Thursday, November 29, 2007
end
It wasn't colon cancer. It was worse: malignant carcinoid, a zebra, one in a million, and untreatable. He's dead this morning -- barely four weeks from his first touch of abdominal pain. He was 38. He leaves a large family. I got nothing more to say except, sometimes things suck.
Monday, November 26, 2007
run through the jungle
The whereabouts of a long-missing Dutch woman have been confirmed. The woman, who was raised in a wealthy family in Holland, had moved to Colombia in her early twenties to teach and volunteer among the poor. She was last seen by relatives four years ago, ,when she told her family she was moving to the jungle to teach indigent children. It now turns out that she is fighting with a Colombian rebel group called FARC. Fragments of her diary were found when the Colombian army overran a rebel camp.
I love this story. It is the story of a woman who broke all bonds of conformity and dared to live big and crazy.
I come from a well-off family too, but unlike my Dutch heroine I chose the life expected of me. When danger called me, I shrank from it and turned my face away.
I was twenty-two and living in Prague when the first bombs lit the sky over Croatia. At that time, I was used to rootlessness and all-night trainrides across the continent, so it felt like all Europe was my neighborhood and my stomping ground. When the first fissures appeared in Yugoslavia that summer -- when I heard the blood-pulse of rising war, of drums and thunder on the horizon -- my blood rose up in answer and an electric thrill ran along my nerves. Think of it: only a trainride away, a mighty storm was gathering. I was drawn to Yugoslavia like a moth to flame.
I had an apartment in Praha 2 -- Prague section 2 -- on Plavetska ulice by the river Vltava. Almost every day that summer I'd cross the river on Charles Bridge and mount the hill to the American embassy. The second floor of the embassy was always crowded with expats, standing in line to pick up packages. Next to the mail pickup counter stood a bulletin board where travel advisories were posted. Neat rows of index cards warned American travelers about hotspots around the world. Recent rash of carjackings on the highways of Spain, said one card. Another read, Caution urged for travelers in eastern Turkey -- British professor kidnapped by Kurdish insurgents and held for ransom. My eyes sought out the latest travel advisories concerning the Balkans. These were updated frequently, and grew more ominous day by day. Unrest in the region. Travelers advised to use caution and stay on main roads. A week later the card read: Sporadic violence; roadblocks, security of civilians declining. All unnecessary travel in Yugoslavia should be avoided. Later it changed to: Strongly urge no pleasure travel to the Balkan peninsula at this time. Additionally, all Americans in the region on business are urged to leave as soon as possible.
Finally that card too came down. In its place this notice ran: The US has closed its embassy in Yugoslavia and all nonessential personnel have been evacuated. Any Americans remaining in the area do so at their own risk and should expect no assistance from the U.S. government.
Reading those words, I got chills.
I used to go to the train station late at night and check the trains heading southeast: the times, the prices. I would imagine myself boarding one of those trains. There was nothing to hold me in Prague. Everything I owned, I could pack in less than an hour. I could walk up to the window and push a few bills across the counter and get msyelf a ticket. I could climb aboard, settle myself in a car, ride all night to Zagreb and get off there. Then I could look around and wait to find out what would happen next.
But I never did buy the ticket. People like me -- Barbie-girls from the suburbs -- just didn't go to wars. We had worried mothers and fathers who would never understand, who would call us selfish and foolish, who would pace the floor, who would never forgive us if we got hurt or killed. We had guilt. We had liberal antiwar politics. We had friends and brothers who would make shocked faces and say, What the hell do you think you're doing?
It was years later when I heard a story about a boy I'd gone to high school with. He was an aspiring photojournalist (I remembered him only as a gawky kid with big ears) and when war came to the Balkans, he dared what I did not. He took his camera and went to the war, carved out a life as a stringer there, made a name for himself and launched his career. I still wonder what his mother and father thought of him going. Didn't they worry? Didn't he care? And why didn't that stop him?
Here is what I think: We are all born with our feet in cement, stuck to the ground before our first breath is drawn, by the expectations of our families and class background. We grow up in cages with clear plexiglass walls we barely take note of. A few of us stretch the walls a bit. A very few of us break them down and walk free.
Me, I was meant from birth to go to college and keep my hands soft -- become a professional something and marry a professional someone like myself. I was never meant to be a cop or a carpenter, a soldier or an adventurer. In the summers I made money as a babysitter, then later as a Kelly Girl, typing for six-fifty an hour. I never considered that I could have made more money on a construction crew. After college I knocked around Europe for a while but in the end I came home, driven by a sense that I was being left out, left behind in a strange backwater while everyone I knew was moving ahead into the Real World without me. I got a small-time job, but still I felt left behind. So I went to med school. Something was still missing, so I got married. That wasn't enough, so I had a kid. Then I got into the habit of pregnancy, so I had a couple more of them. At last I felt like I had caught up. And here I am. It's a fine life -- a routine one, comfortable. It fits me well. After all, it's exactly the life I was raised for.
Here: I have another secret, a secret kinship with the Dutch woman. No one knows this part. At thirteen I fell in love with Eden Pastora. He was called Commander Zero at that time -- a wild Nicaraguan rebel who took half the government hostage in Managua and lived to brag about it. I saw his picture in a magazine in the early eighties: all windblown black beard and fiery gaze. I never told anyone what I felt for him -- who would I tell? But the first man I ever looked at twice was him, and the first thing I ever wanted to be was a freedom fighter in the jungles of Nicaragua. I was never too serious about it, though. I always thought, girls like me don't actually do stuff like that.
Except, now I find out that some of us do -- the brave ones, the ones who crash through the walls and move out into the world, away from the path they were born to.
That is what the Dutch woman is to me: a living monument to all the possibilities that open to those who dare and who fear no borders of geography, or mind, or class, or anyone's expectations.
I love this story. It is the story of a woman who broke all bonds of conformity and dared to live big and crazy.
I come from a well-off family too, but unlike my Dutch heroine I chose the life expected of me. When danger called me, I shrank from it and turned my face away.
I was twenty-two and living in Prague when the first bombs lit the sky over Croatia. At that time, I was used to rootlessness and all-night trainrides across the continent, so it felt like all Europe was my neighborhood and my stomping ground. When the first fissures appeared in Yugoslavia that summer -- when I heard the blood-pulse of rising war, of drums and thunder on the horizon -- my blood rose up in answer and an electric thrill ran along my nerves. Think of it: only a trainride away, a mighty storm was gathering. I was drawn to Yugoslavia like a moth to flame.
I had an apartment in Praha 2 -- Prague section 2 -- on Plavetska ulice by the river Vltava. Almost every day that summer I'd cross the river on Charles Bridge and mount the hill to the American embassy. The second floor of the embassy was always crowded with expats, standing in line to pick up packages. Next to the mail pickup counter stood a bulletin board where travel advisories were posted. Neat rows of index cards warned American travelers about hotspots around the world. Recent rash of carjackings on the highways of Spain, said one card. Another read, Caution urged for travelers in eastern Turkey -- British professor kidnapped by Kurdish insurgents and held for ransom. My eyes sought out the latest travel advisories concerning the Balkans. These were updated frequently, and grew more ominous day by day. Unrest in the region. Travelers advised to use caution and stay on main roads. A week later the card read: Sporadic violence; roadblocks, security of civilians declining. All unnecessary travel in Yugoslavia should be avoided. Later it changed to: Strongly urge no pleasure travel to the Balkan peninsula at this time. Additionally, all Americans in the region on business are urged to leave as soon as possible.
Finally that card too came down. In its place this notice ran: The US has closed its embassy in Yugoslavia and all nonessential personnel have been evacuated. Any Americans remaining in the area do so at their own risk and should expect no assistance from the U.S. government.
Reading those words, I got chills.
I used to go to the train station late at night and check the trains heading southeast: the times, the prices. I would imagine myself boarding one of those trains. There was nothing to hold me in Prague. Everything I owned, I could pack in less than an hour. I could walk up to the window and push a few bills across the counter and get msyelf a ticket. I could climb aboard, settle myself in a car, ride all night to Zagreb and get off there. Then I could look around and wait to find out what would happen next.
But I never did buy the ticket. People like me -- Barbie-girls from the suburbs -- just didn't go to wars. We had worried mothers and fathers who would never understand, who would call us selfish and foolish, who would pace the floor, who would never forgive us if we got hurt or killed. We had guilt. We had liberal antiwar politics. We had friends and brothers who would make shocked faces and say, What the hell do you think you're doing?
It was years later when I heard a story about a boy I'd gone to high school with. He was an aspiring photojournalist (I remembered him only as a gawky kid with big ears) and when war came to the Balkans, he dared what I did not. He took his camera and went to the war, carved out a life as a stringer there, made a name for himself and launched his career. I still wonder what his mother and father thought of him going. Didn't they worry? Didn't he care? And why didn't that stop him?
Here is what I think: We are all born with our feet in cement, stuck to the ground before our first breath is drawn, by the expectations of our families and class background. We grow up in cages with clear plexiglass walls we barely take note of. A few of us stretch the walls a bit. A very few of us break them down and walk free.
Me, I was meant from birth to go to college and keep my hands soft -- become a professional something and marry a professional someone like myself. I was never meant to be a cop or a carpenter, a soldier or an adventurer. In the summers I made money as a babysitter, then later as a Kelly Girl, typing for six-fifty an hour. I never considered that I could have made more money on a construction crew. After college I knocked around Europe for a while but in the end I came home, driven by a sense that I was being left out, left behind in a strange backwater while everyone I knew was moving ahead into the Real World without me. I got a small-time job, but still I felt left behind. So I went to med school. Something was still missing, so I got married. That wasn't enough, so I had a kid. Then I got into the habit of pregnancy, so I had a couple more of them. At last I felt like I had caught up. And here I am. It's a fine life -- a routine one, comfortable. It fits me well. After all, it's exactly the life I was raised for.
Here: I have another secret, a secret kinship with the Dutch woman. No one knows this part. At thirteen I fell in love with Eden Pastora. He was called Commander Zero at that time -- a wild Nicaraguan rebel who took half the government hostage in Managua and lived to brag about it. I saw his picture in a magazine in the early eighties: all windblown black beard and fiery gaze. I never told anyone what I felt for him -- who would I tell? But the first man I ever looked at twice was him, and the first thing I ever wanted to be was a freedom fighter in the jungles of Nicaragua. I was never too serious about it, though. I always thought, girls like me don't actually do stuff like that.
Except, now I find out that some of us do -- the brave ones, the ones who crash through the walls and move out into the world, away from the path they were born to.
That is what the Dutch woman is to me: a living monument to all the possibilities that open to those who dare and who fear no borders of geography, or mind, or class, or anyone's expectations.
silence
"... ?" -- willow
"... ?" -- xander
"... !" -- giles
--"Hush" (the auditorium scene). Buffy tVS season 4
(because today, I have no voice)
"... ?" -- xander
"... !" -- giles
--"Hush" (the auditorium scene). Buffy tVS season 4
(because today, I have no voice)
Saturday, November 24, 2007
update: code 11/14 and social services
I hate loose ends, so I'll wrap up and put these stories to bed.
The patient from Code 11/14 did well -- so well, in fact, that I totally lost interest. He went off to rehab to get his strength back, and hopefully will be back home with his family soon.
Brenda the social worker came to my home at the appointed hour, this time bringing not one but two reinforcements (either she was scared of me, or she wanted to point me out to her assistants as "this is what a really bad mother looks like.") She had actually stalked my children and interviewed them at school. "Does your mommy let you play on the street by yourselves? Does your mommy ever tie you up with that rope hanging inside the house?" She was satisfied with their answers, though disturbed that the younger two were wearing sandals in thirty-degree weather. Clearly she herself has never tried to argue shoe choices with small strongwilled children.
I was outraged. I understand she's just doing her valuable and necessary job, but I'm outraged anyway. My shy oldest girl was probably terrified and embarrassed. I wonder how on earth Brenda introduced herself -- "Hi, honey, I'm a friend of your mommy's, stopping by for no reason and asking nosy questions"? Or "Hi, honey, I'm checking up on whether your mommy takes care of you"?
Then, to "close the case" so I wouldn't have to endure serial home visits, she had made up a document for me to sign. Loulou3 will dress the children in weather-appropriate clothes. Loulou3 understands that she is responsible for supervising her children at all times. Loulou3 will take down the rope hanging in her house as this is a choking hazard, or will closely supervise the children when they are playing with it.
She had actually typed the thing up using my first name. This irritated me more than anything else -- which I suspect means I'm turning into my mother much sooner than anticipated. I signed it. I smiled. I showed her and the others to the door. I ripped up the poisonous piece of crap as soon as she was gone.
She did tell me one thing I wanted to know. The person who'd called in the tip about my allegedly negligent parenting was named Anonymous. So now, on top of everything else, I'm going to die wondering.
The patient from Code 11/14 did well -- so well, in fact, that I totally lost interest. He went off to rehab to get his strength back, and hopefully will be back home with his family soon.
Brenda the social worker came to my home at the appointed hour, this time bringing not one but two reinforcements (either she was scared of me, or she wanted to point me out to her assistants as "this is what a really bad mother looks like.") She had actually stalked my children and interviewed them at school. "Does your mommy let you play on the street by yourselves? Does your mommy ever tie you up with that rope hanging inside the house?" She was satisfied with their answers, though disturbed that the younger two were wearing sandals in thirty-degree weather. Clearly she herself has never tried to argue shoe choices with small strongwilled children.
I was outraged. I understand she's just doing her valuable and necessary job, but I'm outraged anyway. My shy oldest girl was probably terrified and embarrassed. I wonder how on earth Brenda introduced herself -- "Hi, honey, I'm a friend of your mommy's, stopping by for no reason and asking nosy questions"? Or "Hi, honey, I'm checking up on whether your mommy takes care of you"?
Then, to "close the case" so I wouldn't have to endure serial home visits, she had made up a document for me to sign. Loulou3 will dress the children in weather-appropriate clothes. Loulou3 understands that she is responsible for supervising her children at all times. Loulou3 will take down the rope hanging in her house as this is a choking hazard, or will closely supervise the children when they are playing with it.
She had actually typed the thing up using my first name. This irritated me more than anything else -- which I suspect means I'm turning into my mother much sooner than anticipated. I signed it. I smiled. I showed her and the others to the door. I ripped up the poisonous piece of crap as soon as she was gone.
She did tell me one thing I wanted to know. The person who'd called in the tip about my allegedly negligent parenting was named Anonymous. So now, on top of everything else, I'm going to die wondering.
old people
Last night a nurse called me for help: an elderly patient was cursing her, wandering the halls, barging into other patients' rooms and shaking his fist at them. Finally he hurled a phone book at the nurse's head and shouted something about child molesters.
I come across a lot of old people at work. Most of them are a bit demented (some more than a bit) and they tend to go to pieces mentally once they're stuck in the hospital. They wake up in the night and blink around at the dark shadows and think, Where the hell am I? This place doesn't match anything my mind can put a name on. Am I lost? Kidnapped? What happened to my family? Eventually, their brain supplies some sort of answer to try to make sense of things. Damn hot here. What's that weird smell? Oh, Christ, I'd forgotten -- we made land yesterday. Iwo Jima, the sarge called it. OK, you motherfuckers, I'm ready for ya! Come and get me!
The vagaries of mind and memory are amazing to me. One night in med school I woke up in darkness clutching my bed, sure that I was back on the volcano Stromboli in a makeshift tent, with the ground booming underneath me. But under me I felt mattress instead of rock, so I couldn't make sense of anything and fell asleep again in confusion -- like Billy Pilgrim unstuck in time. The next day the local news reported that several blocks from my apartment, an abandoned home had exploded in the night and sent a shockwave through the earth that could be felt a mile away. See how amazing? I hadn't thought of Stromboli in years, but the earth went boom and my body remembered that feeling from the single night, a lifetime previous, when I'd lain on booming earth before. In my sleep my brain slung me backwards like a time-traveler, and I woke up twenty-two in Sicily and in trouble again -- and it felt as real and solid as it had been the first time around. How cool is that.
