Thursday, April 28, 2022

Christy and Liz did Vegas

     And it was a bit of a comedy. I learned some important rules in taking PJ's - never wear kitten heels. After enough wine to get tipsy but certainly not drunk we stopped to refuel in Santa Fe. I got off to use the restroom and getting back on was a challenge - there were no handrails just bungee cords, and somehow I ended up on my back smacking my head on the tarmac. At the time, I remember being worried about flashing the pilot (I didn't, he was back in the building) so I got up as quick as possible and marveled at the fact I had no open visible wounds and climbed into my seat which was also a challenge - it was a tiny Honda which was much more suited to my shorter friend in every way than myself.

    Worrying about flashing the pilot turned out to be the least of my problems. Getting smacked on the back of your head is much harder to deal with than the top of your head (and as a two time recipient of a traffic car arm I feel qualified to be an expert in the arena) bc you have to lay down to go to bed. Rest to recline in a jacuzzi bath. Lay out by the pool in the sun. So I was constantly reminded of my PJ foul throughout my stay. Which required daily scheduled Advil until today - I usually only take it once a year.

    Due to an hour delay we canceled Mizumi in Santa Fe and got room service. The room was incredible. We each had two full baths and there was a half bath. Seven TV's. Three thousand square feet. By the end I was affectionately referring to my bedroom as the womb bc I was in bed every night after dark fall and up reading magazines by 5am. We gambled once, the first night. Well Christy did, she wanted to bet 20 bucks at a Roulette table with her dad's bday. We learned that they cut staff during the pandemic so if you want wine you have to seek it out yourself at a bar you are not served at the tables anymore (at the general ones, at least). Between the lights and sounds and stale cigarette and cigar smells - makes sense to fuel one addictive behavior with another but I had no idea you could still smoke indoors anywhere - I told Christy I need to go back up to the room and go to bed after a half hour.

    The next morning was kind of stressful with a hunt for Advil and food - I learned that if you go to Vegas don't just make dinner reservations make ones for brunch too. After two hours and a Beavis and Butthead moment in the VIP lounge (we were trying to bring the free fruit and coffee and water up to the room with less hands than were needed and I was happy to make the GM laugh with my joke) we finally made it back to our quiet oasis to order room service (which took an hour and a half but I was glad not to be lost - we got so lost for the first 24 hours and I happily helped an old man navigate the guest elevator and the process to get to your room with your key card yesterday bc you have to pay it forward right?).

    We decided to go shopping after lunch and we got so lost coming out of another casino with our cherished tourist trap goods that I decided to Google Map how to get to the Bellagio bc we could see it? But the path wasn't clear. I told Christy it says we have to go down some stairs and up an escalator and over a bridge. She said I feel like I'm in an episode of Dora the Explorer and I laughed so hard I almost peed. Find the map. LOLOL.

    Last night dinner with Ahmad and Kristen was as delightful as expected and I loved getting to have a nice meal connecting old friends and get to know Kristen better.  I slipped the waiter my card and paid for it all it was such an enjoyable evening. Esther's Kitchen was by far the best meal but the room service wasn't too shabby. Today at the women dr. luncheon, which I almost skipped bc I epically puked after my shower and again after grocery shopping on the way home, we had less fancy fare but the fellowship was refreshing. I'm glad I made the effort even though I was so shaky I considered an Uber. I made so many new contacts and we hope to continue this. Happy Thursday, much love, Elizabeth

    

Saturday, April 23, 2022

Christy and Liz do Vegas

     I've started to imagine myself in my own comedy. I was in the weeds yesterday afternoon when Christy was trying to call and text and tell me she rented a guy to transport us in a Tesla - back to the future style - from the airport in Vegas to the Bellagio. I just got a red pedi to match the one she got during the week. Is that a thing? Asked my liquor store buddy. I'm not sure. But I did it anyway. Red toes in Vegas.

