Turkeys and Thanks

So it's Thanksgiving. And I know I have a LOT for which to be thankful. Texts and phone calls and Facebook messages have been pouring in all day to remind me of the friends and family far away who I miss desperately. This morning I started my day with the Village, as our coffee shop opened from 7-9 to accommodate us (they didn't expressly limit coffee to us, but we like to think we're the reason they opened today). Between Village Thanksgiving last weekend and coffee today, I can't help but feel especially thankful to be part of such an amazing group of friends that feel like family, particularly this time of year. I spoke to my sisters and was reminded of how wonderfully our relationship has grown this year. I am so thankful that's come along so well, and for continuing to know them better as well as my nieces and nephews. I got a text from my godson, who's all married now and headed into the Navy (I still think of him as a toddler, chasing a rabbit around the pine tree in my front yard). I heard from local friends that I adore. And I spent the meal in the community which has helped take such good care of my parents. And then I came home and hung out with the three best pets on the planet. Lucky and Maggie even snuggled up with my at nap time.

Of course I spent a good deal of quality time with my folks today. It's been a rough week for us; my dad fell, of course, and hasn't been feeling very well. Yesterday we were given the opportunity to move him to Assisted Living at the beginning of next month. It's probably greatly overdue for him, and frankly, I'm trying to get my mom in as well, because I think their quality of life would go up so dramatically. My mom especially is resistant, and I think my dad feels a little defeated. This stymies me a little. I think they're mourning the loss of their independence a bit, but I also think they have this idea that it's a nursing home, and it isn't. AL is just that - assistance. And the cold hard fact is that their limitations already exist. Not fun, no one is denying that. But frankly, if I could pay someone to cook me three meals a day and do my laundry and be on demand to meet all my needs, I might be all over that (this place has a SPA, for Pete's sake). And the particularly nice thing is that this AL is in the same building they already live, so my mom can visit all day if she wants. Plus they'll let Maggie visit. It's going to be expensive, but worth every penny, for my dad's comfort as well as my and my mother's peace of mind. Having said all that, it was a very difficult decision to make.

Today was lovely, though. I brought them coffee and breakfast, came home and put the finishing touches on a pie (I was recently reminded of how my grandmother used to make my mom a lemon meringue pie every Thanksgiving from when she was little because she didn't like pumpkin) and went back to share the meal with them. Dad was feeling pretty good today and we all managed to go down to the dining room to enjoy the festivities. It was really delightful. I stayed and visited a while after and then let them rest (and came home and took my own nap).  I'm about to head back over there to help my dad get tucked in for the night.

Post nap, I also started putting up my Christmas decorations today! My tree - which I bought last night - looks lovely. And I got all nostalgic pulling heirloom decorations out. I also found our stockings - I need to get another one for Olivia this year. And this year I have a much nicer mantle on which to hang them.

It's a nice little life I have.

Oops.

So I got a little distracted. My sister and niece and great-nephew were in town and we were trying to pack in the family time as much as we could. But I'm back. And so....

1. I'm obviously grateful for family. We had a wonderful visit and it was great to have them here. We covered a lot of ground in a short period of time.

2. I'm grateful for friends who feel like family. Last night was Village Thanksgiving, my favorite holiday of the year. We had so much fun. And have so much to be grateful for, as a group. I'm very blessed to have such a solid group of friends.

3. I'm grateful for fire pits, laundry room raves, and people with whom I can be myself (and more than a little silly).

4. I'm grateful for my gluten free life. I indulged last night - I figured it was the one night of the year I could give in and eat gluten - and boy did I pay for it today.

5. I'm grateful for Sunday night dinners and some quality time with my parents.

Eight

Today I'm grateful for....

1. Friends that feel like family. In fact, friends that feel more like siblings than my actual siblings, even though they're far away and I don't see them very often. 

2. That I'm getting to know my biological siblings. They came into my life late, but not a moment too soon. 

3. My dog. She's currently chasing her tail and cracking me the hell up. 

4. The opportunity to be a doctor, with all its responsibilities and privileges. It's an exhausting job some days, but it's still the best job ever. 

5. My bed. I have this really wonderful, very cozy TempurPedic.  People complain that they're a little warmer than traditional mattresses but I find this to be very soothing. I know it's only 7pm, but I may just go retreat to it right now...

Hail to the chief....and hold the hail

1. In case you missed it, I'm incredibly grateful that our president gets another term to do even half the things I think him capable of. And now the gloves are off, because there's no next term. Bring it.

2. I'm grateful to have the discerning sense to strive to be what I think (and don't argue with me on this, it's what *I* think) is an actual Christian. I.e., I try to be a good, accepting, compassionate person who is interested in humanity and tries not to repeat her mistakes when she inevitably makes them. Look, none of us have it "right" as far as religion is concerned. We just try our best to get through this life and make the world a little better than we found it. I identify myself as a Christian but it is only one tradition I draw from. And yeah, I learned that open-minded acceptance from Jesus.

3. I am grateful to live in a place where I can freely and without fear of prosecution say things like that. Especially as a woman. 

4. I am grateful to be living in the most connected age ever, where we can all express ourselves equally - even though that sometimes means I get in touch with what analysts would describe as my primitive homicidal rage. 

5. I am grateful that the mistakes of each generation do indeed fade like a radio station if you drive out of range.

I am also so grateful for my warm, dry, powered home tonight. Please, please keep those in the Northeast in your thoughts/prayers/vibes/mojo tonight as they batten down for yet another storm while still in the aftershocks of Sandy. It feels so unfair, and I'm holding hope for my friends up north tonight. 

Get out the vote (and then hide from it)

Today I am grateful to live in one heck of a great nation. Yes, we have our quirks and our pitfalls, but on the whole we're a caring lot. We're amazingly diverse and - although we still have a long way to go - relatively tolerant. I won't go so far to say we're the best country on Earth, because this is the only one I've lived in, and there are some other nations out there that do pretty well, too. But it's pretty good here, all things considered.

I am extremely grateful that I have the right and privilege of voting for those who govern me, and I sincerely thank the women before me that secured and protected that right.

I am so very grateful for the men and women who put their lives on the line every day to protect my rights. I don't always agree with the decisions we make with our military forces but I absolutely support those who serve.

