Happy Tuesday (My Wednesday)

     I won't remember anything about Beaker training when we go live in October but. I passed the test. So there is that. Such as busy post call Monday and Tuesday. We had medical executive committee last night in the basement of Cheers. About twenty chiefs showed up to celebrate Anthony Bennett, who is the retiring CMO after 13 years. David Shenker took over. I hate that the committee is on Monday, told that to Kathy Parnell, and was frustrated to have to go to a dinner post call. 

    But it was fun. I walked in at 6:05 after an Uber and the long table was full. Where do I sit? I asked. There was a round table adjacent to it Shenker pointed me to. So I am the red headed stepchild? No, you get to sit at the kid's table alone. LOL. Ok, I'm fine with that. Actually, he said, four people canceled at the last minute so we will make a place for you at our table. I was seated at the head next to Kathy (vice chief, hospitalist). Whew. She's a lot of fun.

    We got through some orders of business after we ordered our dinner. Tasked ourselves with changing bylaws at the next meeting. Chit chatted, and then we were asked to volunteer testimonies about Anthony. Most were serious, about how he developed governance committees that revolutionized patient care. In lab, it was blood bank utilization. I said you know my retired partner Rex Bell? He used to get so miffed because I always called you Tony Bennett. It's Anthony Elizabeth! Not Tony. Someone pointed out that he died recently. I said of course I don't wish that on you! But may you sing with Lady Gaga. 

    Had another shadow today sent by Quinshell. First she's sent me in a year or so - she's the STEM contact at UALR. He was a gem. Affan. Youngest of three boys. His mom is a homemaker, his dad works a jewelry kiosk at the mall. His oldest brother is in psych residency at MUSC (medical university of South Carolina) and his middle brother is in med school I forget where. I tried to schedule him later in the week but he requested earlier because he leaves for Columbia, where he is a sophomore, on Thursday. 

    He graduated from LRCH, and recognized Cecelia, who is a year ahead of him. We met an OB/GYN in line at Boulevard who also graduated Central. I also bumped into my co-chief Shaver while showing him around - Shaver said I graduated at Central decades ago. Sounds like he wants to go into PM&R (Physical Medicine and Rehab). That's Fizzy's specialty, I said, my author friend from Boston. Rangy (OB) asked him why PM&R.

    I like the body, he said, and muscles and exercise. Turns out he is a bodybuilder like Jack. When you read the news and all the hell going on in the world it is refreshing to hear these success stories. The walls that are climbed. Makes me emotional.

    Tumor board this morning at 7:00 - ENT - will never see Sims the same again since he wore rainbow sequined shirt at my bday party and was a big hit. He was buttoned up again with smart glasses and left early to head to the OR. But was still there by phone. I presented three of Stern's cases, some zebras. Medullary carcinoma of the thyroid. Paucicellular pleomorphic adenoma. Was transferring the pics I took at 7:30 am Monday to the jump last night at 9pm.

    One day last week I was trying to wrap things up early and Sims had a late case. Oh no, I worried. Frozens? No, Jessica said, I looked it up. Some lady got a rubber bullet, I guess, from an air rifle that went through her window and got lodged in her tongue. Ugh, that sounds terrible! He's removing it. Not a cancer case, thank God. 

    Heading to Austin on Friday to see S's Dad and stepmom got an amazing AirBnB. Excited to meet Amanda's baby Braxton he's as cute as a button. Just checked in on Mom and Dad hurricane heading their way I think they are prepared. They are planning to move back to Little Rock (the more hurricanes the sooner). Elise told me today that the reason she didn't settle in LA was bc her grandmother's home was destroyed by a hurricane and she has weathered so many during her life in LA that she decided to make camp in a place that can be a safe haven for people to evacuate to. I presented her at med exec last night, admin is excited to meet her. Happy Day, much love, Elizabeth

Moonshadow

     Ack what a week. It will continue this morning with Beaker Epic training and call. GI stuff flared up as bad as since I went to the ED in December. Trying to ride that wave but on Thursday when my stomach hurt so bad I was laying on my floor on a blanket and getting called for frozens it was a little too much. The pinnacle was when I decided to maybe try to go to the bathroom to get it to stop and I puked water, which I had been drinking all morning to try to regulate, all over the floor. I asked Tina to please put a note on the door on stall 3 and call the janitor. I'm going to lay down in my office, I said, I'm so over life.