So now I'm looking forward to senility, when I will at last recapture my lost youth. I'm going to pay someone to set off explosions near me at intervals while I'm sleeping, so I can wake up night after night in Sicily, and be twenty-two forever.
I come across a lot of old people at work. Most of them are a bit demented (some more than a bit) and they tend to go to pieces mentally once they're stuck in the hospital. They wake up in the night and blink around at the dark shadows and think, Where the hell am I? This place doesn't match anything my mind can put a name on. Am I lost? Kidnapped? What happened to my family? Eventually, their brain supplies some sort of answer to try to make sense of things. Damn hot here. What's that weird smell? Oh, Christ, I'd forgotten -- we made land yesterday. Iwo Jima, the sarge called it. OK, you motherfuckers, I'm ready for ya! Come and get me!
The vagaries of mind and memory are amazing to me. One night in med school I woke up in darkness clutching my bed, sure that I was back on the volcano Stromboli in a makeshift tent, with the ground booming underneath me. But under me I felt mattress instead of rock, so I couldn't make sense of anything and fell asleep again in confusion -- like Billy Pilgrim unstuck in time. The next day the local news reported that several blocks from my apartment, an abandoned home had exploded in the night and sent a shockwave through the earth that could be felt a mile away. See how amazing? I hadn't thought of Stromboli in years, but the earth went boom and my body remembered that feeling from the single night, a lifetime previous, when I'd lain on booming earth before. In my sleep my brain slung me backwards like a time-traveler, and I woke up twenty-two in Sicily and in trouble again -- and it felt as real and solid as it had been the first time around. How cool is that.
So now I'm looking forward to senility, when I will at last recapture my lost youth. I'm going to pay someone to set off explosions near me at intervals while I'm sleeping, so I can wake up night after night in Sicily, and be twenty-two forever.
Wednesday, November 21, 2007
sneeze if you're muslim 2
Me: Sarah, does your teacher explain why Muslims say "Alhamdulillah" when they sneeze?
S: shrugs
Me: Well. Here's the thing.
S (looking nervous as she recognizes her mother's Imminent Pontification face): What thing?
Me: "Alhamdulillah" means "thank God" or something. The thing is, if I were God, I'd want people to thank me when they meant it and not just because someone told them to.
S: Oh.
Me: Like, suppose someone says "A-choo! alhamdulillah," all in a rush, and you know they're not actually thinking, "Wow, God! Thank you for giving me that terrific sneeze!" They're just saying it as a habit.
S (brightening with recognition): You mean, like Baba!
Me: Shhh. Well, yes, smart girl. But don't tell your baba I said so.
S: Why not?
Me: Just don't.
S: Can I have a snack now?
S: shrugs
Me: Well. Here's the thing.
S (looking nervous as she recognizes her mother's Imminent Pontification face): What thing?
Me: "Alhamdulillah" means "thank God" or something. The thing is, if I were God, I'd want people to thank me when they meant it and not just because someone told them to.
S: Oh.
Me: Like, suppose someone says "A-choo! alhamdulillah," all in a rush, and you know they're not actually thinking, "Wow, God! Thank you for giving me that terrific sneeze!" They're just saying it as a habit.
S (brightening with recognition): You mean, like Baba!
Me: Shhh. Well, yes, smart girl. But don't tell your baba I said so.
S: Why not?
Me: Just don't.
S: Can I have a snack now?
Tuesday, November 20, 2007
ACLS recert
Yesterday and today I've been stuck in class, recertifying for advanced cardiac life support. We broke up into groups of six and practiced using defibrillators on dummies. Everyone in the class of 25 was an RN or student EMT, except me. So right away, people jumped to the wrong conclusion.
M: Hey, who here knows how to charge the machine for a synchronized shock?
T: Ask Dr. L! You must know, right, doc?
Me: Actually, no. I don't know how to do anything with my own hands.
R: But you're a doctor.
Me: Yes, but I'm the kind with no useful skills. That's what you guys are for.
M: So, what do you do, exactly?
Me: I just write stuff in the charts.
The best description I've ever read of what an internist is, goes like this: "Internists are the guys who write very detailed notes in the chart, carefully documenting the patient's downhill course."
There are lots of ways to tell the specialties apart. Here is a classic tip:
Internists know everything and do nothing, whereas surgeons know nothing and do everything. Psychiatrists know nothing and do nothing. Pathologists know everything and do everything, but too late.
Then, there are the orthopedic surgeons. They're great -- all big strapping guys, bluff and personable, ,who played sports in their glory days. The best epigram I've heard about them goes like this: Orthopods -- strong as an ox, and twice as smart.
Surgeons take a lot of cheap shots, mostly well-deserved. "A surgeon is like a stupid child who has learned to tie a very complicated pair of shoes and is really proud of the accomplishment."
Here's my favorite. This is a story about two subspecialties famous for not knowing when to quit.
The oncology team meeting got underway on Monday morning with a discussion of the sickest of their cancer patients. "What about Ms. Brown?" asked the department chair, looking around at her colleagues. "How's she doing with her metastatic cancer of the everything?"
"She died on Friday," answered the onc nurse. "I saw her name in the obits. The viewing was today."
"That's too bad," the chair answered. "Well, let's give her at least one more round of chemo. After all, you never know. Maybe it will do some good."
All the oncologists agreed it was worth a shot. So that night they crept out to the cemetery with picks and shovels and unearthed the woman's coffin. They pried open the lid. But they were shocked at what they saw.
The body was gone and the coffin was empty, except for a yellow post-it note written in the careful hand of the renal physician. It said: "Gone to dialysis."
M: Hey, who here knows how to charge the machine for a synchronized shock?
T: Ask Dr. L! You must know, right, doc?
Me: Actually, no. I don't know how to do anything with my own hands.
R: But you're a doctor.
Me: Yes, but I'm the kind with no useful skills. That's what you guys are for.
M: So, what do you do, exactly?
Me: I just write stuff in the charts.
The best description I've ever read of what an internist is, goes like this: "Internists are the guys who write very detailed notes in the chart, carefully documenting the patient's downhill course."
There are lots of ways to tell the specialties apart. Here is a classic tip:
Internists know everything and do nothing, whereas surgeons know nothing and do everything. Psychiatrists know nothing and do nothing. Pathologists know everything and do everything, but too late.
Then, there are the orthopedic surgeons. They're great -- all big strapping guys, bluff and personable, ,who played sports in their glory days. The best epigram I've heard about them goes like this: Orthopods -- strong as an ox, and twice as smart.
Surgeons take a lot of cheap shots, mostly well-deserved. "A surgeon is like a stupid child who has learned to tie a very complicated pair of shoes and is really proud of the accomplishment."
Here's my favorite. This is a story about two subspecialties famous for not knowing when to quit.
The oncology team meeting got underway on Monday morning with a discussion of the sickest of their cancer patients. "What about Ms. Brown?" asked the department chair, looking around at her colleagues. "How's she doing with her metastatic cancer of the everything?"
"She died on Friday," answered the onc nurse. "I saw her name in the obits. The viewing was today."
"That's too bad," the chair answered. "Well, let's give her at least one more round of chemo. After all, you never know. Maybe it will do some good."
All the oncologists agreed it was worth a shot. So that night they crept out to the cemetery with picks and shovels and unearthed the woman's coffin. They pried open the lid. But they were shocked at what they saw.
The body was gone and the coffin was empty, except for a yellow post-it note written in the careful hand of the renal physician. It said: "Gone to dialysis."
Monday, November 19, 2007
deconstruction
Something that drives me nuts, is that no one in my family -- aside from the tiny monsters -- ever asks me what I do for a living. I mean, they know I'm a doctor, of course. But they act like I work for the mob and it's impolite to ask too many questions.
So anyway, here's what I did last night on call:
1. Admitted a middle-aged paraplegic with a bladder infection and a funny-looking kidney. Threw antibiotics at her and asked Urology to see her in the morning.
2. Admitted a young woman with a bad pneumonia, getting worse despite oral antibiotics at home. What makes her interesting is that she's taking a immune-suppressing medicine for another medical condition - which means she might have something offbeat and cool, like TB or a lung fungus. Threw antibiotics at her, put her in respiratory isolation (quarantine) and asked Pulm and ID to see her in the morning.
3. Admitted a middle-aged woman who'd overdosed on muscle relaxants, hoping to cure a bad headache. Muscle relaxants don't usually help headaches. However, they do cause low blood pressure, slow heart rate and hallucinations when taken to excess. I tried to explain this to her but she was too busy hallucinating and clutching her head to pay attention.
4 and 5. Admitted twin strokes: two lively octogenarians who both came to the ER with sudden weakness. Threw antiplatelet medicine at them and asked Neurology to see them in the morning.
My God, is that really what I did all night? It sounds incredibly boring. Actually, it WAS incredibly boring. Huh. Maybe that's why my family doesn't ask any questions.
So anyway, here's what I did last night on call:
1. Admitted a middle-aged paraplegic with a bladder infection and a funny-looking kidney. Threw antibiotics at her and asked Urology to see her in the morning.
2. Admitted a young woman with a bad pneumonia, getting worse despite oral antibiotics at home. What makes her interesting is that she's taking a immune-suppressing medicine for another medical condition - which means she might have something offbeat and cool, like TB or a lung fungus. Threw antibiotics at her, put her in respiratory isolation (quarantine) and asked Pulm and ID to see her in the morning.
3. Admitted a middle-aged woman who'd overdosed on muscle relaxants, hoping to cure a bad headache. Muscle relaxants don't usually help headaches. However, they do cause low blood pressure, slow heart rate and hallucinations when taken to excess. I tried to explain this to her but she was too busy hallucinating and clutching her head to pay attention.
4 and 5. Admitted twin strokes: two lively octogenarians who both came to the ER with sudden weakness. Threw antiplatelet medicine at them and asked Neurology to see them in the morning.
My God, is that really what I did all night? It sounds incredibly boring. Actually, it WAS incredibly boring. Huh. Maybe that's why my family doesn't ask any questions.
Sunday, November 18, 2007
crack in the mirror
Sometimes this happens: You're driving along the highway. Up ahead, you catch sight of a car like yours -- same color, same make and model and subtype. You close in on it. The woman behind the wheel has your haircolor, and in fact, your hairstyle too. She seems to be smiling but you can't make out her face. The thought strikes you: What if I pull up beside her and take a good look -- and see my own face grinning back at me?
Here's what to do: Press the accelerator, pull alongside and pass her quickly while keeping your eyes fixed on the road. Do not check your rearview mirror. Get home as fast as you can, and lock the doors.
Here's what to do: Press the accelerator, pull alongside and pass her quickly while keeping your eyes fixed on the road. Do not check your rearview mirror. Get home as fast as you can, and lock the doors.
Saturday, November 17, 2007
return of the sea monkeys
Scene one: preschool
Jake: Guess what! We got little shrimp at my house!
Miss Bethany: Oh, I love shrimp too. Do you dip them in cocktail sauce?
Scene two: home
Jake: Mama, when the sea monkeys grow up, can we make them be dead and eat them with sauce?
Jake: Guess what! We got little shrimp at my house!
Miss Bethany: Oh, I love shrimp too. Do you dip them in cocktail sauce?
Scene two: home
Jake: Mama, when the sea monkeys grow up, can we make them be dead and eat them with sauce?
my name is not loulou 3
My mother had car trouble the day before I was to leave. I didn't panic. I called my best friend's mom: could she drive me to the airport? Then I told my mother not to worry, as I wouldn't be needing her after all.
I had meant to spare her a burden, but instead she burst into tears. The car was already fixed, she said. And in spite of all the trouble between us, she'd always assumed she would be at my side in that last moment, before I flew.
So the next day, she drove me. It was a strained parting. During the month we'd been under the same roof, my mother had not cheered for my plan. In the middle of our silent dinners I'd see her eyes fixed on me, mouth pursed up and lines of pain and anger etched into her face. She'd burst out, It's not going to be like you think, you know. I've traveled in Europe. They're sick of young American bums on their streets. You think they'll be friendly to you? You're wrong.
Or, What do you know about biking any distance? What's the longest you've ever biked, anyway? How will you even get out of the airport? You've never put a bike together. What's going to happen if you can't do it?
Or, Your father and I saved every penny when we were first married. We didn't go running around, loosey-goosey, because we thought it was fun. We were too responsible for such nonsense.
My mother was scared for me; I knew that. She was also impossible, bitter, envious, and mean: a dragging anchor against all my optimism and hope. At least that's how I saw it then. Now that I've got a few young things of my own, I would say she let me off easy. If one of my own kids ever threatens to take wild risks too far from the nest, I'm going to chain her to a radiator until I can beat some sense into her silly, ungrateful skull.
At the airport, my mother helped me maneuver my luggage cart through the lines. The only baggage I checked was an oversized flat box of heavy cardboard. I had paid a local bike shop to disassemble and pack my bike for me, since I had no idea how to do it myself and wasn't interested in learning. The bike was new: a Univega Gran Touring, twelve speeds, gunmetal gray. It had cost four hundred dollars. I'd ridden it in my neighborhood a couple times with the panniers on, trying to get the hang of balancing with all that unfamiliar weight on my rear wheel. I didn't go far, though; just up and down my street. It was sort of a drag, to tell the truth -- slow and heavy and hard to manage. But I wasn't worried. I'd learn by doing, on the road in Europe. I'd chosen Holland as a strategic starting point in my campaign: according to Let's Go: Europe, it was bike-friendly. And flat.
My carry-on luggage was a strange-looking creation. It consisted of two panniers (stuffed with clothes and a tarp), a sleeping bag, a bike pump, a Kryptonite lock, and a handlebar bag full of Allen wrenches and such. The whole mess was bound together with an assortment of bungee cords. Under my clothes I wore a hidden pouch that hung from a string around my neck: it held my passport and asthma inhaler and every cent I'd saved in my entire life, converted into travelers' checks. I'd always been a saver. I'd also been something of a kept woman my last year in college, so that helped.
Something occurred to me years later, that never crossed my mind at that time. My mother had taken out loans, maybe a hundred grand's worth, to put me through college. I had been able to "save" money from my campus jobs and summer work, because my living expenses were paid by those student loans that she signed for. Rightfully, my mother could have reminded me of this and laid claim to every cent I had. But for all those times she'd said, Don't go and I'd stormed, I have the right and I have the money, she had never once pulled that trump card. She was a class act.
Eithet that, or she was just scared it wouldn't be enough to stop me.
At the security gate, we paused for a moment. She looked at me. I was steeled for some final twist of the knife or bitter remonstration. Instead she said softly, "Have fun out there, kiddo. Enjoy your freedom. The real world closes in pretty fast."
That was the last gift she gave me, and the last thing I took with me when I left.
I had meant to spare her a burden, but instead she burst into tears. The car was already fixed, she said. And in spite of all the trouble between us, she'd always assumed she would be at my side in that last moment, before I flew.
So the next day, she drove me. It was a strained parting. During the month we'd been under the same roof, my mother had not cheered for my plan. In the middle of our silent dinners I'd see her eyes fixed on me, mouth pursed up and lines of pain and anger etched into her face. She'd burst out, It's not going to be like you think, you know. I've traveled in Europe. They're sick of young American bums on their streets. You think they'll be friendly to you? You're wrong.
Or, What do you know about biking any distance? What's the longest you've ever biked, anyway? How will you even get out of the airport? You've never put a bike together. What's going to happen if you can't do it?
Or, Your father and I saved every penny when we were first married. We didn't go running around, loosey-goosey, because we thought it was fun. We were too responsible for such nonsense.