    S has alopecia - we think it is related to the nasty bug he got in February where he had to move to the guest room for a week. We saw Ahmad's favorite doctor Dan Smith this week and he is treating it with topical steroids. He said Ahmad has come into great wealth in the past couple of years I said I guessed? He sent me tons of pics of him and Kristen and their daughter Remmie, who is Rennie's age, on PJs. Good for Ahmad, I told him. He has a good heart, like Christy. He will be a good steward of great wealth.

    S and I went to Ahmad and Kristen's wedding years ago at a speakeasy in Chicago. The taxi driver had a hard time finding the door to drop us off. That's why it's a speakeasy, I said, the door should be hard to find. We found it, and inside was glittery and wonderful it was one of my favorite wedding receptions ever dotted with lots of glitzy docs he has met over the years. So happy to be reuniting with him. I remember when I took Jack and C to a crawfish boil in residency and I was the only one with kids and he talked to me and saw me and watched C for me when I had to breastfeed and change J in the bathroom. He's a gem.

    The CARTI bid was submitted Thursday and Melody did an amazing job. I had a long epic dream that night - I usually don't remember my dreams but this one was totally anxiety induced and it took me a few minutes when I woke from it to convince myself it wasn't real. Melody was on public transportation in a smart blue and grey dress telling me she was leaving to go work in Indiana at the University and said it was the best thing for her family. I hugged her and told her I would miss her.

    Then I stumbled off of the public transit and started crying in public all over the town square. Children were laughing and playing but I was not happy. I don't even cry, much less in public. I bumped into a couple of partners who weren't my partners but they were in the dream they looked like mafia goons. One goon was saying all we need is CP? Can I lie and say I'm certified and take her place? I was thinking the CARTI bid was a swan song to us she loved us but had to leave. I woke gasping and telling myself it's just a dream. She has friends and family here. She's not leaving. She laughed when I told her, I think it touched her.

    So excited for my comedy trip with PJ and Tesla (hate Elon Musk but here we are) and penthouse suites and I just finished packing we are leaving at noon tomorrow. I'll be back in time for the luncheon on Thursday - it's an inaugural one for women physicians. Mandee invited me and I widely shared through text - Julie Goodwin is going to talk about burnout. When I stopped by Anthony Bennett's office to tell him I wouldn't be in the med exec committee meeting on Monday and Staggs couldn't come either he shared his story of burnout in cardiology and I told him about my struggles with working during divorce and when my father was ill. 

    He said they are working on a financially prudent way to address burnout and make it a better environment at Baptist for physicians. Looking forward to that, I said. Therapy and fellowship with women in my Sunday school class saved me. But men experience it too - Bob Overacre is a prime example. Maybe we should start a men's group too, he wondered and I laughed. Jealous? But it would be helpful honestly. The environment is so hostile.

    After the luncheon on Thursday S and I are headed to Eureka for a long weekend someone took over the Peabody (which explains why we haven't been able to get a room for a year) and renovated it and it looks amazing. S is sad the Dashwood is changing and I get that but they have made the other upstairs suite so luxurious I'm willing to let that go. Happy Saturday, much love, Elizabeth.

Wednesday, April 20, 2022

Governing Institutions

     It feels like it should have been Friday like a week ago? And yesterday I thought it was twice and had to course correct. I've mentioned the business of work but on top of that we have our CAP inspection tomorrow that happens every two years and it's primarily on Melody as the director of the Little Rock Clin Lab but I've been getting a lot of stuff to sign for micro too. Tina has been working arduously to get all the other departments ready. Jessica too. 

    JCAHO (joint commission) is the inspection body for hospitals and they have been here all week. The odds of all this happening at once are slim to none but here we are. Anthony Bennett called me yesterday and asked if I was available for a luncheon tomorrow that they traditionally throw for the medical executive committee to meet with the physician advisory board associated with JCAHO. Of course, I said, I'm covering needles but I'll be there - I will get covered. Misty Abbott in Conway - I unloaded that this week finally thank God - has been sending me backdated stuff to sign and asked me to scan it all and send it back to her in preparation. I don't have a scanner, I told her, and I don't know how to scan, but I'll find the right people and make it happen. And I did.

