Sunday, September 14, 2008

Long. So....?

It's been just shy of four years that my fingers have been typing out this dreck. And I've enjoyed every bit and then some. Just shy of 4 years and over 350 posts.

From time to time, over the past years, I'd wondered how long I would write this. Somewhere less than 50 years, I figured.

I also wondered how I'd know when it was time to stop. Would I fade away or would I "just know".

Guess it's both. I'll fade away just knowing that I'm done.

My tale isn't told, thankfully. I may even, from time to time, come back and throw something up, purely for the joy of putting words to screen: The further tales of life as a medical resident and then a terrified attending physician. (Scariest night of my life? That first night on call as an attending.) More on the front lines of the garden wars. Even another wretched haiku or 10. The thug deer. The large grey goose who thinks she's a goat, who lives on the farm down the road. (The llama seems to have moved on, I haven't seen him shunning the pretty ponies for months.) Beaker the mailbox and his repeated pummelling by the snow plow of death.

But not now. Not for a while; a long, long while, most likely.

And that's not fair to anyone who still checks in here, from time to time, out of friendship.

I'll genuinely miss all of you, especially those of you (you know who you are, yes you do) who've become real friends over the years, many (though not all, sadly) whom I've had the sheer unmitigated delight to meet and squeeze tightly in real time and space. I love you all.

I'll likely be stopping in to see what's up in your lives from time to time, perhaps more often now, that I'm letting myself off the hook from the guilt of the dangling site.

So, one more big, sloppy hug and a slightly snuffly kiss from me to you.

At least for now.

So long.

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Tuesday, August 19, 2008

Call of the Sirens (Part VIII)

Our scene: A darkened patient room in a large urban teaching hospital. Not particularly nice but not grim, either. Think tan vinyl flooring and grey laminate counters, but cleanish. The time? Between 5 and 6 am. There is a human-shaped lump on the bed under the beige hospital bed spread, breathing rhythmically in a narcotic-induced sleep. A lone figure in pea-green scrubs and short medical student white coat, pockets bulging with assorted paraphernalia, stethoscope draped 'round the neck, silently creeps in, making no sound, holding her breath. In one fluid movement, she pops one end of the stethoscope into her ears and snakes the other end under the covers and onto the patient's upper abdomen (the 'epigastrium', for those who enjoy such jargon). Holding it there for a brief 3 seconds, she then withdraws from whence she comes, out the doorway, to join the other identically attired members of her surgical team, 6 in all, 2 with short med student coats, 4 with long housestaff coats (2 interns, 1 junior resident, 1 chief resident). In terse whisper, the interloper imparts the following, "No complaints. Dressing intact. Breath sounds clear. Cardiac--regular rate and rhythm, no murmurs. Bowel sounds present." One of the members of the team quickly scribbles her words into the patient's chart. Another scribbles some orders and puts it with the rest of the team's charts on the rolling chart rack. On to the next room, where the performance is repeated with little-to-no variation.

Thus are pre-rounds on the surgical team.

Heaven on a scalpel.

Rules:
  • Always round before the patient is awake and family members are present. Talking to patients and especially family, wastes time. The nurses can read your note and take care of all that touchy-feely bullshit.
  • Always have the lightest team member examine the patient, the better to creep in and out without waking anyone. (See above)
  • Placing the stethoscope in one place allows you to (theoretically) examine all 3 organ systems (lungs, heart, gut) without all that needless mucking about that internists are so fond of, placing their stethoscopes here and there around the torso.
  • All this stealth is vital for the team to have rounded on all the inpatients ahead of time in order to be in the operating room by 7 am sharp: gloved, gowned, scrubbed, surgical instruments in hand, attending pimping away. ("So. Dr Piffle. What is the order in which one encounters the vessels that supply the GI tract coming off the aorta, in descending order and is each anterior or posterior to their corresponding venous counterparts?" "Errrrrrrrrrrrrrr....")

Ah. The surgical rotation, where one learns the 4 cardinal universal rules of surgery:

  1. Trust no one.
  2. Eat when you can, sleep when you can, pee when you can.
  3. The esophagus is not your friend.
  4. Don't fuck with the pancreas.