My mother was scared for me; I knew that. She was also impossible, bitter, envious, and mean: a dragging anchor against all my optimism and hope. At least that's how I saw it then. Now that I've got a few young things of my own, I would say she let me off easy. If one of my own kids ever threatens to take wild risks too far from the nest, I'm going to chain her to a radiator until I can beat some sense into her silly, ungrateful skull.
At the airport, my mother helped me maneuver my luggage cart through the lines. The only baggage I checked was an oversized flat box of heavy cardboard. I had paid a local bike shop to disassemble and pack my bike for me, since I had no idea how to do it myself and wasn't interested in learning. The bike was new: a Univega Gran Touring, twelve speeds, gunmetal gray. It had cost four hundred dollars. I'd ridden it in my neighborhood a couple times with the panniers on, trying to get the hang of balancing with all that unfamiliar weight on my rear wheel. I didn't go far, though; just up and down my street. It was sort of a drag, to tell the truth -- slow and heavy and hard to manage. But I wasn't worried. I'd learn by doing, on the road in Europe. I'd chosen Holland as a strategic starting point in my campaign: according to Let's Go: Europe, it was bike-friendly. And flat.
My carry-on luggage was a strange-looking creation. It consisted of two panniers (stuffed with clothes and a tarp), a sleeping bag, a bike pump, a Kryptonite lock, and a handlebar bag full of Allen wrenches and such. The whole mess was bound together with an assortment of bungee cords. Under my clothes I wore a hidden pouch that hung from a string around my neck: it held my passport and asthma inhaler and every cent I'd saved in my entire life, converted into travelers' checks. I'd always been a saver. I'd also been something of a kept woman my last year in college, so that helped.
Something occurred to me years later, that never crossed my mind at that time. My mother had taken out loans, maybe a hundred grand's worth, to put me through college. I had been able to "save" money from my campus jobs and summer work, because my living expenses were paid by those student loans that she signed for. Rightfully, my mother could have reminded me of this and laid claim to every cent I had. But for all those times she'd said, Don't go and I'd stormed, I have the right and I have the money, she had never once pulled that trump card. She was a class act.
Eithet that, or she was just scared it wouldn't be enough to stop me.
At the security gate, we paused for a moment. She looked at me. I was steeled for some final twist of the knife or bitter remonstration. Instead she said softly, "Have fun out there, kiddo. Enjoy your freedom. The real world closes in pretty fast."
That was the last gift she gave me, and the last thing I took with me when I left.
a satisfying life
You know what I really look forward to? Buying stuff. I keep a list in my head of things I need. Right now I'm needing frames for the kids' school pictures; some sort of light fixture to chase the gloom out of the downstairs office; a wall-mounted CD organizer; girly soap; socks for me; socks for kids, and construction paper. There's also forty other things that won't occur to me until my eye falls upon them in the store and I realize how much better, more attractive and more organized my life will be when I acquire them. Nothing feels as good as coming home with my haul and running around the house, putting everything in its place.
Wait, that's not true. Here's something that feels even better: throwing things out, bags and bags of it. I don't know where all this crap comes from.
Wait, that's not true. Here's something that feels even better: throwing things out, bags and bags of it. I don't know where all this crap comes from.
Friday, November 16, 2007
sometimes words fail me
"Seven?!" -- Jerry
"Seven!" -- George
E (flashing a pic of a smiling baby): Here she is! Five weeks old now!
Me: Oh, cute girl! What did you name her?
E: Well, we wanted to name her after my grandmother -- but her name is Geneva Rose, so of course that was out!
(Makes an 'Ick' face and laughs, looking to me as if I'd recognize immediately that Geneva Rose is an appalling name beyond consideration. Actually, I like Geneva Rose -- it makes me think of Alps and roses; two things I approve of. But I laugh and nod sympathetically. She's my friend, after all.)
Me: Okay, so what did you pick?
E: Bevin!
"Seven!" -- George
E (flashing a pic of a smiling baby): Here she is! Five weeks old now!
Me: Oh, cute girl! What did you name her?
E: Well, we wanted to name her after my grandmother -- but her name is Geneva Rose, so of course that was out!
(Makes an 'Ick' face and laughs, looking to me as if I'd recognize immediately that Geneva Rose is an appalling name beyond consideration. Actually, I like Geneva Rose -- it makes me think of Alps and roses; two things I approve of. But I laugh and nod sympathetically. She's my friend, after all.)
Me: Okay, so what did you pick?
E: Bevin!
sneeze if you're Muslim
My six-year-old daughter came home last week with stuff her Islamic teacher wants her to memorize. This includes:
1) the Arabic phrase to say when you sneeze
2) the phrase to say when you witness a sneeze
3) the phrase to answer the sneeze-witnesser if you are the sneezer
4) which foot steps into the bathroom first
5) the phrase to say when one enters the bathroom
6) which foot gets to leave the bathroom first
7) the phrase you should say when leaving the bathroom
8) the thirteen-step ritual for washing (wudu) before praying
It's a good subject for a blog. But I'm so damn exhausted by the whole thing that I can't even find the will to make jokes about it.
1) the Arabic phrase to say when you sneeze
2) the phrase to say when you witness a sneeze
3) the phrase to answer the sneeze-witnesser if you are the sneezer
4) which foot steps into the bathroom first
5) the phrase to say when one enters the bathroom
6) which foot gets to leave the bathroom first
7) the phrase you should say when leaving the bathroom
8) the thirteen-step ritual for washing (wudu) before praying
It's a good subject for a blog. But I'm so damn exhausted by the whole thing that I can't even find the will to make jokes about it.
Thursday, November 15, 2007
social services I
The woman from Social Services called again. She's coming over tomorrow. I'm tired of this story, so I'll make it brief.
I came home from work one day to find a card from the county social work agency, Child Protection division, tucked in the crack of my front door. I was baffled but terrifically curious, so I called. The social worker, Brenda, said there was "something she needed to talk to me about" but refused to do it over the phone. I said fine, come on over.
My house smelled a bit like urine (the cat has kidney stones and likes to pee in odd places) but by our ten a.m. appointment I was mostly dressed and fairly sober, so I figured I'd make a good impression. Brenda showed up with a silent assistant in tow. I invited them in.
Someone had called in a report on me -- that was the gist of it. The informant (I asked who it was and got, "I'm sorry, I can't give you that information") had accused me of neglecting my kids, specifically my youngest daughter. The social worker was evasive about the details. I think I'd been accused of letting her run loose in the street or something. Brenda also asked me if it were true that I go running sometimes at night.
Well yes. I do. So what?
What neighborhood idiot saw me out running at night and reported this to Child Protection?
Suspicion falls on two neighbors. First, across the street and three houses down is a little old couple I don't know. I think they're the ones who keep calling our subdivision's Homeowners Association to complain about my poor mowing habits and penchant for leaving my trash cans by the curb all week. Also, when my six-year-old went out selling chocolates for her school, they were the only ones in the neighborhood who didn't humor her by buying a damn chocolate bar. They said, "No, we don't need those. And you shouldn't be out by yourself, should you?" They're Nazis. I can tell.
More interestingly -- and I really hope it's her -- it could be the high-strung woman six streets over who last year accused me of sleeping with her husband. This was after she kicked him out of the house for losing his license to practice medicine because he'd forked a patient on the exam table who later accused him of rape. It's all very convoluted. I'll be really entertained if she's still plotting petty revenge against me. Whether I did or didn't sleep with him, I won't say, but since she kicked him out and she knew he was a big fat slut long before I allegedly sank my claws into him, I don't know what she can blame me for in any case -- except poor taste in lovers, I suppose. And that would be a case of the pot calling the kettle mean names.
Anway, I answered Brenda's questions and showed her to the door and I assumed it was all settled. Before she left, she remarked over the long rope that hangs from the upstairs hallway down into the foyer. It's made of cloth belts and gis all tied together and the kids play with it a lot -- hoisting stuffed animals into the air, lassoing me when I'm making important phone calls, tying up the neighbor boy and so forth. The lady pointed out that it was a choking hazard and asked me to take it down. I said I would. She left. The end.
Except that she left me a message a couple weeks later saying she "still had some concerns." And once again, it can't be settled over the phone; she has to come to my damn home tomorrow and interrogate me in person. The rope is still hanging there. I thought of taking it down before she comes over, but I'm not going to. I think I'll draw a freakin pentagram on the floor with sheep's blood and drink tequila in front of her and leave my full-color anatomy atlas open to the page titled Genitalia: Male And Female.
I was interested at first, but by this point I'm just irked and bored. Sometimes I do stupid things for amusement when I'm bored. Usually I regret it for a long time afterward. I suspect tomorrow will be no exception.
I came home from work one day to find a card from the county social work agency, Child Protection division, tucked in the crack of my front door. I was baffled but terrifically curious, so I called. The social worker, Brenda, said there was "something she needed to talk to me about" but refused to do it over the phone. I said fine, come on over.
My house smelled a bit like urine (the cat has kidney stones and likes to pee in odd places) but by our ten a.m. appointment I was mostly dressed and fairly sober, so I figured I'd make a good impression. Brenda showed up with a silent assistant in tow. I invited them in.
Someone had called in a report on me -- that was the gist of it. The informant (I asked who it was and got, "I'm sorry, I can't give you that information") had accused me of neglecting my kids, specifically my youngest daughter. The social worker was evasive about the details. I think I'd been accused of letting her run loose in the street or something. Brenda also asked me if it were true that I go running sometimes at night.
Well yes. I do. So what?
What neighborhood idiot saw me out running at night and reported this to Child Protection?
Suspicion falls on two neighbors. First, across the street and three houses down is a little old couple I don't know. I think they're the ones who keep calling our subdivision's Homeowners Association to complain about my poor mowing habits and penchant for leaving my trash cans by the curb all week. Also, when my six-year-old went out selling chocolates for her school, they were the only ones in the neighborhood who didn't humor her by buying a damn chocolate bar. They said, "No, we don't need those. And you shouldn't be out by yourself, should you?" They're Nazis. I can tell.
More interestingly -- and I really hope it's her -- it could be the high-strung woman six streets over who last year accused me of sleeping with her husband. This was after she kicked him out of the house for losing his license to practice medicine because he'd forked a patient on the exam table who later accused him of rape. It's all very convoluted. I'll be really entertained if she's still plotting petty revenge against me. Whether I did or didn't sleep with him, I won't say, but since she kicked him out and she knew he was a big fat slut long before I allegedly sank my claws into him, I don't know what she can blame me for in any case -- except poor taste in lovers, I suppose. And that would be a case of the pot calling the kettle mean names.
Anway, I answered Brenda's questions and showed her to the door and I assumed it was all settled. Before she left, she remarked over the long rope that hangs from the upstairs hallway down into the foyer. It's made of cloth belts and gis all tied together and the kids play with it a lot -- hoisting stuffed animals into the air, lassoing me when I'm making important phone calls, tying up the neighbor boy and so forth. The lady pointed out that it was a choking hazard and asked me to take it down. I said I would. She left. The end.
Except that she left me a message a couple weeks later saying she "still had some concerns." And once again, it can't be settled over the phone; she has to come to my damn home tomorrow and interrogate me in person. The rope is still hanging there. I thought of taking it down before she comes over, but I'm not going to. I think I'll draw a freakin pentagram on the floor with sheep's blood and drink tequila in front of her and leave my full-color anatomy atlas open to the page titled Genitalia: Male And Female.
I was interested at first, but by this point I'm just irked and bored. Sometimes I do stupid things for amusement when I'm bored. Usually I regret it for a long time afterward. I suspect tomorrow will be no exception.
code 11/14
Yesterday I coded someone. It went better than it usually does. He's in the ICU now. He's 8o-plus but tough as nails and we got the pulse back within a couple minutes. He's a really nice guy and he's got a great family: smart, nice, reasonable people who love him to bits -- and that's pretty rare. We'll see what happens.
It's always like a story to me.
Chapter One: he comes to the hospital and gets admitted by my partner; I meet him a few hours later.
Chapter Two: he goes pulseless down in Dialysis -- a "code 500" as they call it at my hospital -- but snaps out of it and goes to the Unit on mechanical ventilation with a not-quite-reliable heartbeat.
That's as far as I've gotten in the plot. I'm hoping for a happy ending.
It's always like a story to me.
Chapter One: he comes to the hospital and gets admitted by my partner; I meet him a few hours later.
Chapter Two: he goes pulseless down in Dialysis -- a "code 500" as they call it at my hospital -- but snaps out of it and goes to the Unit on mechanical ventilation with a not-quite-reliable heartbeat.
That's as far as I've gotten in the plot. I'm hoping for a happy ending.
syntax
Loulou [doing some kind of three-year-old badness, then shrieking joyfully]: EeeeeeeeeeKaaaaaa MAMA! Booobah!
Me: You! Behave!
Loulou [stomping foot]: I! AM! BEIN'! HAIVE!
Me: You! Behave!
Loulou [stomping foot]: I! AM! BEIN'! HAIVE!
Wednesday, November 14, 2007
allison's story I
Today I thought of Allison. Hard to believe she'd be in kindergarten now. I used to think of her all the time, picturing a curious baby with a frizz of black hair pinned with plastic barretts, framing a round brown face. That was just my imagination, though. Actually I never met her, or even saw a picture. She was coming up on one year old when her life and mine swandived toward eachother, almost but not quite colliding, before she slid past me into her future and I went a different way, into my own.
This is her story, what I know of it.
It all started with the ICU. Every second-year did at least a one-month rotation there. It was the toughest rotation for us Medicine residents: we carried six or eight patients apiece on average, did all their procedures (intubating them, putting in lines, sticking needles into chests and bellies and spines and so forth) and took call every third night. You were guaranteed to never see the inside of your call room -- a closet big enough for a bed and a phone -- because you'd spend the whole night on the run between the ER and the six intensive care units on the first two floors of the University hospital. The team consisted of three residents, one Pulmonary fellow, one attending, and a pharm.D. student. There was a mirror-image team called CCU, or Cardiac Care Unit, which took the critical heart cases. Residents on CCU took call every third, as well, so at night the ICU resident and CCU resident could call on eachother if things got hairy. Both residents were on the code team, which meant we carried a code pager that alarmed and sent us running when a patient anywhere in the hospital had a cardiopulmonary emergency. In addition to that we had our regular pagers, which went off every five minutes. The code pager was honkin' big and really annoying to carry around. Plus, it sent me into a cold sweat when it went off.
First-year residents -- interns -- never rotated in ICU or CCU, not anymore. One time I asked an upper-level why that was. "Too many mistakes," he answered, "and too many cases ending like this--" He put his left hand down on Harrison's Internal Medicine and raised his right hand like a man solemnly swearing to tell the truth, the whole truth and nothing but the truth in a malpractice trial.
It was the only month I ever felt any resemblance to those stupid doctors on TV shows. It was scary and exhausting and I wasn't any good at it, but, God, it sang in my blood like a drug. Every patient had a flashy story and ten sobbing relatives, and most of them came in balanced on a knife's edge between living and dying. I felt all the way alive, like I'd made it to the throbbing passionate heart of everything that mattered. It was a soap opera. It was glorious; it was terrifying; I couldn't wait for it to be over and then I felt lost and let down when it finally was. And I miss it so much: miss it like you miss the wild bad boy who stole your heart and took you on a mad ride across Mexico, doing ninety miles an hour with a posse on your tail. I didn't have the cojones to do a Pulm fellowship myself, so I'm going to be missing it for the rest of my sorry chickenshit life.
One day a guy was flown in, a suicide attempt. He was a family man who'd drunk away his job and his money and then decided to end it all, so he downed several glasses of antifreeze while driving around in his car. Eventually the police stopped him and asked what the hell he was doing, at which point he declared, "I'm drinking antifreeze!" The cop asked, "How many glasses did you drink?" but the man, in lieu of answering, fell unconscious behind the wheel.