    Friday was much better! Luckily the OR died down early all week so I didn't have to stay late. I was checking in on the gross room yesterday afternoon. Savanna had noticed I was under the weather on Thursday and was happy to see me on the mend. Today I'm not puking on the lab bathroom floor, I said. That's my new bar. They all LOLOL'd. 

    OMG I love Elise. She is going to be at Beaker training too she joked about bringing mimosas to Tiina and I yelled I already said I'm bringing wine. I took over reviewing her cases Tuesday. She trained at Mayo for surg path but it was pandemic and they are really weird I'm discovering. They miss the forest for the trees and I'm teaching her gestalt. I told her I'm a product of intellectual incest (born at the same hospital I was trained at) but luckily I had some of the greats come through AR. Jesse. Laura. Yeah, they are at Cleveland Clinic and Michigan now but look! They are on Rosai. We are gonna get you up to speed. Support you until you fly.

    I love teaching. If my academic influence wasn't so toxic I'd still be there. I've tried over the years to plug in to UAMS to no avail. So I'm in complete heaven with Elise. We cheesily pondered the difference between endosalpingiosis and endometriosis and peritoneal inclusion cysts this week, our first inside joke (what is the effing point). She is from a small town outside Lake Charles LA and I worried when I opened the news yesterday when Louisiana was burning about her family. No, I've never heard of Merryville, she said, but thanks for your concern. 

    Plugging into the kids this week with songs. They beg for it, but whether or not they listen, I'm not attached to. When I was at Montessori long ago on Lee street, before they moved to 9th and High, I had a teacher named Miss Ann. Ann Montgomery. I think I learned a decade ago she was murdered. She played the guitar. We all sat around in a circle. Lots of campy stuff like You Can't Get to Heaven on Roller Skates and 100 Bottles of Beer on the Wall (how non PC these days lol) but some really good stuff too. My favorite was Moonshadow. He (Cat Stevens) sang some good songs, but that was a stand out. 

    So here I am, cross legged and six years old maybe? listening to Miss Ann. Full circle. Ugh 3 hours of beaker training and triaging but happy weekend?! Much love, Elizabeth.

    

Last Day of Quarantine

     It's been an effing week. Last Thursday I didn't sleep all night from tooth pain. The dentist couldn't get me in on Friday so I called my ex to prescribe Amoxicillin. Must be an abscess, I've never had one, but it is like the worst nerve pain on the planet. Tooth pain was abating with abx but over the weekend I started getting stuffy, allergies? Sunday night was the worst I was up all night drowning in my secretions and put two and two together Monday morning when my brain fog got so bad I was worried about missing something on a case. Went to Dell in micro and swabbed myself and sure enough the PCR came back positive for Covid.

    I had deluded myself that I was immune to Covid. S has had it twice, J has had it three times now, hell almost everyone I know has had it. I called Melody from my office and she said put your cases on the counter outside of your door and go home. Here's the thing about Covid. It's different, then say, the flu. It has this psychological horror associated with it that puts people into panic mode. At one point this week I felt like I should just go join a Leper Colony. I've got the government issued Paxlovid, I was fine by Tuesday, but got a little depressed, bc here I am on vacation and everything was canceled. It's fun playing hooky for a day or two but then boredom sets in.

    I found out Annie got it on her bday too. She said Adele had it first, gave it to Jack, and the rest is history. I learned that it is going around again. Cyclic. More contagious, less virulent. She said people are so paranoid in her school system they have to prove a negative test before playdates, and that they were mad that she was dropping Adele off at school functions when she was still pos, even tho Adele was neg (she stayed in the car with a mask). 

    So between the Amoxicillin and the Paxlovid I've also had an unrivaled upset GI system. I can now understand why toilet paper and Kleenex went into such bad shortage - I had to order a huge delivery from Kroger yesterday. Slept like the dead late into the morning and woke up to 16 texts. I said I feel fine, have felt fine since Tuesday barring some sniffles. Bored as hell. Perfected my Broadway voice ready for my debut, after a much needed shower. Ready to celebrate my birthday.