    So I don't really plan outfits for the next day it's kind of whatever feels right that morning but I just picked out something nice to wear for tomorrow. Involving kitten heels, which is about the highest heel I can manage (with flip flop back ups for office work). Invoking Michelle Obama - who also reported in her memoir that she only wears kitten heels. I know, it's a lofty comparison, but I empathized with her. Some shoes are not meant to be worn when you are running around. I have no idea how those runway girls can manage.

    I have three hours committed for Friday in additional to my caseload - got a 7am BHEC meeting and someone called from UALR wanting to send me students to introduce to pathology and I've got the first one scheduled from 11-1. Excited about that, despite not really having enough time in my day. Luckily Christy and I don't leave until Sunday at noon so I've got plenty of time to clean up straggling cases on Saturday. When the Clin lab director's secretary (the med tech, not Melody) asked me to attend a meeting with JCAHO at 10 am - 11 am Saturday my stomach got tied up in knots.

    Why weren't they worried about the morgue being so outdated all these years and now that we have finally turfed it they want to know the details? I know nothing about it, Jessica did it all. I don't have time for this - I kvetched to Melody. She helped me problem solve, and I told them yesterday that Jessica is off but she will be available at that time by text and I couldn't attend in Google Meets but I too will be available by text. Jessica is giving all the pertinent information to Sarah, the morgue attendant, who replaced John amid some scandal I know none of the details about a few years ago. It will all be ok.

    I could go on about hard cases but feel like a broken record at this point. We are planning an inspection to Hattiesburg MS the first week in May as well. It's a long drive and there are a lot of logistics to work out but Mary is doing most of it. I'm happy I'm in the cool car, and I'm not driving. It's our first trip to inspect since before the pandemic and I'm kind of excited - hotel rooms and dinners on the CAP dime. Fellowship with lab folks and seeing how others operate helps you bring new things to your own table. It's going to be all girls and as usual I'm the supposed leader of the show. I've learned so much doing this over the years - especially that I'm only as capable as the people who support me. They are the rock stars. I'm the rubber stamper. Let me chat with the CMO and CEO all day long as long as the experts attend to the details.

    Jack is stressed out about running for Junior Senator in the next couple of weeks - Mom, I've gotta make posters and make an effort. Everyone thinks I'm a shoe in but I've got a couple of competitors and they are very good. And they view me as a competitor? It doesn't seem to make sense. Well, I said, it's good that you are humble; all good leaders are.

    Reading has gone by the wayside but watching some good shows I've been meaning to talk about. I read Pachinko in book club a few years back and was amazed. Really hit home how racism is worldwide, naive, maybe, but sometimes it takes an epic tale for it to sink in. The TV adaptation is incredible - I routinely get tears, and cannot wait for the new one to drop Friday. Roar is ok? So much good female talent and I can tell they were going for a female Black Mirror. Falls a little short but some of the episodes are incredible - I especially liked How I solved my own murder last night. The duck one was bizarre. But there is good metaphor to be found in every one. Happy Thursday? Ack no Wednesday. Melody and I were joking today how we've been so busy in the last month that the days are all running together. Much love, Elizabeth

    

Monday, April 18, 2022

The Princess and the Pea

     What a Monday. Back on EV, and there was a deluge of body fluids on top of 107 blocks of surgicals. I wished I had taken an extra beta blocker this morning the work was coming so hard and fast after 10:00 (slow start) I got chest pain. At least I had time to mail Cecelia a belated Easter package and Christie Cobb's care package she gave Jack. Christie went up to Fville a couple of weeks ago and spoke at a SHOO event I was not able to Zoom in bc of call but thanked her in text over the weekend. She told me she is the first person in Arkansas to be getting a fellowship in sexual health and intimacy issues. So proud of your daughter, cannot wait to see her rise. The field is wide open. She sent her a Viva the Vulva t-shirt C will be tickled pink. 