The great thing about this guy was his name. See, when I was a kid in grade school we had jump-rope songs, and my favorite went like this:
Lincoln, Lincoln, I've been thinkin --
What the heck have you been drinkin?
Looks like water,
Smells like wine,
Oh my gosh it's turpentine!
How many glasses did you drink?
One! Two! Three! Four!
(and so on)
The antifreeze man, believe it or not, was named Lincoln. That cracked me up. It was so damn good I couldn't keep it to myself. So the next morning, after I presented his case to my team -- told them about his medical problems and the treatment I'd started him on -- I added, "Now, listen. There's a song I have to sing for you, a jumprope song." And for the rest of the month the ICU nurses would whoop and chant "Lincoln, Lincoln!" when I walked through the halls.
All of this, by the way, has nothing to do with Allison. So I'll get to it.
I was on call one night when the ER paged. They had a sick guy needing a bed in the ICU, and as resident it was my job to pick up where the ER left off -- examine the patient, ask him a million questions, look over all the tests the ER had ordered and then come up with a treatment plan and write his admission orders. He was a 35-year-old black guy, a bit slow mentally, with no known pre-existing health problems -- in fact he was afraid of doctors and had avoided them his entire life. He was brought in by his brothers after four days of belly pain and nonstop vomiting. When he got to Triage, the nurses noticed right away that his heart rate was 150 and he looked bad. So they ushered him into the first open bed on Side A -- where the serious patients go -- instead of sticking him back in the waiting room. (The ER docs see side A patients right away; it's the people with sniffles and cuts who spend three hours in the waiting room and then two more hours in a bed on side B, before they finally get seen by an intern who doesn't know what she's doing anyway.)
So, that's how it started. It was about to get much worse. It was maybe five or six o'clock when I got the page, and I don't know what Allison was doing right then -- maybe playing or napping or chasing cheerios around a plate in her mom and dad's apartment on the slightly crappy side of town. She was too young to know about the ER, and she never had a clue what was coming.
This is her story, what I know of it.
It all started with the ICU. Every second-year did at least a one-month rotation there. It was the toughest rotation for us Medicine residents: we carried six or eight patients apiece on average, did all their procedures (intubating them, putting in lines, sticking needles into chests and bellies and spines and so forth) and took call every third night. You were guaranteed to never see the inside of your call room -- a closet big enough for a bed and a phone -- because you'd spend the whole night on the run between the ER and the six intensive care units on the first two floors of the University hospital. The team consisted of three residents, one Pulmonary fellow, one attending, and a pharm.D. student. There was a mirror-image team called CCU, or Cardiac Care Unit, which took the critical heart cases. Residents on CCU took call every third, as well, so at night the ICU resident and CCU resident could call on eachother if things got hairy. Both residents were on the code team, which meant we carried a code pager that alarmed and sent us running when a patient anywhere in the hospital had a cardiopulmonary emergency. In addition to that we had our regular pagers, which went off every five minutes. The code pager was honkin' big and really annoying to carry around. Plus, it sent me into a cold sweat when it went off.
First-year residents -- interns -- never rotated in ICU or CCU, not anymore. One time I asked an upper-level why that was. "Too many mistakes," he answered, "and too many cases ending like this--" He put his left hand down on Harrison's Internal Medicine and raised his right hand like a man solemnly swearing to tell the truth, the whole truth and nothing but the truth in a malpractice trial.
It was the only month I ever felt any resemblance to those stupid doctors on TV shows. It was scary and exhausting and I wasn't any good at it, but, God, it sang in my blood like a drug. Every patient had a flashy story and ten sobbing relatives, and most of them came in balanced on a knife's edge between living and dying. I felt all the way alive, like I'd made it to the throbbing passionate heart of everything that mattered. It was a soap opera. It was glorious; it was terrifying; I couldn't wait for it to be over and then I felt lost and let down when it finally was. And I miss it so much: miss it like you miss the wild bad boy who stole your heart and took you on a mad ride across Mexico, doing ninety miles an hour with a posse on your tail. I didn't have the cojones to do a Pulm fellowship myself, so I'm going to be missing it for the rest of my sorry chickenshit life.
One day a guy was flown in, a suicide attempt. He was a family man who'd drunk away his job and his money and then decided to end it all, so he downed several glasses of antifreeze while driving around in his car. Eventually the police stopped him and asked what the hell he was doing, at which point he declared, "I'm drinking antifreeze!" The cop asked, "How many glasses did you drink?" but the man, in lieu of answering, fell unconscious behind the wheel.
The great thing about this guy was his name. See, when I was a kid in grade school we had jump-rope songs, and my favorite went like this:
Lincoln, Lincoln, I've been thinkin --
What the heck have you been drinkin?
Looks like water,
Smells like wine,
Oh my gosh it's turpentine!
How many glasses did you drink?
One! Two! Three! Four!
(and so on)
The antifreeze man, believe it or not, was named Lincoln. That cracked me up. It was so damn good I couldn't keep it to myself. So the next morning, after I presented his case to my team -- told them about his medical problems and the treatment I'd started him on -- I added, "Now, listen. There's a song I have to sing for you, a jumprope song." And for the rest of the month the ICU nurses would whoop and chant "Lincoln, Lincoln!" when I walked through the halls.
All of this, by the way, has nothing to do with Allison. So I'll get to it.
I was on call one night when the ER paged. They had a sick guy needing a bed in the ICU, and as resident it was my job to pick up where the ER left off -- examine the patient, ask him a million questions, look over all the tests the ER had ordered and then come up with a treatment plan and write his admission orders. He was a 35-year-old black guy, a bit slow mentally, with no known pre-existing health problems -- in fact he was afraid of doctors and had avoided them his entire life. He was brought in by his brothers after four days of belly pain and nonstop vomiting. When he got to Triage, the nurses noticed right away that his heart rate was 150 and he looked bad. So they ushered him into the first open bed on Side A -- where the serious patients go -- instead of sticking him back in the waiting room. (The ER docs see side A patients right away; it's the people with sniffles and cuts who spend three hours in the waiting room and then two more hours in a bed on side B, before they finally get seen by an intern who doesn't know what she's doing anyway.)
So, that's how it started. It was about to get much worse. It was maybe five or six o'clock when I got the page, and I don't know what Allison was doing right then -- maybe playing or napping or chasing cheerios around a plate in her mom and dad's apartment on the slightly crappy side of town. She was too young to know about the ER, and she never had a clue what was coming.
freak of conscience
I bought a sea monkey kit for my three year old. Yesterday we did the preparatory steps, putting fresh water and a purifying mixture into the little aquarium. Today was the day for adding the eggs, which come in a small packet and look like white powder. She was excited. The two big kids grabbed seats next to her at the table, eager for the show.
I tore open the packet and showed Loulou how to pour it in. But I was hurrying, and some powder spilled on the table. Salt and glue and crumbs of God knows what were all over the table, so the eggs were unsalvageable. I swept the powder into my hand and tossed it in the sink.
Sea monkeys, if you don't know, are a cryptobiotic version of brine shrimp. A sea monkey kit can sit on a dusty shelf in Walmart for ten generations, until a monkey-lovin' freak like me comes along and buys it. Then, a few days after the eggs are poured into water, voila! Tiny swimmy plankton spring to life and careen around in nutty spirals, bursting with energy and fierce intentions. I love the damn things. They make me think of great oceans and blue whales, of mystery and magic, of the beaches I used to run on with my brothers, and all the cunning tricks life plays to beat the odds.
I stopped and stared into the sink. How many sea monkeys would never be born because of what I'd done? Or -- more horrible -- how many would be born unloved in the dark hostile world of the drain, to live brief lives of terror before suffocating or dessicating or getting smashed in the blades of the garbage disposal?
Here's what's funny. I've always thought I could abort a fetus -- my own or someone else's -- without blinking an eye. But when I washed those microscopic eggs down the drain and thought of the tiny shrimps who had waited so long for their turn at life and had come so close before my careless moment stole their one chance, I felt sick.
Go figure.
I tore open the packet and showed Loulou how to pour it in. But I was hurrying, and some powder spilled on the table. Salt and glue and crumbs of God knows what were all over the table, so the eggs were unsalvageable. I swept the powder into my hand and tossed it in the sink.
Sea monkeys, if you don't know, are a cryptobiotic version of brine shrimp. A sea monkey kit can sit on a dusty shelf in Walmart for ten generations, until a monkey-lovin' freak like me comes along and buys it. Then, a few days after the eggs are poured into water, voila! Tiny swimmy plankton spring to life and careen around in nutty spirals, bursting with energy and fierce intentions. I love the damn things. They make me think of great oceans and blue whales, of mystery and magic, of the beaches I used to run on with my brothers, and all the cunning tricks life plays to beat the odds.
I stopped and stared into the sink. How many sea monkeys would never be born because of what I'd done? Or -- more horrible -- how many would be born unloved in the dark hostile world of the drain, to live brief lives of terror before suffocating or dessicating or getting smashed in the blades of the garbage disposal?
Here's what's funny. I've always thought I could abort a fetus -- my own or someone else's -- without blinking an eye. But when I washed those microscopic eggs down the drain and thought of the tiny shrimps who had waited so long for their turn at life and had come so close before my careless moment stole their one chance, I felt sick.
Go figure.
Tuesday, November 13, 2007
prosopagnosia IV
So, getting back to the grocery store:
I stuck out my hand to the man and said, "Thank you! But I'm so bad with faces. Tell me, who is your mother?" It turned out that his mother was the woman I wrote about in Saturday Superlatives a few days ago, whose death had such an effect on me. And the devoted daughter-in-law who cried and held the old woman as she lay dying -- that was his wife. Isn't that an amazing coincidence? I remembered that I had met him at the old woman's bedside a couple weeks before, back when we were still pretending she was going to live forever.
So I took the opportunity to tell him that I thought his mother and his wife were two great women. He smiled in a quiet way and said yeah, he knew that. Meanwhile the teenage kids stood around looking embarrassed. It was a sweet moment. I felt like the guy and I were bonding for life in a really meaningful way.
Now I just have to hope I never see him again -- because I won't recognize him next time either, and that will just be damn awkward.
I stuck out my hand to the man and said, "Thank you! But I'm so bad with faces. Tell me, who is your mother?" It turned out that his mother was the woman I wrote about in Saturday Superlatives a few days ago, whose death had such an effect on me. And the devoted daughter-in-law who cried and held the old woman as she lay dying -- that was his wife. Isn't that an amazing coincidence? I remembered that I had met him at the old woman's bedside a couple weeks before, back when we were still pretending she was going to live forever.
So I took the opportunity to tell him that I thought his mother and his wife were two great women. He smiled in a quiet way and said yeah, he knew that. Meanwhile the teenage kids stood around looking embarrassed. It was a sweet moment. I felt like the guy and I were bonding for life in a really meaningful way.
Now I just have to hope I never see him again -- because I won't recognize him next time either, and that will just be damn awkward.
prosopagnosia III
I used to have a line I used whenever I committed an especially gaffish gaffe, like when I introduced myself to a big-boss-guy I'd actually known for years, or when I treated a friend like a stranger. I'd apologize for my mistake, then explain that I'd had an head injury in medical school that had left me unable to recognize faces. I came up with this line because I really did suffer a head injury in med school, and it's a really good story, too: it starts out with me on my way to a baby shower, and ends with me getting whacked over the head and going under in a freezing river. So I was happy to have a reason to bring it up a lot.
But after a while I stopped using this line. I noticed people would look at me funny after I told them. I came to realize that brain damage is one of those things some people don't appreciate in a doctor.
But after a while I stopped using this line. I noticed people would look at me funny after I told them. I came to realize that brain damage is one of those things some people don't appreciate in a doctor.
prosopagnosia II
Here's another example of how bad I am with faces. This is a true story:
I had been dating my husband for about two months when for the first time, I took the bus to his city instead of letting him drive to me. When I got off the bus and looked around the crowded station trying to find him, I couldn't remember anything about his appearance except skinny guy, brown skin, some sort of facial hair. So I sat down with a book and pretended to read. A few minutes later he came up behind me and tapped me on the shoulder with a friendly grin. I was so happy to see him again, I hugged him and held on for a long time. We walked out to his car. As we sped down the dark highway, I put my hand down in his lap. He gave me a slow sideways smile and put his hand on top of mine. And then he said, "So, baby -- ya gonna tell me your name?"
Okay, so I made up that last part. But it could have happened. And that would have been really funny. In a very icky way.
I had been dating my husband for about two months when for the first time, I took the bus to his city instead of letting him drive to me. When I got off the bus and looked around the crowded station trying to find him, I couldn't remember anything about his appearance except skinny guy, brown skin, some sort of facial hair. So I sat down with a book and pretended to read. A few minutes later he came up behind me and tapped me on the shoulder with a friendly grin. I was so happy to see him again, I hugged him and held on for a long time. We walked out to his car. As we sped down the dark highway, I put my hand down in his lap. He gave me a slow sideways smile and put his hand on top of mine. And then he said, "So, baby -- ya gonna tell me your name?"
Okay, so I made up that last part. But it could have happened. And that would have been really funny. In a very icky way.
Monday, November 12, 2007
prosopagnosia I
The monsters and I were in the grocery store. They were looking at reduced-price sticky eyeballs and plastic spiders, while I was snarling at them to hurry up. That's when a man came around the corner, flanked by a couple of teenage kids. He came right up to me and said, "I might never have the chance to see you again, so I just want to say, thank you for the way you took care of my mother."
That was nice.
That never happens to me.
The problem: I had no idea who he was.
I have trouble with faces - serious trouble, like I can meet the same person ten times and still believe I've never seen them before. It's a terrible handicap. In the hospital I'm always ending up on elevators with complete strangers who fix their eyes on me urgently and say things like, "So, have you seen the CT yet? Does Dad have cancer?" This is why I try to take the stairs.
That was nice.
That never happens to me.
The problem: I had no idea who he was.
I have trouble with faces - serious trouble, like I can meet the same person ten times and still believe I've never seen them before. It's a terrible handicap. In the hospital I'm always ending up on elevators with complete strangers who fix their eyes on me urgently and say things like, "So, have you seen the CT yet? Does Dad have cancer?" This is why I try to take the stairs.
einstein's secret
George: You know, Einstein wore the exact same outfit every day.
Jerry: Well, if she splits the atom, I'll let it slide.
Recently I bought two long sleeveless black dresses, identical to the original that I wear as often as possible. This brings my total to five long sleeveless black dresses, three of them identical and the other two near-copies. I wear them under my white coat. They are long enough that I don't have to shave my legs, shapeless enough that they fit me at plus or minus fifteen pounds, and black enough to not show dirt if I wear them while building a retaining wall in the backyard.
I try to wear them in rotation but it's hard to remember which was yesterday's dress and which should be today's, since they live in a heap on my floor beside the shower. Possibly I'm just wearing the same one over and over. But I don't have a problem with that. Whenever I have a full load of wash, I throw all the black dresses into the machine. Then I can't think what to wear, so I stand in my closet blinking around stupidly like Columbus in the New World.
The only problem is, unlike Einstein I still care a little bit about public opinion. I don't give a damn if people say my clothes are boring, but I don't want them to actually suspect I'm wearing the same black dress off my floor every day. So at work yesterday I remarked in a loud voice to no one in particular, "Did you know, I have five black dresses like this one? I'm like Einstein!"
My partner L. overheard from across the nursing station. Her head snapped around and she looked visibly perturbed.
"Einstein wore dresses?" she gasped.
Jerry: Well, if she splits the atom, I'll let it slide.