    Sara and Matt and Joanna, Matt's girlfriend I'm excited to meet, are coming in tonight. After more than a little drama the pool party is moved to Sue's tomorrow and I think I'm welcome? Definitely going to my party (I've spent more than a few K on it) but bought some glittery masks to match my outfit so I can look like the responsible member of the health care profession I strive to be. Happy Thursday! Finally feeling myself again. Much love, Elizabeth

Miscellaneous

     Such a busy week workwise. Yesterday I was bouncing between rad and bronch lab like a ping pong ball. Today I luckily had only one needle in bronch bc I had a GI throwback that uncharacteristically made me two hours late to work. I would have called in, if I'm a normal person, but we don't do that unless we are basically hospitalized so I mustered through it. Felt better around noon, but I'm exhausted. I'm guessing all the docs took last minute vacays before school starting next week and they are making up for it in spades. 

    I told Melody today after I started feeling better that I have a predicament so terrible it's funny. All my body wants is cold water and the Sonic rabbit poop ice (as my mom dubbed it) from the Dr lounge but one of my cavities on the left side is sooo cold sensitive I'm lopsidedly drinking toward the right. My dentist assured me this would get better in the next few weeks, but yesterday was so painful I took Advil, futilely, because I realize it cannot touch nerve pain but I was getting desperate. Melody presented me with a simple genius solution. A straw! Here, I have one. I only know this bc I've been there, she said.

    Jack came back from NYC with Annie and her family today - the pics and videos he showed me are beautiful and hilarious. Will, (about 10) and Adele (approximately 13) stayed in an apartment with Jack and after late night and planned fantastic dinners and dessert they were so hopped up on sugar they would terrorize him and he would hide in the bathroom while they mimicked zombies through the frosted glass door of the bathroom. He had a blast. He told me that he and Cecelia and Harper and Mia are planning Smashing Pumpkins together makes me happy.

    This morning while I was still feeling green Jan, a secretary, came into my office. I'll bet you remember this case, she said, someone is calling about it. I thought in my head I've had 60-70 cases every day this week there is no way I'll remember it. But I did, it was a gross only, and I remembered it bc it just said foreign object. Where from? I wondered. The ear? Under the skin of the arm? Usually they tell us this and on a lighter day I might have investigated but I didn't. Foreign object, gross examination performed. Jan said I assumed it was from the stomach? That made me laugh internally too. 

    Jan said the NP is on the phone and is wondering was it a bug? The patient is in her office and insists it was a bug. I rolled my eyes in my head. I told Jan, Savanna described it as three gray fragments in her gross. I never saw it, I don't look at grosses if the PA's don't have a question. If they saw a bug, I'm sure they would have described it. Jan came in a few minutes later and said I told her I'd investigate, but if I didn't call back, there is nothing more to say. YAY! Boundaries. We get pushes and pushes from clinicians that are very weird and it would eat our day up even more to respond to every phone call.

    I had a weird weird case this week - was so blown away showed it to Hal and Melody and got a handle on it. The clinician called this afternoon and you don't usually get phone calls but this one begged a phone call. This is out of my element! He said. Us too. I showed it around and I've never seen it before it makes zero sense but it is what it is. Should we send it out? He asked. Well, that gets really complicated with the bill, I told him. Who does it go to if we are confident in our dx. If she does go to a major academic center, as you predict the oncologist will send her too, they will review our diagnosis as part of protocol. That makes sense, he said. Thank you. He told me a little bit about her, what she does, who she is. I told him I sent up a little prayer when I released the case. I don't usually hear about the person behind the slide, and it made me a little emotional. I mean yes I deep dive into the charts to correlate everything but the personal side, unfortunately, gets lost there in our current state of broken system.

    Good god happy almost Friday. I need a weekend desperately. They are way too short. Elise and her husband came yesterday to work on her new office - the hospital crew has been working on it all week. I was starting to get queasy around 3 so I made sure that rad and bronch lab were done for the day and left early at 3:30. Hal (he's on call) was ok with that. I said goodbye to Elise, and she incredulously asked, are you leaving for the day? Yes, I said.

