The Hamster Wheel

One year old

2010-04-28T08:54:00.001-05:00

Gabriel's First Christmas

2010-01-11T20:28:00.001-06:00

Gabriel

2009-08-06T07:06:00.000-05:00

2009-05-07T22:14:00.000-05:00

Recrudesce

2008-06-10T22:08:00.005-05:00

In the spring a young man’s fancy lightly turns to thoughts of love...
...and away from blogging.

(OK, so technically we're closer to the start of summer, but it was spring when I started mulling this over in my head.)

So it's happened. I could feel it coming on, but now it's really here. The end of the blog.

Given my penchant for abandoning ill-kept journals with hardly a look back, it's quite a personal achievement that I've kept this blog going for as long as I have. One of our bookshelves houses a few of my past journals. All with only a handful of pages littered with writing, most with barely enough entries to warrant the captivation of any significant part of an hour. Yet this blogger counter indicates that I've posted over 800 entries over the past four years.

I've been wondering when I was going to lose interest in this hobby and move on to another. Those urges to quit have come and gone from time to time, but have never persisted, usually quelled by one of your comments. But I think that the time for a final entry has finally approached.

Maybe I need to find a focus for this blog on something else instead of Things Happening To Me, although I'd find it rather difficult to write about things not-happening to me with any real authority. Besides, as much as I enjoyed semi-anonymously expounding on various topics devoid of any erudite commentary, there's no doubt that a part of this has been rooted in narcissistic impulses.

(Seriously, anybody who keeps a public journal but denies such a motivation is an outright liar.)

It was just going to be a matter of time before I threw in the towel. Placing this blog on the shelf, next to my other hobbies that I've started, enjoyed, and then lost interest in. And so this becomes where the sidewalk ends.

Or who knows, this blogging may actually be a more permanent hobby than I think. Maybe blogging is a little like joining the mob, once you're in, you never really leave The Family.

Besides, without an obligatory post now and then, how else will I satisfy my narcissistic urges? Or share stories about the adventures of having a pregnant wife? (No, she's not, but I'm saying one day she will be and I'll likely use this blog for that.)

Maybe I just need a break. I'll probably be back blogging again in a few weeks.

I'll see you then.

Comments are closed. Email: miknosaj-at-gmail-dot-com

Eustacian

2008-05-30T07:39:00.007-05:00

Physician, heal thyself.
-Luke 4:23

Doctor: [looking through an otoscope] Well, here's the problem. Your ears are filled with fluid. It's definitely your sinuses.

Well, that was a relief... I guess. At least now I knew why I couldn't hear a darn thing.

For the past several days, everything had been sounding muffled yet oddly loud. As if I was walking around wearing ear plugs, but someone had turned up the bass. It was as if I was living underwater. But I wasn't having any ear aches, or nasal drip, or fevers, or headaches, or any of the usual symptoms that would make you think you had a sinus infection. And since nothing hurt and everything else felt relatively normal, I planned to address it with the typical male solution: ignore it.

Nathalie, being rational, thought my plan was stupid. So after a bit of prodding from her, I reluctantly went to see someone about my ears.

Doctor: Well, even though your sinuses aren't infected, we need to drain the fluid. It's small, but there is a chance that you could permanently lose your hearing if we don't address this right away. So I'm going to prescribe you some medications.

I nodded along.

Doctor: One's an antibiotic. The other will be a nasal spray that you need to use twice a day.

Ugh. Gross. Sticking things up my nose? I made a face at Nathalie, who had come with me to visit the doctor. She made a face back.

Doctor: And I'm also going to give you a shot.

Doh! I grimaced and groaned. Nathalie winced in sympathy.

After doing some more paperwork, the doctor left and the nurse came in with the shot. I sighed and started to roll up my sleeve.

Nurse: No... this shot needs to go in your butt.

What? Really? Jeez. I looked over at Nathalie and gave her a bewildered look. She smiled back sympathetically. With even a bigger sigh, I dropped my pants and bent over the exam table. As I was contemplating the importance of always wearing nice underwear, the nurse stabbed my butt with a screwdriver.

Well that's what it felt like, but Nathalie assured me it was simply the needle.

Shorties

2008-05-28T06:08:00.005-05:00

I know I've must have mentioned this before. But if anybody plans on moving to New Orleans, my best advice would be to sell whatever car you have now and buy a truck, SUV, or something that can wade through water. Being that the majority of the city is below sea level, a quick downpour from a passing storm is all it takes to temporarily flood the streets and leave people stranded. If you can actually get a hold of those Ride the Duck boat/cars, that'll probably be best.

Nothing is more depressing than being trapped at your workplace and unable to get home because the streets are flooded. Had I known this was the norm in this town, I would probably not have bought that sporty little car.

* * *

Speaking of cars, I've been meaning to get over to the junkyard to find a seatbelt buckle to replace the broken one on the rear seat of my car for months. Being that the back seat on my car is too small to really accommodate anybody bigger than a 6-year old, nobody ever rides back there. Consequently, the seatbelt is never used and thus no real urgency in getting this done. Getting it replaced would mainly be for cosmetic reasons.

I had finished my clinic a bit after 4PM one afternoon so I decided to see if the local junk yard might still be open. I walked over to one of the nurses stations to see if they had a phone book.

Nurse: [looking for a phone book] Who are you trying to call?

Me: [eyeing the clock] The junkyard. I want to see what time they close.

Nurse: [looks up, shocked] The junkyard? Really?

Me: Uh... yeah.

I guess most people don't expect doctors to be rummaging around junkyards looking for car parts. Perhaps if I asked what time the golf course closes she wouldn't be so shocked.

Nurse: Well, I'm pretty sure they're open until about 3 AM.

Me: Really? Those are some strange hours.

Nurse: Wait. You're not talking about that bar?

Well, no wonder. There's apparently a sleazy bar commonly referred to as the junkyard where you can pick up drugs and prostitutes. That was definitely not what I was looking for.

And unfortunately, the car parts junkyard was closed.

* * *

While I had initially planned on grilling this weekend, much like the rest of the nation, I instead spent it in the kitchen perfecting a pizza crust recipe given to me by SinnerG.

I had always considered making bread dough something of an advanced art and beyond my capabilities. But the recipe looked easy, and it came with her assurance that it was easy, so I gave it a shot... and the results were insanely awesome.

Needless to say, Nathalie and I are a bit carb'ed out from this weekend. I tried to put a temporary moratorium on bread making, but with absolutely no ability to resist freshly baked bread, that failed miserably.

Referral

2008-05-22T13:14:00.002-05:00

It's too bad that car insurance isn't like health insurance, where the insurance company will pay for preventive care visits. Because handing over that $1085 for my car's 60k mile maintenance really hurt.

But if this means another 6 or 7 years without any mechanical trouble, then I guess it's worth it. Especially given the state of that timing belt, I was probably looking at a major valve rebuild had it snapped anytime soon.

I signed the credit card receipt, got my car keys back, and walked towards my car out in the lot. I had found this mechanic after an exhaustive search of reviews and recommendations, and I was happy with them. Not because they were all that cheaper than the dealer, but because they had given me their honest opinion on the state of my brakes.

Finding a good, honest mechanic is more important to me than saving a few bucks from a shoddy one. I'd rather pay to get good quality work, than go to someone that will charge less, but trick me into paying for things I don't need.

So I always use my brakes to test whether a mechanic is honest or not. I'm no mechanic, but I do know a thing or two about cars, and I know how to judge when brake pads need to be changed.

Growing up poor meant our family couldn't afford any new cars. Or newer cars, for that matter. And since we couldn't afford what garages would charge, my dad did most of the work on our cars himself to keep them running. I remember many afternoons spent outside handing various tools to my dad who was either lying under the car or hunched over under the hood. This later evolved into me doing most of my own car repairs.

But some things are better left to be done by guys that do it for a living. So whenever I go to a new mechanic for the first time, I act like I don't know anything about cars and ask them if my brakes need to be changed, knowing full well that they don't. Most places charge $20 to look at the brakes and give me their opinion. If they're honest, I say thanks and ask them to fix what really needs work. If they tell me that my brakes need to be changed, I tell them I can't afford it right now, give them the $20, and then go find an honest mechanic.

So I was quite pleased to find that these new guys were honest. I made a mental note to come back to them if I ever need anything. I might even recommend them to friends.

I get in my car and it fires up beautifully. A quick drive around the block and everything feels smooth... except that my AC doesn't work.

I drive back to the garage, grab one of the mechanics, and they crawl all over my car trying to figure out why the AC stopped working. One of them eyes me suspiciously and asks if the AC was working prior to coming to them. "Yes, of course" I answer. But then I get what he's trying to get at.

He thinks I brought in a car with a broken AC. I get them to work on the engine a bit. And then try to blame them for my broken AC and get them to fix it for free.

Well that was insulting. After dropping over a thousand dollars at their store, you'd think I could at least get a little respect. But I guess when you run a business, you've got to be careful because everybody is looking for a way to scam you. My parents ran a dry-cleaners for a while. I remember how conniving some people can get trying to get the store to pay for things that we were not responsible for. So I just shrugged it off.

A few minutes later one of the mechanics discovered a broken wire. He figures it must have got torn off while he was changing out the timing belt, and took fault for it. I couldn't help but give a look to the other accusatory mechanic, but felt good that these guys were honest to admit their own mistakes. Come back in an hour, it'll be fixed.

So I leave happy and come back in a hour to pick up my car, except the clerk wants another $100.

Me: For what?

Clerk: Well, they fixed your AC.

Me: But it was your fault.

Clerk: Well, there's no proof that it was working before, so we have to assume it was broken when you brought it in.

I opened and closed my mouth a few times, flabbergasted and at a loss for words. My mood instantly went sour.

Unbelievable, isn't it? After much ranting, they dropped the charge by half. But it was apparent that they were not going to give me back my car keys unless they were paid. I couldn't believe that they had the nerve to charge me after all the money I just spent there. Especially for something that was their fault. This is the equivalent of me accidentally cutting off the wrong foot and then having the gall to charge them for that operation.

I guess being honest has nothing to do with running a business.

Disgusted, I paid the extra $50, got my keys, and stormed out.

Those myopic fools. Sure they got my $50 this time, but they lost any possible revenue from all my future business and future referrals...

So much for referring these guys to anybody else. And I thought I was so close to finding a good mechanic. Caveat emptor

Equilibrium

2008-05-19T10:15:00.002-05:00

Nathalie and I got to celebrate the sudden influx of cash into our checking account via the economic stimulus package for about... 3 days.

Unfortunately, the wad of cash from the government sitting in our account completely offset the balance of the universe. And since the universe will always maintain a balance, it corrected itself by quickly creating avenues for the money to bleed out of our account in the form of a car repair and several other miscellaneous expenses.

So we're right back to where we started.
So much for that short lived wealth.

Gauge

2008-05-14T13:10:00.004-05:00

It seems that most medical disasters happen after the sun goes down.

A corollary of this rule is that if I happen to make any plans when I'm on call, they will get ruined. But if I don't make any plans and decide to just sit at home and wait for my pager to go off, the ER will never call me.

Go figure.

One night I got called in to see a man that fell and sliced his wrist open on some scrap metal. It was a bloody mess, but his artery and nerves were undamaged, so there was nothing to do but clean out the wound and sew him up. A part of me wanted to know what he was doing climbing over a pile of junk at 10pm. Another part of me just wanted to get my job done and get back home.

I often make small talk as I work, especially if its something as dull as stitching up an incision. I use it to both entertain myself and get to know the patient more socially as well as to put the patient's mind someplace else other than the fact that I'm sewing him up like a ripped pair of jeans. But I was tired from a long day, so I quietly stitched up his wrist while I contemplated asking about the circumstances of him being in a junk yard that late.

Besides, the patient was on his cell phone talking to his wife, so I didn't bother.

After I finished, I cleaned up his arm and wrapped it with a clean bandage. The patient had finished talking to his wife and sat there quietly watching me clean up.

Patient: Doc, how many stitches did I get?

I know most people not in the medical field commonly associate the number of stitches placed in a wound as a guide to its severity. But it really has no bearing. It's like me judging a restaurant by the number of bites it took me to eat an omelet. Or the quality of a gift by the number of pieces of tape I used to wrap it.

And just as you don't pay attention to the number of sips it took you to finish that can of soda, neither do I pay attention to the number of stitches I place to close a wound.

I tried explaining this concept to a patient once, but they just stared at me as if I told them I routinely drive blindfolded. I could literally hear my credibility dropping. To me, placing stitches is as mentally challenging as putting on your socks. I think most people expect me to put a lot more thought into it, thus the shocked faces when I tell them I wasn't really paying attention.

So I've learned to just tell them a number, and that seems to satisfy most people. For most small incisions, it's not hard to remember. But for those longer incisions, like the 6-inch gash on this patient, I lose track.

On average I find that an inch long incision requires about 3 to 4 stitches to close, so I use that to roughly guess.

Me: About 20 stitches.

Patient: [Eyeing me] About 20? Or exactly 20?

Me: [Losing credibility] Uh... exactly 20.

This guy is going to remove his bandages in 48 hours, count the number of stitches, and then think of me as a quack that can't count, or didn't really know what he was doing. Well, guess I won't be getting a Christmas card from this guy...

Wallflower

2008-05-12T18:24:00.002-05:00

Mattress

2008-05-08T13:38:00.002-05:00

Nathalie and I plan to move away from New Orleans in the next year. In planning, we've been slowly taking inventory of what we can leave behind and what we need to take. Despite never buying souvenirs and avoiding frivolous purchases, we've still got tons of stuff. It's mind boggling how things accumulate. Looks like we'll be renting the really big U-Haul truck.

And as much as I love moving to new cities and being in a new environment, I hate the logistics of the actual move itself. The packing takes forever. Every box, no matter how its packed, seems to weigh a hundred pounds by the end of the day. Every doorway becomes a new opportunity to put a new scratch or gouge in your furniture.

And when it comes to moving, no other piece of furniture is as uncooperative and difficult to move as your mattress. Moving a mattress from one location to another is akin to getting a drunk buddy home. It's limp, heavy, and unpredictable. It takes two of you to lift it. The handles on the sides look like they would be helpful, but much like your drunk buddy's limp arms, they do nothing to make lifting it any easier.

You try to lean the mattress against the wall, and all it does is just slump over and fall on the ground.

Mattress, why can't you stay sober like your friend Boxspring?

Karma

2008-05-01T21:09:00.002-05:00

I've seen Mean Girls.
I've been to high school.
I know how girls can be.

Nathalie and I attended a wedding recently of a long-lost high school friend of hers. Being that it was back in her hometown, Nathalie wasn't completely surprised to see that many of the girls she went to high school with were also in attendance. During the reception, all of them came up to Nathalie to greet her, gushing about how long it's been since they've last seen each other.

The way they were acting, it seemed like these girls and Nathalie used to be the best of friends. But Nathalie confided in me that these very same girls acting so friendly to her now were quite mean to her in high school, picking on her and excluding her. Just the way high school girls can be. She wasn't sure why they were acting so happy to see her now.

Well, that explains why Nathalie didn't seem all that happy to talk to these girls that were coming up to talk to her. Nobody is ever excited to see a previous tormentor.

But Nathalie is sweet. And forgiving. And everything I've ever wanted a woman to be, so she talked to all these girls and was nice to them. Whereas I, on the other hand, being part evil, would have not behaved as civilized as my wife if I were in her shoes. In fact, I found myself giving these girls the evil eye after Nathalie introduced me to them.

Overhearing their interchanges, I found out that most of them were still living in that small town. Many of them chose not to pursue any further education after graduating high school. Sadly, a good number of them had neglected to invest in their future, made poor choices (in education, career, men), and were now young, single mothers working in dead-end jobs.

And nearly all of them had put on a considerable amount of weight.

I'm not sure what their motivation was for coming over to talk to Nathalie. It definitely wasn't to make amends because I didn't hear a single one apologize for their past catty behavior. Perhaps to see if their lives were better than Nathalie's.

But Nathalie had stayed in school, graduated college with honors, and is now a goal-oriented and successful medical professional, working on getting her Masters degree. She has also kept her figure.

I am a bit biased, but there was no question that Nathalie was the prettiest one there. Prettier than the bridesmaids. Prettier than the bride. And from the limited eavesdropping, I'd say the most successful of them all as well. So I'd say that Nathalie got even. Oh man, did she ever get even.

I could see the jealousy in those girls' eyes as they eyed her figure and listened to Nathalie talk about her accomplishments and her plans for the future. I'm not a vindictive type, but that gave me so much satisfaction I couldn't stop myself from smirking. And it took every ounce of willpower I had not to jump up and down, doing a little she-got-even dance in front of every one of Nathalie's former tormentors. Yeah, let's see you pick on my wife now.

Success truly is the best revenge.

Opinionista

2008-04-27T07:08:00.003-05:00

The following is a scene from one of my favorite movies, Reservoir Dogs. Two guys are driving frantically to a rendezvous point after a botched bank robbery. Mr. Orange, covered in blood, has been shot in the belly and is bleeding to death. Mr. White, an accomplice, is driving and trying to keep his partner calm.

Mr. Orange: [crying, bleeding from a gunshot wound] All this blood is scaring the shit outta me, Larry! I'm gonna die, I know it!

Mr. White: Oh excuse me, I didn't realize you had a degree in medicine. Are you a doctor? Are you a doctor?

Mr. Orange writhes in pain.

Mr. White: Answer me please, are you a doctor?

Mr. Orange: [in pain] No, I'm not...

Mr. White: Ahhhh, so you admit you don't know what the fuck you're talking about. So if you're done giving me your amateur opinion, lie back and listen to the news...

I like that last line said by Mr. White.

It's not unusual to have a patient come to the office thinking they're going to undergo/receive a specific treatment for whatever is ailing them. It is, however, quite unusual for them to have the correct treatment in mind. So when I tell them what I plan to do, they're caught a little off guard.

I expect questions from the patient to clarify and elucidate the treatment and how it will help them. And I am more than happy to spend the time explaining everything. But strangely, there are a few people that will argue with me about my treatment plan. "I don't think that's going to work."

"Oh really? Based on what?" I want to ask.

A Google search? Really? They're going to argue with me based on what they found on the internet? I don't care what they've found with a Google search. Unless Google's got a medical degree and finished a residency training program, I'm not interested.

Intuition? I'm all for going with your gut feeling, but I'm not trying to sell you a used car. There are lots of places appropriate for debating and bargaining. I just don't see how asking a surgeon to compromise on something is the best way to go. Especially when it comes to your own body.

I'm not the guy trying to trick you into an unnecessary major brake overhaul when you came in just to get your oil changed.

It's terribly frustrating to get that obstinate patient in the office that comes with preconceived notions of what they need and only wants XYZ treatment done instead of the more appropriate ABC that I think is the best. And for some reason, they refuse to back down and accept that my idea is the superior choice.

My plan is based on formal medical training, science, and the experience of many surgeons before me. Their plan is based on... something not as substantial. One day, it would be so refreshing to be able to say what Mr. White said up there.

"...if you're done giving me your amateur opinion, lie back and listen to the news..."

With medicine, once you take on the responsibility of operating on somebody, you're stuck with them for the rest of your/their life. And I don't want to have to spend the next 20 years of my career stuck taking care of this argumentative, obstinate, ignorant pain-in-the-butt. I'd rather pass this patient down to another surgeon.

So those visits often end with me saying "You're free to go get a second opinion. Here's a list of other surgeons..."

Ischemia

2008-04-24T10:02:00.004-05:00

I knew before even laying my eyes on the bowel, that this patient was headed for the morgue. I could smell it.

As we divided the muscle and fascia below the skin, that sickening stench of death escaped from her abdominal cavity and filled the room. I immediately suppressed a gag, and blinked my eyes as they teared up from that acrid stench.

Sure enough, when the abdomen was opened, we could see that nearly the entire length of her small intestine had turned the color of rot: black, green, yellow, and gray.

It was easy to figure out what had happened. After this patient's heart attack two days ago, a portion of her heart muscle died and the heart developed an irregular rhythm. This completely changed the fluid dynamics within the chambers of the heart, creating small eddies where blood would slow down and coagulate. This consequently developed small blood clots, and one of these clots had made it out of her heart, down her aorta, and got dislodged in the main artery supplying her small intestine, completely blocking any further blood flow past that clot.

And with that blockage, the cells in her intestines suffocated from the lack of oxygen and died within several hours. And much like how shrimp kept in a warm room will quickly rot, so did her intestines. Within the warm cavity of her abdomen, kept at a stable 98.6 degrees, the bacteria in her intestines quickly grew and started eating away. She was literally rotting from the inside-out.

We could remove the rotten small intestine, that wasn't the problem. The problem was that she would have been left with less than 8 inches of small intestine. Anything less than 36 inches is incompatible with life. Without the ability to absorb any nutrients from what she ate, she would simply starve to death... assuming she even survived this operation.

