Tuesday, February 26, 2008

Love Letters

Dear Patients of Last Week,

While it was nothing but an unmitigated pleasure and a true delight to spend 15 minutes with each of you locked in a tiny exam room listening with rapt attention to the particulars of your sputum (purulent), your body aches (extreme) and your fevers (impressive), I'd have really preferred that you'd kept your mask (kindly provided and requested to be keep in place by our friendly and courteous reception staff) on rather than removing it as soon as the nurse was out of the room. Your well-meant touch of asking me why doctors don't get sick was so very humorous that we both laughed heartily, especially after I replied that I was just getting over my 8th bout of illness since October and then stared pointedly at your pointless mask, dangling from it's elastic band at the level of your sternum.

When I next get a bout of severely unpleasant gastroenteritis, I shall be sure to have you over to share a piece of cake and drink out of the same cup of friendship.

Big, wet smooches!
(You know, that lady doctor)


Dearest Neighbor Steve,

You are the bestest neighbor anyone could have and have such a nice large pack of dogs. While we all think Bad Dog Bailey is a sweetheart (well, except Molly-dog, who hates her with the fire of 1000 suns), we think she's more of a sweetheart when she's in her own yard (about 200m away as the dog runs, and runs she does, through the tick-infested tall grass that separates our lands) and not making Molly throw herself against the windows with alarming violence and much spittle. It is also less than joyful when we let said Molly out to relieve herself (after carefully going out ourselves to scout for any wandering canines that would tempt her to badness in the bitter cold), only to have Bad Dog Bailey come trotting from around the side of our house as soon as Molly is let loose. After a half an hour of me trying to get now Bad Dog Molly to get the hell into the house, I am forced to give up and return to warmth and light. Sorry And Frozen And Oh-So-Hungry Dog Molly does finally agree to come in, an hour later.

Please don't take it as anything but a gesture of good will when you see the unsightly high cement wall that we've constructed along our shared property line that is topped with broken glass and razor wire. Good fences and good neighbors and all that.

As you've already lost one lovely pup in your growing pack to a passing car (Poor Maisy, we hardly knew her), we've made a deal with our florist so that for every 5th bouquet of dead-dog lillies we send to you, we get a 6th free! So, that's good, yes?

Yours in Dogginess,
(You know, the one married to Charles, the mother of your son's friend, the one you studiously ignore when in company together?)


Dear Mad-Kitty,

While I think you are the world's best cat and find most of your antics hilarious, (like the one where you jump out and grab me from behind, around the knee and then skitter off, leaving me to pick myself and whatever I had in my arms up from off the floor, you little dickens) this does not mean that you get to be pissy when, unbeknown to me, you've chosen to bury yourself under Sara's bedclothes and then are launched into the air in the middle of a nap, when I go in to turn down her covers. Your pointing out that you clearly make a (very small) lump in the rumpled bed does not bear weight in this circumstance. You are roughly the size of any one of the 107 dolls and stuffed animals that inhabit her bed and are indispensable to her peaceful slumbers.

If you choose to lurk and nap thus, you will be unceremoniously tossed, again and again.

Yours in fond nappage,
(You know, the one who feeds you and makes the bed all warm for you.)


Dear Driver of a Subcompact Last Night,

Let me introduce myself. I am the white knuckled driver of the large minivan, driving home last night in the snowstorm at dusk. There was no one behind me, nor anyone in the approaching two lanes of the highway when you, coming out of the side street as the highway passed through your small Wisconsin town, pulled out right in front of me.

Whee! Wasn't that fun! We nearly collided! I nearly slid into the median as I cursed loudly and tapped the breaks as hard as I dared, fishtailing away! Such a hoot! I know you were just being neighborly and, as I've memorized your license plate, and it's a very small world, not to mention a very small town, I'm sure you won't take it amiss if I flick a lighted cigarette in your window next summer. I don't smoke, but after last night, I felt compelled to start.

Yours in future emphysematous rapture,
(You know, the one driving the fishtailing minivan, wishing for a third hand, so she could have waved a middle finger at you without taking the necessary two hands off the wheel last night.)

Now where's the damn stamps?


