Saturday, July 23, 2022

The Terrible Horrible No Good Very Bad Week

     Monday was ok. I managed to get caught up on January and February QC reports and started on March. When I walked in Tuesday morning I noticed an impending flood. Staggs' overhead tiles near his office were heavy and dripping. I notified Jan and she put in a notice for construction, whoever the heck you call. They came and looked and said they would be back. Seven hours later after another phone call and two more requests for help online we had sprung two new leaks and there were three trash cans strategically placed in the hall and on top of the mailboxes. The secretaries were worrying about leaving for the evening.

    I ran to the C suite and found Mackenzie. I had told her at our lunch that we flooded every two years, but this was another possible after only two weeks. She got on the phone and within five minutes the head guys were  problem solving. It helps to have friends in the right places. Some sort of air conditioning condensation issue - it certainly wasn't rain this time haha we all joked. She texted me the next day after I thanked her for nipping the issue in the bud that she would try to make sure we were evaluated comprehensively so a long term solution could be found.

    Then on Wednesday, cases raining down, not coming out in a fast or efficient manner (this is a chronic issue) I got a huge dump at noon. Chose to work through lunch (and Thursday and Friday) and a supervisor came into my office to problem solve something rather trivial on my computer. You can guess the race and gender. I said no, I'm busy right now, now is not the time. We need to do it right now, he said. No, I just got all my cases, it's not the right time. Scroll down, he said, I'll have this fixed in an instant.

    I started shaking I was so mad. I turned around and looked him in the eye and said what part of what I'm telling you is not clear? Let me say it again. No, I don't want to work on that right now, I'm too busy, I want you to leave my office. Zero boundaries, zero respect was going through the back of my head. He patronizingly told me in his honey sweet voice that we need to resolve this right now. Resolve what? I was wondering. Your feelings? My time was being wasted. My no's were being ignored in a mind fucking way. I stood up and pointed my arm/finger at the door and yelled at the top of my lungs (after two more no's) GET OUT OF MY OFFICE RIGHT NOW!. He ran, I called business office/HR and complained. Second run in, last one was last Summer. The holy shit you deal with as a woman is really frustrating. I like this guy. He's really nice, he's helpful, this is a systemic issue with our world. But still. 

    Thursday I just melted. The work was excruciating and for the first time since I've been there I closed my door until 1pm. Wondering, what is my place in this company? Am I viable? Should I job hunt? I haven't been that insecure since my dad was sick in the hospital. It didn't help that the gross room (my territory) was being criticized and I was trying to help them course correct - none of us are perfect and we all slide toward entropy at times. But when you are in a bad headspace, everything gets taken way too personally.

    Friday, what can I say? Christie's surgery was rescheduled for 2 so I was working my ass off so I could see her post op and talk to her dr. and make sure the post op nurse had the contact information for her driver. I was surprised, I told Kay Chandler, that she could be d/c'd from post op s/p hyst? I thought it was magical thinking on CB's part. I know, Kay said, this has just happened in the last two years. I was incredulous too, but they do fine. She just needs to void and she can go home. So when I went to visit C twice Friday late afternoon I told her you have two jobs. Stay calm and pee. Sure enough, she was home mid evening. When I visited her today she was sleepy but good.

    Kids are doing a grand world tour of Arkansas today - we uncharacteristically had breakfast this morning together. They went to get Rennie and Will and Adele (Annie's kids) from Winnamocka and took them to Fayetteville to visit their grandparents. I stocked up for breakfast today at Trader Joe's after work bc they intend to come back tonight with Rennie spending the night and I wanted them to have bfast options.

    A little nervous about presenting at med exec committee Monday - I asked Mackenzie to put autopsy on the agenda and she complied. Quinn came to me and told me that everyone was kvetching in surgery/trauma meeting a couple of weeks ago that we don't ever do autopsies. I told him Shaver has told me admin asks us to do more autopsies. See, here is the deal. You get a bad rep in the community if you don't communicate. So I told Quinn I would present our policy at the next med exec meeting. 

