Another Year, Another Squirrel...

Last year I wrote about my thoughts from the previous year, and my wishes for the next.  Here's a part of the post:


And what am I looking forward to in 2011....?
 - a new house
 - new responsibilities in my chosen career
 - travel!
 - finally getting to a place where I can enjoy other pursuits... maybe writing a book...?!?!

So let's see how I did...
We got a new house that we are slowly working on.  Bought the house in late February and didn't move into it until August 1st.  Or, actually, didn't get possession of it until then;  we're still in the process of moving in.


I am now Paramedic Coordinator and sit on the Humboldt County Emergency Medical Care Committee, so that part of my life is slowly progressing.  Plus, I've been chosen as a new speaker for our physician's group, so soon I will be lecturing at the annual meetings.


Travel - this year we went to Bonita Springs in Florida, Maui, Medford in Oregon, and to a conference in San Francisco.  We took many local road trips further exploring our area, so I think that counts too.


Funny how life got even busier.  With the move and everything there was no time to get the quilting or knitting or watercolors set up.... Although, I did make it through the whole month of NaBloPoMo and joined BlogHer in the process.
So, new resolutions:
 - to get back into my healthy veggie habits... hubby's just going to have to have a milkshake along with his salad
 - to get back into a regular fitness routine
 - to continue to improve as a physician and further develop my career goals
 - to write, frequently, and start the outline for a book
 - to enjoy every minute that I can with my family and friends
 - to get organized with my quilting and actually finish most of the projects I have started (you can follow my progress here)
 - to go to one new place this year and explore!
 - to remember to thank God weekly for everything he has given me and my family
 - and, darn it, I will pet that Cheetah!!


As for my resolutions.... um, yeah, so how about some for next year, shall we...?


 - we're getting a dog, so the fitness part will be easier
 - to continue to progress in my profession
 - to not forget to pursue vigorously my creative side
 - to continue to enjoy the love and company of family and friends
 - to thank God daily for the many blessings He has bestowed on me
 - and, I think I might have a cheetah connection to pursue in the next year...

HAPPY NEW YEAR's... May your fondest dreams and wishes come true!

All the Lonely People

This is cross-posted from the professional blog I write for....

I know that the holidays can get really depressing for a lot of people, but I had three patients over the weekend that really got me depressed because of their situations. I always said that I would never make a good psychiatrist because I would tend to internalize and identify with my patients, and so that’s why I enjoyed surgery so much. There’s quite a bit of distancing that happens when you’re behind a mask looking at a square of skin.

As an E.D. doc, though, we’re up close and personal with a lot of our patients, so it’s back to internalizing and not having the luxury of a sterile sheet between you and your patient.

Patient One crashed their car. They are homeless, so their car is like their home. Everything they own is in there. They had just gotten kicked out of one “fleabag” motel and were on their way to find something better along the coast when they lost control on a curve. Now, all they have is the clothes on their backs. Well, actually in a hospital bag because they were stripped down to a hospital gown when they arrived. They’re bruised and battered and slightly torn. And, they have no one and no where to go. I can discharge them because, luckily, they didn’t suffer any major injuries. But, they have nothing. So they get admitted. Social Work and Discharge Planning can figure out what to do with them in the morning.

They used to have a life, and friends, and a home. But then they were forced to take early retirement from their work. They lost their home and their social network. They can’t afford housing on a fixed income. So they roam… in their car… from place to place.

Patient Two had a nice home, and a wife. Then their wife died and a part of them died too. So they turned to alcohol to help deal with the pain. Soon their nice home deteriorated as did their health. They have a neighbor who checks on them from time to time. Their neighbor brings them in whenever things get too bad. Patient Two can’t see their PCP because they have an outstanding bill, so the E.D. becomes their PCP. Diabetes out of control again? Yep. Bad cellulitis on your legs again? Yep. Anything new? Yep, pressure ulcers on my bottom from not getting up out of my chair for the last three days because my legs felt too bad. Am I going to be admitted? Yep.

Patient Three has a psych history. They’ve been in and out of the system their entire life which is only 50+ years long so far. They have the look of a 90 year old man. A neighbor stopped by because they hadn’t seen them for a few days and found them looking slightly worse than usual. Not eating or drinking. Somehow, though, they continue to smoke despite the rattling cough in their lungs. How the cigarette paper doesn’t just rip their Sahara Desert dry and cracked lips to shreds is beyond me. Must be the warm stale beer that somehow is within reach. Another admission for “Failure to Thrive.” It’s the least I can do.

Three hots and cot… at least for tonight… at least for today…

All the Lonely People

Stocking the Shelves

I was thinking of the movie "Sleeping With the Enemy" today while unpacking boxes and setting up my pantry.  Did you ever see the movie?  I still get a little freaked out when I think of that creepy music.

Anyway, I was placing cans and jars on the shelves, organizing things just so.  As I was turning all the labels to face one direction, the creepy music started in my head.  I shook it off until I started hanging my dish towel... all in a row with stripes aligned... scary...

Nonetheless, it's nice to get settled finally into the new house.  Or, at least start to.  We are almost done in the kitchen.  Now, to get the rest of the rooms done and the other 80% of the move over...

And the Winner is...

The Red!  She will be coming home with us on January 18th... 

And, now the hardest part... thinking of a name...

The King's New Throne

We're in the process of moving into our new home, and over the last several days, we've slowly started bringing things from our rental up to the house.  One of the objects in the old house that my DH wanted to make sure we removed was the toilet seat.  So, as an early Christmas present, I bought him a new one.