    Reminded me of when I first started and an eight hour day with more vacation I'd ever had in my life seemed like gold. My partners seemed to take it for granted, as I now do and that's easy. Habits form over time. But we are working, as the rest of the medical world and the world in general, for much less doing  much more than when I was just out of residency. First world problems, I know, but it takes a toll. Happy almost Friday, much love, Elizabeth

Happy Tuesday

     So last week was hard. Probably the hardest week in my history. Not workwise (that is this week so far) but work familywise. I'm seeing I tried to compose a couple of drafts but nothing came to fruition. The weekend was mostly R&R. I planned to shop for an outfit for my disco bday party but mostly slept and watched movies and laid out by the pool. It was all I had the energy for. I'm off next week Tuesday through Sunday so I'll find something amidst hair appointments, etc.

    Speaking of the party (August 19th!) just got off a conference call with Jordan and Eleanor and Anna and Aunt Peggy - they were meeting the party coordinator at Fassler Hall and I planned to attend in person but I've been ricochetting off of cases like a ping pong ball the last two days so I attended by speaker instead. We have already doubled our budget it's going to be so fun. Ceiling installation, disco ball, signature drinks. My family is turning this into a reunion - I'm hosting a party the Friday night before that I've already spent a lot of time and money on. Luckily Sue is doing the food - that's not my forte. I'm doing drinks and pool floats and all the fun plates and drink cups and umbrellas.

    So Staggs is gone and Elise is coming on the 14th, it's the end of an Era for PLA, and a new beginning. We also hired a new cytotech, Elizabeth Golden, who started last Wednesday. The Elizabeth's are taking over, and the new female hires are a tipping point. We are mostly female, now. Makes me happy (not dogging men). 

    Savanna and her long time boyfriend Ethan are planning a vacation in September to Eureka, they are staying at the Treehouses, and I'm so excited I've been giving them Eureka tips all week. They are super excited about the Grotto. I told them that the Crescent has the best ghost tour. I told Ethan this morning they have to check into Turpentine Creek. I almost inappropriately texted Savanna at 2am the other night when I remembered. You have to go during feeding time, I told them, which I have never done but heard it's the best time. Savanna told me this afternoon that they looked into it, and apparently Carol Baskin has a financial stake in it. OMG I haven't been in five years I had no idea EWWW. We thought you just had friends in high places, LOL, she said.

    I'm on cytology this week and Cidney is lighting up the bronch lab. There was an extra case today that threw me for a loop. I had one this morning and Gary was doing it - even though he was on molecular he's been helping out all week bc Pam is appropriately reading behind Elizabeth until she gets up to speed. She is from Smackover, was working in Jonesboro so she has experience. She just got married and bought a house in Vilonia. She's a DOLL. Anyway, Gary's case this morning was three slides of blood (not Cidney he's technically the best IV pulmonologist I've ever worked with - also from Jonesboro and trained in New York. Hendrix grad, like myself). I told Gary I don't have time to babysit this guy's bloody slides for an hour please read and text if you see anything interesting. He never did.

    That's about all I've got for now. Don't watch the River Wild it's number two on Netflix right now but one of the worst B movies I've seen on the planet. Carol was very good. Also the Deepest Dive on Netflix. Reading isn't coming easy to me these days but I'll continue to be optimistic that that will change. Hired my old yoga teacher Matt for house visits weekly hopefully with this continued health turnaround (thanks Paula) I can strengthen my core and start yoga again. 

    Was going to try to go to Smashing Pumpkins at Jack's request a few months ago but I gave him the tickets this week to invite three other people or sell. Cecelia, who I chat with on WhatsApp everyday is due back August 16th and plans to try to go but jet lag might squash that ambition. Plus, I learned that Stone Temple Pilots was changed out to Interpol and another band I've never heard of. I tried to listen to Interpol a few years ago when I was reading a Bon Iver article and he said he loved them but it didn't really take for me. Not an indictment (HA HA) sometimes you just have to be in the right mind frame for new music.

    When I learned STP was opening for Smashing Pumpkins I was SOOO excited I've never seen them. It took me thirty minutes of ecstasy to realize that they were opening bc Scott was not alive anymore, despite having read he and his muse's biographies. I wondered aloud to Jack who might be the replacement lead singer, told him they should hire me I do a pretty good Scott. I've seen SP twice and ordered those tixs long before the party and pool party so backed out, it feels less stressful. Guess there was a little more to tell. Happy Tuesday, much love, Elizabeth