Contrast these with the 4 rules of internal medicine, as told to me by a rather cool attending:

  1. Medicine is not a science, it is an art based on science.
  2. There are at least 2 ways to do everything.
  3. Every patient is an n=1.
  4. If you're not having fun, something's wrong.

Taking #4 up there: see, the thing about surgery, is that it is fucking fun and really simple. Not the surgeries themselves, but the approach to medicine. You are congratulated for the shortness of your notes and your ability to turf (transfer the care of) any patient who is not in need of surgery right now, to a non-surgical service. You don't have to waste time on all this differential diagnosis stuff. Who the hell cares why Mrs Jones is demented, all you care about is if Mrs Jones is a surgical candidate. If not, turf her.

Turf her good.

(An aside-- that's one thing that reallyreally bugs me about all these medical shows. See, there are strongly delineated lines between medicine and surgery, especially in a teaching hospital. Surgeons operate and do the post-operative (including the surgical intensive care unit) care. They do not have anything to do with medical issues. They don't manage the insulin. They do manage the pain meds. The patient with some sort of unknown fever, unless there's an obvious surgical source, would never be admitted to a surgical service. The patient would be admitted to medicine, perhaps with a surgical consult as to whether or not surgery might be indicated, but NEVER to a surgical team. Also? There are distinct surgical sub-specialities. Don't mix general surgery with orthopedics, ob/gyn, ENT, urology. They do not generally cross specialities. A general surgeon won't be operating on a deviated nasal septum. Nor will that surgeon be fixing a heart or doing neurosurgery. And vice versa. Pediatric surgeons generally don't operate on adults and vice versa. Got it? Rigidly defined roles. There are exceptions but they don't practice in large teaching hospitals.)

I also adored the surgeries, themselves. All that glamorous, sterile attire. The appropriate etiquette. How to scrub--start by cleaning under the fingernails with the enclosed nail pick, then lather up with the sponge side, then scrub 10 times each part of each finger, then the backs of the hands then the palms, rinse with the hands up, letting the water drip down the arms and not off the fingers. How to move through a sterile field. How to change positions with a colleague at the table-- the one closest to the head turns out of place, rotating back-to-back, and turning around again to face the table. How to stand--arms crossed, hands under armpits or hands held in front of the chest. Never below the waist. Below the waist is not part of the sterile field. Neither is the back nor above the shoulders. How to gown and glove oneself (although the surgical circulating nurses will often do the honors of assisting with the donning of gown and gloves) while maintaining sterility. One does NOT break the sterile field or one will find oneself in small pieces in several parking lot dumpsters.

How not to pee for hours and hours on end. Drinking fluids is to be carefully timed. It's OK to have some coffee up until, say 6 am, but not later, unless it's a short case. Some cases go 12-14 hours.

How to stand so as to try to diminish the pain in your legs, your back, your arms. How to ignore the hunger. The fatigue. How not to look weak. How to bond with your team.

That last one was key, I've no illusions. I adored surgery because of my team. The Chief Resident was an amazing woman who actually enjoyed teaching and let her students do lots. The Jr resident was a middle aged guy who had been a cardiothoracic surgeon in his Eastern European country before he immigrated and had to do all his training all over, again. So he was very happy to have the students do procedures. As he was so qualified, our team would sometimes have 2 suites going at once, with the Chief, an intern and a student in one room and the Jr resident with the other intern and student in the second room, the attending wandering about between the two and the lounge. What's not to love?

And so, why the hell didn't you become a surgeon, m'dear?

Ah. First, because I knew my personality, and while I loved it, I knew I didn't have the soul of a surgeon. I don't like crises. You can't get away from the crashing, life-and-death, what-the-hell-are-you-going-to-do-right-this-minute-Doctor-this-person-is-dying stuff, but it's so much more common in surgery. The tools I have as an internist are the drugs, the endotracheal tube and ventilator, the cardioversion paddles, the labs and scans and the consultants. Not quite in the same league as what the surgeon faces with someone who's bleeding out.

Also, most surgeons are assholes. It's true. I've known lots of wonderful surgeons, but most are not. I'm not fond of assholes.

