Monthly Archives: October 2005

My weekend

At the risk of boring my new readers and offending my faithful readers, I’ll avoid lapsing into an uninspired and ponderous narrative detailing the offerings of this weekend. It was a good weekend, to be sure, but one that doesn’t easily render itself blogable. Hence, I present another bulleted summary.

  • Friday, October 28 David and I journeyed to the northernmost reaches of this city to dine with Clay and Lori. A few fajitas and a margarita later, we spent the rest of the evening playing Trivial Pursuit: Pop Culture Version. One of the two questions I actually knew was What position does Harry Potter play in the game Quidditch? Ten points for whoever leaves the correct answer first as a comment.
  • Saturday, October 29 Far from being a “get-in and get-out” sort of day at the hospital, I nobly overcame two sabotaged discharges. Constipation is no match for the pen that orders a Fleets Enema with the threat of a larger-volume tap-water enema to follow, and a little run of asymptomatic second degree heart block can be addressed with “curb-side” cardiology consult, a medication change, and close follow-up.
  • David and I finished the evening by dining with Adam at a neighborhood cafe. The UT-OSU game played in the background, and Adam, being an Aggie, cheered not so much for the Cowboys as against the Longhorns. However, I’m sure Clay appreciated his alma mater’s second-half come-from-behind 47-28 victory. Three years and running…
  • Sunday, October 30 After rounding, I joined the rest of my immediate family (minus Charity’s husband J.T.) at church for Shelley and Chris’s new membership. We ate as a family afterward and then relaxed at my apartment with coffee and scones. Later, Roman, Isabella, Shelley, Chris, and I wandered down to the nearby park so the kids could play. It was a thoroughly relaxing Sabbath afternoon, and it made me realize how much I’ll miss my family next year when I’m farther away.

Trivia question: 50 points goes to whomever can name the location (city and state) of the house pictured above, or the school of thought co-founded by its famous architect.

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Life’s ups and downs


The elevator rides here can be tedious. Doors take about 5 seconds too long to close. People ride to go up (or even worse, down) one floor. Long waits for the elevator to even come are standard. I’ll often take the stairs for anything less than 6 flights…or use the visitor elevators which are speedier and less crowded.

However, today I found myself on the Lower Level (two floors below 1) needing to go to the ninth floor. After a several minute wait during which quite a few people congregated at the elevator’s closed doors, the car finally arrived.

On boarding, I pushed the “9” button. Also lit were “G”, “1”, “2”, “3”, and “7”. By the fourth stop, we were to the third floor, with only one more stop before I got to nine.

At this point, the unthinkable happened. A nurse in blue scrubs announced to the remaining two of us, “Everybody off. We’re here to get a patient.” I immediately sensed a “power play” vibe when the other rider hesitated and the nurse addressed her directly, “You have to get off. Patients take priority.” With that, she took a key and locked the elevator door open. I peeked outside and saw no patient. Evidently, she was here to retrieve a patient and bring him down to the O.R.

Sure I had the white coat, but I had no key. In this psychological power struggle, I was defenseless, emasculated. Was it worth reasoning with this demigod? Pointing out that we could ride to 7 and 9 and the car could be back to 3 by the time she’d retrieved the patient would be useless. Would there be any hope of evoking pity? Not in a brute like this. Suggesting that she could have informed us at the lower level of her intent to commandeer the elevator would be sure to provoke contempt, not reform. I gathered my white cloak around me and quickly swished out of the elevator, cradling my fragile-yet-still-intact dignity.

My next ride was more pleasant. At one stop going down, two jovial scrub-clad nurses pushing a cart full of candy boarded. Their smiles and cheer were difficult to ignore. Noticing that they both wore clear protective goggles in the elevator, I was reminded that this is Protective Eyewear Week. (I can’t wait till Foley Catheter Week in April!) One asked me, “When do you were protective goggles?” At a loss to come up with a clever-yet-sassy reply, I answered, “Well, I would wear protective goggles when I put in a central line.” “Thank you for answering correctly!” the other said, “Help yourself to some candy.” And just like that, they were gone.

So there I was, having come full circle, back on the Lower Level, battered and bruised by some rather poor elevator etiquette, yet now contentedly munching on a Reese’s Peanut Butter Cup. My day’s karma appeared balanced. Maybe in my next day, I’ll wake up to have the elevator key…

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The Iraqi constitution


My friend, Doctor J, recently posted a link to the blog of an “independent informed observer” of the war in Iraq. This journalist is named Michael Yon. I encourage you to read the post entitled “Purple Fingers.” It’ll take just a couple minutes.