I am grateful I got the chance to support the Wounded Warrior project a couple of weeks ago when I worked as a volunteer at the Tough Mudder Carolinas, a half marathon with 25 military-style obstacles which raises money for the WWP. A group of my crazy, badass friends ran the race and so, to support them I signed up to volunteer. I ended up working a lot harder than I'd anticipated, but had a lot of fun, too. It was great to be at the finish line when my friends came across. And WWP is a great charity.

I am also grateful today that I have the ability and sense of self preservation to insulate myself from the election tonight. Yes, that's right, I'm being a big chicken and avoiding anything to do with politics today. I can't handle the anxiety of it! The race is too close, and the way I see it, the outcomes potentially too dramatically different. So I'm off the grid - no Facebook, no CNN.com, no election returns on prime-time TV. I worked late, listened to my satellite radio music stations on the way home, and am now watching reruns of SVU on USA. If all else fails I'll go to the DVR. And tomorrow, I'll wake up, and with any luck...no, I don't want to jinx it. I did my civic duty (I voted last week, actually) and now am placing my faith in my fellow Americans to make good choices. Here's hoping.....!!!

V

Today I am grateful for...

1. The patients that place an inordinate amount of trust in me and let me into the most intimate corners of their lives.

2. Starting my morning with good friends and interesting conversations.

3. Coffee. Or as it were, coffeeeeeeeeee.

4. Mexican food and its heavy reliance on (gluten free) corn masa.

5. My very entertaining cats.

Days 3 and 4

Okay, so I was watching my friends' son last night and passed out on their couch when I'd intended to blog. So let's recap day 3. Which, frankly, was a rough day and I needed to express my gratitude more than ever, because let me tell you, it was hard.

1. I'm grateful for the innocence of a child, and for when they can retain that innocence appropriately long enough.

2. I'm grateful I still have some of that innocence and wonder in me.

3. I'm grateful I have a good shrink and that we've been able to do some hard work lately.

4. I'm grateful for good friends who trust me enough to leave their most precious possession in my care.

5. I'm grateful for the time I had to hang out with my mom this morning.

Day 4...

1. I'm grateful for the comfort of ritual and the flexibility to meet my individual needs.

2. I'm grateful for good friends and the repeated hilarity that comes with them.

3. I'm grateful for Sunday night pizza with the folks.

4. I'm grateful when I can listen to my body.

5. I'm grateful for the strength my body possesses and the moments I can acknowledge its attributes.

Day two

1. Oh, I'm so grateful it's Friday. (I'm pretty sure you'll see that one repeated this month...)

2. I'm grateful for good friends who can make menial errands into an adventure.

3. I'm grateful that this is the last week for a while I work five full days between my three jobs.

4. I'm grateful that, even if I'm still not making real doctor money, I'm making more than I was as a resident.

5. I'm grateful for Whole Foods Strawberry Piña Colada Popsicles.

A month of gratitude

So one of my friends on Facebook reminded me today about the trend over the last couple of years of posting things we have for which to be thankful every day in November - not just one. I'm a big fan of gratitude, and I think we (or at the very least, I) take too many things for granted. So I decided to take it to the blog, where I have a few more characters with which to work. I can't guarantee that I will, of course, but, ya know. 

I have a lot to be thankful for. More than one day can hold. More than a month can hold, honestly. But I forget that sometimes. So I'm going to start off with five things today. 

And as I was typing the above, it also occurred to me that November is NaBloPoMo - National Blog Posting Month. The thing that got me started to begin with, with the daily blogging that I miss so much. So I'm all signed up. Let's get this party started. 

Day 1:

1. I am grateful to be alive. To have my house, my job, my pets, my family all intact after Hurricane Sandy. It was a non-event in North Carolina, fortunately. We lost power for a whopping hour. We got a little rain and a little wind. 

2. I am incredibly grateful that my friends up north also survived the storm. Barb came through with class and cake, fortunately. Buie wasn't so lucky. She lives on the water and ended up having to swim for her life in the middle of the night to the rescue boats. She lost everything material, but she, and her dogs, are safe and sound. Her siblings and their families are also safe. As bad as things are, I can't even imagine the alternative. Prayers, good mojo, positive energies - whatever your thing, send some her way, would you?  

3. I am grateful it's Friday eve. Today was one hell of a long day at work. 

4. I am grateful to have had the unexpected time I've had with my dad. He's still going reasonably strong. We'll take every day we're given. 

5. I am grateful for the love of a good dog - again. I was unexpectedly reminded today of my old boy Wolfie, whom I had to put down ten years ago next month. He was a special, special dog. With some special needs - unbeknownst to me, we think he had metastatic cancer when I got him, and he spent the next twelve months having seizures, needing medicine, and with a horrible bilateral ear infection he couldn't shake. Poor buddy was probably miserable, but never showed it. He was sweet and protective and just the best dog a girl could hope for. And I think he sent me Maggie. Who continues the tradition of being the best dog ever. 

NPH saves the day. Again.

I came across this today posted at Just Like Doogie Howser...Only Different, a blog I discovered from the NaBloPoMo '08 Blogroll.

Prop 8 - The Musical.

See more Jack Black videos at Funny or Die

(Click here if it won't load.)

I so incredibly love it. It's got Jesus! Shrimp cocktail! Jazz hands! And Neil Patrick Harris! What's NOT to love?!

Not to mention, an outpouring of support for equality and justice from the members of Hollywood's upper eschelon. How many stars can you name?

(Still pissed that Prop 8 passed? You should be. Click here to sign the Petition to Protect Children and Prohibit Divorce.)

(No, no one really wants to ban divorce. It makes a point. Here, watch this.)

What that "MD" really means...

So, this morning, I'm driving to the Target (again) in the cold nasty raininess, and I was thinking, you know, my blog posts of late have so often been just a chronicle of my day. Nobody cares, dude. I should really have a topic today...

Uh, thanks, Dad, but that wasn't entirely what I was going for.

There are upsides and down sides that come with being a good doctor. Or being a doctor, period. One of them is that you become a nightmare for your family's doctors.

Okay, maybe I'm not a nightmare, but only because I work at being more reasonable. And I'm not sure how often I succeed...