Tuesday, February 19, 2008

Call of the Sirens (Part III)

{Here, we have the ongoing saga of what it was to go through medical training way too many years ago. Don't worry, this yammers on about the second year, which had little gore and no glamour. The second year is like that for many things: Too young to be of consequence, too old to be novel. Dull and sadly forgettable. Pimply and annoying. Best just gotten through. Sort of like the crust of a mass-produced pizza, without any dipping sauce. If you missed the prior chapters, that's what the side bar's for, isn't it?}

Between the first and second years, we had our last summer vacation, ever. Some of us (like me and my pal, Lisa, (Hi Honey!) got hitched). Some went on vacations. Some got jobs. All of us reconvened in the fall in the same damn place we'd left a couple of months prior, but at least it was all so very familiar.

And so we come to the second year, the year of pathology. Having spent pretty much all of the first year learning all about what normal was, we finally got to the really sexy part: The Diseases.

Buuuuuuuuuut, not so fast, grasshopper. The first 6 weeks or so were spent in a little side-step of torture known as 'Bugs and Drugs'. Spoken of by those who'd gone through in ashen-faced whispers, often accompanied by the rapid slamming of several shots of cheap liquor, Bugs and Drugs were what broke most spirits. 8 hours a day, 5 days a week, 6 solid weeks of nothing (and I mean nothing) but microbiology and pharmacology.

Now, I've always loved microbiology and what doc-to-be doesn't love the idea of those enticing drugs, but even a steady diet of chocolate can make you ill and this was more like a steady diet of partially corroded batteries washed down with concentrated bleach. To make matters worse, there was no context, just volume and pain. We were taught thousands and thousands of tiny microbes, some deadly, some benign, most we'd never encounter in our long clinical lives (and if we did, we'd just look them up). Many of the drugs hadn't been used in decades, but were thrown into the mix. Yohimbine (WTF?) next to metoprolol (vital) next to cisplatinum (vital if you're off to do battle with cancer as an oncologist, not if you're an orthopedist). So we learned them all, sorta, and promptly forgot them as they were at that point meaningless. We weren't to encounter patients in a theraputic setting for almost a year, so we really couldn't even use the information until then. It'd be like taking driver's ed as a 13 year old.

After Drugs and Bugs, I recall a loud party with the class band, Mostly Large Cells, named after a histologic description of something, probably some sort of lymphocyte, on a slide. Sort of a party of desperation. If it's a false memory, then that's a shame; there should have been a party if there wasn't. No better way to clean out all that recently sort-of-acquired fragile information, thus making way for the next bolus, than by lots of alcohol and dancing.

The rest of the year was spent in blocks of pathophysiology--what can go wrong with the heart for 4 weeks, the GI tract for 3 weeks, the lungs for 3+1/2 weeks, etc, etc, etc. An exam at the end of each section. 8 hours a day, 5 days a week, for 8 months. All in an amphitheater that was identical to the chilly, gray, flourescently-lit cement cave of the first year, just rotated 180 degrees (the first and second year classrooms sat parallel, foot to head), in the Basic Science Building.

But, at least no formaldehyde. And no good stories, at least none worth remembering. More interesting but less novel. Same instructors. Same classmates. Same everything, just rotated 180 degrees.

Ok, maybe there were a couple of good stories, but mostly it was just a grind.

There was a bright spot toward the end of that year, though, and that was that we had some classes in actual physical diagnosis, where we practiced using our stethescopes and reflex hammers on each other on Saturday mornings in the abandoned patient care rooms in the outpatient clinic building of the University Hospital. Yes. That's right. Go ahead and snicker. We played University-sanctioned 'doctor' with each other. We also had two rather awkward evenings where we learned the male and female exams with people paid to be clumsily examined by 90 med students, many of whom were blushing furiously or madly pretending that they weren't at all flustered by it all. The male paid-patients were just average joes, and just stood there, buck nekkid, but the females were 3 local nurse practitioners who knew exactly what we should be feeling for and would tell you, "No, that's not my ovary....no......closer...to your left.....no YOUR left......there! That's it! Make sure you get a good feel so you know what it feels like." Good, but decidedly disconcerting. Of course, you were graded on your exam skills and bedside (drapeside?) manner. If you didn't pass, you had to do it over and over until you got it. Which makes sense.

We also spent time each week in one of the primary care clinics (I was in the University's Family Medicine clinic) talking to real, live, actual patients, learning how to gather their histories about their sore throats or their baby's diaper rash or other similar concerns. We started learning how to do formal presentations, the backbone of the upcoming years of attending rounds, and how to start filling in the shoulders and shoes of a physician. It was cool. We were hot. Even if we looked uniformly dweeby, stubby and fat in our short white coats, stumbling over the words that we tried to make sound natural.

