Accident Prone

     Yesterday I was headed to OT at about 10:55 and I got distracted. I was chasing the sun bc it was a little too cold in the shade and there was a scary looking dude by the admin suites. The parking lot area where I walk to the Dr. lot and BRI is a perfect circle of hell. There is the lab parking lot, and the ER area, and a lot of psych patients hang out at the bus stop to smoke when they are discharged - mostly homeless I guess. So you gotta be wary. I was doing a double take on the guy when the traffic arm, for the second time in 15 years, smacked me on the head.

    This was a new traffic arm - the old one that did it before was rectangular wood this was cylindrical and metal I think. I startled and started sweating but I didn't drop the dozen cookies I was bringing to OT I shook and trudged to the waiting room. But my head was hurting so I dropped off the cookies with the secretary in the full waiting room and tried to chill. Not working. I told the secretary what happened and asked for some Ibuprofen. She went to hunt and in the meantime Stephanie, who had waved to me earlier and noticed I was a little out of it (I think I was borderline fainting) grabbed me and took me into the larger empty space and asked what happened. After an ice pack on my head and me dry heaving into a trash can and all the other PT's worrying she finally convinced me to go to the ER. I'll walk you, she said.

    I really didn't want to burden my partners but if there is one thing my rotator cuff tear taught me it is that you don't ignore this shit at your age it might get worse. I started thinking if I have a small subdural bleed it could get worse and turn into a large hematoma and the last thing I want is a craniotomy. The sad thing is that this was supposed to be my graduation from OT and here I am gaining a new ailment. This year has been crazy. First foot surgery, then rotator cuff tear with first MRI, now I'm in the ER texting my partners that I am slated for my first CT of my head. Oh and the seven stitches in my brow. Ridiculous.

    I had some of my work family bringing me water and cough drops and hugs in my almost four hour experience. I was terrified of the CT. Bruce, who was amazingly attentive, told me it would be way easier than the MRI. I loved the MRI, I said. The cacophony of sounds almost put me to sleep. You are the first person I've ever known to love the MRI. Most people hate it. I'm incredulous. You will be out of here in five minutes we will move your head in and out three times.

    The Aleve the OT secretary found killed my pain but the Zofran they gave me for nausea made me thoroughly exhausted it was all I could do to sign out my morning cases after I was discharged around 2:30. But I got a second wind when I got home and did lots of Christmas decorating shopping. I'm off tomorrow but I work Friday. Still. Nice to have a holiday. I'm feeling a little ambiguous about it all since I follow a lot of Native American activists on Instagram but hell it's family and the country seems to slowly be moving from the wrong direction (Kyle Rittenhouse) to the right direction (Ahmaud Abery).

    We are headed to Mike and Rachel's new lake house tomorrow for a blended family Thanksgiving and Annie and Dave are coming too. I'm so excited I bought some gingerbread house and farm kits for William and Adele and Rennie at the gift shop today. I haven't seen Will or Adele since they were toddlers and a baby. Rachel told me to just bring wine and she always does fried chicken it's so good. God bless my late grandma Loretta her turkey was always dry but she did it with love. Got a house full of kids and friends and Jack is cooking and Cecelia is headed to Harry Styles. I asked her who was opening. She said Harry Styles. I looked at Jack's friends Izzy and Alyssa and said clearly I haven't let my kids go to enough concerts LOL. C said well I guess I don't know. She will have fun anyway. Happy Turkey Eve! Much love, Elizabeth

Awaiting the Arrival

     Jack is home sick reacting from vaccines - three yesterday. Meningitis and Flu and I forget the other. It kicked his ass. The doctor was nice but the wait was tedious. We had lunch prior at Boulevard - he met Anna and that made me happy. We just cleaned out some drawers and closet space in Cecelia's room - Izzy is coming at three and she will be here for three weeks. I'm over the moon because he is cleaning his room and the laundry area - that normally doesn't happen on its own.