So my father calls me this morning. No, wait, let me back this story up even further. I call home Thursday night, and my mother answers the phone, and the reception is terrible. I assume it's me, so I'm wandering all over the house, and it doesn't get better. Meanwhile, she's being all evasive. I finally get tired of piecing together words and phrases across the cell phones (it's cheaper to talk cell-to-cell under our family plan) and was like, forget it, I'll call you on the house phone.

There's a pause. She finally says, "Uh...we're not home."

Oh, okay, so they went out. On....Thanksgiving...but, okay....I ask where they are, and there's another pause, and she tells me they're at the little community hospital by their house. At which point my stomach curls up into a cold little leaden ball. Because my dad always goes back to the hospital where I went to medical school when he's sick. The little community place by them is actually pretty good, but all his doctors are at my med school, it's a tertiary care center, they know him well, etc, etc...the only time my dad goes to the local place is when he goes by ambulance.

Or, it turns out, when he does something dumb that doesn't actually require the hour-long drive to the tertiary care center.

So my father - older, on steroids for his COPD - is coming down the stairs on Thursday carrying something, and whacks his hand on the side post. Which tears a three-inch flap of skin off the back of his hand. What does my dad do? Smooths the flap BACK OVER THE EXPOSED TENDONS and goes about his day (Daddy, I love you, but these are the times I wish I still lived close enough to smack you upside the head). So, finally, at some point later (as the story was told to me....I suspect my mother's influence in this turn of events), he decides, you know, maybe someone who isn't me should look at that. Two hours, several stitches, and one bottle of PO antibiotics later, all is well, and my still-completely-nonplussed father can't understand why I'm all exasperated that it took him so long to go to the hospital.

So this morning, I get up early (all I was doing was lying around coughing anyway), and trek out into the cold and rainy with the goal of beating all the other people to the Target (and also of buying an area rug for the front room). I get out of the receptionless Big Box Dead Zone and I have this voicemail from my folks. At 8:00 my time. And I'm all, why on earth did they think it was a good idea to call me that early...and then I hear my father's tone of voice. And I get this far through the message - "Hi, Kate. It's us. I woke up this morning and my right knee's really sore-"

Which is when I hung up and called home to tell him to get his ass to the hospital. Right about the time the paramedics were arriving.

And so there's all this fuss which ends with my dad in a private ambulance on the way to my medical school and the Fire Department medics telling the contract service, "His daughter's a doctor in North Carolina, so if he gives you any trouble, call her and she'll yell at him."

I...um...if it weren't true....

So what do *I* do? I pick up the phone, call my med school hospital, and have the Ortho resident on call paged. Because that's the logical option, right? An gosh, it was just such a characteristic exchange.

I called the operator, right? Asked if she could page the ortho resident on call. I gave the story, the patient's name, date of birth. She asks for a callback number. Was I calling about a transfer? No. And the she asks what my name is.

I gave the usual last name, but I gave my first name as "Doctor."

Because I know if I see "Dr. Smith 888-555-1212" on my pager it means whole other things to me than some random name with an out of state number. So this little intern gets on the line, all full of attitude and already exhausted at 9am (don't worry, hon, I remember what it was like to be a surgical intern). I an hear the OR monitors beeping in the background. I had a small moment of, ohhh, maybe I shouldn't have called. But I held my ground.

I told her my name and that I was a physician out of state

(get it out there right up front. Both a demand and an apology)

and that my dad was a patient of Dr. H's who'd had bilateral TKAs in the past

(so, yeah, I speak your language)

and now has an open wound on his hand and woke up with severe pain in his knee this morning.

(which, I expect you to know what I'm angling at, here. You'd better be on your game)

I give her a little more, remind her that I'm out of state and haven't looked at the knee, but according to my mother there's a one-inch area of redness. So, should I send him to her or should I have him go to the nearest ER to get antibiotics started as quickly as possible?

She's like, well, I can't tell you over the phone what's wrong.

(No shit, kiddo.)

We fumble with this for a minute. I throw in things like, well, you know, I admit I haven't done any ortho

(although my advisor in medical school was an orthopedic. For four years. I did several dozen knee and hip replacements with him)

in like five years

(I've been a doctor longer than you have)
(For those of you playing along at home, this does not make me right, but it gives me seniority. Which is everything in the surgical world)

but my memory is that it's pretty imperative to start antibiotics as soon as possible if there's any question of infection at a prosthetic joint.

(my hackles are up. I'm not showing my teeth yet, but, don't fuck with me)

She says, is it swollen? An inch of redness doesn't make it a septic joint. But he's welcome to come to us if they want to drive out here.

(so, an equal display of, you don't scare me)

I say, they're headed to one ER or the other. In an ambulance.

(a low little growl)

She says something about not being able to judge it over the phone. I say, "okay, so the question is..."

(I haven't told her what specialty I practice yet, but "what is the question?" is something that consultants use a lot. Which actually doesn't narrow the field down much, but establishes that I'm someone that other doctors routinely ask for help. The fact that *I* posed that phrase to *her* - the actual consultant in this scenario - is a total display of power. Power that I don't have - 850 miles away. Family member, not a treating physician. Psychiatrist, not an orthopedist - but it works. She rolls over)

Well, she says, yeah, I mean, tell him to come in to our ER,

(as in, don't expect me to be down there waiting for him. She hasn't rolled over completely)

the ER doors are always open.

(but I've flustered her and established the upper hand)

And, then we can consult Dr. H's team as soon as we know what's wrong, and his records are here, and yeah, you know, it's just hard to know over the phone.

I say, tell me about it.

(I know I'm being a pain in the ass)

She says, yeah, and it's hard because it's your dad.

(I understand. I'm just as much of a pain in the ass when it's my family)

We hung up, I called my mom back and told her they were aware he was coming in.

Amazing how much goes on between the lines, though, isn't it? And that's the Cliffs Notes version.

At so many points in that exchange could I have gone off on her (Listen, newbie, my 77 year old father, who's on steroids, and has two prosthetic knees, and has now failed PO Keflex and likely has a festering infection in his joint, he's coming to you, so don't fuck it up, because if he loses his joint who do you think I'm going to come after?) but...that's just counterproductive. I'm not all that interested in the politics of it, and if he's going to lose the joint he's going to lose the joint. Plus, I actually was asking for her advice about whether or not delaying treatment by an hour would make enough of a difference to warrant going to an outside facility with fewer resources. This is not about my ego, my power trip, or my need to defend myself from narcissistic injury.

