Doctor Erik’s Science Project

Hour One

I’m working in the Medical Intensive Care Unit and get called down to the Labor and Delivery area.

A 23 year-old girl who is 22 weeks pregnant (22 divided by 4 means she is about 5 and a half months pregnant) has come in with altered mental status.

‘Altered mental status’ is a catch all phrase meaning someone is acting strange. It can mean anything from batshit crazy to comatose.

The OB/GYN resident told me that apparently the girl had been having abdominal pain for a week or two and was taking all kinds of over the counter medications to relieve it. None of it was working. This morning, her husband woke up to her moaning and not able to talk to him. The resident told me her Tylenol level had just come back and was at toxic levels.

I went in to examine the patient. She was lying on the bed moaning and writhing about in some amount of distress. She was visibly pregnant, slightly overweight, but not obese. She did not appear jaundiced. She responded appropriately to only the simplest of questions, able to tell me her name and that she felt bad ‘all over.’ She was breathing rapidly, but her breaths were not labored. Her heart was beating fast. (125 bpm) Her belly was not tender and her pregnant uterus could be felt just below her belly button. For her stage of pregnancy that is a bit low.

Her husband, who appeared about her age, sat in the corner, reading a Tom Clancy novel. He looked up once or twice during my exam. It must have been a good book.

The labs showed she had sustained acute liver toxicity. The drug screen was otherwise negative.


A quick word about drug overdoses.

Tylenol is one of the worst drugs to overdose on. It usually does not kill you, but can cause irreversible liver damage. More than ten 325 mg tablets over a day are enough to cause some damage. (3000 mg is the daily limit in most hospitals.) Tylenol overdoses are one of the most common causes for overdose hospital admissions in the United States.

By way of comparison, if someone overdoses on certain types of sleeping pills and does not die, they will simply wake up in a couple of days. This happened to Sinead O’Connor, who was horrified to find no one had missed her after sleeping in a hotel room for 48 hours with a ‘do not disturb’ sign on the door. She had to call a journalist to report her suicide attempt. (This is one several Sinead O’Connor stories that I love.)


While I was looking over her records, the tech was going in with the ultrasound machine to examine the fetus.


Tomorrow, hour two through four of…

Doctor Erik’s Science Project

Uncynical Wedne—What’s that Smell?

Now, let me preface this story by saying that I love meatballs: Homemade meatballs of veal and pork with plenty of fennel seed and garlic.

I have already warned you of the repulsiveness of childbirth, the most disgusting experience known to humanity. So, since I had to spend a whole month doing obstetrics, I was treated to spaghetti with homemade meatballs.

The next day, wondering around the labor and delivery ward I went about my normal routine. There was a young woman who was fully dilated and likely to give birth soon, so I spent a lot of time in her room.

That was when I remembered that all that garlic, pork, and veal has an effect on the GI tract. So every few minutes, I came up with an excuse to step into the hall. I’d walk toward the nurses’ station to a safe distance, gesticulate with my hands and walk in a circle and then walk back into the room. This worked fine for a while, until the patient actually started to get ready to deliver. That meant I had to put on my sterile gown, gloves, and shoe protectors. And even then, you wear your old shoes.

Once you are sterile, there is no leaving the room. I was hoping the gown, which is thick and water resistant, would contain the garlic laden fumes. But it wasn’t too long before the nurse had a funny look on her face, walked over to the patient and sweetly said, ‘Do you need an enema, honey?’

The patient said she did not. Which is not unusual; when you are about to give birth, the last thing you want is someone shoving something inside your butt.

‘Well,’ the nurse responded, ‘It smells like you need an enema.’

Now, I started a medical ethics group in medical school. I led round table discussions about different criteria to solve ethical dilemmas using a variety of different cases. Believe it or not, this question never came up. Would I allow this woman to get an enema for the smell that I myself created?

Not arriving at an immediate answer, or rather not liking the obvious answer, I punted. ‘No time for that now. She is getting ready to deliver.’

She delivered, though we were ready for her with plenty of time to spare, a misstep on my part. After I realized the gown did nothing to contain the fumes, I began holding my cheeks together with the strength and endurance I’d use if I was hanging on the edge of a cliff and had somehow managed to wedge a rock or branch between my ass cheeks, feet dangling into the abyss. I don't think they have a machine at the gym that prepares you for that kind of endurance training.

And one little bonus I was able to give the patient as penance.