Remove the rotten intestine, she dies. Leave the intestine in, she dies. A lose-lose situation.

The resident across the table from me looked up, "Close?"

I nodded my head. There was nothing to be done. The best thing for her at this point was to close that incision and take her back to the ICU so that her family could be with her the last hours of her life.

I stepped away from the operating table, pulled off my gown, and went to the phone to call the attending surgeon to tell him of the findings.

Upstart

2008-04-21T06:03:00.002-05:00

Between all the moving around I've done and by the nature of being a male, I've lost touch with most of my friends I had growing up. I do have a handful of people from waaaaay back (grammar school!) that I keep in touch with, but in all honesty, to say that we keep in touch would be a bit of a stretch. But we do maintain a relative awareness of each other's comings and goings.

One of these friends have just started her own blog.

The Sock Monkeys

Go click on the link. Go say hello. Look at the pictures of her cute kids. Leave a little note of encouragement (every blogger loves comments!). Maybe we can help her develop that blogging dependency, just like me/you/us.

Strawberry

2008-04-17T08:36:00.000-05:00

I've never given much thought to where strawberries are grown. Unlike peaches (Georgia), apples (Washington), or oranges (Florida), I don't recall any specific state that's associated with strawberries.

Well I've learned that Louisiana is one state that grows strawberries. So much, that one local town near us has an annual strawberry festival with a strawberry King and Queen, baking contest, concert, parade, what have you. I've been meaning to go for years, but haven't had the time until this past Sunday. So Nathalie and I drove on over to see what all the ballyhoo was about.

As expected, just about anything you can think of to do with a strawberry was done and being offered for purchase. Jam, jelly, pie, shortcake, smoothie, daiquiri, deep fried (this is the South, you know)... it was the Bubbagump of strawberries. Not to mention a mind-boggling assortment of strawberry themed knick-knacks.

After a thorough afternoon of entertainment, we bought a flat of just picked, perfectly ripe strawberries to take home with us. And as soon as we got home, we melted some Hershey's bars and engorged ourselves with chocolate dipped strawberries.

At about my 25th strawberry was when I started to wonder about the fiber content of a strawberry and how it would rank next to, say, a prune.

Well, the answer to that question came the next morning.

And I'll think twice before eating that many strawberries again anytime soon.

Mouthwash

2008-04-15T08:02:00.000-05:00

Think back to the time that you were really sick.

I'm not talking about sniffles, sneezing, and body aches. I'm talking about full-on you're-about-to-die sick. Like when you were feverish, having cold sweats, and hugging the toilet.

Remember how miserable you were? How you didn't even have the energy to take a shower, let alone even wash your face?

Brush your teeth? Bah! It'd be a lucky day if you got out of your pajamas and combed your hair.

Well, multiply that a few times and that's probably where most people are after an operation.

At my job, I make most of my "customers" look like this at some point during our professional relationship. And I get paid to do it. It's a strange thing.

Breaktime

2008-04-08T07:57:00.009-05:00

You shouldn't hold in your farts. Because then they'll end up traveling up through your spine and into your brain, and that's where you get all your shitty ideas.

I heard that someplace, can't remember where, but it makes me laugh every time I think of it.

The problem with being a surgeon is that you don't get to take a break in the middle of an operation. Once you start, you're committed to the operation until the job is done. Just as you wouldn't leave a toddler alone in a room full of knives, you can't leave a person with their guts all hanging out on the table while you go take a 15-minute break. There's no autopilot. There's no second string relief. It's just you.

My mental preflight checklist includes "to do" items like greeting the family, answering last minute questions, reviewing the chart and diagnostic films, but most importantly, a trip to the men's room.

Because every operation is semi-unpredictable and can easily turn into an 8-hour disaster, I make sure to pee before every case. It's hard to concentrate on the matter at hand if my brain is more concerned about peeing my pants instead of saving the person's life laying in front of me. There's always a way to get to a "stopping point" during an operation and pause for a bit while you do a mad dash to the bathroom, but that brings on a whole new level of anxiety.

While there's a bit of physical relief, I'm plagued by mental torture as the whole time I'm in the bathroom I'm envisioning every conceivable nightmare happening back in the operating room while I'm out: Cardiac arrest. Bleeding. Contamination.

Because of this, I just tend to hold it.

Peeing before an operation helps, but I've had my share of 8+ hour operations and by that time I usually have to pee again. But over the years I've been able to train my bladder and have become quite adept at being able to go without peeing for extended periods of time... except when I'm on a road trip.

For some reason, my bladder must shrink in size exponentially when I'm in a sitting position. I actually drink less coffee (and all liquids) when I'm driving than when I'm working in the hospital, yet it's a snowy day in Aruba when I can go more than a few hours without having to pull off the highway.

The oddest thing is that it bugs me so much when I have to pull over and stop. It must be a guy thing. It's always an internal struggle in my brain: "I've got to pee" vs. "We're making such good time"

"Making good time." I don't even know what that means. It's not like pulling off to a rest area for 10 minutes to pee will ruin anything, but my brain sure makes a big deal about it.

Bladder: Hey boss, we've got to pee.

Brain: What? No way, you peed before we left the house. [looks at odometer] Besides, it's only been 110 miles. Hold it for a bit longer.

Bladder: [dejected] okay...

30 minutes later...

Bladder: Hey man, we've got to go.

Brain: Look, we'll need to stop and get gas in about 150 miles or so. You can go then.

Bladder: [whimper] okay...

20 minutes later

Bladder: Are we there yet?

Brain: No.

Bladder: Are we close? Cuz we've got to go. It's getting pretty tight down here.

Brain: Can you hold it a bit longer?

Bladder: We really need to go.

Brain: Just hold it. We're making great time. I don't want to stop now. We'll be there soon.

Bladder: No we need to stop.

Brain: [ignores Bladder]

Bladder: We're going to start pushing the panic buttons.

Brain: ...

Bladder: Hey... we're not joking.

Brain: ...

Bladder: Hey!

Brain: ...

Bladder: Hey... Hey... Hey... Hey...

Usually at this point Nathalie looks over at me and asks, "Are you OK?"

Me: [flushed and sweating] Yeah, I need to pee.

Socializing

2008-04-05T10:44:00.000-05:00

Looking back, I think I've made quite a bit of progress from my humble beginnings as a little immigrant kid growing up in Kansas. I've travelled and seen beautiful places, educated myself, and hopefully have made a positive impact in some people's lives. But socially, I'm still as awkward and retarded as I was in highschool.

I sit down and open up Blogger and a bazillion funny and interesting stories and thoughts come pouring out of my head so fast that I usually end up losing 95% of them before I have a chance to put it down on paper to share later. But I go to a party and all I can do is stand there in a circle with my other socially retarded friends and just stare at my bottle of beer as my mind draws a complete blank.

But then after 4 out of the 6 of us move on to another group of people, and it's just me and another friend of mine, my brain kickstarts itself to ludicrous speed and I'm telling jokes and funny stories like I'm Larry the Cable Guy.

So then people start to gather around us to see what the hell is so funny, and then I run out of ideas and I'm quiet and boring and socially defunct again.

Rinse.
Lather.
Repeat.

Abstraction

2008-04-02T08:59:00.000-05:00

It's strange that some people have no idea why they take certain medicines or what medical condition they have. It's usually multi-factorial. Either nobody has bothered to really explain their disease to them, or sometimes the patient isn't smart enough to comprehend, process, and remember that information, or in some cases, they simply don't care.

How someone will gladly take medicines or undergo an operation without fully understanding the risks, benefits, and consequences of their actions is beyond me. Blind faith? Idiocy? Apathy?

So I always try to educate my patients. But of course, occasionally their disease process is quite complex and it would easily confuse anyone not in the medical field. But I try nevertheless.

I don't try to insult them, but I do "dumb it down" significantly, using common layman terms and concepts that I think will be easy to digest. I model my explanations on the way Stephen Hawking tried to explain the origin of the universe in A Brief History of Time. (A great book, btw.) There were a few concepts that I didn't really understand, but I got the gist of the thing.

And I'd say about 60% of the patients understand what I'm trying to tell them. 39% feign understanding, but I can tell that some of the finer details are lost and they're just nodding along, but the overall gist of the matter is being understood.

The other 1%? They don't even pay attention. I had one lady check her text messages on her phone halfway through one of my explanations. A little upsetting and frustrating, but what can you do? Besides, they're the ones doing funny/amusing things that I use as fodder for this blog.

Occasionally I bring their xray or CT scan into the room to show them their cancer, or whatever disease I'm trying to cure with an operation. I point out various things that are very obvious to me, but I'm sure to them just looks like black and white abstract art.

I can tell that I've used up all their attention span, because the patient will often interject with "Well, you're the doctor. Do what you think you need to do."

That's my cue to stop.

I equate this to Jackson Pollack trying to explain one of his crazy paintings to me, pointing out one paint squiggle after another, saying how one squiggle represents his faith in religion, and this other squiggle represents the sadness he felt when he lost a puppy, and that paint blotch represents his inner longing for stable companionship.

I guarantee that I'm not going to understand what he's pointing at. I'm just going to nod along, and at some point, just give up trying to understand his painting and let him know I'm at my stopping point: "Hey, you're the artist. Paint what you think you need to do."

Capsaicin

2008-03-28T10:32:00.000-05:00

Nathalie and I decided that we needed pepper spray. No, nothing to do with cooking. More along the lines for self defense. Or possibly offense. Why Nathalie and I were out trying to buy pepper spray isn't all that important...

I figured Wal-Mart would be the place to buy it. They have nearly everything else, including BB guns, real bullets, and scary Rambo looking knives, so I figured that is where I can get pepper spray. For cheap, too.

But no, after a fruitless search and resigning myself to asking an employee for help, I learned that Wal-Mart doesn't stock pepper spray because it's too dangerous. Never mind that shotgun shells are just sitting on the shelves and bullets are behind an unlocked glass display case.

So we went to a local sporting goods store that sells guns. I figured if a store sells guns, they'll sell pepper spray.

Since Wal-Mart won't even stock the stuff because it's so dangerous, we figured this sporting goods store would keep it locked away. So we went to where we thought would be the most obvious place to keep it: next to the guns.

But obviously, the managers at the sporting goods store think pepper spray is as dangerous as a bunny in a kitten costume because we were redirected to a different part of the store. The part of the store that sold jogging accessories like earbud headphones and iPod cases. No joke, there was a pink Hello Kitty iPod case for sale hanging right next to the mace and pepper spray.

Their nonchalant attitude and stark contrast to the fear shown at Wal-Mart made me question the efficacy of pepper spray, and then question Wal-Mart's rationale for banning the sale of the stuff in their store.

Regardless we bought one. The most menacing looking one, which came in a mean looking black can.

Oddly, we also ended up buying an iPod case.

Idiocy

2008-03-25T10:21:00.000-05:00

This is why men will never outlive women. It's because we're stupid.

Example: Me.

I decided to replace our back porch light with a new, technologically advanced one that will turn itself on at night and off during the day. No more leaving the light on all day because I forgot to turn the light off before going to work. Yay. Good for the checkbook, good for the environment.

After coming back from the store, I open the box and read the directions. The first step instructs me to examine the contents to make sure nothing is missing.

Nope, nothing missing.

Second step instructs me to turn off the electricity at the circuit breaker. It's in ALL CAPS and in bold. In fact, I think the font was a size or two bigger as well. I pause and contemplate that sentence like a monkey would study Aztec hieroglyphics.

I briefly think about the last time I was messing with 120 volts and the nasty shock I got because I didn't turn off the electricity. I then decide that going to the circuit breaker to find the right switch and turn it off is too much of a pain in the ass because with my luck I'll turn off the kitchen circuit, and then I have to spend an eternity resetting every stupid appliance clock in the kitchen. So I dismiss step 2 and move to the rest of the directions.

After reading the directions I go out to the porch, dismantle the old light, and then stare at the bare wires. Probably just buzzing with electricity. Again, I consider turning the electricity off. But for some unknown reason, other than being a man, I continue with the installation of the new light. In blatant disregard for Step 2, which tried so hard to get me to do the right thing.

I guess the part of my brain that's in control of "self preservation" got zapped the last time I messed with household current. I'm a college educated person, for crying out loud. A physician, no less! Yet here I am, working with metal tools and bare wires and live electricity because I'm too lazy to walk 10 feet to the circuit breaker and find the correct switch.

Lucky for me, installation went without a hitch, which was what I was expecting. No electrocution.

But in defense of my stupidity, had it started raining, I definitely would have turned off the electricity. Or at least really thought about it.

Expenses

2008-03-24T05:48:00.002-05:00

Ignorance is bliss. And easier on your checkbook as well.

Up until recently, buying loose tea leaves was something I thought about as much as I would think about buying a Greyhound bus ticket. Which is to say, quite infrequent.

But recently I had an opportunity to try tea brewed from loose leaves (as opposed to the traditional tea bag which I've now come to realize is filled with left over leaf bits and debris) for a taste comparison. I was skeptical at first, but my eyes have been opened and now I've become a convert. Who knew there would be such a difference?

It's not like comparing I Can't Believe It's Not Butter to butter, because they're pretty close. It's like when a restaurant tries to pull off giving you Diet RC Cola instead of Diet Coke. Immediate and profound difference.

So now I put down an extra couple dollars for loose tea at the grocery store. Add this to the extra few dollars I pay for better coffee, better meat, better cheese, better beer... all of a sudden, I'm broke. I'm constantly walking out of the grocery store wondering how $100 worth of food could fit into just a few plastic bags.

I think back to the days when I drank Maxwell House, ate store brand cheese, drank Milwaukee's Best (the Beast!), and thought things were great. A glance at my cart now and it screams that I've become one of those yuppie dorks: estate coffee, imported cheese and microbrew beer...

Sometimes I get to wondering how much money I would be saving had I never tried new things and stayed with what I know. But then again, for a foodie, that's a question not even worth asking.

Uprising

2008-03-22T10:17:00.003-05:00

Over the years, I've amassed a fair number of half-completed and abandoned blog entries. Either I lost interest, didn't have time to complete it and never got back to it, or any number of reasons people give to explain their unfinished projects. Recently, I've been going through the "Drafts" folder, sorting through them and deleting them, trying to do a little blog spring cleaning. This is a post I wrote on Sept 25, 2005, a little after Hurricane Rita hit. I guess it got forgotten amongst the shoddy internet connection and the intermittent power outages associated with the general confusion and mayhem around that time.

Sept 25, 2005
Being on the northeast side of Hurricane Rita as it made landfall resulted in a tremendous amount of wind and rain hitting the little bayou hospital. The surrounding low lying areas started to flood as a result of the rains, and it was going to be only a matter of time before the rising water would enter the hospital. The hospital staff scrambled to evacuate our patients to other hospitals. But where to? Whatever hospitals that weren't damaged by Hurricane Katrina now suffered some degree of damage from Hurricane Rita. And the surviving hospitals were now overloaded and understaffed.

My team spent hours yesterday trying to find places for our patients to go. Relentless calling, pleading, and begging finally resulted in locating beds at several hospitals around the state for our patients to be transferred to temporarily. After spending hours on the phone to find every one of my patients a place to go until our hospital could get back to safe operating conditions, I went to each of their rooms to explain what was going on, where they were going to go, and who was going to take care of them once they got there. I saved Patient L to the very last.

Patient L, a sweet but annoyingly simple bayou lady that has been in the hospital under my care for the past 33 days, asked me "Why do we have to leave the hospital?"

Me: "Well, the flood waters are coming in to the hospital and it won't be a safe environment for you."

Patient L: "So where's the water coming from?"

Me: "I guess the bayous are oversaturated and the runoffs from the levees are not draining fast enough."

Patient L: "So what's going to happen with the hospital?"

Me: "I don't know. The administrators don't think it will be safe for you to be here."

Patient L: "Why not?"

Me: "I don't know. I guess they're afraid the building may not do well with flood waters in it."

Patient L: "Why not?"

Me: "I guess the building wasn't built to the modern codes."

Patient L: "Why not?"

[This interchange went on for quite some time, with each of my answers being returned with another exhaustive "why not?". I was already tired, hungry, frustrated, and stressed out, and as the minutes slipped away, so did my patience.]

Patient L: "Well, when will the rain stop?"

Me: [Letting out a blood curdling scream as I pulled out fistfuls of my hair] "AAAAGH!!!! I.. DON'T.. KNOW!! I'm not a frickin' meteorologist! For fuck's sake you've been lying here watching the TV all day, haven't they said anything about this on the damn TV?!"

It would have been so refreshing to have been able to actually say that...

Liar

2008-03-18T18:14:00.000-05:00

It happens about once a year or so: A man will come to the ER with either a foreign body stuck in his rectum, or with a rectal injury from overly aggressive manipulation of said foreign body.

I don't know what compels these guys to stick various things up their butts, but the large majority of these patients are married men in their 40's. A bizarre midlife crisis, I guess.

I can't imagine the embarrassment of having to go to the ER because of a sexually deviant experiment gone wrong, but the best way to deal with that situation is probably to tell the doctor the truth. Because, as dumb as we are to waste our youth with our heads in the books, and as dumb as we are to generate hundreds of thousands of dollars in debt doing so, we're really not that dumb. Hell, any 6-year old can see through the lies I get told of how "X" got into their butt.

Tell me the truth, I'll probably forget about it later that night. Tell me a lie, and the more outrageous it becomes, the more I'm likely to remember it and talk about it. Perhaps even blog about it many years later. But I don't pressure them for the truth because it won't make any difference in how I'll treat them. I just nod along to their story, putting it away in the memory banks for later.

Three of my favorites:

Patient A: I was hanging up the shower curtain, but then I slipped and landed on the toilet plunger. That's how I got injured.

Something I never asked him to clarify was why the handle happened to be lubricated. Because I found lube all in his butt.

Patient B: I was attacked. He stole my wallet.

You really think I'm going to believe that some guy mugged you by first depantsing you, then lubed up a jump rope handle, stuck it up there, and then took your wallet? Sir, I went to college. C'mon.

Patient C: I went to go sit down on the couch and I didn't see the egg sitting there.

I really wanted to ask him know how he knew it was an egg up in his butt, because I identified it by its outline only after getting an x-ray. That egg was up there a good 6 inches. Besides who leaves an egg just sitting around on a couch? And how absolutely amazing that it didn't break (it was uncooked) but slid so nicely up the butt!

Pineapple

2008-03-14T06:54:00.001-05:00

I rarely spend any time in the juice aisle of the grocery store. Probably because we don't have any kids, and I see juice as mainly empty calories. And if I'm going to be consuming empty calories, they better come in the form of beer, Snickers, or ice cream. We do go through OJ quite a bit, but it's a snowy day in Miami when there's any other kind of juice in the fridge.

That being said, I took a wrong turn and found myself cruising down the juice section. Occasionally, when this happens I end up buying some mango nectar, which I consider the Dom Perignon of juices. As I scanned the shelves looking for it, I found a section filled with cans of pineapple juice.

Why, in this modern age, is pineapple juice still sold in those frickin' cans? You know, the cans that require a special sharp pointy can opener weapon.

Why not a glass bottle? Or even plastic. Wouldn't plastic be less expensive? If you argue that pineapple juice is sensitive to light, why not paper cartons like OJ?

Old time's sake, perhaps? The Dole company can't get away from tradition?

I pondered a bit, looking at the cans of juice. Realizing that I don't own a special sharp pointy can opener, I slowly walked on by looking for the mango nectar in an easy to open, user friendly bottle.

Cited

2008-03-12T21:56:00.002-05:00

The worst thing, of course -- and you're never quite prepared for it -- is when the patient dies during the operation. You die a little every time that happens.
Michael DeBakey, MD

Watchdog

2008-03-11T06:23:00.002-05:00

A significant part of my residency training was spent taking in-house call. That meant after a full day's work, I spent the night at the hospital to be the "go-to" man in case anything went wrong during the night.

Of course, being that the hospital was filled with sick and dying patients, something always went wrong. As the lone surgical MD in the hospital, the pager never stops beeping. When that pager goes off, you don't know if it's a nurse telling you that Mr. So-and-so is having a massive heart attack, or Mrs. This-and-that is bleeding profusely from her wounds, or asking you if Tylenol can be substituted for aspirin. The gamut of possibilities to expect when answering a page is mind boggling. The worst call is when two disasters happen simultaneously and you have to decide which dying patient you're going to save first.

Needless to say, the stress level remains astronomically high and the poor schmuck taking in-house call just gets run to the ground. By the time 6AM rolls around, they look like they've just gotten back from a horse ride through hell.

If nobody dies during your watch and everything is relatively stable come morning, nobody calls you to yell at you and you get to go work another full workday. Fun! Great career choice! I've got to remember to thank my high school guidance counselor.