    Our policy is right in line with private practices all over the country. We only do physician requests, we refer family request to others. We did autopsies pro bono which made sense 30 years ago when 70 block days were high but now 150 is the norm so getting one is like a bomb going off in your day. And the morgue is so 1960. And anything medicolegal is not what we are trained to do.

    I called Susi Jeffus at UAMS to get some back up for the presentation. She said yes, if the family presses the doc we do them but we are a teaching institution and we need it for the residents. We only did 57 last year (I was required 100 to be boarded, now it's down to 50 I hear). 90% are unnecessary, Susi said. There is a new guy at the crime lab who is head of our autopsy service and we hope to move all of them over there eventually. She gave me another private autopsy contact, Jennifer Forsyth, which was nice I thought the only one in town was Peretti.

    When I queried my Pathology Moms FB group they were like why? Do they want more autopsies? I said they don't understand. We need to explain it to them. I told one commenter that now that they are paying for them to be done at UAMS, I'm thinking they will finally come around LOL.

    So clear communication beats fear based silence. Not Earth shattering, but so not intuitive to so many people I am daily surprised. Wish me luck on Monday early evening - I hate to present and am bringing Jessica for back up to explain the transition of autopsy to UAMS, something SVI did a decade ago. Happy Saturday. Much love. Elizabeth.

Monday, July 18, 2022

Post Vacay Call Monday

     Today I had vacation brain. Luckily workload was light for a Monday, which is unusual. Got a lot of backed up admin work done. And Cecelia came over yesterday for a long afternoon by the pool which was a balm. As I've said before, if your kids aren't happy, you aren't. She still needs to spend a few days off of her feet so the wound can approximate - she's got lots of gauze and ointments to assist that. Hopefully by next week she will be able to walk again.

    I saw something on social media today that reminded me of a guy I went out on one date with (the monthly forced dates I tortured myself with on years ago). It talked about how scared women can be to even reject a guy making advances. I usually limited my first dates to mid-morning coffee at Starbucks or a public park that was well populated but occasionally I relented and agreed to a dinner. Twice, actually. Neither went well.

    Every time I go to the Chenal Promenade I remember this one bad date. He was a little short, I know petty, but had a decent knowledge of music and dressed well. I had a couple of glasses of wine, so violated my strict rule not to pass out personal information - cell, email, etc. - on a first date. I was leaving to spend a week in Florida with my parents and sister and our young children. About halfway into the week he emailed me.

    He was in California and waxed eloquent about some museum that was amazing and every picture reminded him of the possibility of us. Um, hello, we had just met. And then he went on to say how I was the best person he had ever met on match and he couldn't wait for us to have a future together. Slow down pony, I was thinking. He described a Coldplay concert he was going to and how they had these cool armbands that lit up and vibrated with the music and how transcendent the experience was (ewww, that was an essential dealbreaker). That, and the fact that at the dinner he complained that his ex-wife was responsible for the divorce, he did nothing wrong. This is a huge red flag, I heard it from doctors to insurance salesman, which he was (the latter).

    It was so unsettling I was trying to figure out how to get out of the Tuesday proposed date when I got back and fate shined upon me - but not my parent's dog. The poor thing had bad cancer and I had to get the slides to diagnose it. All very true, but I realized at the time it sounded like a very lame excuse to cancel but who cares? I'd already written the guy off with creepy vibes. So I didn't feel the need to protect his feelings. 

    The drama that ensued was horrific. He left multiple messages on my phone alternating between Dr. Jekyll and Mr. Hyde. I was an angel, I was a devil. Again, met this guy once. I finally got so fed up I uncharacteristically texted him that if I didn't stop harassing me I would report him to the police - lots of support from friends to get me to that point. That shut him up.

