big deal. I was reliving his birth in the shower this morning - premature membrane breakage on the early morning treadmill walk, the long stay in the hospital with that terrible medicine that stops labor - mag. I could not read or watch TV it wrecks your concentration and blurs your vision. I did get a pedicure, that was nice. Labor and delivery were easy, when it finally was time, after the surfactant. His physicality today flies in the face of his tiny birth weight. Miracles are real.

I wanted to name him Jack, but my husband at the time thought that was a nickname, so we named him John and call him Jack, after my maternal grandfather. I think it's funny that his name is John Schneider, considering I was in love with Bo Duke as a preteen. One of my first crushes. I remember listening to his cassette tape over and over one summer at the beach on the top bunk in our rental house. It wasn't really that good, but I was infatuated. I may have told you all this before, but if history repeats itself (pandemic! protests!) then so can I.

Yesterday I learned that our head transcriptionist - a magician really - her name is Tina, is having her tenth grandchild today. Which is crazy, because she could pass for someone my age. I excitedly popped out of my office and asked if they had a name. "Yes, it's a boy, he's going to be a junior. Darius. I'm calling him D.J."

Tina's husband also works at Baptist. He always smiles real big when he sees me in the hallway and greets me - he calls me doc. It's impossible not to smile back. About five years ago, I learned there was a Martin Luther King celebration at Baptist in the afternoon of that holiday. I wandered in. It was a little disheartening to see how few white people were in the room, so I vowed to attend annually if I was at work that day. Tina was there. A white reverend was the headliner, which was also disheartening, but that has been remedied in years since. I was so surprised when Tina's husband got up to sing - he has an incredible voice. She later told me that her son was one of the one's playing a musical instrument, I forget which one. But I remember him. His sheer height and bulk and pleasing visage make it impossible to forget him.  Don't tell Tina I said that, it's kind of embarrassing. But he's really cute.

I started call this week, for the first time since April, and Monday was super frozen heavy - I had eight before nine. I was bragging to one of my partners that they were all easy and karma hit me in the head when I had a really hard one at the end of the day. I was also trying to sign out my cases and my keyboard stopped working. The bluetooth light came on when I toggled the switch on the back so I thought it couldn't be the battery and kept waiting for it to connect. When it didn't I banged my hands on the keyboard in frustration.

I walked out in the transcription area when I was called for another frozen. Tina was there with one of the other transcriptionists, she had been working on a computer problem with her for over an hour. Which made me reluctant to bother her but I needed help. If this frozen was as hard as the other one, I was going to have a meltdown. After the frozen, of course. I interrupted, apologized, and explained my problem. I asked her how could she be so calm dealing with this issue for over an hour when I was banging on my keyboard after only ten minutes. She smiled and promised to look at it while I went to the gross room.

Luckily, the frozen was pretty easy. Then I got back and my keyboard was fixed. She told me it was the batteries. Of course.

Tonight after work my ex's wife is making Jack's favorite meal at her house - fried chicken and macaroni and cheese. When I asked her what I could bring she said only wine, what a relief. I wrapped some presents last night and I can't wait to go over there and give him a big birthday hug - I have to look up to him now it's the weirdest sensation on the planet. I'm so excited. Hope you have a fantastic Wednesday too. Much love, E

Ascension Day

So I went to the Dr. Lounge for lunch. Their pizza is sooo good. I just discovered it last week. Already had sausage, sausage and veggie, and veggie. Their veggies are fresh and amazing. My brother Michael told me it was because all of the restaurants are so slow coming out of shutdown that mass servers, like hospital cafeterias, are getting the best produce around.

Today was cheese. I sat down next to Ali, an excellent and very friendly GI interventionalist. He told me about a girl he once worked with from India who was a strict vegetarian. She told him thank goodness for pepperoni pizza, it was what she lived on. He kind of did a double take, wondered if he should inform her of her error, and decided to tell her that pepperoni WAS meat. She thought it was sliced peppers or something? I wondered whether she was sad about all the meat she had eaten and he told me she was more sad about not getting to eat pepperoni pizza anymore.

We were on one end of a table full of hospitalists. One was telling a story about a husband and wife across the hall from each other who had COVID - he was taking care of them. The wife went home earlier, the husband had not yet been discharged. He walked in one morning and the husband was dressed up in a tie and jacket and was in the middle of a Zoom meeting for work. He didn't have time to talk to the doctor during the meeting. Needless to say, he was discharged that day.