After surviving an especially harrowing call night, I would often treat myself to the biggest frickin' donut in the hospital cafeteria. This was the apple fritter. It was a huge hunk of donut batter mixed with apples and cinnamon, fried, then covered with a blanket of glaze. It probably had about 4000 calories.

Although I no longer take in-house call, I occasionally get a fritter for old times sake. However, the other day I saw that the donut case was empty. After a brief inquiry, I found out that the hospital suits have decided that the cafeteria will no longer make any donuts because they are unhealthy. And selling donuts in the hospital cafeteria apparently is in violation of the healthy image that a healthcare facility should project.

Irritating, since I like donuts, but I can see the validity in such actions. But then, as I was wandering around the cafeteria, why do they still sell pints of ice cream? What about the ribs with macaroni and cheese they're serving for lunch? The mounds of chocolate chip cookies in the cookie case? The BLT with about 15 strips of bacon crammed into it? Chili cheese fries? This list of "non-healthy" food items available for purchase in the hospital goes on and on.

So are they going to phase these out too? The answer is no. Of all the unhealthy snacks and foods, they singled out and got rid of my favorite: donuts. Frickin' hypocrites!

That commercial on TV with the people freaking out because they can't get a Whopper at Burger King? Yeah, that was me when I found out I could no longer get my most favorite donut in the world.

Unaware

2008-03-09T09:30:00.003-05:00

...[using this product] will expose you to lead, a chemical known to the State of California to cause birth defects and other reproductive harm.

Soooo... how come the other states don't know this?

I recently ran across this warning while shopping for a decent looking wine decanter. It only takes one waste of a poorly aerated bottle to get you thinking about using a decanter.

But reading that warning label, I imagined California busy warning its citizens about the dangers of leaded crystal, while Louisiana just shrugs its shoulders with a look of complete disregard.

Pet

2008-03-07T08:55:00.001-06:00

For various reasons that neither Nathalie or I are happy with, we can't have any pets right now. So we got the next best thing, a Roomba.

(In fact, because this thing picks up hair, it's almost like a reverse-pet.)

It's actually kind of cute, in a funny robotic appliance kind of way. It's got quasi-intelligence and runs around on its own, bumping into things and exploring various corners of the house that I haven't been to in months. I've given it a schedule, so it'll start up and clean while Nathalie and I am at work. Once it's satisfied with itself with the job it's done, it'll go back to the charging base and hang out until it's time to clean again.

It also plays little tunes to let you know how it's feeling: a happy tune when it finds its way back to the charging base after completing a cleaning run, a charge! tune when it starts vacuuming, a triumphant tune when it finishes, and a sad tune if it gets stuck someplace or runs out of juice before it can get back to its home charging base for more food. It'll sit there, playing its sad song every few minutes so you can find it and put it back on the charger.

I had the best time just watching it scoot around the house vacuuming up stuff, picking up crumbs and dust bunnies and other doodads left on the floor. It's also fairly intelligent, so when it starts running low on battery power it'll find it's way back to the charging base and refuel. So cool.

Now if only I could hack it with a motion sensor so it'll greet us when we come home from work...

Alternatives

2008-03-05T06:06:00.003-06:00

Mr. C had been to several other physicians, trying to get rid of the pains he's been having in his side. After months of poking and prodding and one test after another, it finally became clear that an operation was needed.

However, being absolutely terrified of surgery, he had delayed the decision go ahead with the operation for quite some time. But it had finally gotten to the point where he just couldn't take the pain anymore and he decided, reluctantly, to pursue surgery.

So Mr. C came to the clinic to complete the necessary paperwork and for a final visit prior to his operation. One of the other doctors had seen him already and pretty much completed all of the paperwork, but left out a few forms. She had to leave to see another patient emergently and asked if I could finish up. After getting a short briefing about the patient and the planned surgery, I knocked on the door and went into the room to talk to Mr. C and get the necessary signatures.

Upon entering the room, I saw a mournful Mr. C, no doubt fearing the upcoming surgery. I tried my best to put him at ease while simultaneously explaining the planned surgical procedure in detail. At one point, while I was talking about the lack of alternatives to treat his condition, his face lit up.

I could tell from his body language that he wanted to interject, so I paused.

Mr. C: Doctor, can I ask a question?

Me: Of course.

Mr. C: [moves in close and lowers his voice into a hushed tone] I mean no offense, but isn't there some kind of ancient secret Oriental medicine you can do?

As he asked me this, he moved his hands around as if he was performing a magic trick.

I tried to maintain a straight face, but then I started laughing so hard that I started choking. Mr. C looked a little offended.

I told him that sadly I knew of no ancient secrets. But if I had, I definitely would not have hesitated to apply them for his pain.

Chance

2008-03-02T09:27:00.003-06:00

It appears that over the past several months, I've been winning just about every kind of European lottery available. My inbox has been flooded with one important official after another trying to get in touch with me to help me claim my millions. Between these lottery winnings and all the recently widowed Nigerian women trying to unload their wealth on me, I don't know what possesses me to keep working.

Anyway, hoping that this lucky streak will carry on over, I bought a single lottery ticket for the Powerball. The jackpot is for millions and millions of dollars! I'm no different than your average American and completely unable to resist the temptation of getting rich overnight for doing absolutely nothing, so I got suckered into buying a ticket.

Given the extremely feeble odds, I could have found a better use for that dollar. But a dollar is a small price to pay for a Saturday afternoon filled with daydreams about what to do with all that money and wondering just exactly how I plan to tell my boss I going to quit.

Smorgasboard

2008-02-28T07:45:00.000-06:00

I do not understand why the price of blue jeans are up in the triple digits.

People are freaked out about the rising cost of gasoline, but nobody has paid much attention to the absurd prices tacked onto a pair of blue jeans. And amazingly, the more expensive the jeans, the more it looks like they're from a thrift shop.

* * *

What is this magical force that will keep a piece of hair stuck to your tongue despite your best efforts to remove it? NASA should look into that and use that force to secure foam to their space shuttle.

* * *

I bought a bag of peanut M&M's. I came upon a brown M&M and realized that this is the only color M&M in the bag that didn't have a corresponding character. Blue, green, yellow, orange, and red all have been drawn into characters, but not the brown one. What's up with that?

A quick email to the Mars company, the parent company of M&M's, asking why there's not a brown M&M character resulted in a canned email response within 24 hours talking only about how the company is not racist. No mention of why there's no brown M&M character, just that nobody at Mars Co. is racist. They failed to actually address my question.

Up until I read that answer, I didn't even think to correlate brown M&Ms with black people. Or Indian people. Or Mexicans. Or whichever race Mars Company thinks should be associated with brown. Which then leads me to ask what race of people the green, orange, and blue M&M's are supposed to represent.

* * *

No question that the elevators can often run slow. Especially during the lunch rush. As I walked over to the elevators to get up to the 8th floor, there was a woman pacing, ranting, and pitching a fit to nobody in particular about how she's been waiting for nearly 10 minutes and she's in a rush to get back to her company and she's too important to be delayed and blah blah blah.

Thankfully, a down elevator arrived shortly, but it was full of people and they couldn't make enough room for her. She couldn't get on, and as the doors closed on her, this caused her to erupt into another tirade about the elevator system in the hospital.

I tried to ignore her, but just couldn't take it anymore. I pointed to the stairs just 10 feet away from the elevators and informed her that if she's in that much of a rush, perhaps she should take the stairs. Afterall, she's only on the second floor. I figured she could manage one flight down.

She looked back at me as if I just told her to go fuck herself. Which is, in all honesty, what I really wanted to suggest after hearing her self-importance rant for the past several minutes. She then focused her energy in telling me what a moron I am to suggest such a thing. I obviously have no clue that important people are too important to take the stairs.

Thankfully, the elevator she couldn't get on to get down arrived on its way up. I got in, pushed for the 8th floor, the doors closed, and that was that.

Messiah

2008-02-25T08:11:00.001-06:00

A friend of ours has recently started listening to a band called Band of Horses and was quite excited to find out that they were coming to play at a nearby club. He went and bought four tickets, and asked if Nathalie and I wanted to join him and his girlfriend. I immediately agreed.

Several reasons:
1. Nobody likes being rejected. There's nothing more soul crushing than mustering up the courage to ask someone to do something and then having them reject you. So I make it a policy that I usually agree to pretty much everything (within reason, of course) so that the other person never has to face that.

2. You start declining invitations, and next thing you know, you're not invited to things anymore.

3. I like live music, and I like being exposed to new music.

And lastly, I like hanging out with this guy.

So he gives me a CD to listen to while the day of the concert approaches. They sound kind of like The Shins. Nathalie and I listen to the CD the past several days as we commute back and forth from work and decide that it's pretty good.

A few observations from the concert:
1. The Shins look like a group of Microsoft computer programmers. That is to say, just a group of average looking nerdy guys that you would easily overlook if you passed them at a local mall. That's what I expected Band of Horses to look like, since they sounded so much like them. But instead, the guys from Band of Horses looked like Appalachian hillbillies: skinny, long scraggly hair, and long beards. I half expected them to start distilling moonshine during the middle of the concert. There would be absolutely no mistaking these guys for The Shins.

2. Apparently, long scraggly hair and thick beards and looking like Jesus is the "in thing" right now. The club we went to is near a local college, and that was the look the local college guys were sporting. I'm sure the acoustic-folksy sound of the band had something to do with attracting these bearded guys to the venue, but it looked like 50% of the college guys could have easily been mistaken for Jesus.

There was Tall Skinny Jesus, Malnutrition Jesus, Very Large Head Jesus, Needs A Shower Jesus, Jock Jesus, Jesus sporting a popped collar, Jesus with too many shirt buttons unbuttoned, Really Hairy Jesus, and just about every other kind of Jesus you could imagine.

3. When we got to the club, we staked out prime real estate near the bar along the wall. It was a good vantage point for watching the band as well as people watching. And then it wasn't long before I realized that everybody looked awfully young. And at that point I realized that my friend and I had become the "old dudes" that tend to congregate in the corner of the club. Back when I was in high school sneaking into clubs, and even in college, I would always see a couple of old guys standing in the corner. "Hey man, you're out of place," I would think to myself.

And now, I'm the guy that's out of place.

Adaptable

2008-02-23T07:39:00.000-06:00

As much as I love watching movies, I cannot watch a musical. You know that cringing feeling you get when you know you're about to get a huge static shock off the doorknob from walking across the carpet? I get that same feeling about musicals.

No matter how great, how classic, or how enthralling it may be, if any major portion of the dialog is conveyed through singing, I'm not interested. There's no rhyme or reason for it. I just don't like it.

I've seen the Wizard of Oz once. I've seen parts of The Sound of Music. That's about all I could tolerate. Mary Poppins? No. Grease? No. Chicago? No. Moulin Rouge? No. No, no, no. Even Scorsese, who's films I adore, is not enough to get me to watch The Gangs of New York.

So when Nathalie and I were in New York, I was curious as to how I would react to a Broadway show.

And amazingly, I really liked it. There's just something different about seeing live actors as opposed to those on a movie screen. To my utter disbelief, I even enjoyed the singing. Fritz over at The Movie Guys summed up my feelings about musicals quite well with this statement he made in review of Sweeney Todd in regards to his distaste for musicals as opposed to regular movies:

...film [is] a more literal medium than the stage and it seems more patently ridiculous when characters burst into song on film than when they do on the stage, where the stage itself makes things seem inherently more artificial, so it's not as jarring when the characters sing. On top of this, seeing a musical on stage is a more energetic experience. Watching the performers belt out the music live in front of you gives off a palpable energy that rarely translates to the screen (witness the failures of the film versions of Rent, Phantom of the Opera, Evita).

I couldn't agree with his statement more. People on stage on a Broadway show could fart rainbows and I wouldn't think it was weird at all.

I actually heard myself telling Nathalie on the subway ride back to the hotel that we need to go watch more Broadway shows. And I wasn't being facetious. I really did enjoy them.

So does this mean I'm going to go rent Grease and give musicals a try?

Uh... No.

Ranked

2008-02-21T14:06:00.001-06:00

In my own selfish way, I've been happy to see the number of new members at the gym slowly diminish as the days are going by.

I feel quite guilty that I harbor such feelings, being a healthcare provider and all, but there's nothing more frustrating than having to either delay a workout, cut a workout short, or skip a workout because the gym is too full. Walking into the gym to see swarms of people gives me the same feeling as watching the old lady ahead of me at the grocery store pull out a checkbook. I couldn't feel any more let down if I found out I had to spend an afternoon at the DMV.

Anyway, other than the few new members, the landscape of the gym is now back to looking like what it used to before that brief influx of January Resolutionists.

On my way to the locker room, I walked by the magazine rack. I mostly ignore what they have, since they're usually girly magazines like Shape, Glamour, or Good Housekeeping with information that either I already know (What your man is thinking!; What guys want in bed) or have no interest in learning (Sexy hairdo's for 2008!; New purse styles!; Cheap chic dresses!).

But one caught my eye: US News and World Report's list of 100 Best High Schools.

A quick look through the list confirmed what I already knew: my high school I attended in Kansas is NOT a great school. Well, no surprise there. Really. If my high school was awesome, I'd probably be a rich tycoon by now. Gone will be the days of juggling payments and trying to balance the checkbook so that it won't bounce every month. No more heartache watching Nathalie look wistfully at a designer dress or a purse through a store window.

But wait, aren't doctors rich?

Ha! We are the only fools that work day and night to eliminate the very need for our own existence. Not only that, the government and insurance companies pay us less and less every year. How crazy is that? What fool stays at a job where his salary decreases? Doctors. We're idiots.

Nathalie and I watched Fiddler on the Roof recently. The main character Tevye is a poor peasant, but blessed with a great family and a supportive community. But that doesn't stop him from wishing he could have a little more money.

Perchik: [trying to convince Tevye that money isn't everything] Money is the world's curse.

Tevye: Well, then may the Lord smite me with it! And may I never recover!

Amen to that.

Sickness

2008-02-19T10:12:00.002-06:00

Given the fact that I spend a large part of my day in a building packed to the rafters with sick people, it's quite a remarkable achievement on my immune system that I don't get sick with a cold or illness more often than once a year or so. However, after over a year of dodging colds and various viruses, one finally got to me last week.

I've been phlegming it up the past several days, coughing my lungs out and waiting patiently and miserably as my body overcomes this flu. Lucky for me (I guess), I got sick over the weekend so I had time to recuperate. Unlike most other jobs where you can call in sick, being an MD means you go to work sick and take care of the people that are sicker than you. So being sick over the weekend meant I could sleep it off all weekend, instead of having to show up at work and try to function doped up on DayQuil, Ricolas, and obscene amounts of orange juice and other home remedies.

The real big pain in the butt about getting the flu is the chills and fever sweats. As I lay in bed during the weekend sweating through one set of sheets after another, I started to dread the eventual washing of the sheets.

Actually, its not the washing, but the drying that drives me nuts. How is it that the laundry industry just can't seem to build a dryer that will prevent the sheets from becoming bunched together into a big ball? Nothing is more frustrating than going to the dryer after it's finished, opening the door and finding a big old wad of sheets, where the outside is smoking hot and the inside is wet.

The dryer generates so much heat trying to dry this wet wad of sheets that I am always amazed that the outer layer of the sheets hasn't caught on fire.

Of course this is easily remedied by drying the sheets individually. Which is what I do, but really, that's poor utilization of resources and a bit inconvenient.

Valentine

2008-02-14T10:31:00.004-06:00

Nathalie: [cleaning the stove] I always tell you "I love you".

Me: [washing dishes] I know.

Nathalie: When we hang up on the phone. When we say bye at the door. When we go to sleep.

Me: I know.

Nathalie: I tell you "I love you" a lot. Many times during the day.

Me: I know.

Nathalie: ...

That, would be my unspoken cue for me to tell Nathalie "I love you". But being the mischievous pain in the ass that I am, I don't. Instead, I launch into a rambling discourse about nothing.

Me: You know that story about the boy that cries "Wolf"? After a while, nobody believes him. So if I tell you I love you all the time you may stop believing me. Then where will I be? So it's best that I ration it out and parcel out those "I love yous" for key, critical times...

Nathalie: [gives me the look] ...

Me: ...Like now!

* * *

Happy Valentine's Day Natbug!
I love you.
Uh...
Lots!

I know my actions speak louder than words, and I know that you know that I love you, but I also know it's nice to hear it once in a while.

To the best thing that has ever happened to me,
the beautiful girl that claims me as hers;
To the girl that I want to grow old with,
to laugh with me, cry with me, and be with me;
May you never know anything but happiness and comfort
as my heart embraces you with deep, adoring love.

I love you Natbug! Happy Valentine's Day!

Antique

2008-02-13T14:59:00.005-06:00

While the rest of the world has upgraded their TV viewing technology to digital recorders and the such for recording TV shows, Nathalie and I are still rocking the high-tech VCR technology of the 1980's. This had been working fine, until my $30 El Cheapo VCR I bought from Wal-Mart (my favorite place for cheap crap) finally died and went to electronic heaven.

Well, the easy solution would be to run down to the local electronics liquidator and buy another one. But apparently, while that would have been a great plan in the 1990's, it's not so feasible now. It turns out that buying a standalone VCR is an impossibility because nobody makes them anymore.

VCRs nowadays come bundled with a DVD player. At an increased price, of course! How aggravating. We already have enough DVD players. We definitely don't need to spend money on more.

Instead of being able to buy a VCR for a measly $30 or so, I have to shell out nearly two to three times that amount for one that's a VCR/DVD player combo. So I'm forced to spend more money and buy something I don't need in order to get something that I do. It reminds me of how legislators will add on all sorts of riders to an attractive bill in hopes of getting unpopular legislation passed. Or how the pretty girl sitting at the bar comes packaged with a mean, untrusting friend that thinks you're a creep.

So I turned to eBay, but while the cost of used VCRs are reasonable, the shipping costs definitely are not. As a last resort, I turned to craig's list.

I keep forgetting that the people that populate craig's list have absolutely no idea about how to price their used crap they're selling. One seller wanted $75 for his used Sony VCR.

Yes, yes. Sony is a good brand. And I'm sure the VCR was quite expensive back in 1993, but asking $75 for it in 2008? C'mon!

Look's like I might have to either go for the VCR/DVD player combo or upgrade to a TiVO like the rest of my friends. I can't believe I'm going to go waste a sixth of my economic stimulus rebate on a stoopid VCR.

Salmon

2008-02-11T07:40:00.000-06:00

I've never developed a fondness for salmon. I think it's because I can't pronounce the frickin' word right.

When people find out that I wasn't born in the States, they always appear shocked at my lack of an accent. Or my command of the English language. Often both.

That's OK. I'm not offended.

Think of a famous Asian. Jackie Chan? Mr. Miyagi? The Japanese guy from Heroes? William Hung? (She Bang! She Bang!) The majority of those portrayed in the media have thick accents. It's only natural to think that any other Asian you'd run into in the world would as well. It's just a stereotype. I've gotten over it.

I don't have an accent because of three things:

I was just a little over 7-years old when I immigrated. Children under 11-years old are able to adapt and learn a new language more easily.
My family immigrated to Kansas, a very accent-neutral part of the country. I can only imagine the horror that would be my accent and dialect had we first moved to anywhere in the South. Or Boston. Or Long Island.
What accent I did develop, I've worked hard to lose.

Changing, or losing, or adapting an accent isn't that difficult. Look at Madonna. She talks with a British accent now. She was born and raised in Michigan. What the hell is that about?

But there are a handful of words to which I just can never get the pronunciation correct. No matter what I do, I can't make it sound right. No amount of tongue and lip acrobatics will allow me to pronounce it correctly.

One such word is salmon.

I think it's the "L" that throws me off. I know it's supposed to be silent. Even though I know how it should sound, and I can even hear myself say it correctly in my head, it never comes out right.

Saaaalmun?
Sellman.
Saaaamehn.

For some reason, there's this disconnect between my brain and my tongue, and when I try to say "salmon" it comes out sounding nothing like it.

Seriously, I think it's the "L". It just throws my brain off. I start off well with "Sa-" but then my brain short-circuits and it's anybody's guess how I will finish off that sound. I've practiced saying it to myself thousands of times. No improvement whatsoever. It drives me absolutely batshit crazy that I can't say the word right.

So, I've stopped saying it. If I'm trying to describe a salmon colored item, I'll just say it's pink. Or peachy-pink. Somebody will then offer, "salmon colored?" and I'll say "yes."

If I see it on the menu, I'll likely not order it because it drives me crazy that I can't say it right. I think this mental avoidance of the word has also convinced my tongue that it doesn't taste good.

But honestly, I don't think salmon tastes good at all. It definitely has a strong overpowering flavor, especially when compared to other yummy fish like sea bass, or mahi mahi, or tilapia, or even the lowly catfish. I don't care how much life-saving omega-3 fatty acids might be tucked away in its flesh, I'm not ordering salmon.