I guess because I've been living in a rental for the last 13+ years, I haven't thought about the importance of having something new that only you have used.  My hubby made it plain and clear that he wasn't sitting somewhere where others had been.  So today we had the ceremonial removal of the old throne and the placement of the new one.

I did take a picture of the old ring sitting on top of the burn pile, but the actual lighting will have to wait until another day... it's started raining and who know when it's going to be another burn day.  Then we'll have the ceremonial lighting of the ring to show that a new king has taken the throne...

Burnt Offerings

I don't know why, but I get very excited whenever we have a burn day.  With all of the vegetation clearing we have been doing on the property, we have piles of limbs, leaves, briars, etc everywhere.  I want them gone.  So, whenever it's a burn day, I am up on the property starting my fires as soon as I get up in the morning.

Since we're also in the process of trying to move up to the house, I have also been carrying boxes of paperwork (receipts, bills, etc.) from prior moves that need to be burned.  You know, the kind of things that have personal information on them, and you just don't want to throw away in the paper recycle bin.  So, I've saved them... for a while... like several years.  And, now, I am in the perfect position to get my fire started and destroy personal information in a convenient manner.

Anyway, I was looking at the pile of papers I had pulled for today's fire lighting, and casually glanced from time to time at what I was actually putting in the fire.  Hmm... car payment bill... glad I don't have those anymore.  Here's the receipt for one of the many credit cards that got me into trouble... no more of those to worry about since I only have one department store card (with a limit of $100 at that), and all my other cards are debit cards.  I tossed in the flight information from one of multiple cross country trips to see my mother.  Soon after, in went the orientation materials from my residency in Minneapolis.

We were sitting around discussing memories of Christmas recently, and I remembered being so broke at one point in Minnesota that I had $0.45 in my checking account.  The decision going home that night was to spend my last $3.00 in cash on gas, something to eat for dinner or a small bag of cat food.  I bought a dollar in gas, got the cat food, and had just enough spare change in the car to add a can of Spaghettios for dinner.  That experience definitely made me more financially responsible.  Thank, God, for residency meal tickets... they helped me make it through until pay day.

So, today, I started seeing my burn day as an offering... I gave thanks for the ability to not have to worry about gas to go to work, feeding my cats or myself, and for not being financially irresponsible and adding extra debt to my life... of course, don't talk to me about my house and remodel... we'll call that an investment for the future...

Bonus Feature

I saw this on another blog post.  I am sure most of you have read this somewhere before, but I thought it was worth posting...

Written by Regina Brett, Plain Dealer Columnist, Cleveland, Ohio

Life Lessons

1. Life isn't fair, but it's still good.

2. When in doubt, just take the next small step.

3. Life is too short to waste time hating anyone.

4. Your job won't take care of you when you are sick. Your friends and parents will. Stay in touch.

5. Pay off your credit cards every month.

6. You don't have to win every argument. Agree to disagree.

7. Cry with someone. It's more healing than crying alone.

8. It's OK to get angry with God. He can take it.

9. Save for retirement starting with your first paycheck.

10. When it comes to chocolate, resistance is futile.

11. Make peace with your past so it won't screw up the present.

12. It's OK to let your children see you cry.

13. Don't compare your life to others. You have no idea what their journey is all about.

14. If a relationship has to be a secret, you shouldn't be in it.

15. Everything can change in the blink of an eye. But don't worry; God never blinks.

16. Take a deep breath. It calms the mind.

17. Get rid of anything that isn't useful, beautiful or joyful.

18. Whatever doesn't kill you really does make you stronger.

19. It's never too late to have a happy childhood. But the second one is up to you and no one else.

20. When it comes to going after what you love in life, don't take no for an answer.

21. Burn the candles, use the nice sheets, wear the fancy lingerie. Don't save it for a special occasion. Today is special.

22. Over prepare, then go with the flow.

23. Be eccentric now. Don't wait for old age to wear purple.

24. The most important sex organ is the brain.

25. No one is in charge of your happiness but you.

26. Frame every so-called disaster with these words 'In five years, will this matter?'

27. Always choose life.

28. Forgive everyone everything.

29. What other people think of you is none of your business.

30. Time heals almost everything. Give time time.

31. However good or bad a situation is, it will change.

32. Don't take yourself so seriously. No one else does.

33. Believe in miracles.

34. God loves you because of who God is, not because of anything you did or didn't do.

35. Don't audit life. Show up and make the most of it now.

36. Growing old beats the alternative -- dying young.

37. Your children get only one childhood.

38. All that truly matters in the end is that you loved.

39. Get outside every day. Miracles are waiting everywhere.

40. If we all threw our problems in a pile and saw everyone else's, we'd grab ours back.

41. Envy is a waste of time. You already have all you need.

42. The best is yet to come...

43. No matter how you feel, get up, dress up and show up.

44. Yield.

45. Life isn't tied with a bow, but it's still a gift."

Letting the Puppy Out of the Bag

Ok, I think I can finally admit it... we're adding a new member to the family.  And, almost like having a real baby, I have no idea the sex nor what the new member is going to look like.  Which is driving me crazy.

See, I've never gotten a pet like this before.  We've always been a family of "oh, look, free puppies" and picked one out of a box kinda crowd.  Or, "let's go pick someone out at the humane society" as I did with my other three fur-cat children.

I've never had to mail a check to someone, find out that I'm number something in line, wait until several other people have made their choice, and then get to choose from what's left over.  I've been more of the "let's play for a while and see which one I like best."  So this whole breeder thing has got me worrying about how this experience is going to play out.

