Sunday, May 29, 2011

Walking the Grounds

So, this last month we closed on our new home.  It was built in 1980, and the previous owners had lived in it for the last 16 years.  The grounds have not had much up-keep in that time except for a little maintenance of the trails that wind around the 20 acres that the main home sits on, so we have our work cut out for us.  

This photo shows the clearing that a landscaper I hired has done so far.  The right side is the before in case you couldn't guess.  This is about an acre and a half and sits in the front of the house, so we want to have something nice to look out the window at besides the rest of the stunning river and valley view.

This is standing at the start of the trail behind the house.  Right now everything is lush and green after all the rain of the last several months, or several weeks, or several days... it rains all the time.


This is the real start of the trail into the "back twenty."  There's redwood groves further up, chanterelles grow at their bases.  There's a seasonal pond and several meadows further up the trail as well.  I didn't hike it today since I was by myself, and the previous owners said that a bobcat had been seen running around, but I will post more pics when I finally do.  Plus, we have to do a little trail clearing as well.


And, our back yard again... can anyone see a future flagstone patio with a fire ring?  A stone patio with an outdoor kitchen... anyone...?  I already see it right there in my head... just as I always dreamed it would be.

Wednesday, May 25, 2011

Suspension of Disbelief


To say that my mom LOVES telenovelas would be an understatement.  She can't go on vacation without fearing that she's going to miss her daily "stories."  And, not just one, she's usually following two, and sometimes three.  We sometimes have had to plan outings around finales of her Telenovela.  That's Spanish for soap operas.  The great thing about about telenovelas, though, is that they only last a short period of time so that you're not investing years and years, usually just about 4 - 5 months.  Almost the same as you would in a sitcom season, but these are daily hour-long episodes.

Despite my mother's repeated attempts, I usually try not to get sucked in, but there's one out now that I am completely fascinated with.  It's called "Cuando Me Enamoro" which loosely translated is "When She Made Me Fall in Love With Her."  It's a tale of love, lust, revenge, mistaken identity, kidnapping, murder... otherwise known as your typical telenovela.  This one is just getting started, but I can barely stand to let an episode go by.

I record the episodes daily, and I usually try to wait all week to see them.  Obviously, I don't have a lot of self-discipline because I find myself rushing home so I can see that day's episode.  I was good this week... at least I saved up three.  Now I am jonesing for the next one... what's going to happen now that the main couple is together?  What's the evil sister going to do now that she's pregnant?  And can anyone be as handsome as Juan Soler the Argentinean leading man....?



Ah, telenovelas, where men are men, and women are conniving, murderous wenches... now that's a story I can get lost in.

Tuesday, May 17, 2011

Fly on the Wall

At this point in my career, I don't know how many people I've sutured.  Between working as a surgical resident and being an ED resident then attending, I've done a LOT of sewing.  In surgery, I had "closing music."  That music that plays in the background while you methodically close all of the layers of tissue you had previously opened.  I daresay suturing becomes sort of mindless after a while, so you enjoy the right brain entertainment.

You don't get that in Emergency Medicine mostly because it's already a noisy, chaotic place and music would just be a distraction, but sometimes... sometimes you have an evening like tonight where I had a long complex ear laceration repair involving multiple layers and almost plastic surgeon-like skills, and there were no other patients in the department.  Tonight we pulled out the Frank Sinatra (it was a senior citizen after all) and jammed to "I Get a Kick Out of You" while I made his ear look like an ear instead of the congealed mass of torn flesh and cartilage.

Other times, though, music is not needed as you simply seem to disappear into the background while the patient and their spouse/significant other/sibling/parent/entourage provide running commentary and/or simply talk about personal matters while you quietly sew together their torn skin.

I've been privy to family dramas, dates gone wrong, girls gone wild, etc.  Drunks don't seem to care who hears about their adventures on the bar scene, while some some have felt perfectly comfortable talking about sex and STD dramas while I'm sewing.  I've heard about impending divorces, ex-spouse love triangles, and teen angst escapades.  I know people's vacation plans, baby plans, wedding plans, and tattoo plans.

I always thought CO's weren't supposed to talk about their lives in front of their prisoners, but I was always amazed at the amount of information they shared while standing around waiting for me to finish. I learned about promotions, who was leaving, who was coming on, what their kids were doing, medical problems, etc.

Then, there's the solo patient who comes in.  Usually elderly.  It's amazing how you can hear someone's life story in just about half an hour.  You learn about dairy farming, lumberjacking, airplane flying, etc.  You know how many children, grandchildren, great-grandchildren they have.  You hear about the places they have traveled.  And, sometimes you just sit in awe of the life they've lived.

Of course, eventually I start to wish again I could have closing music in the E.D., or even be allowed to wear headphones while I suture....  Come, on, Blue Eyes, sing me another....