And finally, Charles would have divorced me, I'm sure. The residency is brutal, lasting 7-10 years for general surgery, depending on the program. Call is usually every other night. The off call days run 14-16 hours. It's the speciality that brought us the phrase "The problem with only being on call every other night is that you miss 1/2 the good cases." That in itself was enough to bring me to my senses and to make me an internist, with my drugs and scans and long, involved differential diagnoses. And to care why the hell Mrs. Jones was demented, because there are a few rare things that can cause reversible dementia and the surgeons sure as hell weren't going to look for them.

After my glorious weeks as part of the general surgical team, I headed off to my surgical elective, anesthesiology. Good god, what a shitty speciality. All fiddly deadly drugs and monitoring. The gas passers live a life, as the saying goes, of endless boredom punctuated by bits of sheer terror. As students, we were paired up with an anesthesia resident (no interns; anesthesia residents generally do a medical internship) with an attending overseeing. One attending in particular, the Chief of Anesthesia, enjoyed the reputation of being a remarkable jerk and was, for some inexplicable reason, heavily into professional wrestling. As students, we had to call the surgical patients we were to anesthetize the next day, the evening before, and go through all the questions they'd already been asked by the residents. The same EXACT questions. Which I thought was beyond bogus, especially, as we all know, I really don't like talking on the phone, especially cold calling strangers for no reason but to bother them on the night before their surgeries.

So I made it a rule not to call them.

Which, as luck would have it, came back to bite me in the ass the last day of the rotation, the biter being the dreaded professional-wrestling-besotted jerk attending. He asked me something that I would have known, had I called the patient (nothing vital to their care, don't worry, just something beside the issue). I said that I didn't know. He asked "Why not", bushy eyebrows descended to an alarming level. I said, "Because I didn't call." Seeming to swell to the size of a large grizzly bear, he thundered, "Why the hell not?" "Because I'm worthless and weak," I said matter-of-factly, looking him in the eye. I was exhausted and, I suspect, not averse to goading him into killing me and relieving me of my misery.

And then he laughed. And laughed and laughed and left for his standing date to watch Portland Wrestling. And he passed me with an acceptable grade.

Always tell the truth, dearest darlings, no matter what. You're likely to be caught in a lie at some point, and who knows, you might provide comic relief to someone. Plus, the truth is always simpler. Like surgery.

So that's how things ended with Diana and surgery, except I still get to wield the scalpel and suture from time to time in the office, with small things. And I still feel a bit whistful as I don the sterile gloves and ask my nurse to pass me the #11 blade.

But I make it a point to always say "please" and "thank you", just so no one thinks I'm a jerk.

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Thursday, August 07, 2008

What I've Learned On My Summer Vacation

I really don't know what I was thinking.

See, a few months ago, when there were still the remnants of all that winter snow in the mall parking lot, the kids were in raptures over one of those crappy little 'fairs' that were set up by the chain toy store. You know the sort: a small Ferris wheel, some sort of half-assed mini roller coaster, probably a tilt-a-whirl, a few win-a-.99-cent-prize by spending $5 and seeing if you can toss a ring around a bottle and some cotton candy and popcorn concessions.

Their pleas of "pleasepleaseplease" were answered with a 1-2 punch of "No!" and "We'll see about going to the big State Fair in the summer."

A trip to the fair in summer, being months away and warm and bright, seemed like just the ticket. Visions of tents pitched on the grass, breezes amidst the trees, parades of well-groomed cows and the like, accompanied by all sorts of fair food. What's not to like? Sort of a grown-up version of our small county fair that we went to a few years ago.

Oh, Stupid-o mio.

Concrete. Miles and miles of concrete overlayed with a cacophony of screaming. Unbelievably overpriced, with tens of thousands (hundreds of thousands?) of people scuffing along in the opposite direction of where ever it was we were trying to get to.

And to top it all off, I inflicted the whole thing on poor pal, Teri, who I've not seen in 2 years. "We're going to the fair! We'll be near you! Do you want to meet up with us and do the fair? We can get to spend some time together while the kids enjoy themselves."