While I’ve stayed up with current events lately mainly via the local newspaper, cnn.com, and NPR radio, I found this perspective both startling and refreshing. “Purple Fingers” has evidently been recently published in The Weekly Standard.

Did Michael Yon go to journalism school? Probably not. Does his personal story encompass the full essence and scope of the work in Iraq? Is it conservative propaganda? No, it’s simply a story. A story that is highly personal and captures the thoughts and emotions of one caught up in the swirl of history-in-the-making. And it exudes a sense of hope that I really haven’t seen in traditional media.

Yet it’s a realistic hope. One that recognizes that 2,000 American soldiers have lost their lives in Iraq. One that knows the price of freedom. This was a price the colonial Americans knew well, and one that the Tennessee Volunteers nobly helped to pay in the fight for Texas Independence.

I guess the thing I appreciated was the overarching meaning that Yon’s post gave to the suffering and death that we’re all well aware of. He puts himself in harm’s way to tell his story. But being there in the midst of danger, he witnesses first-hand the snaking lines at the polls and the purple fingers of Iraqi voters casting their ballot for freedom.

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A little Thai food

John Knox’s house in Edinburgh, Scotland

Well, another call day gone by. (My friends at rigorous academic programs: please skip to the next paragraph at this juncture.) Now that it’s just us, Sunday proved to be a relatively easy call. We admitted only four patients to the team; two went to me. Of those two, I sent one home on the post-call day. And then there was the sleep…magnificent sleep…seven wonderful hours, interrupted by only 4 cross-cover calls!

And so that’s why private residencies are actually tougher than the traditional academic programs. A good friend of mine from college, Emily, was in town this weekend for a wedding, and the highlight of my week was joining her and her parents for dinner last night at a local Thai establishment. We had fun reminiscing about college memories–many of which have become quite fuzzy–and catching up on the general events of life. Since Emily and her husband live in Maryland, I hope to see them a bit more often in coming years!

Another off day today had many things in store:

  • Sleeping in till 8:00. I’d left my bedroom windows open last night, so the room was nippy and conducive to rolling over and staying under the covers!
  • Leisurely reading the morning paper.
  • Working out
  • Dictating up at the hospital. I’m still behind by three discharge summaries! But the charts are still in coding, so that’s a good enough reason to procrastinate.
  • Buying a couple C.D.’s (certificate of deposit) through ING. This is a great bank. Right now they offer 4.4% interest on an 18-month CD.
  • Picking up a wedding gift for Amani.
  • Taking a luxurious one-hour nap.
  • An afternoon stroll to a nearby Starbucks; reading my anesthesia text outdoors. Roommate David met me there, and we walked to a local burger place for dinner.
  • Adventures in Good Music with Karl Haas
  • Balancing the checkbook.
  • Organizing my room.
  • Waiting for inspiration for an insightful and creative post. It didn’t come. By the way, the picture above represents my Scotland calendar’s October photo.

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Toward a more serene life…

Clutter is anything we don’t need, want, or use that takes our time, energy or space, and destroys our serenity. –from www.cluttersanonymous.net


Are you a clutterer? Take a look at this 20-question quiz. Most clutterers will answer in the affirmative to at least three questions. I answered “yes” to four.

I became interested in this topic after reading this article on msn.com today. There seem to be 12 steps involved, and I wonder how much of this organization’s philosophy is adapted from Alcoholics Anonymous.

My roommate David will be pleased to see me publicly admit I have some clutterer tendencies. Most notably, I save containers. Shoeboxes, Altoid tins, cardboard mailing tubes…all of these things are undoubtedly useful. I keep quarters in an Altoid tin in the car. My shoe-polish and buffing brush goes in a shoebox in the closet, and the mailing tube….well, that is still propped up in a corner of my room–but I know I’ll find a use for it!

Maybe my problem isn’t that I find useful purposes for old containers. It’s when I keep containers that I still haven’t found a use for. After all, my friends started teasing me only when there were ten empty Altoid tins stacked on the shelf. I can still hear Jenni’s voice playfully mocking me, “But, but…I can use them to store buttons!

On the other hand, people like my brother-in-law J.T. inspire me. A rigorous sense of neatness and order permeates J.T. and Charity’s house. And there’s my cousin Robby, now a sophomore in college, whose desk is always neat and well-stocked with an arsenal of freshly-sharpened pencils.

