Feet First

“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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    Wednesday, November 26, 2003
    Not Thanksgiving Day, But Still a Day of Note

    Hi there. Quick check-in for you.

    Multitasking this morning: I'm blogging and I'm on call and I'm waiting till it's time to leave for the airport and I'm celebrating my birthday. Seems emblematic of the past year: I spent most of my time doing something while simultaneously doing something else. This is probably why it seems so unimportant that I'm turning the big 4-0 today.

    (Question from the peanut gallery: If it's so unimportant, why do you mention it? Answer: To have something to blog about, of course.)

    Seriously, I managed to spend the last few months barely cognizant of the fact that said birthday was approaching. Boards will do that to you. I ponder it at odd moments, like while brushing my teeth, and of course when inputting my age on the elliptical trainer at the gym. I know it's none of its damn business how old I am, but it's just trying to help. It also comes to mind when my sister calls me up, as she did last night, and leaves messages like "This is the last time you'll be thirty-nine!" Nevertheless, I say bring it on. Give me a fresh new year, better than the old year.

    I have requested scuba diving lessons from my family for my birthday: I want to start making some inroads on that "life goals" list I drew up a few months ago. I want to challenge myself. But fear not, I have no intention of taking up skydiving... the idea of being thirty feet underwater and possibly confronting a great white shark is more than enough for me. (Note: I also have to stop visualizing worst-case scenarios.)

    Well, that's it for now. I will clock in again after the holiday - happy Thanksgiving to you all in the States, and for those of you not in the States, have a great rest of the week and weekend.

    Tuesday, November 25, 2003
    Yuletide Sign of the Apocalypse, Part II

    See for yourself.

    Oh My God

    If this doesn't qualify as a Yuletide Sign of the Apocalypse, I don't know what does.

    Ancient Habitrail?

    This article brings back memories of my mother yelling, "Alice, take care of that hamster cage! That poor animal hasn't had its cage cleaned in 17 million years!"

    Monday, November 24, 2003
    Midnight Caller

    I was fathoms deep in REM sleep when the pager went off. I usually snap awake within a couple of seconds when this happens, but that night it took nearly a minute to shake off denial, pick up the phone, and dial my voicemail number.

    I recognized the voice of the woman leaving the message. She's a nutcase (I know this is judgemental and un-PC and all that, but I'm going to be honest) who has called many times in the past, always requesting antibiotics on slim grounds. Fortunately, she's not a member of my practice; she belongs to one of my partners who is known for having a large stable of wacko patients. While I was listening to her message and trying to write down her phone number, the pager went off again. Same woman. Total time elapsed between pages: maybe four minutes.

    She wanted antibiotics again, despite just having completed a course of antibiotics. She was coughing, you see.

    "Are you taking anything for your cough?" I asked.

    Of course not, she didn't need cough meds, she needed antibiotics, she replied.

    I begged to differ. This led to a discussion that lasted a good ten minutes (that's par for the course with this woman). I told her I would call medicine for her cough and call her primary care physician the next day, but that I didn't think she needed another course of antibiotics one day after finishing the previous one.

    Another time I got a phone call in the middle of the night from another patient (also a member of Doctor X's practice) who left a long, semi-hysterical message on the voicemail about how she couldn't sleep and she was going nuts and she really, really had to sleep. So I called her up and, lo and behold, she had a prescription of chloral hydrate sitting in her house all ready to use; she just wanted to talk to somebody first. Half asleep, I told her yes, yes, just take the medication.

    On my next call night, she pulled the same trick again at one-thirty in the morning. Same hysterical message on the voicemail.

    This time I dialed her up and, when she answered, I hissed, "Don't you ever do that again!"

    I never heard from her again.

    Saturday, November 22, 2003
    Holiday Shopping Tip

    (Obligatory disclaimer: I have no interest, financial or otherwise, in the website listed below.)

    Need help shopping for your boss, neighbor, in-law, or "friend who has everything"? (How many of those do you know? I can't think of one, frankly.) Well, agonize no more: Dr. Alice is here to save your hide.

    There's a company called cafepress.com which specializes in personalized items (T shirts, coffee mugs, bumper stickers, etc.) for many different websites. The one I'd recommend is Ideogear. Ideogear will take a word and supply you with the kanji, or Chinese ideogram, for that word. (I gave one friend a coffee mug marked "doctor," another a mug with the kanji for "prayer.")