Alas for her and her girls, meet us they did. The cranky, over-heated family who didn't bring enough cash for both riding and eating, or really even just riding. (Who the hell doesn't take credit cards these days, I ask you? That's not just unamerican, it's anti-commercial. Don't they watch TV? Life stops for those who taketh not the bits of plastic.) After a few hours of dragging around, we called it a day and packed it in, leaving poor Teri a little cotton candy colored puddle in front of the cursed Ferris wheel. (We'd gone back on purpose, right before leaving, so Colin could ride it, as promised, but he decided that he'd really rather not ride it after all and just.wanted.to.go.home.) As a topper, Sara succumbed about 1/10th of the way back to the car (conservatively a generous 1/2 mile (1 km) away, swimming like salmon up a stream of lemmings) and so Charles and I lugged her back, between us, Colin dragging behind.

Had we only stopped and indulged the lil' darlings all those months ago with the crappy parking lot fairlet, we'd have saved us all a bunch of woe, not to mention a chunk of change. Live and learn, cupcakes. Live and learn. Trade not the small pain of today for the large woe of tomorrow.

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A couple of weeks ago, though, I got to meet another of us, Teresa, out from Seattle to visit the relatives. We met up at the very large farmer's market around the Madison capital square and I got to sit and laugh with Teresa and her sister and daughter while her brother-in-law entertained her niece and nephew. It was, as it invariably is, an all-out gab fest as two people who've never met in person and yet know scads about each other's lives finally get to sit down and sip coffee and nibble baked goods. It's never long enough, is it? And what is Teresa like? Just like she looks: You have to hug her as soon as you see her. She absolutely sparkles. It should come as no surprise to know she teaches kindergarten. I don't know if only lovely people teach kindergarten or if teaching kindergarten makes people lovely. (I strongly suspect the former. 5-year-olds are sweet but I think were it me in a classroom of them I'd be heavily medicated or lobotomized and Teresa is neither.) I forgot my camera but she brought hers and posted one of us if you care to scoot over and wave "Hi" to her.
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And while we're on the topic of catching up over the past few weeks, what happened to The Pool? Well, it was replaced with a more modest and demure inflatable one that was used with reckless abandon by kids and dog, alike. When it was about to qualify for protected status under the umbrella of the endangered species act as a habitat for several newly emerging life forms, I emptied it, scrubbed it out and left it to desiccate a bit in the sun before filling it anew. Then one of those freak violent summer storms blew up out of nowhere. It ended up down at the bottom of the pasture impaled on something large and sharp, leaving it with a ragged rent in the side, rendering it no longer either "inflatable" or a "pool". Luckily, the pools are still on sale at an even more reduced price. I did toy with putting 5-6 of them in the cart. I think I will live to rue the day that I did not. I was wondering why Jocelyn was disparaging inflat-a-pools in her comment. Now I know.

Pictures for you

I'm just a-learning lessons left and right, aren't I?

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Speaking of learning, I did finally take that agricultural medicine test last week. Not that anyone was really wondering, but take it I did. It was well and truly taken. Now I just need to wait for the results and then figure what the hell I'm going to do with all that newly gotten knowledge about tractor safety and the lot. Assuming I pass, of course. If not, then I guess I'll not need to decide. Win-win.

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Interlude:

Here's the two fawns who seem to be growing and learning without their mum. They keep eyeing my vegetable garden but have decided that the tomatoes that have taken over most of the space aren't what they'd really rather eat. Aren't they pretty? I tried to post a larger, cropped picture but flickr wouldn't have any of it for some reason. Trust me. They're adorable and still have their spots.

Pictures for you

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Firmly entrenched in the heading of "When Will I Ever Learn" is finding that I have somehow agreed to serve my Network and can be found on the roster of the Physician Practice Committee. Gads. For almost 8 years I had successfully avoided such things but found myself thinking, "Hmm. This could be interesting and a way to make some positive changes in the good ol' firm. And breakfast will be served."

