“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler






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 The Gazebo

In keeping with my "The Noun" rut of titling my posts, I will tell you about our gazebo. Yes, we have one. 

I should sort of explain about my dad. He was born during the Depression and grew up on a farm in eastern Pennsylvania, dirt poor. His family home did not have indoor plumbing until he was in high school (and he was the youngest of the family). The house had an outhouse and a pump in the kitchen sink. He once told me the story of how his older brother's dog accidentally fell into the "honey pit" under the outhouse. His brother was able to get the dog out, but the poor thing nearly drowned. What a horrible way to go that would have been. 

There was a local estate owner, a rich man, who went by the name of McFeely. My paternal grandfather used to work there hauling rocks, and my dad worked there too at some point. Anyway, my father admired the estate greatly and one of his motivations for purchasing this home and property was to emulate Mr. McFeely. Hence the gazebo, and a fountain, and a giant garage and a lot of other things. (Incidentally, Mr. McFeely had a grandson who was named Fred Rogers. Yes, that Fred Rogers.)

It isn't that large, maybe 12 feet across, large enough to hold a table and four chairs. The space underneath the gazebo has hosted many a family of feral cats over the years - at one point I started referring to their house as "the cat farm." It's a nice place to hang out after dinner, and the daughter of family friends actually got married in it (she had always loved it). 

My parents' caregivers were invited to their memorial services, both of which were at the house, and collected there to eat and chat. That was three months ago. Once I get the Boards recertification test over with I will wash off the furniture and take some of my meals there. But for now, I look up from my review books and look at the cupola, which is falling apart, and remember the good times that were held there. 

Labels: Family, Memories

posted by Dr. Alice at #

 

 The Car

I'm going to make this brief, because I really ought to be studying, but I also need a break from reviewing diagnosis and treatment of dementia (JUST what I want to hear about right now.) I have to recertify my boards in 45 days, and I cannot wait for this to be over with. 

At any rate, my father was a car man. He acquired cars the way some people acquire cats, and he was vastly reluctant to sell any of them, even when they were no longer being used. The only car I think he ever was eager to sell was a Jag XKE he got third hand, and he only sold it because he was tired of fixing it. (This happened when my sister and I were very young, and we never really forgave him for selling it. Every time he went on an errand we would go with him, and fight about who got to sit in the passenger seat and who had to squeeze in behind the seats - it was a two-seater.) But Jags are notorious for electrical problems, and this was no exception. So it was sold. 

I still don't know why, but a few years later he bought a Mercedes 600 - a limo. Then a second one. He had fun driving them for a few years but eventually they sat and moldered in the oversized garage he built after we moved to the house I live in now. The cars, of course, became nonfunctional after a while. One of them still is, but the other one has been slowly and painstakingly restored for the past three or four years by a local garage that specializes in Mercedes. I took my own car there for maintenance for a while, until I inherited my aunt's Subaru and sold the other car. 

The restoration project took years because that particular model of Mercedes is no longer made. The owner of the garage had to track down parts, remove and steam clean the gas tank as it was full of deposits and corrosion, and so forth. But just as I returned from my summer trip in mid-July I received a message from the owner that they had sold the business, were retiring, and needed to return the car to me. So I got help to clean and reorganize the garage, and donated all the medical equipment that was in there to make room for the car... and it was delivered this afternoon. 

It sat in the driveway and I opened the garage door for it. This car is a tank; eighteen feet long, six feet wide, a true model of mid-twentieth century auto engineering. Sitting in the driver's seat, I actually felt intimidated. It took me a minute to realize that the gearshift was on the steering wheel column and to figure out how to open the car door, even. I eased it in behind its twin, got out and admired it. 

Now, I have to figure out how to get it sold, and the other one too. As I said, the other car does not run. A couple of years ago my brother tracked down someone who specializes in vintage cars. He took a look at them and advised that we not restore them, as whoever buys them would probably like to do that themselves, but Dad really enjoyed the whole process and would have the caregivers drive him down to the garage about every other week so that he could have the owner bring him up to date. They were very kind and patient with him and they have told me more than once how much they enjoyed talking to him. I'm glad to have the car back for the moment, at least, to bring back memories as I drive it down the street to keep it in good condition.

