NaBloPoMo Day 13

"Bows and flows of angel hair and ice cream castles in the air
And feather canyons everywhere, I've looked at clouds that way.
But now they only block the sun, they rain and snow on everyone.
So many things i would have done but clouds got in my way.

I've looked at clouds from both sides now,
From up and down, and still somehow
It's cloud illusions i recall.
I really don't know clouds at all."
 - Joni Mitchell


I don't know that I've ever taken the time to explain about clouds in medicine.  Specifically white clouds versus black clouds.


I was the proverbial white cloud.  A big fat fluffy white cloud.  Nothing ever happened when I was on call.  I had the "Night of Traumas" when I was a surgical resident, but for the most part, I had relatively easy shifts.  As an ED resident, there'd be a trauma here and there... Maybe a code, but not all at the same time.


My good friend in EM residency was the ultimate black cloud.  I would have a reasonable shift and then she would show up.  Traumas would roll in.  Cardiac arrests would roll in.  She laughed and said it was toughening her up.  We didn't want to be scheduled after her... or, Lord, no, with her.


Since becoming an attending, the RN's tease me and tell me I'm a black cloud.  They say the ED has become more busy since I've been working there.  They say not only are there more patients, but the patients are sicker... traumas, codes, people needing to be intubated or sent to the ICU.  I have to admit I have had some busy shifts.  Hmm... wonder if that silver lining is tarnishing just a bit...?

NaBloPoMo Day 12

Today I occupied part of my time listening to our EMS scanner.  I live in a small town with a volunteer fire department.  Every day at noon, the alarm siren goes off.  It also goes on whenever there's an emergency call.  If I'm near the scanner, I can turn it on and listen to what the run is.  I have an interest in EMS, in case that wasn't obvious....

Today's drama was courtesy of a motorcyclist who went over an embankment by the river without his motorcycle and ended up needing to be rescued via helicopter since it was near impossible to get him out by any other means.  The story unfolded through several rescuers and dispatch.  The patient ended up going to Eureka, and a paramedic got to fly along with him, leaving a member of the flight crew to have to hitch a ride with CHP back to his flight base.... oh and someone's personal vehicle got stuck in the mud, twice.

Just another exciting day of small town life... 

NaBloPoMo Day 11

"The ED is like a box of chocolates... you just never know what you're gonna get...!"

One of the reasons I got into Emergency Medicine is the constant variety.  I have no idea on any given day what may walk in the door.  I don't like Urgent Care so much because, for the most part, you see the same people every day:

1.  Chronic back pain

2.  Chronic headache

3.  Abscess

4.  Sore throat

5.  Feeling ill

6.  Tooth ache

7.  Ear ache

8.  any combination of the above which has been going on for the last 2 months

Today's shift was a little more interesting.  Even though we didn't see the large volume (80+) that we saw last week, we had some very interesting cases today...

 - a patient on blood thinners who fell and bled into his knee.  I got to stick a big needle into it and drain out a little more than a cup of blood

- a patient who fell and broke their wrist a couple of days ago.  They took off their splint to take a shower and managed to twist their arm somehow....  the wrong way.  They came in when they couldn't straighten it back up.

- an adult patient with chicken pox

- a patient with a growth on their back that I had no idea what it was but I suspect had been there longer than they were letting on

- a homeless patient that had developed a rash from probably bed bugs who came in wearing flea collars

and, finally, did you ever see that Seinfeld episode where Kramer takes a dog to the vet because it had the same cough that he did?

I had a grandparent today that I am sure brought in their grandchild under the pretense that the child had a sore throat so that the grandparent could get antibiotics for their own sore throat. The child was happy and playing with a reported fever over 103. Tonsils were normal. When I suggested that the child had a viral illness and didn't need antibiotics, the grandparent suddenly became very concerned stating the child went from really sick to feeling fine. They were concerned the child would get worse over the weekend, and that they "really needed to make sure they had antibiotics." The grandparent was looking pretty haggard themselves, and they let me know that they didn't have insurance and were close to losing their home. OK. OK. Antibiotics for everyone.

Seriously, box of chocolates, and I get to indulge several times a week.  

NaBloPoMo Day 10

One of my favorite books is "Como Agua Para Chocolate" which is translated to "Like Water for Chocolate."  Hot, boiling, ready to be converted from plainness to pure deliciousness.

The book and movie talk about how emotions come through in cooking.  I understand it because it's a Spanish tradition to talk about your cooking as though you're talking about emotions.  For example, salsa.  If it's very hot and spicy we say that the cook must have been very pissed off when making the salsa.  In fact, I told that to my best friend from med school who then started encouraging me to get into an argument with my mom so that the next jar of salsa she'd send in a care package to us would be extra zingy.

I find that when I am stressed, nothing "soothes my soul" as my DH stated like cooking.  Emotions and frenetic energy just fall away as I go through the motions of creating the meal.  You can't be frantic when slicing bell pepper to the width of match sticks to join the julienned potatoes and yellow squash which will be mixed with fresh, locally-picked chanterelle mushrooms in tin foil, coated in butter and spices and tossed to steam in the oven.  Medical physiology disappears when you are whisking your merlot-soaked, rice flour roux into the boiling beef broth for your mushroom gravy sauce.  And, nothing beats mixing a slab of butter with maple agave syrup and raisins to pour on top of and in baked apples.