    It's no wonder women are so fed up with the patriarchy. It's not conducive to peace, or respect, or really anything productive besides assault and making lots of money for the assholes in the world. I read the news and it's upsetting but I think it's important to stay informed. So I just persist, and keep doing my day job, and hope that things will course correct in the next few years. It's been a long time coming. Happy Monday, much love, Elizabeth.

Thursday, July 14, 2022

Operation Extrication

     All the C's in my life are having a rough time. Christy is better, but when her hyst was canceled the morning of she about blew a gasket. That's under control and rescheduled, but Cecelia has been in a bad way for the last few days, requiring unusual frequent face time calls. I'll explain.

    About three weeks ago she went out with a bunch of locals who were walking on coals on numerous bonfires. She, who no doubt had a little lubricant on board, decided to do the same. Not surprisingly, the results were not good. She called Jack as she walked the 45 minutes home to tell him how bad it hurt. He supported her. She checked in with all of us on the family Snapchat the next day. The pics were gruesome, but it was mostly superficial blisters I saw the top of the feet only at this point.

    Luckily, she was flying to Seville to see Annie and Dave, both physicians. She also saw a local Dr. She plugged in a lot and things seemed Ok bc she had her Tefla gauze and her wraps and her abx and she went to Florence a week later with friends. 

    Then it got infected, so much so that her dad and the local Dr. recommended bedrest if not in school. This is where my ENFJ slowly over the last week came unglued. Come home, I told her when she FaceTimed me at work last Friday for an hour. About 6 hours of FaceTime later up until yesterday with lots of tears and support she finally agreed. I have seen the bottom of her foot. It looks like a crater. It will heal, but it will take time and I'd rather her be here than unmoored for her last few weeks in Spain. We problem solved - they have those knee scooter thingies but not, apparently, in Spain. And her daily 15 minute commute to school was taking an hour on crutches and she was developing underarm blisters. 

    I called a local travel agency we have used in the past - Poe; and after about a half hour of back and forth we got her a ticket out Friday morning to return to Little Rock Friday night. She first told me that she could not get her out of San Sebastian until next Tuesday. C had told me tearfully she needed to be back by the weekend to finish her course on Zoom next week, so I asked her about ground transportation.

    Ground transportation? I don't know about that. I am the air agent. I patiently told her that C was asleep now but I know she had secured ground transportation to Madrid about a month ago and couldn't we get a flight from there sooner? All the time wondering when did travel agents sub-specialize? Doesn't travel mean land, sea, and air? She knew this was an emergency, why did I have to figure this out with my limited knowledge of international travel? 

    I guess medicine has sub-specialized over the past couple of decades, and while somewhat functional I see it hurt the integration of the patient. There is a lot of unfortunate miscommunication, and you need a family member, preferably one with medical knowledge, to navigate the murky waters. But STILL. She offered me a 11:15 flight today from Madrid, yesterday afternoon. Um, she's asleep? She has to get ground transportation? That makes no sense. What about Friday. I can get the same flight on Friday. OK, great thank you so much.

    The promised flight confirmation to three different emails never came (and we were busy cooking a double batch of meatballs which Noah and Jack have destroyed) so when she FTmed me at 4 and 6 am trying to secure ground transportation I had no idea of the flight number, which was required to secure the GT. Luckily S googled Friday and Madrid and Delta and 11:15 and was able to get it - the heavily Spanish accented guy speaking English in the background said he could not wait for Arkansas to wake up she would lose her spot. When he said he had all he needed and C looked happy announcing she would start packing I breathed a sigh of relief and slept until 10 am. 

    Life lessons can be hard. I promise you can go to Copenhagen to see your friend another time, C, I told her. She worried about blowing all her scholarship money and having to leave a month early. Um, you worked your ass off to pay for your college, cell phone, living expenses, travel - your dad and I laugh about how we cannot commiserate with all the doc in the lounge who complain about the expenses. So stop beating yourself up and get your ass home so we can hug you and take care of you before your sophomore year. If you ever need money for travel we have saved a ton that we have not yet spent - as long as it's education involved it's all legit.

