It's been that kind of a day - almost 12 hours, which is normal for a med student or even light for a resident with small children but for an almost 50 year old almost empty nester it's taxing. Especially when half of us are off - we don't normally allow that but Melody and her husband got Covid over the weekend and I rushed home to get her some Paxlovid right before she spiked a fever at 10am yesterday. She asked for two boxes, I gave her four - her son Seth is still at home and it's always nice to have extra. Jauss told me about it when her whole family got it last summer - and I had Mike prescribe it for S and J's second round it really mitigated the symptoms. When the government offered me 20 free samples since I'm a doc a few months back I jumped at the chance and haven't opened the box until yesterday.
So we had four pathologists off today, which we don't allow. The workload is too intense. AND, I had to get a permanent crown in the afternoon so it was basically a 12 hour day, starting at 7am at ENT tumor board with Don and John and Scott and I met a new rad/onc Howard. He was asking about my Starbucks bfast and extolling the virtues of Slim Fast energy drinks and chicken nuggets from McDonald's and I was like are you from the 80's? Bc you look way too young. I haven't had any of that since the 80's.
I presented a benign vascular lesion of the parotid - I'm getting SO many zebras these days. Last week I had an angiosarcoma on the skin of the breast - I had to google an article in the NIH to stage it correctly because CAP had no template (CAP has a template for everything ad nauseum). I trained with Paula North at ACH who has since moved on to other bigger institutions - she was an international guru in hemangiomas and taught me a lot that I have mostly forgotten twenty years on. Jack had one on his nose - they are much more common in kids not so much in adults.
In kids they have a proliferation phase and an involution phase - luckily Jack's involuted so we didn't have to intervene surgically. The theory at the time was that it was some sort of placental migration, which makes sense - why so often to the face though? Like a stroke, only instead of plaque it is placenta. Paula's husband was Bob Mrak, neuropath, he went on to chair at some smaller place in Indiana if I remember correctly after their divorce. In adults they don't involute, they slowly grow, the gross is kind of like a placenta it's a bloody sponge. So they've gotta come out.
Paula, who was probably my age now when I was training, told me a story that happened while I was on the rotation. One of her teenage sons blocked up an upstairs toilet and ignorantly kept flushing and flushing and left the house. It flooded, the toilet and tub fell through the ceiling, and her heirloom dining room table took the brunt. God the things we put up with to have progeny.
I'm on call and life is going good I guess. Air conditioner unit servicing bedrooms finally fixed after two weeks. Furnaces aren't cheap, but they aren't as expensive as air conditioning units (Bill Benton told me he spent 15K on a new one last week). Mom says weather is weird in Florida. Dad on his way back from Virgin Islands. Eleanor and I still planning party, we have migrated from elegant lite chic with jazz to dress up 1973 with 70's music and it's evolving and fun. Happy Tuesday, much love, Elizabeth.
LOL ETA I bring flip flops to wear for the office but never public. I had a severe right baby toe injury over the weekend so no shoes are comfortable. When I got a frozen at 5 (ovarian torsion, I also had testicular torsion yesterday ouch ouch ouch poor people) I was like screw the sandals I'm wearing flip flops. Won't make it a habit, but it definitely felt freeing.