Yum.  It's all made with love and energy and a sense of peace which I am sure came through in the meal... or else from the glass of Coppola merlot, either way.

Of course, eating is pretty comforting too... good thing DH is making me walk along the beach several times a week...!

NaBloPoMo Day 9

Today's NaBloPoMo prompt asked about your favorite song of this year;  then went on to ask about your favorite song 5, 10, 20 years ago... which made me think about how much I love music, and how eclectic my tastes in music are.

I can't think of a time when I didn't have a radio.  A small transistor radio of some sort.  Then I got a turntable, and I played my mother's 50's and 60's records over and over.  When I turned about 8 or 9, I got to go to the music store for the first time and pick out my own.  I made a list of my favorite songs.  I was allowed to pick out three 45's.

Somewhere in there, I remember the 8 track player in my mother's Olds Toronado.  I used to pack up the case with my favorites when we went on long car trips.  The other day, I actually heard one of the songs that I remember from my favorite 8 track, um, cassette.  Wow, the memories.

Then I remember this awesome new thing called a portable cassette player.  Imagine being able to record your favorite songs off the radio, and you only paid for the cassette!  Mixed tapes became the ultimate symbol of love and lust just about the time I was starting college.

I can still remember the very first Walkman I had.  Then came the Sony CD Walkman.  Oh, my God.  What purity of sound was this?  Wow.  We all listened one by one to the headphones pouring out pure tones and beats we had never heard before.  Every ultimate stereo set now included the CD player for those, eek, $25 CD's with all the boxed wrapping.

Of course, then the MP3 player was born, and my music never became so portable.  Then I got the phone with the music player.  I was stylin'!  Of course, now I have the iPhone with the capability of holding several days' worth of music.  We listened to mine from NY to CA, and I don't think we repeated one song.

Do you sing along to music in your car?  I do.  It makes my DH laugh sometimes.  I was actually voted, "Knows the Words to Every Song" when I was in high school.   If only medical school lectures could be put to music... I would have aced every single exam.  Ok, time to put on some music before I go to sleep... will it be Mana?  maybe some Blue Oyster Cult?  or maybe something from the old days... maybe a little Chicago, which, by the way, was the first 45 I asked for.  "If You Leave Me Now."  Wonder where that 45 is now?

NaBloPoMo Day 8

Many of you who have been reading for a while know that I have three cats... Sofie, Lacey and Winston.  They're indoor cats.  Sofie (the buff tabby) and Winston (the grey short hair) have never been outside freely in their lives.  Sure, during the winter my DH would toss Winston into the closest snow pile at least once after a big snow, but Winston always ran back to the porch, preferring to check out the white stuff from a distance.

Lacey (the black long hair) was six months' old when I got her from the local humane society.  She'd been a stray for the first part of her life, so she's been outdoors.  She'd managed to survive despite being deaf, and I think a part of her misses the smells and sensations.  She's the first to jump to an open window and start sniffing deeply.

My DH and I had a discussion today about when we get a house, letting the cats go outside.  We had talked before about getting cat fencing.  I think it's a safe way to allow the cats some outdoor exposure.  I also saw a wire tunnel system set up so that the cat could go freely in and out of the house and through the garden.  The cat's safe as is the local bird population.  He argued the cats should be allowed to run around freely and then brought in at night.

I know cats that live indoors have longer, healthier lives.  I don't want to have to worry about my cats getting run over by a car, attacked by another animal, or getting into something that is going to make them sick.  Hmm... maybe it's time to start pricing that cat fencing.

NaBloPoMo Day 7

I was raised Roman Catholic, and my DH was raised Baptist.  We've had some interesting discussions, surprisingly not about ideological differences, but about the social scene.

My take on Baptists:  You spend all day at services.  You're preached at for several hours about how everything you do is a sin.  Then you have lunch which the community shares in.  Then there's bible study, or some other kind of teaching.  Maybe you get invited to your neighbors for some coffee and cake.  Then you roll on home.

His take on Catholics:  The service is always the same.  The homily doesn't really teach you anything.  The priest is never fiery and inspiring.  People complain if the service is over 45 minutes.  Everyone's goal at the end of service is to get out and get home as quickly as possible.

Today we went to our local Catholic church for services.  DH kept comparing it to the community church service he attended last week.  I have to admit I was working last weekend and didn't go with him, but I did hear more about the local town gossip than the service.  Kinda like my hairdresser but with prayers for harvest and a neighbor's arm which needs to heal.

I do have to admit, I like being Catholic.  You can go to Mass Saturdays or Sundays.  It only lasts about an hour.  But, there is something nice about having a social service as well.  A sense of community.  I have been to different churches around the country that have this... Maybe I just haven't come across the right church here.  Or maybe, I need to be startin' something...