If I really want it, I might just tell the waiter that I want the fish. To which he'll either ask: "the salmon?" and I'll nod my head, or he'll say "which fish?" and I'll just point to the menu like a caveman.

H

2008-02-07T06:05:00.000-06:00

Despite having had ample time waiting in line before making it to the counter, he took several more minutes to study the menu.

Man: So... what comes in a Number 1?

Girl at the counter: An Egg McMuffin, hash browns, and your choice of coffee, juice, or soda.

Man: Does it come with anything else?

Girl at the counter: No.

Man: Really?

Girl at the counter: Sir, what you see on the picture is what you get.

Man: [staring up at the Combo menu] Really? Nothing else, huh?

The drive-thru was about 5 cars deep, so I parked and came in thinking I could be sneaky and avoid the line, only to be delayed by a man looking for hidden food items not portrayed in the large combo-meal picture menu. I saw the car I would've been behind pick up their food from the drive-thru window and drive off. I should've just stayed in the drive-thru.

I don't know why he was having quite the difficult time understanding the combo-meal concept that has permeated modern-day American culture. By his girth it was suggestive that he was likely no stranger to fast food, yet he appeared to be lost in a foreign land. Perhaps this was his first time waking up early enough to order breakfast.

I looked to my right. The other line. The fast line. The line I didn't get in. They were zipping through customers like a wood chipper. I thought about moving over to that line, but the people behind me from my line had already beat me to it.

All I wanted was a medium coffee. And after a brief thought, I figured I'll just drink the nasty hospital coffee today and turned to leave. The coffee at McDonalds is nowhere close to being worth the time spent standing behind this guy.

As I turned, right behind me was a woman that I vaguely recognized. I hesitated a bit, trying to identify her. But she recognized me first.

Mrs H: [with a sad smile] Hi, do you remember me? I'm H's wife.

Of course. It came rushing back. Oddly, the first thought that came to mind was that I was setting a bad example by getting food at McDonald's. Of course I was only here to get a cup of coffee, but she doesn't know that. Then the second thought was that she shouldn't be eating here either. But who knows, maybe she's here just to get coffee as well.

After a cursory greeting, we both stood there, uncomfortable with each other. Strangers connected by a remote incident. Behind me, I could hear the man interrogating the girl at the counter about the contents of the breakfast burrito.

Mrs H: H died, you know.

No, I did not. It turns out that after storming out of our hospital, Patient H and his family sought out a second opinion, which my attending staff and I recommended. The second surgeon also agreed that Patient H's cancer was at a very late stage, but he was more aggressive and offered an attempt at an operation. Patient H's family, thinking they had nothing to lose, decided to go for it. If he survived the operation, he had a 25% chance at another 5 years. Otherwise, he had about 6 to 9 more months left.

Tragically, the surgery was more than his body could handle and he died of surgical complications shortly after the operation.

Mrs. H fidgeted with her hands as she told me the story.

Girl at the counter: Sir, can I help you?

Amazingly, the man in front had placed his order. I turned around and ordered a medium coffee.

Girl at the counter: That's it?

I smiled and nodded.

Mrs H: Dr. THW, let me get that for you.

Me: Wha-? No, that's OK Mrs. H, I got it.

Mrs H: No, no. Please. It's the least I can do.

I paused, and then relented, slowly putting my wallet back in my pocket.

Mrs. H then placed her order, paying for my coffee.

I waited with her at the counter while they filled her breakfast order. Then I walked with her to a table. I thanked her for my coffee. I looked at her standing next to her tray and she reminded me of how my dad looked in the months after we had lost my mom to cancer. I remembered the emptiness and how there were no words that could comfort my dad, and the immense sadness he carried.

I put my coffee down and gave her a hug.

Mrs H: [quietly] Thank you.

I didn't say anything. Instead I just nodded. There was nothing to be said.

I picked up my coffee, wished her well, and walked out to my car.

Eco-friendly

2008-02-06T06:54:00.000-06:00

The silence was what actually woke me up.

The whrrrr of the ceiling fan had stopped. I opened an eye and peeked out from a half-closed lid to see the fan slowly coming to a stop.

I listened intently for the ever-present whrrr of the computers in the office, but couldn't hear them either.

A glance at the blank screen of the bedside clock/radio confirmed the power outage.

I had no idea what time it was, but judging from the amount of light coming in through the windows, it was probably about 7 AM.

I closed my eye and contemplated what I would do in a powerless house on a Sunday morning. Can't make tea. Can't make coffee. Can't listen to NPR. Can't surf net.

Had the usual epiphany about dependence on electricity, made yet another mental note about upping my efforts for power conservation, and decided that the best use of time at this point was to stay in the warm bed under the covers and go back to sleep.

Which I promptly did.

Cheshire

2008-02-02T06:32:00.000-06:00

Some nights we're too exhausted from the day's work, so we're both out like a light when our heads hit the pillows. But most nights Nathalie and I lie in bed, lights off, alarms set, and cozy under the covers, and talk while sleep slowly consumes us.

Some nights we have serious talks. Some nights are filled with absent minded talk about nothing. Some nights are spent laughing. And some nights we simply lie silently, thankful to have found each other.

The other night, while we were slowly falling asleep, Nathalie told me about her recent jaunt to Starbucks when we were in Dallas. While I was at the conference, she had packed up some reading materials and headed over to a Starbucks that we had seen while driving around some nearby trendy spot. Apparently, everybody else made similar plans for the day and by the time Nathalie got there, it was packed. Nathalie placed her drink order and sat down at the only unoccupied table.

Nathalie's attention was then drawn towards a couple in their early 30's, sitting on a nearby couch having a full-on make out session.

Nathalie: It was really nauseating, they were just sitting there making out.

Me: At Starbucks?

Nathalie: Just sitting on the public couch, making smacking noises and everything.

[Nathalie imitates various forms of smacking and smooching noises for realism.]

Me: I guess they didn't care if anybody was watching.

Nathalie: Ugh. A little peck in public is one thing. But they were so gross.

Me: You should have stared at them. They would've got self-conscious and stopped. People have this 6th sense and can tell when someone's staring at them. Even if they're completely absorbed doing something else, they'll figure it out. And it works pretty quick. It must be like a survival instinct or something. You should have just stared at them with this real creepy look. That's what I do when I come to a light and there's a guy picking his nose, oblivious to everything. I just stare at him until his 6th sense kicks in, and then he turns around and sees me. Then I make eye contact and I'm like 'I saw you, you disgusting dork'. Embarrassment is a great weapon. I should just carry around a camera and...

I realized Nathalie hasn't said much and that I was rambling. She must've fallen asleep. I opened my eyes and turned to face her.

It took me by surprise, but there was Nathalie just inches away from my face, with a crazy wide eyed stare and a goofy Cheshire cat-like grin.

Me: JEESUS! You scared me! What are you doing!?

Nathalie: 6th sense my ass. I've been staring at you this whole time.

Congestion

2008-01-31T08:18:00.001-06:00

In pretty much every public bathroom I've ever been in, there's always a larger number of urinals or toilets than sinks. Under normal use this is nothing to get worked up about. But when the bathroom gets flooded with people, the disproportionate sink-to-urinal ratio often becomes an issue.

There's pros and cons of being a male. One pro is that bathroom lines are seldom long. Except maybe at large rock concerts or sporting events, but even then, it moves at a pretty good clip. A large factor being that most of the guys never seem to wash their hands afterwards. Unhygienic, yes. But it does eliminate that potential bottleneck at the sink and makes room for those that do wash our hands.

Surgery, being what it is, is still a male dominated field. So at the conference I was at in Dallas the past several days, the men's room would face mild congestion during the breaks when everybody hit the bathroom, while the women were breezing in and out of theirs. Of course, being that a bathroom full of surgeons is likely to wash their hands more than one full of drunk rednecks at a tractor pull, the bottleneck at the sink was in full effect at every break.

It's funny watching the faces of the women as they walked by all the guys waiting in line to pee. It always looks like they're trying their best to keep from smirking.

As I moved up in line and got closer to the door, I saw that they guys were leaving the bathroom with a look of mild disgust on their faces. Great. Someone must be making a bad poopy.

But no, once inside the doors I realized that the irritant causing the scowls was not poopy, but the aftermath of eating asparagus.

The hotel had been providing a buffet type lunch for those attending this conference every day. On this particular day, they had amongst the other food, asparagus sitting innocently on a platter. Every time I see asparagus, I have an internal debate: eat the yummy goodness and have stinky pee later, or not?

That day, I ate some. Apparently a lot of the other guys attending the conference did as well.

Tutorial

2008-01-27T20:42:00.001-06:00

Driving in a city you've never been to before is a little like taking care of a friend's dog for the weekend. Except that your friend didn't tell you anything about the dog's disposition. So you have a rough idea of what dogs are like in general, and you know how to handle dogs as a whole since you've been a long time dog owner yourself. But your friend didn't tell you anything about his dog. So the first few hours (or longer) with the new dog becomes a daunting task full of misunderstandings and misadventures while you slowly learn to adapt to that dog's peculiar eccentricities.

And so is the case with driving in a new city. I've found that each city has its own unique personality when it comes to the driving characteristics of those that live there. I'm no stranger to driving, but the first hour or so in a new city is a serious test on one's ability to react to that city's particular driving idiosyncrasies and adapt to the new "norm" without getting into a wreck or causing one.

For instance, drivers in New Orleans as a whole run yellow and red lights routinely. I nearly got rear-ended several times shortly after moving to New Orleans simply because I didn't know that I wasn't supposed to stop when the light turned yellow. I never properly thanked the very crabby gentleman that alerted me to that fact as he screeched to a halt behind me, used his horn to let me know he was OK, and then thoughtfully took it upon himself to get out of his car and come up to my window to leave a film of spittle as he loudly informed me of his version of how traffic should flow.

In Philadelphia, I learned that the white lines on the streets must have been painted merely for decoration as nobody except me seemed to abide by them.

In Atlanta, I learned that the speed limit signs are simply suggestions and should be ignored at all times. Except when someone has been pulled over on the other side of the highway, on the other side of the concrete barrier, across the median, with the officer out of his car and ticketing the driver in the car. If this is the case, you're supposed to slam on your brakes and slow down to less than the speed limit immediately even if the officer isn't looking at you.

No nevermind. That's not unique to Atlanta. That seems to be every city I've ever been in.

Nathalie and I've been in Dallas the past several days attending a conference. I've become assimilated and now drive just like everybody else in Dallas. Which means I don't use my turn signal, drive at whatever speed I feel like on the highway, and if I see an open space in front of the car next to me on the highway that will barely accommodate a subcompact car, I'll quickly pull my 4Runner into it for no particular reason, only to come back into my original lane just a few hundred yards later. No turn signals, of course.

It would be nice if there was some way to be informed about the driving characteristics of each city before you get there so you can avoid becoming a traffic statistic. Maybe something at the Welcome Center along the highway as you enter the state. After you pee, you can pick up a pamphlet or something. Or maybe several large billboards as you enter the city limits that can brief you on how to modify your driving habits to match that of its citizens.

My blood pressure would definitely have appreciated having something like that several days ago.

Frenzy

2008-01-24T20:03:00.000-06:00

I had been lost in thought thinking about the various surgical problems plaguing my patients. I looked up from the sheet of paper in my hand and watched as the display above the doors counted down to one.

* ding! *

As the elevator doors open, I found myself being shoved aside as two little kids rushed in, both screaming "I WANNA PUSH THE BUTTON!! I WANNA PUSH THE BUTTON!!" repeatedly and as loud as they can.

The two people that were in the elevator exited, skirting around the children with a bewildered look on their faces. I let the mother, who's holding an infant in her arms and a purse big enough to conceal another child, enter the elevator, then I followed them all in.

One child is beet red and screaming bloody murder as he pummels the other. The other child is screaming as well, cowering in the corner and throwing wild kicks at her younger brother. Obviously, she got to push the button. Or buttons, I should say. Floors 2, 3, 4, 5, and 6 are all lit. I see that the rest of the buttons were out of reach.

I pressed 9 for my floor and moved towards an unoccupied corner, watching this scene with bemused indifference as the mother's attempt at peace negotiations failed miserably. When the circus act exited the elevator on the second floor my ears embraced the silence and my blood pressure started to come back down. A bit. Thanks to those little devils, I did have four unnecessary stops to make before getting to my floor.

As the doors were closing, a hand shot through the narrowing gap. The doors reopened reflexively and Tom, a fellow resident, entered.

After a mumbled greeting he looked at the buttons, paused a bit before pushing 11 for his floor, and then looked over at me, raising an eyebrow in silent inquiry.

What's there to say? I simply shrugged as the doors closed and we started our slow ascent.

At the fourth stop as the elevator doors opened purposelessly and then started to close, I guess Tom's curiosity just couldn't take it anymore.

Tom: Hey man, why did you push all these buttons?

Me: It wasn't me. It was these...

[pause]

Me: I don't know. Nevermind.

Instead of an explanation, I simply shrugged again and looked down at my list of patients on the 9th floor. I smiled to myself, remembering days gone by with minimal responsibility when I myself had no other priority than getting to push a few buttons here and there.

As the doors opened on my floor, I shouldered up my patient responsibilities and walked towards the room of my first patient.

Maseca

2008-01-21T05:49:00.000-06:00

For dinner, Nathalie and I decided to make fajitas/burritos/tacos depending upon how the tortilla would fold up and how the meat and veggies were going to stay in it. You know how it is, your taco turns into taco salad sometimes.

Well, for no other reason than sheer curiosity, I decided to try my hand at making homemade corn tortillas. So along with a package of pre-made tortillas (as backup in case my tortilla making efforts go sour), I also bought a bag of corn flour.

I followed the simple instructions on the bag and within 10 minutes I was looking at a fairly decent looking tortilla. I took a bite and it blew me away. Like dyslexic Adam and Eve, I took my first tortilla and ran over to Nathalie so she could have a bite. She's not a big fan of corn tortillas, but I was acting like we won the lottery, so she took a bite.

Nathalie and I looked at each other and realized that the tortillas we've been buying from the store just simply sucked. We thought they were good, but we might as well been making tacos and fajitas out of paper plates. These freshly made corn tortillas were crispy, but chewy, and had a light flavor with a hint of corn. We looked at the bag of store bought corn and flour tortillas. There was no going back to that.

I've been trying to think of the best way to describe it, but I can't. It's something akin to the first time I had real, patiently and properly slow-smoked Texas brisket. It was phenomenal and it completely changed my perception of barbecue.

Or this is kind of like the difference between a steak at a steakhouse, and a steak from Applebee's. I thought steaks from Outback were good, then I had my eyes opened by a properly aged and prepared steak.

Not only was it disgustingly simple and ridiculously easy to make, the taste of the freshly made tortillas were absolutely incredible. Now I understand why tacos, tostadas, enchiladas, quesadillas, etc, etc all contain the humble tortilla: Because a properly made tortilla tastes like a gift from God.

I used to laugh and question as to why every Mexican dish seems to contain some permutation of the tortilla. But now I see why. Hell, if I had something that tasted this good, I'd put it in every food I could think of as well.

How can something so simple as corn, water, and salt produce something so frickin' scrumptious? That's the 8th wonder of the world right there.

So open up a new browser, go Google tortilla making, and spend a measly $3 on a bag of corn flour (not corn meal, huge difference) on the way home today and try it yourself. You don't even need a tortilla press or a rolling pin. I squashed mine with a plate and rolled it out with a lager glass (which was then later used to hold a beer).

We're never eating store bought corn tortillas ever again. Neither should you.

Discordant

2008-01-16T16:54:00.000-06:00

Every time I hear Paula Deen talk I have to fight the urge to ram pencils in my ears. That overly saccharine and exaggerated southern accent makes me want to go strangle kittens. I'd rather listen to 10,000 monkeys scrape a thousand forks across a hundred metal frying pans than have to listen to that drawl.

I've lived in South Carolina, Georgia, and Louisiana. I've been to the backwoods of deep, deep Georgia... places no Asian man should ever be, and I haven't heard a southern drawl that thick.

Paula, quit overplaying the "southern" thing. Just talk normal so I can watch one of your shows without having to mute you and turn on the closed captioning.
Sheesh.

Disturbance

2008-01-15T06:52:00.000-06:00

Nathalie and I watched a marathon of poorly reconstructed reenactments of true ghost stories on TV. As terrible as the acting was, the stories were absolutely fascinating. And with each episode more frightening than the last, the entities became increasingly more evil and malevolent, and the stories more deliciously and wickedly entertaining. These stories sent chills up and down our spines, and we huddled on the couch, completely enthralled.

But like anything done in excess (shopping, alcohol, karaoke), it was a lot of fun at the time, and in due time I soon grew to regret it.

As I lay in bed in an old house that was probably built over some sacred burial ground, analyzing every small noise, waiting for the demons to come eat me and Nathalie, I kicked myself over and over again for not peeing before getting into bed. Because now I had to pee.

And everybody knows that this is exactly the moment that the demons are waiting for. And after spending the last 30 minutes laying in bed letting my imagination run wild, I knew that the moment I got in the bathroom, I would be either devoured, or possessed, or torn to bits, or dragged into hell, or any number of unimaginable horrors.

But I really had no choice. My bladder had reached its limit.

I got out of bed and scurried to the bathroom, being careful not to look into any mirrors along the way. Scary stuff being seen via mirrors is probably all bullshit, but tonight wasn't the night to challenge that assumption.

Thankfully, the trip back to the bedroom was also devoid of any demonic misadventures. As I settled back in bed, much relieved (in many ways) but still a bit spooked out, I wondered what kind of bizarre dreams were in store for me tonight. There was a modicum of relief knowing that it was a Sunday night, and I thanked God for his holy holiness. But come midnight, Sunday comes to an end, only to be followed by all things evil that is Monday and who knows what devilish madness awaits?

Line

2008-01-11T18:09:00.000-06:00

Have you ever stood in line with a person like this?

A person that has no regard for personal space?

This person will inch closer and closer to you.
The line isn't moving, but he is.
And the next thing you know, he's pretty much rubbing against your back.

There's nowhere for you to go, but you move forward just a little bit.
Anything to move away from him.
But then he's inching forward again.

You start to hate this person like you've never hated anyone before.

As he inches closer and closer, your boiling point finally gets reached.
You turn around to give him an earful, but you're caught dumbfounded as you realize that this guy has continued to inch forward and now he's actually standing next to you.

You stand there, looking at the guy as your mind just reels back with disbelief, screaming "What the hell is wrong with you?!"

Have you ever stood in line with a person like this?

Well, one of my bottom incisors is like that. It's been inching closer and closer to the other tooth, slowly pushing it out of the way, and it's now starting to make my lower teeth line a toothy mess.

My tooth's strange behavior started when I moved down here to the South. It appears that my transformation into becoming a redneck shows just no signs of slowing down.

Lash

2008-01-09T06:04:00.000-06:00

I knocked on the door as I entered Patient H's room. His wife and grown children were sitting on the couch. Patient H put down the papers he was reading and took off his reading glasses. They all turned to look at me.

I let out a quiet sigh and began.

Me: I've got bad news...

Once a person enters a hospital as a patient, they're stripped of their familiar comforts and placed in a sterile and unfeeling environment. The only constant from their home life remains their illness, which the doctors are also working hard to remove. Much like joining the military, all forms of individuality are removed and soon every patient takes on a sterile anonymity, differentiated from others only by their name on their wristband.

All that they had known before is now unknown. Their familiar routine is disrupted. Suddenly nothing is predictable and everything is uncertain. Their prognosis, the unfamiliar medical words, the neverending stream of unfamiliar faces coming to poke and prod, asking the same questions...

The patient is no longer in control of their lives. Their future now lies in the results of "tests" and "studies", to which there is nothing they can do to influence the outcome. Overwhelmed by the circumstances, the loss of self, the dizzying medical jargon, and the frustration that comes with not understanding their disease or the complex process of diagnosis and treatment, comes the sense of helplessness and apprehension.

In rare circumstances where a choice of treatment may exist, patients are given the opportunity to choose a treatment modality. But this isn't as simple as choosing between the creme brulee or the cheesecake. With little understanding of their medical condition or the ability to fully comprehend the impending consequences of the different treatments, most patients relinquish their control of their medical treatment back over to the physician for fear of further exacerbating their condition, giving up what last bit of control they had of their lives.

When a patient is removed from having full control of their lives to none, sometimes in a matter of hours or days, fear and frustration builds. And patients will often transfer this energy by lashing out at family members, nurses, or physicians.

And so was the case with Patient H. Who, when told that his cancer had spread and was inoperable, raged that I simply had no interest in helping him because of his race. He attacked my training. He attacked my intellect. He attacked my motivations, my age, and my inexperience.