Labels: Family, Memories

posted by Dr. Alice at #

 

 The Pool

I have been back at my parents' home for two and a half months now, and for whatever reason despite the summer heat have not used the pool once during that time. I think the last time anyone swam was the weekend of my mother's memorial service. My brother continues to pay for the upkeep of the pool and has been encouraging me to use it; today I finally did. 

The old pool house, which my father built to contain the pump and heater, is falling apart. The doors are too warped to close and I made a mental note to get that fixed as I poked around looking for the pool skimmer, which I was unable to find. I think our pool cleaner must be bringing his own. I had a sudden memory of one weekend morning years ago when my father, in his usual weekend mode of beat-up hooded sweatshirt and work pants torn at the knee, was working on the pump. It was a beautiful sunny morning and he looked happy. On an impulse I quickly ran upstairs to my room, fetched my camera and made him sit for his picture on the low wall outside the poolhouse. 

"Why?" he asked, clearly finding the whole thing amusing.

"I just want to," I answered. 

The picture came out really well; in fact I framed it and gave it to him for Christmas. It graced the mantel at his memorial service. It's so uniquely him and I'm so glad I took that picture. 

Finally, I gave up on the pool skimmer and stepped cautiously into the water, not wanting to slip on the steps. As I did so I had a sudden memory of my mother getting into the pool in exactly the same way, carefully, hoping the water wasn't going to be too cold. She was younger than I am now, I thought. 

The pool was as warm as a tub. I started swimming slow laps, pausing to pick leaves out of the pool and remembering how our dachshund Otto would run around the pool barking at us (he hated the water), clearly wondering what we were doing in there. On very hot days we would carefully lift him into the pool, no lower than the first step, to try and cool him off. He didn't appreciate the gesture. 

The pool is surrounded by postholes in the concrete, put there to hold a safety net to keep the grandchildren out of the pool when they were little. I suddenly remembered my sister holding her baby daughter in her swim diaper, letting her paddle in the water... my niece turned 24 this week. 

I had not expected to be overwhelmed by so many memories; as I swam my tears landed in chlorinated water. But the pool was soothing and was just what I needed on this hot day after studying for several hours (I have a recertification test coming up in two months).

Finally I got out, ready to come back to the silent house and get ready for tomorrow. At the top of my mental to-do list: pool skimmer. And my bathing suit is rinsed out and ready for my next swim. 

Labels: Family, Random Thoughts

posted by Dr. Alice at #

 

Back At the Old Stand

I have been living in my parents' house now for almost two months. We moved here when I was about eleven, and it's a little strange to be back. The house was built in the 1940s; family lore has it that it was based on the blueprints of the home featured in "Mr. Blandings Builds His Dream House," an old Cary Grant movie. I have never attempted to verify this, but it might be fun to research.

It's a five-bedroom house, currently featuring one resident: me. After the years of caregivers, when there were never fewer then four people here, it feels quite empty. That sensation hit me again when I came home late last week after a two weeks' trip to Europe and walked into a dark and silent building. This does not bother me unduly, as I am a major introvert, but it has been cheering to feel that the house has cheered up since my return (if such a thing is possible). 

I hadn't lived here for forty years, though I visited often. I haven't been plagued with constant childhood memories, but I sometimes look out into the backyard and visualize my sister's wedding reception, which was held here; our beloved family dachshund, now deceased many years; and my nieces and nephews exploring the house on their visits. My father loved this house and spent hours renovating it when we first moved in. He did much of the electrical rewiring himself to the point that no one else really understood which wall switch did what. He replaced and stained the wooden floors. 

My assignment is to get the house cleaned out and ready to be put on the market. That is going to take a while - I've made a little progress but not a lot. I am hoping to hold a garage sale at some point. That project, though, will need to take a back seat to my studying to recertify for the medical boards test which will take place in a little over two months. 

When I finally move, it will probably be into a condominium in Florida, which will be very different from here. I am looking forward to living there but the project has not yet broken ground. For now, I will get back to studying and thinking about what part of the house to address first. 

Labels: Changes, Family

posted by Dr. Alice at #

 

"I Need You to Take This Fish," 

...said my brother as we drove to the Pittsburgh airport. It was early November and we had traveled to our father's home town in Pennsylvania to give him the funeral he wanted. His ashes (to be precise, half of them; we still have the other half) had been interred in his parents' grave. The trip gave us a chance to spend time with my father's older sister and our cousins. Our aunt is the only one of the three siblings still alive; thankfully she is still completely alert and was very happy to see us. One of our cousins, a real outdoors type, gave John some frozen fish he had caught for the trip back across the country.