    Izzy is a friend of Jack's from camp. I met her once about a year ago. Her family moved to the Northeast and they aren't happy there. She is doing school virtually - and she needs to move back three weeks ahead of them to care for her grandparents in Benton. When Jack asked if she could stay here I was like of course. We have plenty of room. Although she didn't ask for anything I shopped today at Edward's after my doctor's appointments with her in mind. Maybe she will like pumpkin bread. Maybe watermelon. It will be fun to have a fresh young face around the house.

    I've been buying extra treats at Boulevard - Jack likes blueberry muffins and S likes scones. Yesterday he told me he gave a muffin to his friend C. Did she like it? I asked. Did they like it, he said. I was momentarily confused. Did two people share it, I wondered. He noticed it and said mom, she identifies as nonbinary. Oh! Have I met them? Yes, at Boulevard. They had on the nice outfit. Oh yes, they were so fancy I thought they might be a hostess. Or out for a fancy brunch. Black pantsuit right? Yes mom. This new generation has so much to teach. 

    Gross room is doing good Shelby is great they are getting things in order. Baptist has turfed biohazard disposal to us so we are figuring that out. I'm a new superstar in OT I might graduate soon. My range of motion has skyrocketed in the last two weeks. Stephanie is floored. I've never seen you do this much before. I gleamed. She's coming to a brunch I planned on January 8 for my Sunday school class. Christy too. I also invited Christina Bash - we talked yesterday she's catering Rex's retirement party and we got a little intimate about being single moms. It's a hurdle. Guys get set up but we just get sidelined and work and take care of the kids. 

    Christy is planning Vegas and it's going to be a blast. She texted me a bunch of possible opportunities for day trips. My favorite is a helicopter trip over Joshua tree and landing in the Grand Canyon for a champagne brunch. She said there are people in the pictures wearing stilettos. That makes me think I could do it in regular shoes. They pick you up in a limo and take you to a private airport they have the highest safety rating the government dishes out. Beats hiking or a burro. Happy Wednesday, much love, Elizabeth

Penthouse Suite

     Christy just booked the penthouse suite at the Bellagio in April and I'm over the moon, so is she. Two king bedrooms, two full baths, a shared living area and a half bath. I spent about a half hour researching restaurants today and made a list of eight. We are only going three nights at the end of April - I said let's do Sunday through Wednesday so we can get a better chance at getting into the good restaurants. After this blog I'm going to go on their website and geek out over the room. She said they have villas, with butler service, but you have to buy them. And I told them I want good room service but I don't want a butler crawling up my ass. This is your compromise, they assured her.

    There was a fourth autopsy last week, actually a third, bc one of them was canceled due to their only needing chromosome analysis and we can do that on formalin fixed paraffin embedded tissue. No need for formal autopsy. When I went into the gross room this morning Jessica said I finally sent the baby over to UAMS. It was from another hospital, a 37 week stillborn. I cussed last week when she told me it would fall to me. I haven't done an almost full term baby since I was a resident at Children's. When was the last time you did one that far along?

    In 2018, she said. Well that is morgue material, and I'm not doing it. Shaver said we do babies, she said, and I said he can do all the babies he wants but Becky over at SVI told me their cutoff is 20 weeks and that is what mine is going to be. Send it over. It took quite a bit of finagling, but it finally happened. 

    My GI sx have ramped up in the past two weeks which is disheartening. I had to leave Rennie's bday party early and I didn’t make the concert past one song from the headliners. But Adam Faucett was good and S and I chatted with Jon Palmer Kricia's husband and Kevin Hefner a nephrologist so it was fun. Had a couple of beers. Enjoyed the evening. I slept like a log when I got home. 

    We are taking C and J and their friends Joelle and Sef (Yousef's kids!) to see Rainbow Kitten Surprise in Nashville after Christmas. They are over the moon - I'm glad my kids are addicted to Indie bands and not Harry Styles Amy Weidower told me the tickets were over 600 bucks ours were only 50 plus bucks a person. So reasonable we got our own lane - the venue is Brooklyn Bowl - with up to 200 of food and drinks. I perused the menu today and placed my order. S and I plan to get the kids established and pay the credit card and listen for a bit then head back to the hotel and let them have fun on their own. RKS plays in my head sometimes it was so ubiquitous for a while. 