But, let's talk positives:  we're getting an Australian Shepherd from a well-known local breeder.  We know that she tends to breed both working and family dogs with excellent skills and wonderful personalities.  And, I will be able to choose from the three girls that were born in the litter of eight.  In this picture, the three are the uppermost puppies on the left, a red and two blues (one being hidden by her brother in the picture.)

Of course, as soon as I said I had told the breeder I preferred a girl, DH said he wanted the black one on the bottom right (which is a male.)  I tried to explain female vs. male characteristics and traits, merle vs solid, and how we had to judge temperment, dominance level, sociability, etc to which he answered, "Fine, as long as it's the dark-colored one."  This is going to be a long 7 weeks...

Idle Threat, I Think Not...

Given the lack of responses to my last posting, I will now start posting thoughts about my most recent dream....

Social media is definitely starting to affect all aspects of my life including, not surprisingly, my dreams.  Last night I was dreaming that I was wandering through a house with an upper apartment.  I was in the apartment when suddenly a storm brewed up.  I was excitedly watching the storm through the window when the house started to shake.  I backed away from the window only to feel the room I was in shudder furiously.

As I wondered what would happen next, the room felt like it was lifting and spinning end over end as can only happen in a dream.  In the midst of worrying if I was going to die because I knew I would soon be crashing to the ground, I suddenly wondered if I had my cell phone close by because I would want to video record the destroyed building and post it on Facebook...

Really?  Death staring me in the face.  Complete and utter devastation, and I am thinking of how cool it's going to be posting everything on Facebook...?!?

Maybe, I've got to get out more... step away from the computer...

A Month of Blogs

So I did it!  Tonight concludes a month of blogging.  Who knew I had the time?  Who knew I had it in me?  Who's been reading this drivel over the last month?  Anyone?  Anyone?  Hello, is this thing on....?

I think it's helped my writing skills.  I think it's helped relieve some stress.  I think it's inspired to write on a more frequent basis than I usually do (once a month if I'm lucky.)  I do think, though, that I am at somewhat of a disadvantage in terms of subject material.

You, see.  I'm a doctor.  You would think I would have tons to write about given I work in the Emergency Department.  But, like I said before, patient confidentiality aside, I live in a small town.  In a smallish area.  Where most everyone know everyone.  I can be at some random medical society meeting and find that the neighbor who walks her St. Bernards around town is the mother of the dental hygenist who is sitting next to me.  So, around here, it's difficult to talk about patients because most everyone will know who I am talking about.

I could talk about my new hobby farm.  Twenty-five acres of pine trees and rolling hills that hasn't had any work done on it for the last 17 years and on which we're still uncovering hidden treasures from time to time.  Not to mention the small flock of birds which I have added and will be adding to:  my little bantams and guinea fowl.  AND, the biggest part of all, renovating and remodeling the house which also has seen nothing done to it in 17 years.

But, seriously, are those things people would be interested in hearing about?  Looking around at the more popular blogs on BlogHer which I've been cross-posting on this month, I'm not a single girl doing the dating scene in the big city.  I'm not the country mom talking about raising my 5 kids while home-schooling and baking pies.  I'm not the city girl living in a foreign country learning how to milk yaks and make my own cheese.

So how about I get some comments going on here.... how about you tell me what you like and don't like.  Hello, hello...?  Is this thing on...?  Better tell me soon, or I will start posting a dream journal... like this afternoon, I was a spy, kinda like the guy on Burn Notice... and then...

Get Out Much...?

There's a stupid movie that came out several years ago called "Employee of the Month."  Stupid, yes.  Entertaining, yes.  Shows that Jessica Simpson can not act, oh yes!

I was thinking about this movie today because it was our bi-monthly or so trip "to the city" to go grocery shopping at Costco.  It's funny, when I first interviewed for a job here, I was warned there were no major shopping centers.  No problem, I thought, since I don't like shopping anyway.  However, everyone talked about going to Costco.

See, the next biggest store is probably Target, and it definitely is no Walmart.  Not around here anyway.  So, everyone goes to Costco for the majority of their shopping.  And, since a lot of people live in areas that are a couple of hours' drive away, they make a day of it.  And, so do we I hate to admit.

My hubby likes hitting the store just about lunch time because that's when all the samples start coming out.  Hit it just right, and you can pretty much have lunch for free.  I like walking up and down the aisles to see what's new, what's still available.  And, every month the selection changes in the center aisle.  So you can almost live the seasons of the year just by seeing what's in the center display.

Yeah yeah, I know, it's the little things that keep us entertained now that I'm living the country life...

Doctor as Patient

So, there's been a lot of gastroenteritis (stomach flu, food poisoning, etc) going around, and last night I fell victim to it.  It got so bad I had to leave in the middle of my shift to go home since I wasn't doing much patient care running to the bathroom every 5 minutes.  As I arrived home, I started going through the usual tips I send home with patients...

 - small frequent sips of clear fluids
 - lots and lots of fluids
 - BRAT (bananas, rice, applesauce, and toast) when keeping down clears
 - return to E.D. if vomiting does not stop

It's that last one that almost got to me.  I wondered at what point during the 4th episode of dry-heaving I would return to the E.D. as a patient.  I rated my abdominal pain (4 - 5 out of ten at it's worse), thought about the fact I couldn't keep water down, and wondered how I would make it through the night.  I started thinking about my patients;  at what point is it too much to handle alone.  For some, it's about an hour into it.  Others go for days.  Me, I toughed it out throughout the day sipping on broth and Gatorade and finally got to the banana...  nothing ever tasted so good.