    The options are limitless: pick your recipient's hobby, profession, or other interest and give them something personalized with the corrresponding kanji. And you can order online, and they'll deliver.

    There. Don't you feel better now that all that gift-giving pressure is gone?

    Friday, November 21, 2003
    Is It Friday Yet?

    I've been a bad blogger... neglectful of my duties. The last few days I've really had nothing to say. Well, not nothing, exactly. I just didn't feel like inflicting every little gnat-like thought floating through my cerebral cortex on you, my patient readers.

    BUT. Our monthly physicians' meeting has been canceled, leaving me with time on my hands and an urge to communicate.

    The weather in LA has changed significantly since last month's fires; it rained hard Halloween night and it's been cool ever since (into the forties at night). I was delighted to return from Mexico's hot and humid nights so that I could enjoy curling under the blankets again. Years ago, many houses used to boast a sleeping porch - a tradition I'd like to revive. Every year at this time I wish I had one; maybe someday I'll add one on.

    This Sunday is the feast of Christ the King - the last Sunday of the liturgical year, which starts over again with the first Sunday of Advent (on November 30 this year). It also marks my debut as verger at St. James'. Yep, I get to wear the robes and carry the stick. I just hope I can get through the service without screwing things up... wish me luck. (Fortunately, I'm being trained by our head verger, who's been doing this for years and knows absolutely EVERYTHING.)

    And, last but not least, my birthday's next week. I got an anxious call from my mother asking what I'd like to mark the occasion. And it is an occasion... I'm turning forty.

    I can't believe this. Internally I think I'm still, I don't know, 29 or something. I don't think anyone actually visualizes themselves turning forty, or fifty, or sixty.

    I had more to say on this subject, but I'm getting buried in the Friday-afternoon rush, so will stop here and pick up on the topic later.

    Wednesday, November 19, 2003
    Bad Baby Names

    I must, must, must give props to Ilyka for this one: unbelievably bad, real-life baby names. You'll laugh, you'll shudder, you'll roll your eyes.

    Tuesday, November 18, 2003
    Whoa, This Is Worrisome

    Microsoft fires worker over weblog

    This is one of the reasons why I try not to give too many details about my work. Unless, of course, they're too funny/juicy/unbelievable to pass up. Caution always pays, though. I wonder if HIPAA covers weblogs? Our risk manager would probably have a fit if she knew about Feet First.

    Well, I have no plans to change anything for the time being - just to try to change any identifying details in stuff that I post, as I always have.

    In other news, the Leonid shower is tonight. V. and her husband and I will be trying to catch a glimpse of a falling star or two. L.A. is probably the world's worst place to try to starwatch, though. If a giant meteor were to land in Southern California, my last words would probably be "Hey, I think I see someth..." KAPOW!

    New Dr. Who

    Could you see Rowan Atkinson as the next Dr. Who? Or even... Eddie Izzard?? It could happen.

    Koo Koo Roo Entree Lookalike

    Click here. Then try to tell me I'm wrong.

    Oh, and I love where they pinned his competitor's number, don't you?

    Monday, November 17, 2003
    Hi, I'm Back

    What did I do on my vacation? I went to Mexico, sat on the beach, and read till my eyeballs fell out. I was also lucky enough to be offered a ticket to The Phantom of the Opera by a friend who had a spare (thanks, Mary!) I'd seen it before, but not for years - I'd forgotten how much fun Phantom is. Bring on the hidden passages, the subterranean lake and the great music! I'm not that much of an Andrew Lloyd Webber fan, but his music for Phantom really holds up well.

    Various and sundry links for your viewing pleasure:

    A very funny article in the Onion - Mom Finds Out About Blog - and the response, via Blogger.

    The trailer for Harry Potter and the Prisoner of Azkaban is viewable here. Looks good. The movie is scheduled for release in June 2004.

    And then there's the Church Sign Generator, for those of you who have not already seen this. This could be particularly cathartic for any Episcopalians coping with the Impending Schism situation right now. ("Bite me, Griswold!")

    Saturday, November 08, 2003
    Off Track

    In the LAUSD [L.A. Unified School District] these days, you often don't get the traditional September-to-June schedule anymore; they teach all year round to get more use out of the existing school facilities and serve more students. Teachers and students still get time off in six-week blocks, but they now call it being "off track." When you're working, you're "on track."