Recently I bought two long sleeveless black dresses, identical to the original that I wear as often as possible. This brings my total to five long sleeveless black dresses, three of them identical and the other two near-copies. I wear them under my white coat. They are long enough that I don't have to shave my legs, shapeless enough that they fit me at plus or minus fifteen pounds, and black enough to not show dirt if I wear them while building a retaining wall in the backyard.
I try to wear them in rotation but it's hard to remember which was yesterday's dress and which should be today's, since they live in a heap on my floor beside the shower. Possibly I'm just wearing the same one over and over. But I don't have a problem with that. Whenever I have a full load of wash, I throw all the black dresses into the machine. Then I can't think what to wear, so I stand in my closet blinking around stupidly like Columbus in the New World.
The only problem is, unlike Einstein I still care a little bit about public opinion. I don't give a damn if people say my clothes are boring, but I don't want them to actually suspect I'm wearing the same black dress off my floor every day. So at work yesterday I remarked in a loud voice to no one in particular, "Did you know, I have five black dresses like this one? I'm like Einstein!"
My partner L. overheard from across the nursing station. Her head snapped around and she looked visibly perturbed.
"Einstein wore dresses?" she gasped.
Sunday, November 11, 2007
Amish people
I met an Amish family. They live in a valley with over a hundred acres. There are more than ten children -- the oldest married, and the youngest few running around in bowl haircuts and suspenders and impish smiles. The boys look exactly like Lukas Haas. They cluster around the window on the top floor of the hospital, pulling up all the blinds and pointing with excitement at the city spread out below them.
The family trains horses and ponies. They have chickens for eggs, and cows that give them milk. They do organic farming and sell their produce to local stores. They raise and sell roses too. Every couple of months, they put up some homemade wine. They make a salve of beeswax, comfrey and other herbs which they also sell. It is good for chapped cow udders, and in people it can be used for a number of skin ailments. They gave some to one of the nurses when she mentioned that her son has psoriasis. They are very friendly and blunt, without guile, and have a sly sense of humor and a nice way of teasing eachother. There are always seven or ten or fifteen of them together. Even the youngest girl wears a bonnet, though the little boys sometimes go hatless. The adults strike up conversations with other patients in the hallways, befriending them quickly and inviting them to come visit their farm.
The family trains horses and ponies. They have chickens for eggs, and cows that give them milk. They do organic farming and sell their produce to local stores. They raise and sell roses too. Every couple of months, they put up some homemade wine. They make a salve of beeswax, comfrey and other herbs which they also sell. It is good for chapped cow udders, and in people it can be used for a number of skin ailments. They gave some to one of the nurses when she mentioned that her son has psoriasis. They are very friendly and blunt, without guile, and have a sly sense of humor and a nice way of teasing eachother. There are always seven or ten or fifteen of them together. Even the youngest girl wears a bonnet, though the little boys sometimes go hatless. The adults strike up conversations with other patients in the hallways, befriending them quickly and inviting them to come visit their farm.
annika's story
I grew up in a village near Bremen. You've heard of Bremen? It's a port city. I was about eleven and we would hear the bombs falling. If we were in school we would have to leave and go into bunkers.
My sister and I were sent to the south of Germany with a lot of children, because the Allied forces weren't bombing there, that is, not until later. We stayed with strangers -- foster parents, as I called them. There was primary school but no secondary school there. It was not an easy time, being a child -- but things were not easy for a lot of people. After a while the bombs started falling in the south too, so I thought I might as well go back home and be with my mother. Our home was bombed. We had a piece of land in the country and later we built another house there, a small one.
The end of the war, that was the worst time. The Allied soldiers came into the city. They were everywhere. I was with my mother and sister in the bunker. There were animals outside, horses and goats, and they were screaming because the shrapnel was hitting them. I heard the sound of gunfire. Then an Allied soldier came into our bunker and told us, "You go back to your home and stay there."
After the war, my father came home. He had not been at the front. He had worked for the war industry. Sometimes, though, he would visit the front to see what the soldiers needed. Only two uncles didn't come back. They died in Russia.
I had wanted to be a doctor, a diagnostician, but after the war I got a job with the Americans. I worked for the Immigration and Naturalization Service. Many of the displaced people, Poles and Hungarians who had been brought to Germany to work, now wanted to go to America. Sometimes there would be hearings to decide if they could go or not. I worked as a translator for the hearings. Someone would translate the Hungarian into German, and then it would be my turn to translate the German into English. I was eighteen only but I had a knack for languages, English in particular.
The reason the people didn't want to go back to Poland and the eastern countries was very simple: the Russians had come. The Russians were terrible, brutal. They raped the women. No one wanted to go where the Russian soldiers were. So people chose America.
Later, when I was married, I went with my husband and visited a concentration camp. I could not believe what I saw there. During the war, we had no idea.
(Annika is a patient of mine. She says she's too old to write her memoirs. So I'm setting down the little she told me -- in the interest of preserving history, and because I love a good story, and because she deserves the tribute.)
My sister and I were sent to the south of Germany with a lot of children, because the Allied forces weren't bombing there, that is, not until later. We stayed with strangers -- foster parents, as I called them. There was primary school but no secondary school there. It was not an easy time, being a child -- but things were not easy for a lot of people. After a while the bombs started falling in the south too, so I thought I might as well go back home and be with my mother. Our home was bombed. We had a piece of land in the country and later we built another house there, a small one.
The end of the war, that was the worst time. The Allied soldiers came into the city. They were everywhere. I was with my mother and sister in the bunker. There were animals outside, horses and goats, and they were screaming because the shrapnel was hitting them. I heard the sound of gunfire. Then an Allied soldier came into our bunker and told us, "You go back to your home and stay there."
After the war, my father came home. He had not been at the front. He had worked for the war industry. Sometimes, though, he would visit the front to see what the soldiers needed. Only two uncles didn't come back. They died in Russia.
I had wanted to be a doctor, a diagnostician, but after the war I got a job with the Americans. I worked for the Immigration and Naturalization Service. Many of the displaced people, Poles and Hungarians who had been brought to Germany to work, now wanted to go to America. Sometimes there would be hearings to decide if they could go or not. I worked as a translator for the hearings. Someone would translate the Hungarian into German, and then it would be my turn to translate the German into English. I was eighteen only but I had a knack for languages, English in particular.
The reason the people didn't want to go back to Poland and the eastern countries was very simple: the Russians had come. The Russians were terrible, brutal. They raped the women. No one wanted to go where the Russian soldiers were. So people chose America.
Later, when I was married, I went with my husband and visited a concentration camp. I could not believe what I saw there. During the war, we had no idea.
(Annika is a patient of mine. She says she's too old to write her memoirs. So I'm setting down the little she told me -- in the interest of preserving history, and because I love a good story, and because she deserves the tribute.)
Saturday, November 10, 2007
the week at work: saturday superlatives
Worst moment: Talking to parents of a really troubled young woman who'd just OD'd. I hate being stuck in the middle of people's messy lives and not knowing what to say. Um, so sorry your daughter is like this. Guess she didn't turn out how ya hoped, huh? Wish I could fix her but I can't.
Most emotional moment: Death of an elderly woman who was much loved by her daughter-in-law, who had cared for her at home for many years. When she passed away (after a week of waiting for the end to come), the daughter-in-law totally lost it, crying and hugging the woman's still body and telling me what a great lady she had been. It reminded me of that story in the Old Testament: Ruth. Whither thou goest... I don't usually give a damn when people die expected deaths, but those two women were something special. I needed a tissue.
Best moment: At the nursing station, we were talking about a patient -- a drug-addicted, malodorous kind of guy with rotting toes about to be amputated -- whose name rhymes with Moby Blow. I was saying that all the docs in my group have come up with different nicknames for him: E. calls him "No Toes Below" and L. calls him "Grody Toe" and I call him "Toeless Joe", which I think has a nice, swingin' kind of ring to it. Then the infection specialist put in her vote, drily noting, "I just call him disgusting." She had perfect deadpan delivery. I laughed and laughed.
Most emotional moment: Death of an elderly woman who was much loved by her daughter-in-law, who had cared for her at home for many years. When she passed away (after a week of waiting for the end to come), the daughter-in-law totally lost it, crying and hugging the woman's still body and telling me what a great lady she had been. It reminded me of that story in the Old Testament: Ruth. Whither thou goest... I don't usually give a damn when people die expected deaths, but those two women were something special. I needed a tissue.
Best moment: At the nursing station, we were talking about a patient -- a drug-addicted, malodorous kind of guy with rotting toes about to be amputated -- whose name rhymes with Moby Blow. I was saying that all the docs in my group have come up with different nicknames for him: E. calls him "No Toes Below" and L. calls him "Grody Toe" and I call him "Toeless Joe", which I think has a nice, swingin' kind of ring to it. Then the infection specialist put in her vote, drily noting, "I just call him disgusting." She had perfect deadpan delivery. I laughed and laughed.
Friday, November 9, 2007
the Russian way
Last night I met a friend at a cafe after work. Well, technically I was still working, because I was on call for another two hours. When she showed up, her first words were, "I wonder if they make margaritas here?" Turned out, the answer was yes. I was maneuvering my straw around the ice cubes to suck up the last few drops of golden tequila goodness, enjoying the happy hummy feeling whirling in my head, when my pager went off. Whoops. I fumbled my cell phone and dropped it on the floor. Then I bumped my head on the edge of the table trying to pick it up. It occurred to me that the margarita had been a mistake.
Fortunately, I had Altoids in my car. (Yay, Altoids -- every tipsy doctor's best friend!) And the patients in the ER were pretty straightforward, so it didn't matter that my brilliant mind was a shade less brilliant than usual. But still. Not good. Today I emailed my friend A. about what I'd done. She's a transplant from Ukraine, and she's got that alluring mix of smartass cynicism and fatalism nurtured by years under Soviet rule and fortified by the radioactive vegetables of her Chernobyl childhood. She wrote back:
As you may know, in Russia surgeons don't even go into the operating room without at least a shot of vodka - that's the truth! It's for the nerves, gives confidence :)
Well, that makes me feel better. And gives me ideas. I could use some more confidence. And I've got a whole box of Altoids waiting in the car. Hmm.
Fortunately, I had Altoids in my car. (Yay, Altoids -- every tipsy doctor's best friend!) And the patients in the ER were pretty straightforward, so it didn't matter that my brilliant mind was a shade less brilliant than usual. But still. Not good. Today I emailed my friend A. about what I'd done. She's a transplant from Ukraine, and she's got that alluring mix of smartass cynicism and fatalism nurtured by years under Soviet rule and fortified by the radioactive vegetables of her Chernobyl childhood. She wrote back:
As you may know, in Russia surgeons don't even go into the operating room without at least a shot of vodka - that's the truth! It's for the nerves, gives confidence :)
Well, that makes me feel better. And gives me ideas. I could use some more confidence. And I've got a whole box of Altoids waiting in the car. Hmm.
Wednesday, November 7, 2007
Funny fast line of the day
I just read this in someone else's blog.
It's so perfect, I'm going to repeat it. Is that illegal?
It goes like this:
"I found a tack in my shoe on Friday. The next day Trev got a nail in his tire. Foreshadowing!"
-- http://fuzzyfish.tripod.com/blog/
It's just exactly right, like a freakin haiku, except funny, plus I don't hate it. I can't stand haikus. I think they're so amazingly pretentious. I suspect the Japanese know that they're pretentious and, in fact, invented them as a sly scam on foreigners. Whenever some tin-eared westerner pretends to understand them and says something pompous like haikus are so spare and elegant; what a lovely Japanese art form! they get to laugh their asses off at us.
It's so perfect, I'm going to repeat it. Is that illegal?
It goes like this:
"I found a tack in my shoe on Friday. The next day Trev got a nail in his tire. Foreshadowing!"
-- http://fuzzyfish.tripod.com/blog/
It's just exactly right, like a freakin haiku, except funny, plus I don't hate it. I can't stand haikus. I think they're so amazingly pretentious. I suspect the Japanese know that they're pretentious and, in fact, invented them as a sly scam on foreigners. Whenever some tin-eared westerner pretends to understand them and says something pompous like haikus are so spare and elegant; what a lovely Japanese art form! they get to laugh their asses off at us.
me and victor hugo
Victor Hugo was kind of a jerk. He was a pompous ass who ignored his family and had a mistress on the side. Plus, I've read Hunchback and I didn't like it.
But Les Miserables.
That book changed my life.
That book created three new lives: my children.
That book is why I got married.
I was spiritually transfixed while I read it, and for weeks afterward I walked around with it under my arm, lost in a daze of altruistic longing. I thought of giving away everything I owned (though I was a med student at the time, and what I owned was negative fifty thousand dollars, plus a cat). I thought of moving from the safe side of town to the rough neighborhood across High Street, so I could live among down-and-out neighbors and be available as a beacon of kindness and generosity, in case anyone around there was looking for such a thing. I never thought about becoming a Christian -- couldn't accept the core beliefs -- but I longed so fiercely to live like the priest Father Bienvenue, that it was like a religious conversion except without the religion. It was late spring of my first year in med school.
I'm going to backtrack so I can mention something else: there was this guy. I'd met him in early January. I had gone home over Christmas vacation, traveling by Greyhound, and on the way back to med school I had to change buses in Pittsburgh for the last leg of the trip. The bus was crowded and I took the last free seat, next to a skinny foreign guy who turned out to be a young doctor himself. He'd just graduated from a med school in his home country and was now sharing a cramped apartment in Houston with a bunch of other doctor-guys from the same university, sleeping four to a room and living on falafel and crowding around the TV with feverish excitement during World Cup season. They were all in the same situation, scrambling hard after the dream of an American residency -- the ticket to a comfortable life in a country where you could curse the president without going to prison. In fact, that's why he was on the bus. He'd been riding it for weeks, interviewing at residency programs all over the place: New England, New York, Chicago. He hoped that one of those interviews would turn to gold but he wouldn't know until late March, when all his hopes would ride on the results of Match Day: the appointed day when residencies and hopeful applicants find out how -- or if -- they've been paired off.
I'm the kind of person who usually puts on headphones and stares fixedly out the window when I have to sit next to someone on a bus, but he and I found a world of things to talk about. When I reached my stop five hours later, we traded phone numbers and I hugged him when we said goodbye.
After that, we stayed in touch by occasional letters and phone calls. His grammar was atrocious but he was a sweet guy, good-hearted, and he liked me more than I wanted him to. He called me that spring, bursting with joyful news: he'd matched for a residency and would start his intern year in July. He'd be only three hours from my own medical school. He wanted us to visit eachother once he got settled in.
His tone was darker when we talked a few weeks later. Something was wrong but he wouldn't tell me what it was. Then I called him in June, and this time he sounded even worse, with a flat voice drained of enthusiasm. I kept after him to explain, and finally he did. There was a problem with his visa. He was on the brink of losing his right to stay in the country. That meant he'd have to give up his residency position, go back home, fix the visa thing, then come back to the US and start all over again -- resubmit his applications, repeat the interviews, cross his fingers once again as the next Match Day approached. Except that it would not be possible. His father had already sold all their land to put up the money for his one shot at making the big time in America. There was no money left for a second chance.
Les Miserables was on my nightstand. My heart jumped and my mouth opened and words came out. It was my big opportunity to do good, and prove to my strait-jacketed spirit that even on the dull defined path to doctorville I could still find adventure. (And shock my mother too, into the bargain.) So I asked him to marry me. I proposed a temporary arrangement with no strings attached. I told him that all I hoped for was that, if he met someone in trouble someday, he would help her like I had helped him. Just like Valjean.
So that's my story. That's how Victor Hugo reached out from another century, grabbed me by the throat and shook me hard, and shoved me through an unexpected door and down a path that ended up changing everything.
The guy and I got closer than I'd intended and we made a go of it for a lot of years, long after the INS handed him his papers and he stood up in a roomful of strangers to salute the flag. We aren't together anymore, but we're still friends, and we're mom and dad to three kids who are growing up strong in this wild world -- where adventure waits behind every unopened door.