Give Me Your Tattered and Torn

In the middle of a barrage of traumas in the E.D. so this will be kind of short.

Certain patients really help to give you some perspective.  I bumped my knee against a 2x4 while cleaning up the chicken coop today, and it was so hard it brought tears to my eyes and now I have a large bruise.  One of my patients fell headfirst down a hill, broke their jaw, wrist and several ribs, AND managed to climb back up the hill to call for help.  Ouch, ouch, and Ouch!

Suddenly my knee doesn't hurt so bad....

Hoka Hey

Hoka Hey - It is a good time to die. - Chief Crazy Horse

I've written before about the Indian saying about a "good day to die."  Today I thought of this as a patient died in the emergency department.  

We have several local tribes and our patient was a member of one of them.  They weren't doing well yesterday according to their niece, and this morning their retirement home sent them to the E.D. with difficulty breathing.  By the time they arrived to the E.D. we knew they were "expectant..." ready to die.

We called family to the bedside, explained the situation, and they understood that the patient would not make it through the day.  We told them to call other family members and asked if they wanted us to call anyone else.  The patient died about 3 hours later.

As I was listening to the now quiet chest that would never take another breath, I was thinking that this was his Hoka Hey, and I hoped his spirit passed peacefully, carried away on eagle's wings.

Squatter's Rights

There are some patients who come into the Emergency Department and just seem to move in.  Funny, because these are usually the same patients who say they "can't stand hospitals" when you tell them they have to be admitted.

Anyway, you know who they are from the second they check in.  They've got a set of bags with them.  They get settled into the bed.  Usually they have their own blanket... pillow... slippers... The cell phone gets plugged into the nearest outlet.  The McDonald's bags start magically appearing.

I know on most days I usually want to get out of the E.D. as soon as possible.  Why would anyone actually want to stay?  You're not sick.  You know you're not sick.  Like Cameron on "Ferris Bueller's Day Off" you just don't have anything better to do.  We had several patients today who were like that.  They got settled in, and I couldn't get them to leave.

We used to have a group of pediatric patients with sickle cell disorder who used to come into the E.D. at the same time.  Their goal:  get admitted so they could have a pajama party complete with PCA pump IV's and terrorizing the nurses.

They would sit and text in the E.D. comparing which medications they were getting, how much, how often, and what kind of pizza they were going to order.  One night we foiled their plans by telling them that we had talked to their primary doctors, and since they were getting follow-up in the morning, they didn't have to be admitted.  They looked sad leaving and carrying their princess-adorned fleece blankets with them.

We were especially busy today and the squatters didn't help... seriously, there's a big world out there... get out in it, and stay out of the E.D.

All Good Things

Sending out Thanksgiving wishes to you and yours...

We plow the fields, and scatter the good seed on the land, But it is fed and watered by God’s almighty hand; He sends the snow in winter, the warmth to swell the grain, The breezes and the sunshine, and soft refreshing rain. All good gifts around us Are sent from heaven above, Then thank the Lord, O thank the Lord For all His love. We thank Thee, then, O Father, for all things bright and good, The seed time and the harvest, our life, our health, and food; No gifts have we to offer, for all Thy love imparts, But that which Thou desirest, our humble, thankful hearts.

All good gifts around us

Are sent from heaven above,

Then thank the Lord, O thank the Lord

For all His love.

Why Do We Do It...?

Some days it feels like this.  You work hard to try to help someone, and they burn you.  Humph, just made a funny.  You see, we had a young patient with severe burns this week.  They'd been working on a piece of machinery which caught fire burning their hands and their face.  They had to go to a burn center.  We have a limited amount of resources in our small hospital.  We're not prepared to take care of 3rd degree burns to the hands.  Our surgeons aren't experienced in doing skin grafting and managing the long term complications of wounds.  Especially to the hands.  Especially in a young person.  So we need to rely on other specialists taking our patients.

Not to mention we live in a secluded area.  The closest large cities are several hours' drives in any direction.  Medford, Redding, and even Sacramento are almost 5 hours away.  San Francisco is about 5 1/2.  So most of our transfer patients are flown.  That involves a flight crew that has to come from one airport to our closest airport and then they need to be driven to our hospital.  So they're taking a risk just in the journey to get to us, not to mention the journey to the receiving hospital.  They don't fly in a helicopter, they fly fixed wing.  So they can't just land at the hospital.

We take the time to make phone calls.  Another physician has to accept.  A patient from our hospital can potentially mean that another patient, perhaps even more severely burned, can't be accepted due to space.  Now you have a flight crew that has to travel via ground and air then ground again to get the patient.  They then repeat this process three more times to collect the patient, deliver the patient, and then get themselves back to base.

And, after all that, the patient signs out AMA (against medical advice).  Why, you might ask?  Because the hospital wouldn't let their significant other sleep in the same bed.  Because the hospital wouldn't allow them to smoke whenever they demanded.  So they left.  Without follow-up.  Without antibiotics or pain medications.  Without instructions for continued care.

That's the society we've created;  an on-demand, according to my schedule, give me what I deserve kind of mentality with no sense of responsibility.  Our hospital isn't going to collect anything on this patient.  The flight service isn't going to collect anything.  And the receiving burn center isn't going to collect anything.  Resources have been spent that could easily have gone to help many others have been wasted on those that don't appreciate it, and who will now not have the means to contribute anything back.