But so often, with medical family members, it is. Because they're worked up and scared and trying to fall back on their favorite defense mechanism - intellectualization - and it's failing them, because they're not in the driver's seat. And in general, doctors really like driving the bus. So some can get pretty nasty when you tell, say, an oncologist that the appropriate treatment for his psychotic daughter is not what he thinks it is.

And a lot of times, a little bit of knowledge is a dangerous thing. See above re: oncologist. If we're talking about a patient, and that rational distance is there, it can go very differently. Quite often, when my patients are getting what I think is not substandard care (or maybe just a little substandard) from another specialist, but not necessarily what I'd do, I'm willing to throw up my hands and say, well, if you don't tell me how to practice psychiatry, and I don't tell you how to practice nephrology, eh, the patient will probably be just fine on both fronts.

(I'm very protective of my patients, though, so while I may not challenge them directly, you can be damn sure I'm keeping an eye on things.)

However, when you lose that detachment, maintaining that same perspective becomes almost impossible. We make pains of ourselves at best; at worst, we get in the way.

What's a doctor to do except know that about themselves? I try hard to be nice, to listen and learn, to be respectful even when I'm getting attitude, and try to be really appreciative when my family's doctors take the time to speak my language. And when I'm on the other side of it, I try really, really hard to be thoughtful and accommodating and understanding and empathic.

So if you're wondering how this story ends, they admitted him, but so far everything looks okay. They tapped his knee (sounds better than "stuck a long needle in it and drew out fluid", doesn't it?) and found more inflammatory cells than they'd expect, but no frank bacteria. So right now we're on the watch-and-wait program. His ortho's going to see him in the morning. We'll see what the big boss thinks.

And, the resident I talked to swears to my parents that I didn't offend her at all when I called. So, maybe I'm doing a decent job of staying on my chain after all.

Have a couple of drinks and quit discriminating

This has been a Luda Service Announcement.

(The new Ludacris album dropped on Tuesday, I picked it up this morning. It's ridiculous how much I love this song.)

Today was slightly more productive. I actually got a fair amount of stuff done around the house today, even if I didn't get everything done I wanted to, or didn't wake up until 10:30. Sparrow and Peng helped me move some stuff into the attic, so the house looks a little less cluttered. I still haven't figured out the best use of the space yet. But I really need to get this stuff organized and freakin' move in. I mean, I've only lived here five months...

It's rough being neurotic sometimes.

I understand why I never really unpacked in at the old place - I never actually believed that they weren't going to fire me. Not because anything at the program indicated that they were going to fire me, but, because life at the Emerald Palace was so tenuous, and they clearly never intended to let me get to second year.

But now, here I am, in a whole new year, and a whole new house, and I really don't think I'm going to get fired. Yet, I'm still surrounded by boxes, have no seating, and can't get my shit together to actually unpack and find places for my stuff in the new house. Now, though, now I think it's just because I'm crazy. Not to mention perpetually exhausted.

Urg.

Lazy Sunday

I keep forgetting it isn't actually Sunday....and I still have two whole days off! I think every weekend should be a four day weekend...

Maybe I don't, actually. Because even though it was only three days long, this work week stunk for almost everyone I know.

Today I did next to nothing, which is very different from what I had planned, which was far from nothing. I slept until noon, then finally got out of bed at 1 (well, I was postcall yesterday, and had only slept two hours on Wednesday night, and then was up all day yesterday, and let's face it, I haven't slept well all week...). Maggie and I went to the Petsmart, went for some dog food and a new retractable leash (the old one died. I mean, I've only had it for five years...), and a PediPaws. I think this may be in the same league as the Furminator, y'all. It's a little rotating drum of sandpaper and so it files your dog's nails down, rather than cutting them. Maggie actually tolerated it really well, and she NEVER lets me cut her nails, so they're always like a mile and a half long and she keeps going clickity-clickity-clickity on the wood floors.

We also got a few "wow am I tired oh look isn't that cute!!" purchases....

One was a puppy Kong. Maggie's never been a fan of the Kong, but so many of our friends' dogs swear by them, that I keep trying. And Maggie's been doing some weird things lately when I'm gone, digging through the trash, chewing up non-food things, that kind of stuff, which tells me that she might be getting a little anxious and/or bored. And we already know how guilty I feel leaving her at home at all, much less as much as I do these days. So we're looking at Kongs in the store today, and they have new ones for puppies that have teething rubber. Which, I've long thought that the regular Kongs hurt her teeth, so, I thought, hmm...let me tell you, she loved it. I threw some treats in there, she spent hours playing with that thing. We may have success after all...

We also got...I'm such a bad owner....matching little reindeer coats for her and Little Maxine. With antlers that light up. Ohmigosh if it isn't the cutest thing ever.

We went over to Sparrow's for dinner tonight, and oh, look at the cuteness...



I'm hoping for Christmas card cuteness before the month is out, but neither of them was exactly thrilled with the outfits, so, we didn't quite get the photo op I was hoping for. But, we'll keep trying.

Meanwhile, Little Maxine got back at Maggie for stealing her bed on election night...

Oh, the cuteness...

Anyway. That's about the extent of my productivity today.

I stopped at the Panera on the way home from Petsmart for soup (they were out of bread bowls, I was sad), and then did a whole lot of nothing until we went to Sparrow's. Well, that's not true. Look what I started:


It's two toes. At the same time. On one big ol' Addi Lace. And so far I haven't even knitted them together once. The yarn is this Koigu KPPPM that Jenn sent me for surviving my intern year. Mmm, it's yummy. And I really like the way it's knitting up. I just have to pick a stitch for it - I've gotten really bored with plain old stockinette socks, but, I can't do anything too complicated if I'm going to knit in lecture, which is really my prime knitting time all week...

OMG, what-ever!

Ahhh...it's nice to not be the only nation with a bumbling, idiotic leader who spends so much time with his foot in his mouth he has Athlete's Tongue...