*************************
So that's the preamble, but here's what I've been building up to: my big idea. Instead of letting friends and family keep buying me useless gifts for birthdays and holidays, I want them to give me nothing but books. But I don't mean coffee-table books, or shiny bestsellers from Barnes and Noble that they think will suit my taste. Here's what I want:
Give me the dog-eared copy of a book you've loved at some point in your life. But first, on the inside cover, write a few lines about it -- I mean a personal note, not a critical review. Tell me what you were doing when you first read it, and who you were back then, and what you found within those pages, and why they touched you. The book you choose doesn't have to be great literature or anything. Maybe it's the book that made you realize you wanted to be a nurse, or the book that gave you solace when you were getting over a tragedy, or the book you happened to have on you the month you fell in love. Then sign it, date it, give it to me. I want a library of beloved books from beloved people, like a treasure-house of all your secret hearts.
I like to imagine that some of those books will fall into the hands of strangers long after I'm gone -- random people who'll flip open the flyleaf and read your scrawled, faded lines. And through your words and your book, they'll glimpse the lives of all you people they've never met who've walked through time and memory and left your mark. Like my Aunt S. in nineteen forty-seven, eighteen years old, when she left the Pittsburgh projects for New York's bright lights to try to make it as a dancer. Or my friend N. in her first days in this country, when she cried for her Slavic homeland, staying in a cheap hotel where she couldn't figure out how to work the faucets. Or even me in nineteen ninety-six, just starting out in medicine and living in a tiny apartment full of cat hair and getting turned inside out by Les Miserables; the year I asked my kids' dad to marry me.
So tell me, readers: what book has meant something to you? Leave me a comment. I want to know.
But Les Miserables.
That book changed my life.
That book created three new lives: my children.
That book is why I got married.
I was spiritually transfixed while I read it, and for weeks afterward I walked around with it under my arm, lost in a daze of altruistic longing. I thought of giving away everything I owned (though I was a med student at the time, and what I owned was negative fifty thousand dollars, plus a cat). I thought of moving from the safe side of town to the rough neighborhood across High Street, so I could live among down-and-out neighbors and be available as a beacon of kindness and generosity, in case anyone around there was looking for such a thing. I never thought about becoming a Christian -- couldn't accept the core beliefs -- but I longed so fiercely to live like the priest Father Bienvenue, that it was like a religious conversion except without the religion. It was late spring of my first year in med school.
I'm going to backtrack so I can mention something else: there was this guy. I'd met him in early January. I had gone home over Christmas vacation, traveling by Greyhound, and on the way back to med school I had to change buses in Pittsburgh for the last leg of the trip. The bus was crowded and I took the last free seat, next to a skinny foreign guy who turned out to be a young doctor himself. He'd just graduated from a med school in his home country and was now sharing a cramped apartment in Houston with a bunch of other doctor-guys from the same university, sleeping four to a room and living on falafel and crowding around the TV with feverish excitement during World Cup season. They were all in the same situation, scrambling hard after the dream of an American residency -- the ticket to a comfortable life in a country where you could curse the president without going to prison. In fact, that's why he was on the bus. He'd been riding it for weeks, interviewing at residency programs all over the place: New England, New York, Chicago. He hoped that one of those interviews would turn to gold but he wouldn't know until late March, when all his hopes would ride on the results of Match Day: the appointed day when residencies and hopeful applicants find out how -- or if -- they've been paired off.
I'm the kind of person who usually puts on headphones and stares fixedly out the window when I have to sit next to someone on a bus, but he and I found a world of things to talk about. When I reached my stop five hours later, we traded phone numbers and I hugged him when we said goodbye.
After that, we stayed in touch by occasional letters and phone calls. His grammar was atrocious but he was a sweet guy, good-hearted, and he liked me more than I wanted him to. He called me that spring, bursting with joyful news: he'd matched for a residency and would start his intern year in July. He'd be only three hours from my own medical school. He wanted us to visit eachother once he got settled in.
His tone was darker when we talked a few weeks later. Something was wrong but he wouldn't tell me what it was. Then I called him in June, and this time he sounded even worse, with a flat voice drained of enthusiasm. I kept after him to explain, and finally he did. There was a problem with his visa. He was on the brink of losing his right to stay in the country. That meant he'd have to give up his residency position, go back home, fix the visa thing, then come back to the US and start all over again -- resubmit his applications, repeat the interviews, cross his fingers once again as the next Match Day approached. Except that it would not be possible. His father had already sold all their land to put up the money for his one shot at making the big time in America. There was no money left for a second chance.
Les Miserables was on my nightstand. My heart jumped and my mouth opened and words came out. It was my big opportunity to do good, and prove to my strait-jacketed spirit that even on the dull defined path to doctorville I could still find adventure. (And shock my mother too, into the bargain.) So I asked him to marry me. I proposed a temporary arrangement with no strings attached. I told him that all I hoped for was that, if he met someone in trouble someday, he would help her like I had helped him. Just like Valjean.
So that's my story. That's how Victor Hugo reached out from another century, grabbed me by the throat and shook me hard, and shoved me through an unexpected door and down a path that ended up changing everything.
The guy and I got closer than I'd intended and we made a go of it for a lot of years, long after the INS handed him his papers and he stood up in a roomful of strangers to salute the flag. We aren't together anymore, but we're still friends, and we're mom and dad to three kids who are growing up strong in this wild world -- where adventure waits behind every unopened door.
*************************
So that's the preamble, but here's what I've been building up to: my big idea. Instead of letting friends and family keep buying me useless gifts for birthdays and holidays, I want them to give me nothing but books. But I don't mean coffee-table books, or shiny bestsellers from Barnes and Noble that they think will suit my taste. Here's what I want:
Give me the dog-eared copy of a book you've loved at some point in your life. But first, on the inside cover, write a few lines about it -- I mean a personal note, not a critical review. Tell me what you were doing when you first read it, and who you were back then, and what you found within those pages, and why they touched you. The book you choose doesn't have to be great literature or anything. Maybe it's the book that made you realize you wanted to be a nurse, or the book that gave you solace when you were getting over a tragedy, or the book you happened to have on you the month you fell in love. Then sign it, date it, give it to me. I want a library of beloved books from beloved people, like a treasure-house of all your secret hearts.
I like to imagine that some of those books will fall into the hands of strangers long after I'm gone -- random people who'll flip open the flyleaf and read your scrawled, faded lines. And through your words and your book, they'll glimpse the lives of all you people they've never met who've walked through time and memory and left your mark. Like my Aunt S. in nineteen forty-seven, eighteen years old, when she left the Pittsburgh projects for New York's bright lights to try to make it as a dancer. Or my friend N. in her first days in this country, when she cried for her Slavic homeland, staying in a cheap hotel where she couldn't figure out how to work the faucets. Or even me in nineteen ninety-six, just starting out in medicine and living in a tiny apartment full of cat hair and getting turned inside out by Les Miserables; the year I asked my kids' dad to marry me.
So tell me, readers: what book has meant something to you? Leave me a comment. I want to know.
Tuesday, November 6, 2007
phone sex 2
The other thing that's really getting to me, is that I really did have my hopes up about those free undies, and I'm beginning to face the sad fact that they will never materialize. I feel used.
Monday, November 5, 2007
phone sex
So, out of the blue, I got a call from a man. He said, "Hi, I work for a phone fantasy service. We provide professional adult entertainment over the telephone. And, congratuations, your friend Laura has gotten you a gift of a phone fantasy! Would you like it warm, hot, or X-rated?"
I was like, What? But I recovered quickly. Okay, yeah! Gimme the X!
He told me a long story, with me in the starring role. It started off with, "You're on vacation at a resort in Mexico. One evening at the bar, you notice a tall dark stranger checking you out..." He had a very rich low voice, and he paused every now and then to give me choices in the plot: "Now, do you want to go up to his room yet, or would you rather take him out on the dance floor first?" I got very caught up in the tale of my imaginary saucy exploits -- so much better than my real life! -- and barely stopped to wonder where on earth Laura had been doing her gift-shopping.
The story built relentlessly to a fiery climax. I was in the stranger's room at last. The lights were down, the music was low, and we were undressing eachother little by little, our hot fingers pulling at eachother's buttons. Our lips and tongues came together. Overcome with desire, I slipped down to my knees on his shag rug and opened my cherry-red mouth in a round O of wonder at his endowments, and then--
--and then the phone went dead in my hands.
I was a bit perplexed, not to mention overheated and annoyed. But I had not an iota of suspicion. The next day I had a conversation with Laura that went like this:
Me: By the way, thanks for that gift. The phone thing.
Laura: Um, what?
Me: The phone-fantasy guy, he called yesterday. That was, wow. I've never heard anything like it. He was really good.
Laura: (getting a nervous look) Okay, I have no idea what you're talking about. Phone fantasy?
Me: You didn't buy me a gift of phone sex from a strange man?
WTF.
Then I remembered an incident from a week or two before. I'd gotten a call from a man who represented Cache --that store in the mall that no one goes into because, when you want Victoria's Secret, why not just go to Victoria's Secret? But he promised me a free pair of undies if I'd take part in a questionnaire to help his store better serve the lingerie needs of women like me. And, underwear whore that I am, I said free undies? sure, I'll do it! So he gave me a bunch of questions about my preferences: did I go for lace or silk? Push-up or strapless? At the end, he asked for my underwear size and favorite color and style (high-cut, cotton, and charcoal gray, gentle readers... and may I mention that my birthday is right about now?) so he could send my free gift. Then he asked if I had any friends who might like to participate. I gave him Laura's name.
Same guy. Same voice. I swear.
The really interesting thing to me is: isn't it amazing how far people will go to satisfy their strange urges? Imagine, he thought up this whole interlocking scam -- just so he could talk lingerie and Mexican sexcapades to strange women over the phone. People are really weird.
It sure was entertaining, though. But now it's been a while, and I still haven't heard back from him. I wonder if he'll call today. God, I hate it when men don't call.
I was like, What? But I recovered quickly. Okay, yeah! Gimme the X!
He told me a long story, with me in the starring role. It started off with, "You're on vacation at a resort in Mexico. One evening at the bar, you notice a tall dark stranger checking you out..." He had a very rich low voice, and he paused every now and then to give me choices in the plot: "Now, do you want to go up to his room yet, or would you rather take him out on the dance floor first?" I got very caught up in the tale of my imaginary saucy exploits -- so much better than my real life! -- and barely stopped to wonder where on earth Laura had been doing her gift-shopping.
The story built relentlessly to a fiery climax. I was in the stranger's room at last. The lights were down, the music was low, and we were undressing eachother little by little, our hot fingers pulling at eachother's buttons. Our lips and tongues came together. Overcome with desire, I slipped down to my knees on his shag rug and opened my cherry-red mouth in a round O of wonder at his endowments, and then--
--and then the phone went dead in my hands.
I was a bit perplexed, not to mention overheated and annoyed. But I had not an iota of suspicion. The next day I had a conversation with Laura that went like this:
Me: By the way, thanks for that gift. The phone thing.
Laura: Um, what?
Me: The phone-fantasy guy, he called yesterday. That was, wow. I've never heard anything like it. He was really good.
Laura: (getting a nervous look) Okay, I have no idea what you're talking about. Phone fantasy?
Me: You didn't buy me a gift of phone sex from a strange man?
WTF.
Then I remembered an incident from a week or two before. I'd gotten a call from a man who represented Cache --that store in the mall that no one goes into because, when you want Victoria's Secret, why not just go to Victoria's Secret? But he promised me a free pair of undies if I'd take part in a questionnaire to help his store better serve the lingerie needs of women like me. And, underwear whore that I am, I said free undies? sure, I'll do it! So he gave me a bunch of questions about my preferences: did I go for lace or silk? Push-up or strapless? At the end, he asked for my underwear size and favorite color and style (high-cut, cotton, and charcoal gray, gentle readers... and may I mention that my birthday is right about now?) so he could send my free gift. Then he asked if I had any friends who might like to participate. I gave him Laura's name.
Same guy. Same voice. I swear.
The really interesting thing to me is: isn't it amazing how far people will go to satisfy their strange urges? Imagine, he thought up this whole interlocking scam -- just so he could talk lingerie and Mexican sexcapades to strange women over the phone. People are really weird.
It sure was entertaining, though. But now it's been a while, and I still haven't heard back from him. I wonder if he'll call today. God, I hate it when men don't call.
Saturday, November 3, 2007
my name is not loulou 2
For a while I told everyone my plan. Friends smirked. My social studies teacher, a man I idolized, told me baldly that I couldn't do it. "But I read this book," I explained to him, fervent and eager. "By this guy. He did it -- he traveled the world like that, he really did."
"The difference is," he said severely, "He is a he, and you are a she." I gaped and recoiled like he'd slapped me in the face. It was 1982. Hadn't he heard?
After a while I stopped talking about it. It got embarrassing -- not the plan, but the condescending smiles. And then things changed -- I mean, I changed. Like everyone else, I got caught up in SATs and college applications. I ended up at one of those colleges where people tell eachother, "We're practically an Ivy League school -- in fact, we're better than the Ivy League schools -- but we don't concern ourselves with silly labels. We're serious people who care about academics, about research. But we could be one of those schools -- an Ivy League school -- if we cared! But we don't!" I turned eighteen in late October, not in a hardscrabble mountainside village or jungle camp south of nowhere, but at a packed campus showing of American Werewolf in London.
Four and half years later, graduation loomed. Everyone else was busy buying expensive suits, having signed on with Price Waterhouse or Smith Barney or whatever, companies who'd come to campus in the fall dragging a wide net to get the bottomfeeders. The others were all aced in for grad school or med school or scholarships at Oxford. They high-fived eachother in the lecture halls: So Maryland said yes! Way to go, bro! I hadn't found the heart to commit to anything. I was on the verge of becoming a hanger-on, one of those rare embarrassments who find work at the bank or liquor store after graduation and stand hungrily on the fringes of the university, trying to keep a desperate grip on campus life while it rushes past them as uncaringly and unstoppably as a train.
Somewhere in the long blue pause of senior year, I remembered the old dream. Travel the world -- I could do it now! On the loose in Europe and beyond, I could pass myself off as not just an aimless drifter, but a free spirit! An adventuress! A girl too damned interesting to follow the crowds of my classmates as they trudged forward into lives of witless drudgery!
I went back to my mother's home to gather up a few things I'd need for the journey. I would take only the essentials: bike, passport, sleeping bag, socks, tools, Eurail pass. When I was all packed, my panniers were brimming and my tools-and-important-stuff bag had just a little bit of extra room. It turned out that I had barely enough room to fit my Loulou, when I got her -- as small and cunning as she was.
But as I counted the days down nervously, clutching my one-way ticket in sweaty hands and fending off my mother, Loulou had not yet come across my path....
"The difference is," he said severely, "He is a he, and you are a she." I gaped and recoiled like he'd slapped me in the face. It was 1982. Hadn't he heard?
After a while I stopped talking about it. It got embarrassing -- not the plan, but the condescending smiles. And then things changed -- I mean, I changed. Like everyone else, I got caught up in SATs and college applications. I ended up at one of those colleges where people tell eachother, "We're practically an Ivy League school -- in fact, we're better than the Ivy League schools -- but we don't concern ourselves with silly labels. We're serious people who care about academics, about research. But we could be one of those schools -- an Ivy League school -- if we cared! But we don't!" I turned eighteen in late October, not in a hardscrabble mountainside village or jungle camp south of nowhere, but at a packed campus showing of American Werewolf in London.