You see, those burns aren't going to fix themselves.  A few short weeks of treatment could mean the difference between a person working or being so disabled as to not being able to dress themselves.  I'll be seeing this patient again: for their chronic pain, chronic disabilities, chronic complaints that "they didn't do anything for me and ruined my hands".  And, we'll all be paying for it in the long run.

Soft Kitty, Warm Kitty

For some reason I am fascinated with this show.  I don't know what it is.  Sure there's the intellectual factor that seems to elevate the show above your average sitcom, but there's something else I can't quite put my finger on.  Regardless, there have been some excellent moments.  Like the "Soft Kitty" song.

"Soft Kitty, warm Kitty, little ball of fur.  Happy Kitty, sleepy Kitty.  Purr.  Purr.  Purr"

They even had a contest to see who could make the best video of the song.  Nothing beats the original....

No Rug, Just the Bear Skin

So now officially it's us against the bear.  I think a few posts back, I mentioned that we were starting to have a bear problem.  Probably just one bear breaking into my bird feeders, then breaking into the barn to get the chicken feed and breaking my storage containers.  Then last night it actually broke into the barn, tore down some wire fencing we'd put up and broke into the coop with the chickens and guinea fowl tearing down the suspended feeder and eating all the food.  Why it didn't eat or kill the poultry, we don't know.  But, luckily it didn't.

Today I called the local game warden who told us to adjust to having a bear around or find ways to "take care of the problem."  My mom had thought perhaps they would live trap the bear and "relocate" it to a more rural habitat;  however, it seems that's a last resort by Fish and Game.  Now, when I mentioned our bear problem with some of my coworkers, I had several offers to help "take care of the problem."  Hmm...
Hubby's sitting up at the house with a 12 gauge, and my co-workers are finding out when game permits are going to be sold.

Is this what I have to look forward to with country living?  Don't get me wrong, I love our semi-rural property, but I don't like the idea of having to "take care of" animal problems.  Especially a large furry problem.  We'll have to see how the drama unfolds...

Sponsored by the Letter Z

After traveling by air and ground for 12 hours to get back home following a visit to my mother's, I am sincerely exhausted.  So I will keep this brief... zzzz....

Back at ya, tomorrow when we return to our usually scheduled program.

I Hate Shopping

I don't know that I've ever admitted this in public, but I really hate shopping.  It's not the going out and getting things that bothers me... it's all the people crowding the aisles, grabbing clothes off the rack, the general chaos.  I only ever truly enjoyed grocery shopping when I was in medical school.  That's because I would be leaving the hospital at midnight or going in for an early start and would stop by the local grocery store which was open 24 hours.

There's something special about a clean, quiet store;  with only the workers moving about the aisles, stocking them.  Everything is straight and orderly.  For the most part, I could take my time and check out new products.  I could stand in an aisle and not worry about blocking someone with my cart while I debated brands of potato chips and soap.  And, my absolute most favorite thing to do.... I could do... I like leaving my cart of groceries at the beginning of the aisle, walking down the aisle to get whatever I need, and then walking back.  Granted I like going slowly up and down the aisles... but, the sheer convenience of leaving my cart behind is heavenly.

I especially don't like clothes shopping.  I'm a "know what I need, walk into the store, grab the item off the rack and head for the cash register" kinda girl.  I had a friend who I went shopping with one time.  She grabbed a pair of pants after deliberating for about 30 minutes as to what cut of pants she wanted;  front pocket, no pocket, pleated with pockets... uuggghh!  Then, she had to grab one size up and one size down from her usual size.  Then it was the parade from the dressing room to the mirror with each one.  Then back again for the next size.  Then back when the right size was established.  Don't even mention picking a different color in the same style because then the process repeated itself.  Just in case the sizes ran different between the two colors.

When I am home, I make my mom go to Walmart at 7 in the morning.  No crowds.  Clear aisles.  I almost feel like I have the whole store to myself.  Plus, since I wear scrubs to work every day, the only clothes I wear are usually, I am proud although maybe slightly embarrassed to say, from Old Navy.  Now that's a run in, grab my size and run out kinda store.  I like it.

Ultimas Semanas

Ooooh, it's getting so exciting!!  After all of these months, we're in the "ultimas semanas."  That means "final weeks" in Spanish.  If you remember a prior blog post back in May (wow time flies!), I had gotten my husband, my mom, and a co-worker involved in the daily dramatic adventures of Geronimo (the gorgeous Juan Soler) and Renata aka Regina (the lovely Silvia Navarro).

At that time, we didn't know if the couple would get together, then they did, then they broke up, then they got back together.  Now, an unexpected pregnancy and a dastardly suitor threaten their relationship.  And, we're in the "ultimas semanas!!"  Actually, I knew the end was drawing near.  I looked up the telenovela on Wikipedia and found out the air dates (while also trying to avert my eyes so I wouldn't mistakenly find out something and spoil the show), so I already knew the end date would be the last week of December.  But, I still can't believe the end is drawing near.

Not to sound cliche, but there's still so many loose ends to tie up.... what's going to happen to the evil mother and psycho office worker?  ...who's going to tell one of the minor actors he's dying of a brain tumor?  ... and how is the evil half-sister going to be punished?  Also, what's going to happen to this twin pregnancy?  They obviously can't have the babies born, so is the mother going to die, are the twins going to die, and if so, who's going to cause it?  Aarrgghh!  There are still so many question.