"It'll be fine!" he had said cheerily. "I have an insulated bag for it, just pack it in your suitcase." Not without misgivings, my brother had accepted the gift. But now we were running late and my brother had just remembered, first, that he only had a carry-on bag with him; and second, that he wasn't going directly home but to a sports function for his son.

So guess who got stuck with a bag of frozen fish in her suitcase? But time was short and we had no choice, so into my luggage it went. I had visions of ruined clothing all the way back to Los Angeles. But luck was with me; the early morning Pittsburgh temperatures were below freezing and I changed planes in Denver (pretty cold there as well). When I landed at LAX it was a cool, foggy day. As I stood in the rideshare line, my brother texted me: "How's the fish?"

"Not home yet," I responded tersely. As soon as I made it home I hauled my bag into the dining room, put it up on the table and began digging through it. To my relief it was still frozen solid. I don't know who manufactures that insulated bag, but I need to get one. 

The fish was stored in my freezer for a few weeks, at which point it resumed its journey to my parents' house for Thanksgiving. My brother and his family took it home with them after the holiday. 

And that is my epic fish story. 

Labels: Family, Holidays, Loss

posted by Dr. Alice at #

 

 The Family Gathers

My brother and sister arrive today with their families for my mother's service, which takes place tomorrow. They all have to leave on Sunday; unfortunately we all are too busy for this to be an extended stay. The place looks nice, with flowers in bloom (courtesy of the local nursery; they probably won't last a week after the service) and windows freshly washed. 

This is a large house, and I'm going to be the only one living here. I'm getting used to the little pops and clicks you hear in any house; when the icemaker goes off I no longer assume that there's a serial killer standing behind me, making ice. And I now have a coyote that visits in the early morning. He just ghosted across the patio and up the brick stairs toward the street. I'm going to be living here full-time starting in June, assuming I survive the next two weeks before the move. 

Going back to my mother, her death was both expected and unexpected. She had Covid at Christmas in 2020 and was never really the same afterward, although she did not have to be hospitalized. She developed a terrible, racking cough which improved for a while and then worsened again in the last few months of her life. When she was in the hospital, the respiratory technician looking at her blood gases  kept asking, "Are you sure she didn't smoke?" Finally I explained about the Covid and he immediately said, "Oh, that explains it." This despite her chest X-ray not showing any significant abnormalities.

Then my aunt (her sister) died, followed by my father six weeks later. I have written extensively about my aunt's illness, but not my father's. He had vascular dementia related to strokes and hypertension. The week after my aunt died, with the distraction of her illness gone, I was able to really look at him for the first time in weeks and realized how much weight he had lost due to his dwindling appetite. After a quick family discussion, I put him on hospice and he passed away in his sleep a month later. Mom never really recovered from those twin losses. She was very depressed, but when we held my father's celebration of life in August and she was able to see many of her friends, she did surprisingly well. It was the last real social event she attended. 

Many of her friends offered to take her out for lunch and the caregivers did take her out once or twice, but more and more she slipped into isolation. In December she was hospitalized, twice in January, and then she became more confused and died at the beginning of February when her oxygen level suddenly dropped and she began coughing up blood. It was shocking and sudden; none of the imaging or tests she had indicated that something like this was going to happen. When asked what had happened, my stock answer was "I could give you half a dozen possible explanations, but I don't know exactly what it was." I am sure there was some sort of pulmonary cause, but none of us in the family saw any reason to do an autopsy.

When she died, I had left her just a few hours before to drive back to my house and run errands. I do so wish I had been there when she passed away, but I did get to spend the previous evening with her, and I take some comfort in that. 

I hope to write more about her later, but I can't face it just yet, and there is much to be done before my siblings arrive. Must go.

Labels: Changes, Family, Loss

posted by Dr. Alice at #

 
It's Time, It's Time, It's Time

Labels: Family, Random Thoughts

posted by Dr. Alice at #

 

Personal Update 

I am settled in here in my mother's hospital room for her third admission in a month. 

At least, that's what I wrote back on the 22nd of January. My mother passed away on February 4; my father on June 19 of last year. My aunt died May 8 of last year. 