And with each outburst, I stood there at the foot of his bed silent, biting my tongue, and just took the hits as they came. Who's to say I'd act any better if someone delivered a death sentence unto me?

His family came to his side to console him, and after answering all of their questions, I excused myself from the room. Although I can rationalize and understand the reasoning behind this unwelcomed animosity, it still didn't make it any easier to tolerate.

Being accused of not doing my best to care for somebody... That definitely hurt the most.

Scalding

2008-01-06T11:54:00.000-06:00

I do my best not to visit McDonalds. Or any other fast food merchant, for that matter. It's got nothing to do with any political or moral convictions. I just simply do not want to eat chemically engineered food.

(Yes, yes. I am fully aware that everything nowadays has undergone some kind of biochemical alteration. But the stuff at fast food places is definitely on the heavier portion of the processed-food spectrum than what I make from scratch at home.)

Regardless, I stopped by just to get a cup of coffee. As I was driving away, I couldn't help but think of the famed Liebeck v. McDonalds case about the scalding coffee spill.

I looked at the cup, and sure enough, warnings about hot coffee are plastered all over the place. Even on the plastic lid. Interestingly, I noticed a line of braille printed beneath the warning on the lid. Obviously warning their blind patrons that the cup holds hot coffee.

Out of curiosity, and curiosity only because I cannot read braille at all, I ran my finger across the dots, only to jerk my finger away from the coffee lid with a pained yowlp.

The lid was frickin' hot.

I looked at my sore fingertip, throbbing from the brief, minor burn. Perhaps McDonalds should find an alternate place for that braille warning.

Resolutions

2008-01-04T06:14:00.000-06:00

I walked into the gym, took one look around, and left.

I hate this time of the year.

Every machine is occupied. The free weight area is jam packed with people milling about. There's people waiting to use the equipment. There's people trying to figure out how to use the equipment.

My usual 30 minute workout will take at least twice as long, if not longer. Unfortunately, I don't have the luxury of spending an hour at the gym, so I sighed defeatedly and walked out.

It'll only be a matter of weeks before the herd will thin out.

Family

2008-01-02T11:45:00.000-06:00

When my family immigrated to America 26-years ago, it was just the four of us. A young couple and their two young kids in search of the American dream. Despite the isolation, language and cultural barrier, and the ever present prejudice, we learned the language and assimilated into the culture while simultaneously trying to preserve our traditions that identified us as Koreans.

My parents quickly found other Koreans and created friendships and found ties to a local church, but the holidays meant it would just be the four of us. With all of our relatives back in Korea, the large family gatherings of uncles and aunts, cousins and grandparents were suddenly gone. And the holidays felt stark and naked.

But despite this, we found that our little family of four was drawn closer together and that we developed stronger ties to one another. The concept of "us against the world" could not have been more true.

We were poor, we were lost when it came to understanding the American culture, and we were often singled out for our differences: my dad at his workplace, my brother and I at school, my mother at the grocery stores. But at dinner time in our little apartment, we were surrounded by the warmth of our love and the comfort that came from such strong family bonds. The happiness we created nightly at the dinner table gave us the strength and courage to go out the next day, and to work hard for that ever elusive American dream.

As time passed, my brother and I both left the house in search of our own dreams. Although our family was separated by hundreds of miles, we would all come back together during the holidays, and it was as if we never left home at all.

When my mother passed away, the three of us felt suddenly isolated. We came back home for the holidays, but things felt disjointed. We couldn't ignore the emptiness.

Then my dad got remarried, and our small family of three suddenly became an extended clan of 14, and we were welcomed in with open arms. The first few holidays were awkward. My brother and I felt out of place in our newly expanded and adopted family of uncles, aunts, and grandparents. It took us a while to find our nook, to find our place in the order of things. But like all things, it became easier as time went by. And before I knew it, I considered those previous strangers my family, and I grew to love them as if they were always mine.

Then I got married to Nathalie, and my family grew even more. All of a sudden, the holidays started to feel like how they were back when I was growing up in Korea. Big. Loud. A little crazy. And full of love.

With each passing year, my family grows a little more. A beautiful baby niece and nephew. The wonderful girl that married my stepbrother. The great girl that's going to marry my brother-in-law. And the best thing to happen to my brother who'll one day join our family.

During dinner one night several nights ago, I saw a certain look in my dad's eyes. I couldn't place it immediately, but during the long drive back home to New Orleans I realized that it was the look of happiness. For the longest time I thought the American dream was about monetary success. We'll, we are far, far away from that.

But I saw it in my dad's eyes.

He's achieved the dream.

Well, almost. I guess a grandchild would be the icing on the cake.

Merry Christmas

2007-12-25T09:01:00.000-06:00

Me: Too bad it's not colder. This could be snow.

Suppressing a yawn, Nathalie nodded in agreement. The temperature gauge on the dashboard read 43 degrees. Nathalie turned on the radio and Bing's crooning voice filled the car.

As we drove to work early this Christmas morning, peering through the rainy darkness, we saw that a few of the houses had their lights on. No doubt those homes housed little children that woke up early to see what Santa had brought them.

The streets were empty. The only other vehicle on the road was a police cruiser slowly making its rounds.

Up until I saw that police cruiser, I had been in a mildly crummy mood. Who wants to be awake at 5AM and going to work on Christmas morning? Isn't this the day you're supposed to be in the living room with your loved ones opening gifts by the tree and having a Hallmark moment?

Yes.

But for some reason, seeing the taillights of that police cruiser brought me to my senses. I realized how lucky I was not to be deployed to a foreign country thousands of miles way where my wife has to worry about getting a visit from a military representative. I realized how lucky I was to be healthy. I realized how lucky I am to have someone to share Christmas with, and how lucky that there are people in my life that love me. And I realized how lucky I am that my family and loved ones are healthy, and have shelter and food.

Thousands of families will get up this morning to come to the hospital to spend Christmas morning with an ill family member. Many more families will wake up this morning and hope that their loved ones abroad are safe and away from harm. Some will spend this holiday alone. Some won't even be in their own homes.

As I watched the wiper blades dance across the windshield, waiting for the stoplight to turn green, I realized I didn't really have a reason to be in a crummy mood.

I looked over to the passenger side at my beautiful wife, quietly nodding along to Bing's Christmas music. I reached over and held her hand.

Me: Merry Christmas, Natbug.

She smiled back.

Nathalie: Merry Christmas, baby.

Company

2007-12-21T08:17:00.000-06:00

Why I happened to be on the Winn-Dixie website is not worth talking about, but when the website loaded up, I saw the banner above for free milk.

Free is great. I love it. I could be a bazillionaire and I'll still get excited to get something for nothing. Forget the fact that I'm partially lactose intolerant. So what that I have to buy 5 gallons of milk before I get one gallon for free. End result is that I'll get a gallon of free milk! Joy!

Then I read the not-so-prominent-but-not-so-hidden disclaimer that this offer is not valid in Louisiana.

What? Why not? No explanation whatsoever.

Well, whatever. Nathalie and I don't shop at Winn-Dixie anyway. The one branch by our house kind of creeps us out.

That saying about how birds of a feather flock together? So true. On our first (and last) trip to the Winn-Dixie store by our house, Nathalie and I noticed that we did not fit into the demographics of the majority of the shoppers there.

Winn-Dixie may be a good grocery store, and perhaps Nathalie and I visited it on an off day for them, but on that one day we were there, a sampling of their clientele consisted of 2 drunk and stoned men buying more beer, many people in need of a shower, a dozen seemingly feral children running amok, one man that kept cutting in line, lots of loud and obnoxious people freely demonstrating that their IQ was in the double digits, and the coup de grace was one man that was returning a package of meat to customer service:

Man: I didn't have time to cook this meat, and it went bad. I want my money back.

What? Can you even do that? I had no idea you could return food that you bought fresh and then ruined at home. More amazing was that the cashier took the package of green meat and gave the guy money. This just opened up a whole hidden world of possibilities to me. I've got a sack of old potatoes to return.

Nathalie and I ran into another shopper that looked as out of place as we did. As we stood in line to check out, we exchanged sympathetic looks. I left that store annoyed, a little grossed out, and feeling a little bit contaminated, as if I needed to shower when I got home.

We've since stuck with the locally owned grocery store by our house. The prices are a bit higher, but I'd rather pay a few extra dollars and leave the grocery store with a happy feeling, rather than feeling like I've just endured the 6th circle of hell.

That other saying about how you're judged by the company you keep? So true, even when it comes to grocery stores.

Highbeams

2007-12-20T08:30:00.000-06:00

Am I the only one that thinks it's a little strange that some stores use mannequins with very prominent nipples?

Christmas hoopla

2007-12-18T07:19:00.000-06:00

This blog got tagged by Jackie for a little hoopla action. I'm going to mix it up a bit and do it Q&A style.

Me: So, we're going to talk about 12 random things about you that is somehow related to Christmas. Afterwards we're going to tag some more people and pass this meme along. You ready?

Me: Sure.

Me: 1. What do you like best about Christmas?

Me: You know, to be honest. I'm not real big on the whole Christmas spirit thing. But I wasn't always like this. This indifference towards Christmas started about 9 or 10 years ago. Now, trying to explain the etiology of my vapid attitude towards this holiday and my disillusionment with Christmas is way too complicated and multifaceted to do correctly within a blog posting, so we won't go into that. Rather I'll just say that my Grinchy-ness is nicely balanced by Nathalie's Christmas enthusiasm.

Me: 2. What's the matter? Did Santa not bring you the pony you wanted one year or something?

Me: No. I told you, I'm not getting into that. Now you've wasted a completely good question.

Me: 3. I didn't know you were such an anti-Christmas kind of guy.

Me: I'm not anti-Christmas. I'm just not all that into it. I still participate. I like giving gifts and the family get-togethers and the such. I just treat Christmas with the same enthusiasm as you might for Labor Day.

Me: I like Labor Day.

Me: Yeah, me too.

Me: 4. Any favorite Christmas gifts from the past?

Me: No. They've all been equally great. But one thing that I've done is changed the way I open presents. For the longest time I was one of those people that saved the ribbon and the paper and opened my presents carefully. A couple years ago I had an epiphany and realized that it is so much more gratifying to the gift giver if the receiver just tears into the present like a maniac. So that's what I do now. Paper bits and ribbon goes flying all over the place as I rip open my present like a rabid squirrel. And you know, it's a lot of fun opening presents that way.

Me: 5. Can you think of any great gifts you've gotten people?

Me: No. Not particularly. I think they've all been pretty good gifts. I try to put a lot of thought into them. Sometimes this is easy and I get their gift months in advance. Sometimes, I can't figure it out for months, and then I'm that stressed out guy running frantically into the mall the day before Christmas.

Me: 6. Any favorite Christmas songs?

Me: No. I despise them all equally.

Me: 7. How can you not like Christmas music?

Me: I think it's more that I'm just sick of it. It's probably from overexposure. To the same songs. Year after year. And then made exponentially worse by hearing The Chipmunk Christmas Song sung by Alvin and the Chipmunks one year and getting it stuck in my head. Or maybe it's all the bad renditions of classics done by musical dorks like Kenny G or Michael Bolton. But, I'm quite partial to songs performed a capella by a male choir (The King's Singers, especially), so if they sang Christmas music, I'd probably listen to that.

Me: 8. Have you been to any Christmas parties this year?

Me: You know, there's nothing more awkward than attending the Christmas party thrown by the office. When did this whole "hugging and fake kissing members of the opposite sex to signify hello" thing start? When I see a woman from work that I sort of know, I stand there awkwardly. Do I shake hands? (It seems so cold and business-like.) Do I do the fake hug/kiss? (I don't know her that well.) Is it acceptable just to say hi? (That seems so unpersonable.) I'm as awkward at these social occasions as I was back in high school. And I still end up in the corner of the room with a group of guys talking mainly with people I'm more familiar with.

Me: 9. What's the plans for Christmas this year?

Me: Well, for the 6th year in a row, I'm working on Christmas.

Me: That sucks.

Me: Oh well. It is what it is.

Me: 10. Geez, we're almost to 12 but I can't think of any more questions. Do you have anything you want to add?

Me: No. Not really.

Me: 11. What about favorite Christmas movies?

Me: Hmm. One of the worst I've seen so far was "Christmas with the Kranks." That sucked. Nathalie and I still joke about how we wasted almost 2 hours of our lives watching that trash. "Die Hard" was a great movie. Sure, not truly Christmas themed, but it did take place during Christmas time. Oh, I do love "Elf". Will Farrell is a genius.

Me: 12. Well, who should we tag to pass this along?

Me: I don't know. Why don't we just ask those that feel inclined to continue this meme to do so on their blog and leave a link to it on my comments section?

Me: Sounds good. Here's the rules:

List 12 random things about you that have to do with Christmas
Please refer to this as a hoopla and not a meme
You have to specifically tag people when you're done
Get to it and post your answers ASAP! Christmas is right around the corner!

Backstage

2007-12-16T14:09:00.000-06:00

After that last post, I should give you an insight as to why doctors are always running late. Well, more precisely, this should be why I'm always a bit late because I can't speak for everyone.

Occasionally emergencies do occur. And as bothersome as your current medical condition may be, it is trumped by the patient who was just involved in a car accident, is actively bleeding to death, or needs immediate surgery. The majority of the time, the patient in the ER takes precedent over the patient in the office.

Now people understand this triage method and have abused the ER system by going there first for their medical care instead of their primary doctors. Of course, we're not stupid, so even if they're in the ER, if I don't think the condition is life threatening in any way, my clinic patients get to see me first and the patient in the ER sits and waits.

Sometimes the patient that's scheduled before you takes up more than their allotted time. They may need an unforeseen office procedure that takes up an additional 15 to 20 minutes more than what was scheduled. They may have a complex problem that takes longer to diagnose. (It's not easy picking the correct diagnosis from a infinite possibility of diseases, you know.) They may have a hard time understanding what's going on, and I have to take additional time to explain it to them. They may not speak English. They may come with 2 pages of typewritten questions to ask, to which I have to answer all of them. They may want me to talk to a family member over the phone. Or, like that last patient, they spend the first 5 minutes complaining about the wait, which does nothing but further delay everything.

Sometimes patient's charts go missing, and we have to send one of the staff out to look for it. Or their x-rays are missing. Or a pathologist's report. These all cause delays.

Sometimes I have to talk to another specialist in regards to a specific aspect of that patient's disease, and we have to wait for them to call me back.

And of course, there's the paperwork. Everything I do requires documentation in painful detail. My ballpoint pens usually last about 6 weeks before running out of ink. That's a lot of writing. Can you remember the last time your pen ran out of ink?

Lastly, I also field pages from nurses taking care of patients in the hospital and with consultation requests from other doctors. I have to stop and answer my pages, listen to them and talk to them, and even if a phone call only takes a minute, that's one more minute added to the overall delay.

We know nobody likes to sit around and wait. We hate that too. So I work as fast as I can, and many times I don't have time for lunch. I just grab a granola bar or some saltines. I laugh when I hear about other people taking 15-minute breaks because I rarely have that opportunity.

Contrary to what you might think, I'm never sitting in the break room drinking coffee with the nurses, or sitting on a computer doing on-line shopping while you're sitting in that freezing cold exam room wearing one of our fashionable paper gowns. I don't like delays any more than you do. If I'm running an hour late, that means I have to stay at work an hour longer to get everything done.

Doctors don't get to clock out at 5pm. After I'm finished seeing clinic patients, I have to go see and take care of my patients in the hospital. Only after everybody's been tucked in for the night can I go home. Sometimes it's 4pm. Sometimes it's 10pm. Sometimes, I stay up all night performing emergency surgery and never go home, only to start a new full workday in the morning. We only go home when the work is done.

I like what I do, it's a blessing to get paid for doing something I enjoy. But I hate having to sit and wait in the office as much as anybody. And as much as I like helping people get better, and as much as I like my job, I like being at home with my wife a lot more. A lot more.

I'm as aggravated as you are when things get backed up. So just bear with the doctors and the nurses, be patient, and find solace in knowing that we're working as fast as we can to get you out of the office so that we, too, can go home.

Waited

2007-12-13T07:50:00.000-06:00

I picked up the patient's chart, glanced over it briefly, and knocked on the door. As I entered the exam room, I extended out my hand.

Me: Hi, I'm Dr. THW, how are you?

Impatient patient: [hands on her hip, glaring] I'll tell you how I am. I got here at 1:30 just like it said on my appointment slip. I sat out there in the hall for over an hour before you guys called my name. And then I sat in this room for almost 30 minutes before you decided to come in. And I bet blah blah blah...

I stopped listening. I simply did not care. I watched this woman rant away about how long we've kept her waiting, how she's got important things to do, and how we're the most inept group of people she's ever met. After she had a chance to blow off some steam, I apologized for the wait, joked about how doctors are never on time, and put the focus back on the surgical problem that brought her to the clinic.

What really aggravates me is that she's at a free clinic, getting free medical care at the expense of tax payers. A brief glance at her demographic sheet shows that she's unemployed and on disability. I'm sure she indeed has important things to do and places to be, but if you don't have employment responsibilities, why schedule them for the same day you're going to see the doctor?

I can't understand it. Instead of thanking us for seeing her for free, the first few words out of her mouth are all complaints. I think this happens because this country is full of people with bloated self-importance who feel like they're entitled to something. We've become a nation of spoiled brats. It's a rarity when I get a patient in that free clinic who is actually thankful for the services I provide for them. Sadly, it's usually the non-English speaking immigrants that actually thank me and my staff, and are truly grateful for our help. I guess you just have to come from a place where you've been ignored to appreciate what this country does for its citizens.

My apology for the wait seemed to appease her and her mood slowly lightened up. During the examination, I continued to make small talk and asked about her Thanksgiving. She then got all excited about the post-Thanksgiving shopping.

Impatient patient: [talking excitedly] ...and I saved over $100 at Wal-Mart on that new TV!

Turns out that she had waited in line outside of Wal-Mart for hours and hours that morning after Thanksgiving to be one of the first 10 people in the store. She had rushed in and was one of the few lucky people to snag a new TV for $100 off the sale price.

From the few minutes I spent examining her, I can see that she'll require an operation that will cost the tax payers about $45,000. Of which she'll pay absolutely nothing. And she'll never feel thankful that this was provided for her. She'll just feel that she was entitled to it.

Lining up outside a Wal-Mart and spending the night sitting on the concrete in the elements to save $100 probably never bothered her, yet sitting in the waiting room of an air-conditioned building for a couple hours to get a $45,000 operation for free causes her so much anguish that she lashes out at the very person that's trying to help her.

She has no idea how lucky she is to live in a country that provides for its citizens in such a way.

I'm sure she caught me smirking, but I just couldn't believe the ridiculousness of the whole thing.

I finished working her up for the operation, sent her on her way, finished writing in her chart, and moved on to the next patient. As I picked up their chart outside the exam room, I wondered if another spoiled American was waiting behind that door.

Bodysnatcher

2007-12-12T07:30:00.000-06:00

As routine, the first thing I do when I get to my office at work is to turn on the computer. The first 15 to 20 minutes of my work day is devoted to brainless internet surfing while I continuously wonder how I ended up choosing a job where I have to be at work by 6 AM.

Given that my computer's speakers have never been functional, I was a bit surprised to hear the Microsoft Window chime coming from it. Simultaneously I saw amongst the mountain of accumulated paperwork on my desk a memo left by the IT tech saying that they installed and setup a new computer. Sure enough, a new computer is sitting next to my desk.

I'm a bit stumped because I don't know why my old computer was replaced. I definitely didn't put in a request. And it takes a near miracle to get administration to approve of getting a new computer. So finding out that my computer was upgraded without a month's worth of begging, completing pages and pages of paperwork, or simply any work on my part makes me suspicious. I guess Big Brother is going through my harddrive looking for contraband.

Well, it's a good thing I never kept any sensitive info on that computer. I wonder what else has been changed since I've been away?

Parkview

2007-12-11T21:28:00.000-06:00

Decibel

2007-12-10T18:49:00.000-06:00

I guarantee that there is not a single person who is genuinely happy to see a child less than 4-years old board a plane with them. No one, except the child's immediate family of course.

And finding out that you're sitting next to, in front of, or anywhere near this child evokes the same internal emotions as being told that you're going to be audited. A quick look around at the other passengers in the immediate vicinity confirms that you're not the only one that feels this way.

Although I have been pleasantly surprised in the past by well behaved children, sadly that is not the norm. I always give the child the benefit of a doubt. But just like playing the lottery, I rarely win.

On our flight back home, we were unfortunate to sit next to 4 children between ages 2 to 4. It got to the point where I was hoping that the next sound I heard was the sound of wings ripping off the plane to end our misery. For the first time ever, I wished that we weren't on a non-stop flight so that there was a chance we could get away from these children and their awful parents at a layover.