We were also scared to death as we knew that as of July, we would be released into the assorted clinics, inpatient wards and operating rooms. Pity the poor souls who were assigned to us. Pity them, indeed.

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Monday, February 18, 2008

Bathroom Humor

Does anyone else find the humor in the bottle of hand soap in our clinic bathroom plastered with the name, logo and prescribing information for the drug Cialis, or is it just me? I'm guessing there's an accompanying bottle of hand lotion somewhere, yes??

And do you think it was intentional or not on the part of the drug company?

(And, no, for those who remember my diatribe of two years ago, I didn't use it, preferring to wash with the soap from the dispenser on the wall, labelled instead with the name of the soap-dispenser manufacturer. I also tried to peel off the drug label, in an act of vandalism and defiance, but it wouldn't budge. Apparently, they're on to me.)

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Tuesday, February 12, 2008

Haikus For Stupid Pets

The cast of characters: Molly--70 lb (30kg) 2 year old German Shepherd Dog, and Madison--5 lb (2.5 kg) 2 year old cat. Both born within weeks and on the same farm as each other.

Oh, you stupid duo.
Worse than brothers and sisters,
At least in our house.

First, YOU. Dog. Yes. You.
What the hell were you thinking?
The small cat is armed.

Don't you corner her
and piss her off. Just DON'T. You
get what you deserve.

And YOU. Cat. Yes, you.
Those claws of yours don't retract
When hooked to the nub.

Mrararo! (Caterwalling)
Hnnnnnnnnnnnnn! (Dogerwalling) I turn.
Dog has grown a beard?

Dangling from both jowels,
All 10 claws sunk in her face,
Deep as they can go.

A foot off the ground,
Mad is, swinging back and forth,
While Mol shakes her head.

That fails, so Mol takes
her paw, slides it down Mad's arm,
to her throat and pulls.

Now Kitty's choking
and swinging and driving her
claws in even deeper.

(Dammit! Once again,
the camera's at the other
end of the whole house.)

With a large sigh, I
cross the kitchen and try to
disengage the cat.

Sadly, she's sunk in
so deeply that I can't back
her claws from Mol's face.

After much wrestling,
I close my eyes and riiiiiiiiip them
out of Molly's cheeks.

Cat is mad.
Dog is sad.
I have had

Pictures for you

(Yes, this is an old picture but it fits.)

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Wednesday, February 06, 2008

Snow Day

I am always reminded of that Simpson's episode. You know the one, where Bart get's his wish that school is cancelled by this huge snow storm so he can eke out this extra day to study for that test that, should he fail, will mean that he has to repeat the 4th grade.

Snow Day! The rest of the town gets to play in the snow, of course, and it is named "The Bestest Day of the Year" or something like that, by the mayor. Today, we were the rest of Springfield, except it was too damn blizzardy to actually go out and play in it. Charles and I did honestly try to get to work today but were stopped in the middle of the road, about 100m from our driveway, by drifts of snow that blocked the road that were half way up the car's windows. Turns out there are a few things that the shameful SUV can't get through, despite it's much touted 4 wheel drive.

Anyway, I've always wanted to live somewhere that got big-ass snow falls. Snow that was past your knees. So much snow in a day that you shouldn't (and couldn't) go anywhere but stay your house, strolling from window to window, mug in your hand, to see how much higher the snow has piled in the last 5 minutes.

I figured Wisconsin would provide this.

So far, it's had snow. Nice amounts. Just not a big-ass amount like the old timers talked up. Yet.

But finally, FINALLY, I got the dream. More snow than we could deal with.

The pictures speak for themselves:

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The front Door.

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The swamped front porch. (And, yes, the porch is raised so you have to step up onto it.)

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Molly wading up the walkway after forging off to that great white latrine in the yard.

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The (heh) driveway. Note the lack of a large pile of snow blocking it. (Don't confuse the drifts with snowplow-induced piles.) That would be because the highly touted Wisconsin plows have been absent THE ENTIRE DAY because it was just too much for them. Poor fragile plows.

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The road. Beaker's head (Remember Beaker? For those of you who were wondering, he's still there, patsy for the plows; but today, he was granted a stay of execution.) can be seen as the small dark green rectangle to the left of the road. Wave to him, as we doubt that he'll be seen for days after the plows finally do bury the rest of him with the feet of snow that are currently lying in the road. Poor Beaker, we knew him well.)