Well, it's going to be an exciting 5 weeks.  And, based on the fact that my prior blog post has gotten 3 times as many hits as all the others this year, I guess there's some interest out there in Enrique Iglesias, or maybe a lot of other women are as smitten with Juan Soler as I am... grrr....!

Betty and Veronica

I was saddened today when a friend posted on her blog about a death of a family member.  I say, and truly mean, friend even though I have never met her.  We met while blogging initially on AOL and then followed the group over to blogger.com.  It's amazing how fast three years can pass, and how much you can learn about someone by reading and commenting on each other's blogs.

We've never met, yet we know about each others' families (her kids, my cats), our jobs, our recent moves.  She's cheered my career from residency to now attending status, and I've sympathized with her pet's illness and occasional family dramas.  Her faith, through it all, has continued strong which is what attracted me to her blog in the first place.

I thank you for always commenting on my posts no matter how mundane I sometimes think they are... at least I know someone is reading them.  And, even though I don't always comment, I read each and every one of yours... my thoughts are with you and your family at this time.

The Late One

Trying to get this one in under the wire...

I love to teach.  I think I've mentioned that before.  It's not that I want to be a school teacher and do it on a daily basis, but I love working with medical students and residents sharing knowledge and experience.  That converted over to giving lectures to the paramedics and firemen during my residency. Now I present a monthly lecture to our nurses and EMS providers.

I think it's not just about the teaching.  I think it's the fun of playing with programs like Powerpoint and Keynote.  Especially Keynote.  Now, I consider myself a Powerpoint maven.  I could do things with the program that made lectures pop.  But, when I went to buy my Mac, the salesman gave me a brief demo of what could be done with Keynote.  WOW!  Not only did I fall in love with my MacBook and would marry it if I could, but Keynote would definitely be the illicit affair I would have.

After putting together a complex slide presentation for our residency graduation party, I now consider myself a Keynote savant.  This post is late because I've had back to back lectures to prepare for, and I am currently working on a very professional lecture for the local medical society.  But it will still have some pop... and some squirrels... I always have squirrels in my lectures...

Seinfeld Moments

Not much to write about today, but as I was watching TV thinking of inspiration, I started thinking that everyone can relate something in their life to a Seinfeld moment. At least several times a day, I can think of something that I can relate to an episode; or a line I can quote. It's funny, but as time is passing, it seems less people know about Seinfeld and so it's getting harder and harder to make the reference. Blank stares all around. Anyway, one of my favorite shows of all time. Enjoy!

And For My Next Trick...

Every once in a while I do a procedure in the emergency room that isn't done very often.  Every once in a while I do a procedure while there are nursing and paramedic students around.  And, every once in a while I do a procedure that isn't done very often while there are students around.  Like today.  Today I drained a knee.

Now, we do knee "taps" not infrequently in the emergency department, but it's unusual to do one on a pedi.  That's pronounced pee-dee... as in pee-dee-atric patient.  Not peh-dee as in peh-dee-cure.  Anyway, we get sick pedis every once in a while, and tonight I got a small patient with a big knee that needed to be tapped.  And, I had a nursing trainee and a paramedic student en tow.  Throw in mom and little sister, and I had quite the audience.

I don't mind performing under pressure.  Heck, I'm an E.D. doc, and I do it all the time.  Add an audience, and it just adds to the fun.  I remember as a surgical resident sitting in report looking at chest films and hearing the intern say that one of the patients was suddenly short of breath and with a fast heart rate.  He thought he might just be in pain.  I took a look at the chest x-ray and quickly realized the patient had a collapsed lung and might be developing a potentially lethal complication called a tension pneumothorax.

I called out my suspician to the trauma team, and we rushed out of our conference room en masse to the patient's bedside.  I had my senior resident, the attending and about 3 interns plus several medical students all rushing around gathering supplies.  I was given the job to put in the chest tube since I was the junior resident and responsible for this.  Now that was pressure.

Tonight, not so much... but still, you have to get used to working under a spotlight sometimes.

Waiting for Tonight

I often wonder what makes a person come into the emergency department with a non-emergency.  Especially when they have a problem that's been going on for more than, oh, 6 months... a year... 3 years.  And, I doubly wonder about them when they tell me that they've actually been seeing their doctor on a regular basis and never brought it up... not once... not ever... didn't think it was important.  Until today, more often, tonight.  And, can you please fix it and make it go away?

Now, my mother would often say, "Those doctors don't know anything.  They just want your money and to give you pills."  That, of course, was before I went to medical school.  Afterward, when she would complain to me about a chronic problem, I would ask her if she had told her doctor about it.  Her answer, "Well, that's what I have you now for."  And for, I suppose, all the other patients that come into the E.D.

But, seriously, what was it about today... tonight... that suddenly made it worse?  Come on... tell me... you know that I am not going to be able to fix you.  Because if your primary care doctor who has all the time in the world and a heck of a lot more resources can't figure out what is wrong with you, then how do you expect me, the lowly E.D. doc who has maybe five minutes to spend with you amoungst the maelstorm of humanity, and who doesn't know anything about your background, your meds, your allergies, your homelife, your mother's maiden name or the name of the boy you kissed in the fifth grade to fix you today... tonight...?

Please tell me...

Egg-tastic!

The bantams that I got in mid-September have started laying eggs!  They are Golden Seabrights, and I have a rooster (Waddles) and two hens (Mabel and Sheila).  I am not quite sure which of the hens is laying, but I am very excited about their being happy enough with their new surroundings to start.

In the spring I will probably let them have a clutch of chicks, but until then we will just enjoy the fruits of their labors...