But then, also on CNN.com today, the same world power proves that there are some areas in which same-sex couples cannot ever expect total equality - or rather, it cannot be expected of them.

(The last line of the above article also makes me wonder a little what kind of snake charmer is selling the Japanese their polar bears.)

The US for so long has been the world's petulant adolescent, Japan one of the wise elders. Sometimes the generations really do have a lot in common. Next thing you know they're going to be text messaging all night and...wait, I think they're already responsible for the Wii...

Happy Turkey Day, y'all.

I'm finishing up the end of my call night and so looking forward to the four day weekend. There's a big fat nap in my future (assuming I can stop coughing long enough) and then I'm off to my aunt and uncle's for a lovely evening of tryptophan and that silly jellied cranberry sauce (love that stuff). Hopefully I'll have something more productive to say for today after I've slept...

The Lion Tamer

Life on Life's terms

It's an old AA mantra. I'm trying to hang on to it today. Not that I've ever been in AA, but, I think it's useful.

Here's my day.

I woke up at 4:45 this morning, after a restless night of coughing and choking and fussing. I putz for a bit, decide I'm going to go to the Starbucks for breakfast, because I have a little time and a distinct absence of clean dishes, and it's not that far. And so I'm headed down the road, at like 6 am, and I pull off of one highway to another, and there's this woman, standing in the road, in a dress and a coat and heels. She looks a little wobbly. I can't tell if she's trying to summon help or hitchhike. In an uncharacteristic display of good judgment, I resist my urge to save the whole world and do not stop. Instead, like a responsible citizen, I call 911 from my cell phone. And talk to the world's stupidest dispatcher.

I say, there's a woman standing in the road where Road X N pulls on to Road Y E. He asks me six questions about if she's "in" the road, or off to the side of the road, or near the road. I tell him she's in the outside part of the lane. He says, is this the on ramp or the off ramp? I tell him - for the fifth time (no kidding) - that it's coming OFF of Road X and ON to Road Y, so, well, whatever that means to you. He asks for a description. I tell her she's a tall, slender Hispanic woman in a green dress and a brown coat, and heels. He - I could not make this up if I wanted to - asks me what color her heels are. I said red. I honestly have no idea, but it seemed like the quickest solution, and, well, I doubt the officers were going to get out there and be like, oh, sorry, we were looking for someone in red heels, couldn't be you! He asks me if she looks intoxicated. I said she looks unsteady, but it's 40 degrees out and she's standing in the roadway in heels, that could make a girl wobble. He finally dispatched a car. I hung up and rolled my eyes extra hard.

(Angie, you think maybe we could trade him into your department, you could come here? Clearly we need some competence...)

So I get to work, and I have an early therapy patient on Tuesdays. Who asked me if he was losing his mind because he pulled kind of a bonehead move the other day. I told him no (45 minutes later. 'Cause at that point in the day I was still a good therapist), and neglected to mention the three times in the past two weeks I have walked up to other silver Jeeps and wondered why my key won't work in the door.

We had one patient in the child clinic, who didn't show. I tried to dictate all my notes from yesterday, made it through two before the coughing fits rendered that a bad idea. My afternoon clinic was fine, everyone was doing well.

For the first time in my recorded history, I batted 1.000 this week - every patient I had scheduled showed up except one who cancelled well in advance. I guess we're not truly there yet, until the two therapy patients I have tomorrow afternoon come, but I think they will. And wow, let me tell you, I was hoping for some no-shows yesterday...although, good for them.

So, I'm getting my afternoon clinic squared away, and....within ten minutes of each other, both of my therapy kids crashed. Boom. One of them did so in the office (fortunately, he was seeing his med doc today, not me). I know with these kids an hour a week is like giving them a bucket on the Titanic, but, still. In my self-indulgent, PMS-y (yes, still), immune compromised, underslept moments of self-pity, I feel like just the worst therapist ever. Cognitively, I know this to not be true, but, as one of Sparrow's patient's pointed out recently, thinking and feeling are not the same thing.

And I feel pretty bad about it.

And then, of course, I made another trip to the Starbucks (it was coffee or dinner, as it often is. And as always happens, coffee won. At least it wasn't the same Starbucks as this morning) and ran off to class. Which was long. And, um...I couldn't actually remember anything I'd read in my febrile delirium over the weekend. Lovely.

I just need to go hide in my bed....

Presents.

I came home tonight, and had a padded mailer in my mailbox, and a big Express Mail box on my doorstep. I was excited. The mailer, it turns out, was....odd. It was a book of "poetry" from the Center for the Advancement of Psychotherapy (sketch). They, of course, included a handy postcard telling me where I could mail a donation for the lovely gift they had just sent (even more sketch). The other, however, was from my aunt and uncle (the biological ones) in Chicago, and it was awesome. They sent me the 32-page Commemorative Edition of the Sun-Times Sunday magazine from November 9, entitled, "Obama: A Walk Through History."

Sometimes....my family makes me so proud....

It's funny, actually. My aunt and uncle (my mother's brother) have always been staunch Democrats. My cousins are both ardent Republicans (this makes no sense to me...my older cousin plays bass in a metal band....how can he possibly be a Republican? I think those two are mutually exclusive...). My parents are vehement Republicans (my daddy was not allowed to play with Democrats when he was little, because they were not nice people, according to my grandfather). And you ALL know what a flaming liberal tree-hugger I am. So I think my aunt and uncle are just glad one of us kids turned out to have some political sense.

They also sent me a Target gift card and a very nice card regarding the fellowship I was recently awarded through the PECC (it's a scholarship, really. They call it a fellowship because it sounds snootier). And you know how I always love me an excuse to go to Target.

The appearance of gifts made me slightly anxious, though, because I thought one of them might be from my Secret Santa - my knitting buddies back home are doing a holiday gift exchange, and I got to play along, too. Which was all well and good until this morning, when I realized that the socks I'm knitting for said exchange...um...don't match. And, okay, they're supposed to not match, but not in the way that they currently don't match. And apparently they're due next Friday, i.e., they have to be in Illinois by next Friday. Crap.