It's been a difficult time. I have been writing, just not on the blog. I started keeping a journal last December with the intention of using it to clarify what I want to do both for myself and for my mother. But my mother never really recovered from the twin blows of losing her only sister and her husband six weeks apart. My siblings and I are planning a celebration of life for her which will take place in about ten days; I am in the process of selling my house and moving to my parents' home so that I can get it into shape to sell. 

I'm not going back to work, at least not full time; I am considering working virtual sessions to keep myself busy when I'm not throwing out junk or battling spiders. (I sometimes think my parent's house is one solid cobweb.) But right now I am packing and sorting, and I hope to put together an estate sale at some point. And I hope to document the process here (at least the interesting part). 

Labels: Family, The Doctor's Life

posted by Dr. Alice at #

 

The New Normal

The process of dying, I have come to realize, is a procession of "new normals"; much like aging, but at an accelerated pace. It's frightening to look back at what my aunt could do three months ago and where she is now: bedbound and unconscious. It happens in stages.

- She went from needing assistance to walk, to a walker, to a wheelchair.

- When she first came to stay she was able to go upstairs and to shower by herself. First she lost the ability to climb stairs. We cleaned out a room used as an office on the ground floor and she moved in there. Hospice provided an aide to help her shower; that came next. 

- The bathroom. One morning she was standing brushing her teeth, turned around, lost her balance and fell (I was standing nearby and was able to catch her; no harm was done). After that I insisted that she have an escort to the bathroom. Then she needed full support. One morning as I was holding her she could not take one more step. After that it was the bedside commode. 

- Being able to stand. For a long time she insisted on eating breakfast in the kitchen and going to her chair in the living room, but in the past two weeks she has been restricted to her room. Using diapers was the last taboo; she required three people to get her out of bed and on/off the commode and to dress/undress her as she could not support herself.

- for the past week she has been minimally responsive, gradually becoming unconscious. The medications (morphine, lorazepam) have helped a lot. She fought their use for a while, as she had been a very successful member of a twelve step program for decades; but we kept explaining patiently that there was no reason for her not to use the medications. The pain finally convinced her to agree to their use.

Now we wait. I believe she has only hours left. Helping someone to die at home is incredibly difficult but also rewarding (especially given that, had she been placed in a facility, she would have had no visitors or independence; I think she would have died much sooner). 

I'm too tired to say anything else right now.

Labels: Cancer, Family

posted by Dr. Alice at #

 

 Roses

My aunt loves roses and grew them in her backyard in the desert. (There are heat resistant roses available; a neighbor of hers once insisted on growing English roses, spent a fair amount of money on them and then watched them die in the heat and relentless sun.) Her friends who have come to visit have cut and brought the blooms with them. The living room smells of roses. 

Yesterday she developed chest pain, likely due to the tumor infiltrating into her chest wall. She is now on regular doses of morphine and benzodiazepine (for the anxiety and agitation). Hospice is coming daily. She is taking liquids by mouth but very little food. 

We vacillate between long hours of nothing as she sleeps punctuated by a concerted effort to get her to the toilet, calm her, change her clothing. I pass the downtime by cleaning the kitchen and clicking from Facebook, to Twitter, to email. The house is hushed. It is a waiting game now. 

I hope her passing is peaceful. 

Labels: Cancer, Family, Medicine

posted by Dr. Alice at #

 

 The Dying Patient

They don't tell you what it's like to be with someone who's dying. As in, being there all the time, day in and day out. Sometimes I wonder if even the hospice doctors and staff know. It isn't that they are not kind. But the nurse, who currently is coming twice per week, checks vitals and asks about bowel movements - "Do you have any questions?" and then she is out the door within 15 minutes. I do not say this to criticize, as I have done my share of such visits. But after a while it is hard to know what to do or say, how to pass the time when not focused on such minutia. 

My aunt is suffering. Not to say that she is in pain, but she is a very social person and has always been someone who likes to stay active and do things. At holiday dinners, rather than sitting around with a cup of coffee she was always the one cleaning the kitchen or getting the meat off the turkey carcass. Now she is too weak to walk and too confused to focus. She cannot get much enjoyment from reading; cannot remember which of her friends has called her from hour to hour. Her sole consolation is conversation and I am not the best source of that. I have tried to think of entertaining topics but have long since run dry. My father is too demented to talk to her and my mother is too hard of hearing; plus my aunt has suffered vocal cord paralysis due to the tumor and can barely make herself heard.