I mentioned yesterday that childbirth splits open the vagina. After the birth is over, we sew it back together, logically enough. But sometimes we will throw in an extra stitch, making the vagina just a little, um, snugger than it was before. It’s called the ‘love stitch.’

Needless to say, she got one.

Ah, The Miracle of Birth

One of the questions my family and friends like to ask me is, ‘What’s the most disgusting thing you’ve every seen?’

They know I have a slight taste for the macabre and am likely to give them a good story. And those stories do exist.

I have been the last man to touch a woman’s breast while it was still attached to her body, withdrawn and pulled a man's leg as it was sawn off. I’ve seen a man vomit blood until he died. I’ve connected instruments through a woman’s open abdomen as the surgeon fed me the pieces through the patient’s rectum. (I originally wrote ‘as the surgeon fed me the pieces through her rectum,’ but felt I should be more precise.) I’ve found maggots on my shirt after examining a man's gangrenous foot. I’ve seen the powder burns on the temple of a fifty-year old man who got drunk, fought with his wife, and locked himself in the bedroom to put the family gun to his head.

FUN FACT: If you have a handgun in your home you are five times more likely to commit suicide than someone who does not.

But the most foul, disgusting thing I have ever seen is childbirth.


Everyone seems to anticipate being squeamish about the water breaking. Well, let me tell you, that water is Evian compared to what comes next. No one mentions that childbirth is full of blood, piss and shit. If it is a difficult delivery, my gloved hands are maneuvering around the little turdletts and occasional trickles of piss the woman passes as she bears down.

The vagina is almost always ripped open. To avoid this—are you ready ladies?—we cut the vagina open with scissors. The first time I tried, I gave the scissors to the senior physician because my hands were trembling.

It is simply horrendous.

Women screamed at their husbands, ‘You did this to me you ass-fucker!’ I sympathized with them; though I noted that had they been ass-fucking, none of this would be happening.

After watching several childbirths I could not imagine intentionally impregnating anyone I cared about.

I recommend hiring a co-ed.

Tomorrow: Uncynical Wedne—What’s that Smell?

The Goat, Part III of III

Or, Judith Butler Sitting on My Face

For those of you who do not follow the link, no one in this photo is named Judy.

My Goat, Part II

This is not the first time I’ve had a goatee. When I was going to Columbia College in Chicago, I was pretty rough and tumble. I wore an old army parka everywhere, wore dirty jeans with rips at the knees. I remember my dad saying, ‘Even though we just did your laundry, you still look dirty.’

It was the first time a woman looked at me and then crossed the street to put a safe distance between us. I felt like saying something, but what can you say to that, really? ‘I’m not going to rape you, ma’am.’ I can’t imagine that would be reassuring. Instead, I turned down a side street because I could see she was still giving me nervous glances.

Anyway, it was spring of ’90, about a year before grunge hit big, and goatees still felt more Medieval than Seattle and I was in the computer lab (with huge floppy discs, dot-matrix printers and no internet) and this guy sitting across the table from me said:

‘Hey, does trouble follow you around?’

I kept typing because, while one may or may not argue that trouble does, in fact, follow me around, no one had ever asked me that directly. But the room was empty and no one answered him, so I looked up.

‘Excuse me?’ I asked.

‘Man, does trouble follow you around?’ he repeated. I just stared at him, trying to figure out where this was going. We went on in silence for about five seconds. I was trying to figure out if I could take this guy if he attacked me, but he was two inches taller and had twenty pounds on me, easily. ‘I’m thinking about growing a goatee, but my girlfriend says trouble will follow me around if I grow one. So I’m asking you: Does trouble follow you around?’

I think about the lady who crossed the street. I also think about all the offers I get for weed, smack and even opium from people on the street. I think about how only a few years earlier my fantasies were of being Johnny Depp in 21 Jumpstreet and busting these peddlers, throwing handcuffs on them and flashing my badge as I threw them against the wall.

I think about the night a kid ran past me being followed by an old Russian Jew yelling ‘Stop Thief!’ I turned and chased him into the proverbial dark alley. I think about how I stood guard, staring into the darkness hoping to fucking god the kid didn’t have a knife or—worse—a gun. I stood there blocking the exit of the alley staring for what seemed an hour, but was more likely twenty minutes until the Russian’s wife came with a cop whose flashlight found the kid still stupidly clutching a handful of gold chains. He was not thrown against the wall with a flash of the badge. He cowered as the cop turned him around and put the cuffs on him.

‘No,’ I said, ‘trouble doesn’t follow me around.’

I shaved the goatee off before making my next move to Iowa City.