    I'm already doing that stupid thing where I remember leaving for vacation and wish I could move back in time. The McDonald's stop with Jack and Noah - Jack was a snob about it but went back for seconds he loved it so much. The time with Matt, before he had to go back to Atlanta. but there is more fun to have with family and more wine to drink and food to eat so I'm going to try to live in the present, like I preach to Cecelia (easier said than done). Happy Thursday, much love, Elizabeth

Thursday, July 7, 2022

Friday Eve

     I am so freaking exhausted. All those specimens that were piled up on the countertop at the end of last week hit us like a hammer on Tuesday and Wednesday - short week my ass. I can be very efficient if necessary, so I am still getting home on time, but at what cost to my neck and my psyche I cannot describe. No breathing room at work lately. Florida will be a balm. I uncharacteristically texted my dad today and said please, get me a 90 minute massage down there next week ASAP. I feel like there is a knife lodged in the back of my C spine.

    It flooded again in our department Sunday. This has happened like 10 times, every couple of years, since I've been here. Usually after a long rain, once when the sink was dislodged due to presumed hanky panky, and now what? Luckily my office has never been hit but Hal's and Brian's have been center stage to much damage. And it's ALWAYS on a Sunday. So we have had industrial fans in the office all week. It hit the hallway this time - blew out some ceiling tiles and was so forceful it practically soaked everything in all the open mailboxes. Lots of slides and paperwork affected. 

    Tina got a phone call on Sunday - she didn't go in - the techs were just alerting her. Maintenance was called. I don't understand? I told the secretaries on Tuesday morning. The smell was gnarly, and persisted Wednesday until a night cleaning crew came - today was a little better. Is it air conditioning condensation? Where did it come from this time? What are we, Noah's Ark? Do we have to put up with this for 40 years (don't blame me if I have my biblical references off I'm not a scholar in that arena.)?

    On a good front Christy, who has had a few beaus since she was divorced but none worthy of introduction, has found a French lover Sebastian. I met him a couple of weeks ago when he took our pics before we went to the musical. When she stopped by on her way home from a family weekend in Harrison on Monday afternoon with gifts from Courseys S and I tipsily agreed to host them for dinner Wednesday night since she is NPO tonight for a hyst tomorrow and we are going out of town for a week.

    Finding the energy to host on a work night is not something I enjoy doing but it's Christy! I texted S Tuesday do you remember agreeing to this (what the hell were we thinking)? They showed up a little before 6pm and he has passing English and a heavy French accent. Works at Dessault Falcon most of the year and lives in Bordeaux the rest of the time. It was a lot of fun. He is heavily into musicals, so I showed him the puzzle we were working on and he excitedly told me every one he had been to and where and I did the same. One of his faves is Rent, which I haven't seen, but remembered C telling me that he has a great singing voice and belted out the lyrics while he introduced it to her on TV.

    The twilight post dinner swim was invigorating - I vow to do it again, with or without company, especially with this awful weather. And it was so wonderful to see my friend with new confidence and happiness. A little emotional attention and great sex will do that for anyone. She, like I did once, has vowed to never marry again but I love that she is enjoying a little stability. He is clearly enamored. We joked about how she is robbing the cradle - he is only 41. Good for her. And his intelligent take on politics reassured me that he wasn't an idiot. She also knows when to make an exit. Her Uber call timing is uncanny. Right before sunset, so I could wind down.

    Christy was giving me hell about not watching something she shared a couple of days ago on YouTube and I told her I tried for three minutes which is really impressive. I don't watch things. Or listen. It makes me angry and bored. It's too slow. I read things. But not very well lately. Even Stranger Things is making me roll my eyes these days. I'm the only one not running up that hill. Trying to watch Pieces of You, which I remember reading, but it's a farce, just a way to pass the time. 