Two days ago she told me she wanted to pursue assisted suicide (I think the preferred term is "assisted euthanasia" these days). Her first discussion with the hospice doctor is scheduled for tomorrow. I don't see how she could not qualify, I just don't know whether she will be able to last the next two-plus weeks until all the criteria are met. We should perhaps have discussed this sooner, and I feel badly about that now. I told her that once again she was a groundbreaker, as she has been so often in her life. 

She was raised in a small Southern town and went on to teach as a career - not much else was open to women in those days. Her first marriage, the product of elopement, failed shortly after she moved to Alaska (her husband was transferred there). She went on to marry again, and eventually left her second husband for a female partner. That relationship lasted 25 years. She successfully fought cancer once and then developed lung cancer more than ten years later. She has traveled, volunteered, has made many friends and excelled at entertaining them. 

Religion is not a consolation for her, she puts her trust in friends and enjoying life. She has outlived her prognosis by nearly three weeks, but I don't know how much longer this is going to go on. All I can do is to be here, and it is humbling. 

Labels: Family, Medicine, Random Thoughts

posted by Dr. Alice at #

 

Therapy Session

Back I am at the blog, in search of counseling. Did I mention that this blog serves as my makeshift therapist? I visualize it as female, of no particular appearance, leaning forward, professionally caring but geared to forcing the truth out of me. 

Then we sit and look at whatever this truth is. 

Well, (I brace myself,) the past month has been a little tough. It's indisputable that my father's dementia is getting worse. His sister called last week to speak with him and then asked to talk to me; she wanted to know how he's doing. He can't really carry on a conversation any more, though he is always glad to hear from her. I think he had another stroke about a month ago; he has to be coaxed to eat, and often falls asleep during breakfast or dinner. He can't tell us when he has to go to the bathroom any more and is often incontinent without being aware of it. In addition to that my aunt, the one with metastatic lung cancer - remember? She's on hospice now - is becoming weaker and weaker. She is eating less and her weight loss is accelerating. A few weeks ago I made the decision to move in with them, and I've been staying there more or less full time. 

This means I won't be seeing patients for now. Not that I was seeing many, just one four hour shift per week, but it was something. It made me feel like a doctor again and not just an overloaded daughter, gave me a chance to dust off my skills rather than letting them atrophy. Even virtual visits are not an option, as it has become impossible to spend four uninterrupted hours online due to the needs of my parents and aunt.

My aunt is my main responsibility right now. She is becoming increasingly confused as well as having major memory loss (probably due to the chemo and radiation). She isn't able to keep herself occupied with much - she does read but I don't know how much of the book she retains day to day. In an effort to give her variety, I tried to show her how to use my Kindle but she simply could not fathom it, even after I set up a book for her with a large font. She could not remember how to tap it to turn the pages. Physically, she is wheelchair bound and requires oxygen at all times. Even taking her to the bathroom has become a significant journey.

Her friends have been very supportive and have made the drive from the Palm Springs area many times in the past two months to visit. Two came yesterday and two more are coming today; yesterday, two men (partners) and today two women (also partners). The women have a lovely long-haired dachshund that loves my aunt, and my aunt loves her right back. I will miss seeing her today as I had to go into town for an orthodontist's appointment (my treatments are over and I am graduating to a retainer, hooray!)

My aunt has outlived her prognosis, I think due to force of will alone. Major props to her for this. Taking care of her has taught me a lot, as I have never seen major illness from the family point of view before - only as a physician. Eventually I will go back to work part time, and I hope I will take what I have learned with me.  

I don't know whether all of this commentary adds up to anything or not. At least it is a relief to put it down.

Labels: Family, Random Thoughts, The Doctor's Life

posted by Dr. Alice at #

 
"But I'm Feeling MUCH Better Now!"

Labels: Family, Pop Culture

posted by Dr. Alice at #

 
In Mourning

This past week I lost a friend, the husband of my good friend V. Shortly before Christmas he became very ill and after several weeks in intensive care he passed away. He would have turned 62 today.

R was an unassuming, yet fun and interesting, man. His interests included astronomy, woodworking, music (especially novelty music - his Christmas CDs have to be heard to be believed) and dogs. He dabbled in brewing his own beer. He was a wonderful father and was always to be seen at his children's soccer and softball games, acting as team photographer. He was proud of his Irish heritage and every St. Patrick's day he and V threw a huge neighborhood party.