Saturday, May 14, 2011

Welcome to My World

A sort of typical day...

I come into the ED in the morning.  Usually I have time to run to the cafeteria and grab something to eat;  oatmeal, powdered egg special, etc.  Sometimes I will stop at Starbuck's on my way in; Caramel Macchiato and a sausage sandwich.  The board may be empty, or the early morning Dental Pain will be just getting put into a room.  I drink some coffee.  Check my leftover dictations.  Then I find the strength to go see that first patient.

About this time the first of the Chest Pains or Shortness of Breath will come in the door.  They've been dealing with their problem all night long, called the doctor's office this morning who told them to go straight to the ED.  So now they're mine.  I listen to the story, write basic orders and now these patients are cooking.

People are waking up, soon the kids with fevers, people with abdominal pain, maybe another Chest Pain or two will roll in the door.  But still, I am working with maybe just three or four patients.  Move the pans around the stove and make some adjustments.

Around 1 p.m. I am thinking about lunch.  Should I see that new Abdominal Pain or go grab something to eat?  Whoops, should have left because the ambulance is rolling in with Altered Mental Status.  That could be anything from an overdose that was just discovered to a possible stroke from the nursing home.  I wait on lunch, but the clock is ticking because the cafeteria closes at two, and I still have another 6 hours to go.  What to do?  What to do?

About this time the busload of patients starts to roll in the door.  The Fevers, Abdominal Pains, Abscesses and Rashes start to mix in with the Couldn't See the Doctor in the Office Today So They Sent Me to the ED.  There might be a traffic collision.  Or maybe a roll-over ATV accident.  As the afternoon wears on, so do the traumas.  Now Lacerations start to blend in.  As doctor's offices close, those that waited for the last week just can't wait one more day.  Or the Dental Pains or Back Pains that are looking at one more night without narcotic pain medication start to show up.

The clock watching starts.  There's two hours to go and the board is full.  The waiting room is starting to fill up.  Ambulances are coming and going.  I'm wondering how many beds I have left in the hospital.  The nurses are getting antsy because they have half an hour to go.  Everything seems to go in slow motion.  About this time someone gets really sick requiring multiple procedures and everything get delayed that much more.

Then fresh help arrives, but I am trying to plan my escape.  I've got a pile of charts to dictate, and I don't want to be here long past my time.  There's a bunch of people in the waiting room, but I don't want to get started on work-ups that I then have to sign out.  An hour left, and I am only going to see the "Yes, you've got poison oak here's your steroids," or the Crashing as We Speak.  Sometimes I will give some basic orders for analgesics or to get lab work started.

Of course, the Law of Karma states that any labs or CT results I've waited two hours for are mysteriously going to be available 10 minutes before the end of my shift.  Suddenly I am waiting for call backs on admissions, doing discharges and subsequently dictations on all of my patients while the oncoming doc just starts picking up new patients.  Two hours later I am walking out the door.... My goodbye to the overnight doc is, "See you in the morning."

Tuesday, May 3, 2011

Life Gets in the Way

I know that I have been scarce around here, and I wonder if anyone is still paying attention.  Regardless, it has been a very busy month.

Out of 30 days in the month, I worked 17.  The rest of the time, I was either having a meeting or traveling.

I had to buzz home to SoCal twice, the first time to take care of some business for my mom, and the second time to take an extended weekend break and travel for my mom's birthday.  We went gambling.  Suffice it to say, she won on just about every machine she touched.  Talk about lucky.

Hubby and I have still been exploring our new home.  Speaking of which... We closed on a house!  I am now a home owner... or, more correctly, a mortgage holder.... But, I digress.... the picture here is from Dry Lagoon State Park.  A lovely beach where people go to hunt for agates.  We started off not even knowing what we were looking for, but some nice fellow beach goers showed us what to look for.  We found three small ones, but even so, it's a beautiful place.  And we saw Roosevelt elk!



We also drove south again so that I could watch my husband literally throw himself off a cliff.... as you can see by the picture below, he had a great time doing it, although my heart was in my throat for the first few minutes.  I don't know that I will be doing this any time soon, but the views are incredible!



Work is, well work.  Some days I feel like I have finally found my pace and my stride, then boom!  The next day the walls come crashing down, and I feel like a medical student again.  I have to say that it has been interesting and challenging.  Most of the patients are the garden variety belly pains, headaches, coughs and flus, etc.  But, every once in a while a cardiac arrest, trauma or something very complicated comes through the door.... then you feel like you are flying by the seat of your pants.

Anyway, I promise I will try to blog more this month.  There are times when I feel like I am so full of ideas that I just have to write them down or bust.  Then Life gets in the way....