    I also sent Mia some treats - Jack said Harper had miscounted the RKS tickets and she tried to give her's to Mia but Mia declined and drove them there and picked them up instead. Mia deserves treats. She and I went shopping at the Farmer's Market in Fayetteville weekend before last with C and it was lovely. I came across and black female owned stall selling candles at the market - also advertised they were LGBTQ friendly so I bought six candles. The most amazing smells. Nordic Night. Black Sea. Patchouli, which makes me think of my mom, bc she always wears it as her perfume. Candles by Whitney, and they have real gold flakes and are affordable and they have an online presence I will use for gifts. I've got Black Sea going right now and it fills up the room.

    At around 2 I was pushing glass so fast a shard of slide broke off and wedged itself into my palm. Hurt like the devil. Lots of sensory receptors in the palm and sole and I hit one hard - first I thought I was bit by a bug but glass makes more sense. I asked the secretaries if they had tweezers - they did not, and I got all sweaty and almost passed out. Tina ran to the gift shop to get some and Kimberly sat me down in my office and turned my fan on and got me some water. A few minutes later they got a flashlight and located the tiny piece of glass - so tiny I felt ridiculous - and extricated it. My palms were so sweaty a band aid seemed like a bad idea but Kimberly got some tape and managed to staunch the blood so I could keep working.

    Work is so crazy. We are in the middle of working on a bid for CARTI against some of the local groups and thank god Melody and Michelle are spearheading but we all have to put some work in. It's due Friday - and they are having two-three hour meetings twice a week in the evening with our business and marketing managers to put it all together. So I have extra incentive to get my work done so I can help Melody and Michelle. Without them we would never have gotten this together, but we had to form a subcommittee because when all of us pathologists get together the talk gets circular and nothing gets done.

    But this time next week I'll be in Vegas! Got reservations for Mizumi on Sunday night and Ahmad and his wife are joining us at one of their fave spots Esther's Kitchen on Tuesday. When I told Ahmad what I'd managed for Monday he said with your permission I will get you reservations at The Cut by Wolfgang Puck I know the GM. His polite way of saying that restaurant sucks. He's such a gentleman, and I really need to cancel the one I made Monday so hopefully things will lighten up a bit so I can get to that and some bills. We are all drowning at PLA. It doesn't help that my GI issues have resurfaced with a vengeance, so my energy level is low.

    I looked up at the schedule at one point this afternoon, in between sending out a guy's heart biopsy who's not doing well to Mayo for ATTR and AL testing on the paraffin block and sending out another testicle to Jesse. Two testicles in one month! I told Staggs. What are the odds. Strange spindled cell lesion in an 87 year old I found an article telling me how to work it up and he said, you have wasted too much time on this testicle already. Sarcoma, NOS. Send it to Jesse with a block. I realize that, I told him, but I'm a little manic with all I'm doing. His insurance supports out of state consults so it is gone.

    Anyway, I discovered I am not on call again until late June whew. So relieved. A bit of a respite from that I'm still digging out from under a busy Saturday. Just packed aforementioned candles for Kimberly and Tina to thank them for doctoring me today. Creme brulee for Tina - she is a sweets lover, and Lavender Vanilla for Kim - she needs calming she's an energizer bunny who does too much for others. It's amazing how appreciative others are when you see them. Happy Monday, much love, Elizabeth

Saturday, April 16, 2022

Thank God this Week is Almost Over (Happy Easter Ed.)

     I thought I was just raw and bloody on Monday but by Thursday I felt like someone had additionally cut my arm off and was tasering a frayed nerve while I tried to work. Then there was this imaginary person that stuck a pole in my back, twisting it occasionally, to remind me it was there. Shaver called in twice, and that's not a problem - he's a giver and deserves a break- but sucking up his work on top of our own was a lot. Not complaining. I'd run into a burning building to save him, as well as most of my partners. 