All this must have taken place right before lunch when my defenses and blood sugar were at a double ebb for I found myself responding that I'd be delighted to take a seat at that table. I now find that I've somehow become one of 2 physician leaders of the Patient Access sub-committee of the original committee. That's 2 committees. What were they thinking? What was I thinking? I'm the one who sits in the back and nods in agreement from time to time while eyeing the danishes and wondering if I can somehow snag another one while looking like I'm just stretching, sort of a variation on that old first-date-in-the-movie-theater move where his yawn ends with an arm around your shoulders. Now I'm to be at the head of the table at the horrible hour of 7 am, expected to contribute many things of worth AND I've not heard a word about food at these sub-committee meetings. I fear a large tumor has taken over the logic and reasoning bits of my frontal lobe. Here's hoping it rapidly eats away the rest of my higher functions and personality so I won't suffer too long. As an added bonus, we're to round up several other physicians to serve along with us. Ever try lining up docs to do such things? Forget herding cats. It's like herding birds. Birds who never return your calls. Can't say I blame them.

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And while we're on the subject, is there anyone else who would be horrified to find that the gown you were handed by the nurse for your daughter to change into at her kindergarten check-up/meet-her-new-doctor-now-that-your-insurance-has-changed appointment had 8 McDonald's characters spread across the front in various medical garb, all grinning horrifically?

I felt like putting posters of "Supersize Me" up all over the exam room. Good grief.

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So, that's my hiatus in brief. Well, not really brief, actually.

I'll leave you (and you, Teresa as I promised you one, and you, Jocelyn, as you appreciate the inappropriate conversationalist that is the manic gardener, and you, Teri, as you are a true friend as you're still speaking to me despite the horror that was the state fair) with the following of my lovely tree lily. It topped out at over 6 ft (2 m) high and smelled of sweet, sweet summer. Don't look too closely as each cup was full of gorged and stupefied earwigs. The good with the bad, as is life.

Pictures for you

Hope the rest of you are well and you avoid state fairs and committee meetings.

(Oh, and if you happen to not look where you are vigorously weeding along your raised garden bed, and put your hand --gloved, thank god, but inadequately so-- in a hornet's nest, this will lead to a most painful stinging, causing a stream of fuckingshitfuckingshitsonofabitchFUC!KING!SHIT! to issue from your mouth as a reflex, and your small children will learn how to correctly pronounce, enunciate and vocally inflect those most taboo of words. They'll be the pride of the school playground in a few weeks.)

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Tuesday, July 22, 2008

Haikus For My Own Private Waterloo

I suck as a mom,
not for the obvious, but
for the stupid stuff.

I make them eat their
vegetables and drink their milk
And do their homework.

Their wails make me smile
as I set the course; mixing
Athens with Sparta.

But then I get a plan.
Something to make them smile,
Glad I am their mom.

Good in it's way, but
then I get cocky and make
promises. I'm doomed.

Like just this Sunday:
"Hey, Colin, let's have your friend
to play in the pool!"

What pool? Well you ask.
Really more a plan as it's
still stuck in its box.

See, after years of
inflatable pools that
die and go to ground,

this year we made a
change and got a Slip 'n Slide
for their summer fun.

But it was no pool.
Nope. It was a little fun,
but it was no pool.

So, "Fuck it," I said.
Life's too short to not have a
pool in your backyard.

The problem is it
kills the grass as it sits there,
for more than a week.

But, wait! We've a slab
of vacant concrete poured by
the prior owners.

It's flat! It's grass-free!
It's level (I think it is).
The place for a pool.

Off we go, to Toys
R Us, Where pools are on sale!
(Who needs measurements!?!)

So, after breakfast,
and laundry. And dinner prep.
And my exercise,

I head out to the
Midwest backyard, where its now
90* in the shade.

Colin's friend arrives
with flip-flops, swimsuit and towel,
ready for a dip.

Alas, the pool is
still theoretical and
laughing at me.

See, it's a full yard
(a meter) too big for the
handy cement pad.

The pad, I might add,
is only mostly level,
for all it's grass free.

Two options there are:
Charles says let it go and get
another, smaller pool.

Me? I say let's do
the more miserable way
and build up the slope.

Thar's rock a-plenty
in the fire pit. I can
build a pool rampart.