    Enjoying more Merlin with Jack and the third season of Succession and more Invasion, which we almost abandoned, but it picked back up after a while. So happy tomorrow is my Friday. I've got OT lined up (which I aced on Friday - might finally graduate) and Ruby on Wednesday and Maddy on Friday morning. Then Eureka. Hope your week is going well. Much love, Elizabeth

Pole Dancing

     Christy and I are planning a trip to Vegas, in April or May. I'm dying to go - I said, I've only been to the airport. I want to stay at the Bellagio. Let's find out who is playing and see some shows and shop and spa. I've been there once, she said, it's truly five stars. We should find some pole dancing classes. I'm pretty sure my OT would recommend against that, I said.

    A few years ago Christy took pole dancing classes. She even arranged a group one for some of us but it was in NLR if I recall and there was a storm of the ages so we all canceled. Girl, you could do it. I'm the only one who has failed pole dancing class four times. I never got off the ground. But it was fun! You need booty shorts, I told her I'm pretty sure I'm past my booty short prime. She said she could lend me some. I was in the class with strippers, she said, they were all wearing them so even though I'm pretty sure I looked bad I wore them to keep up.

    Did I ever tell you about the sticky spray? She asked. No, please tell. Well, they use this sticky spray to help you stick to the pole. Which I never did. But it turns you into a human lint brush. Dirt, dog hair, you name it. You really need to shower right away. But it's ok if you stay on the floor, you still learn things. Good kitty and bad kitty. With bad kitty you have your back up and with good kitty you relax on your thighs and squeeze your arms together and push up your tits and toss your hair. I LOLOL'd.

    She started some new exercise program with some NFL superstar who is retired and lives in her complex. She's excited - she wants me to come to her session next Thursday and meet him. Well, I don't want to do an intake interview, but I'll watch you and see if it is something I might be interested in and see if he offers one on one sessions in the evening it would be tough for me to get to Rahling Road from Baptist in rush hour. David is his name, I forget the last, but I googled him at her urgency a few months ago and he is very legit. And awfully cute. He and his wife have two young kids Christy gifted them with toys when they moved in.

    This week has been hard, but Cecelia is better so I'm better. She's invited her three new friends she is planning to live off campus with next year to come to Spring Break with us so I've got to e-mail the person in charge of the luxury rental and tell her I want the luxury apartment out back too. Rennie is turning eight this weekend - Rachel planned a party at Maumelle Park in a pavilion so I shopped at the Baptist gift shop and scored and just wrapped presents. I'm so excited.

    We had a partner meeting Monday night. We don't do this often enough - I need to change that when I am Chief, so whenever we do it becomes heated. Once, years ago, in the private party room at Cheers, I thought I was going to have to fight off blows between a couple of them. We are trying to decide if we want to hire or not that bonus without Rex was nice but I'm sick of having to take a beta blocker by noon to finish off the stressful day so my vote is hire. We will see where that goes. It's moving in a positive direction.

    We had three autopsy requests last week - the PA at UAMS who is taking them wondered overwhelmingly how many of these do you get in a year? This is the only three, Jessica told her. Bad things happen in threes. Good things also happen in threes. I'm glad to be off call. Full week of work but I'm off next Wed through Friday and we are heading back to Eureka to the Emily Dickinson suite - never been to that one but the pics online look amazing. Happy Tuesday. Much love, Elizabeth.

Covid Update

     This call week has been hell but today was the best day we got all our cases on time and I had a decent lunch break. Then I finally had time to check my email and some CAP person said I was overdue for an inspection and I had three months to complete it. Not true. I never agreed to inspect that lab. Well Staggs did, and he said you would do it. WTF. I told her I've been doing inspections for over 12 years and we just lost our lab director there and the second in command and we are not equipped to do that. And please send me the form that I usually sign with Stagg's signature because he has never done that before. This is a waste of my time.