But I know karma will have its way. One day Nathalie and I will be the parents bringing a small child on board an airplane. And one day I'll be on the receiving end of those hateful looks. And undoubtedly, one day my child will be the one driving other people crazy with his incessant wailing about Elmo.

But the one thing I will never forget to do is to apologize to the other passengers. Maybe I'll buy ear plugs to hand out to the nearby passengers as a courtesy.

On location

2007-12-04T09:18:00.000-06:00

On location

2007-12-03T00:04:00.000-06:00

On location

2007-12-02T18:21:00.000-06:00

Exeunt

2007-11-29T12:28:00.000-06:00

All work and no play makes Jack a dull boy.

It's time to play.
See you in 10 days.

Stay tuned for pictures.

Trust

2007-11-28T06:28:00.000-06:00

When did we become such a nation of paranoid, distrustful scaredy-cats? Or have I just gotten older and lost the innocence of youth?

I'm ashamed to admit that the first thing that went through my head when a guy in a pickup truck pulled over to my car on the side of road was not of "he's here to offer help" but one of "he's here to do something bad." Like kill me and Nathalie.

Protective husband instinct? Possibly. Paranoia? Probably. The world gone to shit? Also likely. Just a consequence of time and location? Maybe. We were on a deserted section of a local highway in the middle of the night.

A few months ago, Nathalie and I went out in the middle of nowhere to look for some shooting stars. During the few hours that we spent out there parked by the side of the road staring up into the sky, just a handful of cars passed by. We really made an effort to get out to nowhere. It's not easy getting away from light pollution.

At one point in the night, a pickup truck slowed down and stopped next to our car. Being that we were so far out in the middle of nowhere, there wasn't much ambient light, so it really was hard to make out anything. I definitely couldn't see into the truck to see the driver.

Instinctively, my right hand went for the large police style steel flashlight I keep under my seat and I felt my body tense up. Being that we were in the convertible with the top down, I felt terribly exposed and at a disadvantage. And there was something terribly menacing about that large truck rumbling beside us. I truly wished I had something more substantial than a flashlight to protect us.

But then a voice came from the truck, "You guy's need any help? Is your car OK?"

How have I become so paranoid and distrusting that I now perceive everything as a threat? Was I just that naive when I was younger? Or has the world really become an evil place to live? The emergence of TV shows about child predators, increased violence, and our increased isolation from each other make me doubt it was naivete and that I am just now beginning to open my eyes to the terrors of the world. Instead, the underlying evil that has always been there has just become slowly worse over the years. Look around. The number of malevolent people have proliferated uncontrollably.

I know that 20 years ago, if someone pulled up next to me on the highway the last thing on my mind would've been wishing I had something other than a flashlight, realizing I had brought a knife to a gun fight.

We waved him off and he drove away, leaving us back in the dark and with our thoughts. And after first feeling relieved that he wasn't a threat and then talking about how rare it is nowadays to get help from strangers, we settled back into our seats and resumed star gazing.

I had forgotten that some places still have decent people who stop to offer help to strangers. He will never know how close he came to getting his head bashed in by a flashlight yielding paranoid freak. And instead of this one incident doing something to make me believe in the goodness of the world again, I am preoccupied thinking of the potential scenarios had he been a badguy.

This experience made me realize how exposed, vulnerable, and foolish we were driving out to the middle of nowhere. And I now carry a better weapon in the car than a flashlight.

I know it sounds bad. Blame the decline of our society.

I'm the product of it.

Magic

2007-11-26T09:45:00.001-06:00

Cooking is like magic.

There are those who do it very well. These are the big name magicians that usually appear on TV. You ooh and ahh, and are just amazed by what they can do.

There are those who do it fairly well. These are the guys at the state fairs and such that work the local crowd.

And then there are people like Uncle Barry, who really sucks at performing magic tricks, but people are too polite to tell him, so he continues to annoy you at family gatherings with the coin behind your ear trick, or the fake thumb trick, or any number of poorly performed bits.

For the longest time, I was deathly afraid of becoming a Uncle Barry, so I never cooked. Cooking was just like the field of magic. I know it's something anybody could do, and do well with practice, but I didn't want to figure it out. Trying to figure out the intricacies of cooking is like deconstructing how David Copperfield made the Statue of Liberty disappear and tricked Claudia Schiffer into dating him. Something that could be done with time and patience, but something I didn't feel like actually doing myself. I was more than happy just watching other people do it and enjoy what they could do.

I watched cooking shows with the same interest as I watched Penn and Teller. They explained how everything was done, and being of an engineering background, that was greatly satisfying to know the answers. But I didn't think I myself could replicate what they were showing on TV. Just because someone explained how to swing a golf club doesn't mean you'll be replicating Tiger Woods anytime soon. Titanium clubs or not.

Making biscuits from scratch would be the equivalent of asking me to build a spaceship from various gadgets around the house. What am I, ET? I scoffed at the notion. But one day, a friend of mine walked me through making pancakes from scratch, and it was ridiculously easy. Not only that, what I made was edible.

I couldn't believe it. It was crazy. It was easy! It was no disappearing Statue of Liberty, but it was better than anything Uncle Barry was doing. And fueled by this initial success, I starting cooking. But even now, many years later, I'm still amazed at how easy it is to make something delicious from scratch.

But for the longest time, pecan pie has been my Moby Dick. Yes, I know, the simple pecan pie. No, actually, cooking fish is my Moby Dick. Even my best fish dish would be turned away by even Andrew Zimmern. Pecan pie is more like... well, just a good magic trick. One that borders on supernatural. One that just can't be figured out.

It's because pecan pie was something my mom made extraordinarily well. Not even the best pecan pie baked by a true Southern woman could measure up to my mom's pie. An amazing feat considering my mother was a Korean immigrant and had never even seen a pecan until she moved here. Knowing this, I didn't even want to attempt making one of my own because I knew I would only be disappointed with the result.

But it's been nearly 10 years since I last tasted my mother's pecan pie, and I've been aching for it forever, so this past holiday weekend I tried my hand at baking a pecan pie. ...and it wasn't great, but it wasn't bad. Just good enough to get me to try again and get it closer to perfect.

I wish I knew what my mom used to do. But there's no way of getting her to reveal that trick now. My quest for the pecan pie has turned into the plot of The Prestige. I'll play the role of Hugh Jackman, my mother the role of Christian Bale, and her pecan pie will be that magic trick I just can't seem to figure out.

Except I won't go all evil trying to get her secrets.

Thanksgiving

2007-11-21T09:24:00.000-06:00

Oh yeah, it's funny now. In fact I'm grinning about it while typing this out. It's interesting how just a little bit of time will make things all better. Because I feel fine now. But man-oh-man, when it happened I guarantee there were flames shooting out of my eyes, ears, and even my butt.

And as much as I think it's stupid, that waiting period before buying a handgun does make some sense. Although the cooling off period might not work. They might just continue to stew over whatever events made them go homicidal in the first place. Next thing you know, instead of being all cooled off, they're like Bruce Willis in the pawn shop in Pulp Fiction trying to choose how he's going to get even with Zed: Going from one weapon to another, each one getting steadily larger and more ridiculously dangerous. Wait, I'm getting off topic.

So part of being in the academic medical profession is that you're expected to contribute to the advancement of medicine. And by contribute, they want you to write a research paper every so often and get it published. Of course, before it gets published, they have teams of older, more experienced, and much smarter surgeons on a panel that read your feeble attempt at a paper, write hurtful editorial comments that destroy your ego a bit, and make you do several re-writes before publishing the darn thing.

Needless to say, writing a paper is a bit stressful. And time consuming. Unfortunately, unlike when I was in grade school and a "research paper" meant a quick trip to the library and copying something out of an encyclopedia, (with the advent of the internet, Google, and wikipedia, I can't ever imagine a kid doing that nowadays), research at my level actually involves research.

Which for a clinical physician means pouring over piles and piles of patient charts and gathering endless amounts of mind numbing data that will drive even an actuary to suicide.

So I've been doing this research thing for the past 4 months. And with the deadline looming just weeks away, it has been a stressful pain in the butt. And yesterday, after going through about a million re-writes, I was coming real close to finally finishing my paper.

I've been sitting at my desk for hours and I needed to take a short break, so I clicked on the save button. But then Microsoft Word spat out a curious statement about how it couldn't do that. This I didn't particularly understand because it happily saved my file not just a mere 10 minutes ago. As I clicked the "OK" box to acknowledge its first denial, it then spat out another statement about how it needed to close.

My heart started to sink into my stomach, but knowing that I had just saved the file recently gave me some reassurance that even if Word crashes, I have my paper saved. As I clicked on the "OK" button, I had that split second of omnipotent clarity realizing that I should have never done that. Because the computer then mutinied against me.

I could not believe my eyes, but before me was a text box spat out by Word saying that not only could my file not be saved, it was going to delete it.

Me: Oh no... wait, wha... Oh no! AAAHH! &#%@!!!

And sure enough, it did.

Me: What the... [furious mouse clicking] What the... [furious keyboard pounding] Oh no! Oh no! Oh no no No!

At this point I realized it was truly gone. The stupid program had actually deleted my file. I have never in my life seen this happen or have even heard of it happening before. The file I've been saving to for the past several hours was now nowhere to be found. Sure I had backup copies someplace, but everything backed up was from the day before. I had been at that desk for hours. Frickin hours! There was no way I could remember all the infinitesimal changes I've made all day. Hell, I could hardly remember what changes I made to the paper just 15 minutes ago!

I took a deep breath, calmed myself down, and searched through my computer. Nope. My file was nowhere to be found. Not even in the temporary file folder. Not even in the recycle bin. That piece of shit Word had actually deleted my paper.

Me: You... YOU!!! YOU!!!

[I struggled for a way to properly express myself, but found none]

Me: Gaaah!!!

Expletives, curse words, and all things evil and dirty spewed forth from my mouth as I rampaged through the house, stomping and fists a-waving. I howled with the fury of all those that had been wronged before me. I cursed Dell. I cursed Word. I cursed Microsoft, Bill Gates, and his mother.

I calmed down a bit, grabbed an orange from the refrigerator, and went back to the computer. After several minutes of frantic mouse clicking and keyboard clacking, I was back to hollerin', ragin', and stomping around the house again.

Meanwhile, Nathalie sat quietly on the couch observing, letting this storm run its course.

Which it did.

I eventually sat down at my desk, and glumly and defeatedly ate my orange.

And after a few sullen sighs, I opened up my backup copy from the previous day and started editing my paper all over again, trying real hard to remember the changes I had made that day.

And today, I'm probably back to where I was before my computer erased my file and getting closer to completing my paper. So for that I'm thankful.
And I'm thankful to have a wife that's understanding and knows how to deal with a husband that temporarily regressed to 3-year old.

And thinking back to the tirade I went on, I can only grin thinking how ridiculous I must have looked. Oh well, "Live the day."

Happy Thanksgiving!

Recycled

2007-11-19T12:05:00.000-06:00

So who really uses and re-uses their paper towels over and over again to clean things up? Really, who?

You watch those commercials and they make it seem like everybody is sitting around their kitchen lamenting the fact that their store-brand paper towel won't hold up to repeated use.

Is this really happening? Do people really reuse paper towels? Am I and Nathalie this wasteful? What about when I blow my nose into a paper towel because I'm too lazy to walk over to the box of tissue? Should I wash my "hanky" and reuse it?

No matter how thick or how strong a sheet of paper towel may be, it gets used just once by me. Once it wipes up that mystery stain, it's over. To the trash. Unlike what they show on TV, there's no rinsing over the sink, wringing it dry, and then reusing it.

I mean, c'mon. There's a whole frickin' mega-roll over there! It's not like there's a paper towel shortage.

Sad to say, but it's only recently that I realized that I've been throwing money away buying these "premium" paper towels. Considering that I've never in my life ever re-used a paper towel, I saw no reason to continue wasting my money. We've since switched over to buying the not so fancy, easily-ripped-when-wet paper towels, and they work just as well. At half the cost.

You watch those Bounty commercials and they make it out as if they've got teams of scientists trying to develop the ultimate paper towel. Hey, people at Bounty, it's a paper towel. Perhaps you should focus that manpower on something more important, like reducing the calorie content of a donut without sacrificing taste.

Injection

2007-11-18T12:30:00.000-06:00

Still groggy from being woken up at 3 AM, I reached for the phone after grumbling out a few four-letter words and returned the page. The ER was calling.

When the ER doc said the name of the patient, it sounded vaguely familiar. Like the name of a distant high school friend. As he continued to tell me more about this patient's arm, my mind wandered back and forth, trying to match a face with this patient's name.

All of a sudden I realized I was only listening to about every 5th word the ER guy was telling me. No matter. All I really needed to know was where this patient was and his name. The rest of the information I'd get myself when I get to the ER.

I know that sounds like it's the wrong thing to do, but ever play that game Telephone? Or Grapevine, or whatever it's called? Where someone says one thing (like the sky is blue), it gets passed down the line, and by the time you hear it, it's something completely different (like Joe's mother's a gorilla). Anyway, something similar happens in medicine as well. The patient tells the ER nurse one thing, she tells the resident another thing, he goes and tells the ER staff yet another permutation, he processes it, and then he calls me for a consult and tells me something related to it, but not quite correct. So I always make it a practice to just get my own history when I get to the ER.

So I get up, get dressed, and drive to the ER. The whole time trying to figure out why this guy's name sounds so familiar.

But the minute I walk into the room I recognize him as the kid I took care of about 6 months ago. I remembered him because he came in as a trauma after rolling his ATV, and while examining him for life threatening injuries, I found a marijuana pipe in his pocket. The kid lucked out and left the hospital without surgery, despite suffering a fractured spleen.

Turns out he started crushing up the Vicodins I prescribed him for pain control and shooting it up his arm. After he ran out of the Vicodins I prescribed him, he went around weaseling prescriptions from one ER to another. And since he had a legitimate reason for his pain (4 broken ribs and a fractured spleen), the various ER docs gave him refills. Which he then continued to shoot up.

Well, considering a 17-year old knows nothing about surgical sterility, he never disinfected the needle between uses. Being young, his body easily overcame the small subcutaneous infections caused by the needle. But 4 days ago, he accidentally injected the crushed Vicodin into his brachial artery.

This bled and caused a hematoma to form under his skin. A large blood clot. This then became bacterial growth medium. His arm swelled up with the infection, and when pus started to drain out of it, he came to the ER.

And so here we were.

As I started to drain the pus and start the debridement of dead tissue from his arm, I asked him if he was still doing dope. To which he vehemently denied.

Kid: No man, I told you I was going to quit.

I checked his urine drug screen. Surprisingly, he wasn't lying. He only tested positive for opiates. So it looks like the talk I had with him about stopping marijuana before he left the hospital last time worked.

It's too bad I didn't mention anything about shooting up crushed Vicodin.

Cinna-hell yeah!

2007-11-16T09:32:00.001-06:00

As you approach the department store entrance, you see them. Women wearing strange futuristic smocks emblazoned with the product's logo, spraying clouds of perfume onto little cards and forcing them on passers-by.

I usually shove my hands in my pockets (Sorry! Have no hands! Can't take!), avoid eye contact, and rush past them, holding my breath.

The majority of the perfumes smell about the same to me. But I can classify them into three broad categories depending on who they are most likely trying to target:

Fruity and light smelling perfume often used by teenagers. Attracts other teens and pedophiles
Heavy, nausea inducing perfumes used by the Medicare population. I'm not sure if this does more repelling than attracting.
All other perfumes. Each has their own distinct subtleties, but they mostly smell the same.

I've yet to smell a brand of perfume that made me stop in my tracks and inquire about it. Most times, it's just "that's nice". I can easily discern those that are terrible, but that's about it as far as my perfume preferences go.

I think if you really want to get a man's attention, and wear perfume that works, get something that smells like a freshly baked cinnamon roll. I guarantee that will get me (and every other man, woman, beast, and child) to stop dead in our tracks and start looking around.

Phermones? Pfshaw! You've got Eau de Cinnamon Rolls!

Shrinking

2007-11-14T07:12:00.000-06:00

A strange trend has caught my eye recently.

Without a doubt, I know that I haven't lost an ounce of weight over the years. If anything, I've gained a handful here and there. Sure, with my recent exercise regiment there's been a bit of reshaping going on, but it's definitely not anything that's glaringly obvious. My body has settled a bit with age, but I can still fit (more or less) into the same clothes I wore 10 years ago. I really haven't changed very much.

Yet, I've had to go down a size in the shirts I buy. I'm now wearing size Large shirts instead of X-Large. I tried on a X-Large shirt recently while clothes shopping and I looked like I've borrowed a T-shirt from Andre the Giant.

It's definitely not that my upper body has shrunk, I still wear the same sized suit jacket. The recent fashion trend towards slimmer, tailored clothing may play a small role in it, but it's not like I'm now walking around in skin tight shirts while I wore everything real baggy 5 years ago. Far from it.

My theory is that the clothing manufacturers have gradually increased the cut of the shirts to accommodate the increasing prevalence of obesity in this country while simultaneously trying not to alarm the male psyche.

It's like how some fashion labels will give women a "discount" in size to make them psychologically feel better about spending so much money on a dress. While you normally fit into an 8 at The Gap, Vera Wang says you fit into a 4.

Perhaps a similar concept has trickled down to every day men's fashion. As they get fatter and fatter, they can still feel good about themselves because they're still wearing the same sized clothes they were 10 years ago. Thus no emotional crippling, no loss of productivity at the workplace due to male depression, and no change to the economy.

The general understanding is that men aren't emotionally fragile when it comes to their appearances. Go take a walk through Wal-Mart, you'll see what I mean. But, at the same time, the spam that fills my email regarding hair growth and penile growth/performance says otherwise.

Men are sensitive to their appearances. They just won't admit it. I don't know a single guy that would like to be known as the Fat Guy. This subtle increase in clothes sizes is a form of fashion Prozac. Keep people thinking they're not fat and keep them happy. Why rock the boat?

(Those penile growth pills and creams are another topic altogether. I'm amazed that some men actually think that increasing their penile size will have women flocking to them like a shoe store having a sale. No, sorry dude. It's probably your personality, or lack thereof, that's repelling women.)

Overheard

2007-11-13T06:42:00.000-06:00

Old Man A: The problem with America is stupidity. I'm not saying there should be capital punishment for stupidity, but why don't we just take the safety labels off of everything and let the problem solve itself?

[pensive pause]

Old Man B: Ignorance is curable, but stupid is forever.

Choices

2007-11-12T07:23:00.000-06:00

Story as told to me by an attending from his days as a resident.

I had finished looking over Patient R's most recent CT scans and laboratory work. Her pancreatitis was one of the worst I've seen, and given her condition and the state of her illness, she had nearly a 70% chance of death. She had been on the service for about a week with minimal improvement. At this rate, her prognosis wasn't looking so good.

I went into her ICU room to do a quick "once over" before moving on to the next patient on my census: checked her ventilator settings, the IV drips, and ensured that she was comfortably sedated and asleep. As I was walking out of her room, I ran into her family members coming in for visiting hours.

I stopped to give them an update on her status, the latest findings, and told them exactly what my thoughts were on her chances of survival. The husband grimly nodded in understanding, but their son, a man the size of a gorilla, didn't seem to like my report very much.

He had never said very much to me over the past week that I've been taking care of his mother. Just a simple hello or two, and a bone crushing handshake the first time I met him. Most times, he just listened to what I had to say, nodded once or twice, and then would go sit next to his mother.

Today, he stood over me and spoke to me a slow and deliberate way:

Son: You gonna fix Momma.

Me: Well, we're doing the best that-

Son: [interrupting] No. You gonna fix Momma.

Ah. Yes. And with that last statement, I understood perfectly.

The son never spoke another word during the next 3 weeks Patient R stayed in the hospital. And thankfully, she did get better and was discharged home. I made sure of that.

Cede

2007-11-09T06:35:00.000-06:00

Asparagus reminds me of a joke I heard when I was little about two explorers that were captured by cannibals. They pleaded all sorts of ways to be released, but to no avail. The explorers were told that they would be killed and their skin used to make canoes. And sure enough, they killed one guy and used his skin to make a canoe. The second guy begged the cannibals to give him one last wish, and asked if they would get him a fork from his backpack. The cannibals grudgingly complied and gave him a fork. To which he started stabbing himself screaming, "Screw your canoe! Screw your canoe!"

OK, so I didn't retell the joke very well, but you get my point. Asparagus isn't going down without a fight. Sure, you may eat it tonight. But it will avenge its death and haunt you with it's funny pee smell.

As you wrinkle your nose up in disgust after you pee, the thought of "Why did I eat this?" crosses your mind.

Distribution

2007-11-06T06:45:00.001-06:00

As expected, not a single kid showed up at our house for Halloween. Why? Because we had bought some candy.

And also because we turned our front porch light off.