Part III

Uncynical Wednesdays: The Gates

Everyone seems to be talking about Christo’s The Gates. Even here in the south I hear people talking about it. Almost uniformly there’s distain for the project. As if Central Park is some starlet whom everyone loves, now sullying herself with some ne’er-do-well.

The principle objection seems to be ‘Is that worth Twenty-One Million Dollars?”

The answer is straightforward: “Yes. At least to the couple who paid for it.”

But of course, they are not asking about the economic sense of worth. A bit surprising since movie grosses are now given more press than movie reviews. (Or maybe that is exactly their point, and I’m the one who’s missing it.)

They are talking, I guess, about its artistic value. I’m going out on a limb here, but I have heard New Yorkers complaining about The Gates. They talk about Central Park so eloquently, waxing poetic on its beauty, how it’s a haven from the city, how much they appreciate it.

I submit that this is the real value of The Gates: Calling attention to the Beauty and Wonder all around us.

After it’s gone, Central Park will be new again. I suppose you could compare it to a near-death experience.


I’ll leave you with one of my favorite Nietzsche quotes:

‘I don’t like it.’-Why?-‘I am not up to it.’-Has anyone ever answered like that?

My Goat, Part I

Those of you who enjoy reading between the lines may have noticed a subtle trend over the last couple of week: several references to goats.

‘Why this preoccupation with goats?’ You may have asked yourself, as I did, while reviewing recent blog entries. But, unlike you, I had the advantage of being able to look in the mirror and see—there, upon my face—a goatee.

‘Erik, you are such a good looking young man,’ the Physician Emeritus at my hospital said, putting his arm around me, ‘Why would you grow that thing on your face?’

This was not a complete surprise. I had once heard him chastising another resident for a goatee saying, ‘What a man cultivates around his mouth grows wild around his ass.’

I smiled and told him I had grown it out of laziness being in the ICU. Not shaving bought me a little extra time in the morning. The regimen became piss, brush teeth, wet hair, put on scrubs, socks, shoes, pager, and watch, then walk out the door as I grabbed my wallet and keys. I told him I was going on vacation the next day and that the goatee would be gone by the time I got back.

What I didn’t tell him was that nurses had started giving me their number since it appeared.

When I went to college in Iowa City we’d go out, I had one friend who’d get phone numbers stuffed in his pocket. And he was a bigger asshole than I am. Someone once introduced themselves by saying, ‘You look like a nice Italian boy.’

‘I’m none of the three,’ he said and walked away.

So we would head out and he would find a phone number or two slipped in his pocket. That never happened to me. I complained about this to my roommate who consoled me by saying, ‘It’s because you don’t look like the kind of guy that would call someone slutty enough to just stick their number in your pocket.’

‘But I am,’ I protested. ‘I’m exactly that kind of guy.’

‘I know that,’ he said, ‘but you don’t look like you are.’

Using the technique of comforters everywhere, he softened the insult by interpreting it as flattery.


That look that he said I din't have was actually shed in Chicago before I moved to Iowa City. The story of that on Thursday, as it is not suitable for Uncynical Wednesday.

Part II

Ma Vie en Rose

When I was seven, my parents divorced. For five years, no one would tell me why. “Your father likes to go out and I am more of a stay at home person,” my mother said.

“That’s a stupid reason to split up,” I remember thinking. I don’t remember if I said it out loud.

Then one afternoon when I was twelve, my sister and I found my father’s stash of magazines that had photo spreads of men. This was the late seventies and they were mustached and hairy-chested. They looked like the brawny man on the paper towels. Only no flannel shirts, or any clothes at all. And there they were, lounging in the woods and hugging other naked men. There were no erections: no explicit sexual content. But the intent was clear.

Our first thought was that it must belong to Mark, who had been my father’s roommate for nearly four years. We called mom to ask her how we should tell Dad about Mark’s unusual pornography. She said she would call us back in 15 minutes. When we heard Dad’s car pull into the garage, we knew the jig was up.

“I’m Gay,” my father told us that sunny afternoon, sitting on the couch, my sister on his lap, and me sitting on the floor next to them.


Having a gay father placed me in a rather select subgroup of individuals. Other than my sister, I knew no one in my position. So when I was 13 and saw La Cage Aux Falle, the 1978 French film recently remade as The Birdcage, I thought ‘That is me—that’s going to be my life.’ My father was horrified when I told him this. ‘I don’t wear base.’ He said, alluding to the scene where the son wipes the make-up off his father’s face and smears it onto the freshly painted walls.