    Easter is kind of a big deal, but it snuck up on me this year. Feel bad I didn't send anything to C. I was busy diagnosing melanoma in the intranasal cavity and lymphoma in the bladder what is up with weird tumors these days? Even Melody was shocked as hell. She has family plans at Boulevard tomorrow - Kimberly secured her a reservation and they are both over the moon I'm excited for them. I've got 10am Reiki with Lisa. Sorely needed. The last three weeks have been unbelievably crazy.

    Not much else to say here. Just checking in. Oh I talked to Lucy this week! She's lonely and California is expensive and hard. I told her most of my life has been hard. Find your escape - I said, pick your poison. Mine is books and music. You are good at escaping, I told her. Haha I am, she said. I told her that I would try to get out and visit her maybe this fall. Count on me as a parent, or a sibling, or a friend. We all need a person. Happy Saturday, much love, Elizabeth


Tuesday, April 12, 2022

Raw and Bloody

     I'm supposed to be writing an overdue bit of my part for a contract bid but holy hell. I only realized I was overdue, thought I was on top of the shit, at 3:00 today. Overly apologized and it's gonna be ok. I walked into Melody's office this morning after presenting an effing epitheliod rhabdomyosarcoma at ENT tumor board and said I'm raw and bloody. Feel like my skin has been peeled. She laughed. That's an apt portrayal of how my month has been so far. It's weird, every day we think it's not going to get worse bc it couldn't but it does. So we have stopped hoping we are just pushing through.

    My attending at my three months in residency at ACH was the international expert at rhabdomyosarcoma. So I've seen a lot, and gave a good presentation, although it's such a zebra this is my first real case. The outside derm diagnosed it as melanoma in situ collision tumor with atypical fibroxanthoma (AFX) and well. They got it wrong. They also screwed us over years ago with pod labs in a subcommittee of the Arkansas legislature (who I knew (the subcommittee) at the time had no idea of what was going on so it was freaking useless) so LOL. Karma is a bitch. It's usually in kids, not 83 year olds, so even the rad oncs were like IDK? Need to review the lit? Treat it like a high grade son of a bitch, said Scott Stern.

    I was also on the hook for an organ harvest until 9 last night which frayed my every loving bloody nerve. I get this once every 5 years so I always have to print off articles on liver viability evaluation by frozen section and Batts and Ludwig criteria, which I dutifully did. Christian, from ARORA, seemed to think he would know if he needed me or not by 7:30 but it's always a bit of a toss up and when I texted him at 8:30 after I finished preparing for 7 am conference he said they were just getting a visualization on the liver and the kidneys.

    I had looked up the patient earlier - the donor - and she had a history of bad polysubstance abuse. No judgement here, but I was thinking that means the liver is probably shot to hell and I won't have to go in. Giddy optimism. I chided myself. I should be thinking of the recipient not the donor what kind of monster am I. When he texted at 9pm no biopsy I was like thank fucking god sorry for all those out there who need livers. There was an Arkansas storm of the ages who wants to drive in that shit.

    I was triaging cases this morning and saw that I had a testicle at 9am. I fing hate testicles. The tumors are so hard and so uncommon I sent the last off to Jesse a year ago. Then I saw grossly on the slides that they were bloody as hell and got optimistic. Maybe torsion? Testicles and ovaries do this occasionally, painful as hell from what I read, but treatable with surgical excision. I dove into the chart and the patient, young, thirties, was visiting a friend and was a drive by shooting victim - they hit his thigh and his penis and his testicle. Easy for me, unthinkable for him. I told Melody, we may be bloody and raw as hell, but there is worse. She agreed.