Four and half years later, graduation loomed. Everyone else was busy buying expensive suits, having signed on with Price Waterhouse or Smith Barney or whatever, companies who'd come to campus in the fall dragging a wide net to get the bottomfeeders. The others were all aced in for grad school or med school or scholarships at Oxford. They high-fived eachother in the lecture halls: So Maryland said yes! Way to go, bro! I hadn't found the heart to commit to anything. I was on the verge of becoming a hanger-on, one of those rare embarrassments who find work at the bank or liquor store after graduation and stand hungrily on the fringes of the university, trying to keep a desperate grip on campus life while it rushes past them as uncaringly and unstoppably as a train.
Somewhere in the long blue pause of senior year, I remembered the old dream. Travel the world -- I could do it now! On the loose in Europe and beyond, I could pass myself off as not just an aimless drifter, but a free spirit! An adventuress! A girl too damned interesting to follow the crowds of my classmates as they trudged forward into lives of witless drudgery!
I went back to my mother's home to gather up a few things I'd need for the journey. I would take only the essentials: bike, passport, sleeping bag, socks, tools, Eurail pass. When I was all packed, my panniers were brimming and my tools-and-important-stuff bag had just a little bit of extra room. It turned out that I had barely enough room to fit my Loulou, when I got her -- as small and cunning as she was.
But as I counted the days down nervously, clutching my one-way ticket in sweaty hands and fending off my mother, Loulou had not yet come across my path....
the mount everest of parenthood: I plant my flag
I just threw my first successful kiddie party!
Successful, because my kids actually behaved halfway normally, AND enough grownup-y friends came that I even had fun (apart from the fun of seeing my kids be almost normal), AND enough other kids showed that I didn't feel like a loser-by-proxy, AND the whole thing -- held in a rented gymnastics joint -- lasted exactly ninety minutes with no embarrassing dragged-out finale of watch-checking and throat-clearing and parents sidling toward the door.
I haven't felt this proud of myself since the first time someone told me, "Doctor L, you saved my daughter's life! Thank you, thank you!" (Which has happened exactly once, to tell the truth.)
Successful, because my kids actually behaved halfway normally, AND enough grownup-y friends came that I even had fun (apart from the fun of seeing my kids be almost normal), AND enough other kids showed that I didn't feel like a loser-by-proxy, AND the whole thing -- held in a rented gymnastics joint -- lasted exactly ninety minutes with no embarrassing dragged-out finale of watch-checking and throat-clearing and parents sidling toward the door.
I haven't felt this proud of myself since the first time someone told me, "Doctor L, you saved my daughter's life! Thank you, thank you!" (Which has happened exactly once, to tell the truth.)
Thursday, November 1, 2007
haunted 1
Yesterday one of mine died.
People die on me all the time, but it's almost always expected, and usually they're ninety-four percent dead for quite a while before their last six percent gives in. This one wasn't. He was a grandfather with a great smile, a medium-bad pneumonia and heart trouble. He bragged nonstop about his grandkids, whom he'd raised since birth while their parents were in prison. He was getting better for the first two days, then looked suspiciously worse on day 3. That night while I lay sleeping, fluid leaked from his blood into his lungs and he began to gasp. His heart beat slow, then slower. My on-call partner went for broke trying to bring him back, and the cardiologist jumped in and did everything but donate his own heart to the man, but he died anyway -- leaving the grandchildren, who I suppose are now en route to foster care.
Today's moral: If you have kids, don't get yourself sent to prison.
I'm haunted. Did I miss a warning sign? From the beginning, I thought something was a little off. The patient looked okay but his numbers didn't quite add up. There was something funny about the low level of bicarbonate in his blood. I came up with lots of possible reasons for that -- he was in renal failure for one thing, and hyperventilating for another, and then I poured saline into him which drove up his chloride. But still. Would another doctor have seen what was coming and been able to avert it?
I've been a doctor for ten years. This is the third time in my work that I've wondered if someone's sudden death was my fault. The first two times, I was proven innocent beyond doubt. This time -- I don't know.
I wish I could ask a friend to look over the chart and tell me if I missed anything. On the other hand, I'm afraid to find out the answer.
People die on me all the time, but it's almost always expected, and usually they're ninety-four percent dead for quite a while before their last six percent gives in. This one wasn't. He was a grandfather with a great smile, a medium-bad pneumonia and heart trouble. He bragged nonstop about his grandkids, whom he'd raised since birth while their parents were in prison. He was getting better for the first two days, then looked suspiciously worse on day 3. That night while I lay sleeping, fluid leaked from his blood into his lungs and he began to gasp. His heart beat slow, then slower. My on-call partner went for broke trying to bring him back, and the cardiologist jumped in and did everything but donate his own heart to the man, but he died anyway -- leaving the grandchildren, who I suppose are now en route to foster care.
Today's moral: If you have kids, don't get yourself sent to prison.
I'm haunted. Did I miss a warning sign? From the beginning, I thought something was a little off. The patient looked okay but his numbers didn't quite add up. There was something funny about the low level of bicarbonate in his blood. I came up with lots of possible reasons for that -- he was in renal failure for one thing, and hyperventilating for another, and then I poured saline into him which drove up his chloride. But still. Would another doctor have seen what was coming and been able to avert it?
I've been a doctor for ten years. This is the third time in my work that I've wondered if someone's sudden death was my fault. The first two times, I was proven innocent beyond doubt. This time -- I don't know.
I wish I could ask a friend to look over the chart and tell me if I missed anything. On the other hand, I'm afraid to find out the answer.
If a blog falls in a forest
"Worlds are colliding, Jerry!" -- George Constanza
As of this moment, two people in the world know of this blog. No one else can be told. I would cut off my right arm to be read by million of adoring fans, but it will never be.
It's like this:
If I tell anyone connected to HospitalWorld about it, I will have to write a respectable and demure blog that can't be snickered over by idiot surgeons in the doctor's lounge, won't infuriate my boss, incite HIPAA lawsuits, or otherwise bring down my reputation as a dull professional. I'll have to sound always like a caring and serious person: the kind of doctor you would consult on a tricky case, the kind you'd trust to recommend Hospice for your sister dying of cancer.
If I let any people from FamilyWorld learn of it, I'll have to scrub my words clean of all intimate details, avoid further mention of the social workers sniffing around my house, and write nothing entertaining about my relatives (for example, how they rank in order of insanity). In other words, I'll have to say nothing I don't want flung back at me over Thanksgiving dinner in twenty years.
If I open this blog to my friends in MamaWorld, I'll have to talk forever nice about my children -- their innocence, their sweet mischievous grins, etc. (If you haven't been sucked into MamaWorld: it's a sort of portable weirdville in which women fake-admire eachother's children and pretend that motherhood is a special indescribable joy that sets us apart and above other women. For keeping up this pretense we're rewarded with a special key to the Mama Club. This is valued partly because we can clutch it for security and flaunt it smirkily in front of the keyless multitudes, but more because it wins us smiles from strangers and approval from society, and provides blanket protection against nasty words we might otherwise be subject to: ambitious, driven, aggressive and unfeminine; also cunt, slut, coldhearted bitch, and loser destined to die alone.)
So that's my dilemma.
I still want an audience.
I still think I can change the world.
I just have to puzzle out the conundrum: how can I get myself an audience of complete strangers with no ties to my actual life?
As of this moment, two people in the world know of this blog. No one else can be told. I would cut off my right arm to be read by million of adoring fans, but it will never be.
It's like this:
If I tell anyone connected to HospitalWorld about it, I will have to write a respectable and demure blog that can't be snickered over by idiot surgeons in the doctor's lounge, won't infuriate my boss, incite HIPAA lawsuits, or otherwise bring down my reputation as a dull professional. I'll have to sound always like a caring and serious person: the kind of doctor you would consult on a tricky case, the kind you'd trust to recommend Hospice for your sister dying of cancer.
If I let any people from FamilyWorld learn of it, I'll have to scrub my words clean of all intimate details, avoid further mention of the social workers sniffing around my house, and write nothing entertaining about my relatives (for example, how they rank in order of insanity). In other words, I'll have to say nothing I don't want flung back at me over Thanksgiving dinner in twenty years.
If I open this blog to my friends in MamaWorld, I'll have to talk forever nice about my children -- their innocence, their sweet mischievous grins, etc. (If you haven't been sucked into MamaWorld: it's a sort of portable weirdville in which women fake-admire eachother's children and pretend that motherhood is a special indescribable joy that sets us apart and above other women. For keeping up this pretense we're rewarded with a special key to the Mama Club. This is valued partly because we can clutch it for security and flaunt it smirkily in front of the keyless multitudes, but more because it wins us smiles from strangers and approval from society, and provides blanket protection against nasty words we might otherwise be subject to: ambitious, driven, aggressive and unfeminine; also cunt, slut, coldhearted bitch, and loser destined to die alone.)
So that's my dilemma.
I still want an audience.
I still think I can change the world.
I just have to puzzle out the conundrum: how can I get myself an audience of complete strangers with no ties to my actual life?
more ominous than the Men in Black
The Men in Black dismissed my threat to the President. I'm insulted.
However, the local department of social services is more diligent: they are investigating me for child neglect! It's the most interesting thing that's happened to me in a while. (Is it possible the president's men put them up to it?)
I'm looking forward to an in-depth insider's look at what many families face daily. It strikes me as hilarious... though I won't be laughing if I end up in parenting classes with Britney Spears. Details later. Must go save lives, like all the doctors on TV.
However, the local department of social services is more diligent: they are investigating me for child neglect! It's the most interesting thing that's happened to me in a while. (Is it possible the president's men put them up to it?)
I'm looking forward to an in-depth insider's look at what many families face daily. It strikes me as hilarious... though I won't be laughing if I end up in parenting classes with Britney Spears. Details later. Must go save lives, like all the doctors on TV.
key to happiness
What's the best feeling in the world?
Being sick as a dog and full of dread about the coming workday. Wondering how you'll survive it. Wishing you had just one more day off to recover. Then finding out you misread the work schedule, and crawling back to bed.
The key to happiness: Expect hell. Rejoice over purgatory.
Being sick as a dog and full of dread about the coming workday. Wondering how you'll survive it. Wishing you had just one more day off to recover. Then finding out you misread the work schedule, and crawling back to bed.
The key to happiness: Expect hell. Rejoice over purgatory.
my daughter, the outcast
Once I read a profound statement in a magazine interview. I love it. I have no idea who said it. It goes like this: "Every worthwhile person I've ever known, has been an outcast at some point in his or her life."
My daughter is an outcast. Not the temporary kind, like the celebrities who say something crass and get ostracized for an obligatory ten minutes. She's the dyed-in-the-wool real deal: born different, growing up different. She's a girl with faint pariah markings, invisible to most adults, but clear as day to other children. A girl no good at fitting in.
Here's an idea for a book: I'd like to take a poll of former and present outcasts, and give them each a page to tell their story. Here's what I would ask them:
1. When and why were you an outcast?
2. Would you say you were an outcast because of something you said or did, or because of who you are?
3. How did it stop -- or did it never stop?
4. Did any good come of being an outcast?
5. Did the experience scar you? change you?
6. What words do you have for the outcasts of today, and for the never-been-outcasts who don't understand them?
I was an outcast at my first residency. Everyone hated me -- that was the bad part. But because I walked alone, I was the only one free to speak against what went on there.
No other resident ever thought of rocking the boat. They were smack in the middle of the boat, had paid a high price to keep those comfy seats, and had their eyes fixed on the opposite shore where a gilded citadel awaited them. (Meanwhile I was in the drink with waves crashing over my head, gasping and struggling to hang onto the side with one hand.) With their arms draped around eachother in comradeship, they moved and thought as one body. It wasn't their fault. They checked eachother's faces when shocking things happened, and were reassured. No one was the first to declare outrage. No one else was quitting in disgust. It must have been easy for each to convince himself that nothing shocking was really real. See? No one else minds. It's not that bad. Anyway, I didn't see a thing.
The other residents played golf with the attendings. The corrupt bosses joked with them in the doctors' lounge, gave them praise and pats on the head and promises of rich practices waiting after graduation. That made for a pretty strong incentive not to bite the hands that fed. I lived a different reality: the same hands that fed them, slapped me. And when I finally got mean enough and desperate enough to bite back, I sank my teeth as hard as I could and went for bone.
I wasn't more virtuous than the others. I certainly wasn't braver. I just didn't have anyone around me to dispute the evidence of my eyes and ears, or convince me I should keep silent and play along for everyone's good. I had no loyalties. I didn't give a damn how crappy the call schedule would become for the rest of them after I walked away.
So this is why I think we should celebrate our outcasts: Yes, it's true that sometimes they stray too far from the herd and end up holding classrooms hostage with assault rifles. But aside from those few -- and I do think they are few -- the rest perform a function priceless to society. They are maybe the only ones among us who get to see, think, and act for themselves. They keep the majority from drifting over the line into mass insanity. Therefore, I propose National Outcast Day, with parades in every city and little children waving flags: one day a year when anyone who's cranky, odd or reclusive wakes up to find her doorstep heaped with bouquets and notes of appreciation.
I hope my daughter loses the mark of the pariah as she grows, because as a mother it breaks my heart to see her so alone. I want an easy, happy life for her. But if she never learns the trick of changing to fit in, maybe it's not so bad. Maybe she'll grow up smart and free-minded as few others ever can be.
Maybe the people who can't shape themselves to fit into our world, have the best shot at reshaping the world to fit their vision.
My daughter is an outcast. Not the temporary kind, like the celebrities who say something crass and get ostracized for an obligatory ten minutes. She's the dyed-in-the-wool real deal: born different, growing up different. She's a girl with faint pariah markings, invisible to most adults, but clear as day to other children. A girl no good at fitting in.
Here's an idea for a book: I'd like to take a poll of former and present outcasts, and give them each a page to tell their story. Here's what I would ask them:
1. When and why were you an outcast?
2. Would you say you were an outcast because of something you said or did, or because of who you are?
3. How did it stop -- or did it never stop?
4. Did any good come of being an outcast?
5. Did the experience scar you? change you?
6. What words do you have for the outcasts of today, and for the never-been-outcasts who don't understand them?
I was an outcast at my first residency. Everyone hated me -- that was the bad part. But because I walked alone, I was the only one free to speak against what went on there.
No other resident ever thought of rocking the boat. They were smack in the middle of the boat, had paid a high price to keep those comfy seats, and had their eyes fixed on the opposite shore where a gilded citadel awaited them. (Meanwhile I was in the drink with waves crashing over my head, gasping and struggling to hang onto the side with one hand.) With their arms draped around eachother in comradeship, they moved and thought as one body. It wasn't their fault. They checked eachother's faces when shocking things happened, and were reassured. No one was the first to declare outrage. No one else was quitting in disgust. It must have been easy for each to convince himself that nothing shocking was really real. See? No one else minds. It's not that bad. Anyway, I didn't see a thing.
The other residents played golf with the attendings. The corrupt bosses joked with them in the doctors' lounge, gave them praise and pats on the head and promises of rich practices waiting after graduation. That made for a pretty strong incentive not to bite the hands that fed. I lived a different reality: the same hands that fed them, slapped me. And when I finally got mean enough and desperate enough to bite back, I sank my teeth as hard as I could and went for bone.
I wasn't more virtuous than the others. I certainly wasn't braver. I just didn't have anyone around me to dispute the evidence of my eyes and ears, or convince me I should keep silent and play along for everyone's good. I had no loyalties. I didn't give a damn how crappy the call schedule would become for the rest of them after I walked away.
So this is why I think we should celebrate our outcasts: Yes, it's true that sometimes they stray too far from the herd and end up holding classrooms hostage with assault rifles. But aside from those few -- and I do think they are few -- the rest perform a function priceless to society. They are maybe the only ones among us who get to see, think, and act for themselves. They keep the majority from drifting over the line into mass insanity. Therefore, I propose National Outcast Day, with parades in every city and little children waving flags: one day a year when anyone who's cranky, odd or reclusive wakes up to find her doorstep heaped with bouquets and notes of appreciation.