One of my favorite memories growing up was Dad and I making cream puffs together. They were delicious. I also remember the time we went pheasant hunting and came upon an apiary. Dad explained that the bees were hibernating and we could see them if we opened up the boxes. I remember thinking, “I didn’t know bees hibernated,” as he opened the boxes and they swarmed. We ran and ran through the snow back towards the car. Thankfully, wearing snowsuits and gloves and hats, we didn’t get stung.

The thing that most annoyed me about having gay parents was that they were up on the current trends and music before I was. Well, up until I was about 19, anyway. When my dad came to visit me in college, a friend sat down with us and she started flirting with him. I mean really overtly. Dad did look young, but I was getting creeped out. Finally, I barked “Shiela! Stop hitting on my dad.” She was horrified to find she had been so shameless with a man 20 years her senior.

So this year Dad and Papa Mark will be celebrating their thirty year anniversary.

Happy Valentines Day, everybody.

Hey Jude

When my little brother Julian graduated from high school last summer, I wanted to give him some advice that helped me in college.

Not stuff like avoid 7:30 classes, which I felt was obvious. But apparently not, because he signed up for one and excessive absences dropped his grade to an F and caused my dad to drop him from the payroll. So now he’s washing dishes and thinking about a job at a factory making pasta outside of town.

Not seeing the future, my original advice was a summary of Aristotle’s Twelve Virtues. But when my sister read it, she said it was too abstract. So while flying back to Iowa, I swung by the airport bookstore and bought a delightful little gem called “Don’t Sweat the Small Stuff.” It’s so small it can fit in your pocket. The advice seemed pretty decent. I figured I could give him my own version of pithy advice.

This is what I gave him:

1. Trust no one. Everyone is misinformed, misguided, misunderstood, or a combination of the three. All information is suspect.
2. Trust everyone. Despite being is misinformed, misguided and misunderstood, most people don’t mean any harm. Be open and friendly. Don’t treat people with suspicion.
3. Vary your sources. The best way to avoid being misinformed and misguided is to learn from all kinds of sources and see which ones seem reasonable when compared with the others.
4. Intermingle amongst cliques. The best way to avoid being misunderstood is to hang out with all kinds of people. Become friends with people you don’t immediately like. You’ll discover they’re interesting and they challenge assumptions you never thought about. You’ll be surprised to find that they have good traits you can use to improve yourself.
5. Trust no one. If people start asking things of you; if they ask for your money, your possessions, your time or your sympathy they’d better be good friends. Your sympathy is the most valuable thing you can give someone. If someone’s asking for it, alarm bells should start ringing. Get the hell out.
6. Love is not enough to make a relationship work. Love’s there in every good relationship, but it’s also there in lots of abusive, shitty relationships. If things aren’t working, and you’re spending a lot of time fighting and angry, move on. It’ll feel like the world’s falling apart and you’ll want to die. But it will get better, and you’ll find someone new.
7. Human beings are insecure. Every one of us feels, on some level, in some situation, incompetent. Confidence does not mean you believe you’re perfect. It means knowing you’re doing your best and working to become better than you currently are.
8. Being right all the time makes you an asshole.
9. The two most courageous statements people can ever make are “I don’t know,” and “I need help.” Making those two statements at the right moments can make you a hero and keep you out of immeasurable trouble.
10. The future is never as good or as bad as it looks. Don’t get too worked up about things before they happen. When budgeting, always double the estimated cost. When traveling, pack half of what you expect to wear. (except with underwear and socks)
11. 90% of life is just showing up. (Not mine, but very true)
12. Your Character is best demonstrated when you lose. Dealing with defeat graciously will garner you more admiration than winning ever could--but it has to be sincere. Obviously false graciousness is worse than poor sportsmanship.
13. If you say something, mean it. If you promise something, do it. Don’t allow yourself to be described as two-faced or dishonest.
14. Sometimes it’s easier to do something than explain why you shouldn’t have to do it. (That’s from Grandpa.)
15. If you want something to never happen, tell someone to do it “whenever they have the time.” No one ever has the time. (That’s from Grandpa, also.)
16. What’s obvious is not always what’s important. What’s important is not always what’s obvious. (Not mine, but also true, and not obvious.)

A Lid For Every Pot Calling the Kettle

Last week, one of the OB/GYN residents was telling me about a patient of hers that lived ‘on the northside.’