A hospitable couple, they made me welcome on summer weekends - I would drop by, bringing wine and appetizers, and R would fire up the barbecue after we swam in the pool.

I will miss him very much; he will be missed by many. The funeral is in a week and I am sure the church will be full.

Labels: Family, Random Thoughts

posted by Dr. Alice at #

 
Nine Days Later

Well. Dad got through the aortic valve procedure okay, I am glad to say. The one-week follow up did not go so well. I don't want to throw in too much detail but he had a lot of swelling and pain which developed after he was discharged from the hospital. He of course did not share this with anyone, including my mother, until the night before the appointment. He insisted on wearing an old pair of scrubs to this appointment, as he could not put on a pair of pants - but he could not tie the scrubs and his pants kept falling down. (I sent an urgent memo to my mother to get him some sweat pants ASAP.)

He had to have a lot of neurologic testing done that day which further delayed us, and the cardiologist who had presided over the AV replacement wanted him to have an ultrasound. Long story short, we did not get home until after 9 pm, at which point my mother realized that she had lost the key to her car.

So I drove the 30 miles or so to their home and picked up the spare key, then drove back, then realized I had lost my cell phone.

That was the worst day by far. The rest of the summer was still pretty hairy, but nothing like as bad. While all this was going on, one of my co-workers was out of the office due to a severe illness of a family member; add all this up and you can probably see why I have not posted in a while.

But it's fall now, things seem much better and I'm going to leave it at that. It's time to get back to my usual ramblings.

Labels: Family, Medicine

posted by Dr. Alice at #

 
Plunged Into Caregiving

About four months ago my mother asked me to call my father's cardiologist to get clarification on something - "He wants us to do some testing. Is this really necessary?" So I did.

"Your father has aortic stenosis," the cardiologist said without preamble (he knows I'm an MD), "and it's pretty significant."

My attitude when we opened the conversation had been doctor-to-doctor. Now suddenly all that vanished and I was repeating, in a very small voice, "Dad has aortic stenosis?"

The gist of the conversation: yes he did, and furthermore it was getting worse, and the cardiologist wanted to do an angiogram. One angiogram later, Dad had a stent in his right coronary artery but still no clear word on the valve. Cardiologist #1 suggested that we see his pal, Cardiologist #2, an expert in aortic valve problems. By a stroke of luck #2 works at my hospital, Tertiary Care Medical Center.

This guy is hardcore. He has a large office in the very newest building on the hospital campus. Each room has a chair that looks a bit like a recliner, which doubles as a scale. Yes, they press a button and the chair raises a few inches off the ground and they weigh the patient sitting in the chair. He also has a fleet of nurse practitioners and technicians, high grade office equipment and the ability to perform echocardiograms in the exam rooms. The tech clearly knew what he was doing but still could not get a clear picture of Dad's valve. He pressed a button on the room's intercom, ordered a bag of contrast and this was infused through a vein, right in the exam room, by a nurse who appeared out of nowhere.

It's wonderful what money can buy. I guarantee you that no internist or primary care doctor has facilities like this.

After this, we found that the AS was really quite bad indeed. Dad needed a valve replacement as soon as possible. We all agreed that the traditional method (aka "cracking the chest") was not a good idea as Dad is not in the best medical condition. He has a history of several strokes and some dementia. Cardiologist #2 specializes in valve replacement via the femoral artery. How he does this I have no idea, but overall it is less stressful and risky than open chest valve replacement.

Today we go for the final round of preoperative assessments and tests. He is having more of a workup than average because he's been entered into a study wherein the surgeon places a filter in the aortic arch before doing the valve replacement, which should lessen the risk of additional strokes. Tomorrow, if all goes well, he has the procedure.

I have been in charge since the workup started: transport to the hospital, spending the night in the hospital with Dad postprocedure and translating developments to the rest of the family. I now really empathize with patients who get confused and lost, and who complain about having to go to the doctor all the time; I am learning exactly how that feels. As you can imagine, I've had to do some canceling and reworking of my office schedule, but I really don't care. All I want is for this to work.

Wish us luck.

Labels: Family, Medicine, Science

posted by Dr. Alice at #