I hope my daughter loses the mark of the pariah as she grows, because as a mother it breaks my heart to see her so alone. I want an easy, happy life for her. But if she never learns the trick of changing to fit in, maybe it's not so bad. Maybe she'll grow up smart and free-minded as few others ever can be.
Maybe the people who can't shape themselves to fit into our world, have the best shot at reshaping the world to fit their vision.
my name is not loulou
"Mom, how do you spell Loulou?" Saturday morning. Sarah was sitting on the kitchen floor, yanking up her shinguards. "Is it L-o-o-l-o-o, or L-u-l-u?"
"Me! I'm Loulou!" shrilled Loulou, jumping up and down. "I need to go pee!"
"Can't we leave yet?" said the other one, my monster in the middle.
I smiled at Sarah. No one had ever asked before. "Well. It's L-o-u-l-o-u. But that's not the usual way it's spelled," I said. "Actually, there's a story there."
"Tell us the story, tell us the story!" yelled all three little monsters in unison. Suddenly I remembered why it was that I had kids. There's nothing quite as good as a captive audience hanging on your every word.
Long ago and far away.
Long ago and far away, in a moldering public library with a cracked ceiling that leaked in heavy rains, an unattractive girl of, let's see, about fourteen picked a book out of a wire rack. You know those racks -- the ones where they stick the books that aren't important enough to get a slot on an actual bookshelf. Books with lurid covers. Teenage romances, pulp horror reads -- a melange of dubious literature jammed in haphazardly, whose only common feature is that they aren't worth the trouble of the Dewey Decimal filing system. Books like the one I picked up that day, that changed my life.
It was a how-to travel guide by a freewheeling, paisley-wearing child of the 70's. He'd spent five years hitchhiking across several continents. Finally -- after seeing volcanos throw fire into the sky and waves crash on warm exotic shores, after bumping across the Andes in a truck driven by a drunken lunatic, picking fruit for fast cash, scoring illicit substances in Kathmandu, getting robbed, getting stoned, falling in love -- he'd come home to grad school and written a book telling all wannabe globetrotters how we too could have the life he'd lived. Didn't take money in the bank, either. It just took a backpack, an outstretched thumb and a sense of adventure.
I read the first chapter standing there at the wire rack, transfixed. I took the book home and read it six times. Returned it, paid the late fee, took it out again, returned it two months later but found I couldn't live without it. Finally I stole it once and for all, using an elegantly simple trick my brother had taught me: I dropped it out of a window from the dusty second-floor Journal Annex, and snuck out to retrieve it from the shrubbery after closing time. I slept with it under my pillow after that, bringing it out late at night, drinking in the words, dreaming of my future. Forget suburbia, my mother's crappy marriage, the freedom she'd sacrificed in favor of convention, the surprise pregnancy that had ended her studies, the children who had weighed her down, the nine-to-five, and her false-cheery resignation to it all. ("Of course I got married when your father asked me. Back then, it was just what people did. I didn't want to live at home forever.")
Not for me. I would run amok among the rough,wild wonders of the world. Homeless, wings on my feet, owning nothing more than I could carry.
"Mama! Where my Care Bear? I WANT my CARE BEAR!" I slung the soccer gear into the trunk of the minivan and drove the monsters off to practice, down the street lined with lollipop-shape trees, where every fourth house has the same floor plan.
"Keep going," Sarah prompted. "Then what happened?"
The first bitter fight my mother and I had was over that book.
"When I hit eighteen, I'm doing it, I'm leaving," I told her.
"You'll get killed out there," she spat. "They'll find you in a ditch."
"Eighteen's legal. You won't be able to stop me."
"If that's what you plan on, you just leave right now. Pack up and go. Spare me the next four years of worry."
I was shocked by her vehemence. I had thought she'd shrug and answer, "Okay, silly girl. Whatever you say." Then it hit me: she was taking me seriously. Like she looked at me and saw for the first time not a silly girl, but someone whose daydreams were hardening into plans, whose plans might turn into facts. Someone to be reckoned with.
I considered this, long after she'd swept out of my room in tears. I hadn't known I was so grown up already.
"But what about Loulou?" Sarah asked from the back seat.
"I'll get to that," I told her. "The story has to start at the beginning. But everyone shush now, or I'll miss the exit."
"Me! I'm Loulou!" shrilled Loulou, jumping up and down. "I need to go pee!"
"Can't we leave yet?" said the other one, my monster in the middle.
I smiled at Sarah. No one had ever asked before. "Well. It's L-o-u-l-o-u. But that's not the usual way it's spelled," I said. "Actually, there's a story there."
"Tell us the story, tell us the story!" yelled all three little monsters in unison. Suddenly I remembered why it was that I had kids. There's nothing quite as good as a captive audience hanging on your every word.
Long ago and far away.
Long ago and far away, in a moldering public library with a cracked ceiling that leaked in heavy rains, an unattractive girl of, let's see, about fourteen picked a book out of a wire rack. You know those racks -- the ones where they stick the books that aren't important enough to get a slot on an actual bookshelf. Books with lurid covers. Teenage romances, pulp horror reads -- a melange of dubious literature jammed in haphazardly, whose only common feature is that they aren't worth the trouble of the Dewey Decimal filing system. Books like the one I picked up that day, that changed my life.
It was a how-to travel guide by a freewheeling, paisley-wearing child of the 70's. He'd spent five years hitchhiking across several continents. Finally -- after seeing volcanos throw fire into the sky and waves crash on warm exotic shores, after bumping across the Andes in a truck driven by a drunken lunatic, picking fruit for fast cash, scoring illicit substances in Kathmandu, getting robbed, getting stoned, falling in love -- he'd come home to grad school and written a book telling all wannabe globetrotters how we too could have the life he'd lived. Didn't take money in the bank, either. It just took a backpack, an outstretched thumb and a sense of adventure.
I read the first chapter standing there at the wire rack, transfixed. I took the book home and read it six times. Returned it, paid the late fee, took it out again, returned it two months later but found I couldn't live without it. Finally I stole it once and for all, using an elegantly simple trick my brother had taught me: I dropped it out of a window from the dusty second-floor Journal Annex, and snuck out to retrieve it from the shrubbery after closing time. I slept with it under my pillow after that, bringing it out late at night, drinking in the words, dreaming of my future. Forget suburbia, my mother's crappy marriage, the freedom she'd sacrificed in favor of convention, the surprise pregnancy that had ended her studies, the children who had weighed her down, the nine-to-five, and her false-cheery resignation to it all. ("Of course I got married when your father asked me. Back then, it was just what people did. I didn't want to live at home forever.")
Not for me. I would run amok among the rough,wild wonders of the world. Homeless, wings on my feet, owning nothing more than I could carry.
"Mama! Where my Care Bear? I WANT my CARE BEAR!" I slung the soccer gear into the trunk of the minivan and drove the monsters off to practice, down the street lined with lollipop-shape trees, where every fourth house has the same floor plan.
"Keep going," Sarah prompted. "Then what happened?"
The first bitter fight my mother and I had was over that book.
"When I hit eighteen, I'm doing it, I'm leaving," I told her.
"You'll get killed out there," she spat. "They'll find you in a ditch."
"Eighteen's legal. You won't be able to stop me."
"If that's what you plan on, you just leave right now. Pack up and go. Spare me the next four years of worry."
I was shocked by her vehemence. I had thought she'd shrug and answer, "Okay, silly girl. Whatever you say." Then it hit me: she was taking me seriously. Like she looked at me and saw for the first time not a silly girl, but someone whose daydreams were hardening into plans, whose plans might turn into facts. Someone to be reckoned with.
I considered this, long after she'd swept out of my room in tears. I hadn't known I was so grown up already.
"But what about Loulou?" Sarah asked from the back seat.
"I'll get to that," I told her. "The story has to start at the beginning. But everyone shush now, or I'll miss the exit."
film noir
Struggling with the existential question today: what is a blog for? Am I writing to myself or to an audience? How freakin self-aggrandizing is it to imagine that anyone cares about my thoughts -- like I'm the second coming of the Buddha chock-full of enlightenment for the masses. Like the world should hang on my every word.
And what's going to happen if I'm someday outed as myself. Imagine: Dr. E. (see previous post) would know in a heartbeat that he's the ass in the story and would think up some devious revenge. I can see my employer being less than happy with that scenario. Or, what if I gain a following of millions and then use this blog to out my former employers, purveyors of America's most shockingly corrupt residency program cum butcher mill. I might end up in court, defending myself against charges of libel. (I'm not too scared, as the medical records of a lot of hacked-up women would prove my case. But I digress... that's a dark, long-buried tale of rot and human evil, that will not be disinterred tonight.)
I come clean: I just like to hear myself talk. Didn't get enough attention as a young tot. Was told by one too many junior high English teachers that I should think about a career in letters. Can't shake a sneaking suspicion that I'm right about just about everything and the world should shut up and listen.
So it's like this: I'll write any damn thing I want with the full expectation that no one will ever wash up on this tiny island of babble lost in an ocean of endless noise. Any stray travelers who land on my shores are free -- in fact, encouraged -- to leave immediately. But if you find yourself so inclined, you may read my words and gasp at the primal truth and beauty they contain, fall directly in love with me, set candles on an altar in my name, park across my street all night chainsmoking Marlboros while your mad, fevered eyes follow my silhouette as I move through silent rooms, and finally draw your gun and aim through the foyer window and end me with the first blast then yourself with the second. Then, of course, you must slip into death with my name caressed on your tortured lips. Loulou...Loulou...
It's a lucky name to have, in such circumstances. Imagine, if my name were La'queshandra, how hard it would be to gurgle it out before you died.
And what's going to happen if I'm someday outed as myself. Imagine: Dr. E. (see previous post) would know in a heartbeat that he's the ass in the story and would think up some devious revenge. I can see my employer being less than happy with that scenario. Or, what if I gain a following of millions and then use this blog to out my former employers, purveyors of America's most shockingly corrupt residency program cum butcher mill. I might end up in court, defending myself against charges of libel. (I'm not too scared, as the medical records of a lot of hacked-up women would prove my case. But I digress... that's a dark, long-buried tale of rot and human evil, that will not be disinterred tonight.)
I come clean: I just like to hear myself talk. Didn't get enough attention as a young tot. Was told by one too many junior high English teachers that I should think about a career in letters. Can't shake a sneaking suspicion that I'm right about just about everything and the world should shut up and listen.
So it's like this: I'll write any damn thing I want with the full expectation that no one will ever wash up on this tiny island of babble lost in an ocean of endless noise. Any stray travelers who land on my shores are free -- in fact, encouraged -- to leave immediately. But if you find yourself so inclined, you may read my words and gasp at the primal truth and beauty they contain, fall directly in love with me, set candles on an altar in my name, park across my street all night chainsmoking Marlboros while your mad, fevered eyes follow my silhouette as I move through silent rooms, and finally draw your gun and aim through the foyer window and end me with the first blast then yourself with the second. Then, of course, you must slip into death with my name caressed on your tortured lips. Loulou...Loulou...
It's a lucky name to have, in such circumstances. Imagine, if my name were La'queshandra, how hard it would be to gurgle it out before you died.
the er after dark
It's been twenty hours since I threatened the life of George Bush, and no one has paid any notice. This gives rise to several theories:
1) Big Brother is not monitoring every word written on the internet, as a certain paranoid stranger warned me.
2) Big Brother is watching, but has already researched my background and interrogated my relatives and former sex partners, and so far does not consider me a credible threat.
3) Big Brother is watching. However, his henchmen are underpaid and apathetic, so they're pretty much just eating doughnuts while terrorists like myself run rampant.
4) Big Brother is watching, and stealthily closing the noose around my neck while I sit here typing idly like I had the all the time in the w-- (splat!)
5)Big Brother is yelling, "State of high alert! Someone's threatened the president! The color is orange! No, it's red! Let's have a subcommittee meeting!" Henchmen are too busy running in frantic circles to actually trace my address and put a stop to my evil plans.
Regardless, I think it's safe to quit worrying that anyone gives a damn what I write. Ahh. Now I can get on with it.
Last night I was in the ER. This morning I called my partner L to tell her what fishies I'd caught by night, for her to cure by day:
Me: I admitted a woman with a stone blocking her right ureter. She's got diabetes and a urinary tract infection and the right kidney is blown up like a water balloon. The ER doc called the urologist first, some guy named Dr. E, but he said to send her home. I think he must be insane. I admitted her. But I asked the staff to consult him urgently this weekend, just to punish him.
L: God. So now I'm going to have to talk to him. Thanks a lot.
Me: He's that bad? Do you know him?
L: Yeah, I've talked to him before. He's not crazy. He's just an ass.
What a perfect line: He's not crazy; he's just an ass. I'm going to steal it. I think it will come in handy often.
Posted by loulou3 at 7:54 PM
1 comments
1) Big Brother is not monitoring every word written on the internet, as a certain paranoid stranger warned me.
2) Big Brother is watching, but has already researched my background and interrogated my relatives and former sex partners, and so far does not consider me a credible threat.
3) Big Brother is watching. However, his henchmen are underpaid and apathetic, so they're pretty much just eating doughnuts while terrorists like myself run rampant.
4) Big Brother is watching, and stealthily closing the noose around my neck while I sit here typing idly like I had the all the time in the w-- (splat!)
5)Big Brother is yelling, "State of high alert! Someone's threatened the president! The color is orange! No, it's red! Let's have a subcommittee meeting!" Henchmen are too busy running in frantic circles to actually trace my address and put a stop to my evil plans.
Regardless, I think it's safe to quit worrying that anyone gives a damn what I write. Ahh. Now I can get on with it.
Last night I was in the ER. This morning I called my partner L to tell her what fishies I'd caught by night, for her to cure by day:
Me: I admitted a woman with a stone blocking her right ureter. She's got diabetes and a urinary tract infection and the right kidney is blown up like a water balloon. The ER doc called the urologist first, some guy named Dr. E, but he said to send her home. I think he must be insane. I admitted her. But I asked the staff to consult him urgently this weekend, just to punish him.
L: God. So now I'm going to have to talk to him. Thanks a lot.
Me: He's that bad? Do you know him?
L: Yeah, I've talked to him before. He's not crazy. He's just an ass.
What a perfect line: He's not crazy; he's just an ass. I'm going to steal it. I think it will come in handy often.
Posted by loulou3 at 7:54 PM
1 comments
inaugural post
I've decided to do it. Start a blog, and kill the president.
It started like this: I was arguing with strangers on the internet (why do I do that?), when someone made the random comment that the Government watches everything we write. I said, "Really? I'm going to kill the president!" He posted back that I should expect a visit from Men in Black sometime soon, and suggested I start a blog to keep the world posted on the fascist tendencies of our leaders.
And so I thought, Yes! In fact, I've been thinking of killing the president for some time now. I'm an angry American. I have ties to a Middle Eastern country that's accused of sponsoring terrorism. I have legal access to many kinds of poison. I've used them on people before.
Mr. Bush should worry. I invite the Men in Black to come calling: by the time they read this -- if they really do -- it may be too late.
-- loulou3
It started like this: I was arguing with strangers on the internet (why do I do that?), when someone made the random comment that the Government watches everything we write. I said, "Really? I'm going to kill the president!" He posted back that I should expect a visit from Men in Black sometime soon, and suggested I start a blog to keep the world posted on the fascist tendencies of our leaders.
And so I thought, Yes! In fact, I've been thinking of killing the president for some time now. I'm an angry American. I have ties to a Middle Eastern country that's accused of sponsoring terrorism. I have legal access to many kinds of poison. I've used them on people before.
Mr. Bush should worry. I invite the Men in Black to come calling: by the time they read this -- if they really do -- it may be too late.
-- loulou3
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