    She deep dived into her emails and said that I was right, it was her mistake, but would we still do it. Plan an inspection in three months over the holidays with a lab in complete chaos? Hell no. I will provide backup if you can send five people. Luckily in the meantime I had called Mary and she said we were not even equipped to handle that lab from NLR, it had tons of AP that they don't even do. She pressed and pressed and I pushed back kindly but firmly and when she offered to take me off of the assignment bc it was her mistake I gladly took her up on it. 

    In the meantime I had time to watch Mandee's Covid update - we have to watch and sign a form that we did in order to participate in some incentive stuff. I gladly did - I learned a lot about the upcoming new horizon on Covid - even though we are declining we are not out of the woods. We are only 48% fully vaxxed in AR. Any new variant could knock us back on our ass. They are flailing in the UK, but good news is that most of the new cases aren't sending people to the hospital there. 

    Stephanie was busy with her yearly C.E's so I had Maude on Tuesday. She is a grandmother and asked me all about Covid. I told her that it's definitely not as prevalent and our ICU's, while still full, are not mostly Covid. She wondered if we are out of the woods. I told her there are a lot of other species, not just human, that are vying to live and Covid is not an exception. It's not personal, I said, it's Darwinism. Then I read an article over lunch that was called Gaia theory I think? I loved it. The Earth is a living organism, and if we humans abuse it it will push back. That's part of what's going on here. The Earth, the animals, the bacteria, the viruses, they are pushing back on our abuse and if we think we will win, we are stupid.

    Mandee said there was a recent update by the ADH that said the invasive fungal species - Mucormycosis and the like - are seeing a resurgence in post Covid patients. They are getting a lot more reports than usual of its presence attacking humans. And Strongyloides is attacking the Hamptons and immigrant Texas communities. Parasites that normally plague third world countries. Ones that plagued the South at the beginning of the 20th century. Earth is fighting back. Go Earth.

    Cecelia is doing well - she is coming in town this weekend to volunteer at Camp Aldersgate and we are planning brunch at SOM on Sunday. I hear the weather is supposed to be amazing from the guy that works at the liquor store. He raved about the pumpkin roll planned in Hillcrest but I've got work on Saturday and a gross room party planned at Laurie's on Saturday night. Jessica is going to drive me I've been invited to the game. I'd rather sleep in on Sunday than go to a pumpkin roll.

    I was bragging to Jeff I had a game invite - he is always trying to talk sports but that's not my forte. Who are we playing? I wondered. Mississippi State, he said. Are we going to win? He's not optimistic but said it could be close. Savanna is like you, Jessica said during a frozen, she doesn't know football. Well we will either sit in the corner and talk about something else or pretend to know what is happening. Savanna laughed. RAH RAH RAH. I can pretend too, I said. Might be fun.

    Deep diving now into a box of wine. Boxes are so much more financially prudent. They kind of remind me of the prostate. At the beginning they are young and have a strong stream but when you reach the end they flag and spit like a hypertrophic prostate that is blocking the urethra and needs surgery to relieve the issue. Finished Clickbait it was so good. Kimberly recommended Invasion it's on Apple TV and we started it last night it was really good. Looking forward to watching more. Happy Friday Eve, much love, Elizabeth.

The End of the Awfultopsy

     Yesterday late morning I walked into the gross room for frozens - I had earlier learned I was on call this week and there were 200 blocks so it was already a hectic day. Jessica was in a frenzy. There's an autopsy! Good god, I sighed and she must have noticed I looked like a deer in headlights because she immediately said, it goes to Hal. You did the last one Christmas Eve. That's how long it has been. Didn't we get rid of these in the new contract?

    We did, I said, but the logistics have not yet been set up. I'm having too crazy of a day to even get involved. Just talk to Hal. Can you ask Shaver? He's off, she said. I'd better stop talking and go do the frozen. I cracked her up with a story of it - Peter Kim, who I was friends with before med school he did my dad's hiatal hernia repair years ago and married a pediatrician named Elizabeth, was doing a Whipple resection. He needed the pancreatic margin. The margin was negative and the tumor was two cm from the margin grossly. I called the OR bat phone to tell him and the nurse said Oh! Let me go tell him you have the frozen results. 