The Northside, for those of you who might need a refresher on sections of this town, is the section that was not highlighted on the Superbowl map of ‘places of interest.’ Now, in most major US cities, that is the section of town that realtors euphemistically—and illegally—refer to as ‘a little dark.’ But here it’s the section of town that is white, poor, and has a propensity for displaying their white supremacy flags Confederate flags.

Her patient was telling her to avoid that part of town. She did not spell it out, but she was giving her that advice because the resident was racially mixed.

“I don’t think its right, the way everyone just displays their Confederate flags all over the place,” the patient said. “They should display them inside, like I do with mine.”



Hearing this gave me an idea.

People who display white supremacy flags Confederate flags have their little catch phrase “Heritage not hate,” which I find a bit self-consciously naive, as they are well aware that an important part of the heritage of the confederacy was that whole slavery thing. (Some try to minimize the importance of slavery, but that’s hogwash. The birth of the Republican Party was formed by uniting the disparate anti-slavery parties in the US. Only the formation of the national treasury comes close to having the same sustained argument in domestic policy in the first 100 years of our nation’s history and everyone knows it.)

Anyway, there is still a movement requesting reparations for slavery. A law student recently filed a suit in federal court after discovering evidence that Aetna and the railroad company CSX (whose headquarters are here) directly profited from the sale of slaves. The suit estimates slaves performed as much as $40 million worth of unpaid labor between 1790 and 1860. The current value of that labor could be as high as $1.4 trillion. I don’t know how they will estimate how much should be billed to Aetna and CSX, but I think I may have a better idea.

Most people who dismiss the idea of slave reparations do so with the argument that slavery ended nearly 150 years ago and that people should ‘just get over it.’ Curiously, I think we have a match of people who think that the Confederacy has importance in modern day life.

We have people who are eager to claim their heritage of the Confederacy, and people who are looking for its inheritors. I am surprised no one has thought of this before.

I propose we simply trademark the white supremacy flags Confederate flag, and all proceeds go to a Reparations Fund.

All the Bumper Stickers, T-shirts, Beer Cozies, T-Shirts, Caps, Flags, T-Shirts, Handkerchiefs, T-Shirts, and Hunting Knives bearing the image of the Confederate flag® would each contribute a few dollars to the Slave Reparations Fund. The State of Mississippi would also contribute quite a bit, as their State flag still use the—newly copyrighted—Confederate flag®. The more Heritage, the more money for Reparations.

They could perhaps meet with Bad Boy Records, which has a very aggressive anti-piracy department, to ensure that no unlicensed merchandise is sold.

Not even at the Daytona 500.

Uncynical Wednesdays

The Innocent Eye Test
Mark Tansey

What Comes Around

I've been Tagged by Hot Babe with this list of questions to answer.


1. The last doughnut you ate out somewhere:
Morning Report, I usually eat one. Okay, two.

2. The last doughnut you ate at home:
It’s sitting in front of me as I type. I hope I don’t get glazing on the keyboard.

3. What was the last doughnut you bought:
A dozen from Krispy Kreme, six glazed and six chocolate glazed. It was on the way home from Superfest early Saturday morning.

4. Got Netnuts? (or a similar service):
No, I tried, and though they had keywords ‘glazed’ ‘cream’ and ‘topping,’ it had absolutely nothing to do with fried dough. Sadly they have not perfected internet doughnut technology. (Note to self: Perfect Internet Doughnut Technology)

5. List five doughnuts you adore/mean a lot to you:
1. Glazed- Simple, modern, minimalist.
2. Chocolate Glazed- A classic.
3. Blueberry Filled and a powdered sugar coating- In eighth grade I was in a all-day class on Tuesdays. If we performed well, the teacher would drive across the street to Velvet Cream and get us one doughnut each. I was a work horse for that doughnut. I loved going to school on Tuesdays with ‘doughnut money.’ (35 cents)
4. Pillsbury Biscuits with holes punched in the middle with grandma’s thimble, then fried and topped with powdered sugar glaze– We would do this at the farmhouse. Forget the sentimental aspect, these were unbelievably delicious.
5. That Dozen from a Gas Station in Northeast Iowa- My sister’s $300 car broke down coming back to Iowa City from Madison. I can’t remember how she made it back, but we had to drive through the countryside to retrieve the car. We stopped at this gas station and bought a dozen doughnuts that were prepackaged. They had this whipped cream filling, which I normally don’t like, but after we ate one or two our mouths started tingling a little. Neither of us was really sure it was happening, because it seemed too strange, so we idly continued to eat them until our mouths started going numb. Finally, we turned to one another and said something like “does yu mouf fee foonie?” Then we started hurling the doughnuts at passing cars and livestock. Ah, youth.