    When I had lunch with Mackenzie yesterday, who strikes my as a highly intelligent and focused woman just on the verge of coming into her own, I asked her about books or tv, what she likes to do in her free time. She said obviously both, but the pandemic has taken it away from me. She said the amount of Covid information and hospital response has ruined her appreciation for the arts, at least for now. I told her I totally agree, it's attention span rather than appreciation for me.  As we sat there surrounded by twenty men (mostly old and white) and one woman at various tables in the Dr Lounge I entertained her with path stories. She's gonna help me out at the end of the month explaining the new autopsy policies to med exec committee - Jess is coming too.

    I asked her if she had any inkling when the mask hospital mandate would be lifted. I told her that I heard in micro huddle last week the numbers were climbing - 16 in house, 6 in the ICU, one or two on ECMO. She said today it is 20. Ugh, I said, as I replaced my mask before I walked her back to the C suite and returned to my own cozy but stinky lab office. As long as the numbers go up, makes sense to mask up. At least in the hospital. Happy Thursday, much love, Elizabeth


Monday, July 4, 2022

Placenta Crew

    The gross room was deluged this week. We at PLA are experiencing bomb shells daily and our company same same. I got a little sideways with Jessica in the middle of the week but she plugged in and they were working their asses off every time I stopped by Thursday and Friday. But it looked like they were treading water/running up a down escalator. The countertops in the gross room looked like someone really hungry had gone to Kroger for the first time in a month. THIS IS CONWAY. Jessica said when I stopped by Friday afternoon. THIS IS HEBER. It's never been like this, I said. Bob is off next week, so they let him go at 3:45, but there was still a massive amount of work. 

    Jessica said that Bob lamented why are we working so hard? But there is still so much work to do? Makes no sense. I told her we pathologists feel the same at PLA. Their income is fixed, ours is fluid based on bill collections, so we have been taking a hit ever since I was hired to protect them, our family. Saturday I texted Jessica and Savanna, who were frankly overwhelmed. When are you coming in. I will help you. 

    So we planned to meet at 8am to noon today and I was kind of excited really I haven't grossed since residency. There are things you turf when shit gets crazy. Placentas are one of them. Breast reductions too. So there were over 20 placentas they couldn't get to this week. I said no worries, family canceled at the last minute (thank God) I'll come in Monday morning and help.

    We wasted 20 minutes trying to get me in the system and I said let me just write down the weights and the measurement and the cord measurements on a piece of paper and y'all can dictate once I get the sections in the cassette. I worked Bob's station. His sink SUCKS. At one point I asked Jess for help - placentas are the bloodiest specimens on the planet and after you do a couple, much less 20, it looks like a murder scene.

    She ran the disposal which was frighteningly far away and LAWD. The shitbucket smell surfaced. Placentas may be bloody as hell, but at least they don't smell bad. She got the virus x spray and the industrial odor eater and about ten minutes later I was able to approach the sink without dry heaving. Jess said they probably need maintenance to change his p trap too. Then I cleaned and cleaned and cleaned. It was cathartic. Bob and Savanna's station have never looked so good. At one point I was scrubbing dribbled blood counterside and Jess was like Liz? You didn't do that. But it's fun to get it up. I miss this, I told her. Call me anytime you get behind on a weekend. 

    I was texting them poolside today. So appreciative they came to work on a holiday weekend. Feel like I got some street cred today, I told them. When you've got a sinking ship, you need all hands on deck. We are not exactly sinking, but we've got some serious things to address. Planning lunch with Mackenzie, our new admin, on Wednesday. We need to plug in to admin, however crazy it is right now. Dad is good counsel here. Leaving LR to see them next Saturday after a thankfully short week. Hopefully Noah and Jack won't stink up the car too bad. Happy 4th, much love, Elizabeth.