Bantam eggs compared to a AA Large egg from the grocery store... how many of these will I need to make an omelet...?

Three Wishes

Everyone was talking about the date today, and a lot of Facebook chatter seemed to be focused on making three wishes...  If you could make three wishes what would they be...?

1.  To be able to go back and learn to cook with my grandmother.  I long for some of her special recipes.  Some are simple dishes, some more complex.  I would run to the corner store for her, and I should remember most of the supplies, but I don't remember how to put the dishes together.  I really miss her special sauces and soups.  No one makes them like her.

2.  Did you ever watch the movie "Peggy Sue Got Married?"  I would like the chance to see certain forks in the road where I made a choice that affected my life and find out where my life would have been different.  Would my life be very much different than it is now, or would I have pretty much ended up in the same circumstances?

3.  I would like one special talent.  I know a lot about a lot of things.  I've dabbled in music and the arts.  But, I know I will never be a master anything.  I just don't have the dedication, nor the skill.  I can do some things well, but I will never be the best at something.  Kind of like the goal I had as a kid to be in the olympics.  Every year that passed was another opportunity lost.  At this point I think I could possibly only compete in sailing or equestrian.  Although Dara Torres did give a lot of us inspiration to be better than ourselves.  Hmm... wonder if it's too late to take up swimming....?

A Page and a Half Day

We have a patient log we keep that helps us keep track of our patients during our shift.  It's basically a sheet of paper with 20 sections wherein we place patient stickers.  The average amount of patients you see is about 20, so you fill up a sheet during your shift.  Extra patients go on the back... today I filled a sheet and a half.  Thirty patients!  That's a lot for a small town E.D., and it can be overwhelming for a single physician during a shift...

Today I saw:
 - child with vomiting; there's a lot of the stomach flu going around
 - teen with a possible STD
 - nausea and vomiting; did I mention the stomach flu?
 - thrombosed hemorrhoid; they hurt, you not me, but I have a fun and satisfying time cutting them out
 - gallstone and pregnant; ouch
 - baby with a fever
 - patient with dizziness that had no findings on all of her labs and CT scan
 - elderly patient with broken pelvis after a fall
 - patient with high blood pressure needing to start medications
 - Bell Palsy, worried they'd had a stroke, it's scary not to feel half your tongue
 - MS patient with pain
 - patient with a zit that turned into a facial infection needing antibiotics
 - patient who passed out then left against medical advice even though they had abnormal changes on their EKG
 - patient with infection of his both of his legs
 - back abscess that needed draining; I think all docs find these somehow satisfying
 - infected hand from a bug bite
 - shortness of breath that turned out to be from heart failure
 - drunk and on meth coming in with nausea and vomiting
 - nausea and vomiting that comes from having too high a nicotine patch dose
 - abdominal pain from a large spleen, why the large spleen...?  maybe the medical docs can figure that out, not for me to know
 - worsening back pain after a fall
 - back pain after a fall due to spinal fractures and spinal cord impingement
 - Nursemaid's elbow, another satisfying procedure
 - belly button infection that I burned with a silver nitrite stick, cool
 - another stomach flu victim
 - vaginal bleeding in a pregnant woman
 - chest pain in a patient with no heart disease that's been coming in over the last year with the same problem
 - broken foot

Wow... what a day!  It's amazing to see all the patients laid out like this.  Now to get all these dictations done... and you know how much I love dictations... ugh...!  Back for more in the morning.

On Writing...

I want to write a novel.  In fact, if it wasn't for my schedule this month, I would have gladly joined in on the NaNoWriMo challenge.  But, I just don't have the time.  Not this month.  Not next month.

I want to write a novel.  But, I am worried.  What if I'm a "one hit wonder?"  What if I suck miserably and end up on someone's "don't read" list?  What if...?

I want to write a novel.  I need a quiet place.  Or a coffee shop where I can sit in the corner and just write, pumped up on caffeine.  And scones, or bread pudding... I really like bread pudding.  With jam.  Lots of jam.

I want to write a novel.  A good fact-checker is essential for writing a novel.  Google would be very helpful.  Also, I need to make sure someone is checking for continuity.  Don't you hate watching a movie and seeing a mistake?  Like someone's wearing a ring, then not wearing one, then wearing one... all within the same scene.  Drives me crazy.

I want to write a novel.  I really don't have a lot of discipline.  I think it takes a lot of discipline to sit down and actually write every day.  I know just doing this blog a day for a month take a lot of discipline.  But a novel, that's going to take several months....

Maybe I'll just stick to blogging.  Short, sweet, not much in the way of character development because I am the main character.  Don't have to worry about dialogue because it's all inner monologue.  Yeah, I think for now this will suite me just fine...

But, I still wanna write a novel.

Well Burl Me Over...

I think I said we like stopping at different places when we travel, and today we stopped at "It's a Burl" on our way home.  It's a great art gallery that includes several buildings.  I didn't know what a burl was, and today I learned all about burls, where to find them, and how to polish my own.

This is a picture of a redwood tree burl, and it's basically a cluster of sprouts.  Some are from the roots, others are along the tree, some come out when the tree falls.  It all depends on the type of tree.  And from these burls you get pieces of art like this table...

I love learning stuff like this... that's what traveling is all about...!

History Lesson, or Maybe Not

One of the things DH and I like to do when traveling is stop at small shops with local products.  I had seen a wine and cheese tasting store in a small town near Medford, Oregon while my DH continued his search for the perfect hang-gliding spot.  While on our way back, I asked if he would stop so we could taste some of the local wines which Oregon is becoming more famous for.