6. Name your guilty pleasure doughnut (or genre):
The Flavor of the month at the hospital cafeteria. A while ago it was Key Lime Pie Doughnut. Key Lime filling, Icing, and topped with graham cracker crumbles. Too high concept for me, but pretty good.

7. Name 3 people to whom you're going to pass these questions on, and why:
No one, the cycle of violence stops with me.

Superbowl Wrap-Up

We had a special event in town last week: The National Football League had their championship game. It is such a big game they refer to it as the ‘super’ bowl. The entire city was transformed into something interesting that gave all of us a story to tell. Here is mine:

Monday

Came home, post-call and slept. Stayed in and watched Wet Hot American Summer. Laughed.

Tuesday

Orthopedics clinic: While looking at a pelvic X-ray, a female nurse points to the outline of the patient’s large penis. The female doctor tells her sternly that the penis will point to the side of the patient’s injury. I concur. “It’s referred to as Hardwick’s sign,” She believes us.

Met Cecil at Mossfire Grill for ‘$3 martinis.’ Drank 3 Gibsons. Went to a series of dive bars looking for karaoke.

Ended up switching to beer, then to scotch.

Never found karaoke. Got home late.

Wednesday

Woke up early, hungover.

Clinic all day with Doctors Pasteur and Osler. Snoop Dog at hospital visiting sick children.

Artwalk downtown: This happens the first Wednesday of the month anyway, and is usually fun. Beer and wine and snacks as you wonder around businesses displaying works from local artists. Got home late.

Thursday

Woke up early. Evaluated patients in the pre-operative clinic, lunch, pulmonary clinic in afternoon. Had an 18 year-old patient who was in a persistent vegetative state after a near drowning. Felt sad.

Meet Yuval and Cecil downtown and go to concert: Kanye West & Big Boi of Outkast. Cecil gets us in clubhouse: Much drinking, schmoozing with folks from L.A. Have not had this much fun in Jacksonville in a long time. Well… ever.

On the way back to the car we see a lot of Eagles fans. This is the first reminder I have of how disgusting Eagles fans are.

Back in Miami, I had season tickets for the Dolphins. Now, rivalries do exist. For example, the Jets and the Dolphins always tease one another. My Favorite sign they made read “The Dolphins Suck and Marino Swallows.” But there was usually a certain tongue in cheek about everything. Eagles fans seem to lack any sense of humor about anything.

Eagles fans seem to think ‘fuck’ is part of an article of speech. It precedes every noun they say. Apparently, in the grade schools in Philly instead of ‘a,’ ‘an,’ and ‘the,’ they learn ‘a-fucking’ and ‘the-fucking.’ Such overuse of the word should diminish the vitriol with which its said, but for them, oddly, it seems increased. They treat people as if someone has stuck a pinecone up their ass and no one will tell them who did it.

Whenever the dolphins played the Eagles, there were a huge number of fights. Mean fights. I’ll admit fights would occur at games throughout the season. But at Eagles games, there were always fights and always a lot of them. (Fun Fact: There is actually a jail and a courtroom in the Eagles home stadium. To my knowledge they are the only NFL team with such a distinction.)

They are the only fans that I dislike. But I figured they would (1) be in good spirits and (2) be better behaved. I was (1) right and (2) wrong.

Got in street fight, a knife was pulled, but my dance moves were fresher than theirs. Got home late.

Friday

Woke up early. Went to Urgent Care clinic. All my patients had complex educational/social issues that took a lot of time and effort to solve. An intern offered to see one of my patients, but he ended up creating a lot of extra work for me. Frustrated, I head home.

Toph in from Atlanta. Go to Gene’s seafood and have “grouper French bake.” The French sauce, I find out, is a 50-50 mix of cream cheese and mayo. I asked for butter for my potato because I could only find Country Crock on the table. The waitress helpfully brought some more Country Crock. When I tried to clarify that I would like butter, she looked at me like the RCA dog, ear cocked to one side and nose scrunched up.

We met Cecil downtown at the ‘Superfest.’ Cecil is the master of thrift and has brought a case of beer with him. It would never occur to me to do this, but the stands are charging six dollars a bottle, so he is saving us a tremendous amount of cash. Cecil handed me a beer, and as I twisted the cap, the fireworks started. After the fireworks were over, we waited for about an hour for T-Bone to show up with more beer. We walked through the festivities toward the East Bay Club, one of many cool nightclubs that were built last Tuesday and will be returned to empty storefronts this Tuesday. A friend of mine and Toph’s got us through the door, bypassing the large line. We hung out with New Yorkers most of the night. Got home late.