Pictures for you



Yeah. Good plan, that. Hot
and humid. The sweat burns with
the dirt in my eyes.

I forgot the bush
I had to transplant so the
pool wouldn't crush it.

(Colin and his friend
went down to the basement and
played video games.)


Charles, always wise,
remained exiled on Elba;
he had to study.


Hours later, I
Once again filled the bastard
and prayed for success.

Let's define 'success',
shall we? It holds some water
and is sort of round.

Maybe it is less
than half its expected depth
and shaped like a "D"

Pictures for you

And there's a sort of
waterfall at one place as
one side collapses.


Pictures for you

On a side note, I
noted a water beetle
made the pool its home.

This was only a half
hour from starting to fill the
cursed fucking pool.

(How a water bug
got in that fast? I'm flummoxed.
Call her 'Harriet'.)


Pictures for you



So, there we are kids.
I tried, I really did, but
I suck as a mom.

Tomorrow, you can
splash in your puddle and make
friends with Harriet.

Maybe now you'll find that
the poor Slip 'n Slide is not
such a wretched deal.



-------------
The following day,
my own private Waterloo
sinks to sad, new depths.



Pictures for you

Hell with it. I'll clean
it and donate it to some
poor sap at Goodwill.

The rock, of course, will
all have to be schlepped back to
the fire pit site.

The transplanted bush?
There it stays. I'll plant a spare
in its former spot.
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I want it noted that
I was just transiently
thwarted in my quest.

The next day I found
Another pool, smaller, less
tricky to put up.

Napoleon has
nothing on me for stubborn
personality.

*34 degrees C for the civilized world.

Anyone want a minimally used pool with filter-pump (complete with O rings lubricated) and ladder assembled? You need a 13 foot (4+ meter) scrupulously level spot of yard or you will rue the day and regret the loss of your sanity. Actually, I've been using the ladder in my multi-month window-washing quest, so at least the ladder has been pressed into honest service.

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Monday, July 14, 2008

Call of the Sirens (Part VII)

And so, we come back to our continuing saga of a goof attempting to become a physician. We've seen her go through the first two years of unrelenting butt work and are now in the spring of her discontented third year, having finished everything but pediatrics, something she already knew she didn't want anything to do with.

Which, of course, led her to just relax and have some fun and be told she should really go into pediatrics by lots of misguided people. But nonono. She knew better, she did. She could never see the tinytiny eardrums of those tinytiny infants, brought in by their terrified parents worried that they had ear infections. She also knew that she just couldn't take a life of constantly reassuring those worriedworried parents. But most of all, she knew if she went into peds, she'd have ended up in prison for having messily and publicly murdered the first person she came across to abuse a child. Either that or she'd have offed herself after the first time she made a mistake that endangered a child.

No. Peds it was not to be, fun as it was. She did learn how to give a good shot, though. How vaccinations would happen in the out patient clinic was someone would have a small child who needed several vaccines and the call would go out to all available nurses, nurse practitioners and me, the lone med stud. As soon as we had enough bodies, each armed with a syringe, we'd sidle on up to the tot, peacefully resting in the arms of a trusted adult. We'd each grab a limb, syringe firmly grasped in the other hand and, on the count of three, we would simultaneously stab the little angel, instantaneously transforming them into a howling, sobbing devil, complete with bright red complexion, banshee howls and visage of doom and destruction.

They said this was apparently less traumatic than giving each shot separately. Maybe they were right. I think there were studies quoted. There are always studies quoted in medical education. There seemed to be about the same amount of screaming this way as there was when my own two got their shots, one at a time, and there wasn't all the distressing repeat performance for the subsequent injections that happened with giving them in series.

The other thing I remember was that lunch and a show was provided each noon. Lunch was usually some sort of sandwich assortment and the show was usually something along the lines of "Pediatric Eczema and You" or "Meningococcemia: Know it. Fear it." Good times. The peds residents and attendings were also a happy, cheerful bunch, almost to a person.

I'm sure they were all heavily drugged or lobotomized. Perhaps both.

So that's that for the third year of med school. The rotation that was by far the most fun was the one I'd known from the start that I had no desire to pursue. I'm sure there's some sort of life lesson in that but I'm damned if I'm going to learn from it.

