Thursday, March 3, 2022

Pisces New Moon

     New beginnings. I'm honestly tired. It's been a rough and busy week. Fun things, not all hard things, but still. I'm glad we are heading into the weekend. Jack and S and I are headed to Fayetteville tomorrow after work/school to do early bday celebration with Cecelia (19!). I got reservations at Cheers in the OPO early Saturday evening - they were booked from 6-8 when I called yesterday so I got a 5:30 slot. Menu looks amazing. Gonna be cloudy and rainy so I packed accordingly - luckily no calls for winter weather. She's invited Blakely and Woody. She seemed in good spirits when she called this morning - but had a packed weekend. I reminded her that Jack is supposed to be staying in her dorm? But the VRBO on Oak Street we got should accommodate him if she was too busy. She decided to try to cancel some things in order to hang out with Jack. That girl is always trying to fit 10 things into one slot. And she's always late. A character flaw, she acknowledged. But she has so many strengths that it's kind of easy to overlook.

    I had my second med exec committee Monday night and am starting to get the flow. I noticed they ask all the departments for updates - most decline, but it made me think I need to bring some juicy lab stuff to the table at the next one - we lab people need to insert ourselves into the conversation. Baptist is treating us to Trio's on the last Monday of March - no alcohol, Greg Crain asserted, you can buy that yourselves, but we will buy food. I'll take that. I'm starting to rethink this position and ally myself with admin. Cody Walker brought us surprise free strawberry banana smoothies yesterday - I was thankful bc I was so busy I forgot my 2:30 snack and it was already 3:00. It was lovely, I told him in the Dr. Lounge this morning. So appreciated. And my employees really appreciate Baptist giving them free meals if they stay at work during the storm. If the Ukranian president can try to negotiate with Putin, getting in good with admin should be a walk in the park. I'm softening. Getting to know people does that, no matter what side you land on.

    In med exec committee they bring raw policy changes to the table and we hone them. Last month it was how to treat physicians over 75 and everyone thought the plan was too punitive. So we fixed it and approved it on Monday. This time it was surgical time out - they are trying to make it better and the head of surgery presented their proposal. In case you don't know, surgical time out is something we have been doing for years to try to prevent operating on the wrong side. There was a neurosurgeon in my training who operated on the wrong side of the brain, so this is important. It was modeled after the airlines. A checklist. Involving a white board, and radiology, and verbal checkpoints to get everyone's ducks in a row to prevent mistakes. 

    The surgeon's decision was to mark everything with a marker before you operate. There was quiet dissention. Julia Goodwin, the chief of OB, said I have to mark the vagina with a marker? Not happening. She was so deadpan I almost LOL'd. David Shenker, the Chief of Staff (another OB), proclaimed that he would never write on a woman's perineum, no matter the policy. Some suggested they just make and x on the suprapubic abdomen. What's the point of that, said Julie. That's not even where I am operating. Seems silly and redundant. 

    Whit Goodwin, who I bought my Tallyho house from, had come to present something even though he is not chief. He seemed a little miffed that he missed the Trio's treat by a month. I hate to be a fly in the ointment, he said, but us rads often try to get a line in and if it doesn't work we move to another spot. So you want to remove procedure exemptions and make us do it too? It will always look like we are screwing up. Chief of ED echoed that. Sometimes in an emergency it's too crazy to do a time out and mark a pleural tap. So that one got sent back to committee for revisions. 

    ENT tumor board was Tuesday morning at 7 and I presented  a couple of weird cases for Sims and Stern - a pleomorphic dermal sarcoma (sorry guys I had to google that but it has none of the high risk behaviors like abundant necrosis and size over 3cm and invasion into muscle so I think it will be a good actor) and Merkel cell carcinoma (unlike PDS this is a board question however rare and this one behaved like a book). I also finished Q/A for the last six months of 2021 yay!!! Only backed up two months now. We all look really good. We are a stellar group. Turnaround time, comparison to outside diagnoses (I look at 50-80 of those every month). I'm proud to be with PLA.

    I'm the only one not trained on Dragon but everyone is raving about the efficiency. I think possible conversion to digital will be even better. My friend from Russia who is in my book club, Natalya, took her premature baby boys home this week and is planning a meet and greet with tea and cakes. William and Alexander are beautiful - she sent pics, and Kewan and I told her we can't wait to hold babies again. Things are busy, but everything is coming up roses. Happy Thursday (not birthday - everyone gets that wrong with the mask but hopefully that will be over soon). Much love, Elizabeth


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