Saturday

Woke up late, hung out, went to brunch at The Brick, had a bloody mary and the crab benedict. Napped. Went back to Superfest with Toph and Cecil, hung out on dock and watched fireworks. Better display than Friday night. Met Cecil’s friend Steve who is in from Tampa or something. We were hanging out and then Steve had to go. He wouldn’t tell us what he needed to do or where he was going. Now, I don’t care that people do drugs and have to track down dealers and make people wait while that goes down, but lets not be cagey and evasive. Just be honest or lie, but don’t try to be mysterious.

Started walking toward East Bay Club. Everyone needs to piss except me, so I get in line to buy a Gyro. After about 10 minutes Steve, whom I have just met, comes up to me and says “We’ve finished peeing and this food doesn’t look good. Let’s go.” I looked at him and told him “You need to get the fuck away from me.”

We made it back to the East Bay Club and lose Steve. Start having fun. On the way home, stop by Krispy Kreme and get a dozen. Think about buying a Krispy Kreme T-shirt . Watch Television for about 30 minutes. Go to sleep very late.

Sunday

Watch ‘Wishmaster 3’ on the SciFi channel while reading the New York Times.

Toph and Cecil go to game. I take down the Christmas tree while watching professional poker. Talk to Them via cellphone.

The Eagles fans were threatening to riot during the first half because—while the score is zero, zero—the scoreboard suddenly reads Pats: 6 Eagles: 0. They are screaming such things as “You can’t do that this is th’fucking Superbowl.” As if this technical glitch will somehow actually award the Patriots those points. The referees will scratch their heads and say ‘there is nothing we can do about this. We have to let them keep those points.” Somehow, miracle of miracles, the scoreboard is corrected.

The Halftime show horrifies and offends millions around the country by being pedestrian and lame.

“What was that, an outtake from Paul McCartney’s summer tour of ‘93?” Bush senior asks.

Around the rest of the world, people are troubled by the American flags waving during Live and Let Die. The question is asked “Have Americans really stopped saying live and let live and now have decided to give in and cry, say live and let die?”

Bush Junior answers with a simple “yes.”


When the Eagles lose, I go to bed happy.

Monday

The Potemkin town is removed.

Reader’s Digest’s Four Things You Never Knew about Hospital Nurses

1) 90% are practicing Satanists.
2) They eat your leftover applesauce.
3) They are better at drawing blood than most physicians.
4) They don’t need any blood to run tests. God only knows what they do with it. (See #1)

The Goat

Dr. Osler is a senior physician who is quite brilliant. Today Dr. Pasteur and I were observing him in his clinic.

There was some downtime and in the physician’s workroom Dr. Pasteur was talking about a girl he had dated, whom they referred to as ‘the goat.’ I asked why they called her the goat.

“Because when she laughs, she shows her gums like a briar-eating goat,” he explained. “That and she likes anal sex.”

“Nothing wrong with that,” I said.

“No,” Pasteur said, “But she isn’t clean down there.”

So we all laughed and talked until the next patient showed up. It was a gentleman whose breathing was so bad that he was confined to a wheelchair.


I’ll digress from the story to explain a clinical tidbit here. People with lung and heart problems have a hard time doing the typical activities of daily life because of exertional dyspnea. That is, they get out of breath whenever they attempt to do much of anything at all. We can grade this by a variety of things. Can they walk one block without stopping? Can they walk to their car from their house? Can they walk to their kitchen? Can they get out a chair and take a shower? Can they brush their teeth?

The biggest problem for them is when you don’t exercise because you get out of breath, your muscles get out of shape. When your muscles are out of shape, you need to breathe harder to exercise. When you can’t breathe harder, you are not able to do things you could when your muscles were in shape. When you are not able to do those things, your muscles get in even worse shape, and you need to breathe harder to do even less. This downward spiral continues until the patient dies.

The surest way to kill off a patient is to get them a mechanical wheelchair. But they will love you for it because they will be able to do things without working as hard. Unfortunately, it is being forced to work that slows down the progression of their illness.


This man’s wheelchair was not mechanical, but was still a concern. Dr. Osler asked if he would be interested in pulmonary rehabilitation classes, which is physical therapy and exercise.

“Oh no,” the man said, “I get plenty of exercise.”