Now, the fourth year of med school is sort of like the third, but the rotations are usually smaller bites and you have to decide what the hell you want to go off and be an indentured servant for at the end of the year. You get to take ENT ("otorhinolaryngology" for those who crave big, multi-sylabic words) and learn to use the head mirror (that mirror thingy that olde-tyme docs wore strapped to their foreheads), which is actually really hard to use. At least it was for me. There's this trick to peering through the hole in the middle while focusing the light from the lamp across the room that reflects off the mirror and into the patient's throat, all while using an angled mirror (like the dentist uses) to see around the bend in the throat to examine the vocal chords, while NOT making the patient vomit all over you by inadvertantly bumping the back of their throat with the mirror. Of course, now-a-days, you'd just use a head lamp to see, or, even better, a fiberoptic laryngoscope, so you could actually see 'round the bend of the throat and not make everything thing up. ("Oh, yeah! I see it! That bitty nodule on the miniscule vocal chord. Really. I see it. Promise.")

You'd also do a week or two in ophthalmology (the eyeball guys), and get really skeezed out by all things horrible and eyebally. (The worst? The enucleation surgeries where they removed the whole damned eye for some sort of hellacious tumor or other. Heart rending and really gross. Yeah team.) Why the hell anyone would want to go into that was beyond me, but they did. It was a highly sought after residency. Blech. Two of my friends went into it. I'd always thought them sane, but I had to reconsider after that.

There was a week spent in the auditorium doing Law And Medicine, which scared the shit out of us. "YOU WILL BE SUED." "IT WILL BE HORRIBLE." "YOU WILL WANT TO KILL YOURSELF." "THIS IS NORMAL." "YOU WILL THEN TURN TO COPIOUS DRINK AND/OR DRUGS." "THIS WILL RESULT IN THE LOSS OF YOUR PRACTICE AND YOUR LICENCE AND YOUR FEW SHARDS OF SELF RESPECT." "HERE ARE SOME MORE CAUTIONARY TALES OF REAL PHYSICIANS, EACH ONCE A WONDERFUL, PROMISING PROFESSIONAL, NOW TO BE FOUND UNDER THE BURNSIDE BRIDGE WITH THE DISBARRED LAWYERS AND OTHER BUMS." Gah. "But don't let that bother you."

There were several electives, like dermatology (oozy and dull and all the rashes looked like all the other rashes) and ICU (terrifying but cool); and you also had to take neurology (oh, good GOD the damned neurologists and their 5+ hour attending rounds with nary a chair in sight; oh, how we all hated neurology with all their fiddly tests that never worked like the books said and their confounding and complicated tracts and cross-tracts. Like learning the wiring of an enormous 1910 house.)

And then, there was surgery. And the sirens called. Oh, yes they did.

But I am tired and there are children to be put to bed. So I will leave you here with images of eyeballs and rashes and a line of drooling, incontinent patients (and students) with horrible neurological diseases in your heads.

Because I'm not a pediatrician and, therefore, not nice like that.

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Wednesday, July 09, 2008

20

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20 years ago found the above starry-eyed, broke kids standing up in front of their nearest and dearest, dressed in meringue and tails, promising to care for, love and provide really good beer to for the rest of their lives. As neither of them could think of anything they'd rather not do more than stand up in front of a couple hundred people and be the center of attention, the whole damned ceremony, from bridesmaids slow-stepping down the aisle to Pachelbel's Canon in D, (I'd always loved the music and this was at least a year before I'd heard ANYONE else use it in their ceremony.) to the last of the bride's train disappearing out the door at the end, took 5 minutes. 10 minutes tops. For real.



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They then went off with those nearest and dearest and ate cake (which they did not smear on each other and the white-white dress and rented tails) and cold cuts (poor, we were) and drank good beer and cheap champagne.



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All while making their very best friends dress in the height of wedding fashion of the late '80s: the tea length, off-the-shoulder dusty rose dress and the morning coat, with cravat. Amazingly, some of those friends still speak to us, although not the majority. If anyone wishes to step forward and identify themselves in the pictures, feel free, otherwise, I'll preserve anonymity. (Hi, Stacy!)