Is this unattainable for regular people like me? Perhaps not. Perhaps a first step would be throwing out that mailing tube. Properly disposing of or filing my mail the day I get it. And yes, parting with those Altoid tins squirreled away from David’s probing eye.

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Just when I was getting some sleep…

Sleep is precious on call. Yet sometimes it’s interrupted for the dumbest reasons: “Doctor, Mrs. Jones is constipated. Will you order some Milk of Magnesia?” This befuddles me in a number of ways. First of all, why would a patient wake up at 0200 and call the nurse because she’s constipated? And why is this something that the nurse believes needs to be addressed at this hour? I have so much appreciation for the job nurses do, but sometimes I wonder when I get calls like this.

A number of such calls were in store for me my last call night, ranging from the above to correcting electrolyte abnormalities. Another patient I went to see had lupus, rheumatoid arthritis, and major cellulitis with abscesses. The primary team had stopped the i.v. morphine and i.v. Dilaudid because the patient was over-sedated that day–she’d fallen asleep while eating! (Good move.) Her still-potent-yet-orally-taken Norco just wasn’t doing the trick controlling her pain. So after getting the story, reviewing the chart, and examining the patient, I said, “I’ll ask the nurse to bring you a little morphine.” I felt sorry for her with all these ailments, and I believed she was in pain.

“Actually, morphine doesn’t work for me, Doctor,” the patient replied. “That i.v. Dilaudid is much better. I need you to write for that. And besides, I would hate to have that morphine just go to waste, because it really does nothing for me.”

I paused. Something was amiss. The “drug-seeking” vibes had nearly knocked me off my feet. As I gathered my wits together again, I took control of the encounter. “Hmmm…I understand what you’re saying, but your primary team was concerned you were over-sedated today, and that Dilaudid is pretty strong stuff. I think morphine is a reasonable step up from Norco. We’ll go with that.” By commanding a “this is what we’re going to do” tone, I staved off any protests. No more calls from that patient that night!

My final call of the night came at 0300 and with a definite Indian accent. “Doctor, we need your help. Patient has died. Can you please pronounce him?” I pulled on my scrub shirt, wrapped myself in my white coat, and with my eyes still bleary, made my way down to 3-west. “Which room?” I asked, stumbling by the nurse station. They pointed down the hall.

The hospital is quiet at night, but this night was stiller yet. Upon entering the chamber, I closed the door for privacy. The body lay motionless, the morphine infusion still pumping into the the pooling veins. “End-stage AIDS, on hospice care,” is what somebody had murmured as I passed the nurse station. I donned a gown and gloves and performed several objective tests to tell me that yes, this corpse really is dead. Around the time I got to the corneal reflex, I started to feel weirded out. Quickly I finished this patient’s last medical examination and scribbled a death note.

Maybe it was the quietness of the room interrupted only by the humming of the morphine pump, or maybe it was the speed with which I fell back to sleep, but the whole memory still has an eerie, dream-like quality to it. Unlike my last pronouncement, this one was totally isolated from any sense of suffering. I had seen no family, and my entire time with this patient was after he had died. This is what you get when you distill out the art of comforting and of walking with a patient though his final days and hours. This was plain science: Doctor and cadaver, scientist and object. A few straight-forward tests, a simple experiment. And then back to the call room for a couple more hours’ sleep.

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October 22, 2005

Today was my first day off in more than two weeks. I know that’s nothing compared with The Old Days of residency training, but still it makes me appreciate the time a lot more!

The weekend began with a little quartet work Friday evening with Dawn, Erin, and David. We had a potluck dinner and then spent an hour playing works of Barber, Corelli, and Mozart. I can’t speak for the others, but my sense of rhythm and my ability to play anything faster than an eighth note have disappeared along with my ability to study for more than an hour and memorize anything.

My faithful readers will also note that I’ve learned how to place pictures in a position other than “center.”

“Sleeping in” till 7:30 (yes, I know it’s sad) was a great start to the day today! My brother–who had spent the night–and I drove over to the city where he lives, and he showed me his classroom. I treated David, Charity, and myself to lunch, and then we hung out at the local Botanic Gardens in the refreshing Texas October weather! It was the sort of day that started and ended with cool 60-ish weather. By the time we made it to the gardens, it was pleasantly warm in the sunlight yet still cool in the shade. This, I feel, is the essence of autumn in Texas. It lasts for a few days here and a week there.

A train ride back into town and a picnic with the folks from the residency program with volleyball and Mexican food closed the day.

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