    It's early in call and work is taxing but doable, I told Jack. We had a long and fruitful talk tonight about family and friends and many other things. I'm emotionally over the edge but sharing with partners helps and they share with me and we bond? Most of us. Rare ones are lost causes. Melody is a gem. Shaver is having trouble with a cold but overall supportive. I'm counting down the days to Sedona, and Vegas, and Eureka - all happening within the next month (AND HALSEY!!!). Happy Tuesday, much love, Elizabeth.

Thursday, April 7, 2022

Connections

     Please try to make them. There is something there. Vortexes and shit. The world is changing and this is important. Every day brings new things. Sending lots of love you are the key. Sober as shit sending love. It's up to us.

No Time for Tears

     I wandered into the bronch lab at around 11:45 a.m. today. Van is on today, and while all the other cytotechs text standby to alert me there is a procedure starting and ready when it's time for me to do a wet read Van always texts Come on down, bc the bronch lab is in the basement (near the dr. lounge so always an opportunity to grab snacks and drinks after). It happened so much this week I started imagining myself on The Price is Right, which I loved as a kid - walking the hospital halls with celebratory music blaring and announcers congratulating me on my good luck to be a contestant. I was escaping, I know. It was another helluva shitty week. Body fluids deluge. When it rains make hay.

    Van has a tendency to be a bit of a cowboy and so when I told Cidney it's all necrosis, get cultures, rare atypical cells possible degenerative (he was trying to stage a lung mass by the hilar nodes) he looked really frustrated. Are you going to to try for the mass? I wondered, bc he was already out of the nodes. The patient was intubated, so couldn't hear anything. This isn't always the case, but for some reason he was reaching up lazily with his arms and legs and Cidney and the nurses kept trying to gently restrain him. Cidney, who is usually cool and collected, cussed with his body and grabbed another needle attached to tubing and tore the sterile wrapping off and threw it on the ground. Yes! I'm going to go for the lung. All the assistants were still and tense.

    It's not just you, I said. The last two weeks have been crazy. There is something in the ether. I almost cried Monday, I was so overwhelmed, and I'm not a crier! Not about work anyway, or divorce, or the big things. Then I told myself I had no time to cry, I had to go on. He was smiling and laughing and the room relaxed. I told him I was going to go to the dr. lounge for desperately needed water but feel free to call me back for the mass - Lord knows I need the exercise and I like to get out from behind my scope especially during weeks like these. I texted Van twenty minutes later to see where he was and he said Cidney just did an FNA and put it in formalin. Thank goodness. I was hangry.

    Lately - two or three months maybe - lunch has been very comfort oriented. Fruit and honey and peanut butter - baked lays for a texture fix. Banana is my go to - but any hint of brown or green repels me they have to be perfectly ripe so sometimes I do strawberries or honeydew. There is this one doc who piles up on fruit every morning - I grab to put in the fridge for lunch. He swears the Baptist dr. lounge has the best fruit on the planet I have to agree. 

    When I learned that Halsey added WalMart Amp to her schedule this week and tickets went on sale Friday I started hunting for a driver (interstates still make me a little panicky) totally willing to pay for tickets and Embassy Suites. I was also willing to pay $2400 for two days off but luckily I was able to move some things around. Christie has her younger sons high school graduation from Catholic and Cecelia will be headed to Spain on May 23 for the summer on her scholarship. Laurie is seeing Jack White in Tulsa. Jessica doesn't know Halsey and will already be short Laurie. Stephan doesn't get much vacation and said to use him as a last minute resort. I texted Kim and Mary Grace. 

    Mary Grace is starting a new job (she was unceremoniously and misogynisticly fired from Falcon Jet after schooling a younger colleague). She is the most badass female pilot/engineer on the planet and I hated that a wimpy white male fucked her over but things happen for a reason and maybe this job will be less abusive and allow her to attend more of her superstar daughter's volleyball games. Kim said her daughter Liv (She's Cecelia's age), who idolizes Halsey would want to go and with Christy's help (crappy computer issues - Baptist has new terrible firewalls and the internet in the basement sucks and I hate trying to do this shit on my phone I need to start bringing my laptop) we secured three tickets. Kim, Christy's other BFF, is vacationing at a lake in HS and has been listening to Halsey all day. I told her I just booked a two room double bed suite at Embassy Suites and cannot wait to go. She's going to drive us in my new Jeep.