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There was no dancing (including no Chicken Dance), as Charles detested dancing, and the music was initially classical music, followed by a compilation of U2 at the end, on the cassette player of their boom box. (With some of their wedding loot, they bought the first CD player of their lives and a TV. Marvelous Charles was already starting down that long, slippery slope of home electronics obsession.)



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And everyone had their picture taken. A lot.


After that, the two kids, high on champagne, cake and love, went home to stop shaking, open the pile of loot in their skuzzy med school apartment and grin, falling into exhausted sleep. The friends all went to the campus grounds of the happy couple's alma mater, and celebrated more. (The ceremony had been held in the campus chapel and the reception in the law school library.) The friends all got very happy on the leftover champagne and food and some bushes were fertilized with minimally digested cold cuts. We have pictures of that, too, but are holding them in reserve for either a slow blogging day or the reciept of the appropriate blackmail funds.

The next day, the young pair left for a lovely week in Canada (Victoria and Vancouver), where it was very cold and rainy and they bought thick sweaters and their first few CDs for the CD player.


And how'd that all work out?


Swimmingly, thank you. Every morning, Marvelous Charles makes me a latte and asks me how I slept. If he gets up at night (because the dog, she has neeeeeeds, she does), he always shuts the door so the light and noise don't keep me awake. He tells me I'm pretty when I look disgusting. He brings me tea when I'm sick.

In short, much better than that other Charles and Diana. Besides, my Charles is way cuter.

So, happy anniversary to the disgustingly happy couple who still holds hands in public, just to annoy everyone else. We may be revolting, but at least we're revolting together.

Feel free to throw rock-filled rice balls now.

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Wednesday, July 02, 2008

Second Childhood

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It came as something of a surprise last night when I found myself, after work, stopping at the local Shopko and, after a serpeginous route that took me past the sunscreen, bug repellent and little girls' sundresses (sale! $3.99 a piece--to replace the ones that have shrunk in the wash to Hollywood starlet length) standing in front of the baseball mitts, my real reason for stopping.

Me. Baseball mitts. Me. The one who spent her school years dreading the hours spent in PE, where balls were frequently thrown. Balls combined with poor hand-eye coordination, thick glasses and jeering classmates rarely lead to happy, smiling outcomes, except in trite family-oriented movies. Rest assured, there were no game winning saves in my PE history, only years of scheming how to have the fewest times at-bat or at-serve or at-pummelling as possible:

  • For softball, you make sure you are last in line to bat and, as able, discretely trade places with the athletic kids in line behind you who want to move up in line. It goes without saying that you go waaaaaaaaaay out in left field when it's time to switch sides.
  • For volleyball, you place yourself at the front of the net in the spot you rotate to AFTER you serve (I think it's front left).
  • For basketball, you pass the ball as soon as you touch it and never make eye contact with the person with the ball, so they don't throw it at you.
  • For dodge ball (the worst!), you get yourself hit as soon as possible, sometimes even faking it so you can go to the sidelines and, again, swap places with those who want to get back in, making sure you basically stay toward the middle-end (but not conspicuously at the very end) of the line.

I actually liked soccer, but we rarely played it. This was the '70s, people. Soccer (OK, yes. 'Football' for the civilized world.) was not played by middle-class, red-blooded American children.

So, back to standing in the middle of the baseball mitt aisle. I then proceeded to spend 20 minutes trying on all the sizes and models, finally deciding on that particular glove, above, being suspiciously examined by Mad-Kitty.

My very own first baseball mitt, at the age of 42. After I got home, we all went outside and played catch, liberally covered in bug spray, until Sara got unbearably cranky and Charles got tired. After years of trying unsuccessfully to ignite a passion for soccer in the small ones, we find that baseball seems to be our family's game. It goes without saying that I now love playing it.

Go figure. I still can't throw to save my life and I am at a 2nd grade level when it comes to catching and batting, but I'm having fun! with a ball! and coordinating the hands and eyes!

Never too late to indulge yourself or continue your childhood. I will draw the line at dodge ball, though. Some scars run too deep.

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