    WTH? I told Jess. Does she think I have all day to be on hold for a frozen? Put me on speaker immediately like the rest of the world. She came back. Tell me, she said, and I'll tell him. Oh lord. Damn travelers, like Bandy said. I heard her say SHE SAID THAT THE TUMOR IS NEGATIVE. I yelled into the phone no! no! That's not what I said. I repeated the diagnosis like three times before she finally got it right. 

    Hal tried to come talk to me about the autopsy over lunch but I was having a hard, intimate conversation on the phone so I told him I couldn't help him he needed to figure it out. Let's just say when your kids aren't all right you aren't either. I almost chartered a plane to Fville yesterday. When we got off the phone I called Jessica and said if Hal wants me involved it's not happening today tell him not to bug me I've got a family emergency. I shut the door and locked it and worked for two hours.

    When I came out Hal was checking billing charges and I apologized and he was like no, I get it. You were shaking. His son Michael, who was born on the same day as Cecelia, decided to join the special forces of some military unit I forget. Halfway into training, he broke his foot. Now he's out six to eight weeks in some med unit and won't be home for Christmas. He has to resume his place with a new unit. That's good he doesn't have to start over, I said. But I bet he's sad he can't graduate with his class. He's making some of the best friend of his life, Hal said. And they take away their cell phones. He's allowed to call once a week, and if I miss the call I miss it. I'm now married to my phone. 

    While I was locked in my office Brent managed to call UAMS and get transportation and billing and logistics for the body. Jessica was on cloud nine. She was talking to the nurses in the ICU and a PA contact at UAMS. Today I went into the gross room around three to do five Sims frozens and a sixth one for a new doc Bareto that Laurie said was real nice. Jessica was problem solving - UAMS wanted a negative Covid test on the patient within the last 14 days and he had been in our ICU for 30 days and hadn't been tested since day one. What do I do? She asked. I'll help.

    I took her to Amy in micro and we got a swab and she gave us a verbal order form and we went down to the morgue - I hadn't been there since Christmas Eve and was glad Jessica was with me I always get lost going to the morgue. I was kind of excited to be a part of the last experience there. We denied a bunch of Covid autopsies bc there is no negative pressure and it hasn't been updated since the 60's. Becky was the one who gave me the idea to ship them to UAMS years ago - she got their accrediting organization to ding them - but after three years of trying I gave up and trashed my research.

    I can't remember if I told you about an autopsy I did - can't remember which one - where the rusty circular bone saw broke while we were cutting the skull and the saw part flew off of the base and hit the wall. If this was just a regular wall it would have stuck, but it was a tile wall so it bounced off and skittered all over the morgue before it expired. Someone could have been seriously hurt. 

    Sarah, the morgue attendant had opened the bag of our patient in the cooler just enough so we could get the swab into his nose. Jess and I gloved up and she started trying to break the swab in half (think glow stick - I guess this activates it?) and I said I think you have to remove the plastic seal first. She struggled with this for a while - I said it's probably at the non-swab end so you don't contaminate it. I struggle with those too, take your time. Then she spent almost a minute twisting it in half. How far do you put it up? She had asked Amy earlier. Until you hit resistance. At least he won't complain, we joked. He had a sweet face, and I silently prayed for his peace in resting.

    I told Jessica, well for one thing you can be certain Baptist won't be rotating you on the swab station. Sarah laughed. I had a late possibility of frozen with Sims but just got cleared yippee. Watching Clickbait on the recommendation of Alyssa highly recommend. Eureka was wonderful but I tested gluten - could not resist the perfectly toasted English muffin and the soft creamy butter served to the Sara Bernhardt suite (hell it rhymes with Amelia I was close) and paid for it dearly for the past two days almost to the point of passing out from dehydration. Canceled dinner plans tonight. Need to relax. Happy Tuesday - hope yours is a good one. Much love, Elizabeth