And because we had no jack o'lantern this year either.

This year, we turned into Halloween scrooges, and decided to do whatever we could to discourage kids from coming to our house. So then why did we buy the candy?

Whenever we buy candy, not a single kid shows up at the door. Not even a large jack o'lantern in a strategic location and lighting up our front porch like Las Vegas seems to do any good.

This is what happened the first time we moved to the neighborhood: Given that our house is located a mere 1/2 block from a large elementary school, we figured that our place would be crawling with kids. And lest we suffer the consequence of having our house egged by angry kids for not having enough candy, we spent a minor fortune and bought bags and bags of candy. Not to mention the large pumpkin we purchased and spent several agonizing hours trying to carve the darn thing.

But come Halloween night, only a handful of kids came. That last kid pretty much hit the jackpot because he got about 80 bars of Snickers. Fun Size, of course.

I was eating left over Halloween candy until... well, pretty much the following Halloween.

So the following year, we still buy a pumpkin and carve it out, place it in that strategic location, light up the front porch, and sit and wait. But that year we only bought a small bag of candy. Fool me once shame on you, fool me twice...

But then we got fooled because every kid within a 50 mile radius of our house showed up. Of course we ran out of candy within minutes, and then there we were scrounging around the house looking for things to give out. Old candy, granola bars, breakfast bars, fruit, handfuls of Lucky Charms, scoops of uncooked rice.

It was like facing a band of locusts. We turned off the porch lights, blew out the jack o'lantern, hid in the back of the house, but it just didn't seem to matter. Soon we were giving out handfuls of change and old CD's that I've already uploaded onto my computer. I think once word got out that we were giving away material goods, kids came back for a second shakedown.

So the following year, we were prepared and bought lots of candy. And as you correctly guessed, nobody came. And I was eating left over Halloween candy until just recently.

This year, I've had enough playing this bizarre Halloween mind game. So Nathalie and I decided to withdraw from the whole Halloween thing: No porch light, no jack o'lantern, no nothing. Except a bag of candy, because that's apparently what keeps kids away from our house.

While taking the trash out, I noticed that my next door neighbor, who had always carved out a pumpkin and did the whole Halloween thing, was being scrooge-like as well. No jack o'lantern, no welcoming porch light, just a dark and forboding stoop.

Neighbor: I'm not doing Halloween this year.

Me: Yeah, me neither.

We both stand around alternating at looking at our feet and then off into the distance, slightly uncomfortable, standing in the way you do with a neighbor you seldom talk to but often wave at.

Neighbor: I've lived here 8 years and I can't figure it out.

Yup. Just like life. Unpredictable. Whenever you're ready for something, it'll never happen. It's always when you least expect it, that it happens. Like meeting the girl of your dreams.

I had quit the bar scene, the club scene, and everything else, even the church scene and the pumpkin patch scene. I was tired of the game and all the players. I gave up looking, stopped trying so hard, and started coasting along with life, just liking where I was and how things were. And just as I was getting comfortable with everything, along comes Nathalie to shake up my world.

Happy 2nd anniversary Natbug!

Annum

2007-11-02T10:43:00.001-05:00

To surprise his wife for their 15th wedding anniversary, one of the surgeons that I know decided to commission a local bakery to recreate the top layer of their wedding cake.

But this proved to be more difficult then he initially planned because he just couldn't find a good picture of their cake. They had a small wedding and didn't have a professional photographer, so he had to dig through piles of old snapshots and call all sorts of relatives to locate a picture of the cake.

But at last he found some pictures, found a bakery, and finally got a cake made. He was so excited about surprising his wife with this cake that he was just giddy with excitement. Finally, on the evening of their wedding anniversary, he triumphantly brought out the cake and placed it in front of his wife.

Who looked at it, smiled, and said it was a pretty cake.

Surgeon: [hardly able to control himself] Does this cake look familiar?

Wife: [thinking] ...uh... I don't know... Should it?

The two of them then sat there looking at each other. One completely flabbergasted that she didn't recognize the cake. The other wondering why he was looking at her so strangely.

He told me this story after I told him that Nathalie and I will be celebrating our second wedding anniversary this weekend.

Surgeon: You'd think a woman would never forget her own wedding cake, but there we were.

I was laughing too hard to respond.

Flush

2007-11-01T09:30:00.000-05:00

A sure sign that you're getting old is the inability of the body to rebound from a hard night's work. I remember the days when I could get by on almost no sleep, looking and feeling as fresh as ever. But it's become evident that my parts are starting to show signs of age, and the body isn't what it used to be. Now, waking up in the middle of the night to respond to an ER call means I'll pay the price for it in the morning.

This morning it took all I could summon to get my aching body to the bathroom to get ready for work. Although I spent less than an hour in the ER working up a patient, the total time I was awake was about 3 hours from the moment my pager went off to the time I actually fell back asleep. Which meant that although I went to bed around 10 PM, I only got about 4 hours of sleep last night:

About 10 minutes talking to the ER doc after my pager goes off
30 minutes spent getting dressed and driving into the ER
45 minutes spent with the patient and doing paperwork
30 minutes spent driving back home and getting in bed
20-30 minutes spent wondering if I missed anything and planning for how to take care of the guy in the morning as I lay in bed wide awake
15 minutes spent staring at the clock and stressing about trying to fall back asleep before finally falling sleep

I walked into the bathroom this morning like a zombie. A very slow moving and discombobulated zombie. It also didn't help that I worked out yesterday, adding muscle aches to sleep deprivation as spontaneous groaning noises escaped from my mouth.

But all that disappeared in a flash as I realized I just flushed my left contact lens down the sink.

Oh, SNAP!

Wow, talk about waking up quick. My heart sank, several expletives shot out my mouth, and I was wide awake howling with misery.

If I wore disposable lenses, that's one thing. But I don't. They're RGPs. And they're frickin expensive. Add to this misery the fact that I haven't been to an optometrist in ages, so I don't have an up-to-date eye prescription. I won't be able to get a replacement pair for weeks. And who knows where I've placed my back up pair.

Misery, misery, misery.

I stared down the drain, but no contact lens there. So I thought I might be lucky and that my contact lens would've gotten stuck in the trap.

Oh please oh please oh please!

But when I opened it up, there was no contact lens. But I did discover lots of nasty slime and gunk which explained why the sink has been draining kind of slow lately. Besides, even if I did find my contact lens, there was no way I was putting that in my eye after it touched that disgusting crap.

So anyway, I luckily found an old pair of contacts after some frantic searching. (Sometimes it's a good thing being a pack rat.) And although its an old lens, I think my left eye is OK. Regardless, it's a good thing I'm right eye dominant.

;)

Spooks

2007-10-31T07:00:00.000-05:00

Daylight

Moonlight

Happy Halloween

Replacement

2007-10-29T06:58:00.000-05:00

As I was looking at my patient laying in bed after her abdominal surgery, I remembered that she has smoked about two-packs a day since the late 60's. She's been smoking longer than I've been alive. This explained her poor oxygenation and terrible wheezing.

All of the immediate health risks aside, I was sure she was dying for a cigarette. The last thing I need is a patient to become irritable and demanding from nicotine withdrawal. It drives the nurses crazy. Then the nurses call me to complain, and that drives me crazy. So I thought I'd intervene early.

I always ask if they honestly want to quit, and help them if they're willing. If they reply with anything less than an enthusiastic response, I leave them be and let their primary care physicians deal with it. I've long given up any hope of convincing people to quit smoking. I'd have better success trying to get someone to fall for that Nigerian money scam.

Unless they're willing, trying to force someone to quit smoking is about as easy as trying to force someone to change their political views. It just isn't going to happen. So instead, I just try to decrease their nicotine cravings by pasting on nicotine patches like how a 3rd-grader would decorate his notebook with stickers.

Happy patient = happy nurse = less annoying phone calls to me. And then I can spend my time doing something more important. Like blogging.

Me: I know you're a pretty heavy smoker, and it's now been two days since your last cigarette... would you like for me to prescribe you a nicotine patch to tide you over?

Patient: No. I'm OK for now.

[She did look quite comfortable. I began to wonder if she's somehow been sneaking out for smokes.]

Family member: Yeah, she'll be OK, Doctor. She always quits when she's admitted to the hospital.

Me: [in pleasantly surprised disbelief] You're gonna try to quit?

Patient: No, of course not, don't be silly! Once I get out, I just smoke double what I've been doing in order to catch up.

Failure

2007-10-25T07:56:00.000-05:00

The medical team consulted me to evaluate one of their patients because they found what looked like colon cancer on a CT scan. They later confirmed it with a colonoscopy, which found a mass in her colon consistent with colon cancer. I went to her bedside later that afternoon and found an lady in her mid-60's laying in bed with her husband sitting by her.

They had the weathered look of people that live off the land. Their skin was deeply wrinkled and leathered, showing evidence of years spent working under the sun. They were simple folk, and in the first few minutes of making small talk, I found that they were shrimpers.

I looked at the two, and they reminded me of my own parents. How hard they worked to make a living. Like my parents, they also only had a high school education and made the best of what opportunities was available to them.

She had finally come to the hospital because her husband pretty much dragged her in. When I asked her why she didn't come to the hospital sooner for her symptoms, she simply told me that she was afraid we'd find something wrong. Logic which makes sense, but is deeply flawed.

I had reviewed the CT scan before coming to see them, so I knew that her cancer had spread into her liver. And from the laboratory results, I knew that she was in early liver failure. A bad sign. I told them of my findings. I told them the treatment options, and that at this point, the only thing we could offer was palliative treatment. And as much as I hate it, I told them the truth: she only had several weeks to live. Maybe a couple months at best.

They looked at each other and hugged each other tight. And just like what I told my mother when we found out she had cancer, the husband told his frightened wife that she will beat the cancer.

Mrs. P: [trembling] Doctor, why did this happen? What did I do wrong?

Nothing.

You did nothing wrong.

Mrs. P died less than a week later from massive liver failure.
She was 63.

Overheard

2007-10-24T10:15:00.000-05:00

Two days ago, it was in the mid-80's. Overnight the temperature has plummeted (to the 50's) and all of New Orleans is freaking out as if a new ice age is upon us. I actually saw someone walk into the hospital wearing a down coat. A little overkill, I'd say.

Man: [lurching away from his wife] Yeaah!! Your hands are FREEZING!

Woman: [taking her hands off of his neck] Well, you know what they say, "Cold hands, warm heart."

[Man explodes into a laughing fit]

Woman: What's so funny?

Man: [still laughing, barely able to talk] "Cold hands, warm farts?"

Woman: No. Heart! Heart! I said warm heart!

Man: No, you said fart.

Angus

2007-10-22T13:41:00.000-05:00

To continue my immersion into the regional culture, Nathalie and I went to a rodeo this weekend. Neither one of us have been to one before, so it was a great experience for the both of us. We got to the stadium early so that we could wander around, browse the handicrafts on sale, and eat at the food stands selling local-regional favorites. Among the many, we sampled: funnel cake, smoked meats of all kinds, boiled peanuts, hot-links, and cracklins.

I've never had boiled peanuts before. They weren't bad, but I'll probably never buy them again. Just a texture issue. I'm just not used to eating warm and moist peanuts that squish in your mouth.

The hot-link was also something I'll probably avoid in the future. Although juicy and spicy and good, the unnaturally red artificial casing left a lot to be desired.

And the cracklins? Who doesn't like fried pork fat? Hell, the only reason I didn't buy any more for the drive home was that I was so full by the end of the rodeo that I was about to throw up.

But enough about the food. The rodeo itself was more entertaining than I thought possible. There's just something fascinating about watching a man try to tame a 2-ton beast. Nobody got seriously injured, but we lost track of the number of men who were flung across the arena by the horns of an angered bull or the rear of a bucking horse. In most cases, these guys simply got up and limped out of the arena. It's absolutely amazing what punishment these guys can take.

One of the funniest side acts we watched between the major rodeo acts was something called a the Ghost Riders. A man actually trained monkeys to sit on the back of Australian shepherds and then trained them to herd sheep around the arena. It was the most bizarre thing I've ever seen. There were four sheep left to run amok and then three dogs (with monkey riders) were let loose. These dogs were able to herd three sheep into a small pen, and despite all the running around the dogs did, not a single monkey fell off. This probably got one of the loudest applauses when it was over.

If there was one message I got from the rodeo, it's that Jesus and national pride are two very important things to rodeo enthusiasts: The national anthem was sang at least twice, about 15 minutes were spent watching Christ's crusaders in flowing robes with swords on horseback as they raced around the arena to inspirational bible verses read aloud over the PA system, followed by about 5 minutes of men on horses riding around with the American flag waving behind them, 2 group prayers were said, one of which required holding hands with the person next to you, as well as a full-on military salute to fallen soldiers.

During the dull moments of the show, which were few and far between, I scanned the crowd and people watched. And of the 5000 or so people at the show, I think I was the only Asian in attendance. I probably stuck out like a sore thumb.

Nobody acted any different towards Nathalie and me, but I couldn't help but feel terribly out of place. Kind of the same way I felt eating at the BBQ joint in South Carolina where they had photos of klansmen in full regalia on the walls. Neither my Jewish friend or the Indian guy with us had any idea about the history of that restaurant. We just knew they had great BBQ pork (which they did). It was only after we sat down and placed our orders that we noticed the decor. Nobody paid any attention to us, and we actually got great service. It was just strange to be eating someplace that used to harbor such close-minded discrimination.

Not to say that I felt uneasy at the rodeo, far from it. I got the same indifference anybody else would get at most large sporting venues. It was just an amusing observation that I was the only Asian guy there, unlike, say at any other major social gathering.

Regardless, the rodeo was great fun. Who knows, I may go watch a NASCAR event next.

Launch

2007-10-19T05:24:00.000-05:00

Nathalie and I have come to the conclusion that there is never going to be a perfect time to have a baby.

It's not like launching the space shuttle where they wait for various weather and planetary conditions to line up just right to a predetermined mathematical formula. Having a baby is going to be like what Hurricane Katrina was for us: an unexpected surprise that will alter our lives forever.

Except having a baby won't be a disaster.

So anyway, while we're just living our lives trying to find a good day to launch our space shuttle, I've entertained myself by finding cool clothes for the future baby. The internet is full of onesies and T-shirts with funny and outrageous designs that is sure to alarm those working at the department of child services. This one had me laughing all day:

No question. I'm definitely buying this one.

Canvas

2007-10-18T06:46:00.000-05:00

The day had been going fairly well. This was the last case of the day and everything was right on schedule. The first two operations had gone by without a glitch, and the entire operative team was settling down into a rhythm like a well oiled machine.

As was the norm, the junior resident and I got started on the case. We would perform the less complicated portions of the operation and get everything set up. The attending surgeon would scrub in later on for the critical portions. We were making good progress with the surgery, the tissues were dissecting easily, and this was turning into a textbook case. Everything was going like clockwork.

The junior resident and I quickly completed the initial dissection and discussed our plans for the upcoming weekend while the attending surgeon was getting gowned up.

Resident: ...and the House of Blues is having this awesome-

Attending: [interrupting as he rushes over to the table] OK boys, we've got to make this quick because I need to pitch a tent.

[The resident and I stopped talking and looked at each other in silence]

Resident: [gives me the Did he say what I think he said? look]

Me: [I look back Yeah, he definitely did]

The room fell silent. Even the nurses in the room had stopped talking. I quickly broke off eye contact with the resident because I knew if we kept looking at each other, we'd bust out laughing. I could already feel the giggles starting inside me.

[deafening silence]

Nurse: Now what you mean you're going to pitch a tent? You take some Viagra or something before you come in here?

So of course, that comment sent us into a laughing fit. After he innocently explained that his kids are going camping in his back yard, we educated him on the current implications of such a statement and brought him up to speed on the vernacular of the modern day as his face went through one shade of red to another.

Chip

2007-10-16T11:40:00.000-05:00

It has come to my realization that as much as I like potato chips, it's the sprinkled artificial flavor I like more than the actual chip itself. Sure, occasionally I have a hankering for plain, regular flavored potato chips, but most of the time I buy flavored chips: salt&vinegar, BBQ, dill pickle, jalapeno...

The chip itself is simply the delivery system for the flavoring. And I'm pretty certain that the chip carries most of the caloric load as well. Thus it would be ideal if I could just buy a cannister of the flavoring and just dip my finger into it whenever I get that snacking urge. Kind of a like a bizarre pixie stick. That way I satisfy my salty flavoring crave and also minimize my caloric intake as well.

I bet there is a market for this.

Comment

2007-10-14T14:35:00.001-05:00

Occasionally patients will feel inclined to write to us after their hospitalization and send us a thank you card for taking care of them. I received one recently from a feisty 82-year old man who was finally discharged home after spending several weeks recovering from his emergent operation as a result of a bad car accident. He went on to thank us for how pleasant everybody was and how grateful he is... a typical thank you card. But there was one completely unexpected line he wrote in the card:

It's too bad the hospital coffee tastes like bear piss.

I could not agree more.

bff jill

2007-10-11T07:23:00.000-05:00

I'm all for change and progress and technology, but one thing that just drives me nuts is this whole evolution of the text language. I understand the necessity of abbreviations to make text messages more efficient, but the alarmingly rapid integration of this nonsensical jabber into daily language just makes me cringe.

The AT&T/Cingular commercial where the mother is upset at her kids (and the grandmother) for not texting enough has the equivalent effect as nails on a chalkboard to me. Not only do I not understand half of what the frickin commercial is talking about (despite the subtitles) because the entire commercial, even the narration, is done in text-speak, I can't tolerate how corporate America is helping to propagate the decline of the English language. (Ironically, so am I by blogging about it.)

Eloquence of our language has been all but lost over the past 50 years. Read a copy of various letters and speeches given by our past presidents Eisenhower, Lincoln, and Jefferson. You'll be amazed at the beauty of their construct. Now compare that to our modern day language and even the words spoken by our current elected officials, and there is no question that our nation has become dumbed down as a whole.

I saw a movie called Idiocracy recently in which Owen Wilson (or was that Luke?) is frozen in time and then revived 500 years in the future only to find that America has become a nation of idiots. Although the movie as a whole wasn't that great, it was a great piece of social commentary. And unfortunately a true insight into the on-going decline of our once great nation.

Pushy

2007-10-09T15:28:00.000-05:00

I was dreading the trip to the mall. I needed a suit jacket, and unfortunately, that is one of the few things that you really should buy in person. As much as I love on-line shopping, some things you need to try on first. Besides, it's pretty hard to feel the texture of the suit through the computer screen. And as much as I hate the mall, it's less aggravating than having to wait in line at the post office to ship something back.

It's not that I don't like to shop, because frankly, who doesn't like getting new things? But I just can't stand the crowds, the inability to find anything in the haphazard arrangement of most department stores, and the parking nightmares at the mall.

On-line shopping is great. I lounge on the couch with the laptop, surf several stores simultaneously, use the search function to find exactly what I need in about a second, find the lowest price, and have it shipped to me in a few days. All without having to dodge those annoying sales people who pounce on you the moment you enter their store.

I know they're just trying to be helpful by approaching me, but the only thing they really accomplish is being an annoyance. I don't know about anybody else, but I don't like being bothered when I'm shopping. I'm in my own little world doing various thought processes, and really, I like my anonymity and to be able to just browse without having to tell someone to leave me alone.

It would be more ideal if sales people stood under a large "help" sign in the corner of the store someplace, and similar to how I can click the "FAQ" button on an internet page if I need to, I can just go to the "help" sign and find a salesperson.

Sadly, my trip to the mall for the suit jacket was a failure and I didn't find any that I liked. I would have stayed and browsed longer, but a creepy old salesman that kept following me around the men's department was starting to weird me out.

I may actually try buying one via the internet.

Besides, seeing the UPS truck coming up the driveway is as fun as seeing Santa Claus.

Touch

2007-10-05T13:47:00.000-05:00

I stopped at the door and watched as the nurses continued on, wheeling my mother's gurney through the double doors and into the hallway leading to the operating rooms. Today, I was a visitor, and this was as far as I was allowed to go. I watched them turn the corner and disappear, and then turned around and slowly made my way back towards the waiting area. Halfway down that hallway, it just hit me like a ton of bricks, and my eyes started to water.

For months, I had prayed daily, kept hope, and stayed strong. Despite my mother's overwhelmingly poor odds, I knew deep inside that she would be part of that 3% of patients that would beat her cancer and survive.

Months before, when the oncologist had the courage to tell us the truth, that he didn't think my mother would be a survivor, I acknowledged him, but internally I refused to believe him. "What do you know," I thought. How can this man fail to understand that my mother would be able to beat her cancer?

My mother was a good person, a devout Christian, had made many sacrifices for others, and lived a good life. Karma was on her side. God was on her side. She always responded well to medicines. She was only 49. She would beat this cancer. The oncologist had no idea what he was talking about.