Also, a few days ago, my cousin (different cousin. Obama supporter) gave me the Aloha Award on her blog. Here are the rules:

"First, answer this question...If you were stuck on an island, what 5 things would you want to have with you? Then, spread the Aloha! Send this award to 5 other people and let them know they've been given The Aloha Award! That's it, easy peasy! Keep the chain going and spread the aloha all over the blogospshere! (be sure to link to the person that sent you the award...so we can keep the linky love going!)"

(Not Danielle's words, I'm guessing)

(PS - there will be no linky love allowed on my island of stuckness. Stop that! Stop that right now!)

Ahem.

Alright, if I were stuck on an island and given my choice of five things, I would take...

1. My dog. Not only would she be an wonderful companion, and enjoy running off leash (I'm assuming it's a relatively small island. Where's she gonna go?), but if I can learn to spin between now and the time I get stuck on this island, she could be an excellent source of yarn fiber.

2. A laptop with a solid satellite wireless connection (hey, it's my island, back off!)

3. Sunscreen. A lot of sunscreen. Don't make me tell you the story of the last sunburn I sustained in Hawaii.

4. A really good set of knives.

5. Phosphorus matches. Because, I am not patient enough to do the whole flint and steel crap.

And I tag....

Barb
Peng
Angie
Jenn
Allison

Pomaika`i, hoapili.
(Good luck, friends)
(I hope that's what it means...)

Two ex-wives away from being a country song.

Seriously. Here's my day...

10:30am - wake up, for real, after waking up every 90 minutes to cough self into a fit of gagging, hacking, kak-kak-kak-ness, and probably a few times in between.

10:31 - wonder what the heck was wrong with my head last night, because entire night was categorized by epic, disorganized, really bizarre dreams. When I woke up, I'd been dreaming about (I'm so not kidding) flesh-eating bacteria that wrote boy-band lyrics through these kids in a cult that burned down my church (the cult, not the kids specifically). The kids were coming to my clinic, which seemed to be some sort of OB-Psych-ER hybrid, and one of them was living with me. Possibly in the hospital. Along with four dogs from the cult. I could not make this up if I tried.

10:33 - wonder what Freud would say.

10:35 - shower. Sometimes known as steam cleaning. This allows for penetration of the thick layer of concrete-like goo firmly sealing my eyelids shut and a small amount of air to pass through my sinuses for maybe 45 seconds, until they clog up again.

11:00 - execute decision that, while I can still see and possible even breathe a little, I'm going to go to Starbucks and the grocery. And then play it from there...

11:02 - turn key in ignition. Car makes odd clicking sound that is remarkably similar to above-mentioned kak-kak-kak-ing.

11:03 - wonder if I should call Sparrow for a jump. Notice that Juan's truck is parked in the driveway; wonder how to say "jump start" in Spanish.

11:23 - note that when I let the key rest, the radio, blowers, and interior lights come on. Note the presence of 3/4 tank of gas. Decide it can't possibly be the battery.

11:24 - call my dad (because, really, what do you do in these situations, except call your dad who is 850 miles away and say, "No, here, listen to this," and hold up the phone while you try to turn the engine over). Dad says it's probably the battery. Make him listen to the engine again and tell him it isn't the battery, because the lights work (will later tell him that dying batteries make a progressively slowing "ruh-ruh-ruh" sound, not a "click-click-click" sound). Become frustrated that my father - who's an engineer, not a mechanic - can't diagnose and/or fix the problem over the phone, from 850 miles away.

11:27 - Call AAA.

11:28 - sit down on the ladder that we've lain behind the gate of the fence because Little Maxine was trying to dig out there. Pet Maggie, who's outside all like, "what's wrong with the big noisy silver thing?"

11:34 - finally get through to AAA. Because circumvented the "if you aren't in the state of Illinois, press 2", and called the Illinois operator. She is very helpful. She transfers me to the NC operator, who, not so much helpful. She asks what service I need, and I say, probably a tow, because the woman in IL said I'm probably going to need a tow. She yells at me when I don't know where I want it towed (how is "wherever's closest" not an answer?). Does not understand how the name of the cross street is "like the holiday" (i.e., "it's the corner of Main and Christmas." "Christmas with a K or a C?" "C. You know, like the holiday." "What??" "The holiday. In December." "Ma'am, is that with a K or a C?"). Cannot comprehend how I don't yet want to commit to wanting a rental car until I find out what's wrong with mine. Get very annoyed, which is not helped by

11:34:30 - Maggie decides to make a break for it (chase me! It'll be fun! You'll feel better! Wheee! It's an adventure!!).

11:46 - devil dogs across the street scare Maggie. She darts back to hide behind me. I smack her on the tucas (so very hard I'm not sure she knew it was a smack) and stick her back in the house.

11:48 - start making eggs, because, obviously not going to get breakfast at Starbucks. Call parents to whine report in.

12:03 pm - yell at poor unsuspecting mother when she suggests I call someone local for advice on where to tow my car. Because I can't yell at the AAA lady, she's not required to love me. And I'm sick, and stuck, and my dog ran away, and my car died, and I forgot to put cheese on my eggs. And I woke up dreaming about pop-song-composing flesh-eating bacteria.

12:06 - tow guy comes. Tells me he can't service my car through AAA because my tags are expired.

12:07 - remind myself not to cry in front of the tow guy.

12:07:15 - tow guy says, "Well, let me see what's wrong with it first..."

12:07:45 - tow guy turns key in ignition. Car goes, "click click click".

12:09 - tow guy hooks this thing called a "power pak" up to my battery.

12:09:10 - car starts right up.

12:09:11 - resist urge to hug the tow guy.

12:10 - tow guy suggests it's time for a new battery. Ask tow guy where good place is to get battery. Tow guy suggests his service station.

12:15 - lock house, lock dog in crate, head to Starbucks with stated intention of charging alternator.

12:22 - make jubilant phone call to parents. Give dad satisfaction of being right, over the phone, 850 miles away. Apologize to mom.

12:40 - tea. Scone. Better.

1:05 - pull in to tow guy's service station. Walk in and announce I need a battery. Get blank looks from guys behind the desk. Weird but seemingly nice black guy who always offers to help my inflate my tires despite me crouched in front of the tire with the air hose in one hand and a tire gauge in the other and obviously knowing how to inflate my own tires (turns out I go to tow guy's service station a lot) pulls out $7000 voltmeter (I told him they were like $12 at Radio Shack). Confirms that I need a new battery.