We wandered around the store and sampled some of the dessert wines they were pouring, and we happened to ask about the region and why the town was a historical landmark.  Blank stares all around.  Now, not to say anything about the local clerks, but we like to find out a little something about the places we visit.  And, if you're going to work in one of these little towns where someone might be interested in the local history.... well, I'm just saying.

What I did find out about the town (thanks to Google) is that it was the first town settled in Southern Oregon.  Cool.  That's all I wanted to know....  And the little shop we stopped in... yummy homemade fudge and in-store smoked meats... OMG!  Not to mention the two bottles of local dessert wines we picked up... Cranberry/raspberry wine and a pear wine.  Delish!

Sing It Loud, Sing It Proud...!

I know most people like to sing in the shower, but I sing in the car.  Especially on road trips.  Especially to my DH.  I think I wrote a few posts ago how he has some songs for me, but there are some songs he likes me to sing while we're driving.  I don't know why, but I have fun.  I'm usually softly singing to myself as we drive, but sometimes I really belt it out.  He joins in on some songs but usually always on the "wooh wooh's" when "Big Black Horse and a Cherry Tree" comes on.

Today we drove north to look at a car that he wanted to buy.  Several hours north, so there was ample opportunity for stretching the vocal cords.  Especially while singing Whitney.  I don't know how she did it, holding those long notes.  My favorite is "I Have Nothing;"  particularly when she sings the part, "...I have nothing, nothing, nothing" and then goes right into "don't make me close one more door" without taking a breath.  Whew...!  Can barely make it through... But, I love the challenge...

Where do you like to sing...?

Sausage Stuffing

I wear pajamas to work.  I wanted a career where I didn't have to think about getting dressed every morning.  Not that I mind dressing up, just when you're in the medical profession it's one less thing to think about. So I wear scrubs, daily.

It's actually very comfortable;  that and my collection of Dansko clogs.  I've got about 6 pairs now.  However, it's not very comfortable on those rare occasions when I've got to get into regular clothes.

See... scrubs are generous.  They're not form-fitting.  I could gain and lose 10 pounds and still fit into the same pair of scrubs.  So when I have to dress up in regular clothes... well, sometimes it's not that pretty.  Like most women, I just can't pull something off the rack and think it will fit me well.  That little black dress I used to wear, forget about it... not happening this month.

Tonight was the benefit ball for the hospital;  the one time a year when everyone gets dressed up and raises money for some new equipment for the hospital.  I think I've explained this is a flannel-wearing, Carhart-sportin' kinda place, so getting dressed up for anything is quite the event.

My friend refers to it as "sausage stuffing" which pretty much describes what happens when you try to fit your size 12 body into your size 10 dress... She likes to say she's one good bout of gastroenteritis away from fitting into a size 6.  For me that would involve several months on a liquid diet and some pretty radical surgery.  But, I digress.  We had a lot of fun tonight.  Thanks to some elastic, a little spandex, and some smart clothing buys... Spanx, anyone...?

Bear Necessities

So we have a bear problem.  It started about a week ago when the contractor staying at our house told us he'd seen a bear in the "front acre" on the side of the house.  Then, a couple of days later I went up to the house to find this...

My wonderful, nee expensive, feed container was completely destroyed.  Since then we've been finding bear tracks close to the house and scat behind the barn.  So, we spent all of today "bear proofing" the hen house.  We closed off the barn, nailed hog wire all over, and made a door to help further secure our small flock of chickens.  I think the next step will be getting shot for our 12 gauge, but we're attempting non-violent means to start.

My guineas just turned 6 weeks old and our little bantams laid their first eggs today, and I think a bear skin rug might become de rigueur if anything happened to them.  

Under Construction....

So, we've been working on our house over the course of the last three months, and for the first time I feel as though I've starting to see the reality of what my home will look like.  I'd like to share that picture, but I am working the night shift and the patients, despite my best attempts to keep them away, keep coming... so this post, as is my house, is under construction... more tomorrow... but I got today's NaBloPoMo post in on time...!

Losing Faith in Humanity...

So every once in a while I come across a patient that really affects me.  There's been this couple who over the course of the last year have been coming in periodically to the E.D.  Usually, one or the other of them is sick.  Really sick.  Respiratory type problems:  pneumonia, the flu, difficulty breathing.

They're usually dirty.  Unkempt is what I dictate.  Or poor hygiene.  But they always seem grateful for what we can do for them.  A meal, a ride, free medications.

The woman came in again the other night.  Shortness of breath.  Smelling of motor oil.  A friend was letting them stay in their garage since she's been sick.  Because you see, they're homeless.  Living under a bridge by the river.  As, I was leaving that night, driving past the spot where they've told me they live, I felt bad.  Felt like I should do something more.

You always maintain professional distance from your patients, but there's some patients that just affect you.  I started to wonder what I could do.  Not a hand out, but a job offer.  Maybe something simple like yard work, maybe.  The thought stays with me throughout the night.

The next day I hear the patient was discharged to home;  she'd come in feeling short of breath from all the meth she used.  Then I get angry.  Seriously?  You're homeless, you couldn't stay in the hospital the last time because you had to go back to your campground and "feed the dogs;"  you already spend your money on cigarettes and now you're also using meth.

Seriously?  Sometimes I wish I was back in surgery.  A piece of skin under the drape.  See the problem, remove/replace/fix the problem.  Because sometimes the things I hear about my patients just makes me wonder, seriously?