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The house. You can see where we had to excavate the garage door so an attempt could be made for Charles to get out again tomorrow. That is, if the plows have made an appearance. If not, it was a wasted effort.

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Guess there'll be enough for us to ski this weekend.

All in all, it was pretty cool, especially if you pushed the thought that if something happened to someone, there was nothing anyone could do. No ambulance could make it in, no car could make it out. I found myself cursing the lack of a stash of sutures and some good anesthetic. And a crash cart. My kingdom for a crash cart.

Best to just sit tight and drink tea and eat pumpkin bread and look at the snow. Which we did.

Sunday, February 03, 2008

Mid Life Crisis

I am an adulterer.

I'm not proud of it, but it is what it is.

See, for decades, basically since I was out of footie jammies, I've not been a lounge-around-in-a-robe sort of person. It's not that I don't own a robe. I own a perfectly fine robe. Its got flowers on it. Blue and maroon ones, if you will know, lined in a blue terry-cloth. It wraps around and ties with a tie and hangs to the mid-calf. I wear it when I'm ill or chilly of an early morning. A perfectly fine robe that, as it does fairly light duty as a garment, is only washed a few times a year and is only slightly rattier than the day it was bought, I'm guessing some 20 or more years ago. I'm pretty sure I got it to go to college, primarily for schlepping down the hall to and from the dorm showers, again of an early morning. So, as you can see, Faithful Flower Robe was set to go through life with me and would probably have attended me on my death bed, should I have died of an early morning, before a shower.

You can see where all this is going, of course. I'm led to believe that this is how most affairs occur. You truly aren't looking. Perhaps you've wondered about it, why others seem so enamored with their robes that they seem to seek out their company. They speak of whole days lounging around together, reading or watching romantic movies, sharing a carton of ice cream, falling asleep together on the couch. But not me. No. FFR was perfectly comfortable, if neither handsome nor sexy. Why jepordize a nice, stable relationship. I'm not that sort of person.

And then, there I was, of an early Friday afternoon, killing time while Lilian was doing her time in rehab (cardiac, not ilicit substances; what kind of folk do you think we are?), wandering around the town's Shopko, looking at this and that, and what do I spy? A table with these young, nubile, soft robes piled on top. On sale. Before I knew what I was doing, I was fondling them. Surely there won't be one in my size.

There were two.

Surely they must be flawed: Bad breath. Some odd ink stain on the front. Dry clean only. But no. Pretty, washable, no embarassing ink tattoos in visible places, and a cheap date at under $ 20. Before I knew it, I had chatted him up, plopped him in the cart, whisked him home, washed him (who knows whose grubby hands had been on him before I found him?) and, before dinner was even thought of, I was wrapped in his arms. And since then, I've looked for any excuse to curl up with him. Instead of a pair of jeans and a sweatshirt, when I come home, it's straight for him. He's had to be washed twice in two weeks after two unrelated food incidents marred his good looks, and he just gets softer. I find that wearing him over sweats just isn't nearly good enough and have taken to wearing shorts and a t-shirt in Wisconsin in January, so I can feel him snuggly 'round my arms and legs. If I lived alone, I'm sure I'd wear even less, channeling that wretched Brooke Shields / Calvin Klein ad from 20 years ago, "Nothing comes between me and my {obscenely soft robe}."

And the worst of this? Where have I installed Obscenely Soft Robe? In my closet, on the same hook as Faithful Flower Robe. FFR has to know about us, despite my tale of telling him that OSR and I are just friends and that I'm doing OSR a favor by spending time with him when I'd clearly rather be with FFR. I mean, they must talk, mustn't they? The sweaters on the facing shelf must also be aware, them and the shoes (such a clique-y bunch, the shoes) which means the rest of the closet knows. How can FFR hold his head up? I should do the right thing and just end it all, once and for all, with OSR, but here I am, on the couch, wrapped in his soft embrace and I know I'm not strong enough. Plus, I can't return him. I've lived in him for two weeks and I'm pretty sure I've (ahem) lost the reciept.

But there may be another side to this, which occurred to me as I saw them together this morning, sharing a hook, sleeve-by-sleeve. I wonder if OSR may possibly be sharing his affections when I'm not around.

If so, I don't want to know.

Pictures for you

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