    Turns out I do cry sometimes - I temporarily lost my shit when I got home and discovered on Instagram that Ketanji was confirmed. And movies and words and music can stir me to tears - Jack laughs sometimes when it happens on even Merlin. They are both good - I'm excited he is going up to see her on Sunday and they are going to Rainbow Kitten Surprise together. I'm hosting my Sunday school class with a few extra invites this Saturday for a potluck brunch and that will be a balm. Call again next week but hopefully weekend will refresh me. Happy Friday Eve, much love, Elizabeth

Sunday, April 3, 2022

This Week Has Been a Year

     How do I even start explaining the call week from hell? It definitely begs wine. It started off with late frozens (this was diagnosed as a collision tumor between an atypical fibroxanthoma and a melanoma in situ can you read margins?) and med exec committee at Trio's on Monday. Mandee begged me to sit by her, Joseph Hackler was at my other end. He is Christy's cardiologist, and when I told him she chartered a PJ to Vegas for us at the end of the month he stood at proper attention. We need to keep her in good health. I nodded, yes I agree.

    Mandee gave a 30 minute presentation on safety (Troy Wells left but was like - these things aren't for agendas on dinner nights out who is responsible for this - Anthony Bennett of course) and it all came down to a ditch in Saline County near Sonic. There is apparently a Facebook page with 9800 members covering this ditch. Kathy Parnell said she has been in the ditch; she gets a big gulp at the beginning and end of her every day. There is a ditch t-shirt. There is also a Subway ditch in Jonesboro. Long story short, Sonic has been trying to fix the ditch but Arkansas highway department is stalling. So safety can't happen unless your governing bodies are willing. 

    I had a case of the decade! 29 year old with gut pain and BRBPR (bright red blood per rectum) was being worked up for inflammatory bowel disease after failing improvement over treatment for infectious colitis. Sven Hida was the interventional GI - I received his call the next day and told him our working diagnosis. Kaposi's Sarcoma of the gut. Sent out HHV8. Do an HIV. He texted me at three that it was positive. His description on endoscopy - mucosal islands and mounds - perfectly matched the unusual zebra presentation and the articles I had printed online of rare case presentations. Quinn told me it was a frequent flyer diagnosis in the eighties. At least in the skin. Not so much now. Especially in the gut.

    Another work meeting Wednesday night in the private room at Cheer's (two in one week?) was a helluva lotta fun and there's some possible merging in the works but it's too early to talk about. Still exciting as hell. Oh I met Anna's bf on the sixteenth floor of the Regions building (what a view!) and it was a bit shaky and anticlimactic bc I got stuck for 10 minutes in the rickety old parking deck elevator and my hands and feet were still numb from a near panic attack. 

    Jessica got stuck in an elevator at Baptist for an hour with a cart full of placentas and she got to know her other party - a visitor - quite well. Christy got stuck on her condo elevator with Sonny years ago when he was a puppy. She screamed until a neighbor going to the hospital heard her. The fire department told her to stand back - it's a really small elevator, she said. There is not much room to do that. Mine was 1960's horror movie honestly and when I finally got off I hugged concrete and breathed a sigh of relief. Hands and feet still numb when I met Alex but a big glass of ice water helped.

    Watching Severance it was harder for me to get into than S. He loves the aesthetics for me it was kind of like Girl With the Dragon Tattoo when is this going to take off? But it did and it's addictive now. Looking forward to a hopefully day off before a new work week. Getting lots of calls to take pics of the Kaposi's in the gut. Someone wants to write it up. Sigh. That's why I exited academia, to get rid of all that shit. But I'll do what they want - take pics on my iphone. Make people happy. Sunday sleep in day that's my plan. Much love, Elizabeth.