After that, my day got better. I sat in the service station for a while, wishing I'd brought my knitting, sending long rambling texts to Claudia and watching this thing on MTV about the top ten over-the-top Sweet 16 parties of the rich and overprivileged. Which I then spent a good deal of time discussing with the mechanics. Tow guy showed up with subs from Jersey Mike's (a local chain, which is allegedly very good) and offered me part of his sandwich. Twice (I love North Carolina...). They hooked me up with a shiny new battery and a new little bulb for my license plate light (which is what actually got me pulled over the other night, and needs to be fixed anyway before I can pass my state inspection). I then motored over to Whole Foods, where I spent a ridiculous amount of money on...well, what, I'm not certain. I got small little tokens of affection for Sparrow, JD, and Cleo for their help in not making me take yesterday's call (I also bought a little bundle of flowers for JD's wife, whose tolerance was key to this operation). I got wine and chocolate to take to my aunt and uncle's for Thanksgiving (I'm also charged with getting the crescent rolls that come in a tube). I got a lot of random other things, which, frankly...I'm no longer allowed to shop post-call (except I still do), and so now I'm not allowed to shop when I'm sick...maybe I should just never be allowed to shop again...

After that I ran some things over to my office, and then stopped by Sparrow's and had a very nice cup of tea. She also gave me some leftover rock star garlic chicken that Rene had left for me, because she also rocks (she called earlier and was like, hey, I'm stopping by with leftover chicken, because I know you don't want to cook...I, unfortunately, was in search of a battery...) Little Maxine was all snuggled up parrot-style on my shoulder, so Sparrow was like, do you want to take her home? I'm going to be out all evening, I can pick her up on the way home...so now there's a teeny-weeny Maxine-y (Maxinie?) sitting at my feet and whimpering to be played with. Maggie's tossing around her stuffed alligator in the living room.

Is it weird that I can identify dog toys by their squeak at this point?

I'm feeling a little better today. Don't seem to have a fever, or at least much of one. I'm still doubting my ability to get a good night's sleep tonight, but, we'll see. And then...it's funny, I've been all stressed out about next week, right, because my Monday and Tuesday clinics are just packed to the gill....except...um...then that's it. If I wasn't on call Wednesday night (and hadn't thus scheduled a patient for the afternoon), I'd pretty much have a five day weekend, because I don't typically see patients on Wednesdays, and our lectures are cancelled. Uh, I think I'll be fine.

Guess I'd better go throw an alligator, snuggle the little one, and think about dinner....

Admitting defeat

Damn stupid virus.

So, last night, right, Sparrow and I had left it that I would go in for call this morning, insisting of course that I was fine, and then Cleo (who was on call last night) would assess me, and if she felt I lacked capacity to make the decision about taking call (sorry, shrink joke), she'd send me home and Sparrow would pinch hit, at least for the day shift. But, of course, I would be fine.

Ah, it was a good plan...

So I got all, like, I'm going to bed. I'm going to be well-rested and fine tomorrow. Ahh, bed. Except...once I laid down...I couldn't breathe. No, really. My nose was dripping, my sinuses were full of concrete, and every time I relaxed enough to get to sleep I'd shut my mouth and then start suffocating. Which was between the times I started choking and coughing as I kept drowning in my own secretions. Ugh, it was awful.

So I finally gave up around 12:30 and decided to do something about it. I put on some passable clothing, climbed into my car, and headed for the Walgreens.

::sigh:: I hadn't even made it past the hospital before I got pulled over.

Okay, fine, so my tags are expired. Because in Illinois, they send you a letter reminding you that your plates are about to expire. In North Carolina, they send you a letter reminding you that, hey darlin', your tags expired two months ago and you should really get that fixed.

How was I supposed to know?

Fortunately, Officer Friendly was "feelin' the holidays" and took pity on my snotty, pathetic, transplanted self. So I went to Walgreens, bought cough syrup, and Afrin, and nose strips, and saline spray. And wound up continuing to cough and drip and drown all night. Except I couldn't swallow, because my throat was so sore from the Afrin. And I was sweating and tossing and turning and, oh, yech, it was a terrible night.

This morning, when my alarm went off at 6:30, there was just no way I was going to be of use to anybody today. And, my temp was still 102. So Sparrow took the first half of my shift (did I mention she was a goddess?) and JD took the overnight (he is also fabulous, although - to his relief, I'm sure - not a goddess). Ohh, thank God.

Although...I can't even begin to tell you how guilty I feel. I know, I know, stupid, unwarranted (ahem, 102) - and not that I won't pay back the time - but there nonetheless.

So, Maggie and I sat around most of the day trying to nap (she was a lot more successful at that than I) and watching TV. The unfortunate part of that is, while Thursday and yesterday I had a lot of good stuff accumulated on the DVR...today, the TV was crappy.

Which did not stop me from watching it. Despite all the interspersed commercials about how part of a healthy lifestyle is limiting TV to two hours per day or less (ha!). And my increasing guilt about what a disaster the house is (because I haven't really moved in. For a whole bunch of ridiculous neurotic reasons and a couple of moderately reasonable ones - like I have too much stuff and a significant paucity of time). But I'm siiiiiiiiiiick....

I watched a documentary on the Jonestown tragedy (which was 30 years ago this week) on the History Channel. I watched a terrible Lifetime movie. I watched a couple of episodes of Scrubs, and M*A*S*H, and the Cosby Show. I forgot how much I used to want to be Claire Huxtable...

I watched a show on Freebirthing on Discovery Health that was...well, interesting. My cousin blogged about this (and the show I watched after it) earlier in the week, and I was intrigued. Hmm. As a former deliverer of babies, I cannot in any way condone what they're doing. Cannot condone no prenatal care (a drug store BP cuff and a fetoscope? Come on). Cannot condone knowing that you may have something wrong that could easily kill you and your baby in minutes and not getting it checked out. Cannot condone such over the top disregard of what we've learned over the past several thousand years.