And with every small victory my mom achieved with her cancer, we rejoiced and praised God. And with every set back, we prayed harder. And we all believed that with enough prayer and hope, she would survive.

But she started to regress. Slowly at first, but then piece by piece her body started to give up. But we kept praying and kept believing. And still, I refused to believe that my mother... my mom, would be a prey to cancer.

But that morning, as I was walking back to the waiting room, it hit me. And for the first time, I finally acknowledged the truth, and accepted my mother's fate. But it felt like a hole was being torn out of my heart and I was betraying my mother and giving up just by the mere act of accepting the truth. And there was no relief, and no asylum gained by doing so. It only seemed to hurt even more.

And I stood there, leaning against the wall for support, overcome with grief and crying my eyes out as months of repressed hurt, fear, denial, and mourning came pouring out of me.

I cried for her. I cried for my dad. I cried for my younger brother. I cried out of frustration, grief, and anger. I cried out of the unfairness of life and it's unforgiving nature. And I as I stood there crying, I felt completely alone.

For months, I had acted as the rock that my family could lean on. But at that moment, in that hallway, I wanted someone to lean on. I needed someone to lean on. Someone to hold me as I came to terms with my mother's illness.

But nobody came.

People passed me along that hallway, but nobody bothered to reach out to me. I stood in that hallway in that sea of sorrow, wanting someone to stop and offer just a small word of encouragement, or to tell me that everything would be OK, even if it weren't true. But nobody ever did. And I felt very alone.

And I've never forgotten that heart wrenching feeling of loneliness and sadness.

So when I saw this little elderly woman crying alone in the hallway as I was walking out to eat my lunch, I remembered. And I went up to her.

Me: [cautiously reaching out for her elbow] Ma'am, are you OK?

She slowly turned around and in between sobs, she told me her cancer had been successfully treated, and that today, her doctors couldn't find any traces of it.

Her: [sobbing] It's OK. I'm OK. I'm just so happy, I can't stop crying.

Me: Well, give me a hug. Congratu-

But before I could finish, she latched onto me and gave me the biggest hug of my life. And I hugged her back as she released those tears of joy and relief, my heart being warmed with joy as well.

And we stood there in that hallway, two strangers united in an impromtu embrace as others passed us by, one stranger simply celebrating the triumph of another as the other wept with happiness.

Tele

2007-10-01T17:41:00.000-05:00

This is the other ghostly event that I experienced while living in that haunted bookstore. After that one time, I never heard the footsteps again, and after several months, I had pretty much forgotten about it and the initial fright and drama had long faded away.

One Saturday night, despite my roommate's persistent attempts to get me to join him and a few of the guys for drinks, I elected to stay home and study for an upcoming test. I had already gone out the night before and I had lots of studying left to do.

So I sat in the apartment alone, studying for my test, when the phone rang. (It looked just like the one in the picture up top. Being a poor college student, I only had a corded phone. Cordless phones were the "in" thing, but out of my price range, and cell phones were the size of desktop computers back then.)

I went and answered the phone, but there was only silence.

Me: Hello?

[silence]

Me: [Thinking this is my friends pulling a prank on me] John, is that you?

[Nothing. Not even breathing noises.]

Me: Hey man, seriously, I've got to study. Leave me alone.

As I was about to hang up, I heard the voice of a small child whispering into the phone in a halting, staccato rhythm:

Voice: Can... you... come... out... and play?

I didn't expect to hear that, so it came as a surprise, especially considering that it was near midnight. What child is up this late? But then it was obvious that my friends were probably nice and drunk by now and were messing with me. So I just hung up.

As I was trying to figure out which one of my friends could disguise his voice so perfectly to sound just like a little child, the phone rang again.

This time, when I picked it up, I didn't say anything. I decided to play this one out and see if they would start talking first.

The phone was silent for what felt like an eternity, although it was probably only about 30 seconds or so. Then as I was about to hang up the phone, the child like voice whispered into the phone again:

Voice: Can... you... come... out... and play?

I remained quiet.

Voice: Come... out... and play.

I didn't even breath into the phone. I decided to ride this one out and see when my friend was going to start cracking up.

Voice: Can... you... play... with... me?

I just held the phone to my ear and started looking over the chapter questions that I was working on before this whole thing started.

Voice: Come... out... and... play.

[pause]

Voice: Can... you come... out... and play?

It was starting to get eerie. Whoever was on the other end of that call never changed their voice, whispered the whole time, and spoke in that strange halting and pause rhythm that was starting to give me the creeps. After several minutes of not hearing a peep out of me, I figured the prankster would either hang up out of frustration, or start laughing at me, but none of that happened. Instead, the owner of that childlike voice kept asking me to come out and play.

I had been on the phone for over 5 minutes and I decided I had enough. It didn't look like the prankster was going to reveal himself anytime soon, and I needed to get back to studying, so I just hung up the phone. Immediately, it rang again.

I hesitated a second, but then I picked it up. And I could hear coming from the earpiece before I even got it up to my head:

Voice: COME OUT AND PLAY! COME OUT AND PLAY! COME OUT AND PLAY!

All the hairs on my neck just stood up. And I slammed the phone down. I sat there for a minute trying to figure out what the hell was going on.

Well whatever it was, and whoever was prank calling me, I had enough of this for one night. So I went and unplugged the phone line from the wall, sat back down on my chair, and looked at the phone confused and a bit frazzled.

Then the phone rang.

Yes. The phone that was completely disconnected from the wall rang. The one with no phone line connecting it to anything. It rang. And rang. And rang.

I couldn't even move out of my chair, and I sat petrified as that phone kept ringing. I was freaked out of my mind and I felt like throwing up.

Then it stopped. And it was deathly quiet.

I waited and stared at the phone, wide-eyed, frozen in fear, and not sure of what was going to happen next. I must have sat motionless for 15 minutes or so, not sure what to do, not sure what to expect.

I realized I had to get out of there, so I grabbed a few things and went over to my cousin's apartment for the night.

When I questioned my friends the next day, none of them admitted to the prank, or of any knowledge of a prank. And from the looks of puzzlement on their faces, I could see that they too were mystified by the events that took place and that this was not a prank they set up.

I ended up just throwing that phone away and buying a different one. And I never heard from that voice again. And for the rest of the 2 years that my roommate and I lived in that bookstore, we never experienced another event.

But I will never forget how that voice sounded, and these two crazy events that took place in that haunted bookstore, as long as I live.

Boots

2007-09-27T07:37:00.000-05:00

I don't believe in ghosts. But this actually happened to me.

After my sophomore year of college, I decided it was time to move off-campus. So a buddy of mine and I were quite fortunate to find an awesome apartment located on the third floor of a 100-plus year old brownstone. It was in walking distance to everything, the building itself was gorgeous with real hardwood floors throughout, and we even had rooftop and balcony access.

The first two floors were occupied by a bookstore (from which we were renting the third floor from), so that after the bookstore closed at 5pm, my roommate and I were the only inhabitants of the building. This meant we could be as loud as we wanted and not have to worry about disturbing anybody living below us.

There were two ways into our apartment. One was through the back door, which was essentially a modified fire escape. The other was through the bookstore via the main stairwell in the middle of the building. The owners would lock this door to the main stairwell after closing time to keep us from running amok in the bookstore. This didn't bother us much considering we mostly used the back door to avoid the bookstore patrons anyway.

One night, as I sat at my desk studying into the wee hours of the morning, I heard footsteps directly below me, resonating up from the floor below. It was the sound of somebody wearing heavy boots walking on the hardwood floor. Except it didn't really sound like walking, more like stumbling.

Clump, clump... clump... clump, clump, clumpclumpclump.

I looked at the clock: 1:33AM. I stopped studying and sat there mulling things over a bit. Being that the bookstore was privately owned, it wasn't unusual to have the owners come back after closing time and to do inventory and other stuff. But I've never heard them rustling around this late at night. I listened quietly for a few minutes, but didn't hear anything else.

There was a chance someone might have broken into the bookstore to burglarize the place. So I grabbed a flashlight and went down to the door in the main stairwell, which had a small window, and looked into the bookstore.

Nothing. I shined my flashlight through the window and looked around the best I could. There were no signs of anything wrong. Everything looked like it was in order, the lights were off, and I didn't see anything.

Not satisfied, I then went out our back door, walked to the front of the building, and looked at the door to the bookstore. There were no signs of forced entry, the door was locked, and it was dark in the bookstore. Everything looked as right as rain.

Quite perplexed, but more worried about the chemistry exam I had to take in a few days, I decided to go back in the apartment and get back to studying. Once in the apartment, I looked through the main stairwell door window one more time, saw nothing, and then went back to my room.

But as much as I wanted to get back to studying, I couldn't get my mind off of trying to figure out who had been, or currently was, in the bookstore. As I was deep in thought, I heard the footsteps again.

Clump, clump... clump... clump, clump, clumpclumpclump.

Then silence.

I started to get up from my desk to go for a second look when it dawned on me that these footstep sounds were exactly identical in cadence and rhythm as what I heard the first time.

Then I realized that each time I heard the footsteps, they were going in the same direction: From the second floor balcony towards the center of the house. And that I never really heard the footsteps coming the other way.

What the hell was this burglar doing down there? Stumbling loudly from the balcony to the center of the house, and then tiptoeing around?

Then I realized something: Two weeks ago, the bookstore owners had the first and second floor carpeted.

The noises I heard were the sounds of someone walking on hardwood floors. No question about it. But how that could happen given that we now have carpet, I don't know. I decided that it was definitely too late and too bizarre for me to figure out, I must be hallucinating, and that it was definitely time for me to go to sleep. But not in this building.

So I grabbed a few things, and hiked on over to my cousin's apartment to crash on his couch.

C: [sleepily answering the rabid knocking on his door] What the hell are you doing here?

Me: [rushing past him] Never mind, I'll explain in the morning.

The next morning, once the sun was up and all the demons were hopefully back in hell, I went back to my apartment. I entered through the front door of the bookstore to find one of the owners straightening up the place.

Me: Debbie, were you guys in the bookstore last night?

Debbie No, why?

Me: Are you guys missing anything? Were there any signs of a break in?

Debbie: [beginning to look concerned] No... why?

As I started to explain the boot noises, Debbie's face goes from concerned to complete relief.

Debbie: [relieved] Oh, you heard the footsteps! Whew!

I stopped telling my story.

Debbie: Wow, you had me worried for a bit! Did the apartment get real cold by any chance?

So, apparently this had happened several times over the years. Debbie went on to tell me that the tenants will hear those footsteps, or get woken up by a persistent chill in the middle of the night. Usually this only happens about once or twice a year, and nobody is ever hurt, but several years ago the chills continued for days until the tenant just broke off the rental agreement and left.

Debbie: This place is haunted, didn't we tell you?

What?! Where the hell was that on the rental agreement?!

Discharge

2007-09-24T21:00:00.000-05:00

Trying to save someone's life while simultaneously trying to respect their wishes often isn't as clear cut as it should be. The easiest choices are made when a patient isn't capable of making them on their own, and you're the one that has to make decisions for them. It gets real confusing when they appear to be fully with it and decline your help.

Sometimes, you ignore them and do what you think needs to be done. Knowing when it's appropriate to do something like that... well, that's a tough decision to make. A very tough decision.

A middle aged man was brought into the trauma bay after a botched suicide attempt. He decided to use a shotgun to kill himself. After finishing his suicide note, as he was making his way to the bedroom he dropped the gun, which subsequently discharged a load into his abdomen.

His daughter, who was in the house, found him and called 911.

Although he was initially knocked unconscious, he was fully awake by the time EMS brought him to the hospital. The patient was, amazingly, still alert, fully coherent, and screaming at us to leave him alone and let him die, threatening us with everything from bodily harm to a lawsuit if we did otherwise. His daughter was in a heap in the corner of the room having an emotional meltdown. His wife circled the ER yelling at us to save her husband while simultaneously verbally abusing her dying husband. My junior resident was holding pressure on that bleeding abdominal wound with a towel, as two nurses were trying to tie down the man's arms, with one holding his legs down. The ER doc was struggling to get a sedative in the patient while getting spat on by the patient.

I had rushed to the ER to be greeted by this scene, and I stood there for a minute, wishing I could be anywhere else.

The ER doc asked me what I wanted to do. Morally and ethically, we're bound to the wishes of a patient in a normal state of mind. The confusing factor in this case was that this patient, despite his apparent trauma, appeared fully alert and mentally capable of making decisions for himself.

Although I made a decision and gave out an order to the nurses in less time it took me to take a couple of breaths, I agonized over that decision in my head for what felt like an eternity.

So against his wishes I sedated him, with him screaming at me that he will certainly kill me. We then quickly took him to the operating room. Removed his destroyed spleen and kidney. Removed the disintegrated parts of his colon and small intestine. Transfused multiple units of blood to replace what's already been lost and what I was continuously losing as we operated. Created a colostomy. And several hours later, wheeled him into the ICU.

He spent several weeks in the ICU chemically sedated and paralyzed, slowly recovering from his injuries. He had several set backs, which required two more operations. And during that time, I had rotated off of the service and handed over the care of this patient to another resident.

I had kept up with his progress with occasional updates from the other residents. Then I heard he was being moved out of the ICU and onto the surgical ward.

I decided it was time to go see him. The last time I saw him awake was in the ER. And I recalled the exact last words he said to me with inhuman rage as I sedated him, "I'm going to fucking kill you if you don't let me die."

I looked into his room and saw him in bed watching TV with a blank stare. A corner of his room was full of get-well cards and balloons. He was holding the hand of his wife, who had fallen asleep in the chair by his bed. He slowly turned to look at me as I entered the room.

Patient: You're the asshole that I saw in the ER.

[sigh] I knew this was going to be tough. He looked a lot thinner. I looked at this abdomen, a mess of an open wound covered in bandages from the recent skin graft. It's not easy repairing a shotgun blast from such a close range. The last month of recovery hadn't been easy for him. And he still had a long road ahead of him before he would be fully recovered from this. His eyes caught mine looking at his colostomy. I broke off the gaze.

Me: Uh... yeah. That was me.

We both looked at each other in silence for a very long time. A thousand thoughts fluttered through my head. All of a sudden I became aware of my hands, hanging loosely by my side. Not sure what to do with my hands, I eventually stuffed them in the pockets of my white coat after fidgeting with them for a bit.

Me: Sorry. [What do you say in this situation?]

[silence]

Patient: [softly] Thank you.

I didn't ask what he meant, and he didn't elaborate either. He extended out his hand, and I shook it. Whether he was accepting my apology for disrespecting his wishes, or whether he was thankful that I did and saved his life, I will never know.

But we both knew that enough words had been said between us. I wished him well and walked out of his room, as he slowly turned his gaze back to the TV screen.

Nobody said this job would be easy.

Obvious

2007-09-21T07:50:00.000-05:00

I was telling a co-worker about the time Nathalie and I got lost in the middle of the forest in Maui. It had gotten dark, the overhead canopy blocked out any light coming from the moon, we couldn't see a thing, and we were trying to guide ourselves out of the forest by the light of my little pocket flashlight.

We were following the small trail that we were on when we hiked into the forest. The forest floor was slippery and muddy, so the going was slow, but we were making progress. And then all of a sudden, the trail just disappeared. We swung the little flashlight around madly, trying to find the rest of the trail. Panic started to set in, but then we finally saw what appeared to be a trail about 15 feet away.

We made our way over there, but then we were horrified to find out that it wasn't a trail at all. Just a patch of dirt. We then turned around to get back to the trail that we were just on, but we had become disoriented and had no idea where it was.

Now we were completely disoriented, with our bearings completely lost, and with absolutely no idea where we were or what general direction we needed to go. Nothing resembled a trail, and pretty soon nothing looked familiar and everything looked like nothing.

The only thing keeping us from going crazy with fear was the light coming out of my little flashlight. I couldn't th-

Co-worker: [interrupting] Ohmygosh! That's crazy! Did you guys make it out?

Me: Uh... No. We never found our way out of the forest. We were lost for good and nobody ever came to find us.

Co-worker: Wow. That's crazy!

[silence]

Co-worker: Heyyyy....

Choices

2007-09-18T09:51:00.000-05:00

Me: You're definitely declining a blood transfusion.

Patient: Yes.

Me: Even if it will save your life.

Patient: Yes.

Me: You're sure. You understand everything that I've said and told you.

Patient: Yes.

The patient looked at me, and I at him. He had come to the hospital after passing large amounts of blood after a bowel movement. So far, all non-surgical treatments had failed, and we had decided to go to the OR and surgically remove the bleeding colon. It was only a matter of time before he would essentially bleed to death.

The complicating factor in this case was his absolute refusal to consent for a blood transfusion. He was already at a disadvantage due to his heart condition and smoking history, but his massive blood loss compounded those factors into overwhelmingly poor odds.

But you have to respect a patient's wish. And even if it means this patient might die, I had to respect his decisions and uphold them. I thought about asking my patient-

Anesthetist: [yelling] HEY DOC!

I immediately snapped out of my daydream. I looked up, surprised.

Anesthetist: Stop for a second, let's check to see if he's got a rhythm.

I had been pumping away on my patient's chest, lost in thought, recalling the last conversation I had with this man before coming to the OR. I looked around and regained my bearings.

The case had gone fairly well, we were able to remove the colon and stop the bleeding, but as we were about to start closing the abdomen, the patient's heart went into a pulseless arrhythmia. There was no doubt that this was brought on by the low blood volume exacerbating his previous heart history. We had immediately started cardiac resuscitation. And while performing chest compressions, I had become absorbed in my own thoughts.

I stopped what I was doing and we all turned towards the monitors.

No rhythm.

I stepped down as a fellow resident stepped up to resume chest compressions. We had been doing this for 20 minutes, and I was drenched in sweat.

We all stood helplessly, hoping that the patient's heart will regain function.

Anesthetist: [asking one more time] No transfusion, right?

I solemnly shook my head. There was no guarantee that a blood transfusion would help my patient, but it would definitely help stack the odds in his favor. But I had to respect his wishes. So I did what everybody else in the OR was doing: watching the monitors and praying for a miracle.

We stopped resuscitation about 15 minutes later.
He was pronounced at 3:19 AM.

Scented

2007-09-17T06:37:00.000-05:00

In a recent edition of Car and Driver, I ran across an ad for Ford Mustang cologne. It had this cheesy picture of a tough, scruffy-looking cowboy character wearing mirrored aviators in the foreground with a black Mustang being driven through a dusty, desert trail in the background.

Uh, chee-sy!

It didn't have one of those flaps you can peel open to take a sample sniff. Besides, how good could this possibly smell? My best guess would be that it would smell cheap and be way too musky: Representative of both the car itself and most of the guys driving them. I let out a "wow, I can't believe they actually made this" and then flipped the page.

So by chance I happened to be wandering through Wal-Mart and spied one for sale on the shelf. Curiosity overtook me and I had to take a sniff.

Surprisingly, it actually smelled pretty good. Light, crisp, with citrus hints. Very summery. It smelled a hell of a lot better than I ever imagined it would. It smelled expensive. It didn't smell like a guido. I was a bit flabbergasted that this Ford Mustang cologne was something that I might actually consider purchasing for my own personal use.

I stood there in the middle of the aisle, staring at the bottle in my hand, mouth open in disbelief.

So there you go. Don't go judging books by their covers.

And no, I didn't buy one.

Katrina stories, 10

2007-09-13T06:34:00.000-05:00

The people that stayed behind to ride out the hurricane can be placed into two broad categories: one group just didn't have the means to leave, the other chose not to leave. Most of those that chose not to leave had been through many hurricanes in the past and have stockpiled enough supplies to ride out a storm. And of course, a small minority of the group that chose not to leave were just obstinate.

One of the nurses who stayed behind to help had a generator at his house, which was enough power to run the small window AC, a small refrigerator, and some lights in the house. This is his wife's story:

It was mid-afternoon. She was sitting in the bedroom, listening to the radio and trying to get the TV to work. It's now been about 4 days since the storm and like everybody else in the nation, she was curious about what was going on with the flooding and the looting and the general mayhem.

Frustrated about not being able to get a decent signal on the TV, she turned that off and just listened to the battery powered radio. All of a sudden, the window AC unit just died. Thinking the generator ran out of fuel, she got up from the couch to go outside and refill the tank, but she could clearly hear it chugging along outside.

She then realized that the window AC unit probably blew out a fuse, so she took the front panel off to have a look. A noble effort, but no serviceable parts other than a filter were available. Stumped, she decided to go outside and see if there was anything she could do from there that might get the AC working again. Who knows, maybe the extension cord plug had become disconnected from the generator.

Sure enough, that's what happened. The extension cord plug had been pulled. But she was also surprised to find that the generator had been stolen, and in its place were the remnants of their padlock and chain and someone's beat up lawn mower happily chugging away.