Then my other good friend Eric, also a hospitalist - he and his kids live in the house that Mike and I lived in on North Spruce street years ago - told another story. He was taking care of a woman 90 years old who slipped in the tub when her 60 year old daughter giving her a bath left the room for a minute. He ended up getting into good relationship with the daughter, who was preparing for her upcoming wedding at the Capitol Hotel and enjoyed describing her wedding dress. He asked who she was marrying - she said, "Well, you know him." Eric wondered how. "He's Squidward." Turns out the voice actor who is Squidward graduated from Central High School and has made tons of money throughout his lifetime doing lots of voice acting. How cool is that? Eric pulled out his phone and showed me a picture of the wedding, you of course know the theme - the cake had a pineapple on the top and a video he showed me played the SpongeBob SquarePants theme song. Everyone was dressed formal and nice. I even caught a glimpse of the famous groom.

Ascension day is celebrated the 40th day after Easter Sunday, so it varies from year to year. It commemorates Jesus Christ's ascension into heaven according to Christian belief. Most people aren't aware of this day, I've found - I polled quite a few. The Bible says that Jesus promised the disciples that they would soon receive the Holy Spirit, and asked them to remain in Jerusalem until the Spirit had come. I just copied that from Google.

Despite some snafus, we are doing relatively well with testing - I'll save some entertainment in that arena for another day. Numbers are still good at Baptist. As of yesterday (5/20/20 - I just love those days where the day matches the year - it's thrilling to write) we had 16 inpatient positives, and 2 patients on the vent. I'm sure the Arkansas data is easy to find somewhere so I won't repeat those numbers. I'm headed to my favorite place on Earth, Eureka Springs, for the long holiday weekend with my husband. New place - a cabin on Beaver Lake. I can't wait. I think I'll have a bonfire. With lots of accompanying food and drinks, of course. Happy Thursday. Much love, E

Covid-19 has Ushered in a New Era of Fashion More Suited to Ladies on the Go

I'll admit I was crushed when, the day before I was due to get my every 6-8 week highlight job, they closed the hair salons. How long would it be, I wondered, before I could get my touch up? I bought an at home bridge dye kit from my beloved hair stylist and still haven't taken the time to learn how to use it. I watched my beautifully manicured toes slowly deteriorate. Now all that's left is a couple of spots on my big toes - the rest are au naturel with my distinctly bad hurried nail clip job. I had stopped drying my hair a couple of months earlier and was reminded of how much time this saves me and my curls come out when I am not violently taming them with my Dyson hair dryer. I thought of Linda Hamilton. Not from the first Terminator, the one I saw in the theater with my Dad when it came out but the new, aged, experienced version of Linda - the one where she is in her 60's and her roots are grey and she is beset with substance abuse issues from her traumatic past but is still a righteous badass.

Would that version of me give a crap if my toes looked like they do? If my brown roots are nearing two inches, rendering my dirty blond hair much dirtier? Hell no. All those random bruises and cuts I get from bumping into things - I'm a klutz - suddenly took on a new, cooler significance. I imagined them being battle scars from fighting the evil empire over all this Covid testing - keeping the false Gods with their promise of accuracy hiding their lies and desires to make money off of this pandemic at bay. I started to show them off, be less insecure about having them. Abandoned the desire to get those roots touched up with my at home kit. Also the desire to do my own pedicure - that can wait, shouldn't be too much longer now.

I scheduled a hair appointment today for June 11 - first available that works for both myself and Deidre. I cannot wait to see her - our relationship spans about 17 years and we have become almost like armchair therapists to each other over the years. In the meantime, I'm going to embrace those roots - even Deidre texted me that roots are actually in now. I'm not going to worry about that strange piece of white that is on the cherry red polish left on my left big toe. I have wondered what it is (White out? Caulk? - None of those make sense really) and tried to pick it off to no avail. It no longer seems important, thank goodness. I see a future full of scrubs and roots and not perfect pedi's looking actually much cooler than someone who is perfectly coiffed (although it is fun to dress up sometimes and I will continue to do so if it works for me). Back to 90's grunge, with a lot more experience and know how.

Happy Monday! It's been a while. As I teach my kids, sometimes you have to put on your own oxygen mask first in order to be your best self to others. And if that best self can look shabby on the outside, it doesn't matter, because she shines on the inside. Much love, E