There was this one woman I just wanted to slap (the one with the drugstore prenatal care and the possible low-lying placenta. Minutes). She was going on and on about how horrible her first birth was and, you know, if she'd only known how risky the interventions were that they were doing (minutes!! Bloody! Horrible! Traumatic! Well before your husband would even call EMS!). Please. Because a shoulder dystocia or a cord accident without the benefit of a trained attendant, yeah, that's not risky. She also ranted about how, at her first delivery, the doctors kept yelling at her that she wasn't pushing right. And she didn't know "what the big deal was, because, you know, it only took like ten minutes."

That's when I started yelling (well, rasping) at the TV.

Okay, now, I concede that I haven't delivered as many babies as she - oh, no, wait, I probably have a couple hundred on her. And I can tell you, when we start saying things like that in a situation like she described, it's because the baby's in trouble.

Which is the PERFECT indication to have a baby far away from any medical care. Idiot. Shouldn't be allowed to breed.

Ahem.

But on the other side of it...you know, I don't support unattended births. I don't even really support home births, because they scare me. I concede that women have been doing this for thousands of years. I absolutely concede that more births around the world occur outside of the Western medical setting than not. But I also would point out how many fewer moms and/or babies die in childbirth or have poor delivery outcomes in the Western world than in the third word or developing nations. But by the same token, I don't either entirely support the medical, institutionalized birth. I've said this before on here, that I dislike the assembly line, everyone gets an epidural at 4 cm, everyone delivers in lithotomy kind of birth, which we do because it makes us feel as practitioners like we're more in control of a chaotic process. But the truth is, I think it often leaves us less in control. I got in so much trouble for deviating from that standardized delivery, but I really felt like everyone was better for it, including me. As I told my patients time after time, my philosophy was this: look, it's your birth, your body, and your baby; I'm just here to keep everybody safe. So, within reason, we'll do this however you want it. Which involved any number of things, even in my short career - backrubs, perineal massage, mineral oil, olive oil, music, Wiccan sand circles, I delivered babies with their moms in pretty much any position they could come up with, and once or twice I was more or less on my back.

Interesting, isn't it, that as much as they complained about my "avoiding" the OR, the only time they commented on how I jumped in on the labor deck was to tell me I was somehow doing it wrong...

Anyhow. The bigger point is, I loved labor and delivery.

So there was this woman on the Freebirthing show who had this completely amazing delivery. It was a water birth (one thing I haven't done, partly because we didn't have the facilities, partly because it yicks me out), and wow, it was so peaceful. There was no screaming and raving and wailing. She just let things happen, accepted them as they came. She claimed it was more or less pain-free, which, I think that depends on your definition of "pain-free" (i.e., I've seen plenty of women control a reasonable level of labor pain with meditation and self-hypnosis). But it was just entrancing to watch. She was nearly silent through the whole thing. And her baby came out, sweet, beautiful, and didn't cry. I, of course, got worried, and apparently she did too, but the kid was breathing just fine. I guess he just didn't have a lot to say. She interpreted this as him being "relaxed", and I'm not sure I disagree with that. The whole thing was completely beautiful. The only thing I would've done differently (aside from being somewhere less than 500 feet from a functional OR) is that her husband didn't touch her the whole time, apparently to protect himself from some British law regarding unlicensed attendants at a birth. Which is sort of sad.

Still. Would it kill you to have a midwife on hand?

The other program I watched was on the "pregnant man." That was a lot more productive. I still don't consider him a pregnant man (uterus = not a pregnant man), but I really support what they did, and I can see his point. I had a lot more respect for them after I saw the program. They seemed like a sweet family. I really appreciated the wife's efforts to breastfeed. I did think it was sort of interesting how quickly they seemed to fall into traditional gender roles. They seem like they have been (the wife has two daughters from a previous marriage) and will be good parents (which is fortunate, because there's another one on the way), and really, can you ask for anything more than that? Everybody's family is different. Everybody's parents screw them up. And the show was an interesting and compassionate commentary on the issues that transgendered couples face. Plus, that kid's adorable. And, I do not envy any boy who comes sniffing around her in 15 years or so - she is so going to be daddy's little girl!

I did get two very amusing quotes out of today's TV watching extravaganza, though. The first, from the stupid Lifetime movie:

"Your son is looking at porn on the internet!"

"That's nice, honey. G'night."

(which, incidentally, was the correct response, at least initially. You know, before he developed his big porn addiction and started lying and stealing and the whole world came catastrophically crashing down...in typical Lifetime fashion...)

And, care of Dr. Huxtable...

"Regional forecast...warm, and no babies."

If I was an OB, I'd so totally steal that (hmm...maybe I can still make it work...)

Okay, yeah, I'm done babbling...

Gratuitous Cuteness

So I've now spent a good deal of time arguing with Sparrow over whether or not she's going to take part of my call tomorrow. Because she's the only one available. And she was on call last night. Which...because I'm a stubborn masochist and Sparrow just rocks, I'm betting you can guess how this conversation has gone...

Me: I'm fine!

Sparrow: No, you're not!

Me: Of course I am.

Sparrow: You're being ridiculous.

Me: Probably.

Sparrow: Let me do it!

Me: No!

Sparrow: Yes!

Me: I'm fine!

(repeat)

She's awesome. She and Cleo spent a lot of time today trying to find someone to cover for me. In the end, I just don't think it's worth the drama (you know, I won't think it's worth the drama until I end up with pneumonia...). And I'm on with Dr. Itchy tomorrow, as my intern (it's a long story how he gave himself that pseudonym), who is also fabulous. I'm sure it'll be fine. I'm sure I'll be fine. And Maggie and Little Maxine will have a good time over at Sparrow's.

I actually have a lot-ish to say, including my worthless trip to the doctor today (Larry wasn't in the office, so I saw Kelly, another attending, who didn't remember me despite the fact that I worked with her for two months straight less than a year ago. She asked me, "do you work around sick people?" ::sigh::), but I really need to go to bed. So instead, I give you gratuitous adorable pictures of the pooches.

Little Maxine came in all muddy this morning, so I scooped her up in this big towel, and she was all like, "ahhhh...." So I had to take pictures. The ones of Maggie in her chair are apparently her attempt at claiming the Cutest Puppy Ever title.

("Hey, everybody!")







("Ha! Maggie's funny!")

This has been most of what I've seen of Mags over the past few days. She's been dutifully stationed at the foot of my bed.



So sweet.

Such good girls...