“Well sir,” Dr. Osler said, looking at the man slumped in his wheelchair, his toes blue from lack of oxygen despite the tank hooked to his nostrils, “Don’t take this the wrong way, but you don’t look like you get plenty of exercise.”

“Sometimes I walk my wheelchair at the flea market,” he said.

“And he helps me take care of my goats,” his wife said. “I raise pygmy goats.”

“Any of you want a goat?” he offered, looking at the three physicians. Both Osler and Pasteur were trying not to chuckle at the coincidence. I perked up.

“Dr. Pasteur,” I said, “Would you be interested in a goat?”

“They are clean as a whistle,” the wife said. “They are even paper trained.”

Dr. Pasteur was staring at the ground and Dr. Osler buried his face in the chart. I decided to press the issue.

“Her goats,” I said with a benign smile, “are clean as a whistle.”

Uncynical Wednesdays: Colorblind

The pop song that I am most enjoying right now is the Nelly/ Tim McGraw duet “Over and Over.” I saw the video for it about a week ago, and the director was none too subtle about the undercurrent. In fact it should just be called the current or over-current. That though urban blacks and country whites are different, we are all the same deep down. Heartbreak is heartbreak. Of course, part of this may have been because most alternative visions for the song could have left the impression they were singing about each other.

But still, songs/acts that have tried to attract divergent groups have always had a soft spot in my heart. Even Ice-T’s Body Count, which was attacked by the president for its song ‘cop killer,’ pulled thrash-metal and gangsta rappers into the same venues. To hear Ice-T tell it, everyone got along splendidly.

I grew up feeling pretty comfortable around mixes. The junior high I went to was about 90% Black, the remaining 10% was made up of Hispanics and Anglos. By high school, it evened out to about 30%, 30%, 30%, the remaining 10% were a mix from around the world. So when I went to a small Christian college in Tennessee, I was a little freaked that out of 500 students there were only about 10 blacks . I tended to hang out with them. They were very cool and teased me by nicknaming me Tyrone.

When I transferred to the University of Iowa, my roommate was, like me, ethnically mixed. I look very Anglo: fair skinned, blond hair, and blue-eyes. He looked very mixed: mocha skin and the nappy hair that was popular in the early nineties.

Anyway, we had this running joke that we were some techno-pop band called Colorblind. We would do this annoying running gag as well-intentioned but insipid stars. We would stage interviews with Catie Couric talking about how racism was dead in America and how everyone should be like us. “Just be Colorblind” we’d say with jazz hands. In retrospect, it was kind of a weird joke that I don’t think I’m explaining very well. But it amused us. We would do these routines for, like, forty-five minutes at a time. We didn’t have many friends. I mean, outside of the performance artist circles.

Anyway, one more reason to like Tim McGraw, I mean besides the porn star goatee.

The Hours

Like every fourth day last month, I was Post-Call yesterday.

That means I went into the hospital in the morning two days ago, took care of the patients I already had under my care, spent the afternoon and night admitting new patients, took care of the new and old patients yesterday morning, and returned home. So I spent between 26-30 hours on that shift.

In the hospital, there is a cafeteria, where I eat when I can. I have a call room, where I sleep when I can. This is the mantra. Eat when you can; Sleep when you can. (If you will permit me to have a semicolon in my mantra.)

This is how the four day cycle works in the Medical Intensive Care Unit:

• Day one: Work 6 am- 7pm
• Day two: Show up at 9 am, work through next morning
  
• Day three: Leave by noon
• Day four: Work 6 am-1 pm
• Every other cycle, I had day four off

Eighteen months ago, an act of congress severely cut back the hours we are permitted to work. The new regulations set the following rules:

• No more than 80 hours per week.
• No longer than 30 hours per shift.
• No less than 10 hours between shifts.
• No more than 12 new admissions per 24 hours.
• No more than 24 patients under my care.
• One guaranteed day off per week.

What makes this doable, and it is doable, is that some months are not this intensive. This month I am working outpatient clinic, where things are considerably more relaxed. I am working simple 7:30-5:00 Monday through Friday, with two day weekends, for the most part.

There is much debate if the guaranteed day off means one calendar day (midnight to midnight) or 24 hour period. Our program has interpreted it as one 24 hour period. This means that some weekends this month I get off Friday 5 pm, work Saturday night 7 pm-7am, then return back Monday 7:30 am.

Anyway, some people sensed I was getting a bit crusty last week, even on the blog. So thought I would let you know that I’m likely to relax some in the coming days.