    Well, I've been on track a hell of a long time and now I'm going off track for a week. If you want to know where I'm going, click here. I'll see you in a week.

    Friday, November 07, 2003
    What If You Were Only Born With Middle Fingers? and Other Questions

    I think you'll enjoy this post from Paulapalooza. If you know any six-year-olds, or have ever been the parent of a six-year-old, or have been forced to answer question after question from a six-year-old, all on the same subject, you will definitely enjoy it.

    The Boards

    In case you're wondering, I have proof that there is a God. The proof? Out of four hundred candidates, it was V. who was assigned to sit next to me during the Boards exam. For those of you who don't know, V. is my best friend at work. She's an endocrinologist/internist. We both had to recertify (she in Endo, I in General Internal Medicine) and we both had the jitters.

    The recertification process is relatively new. Only docs who were board-certified after 1989 have to do this; in other words, V. does not have to recertify in Internal Medicine, only in Endocrinology (she finished her Endo fellowship after '89). I sat the Boards the first time in 1993, which means that I'll have to go through this once a decade for the rest of my professional life. Having done it, though, I can say that it's no longer something to be dreaded. Hopefully it will eventually become a relatively routine process, though it will always be a pain. By the end of the whole thing, V. and I were thinking about what would be going on in our lives next time around:

    "The next time we do this, David [her son] will have his learner's permit." So will my niece, for that matter.

    We took the test in Pasadena, in the city's big Exhibit Hall; her husband's office is five minutes away. We each had to complete three modules, each lasting two hours consisting of sixty questions. When we were done, we staggered out and drove to Bob's office, where he took us to a Mexican restaurant a block away and we consumed margaritas and a platter of appetizers.

    At least it was only one day; the first time you certify it's a two-day test, eight hours each day. That was bad.

    Thursday, November 06, 2003
    I Wasn't Embarrassed To Admit To Being a Californian...

    until I read this.

    You've Probably Already Seen This...

    but just in case you haven't, they found Nemo.


    It's over!!
    More to follow.

    Tuesday, November 04, 2003
    Bummer, Man

    Per L.A. Observed, our local news station KNX has axed its nightly hour of old-time radio drama. The final episode aired last Friday night; fittingly for Halloween, it was "War of the Worlds." This saddens me. I didn't tune in every night, but it was great to hear some of those old shows - "Gunsmoke," "Dragnet," and "The Lone Ranger" among others.

    Some nights when I was either on call and coming back from the hospital, or just leaving the office really late, I'd turn on the radio to KNX and drive slowly, listening to the sound effects, corny music and snappy dialogue. Radio really is a "Theater of the Mind," as they say... it's amazing how wrapped up you can get in the action, driving along. Some nights I'd pull into the garage and sit there for another five minutes, waiting for the show to end.

    My dad used to do the same thing; KNX has had a "Drama Hour" for decades. He'd sit in the driveway, too, waiting for the Lone Ranger to track down his man and bring him in, or for Marshal Matt Dillon to solve the problems of the town and have a chat with Miss Kitty on the side. (Incidentally, did you know that the actor who played Matt Dillon on the radio was William Conrad?) The first time I heard that, I almost lost control of the car, I was laughing so hard.)

    If I ever want to hear those shows again I'll probably have to buy them on tape or CD or something. Unless we, the radio audience, get lucky and some other station decides to pick up where they left off.

    "Click the Refresh Button, or Take a Cold Shower and Try Again Later"

    Via Ernie:

    The 404 Porn Not Found button. No, it's not particularly dirty, just funny.

    Monday, November 03, 2003
    Smallpox: The Musical

    Somebody has actually come up with these lyrics:

    The halls are awash, with the sound of mucus
    And everyday ills, are now shown the door.
    'Cause deep in our hearts, what has so confused us, is fevers and pustules and festering sores

    Catchy, eh? Armageddon, musical style!

    Sunday, November 02, 2003
    Again With the Dilbert

    Those of you who know me will find this cartoon very funny. Alice is definitely my favorite Dilbert character.


    Well. I thought I�d take a few minutes on my dinner break to fill you in on my life before I go back to hitting the books:

    1. Boards are in three days. I think I�ll be okay � I think. I just need to keep studying a bit longer. I now realize that I should have started sooner, of course; ten years from now (if I�m still in practice then) I�ll begin this process at least a year ahead of time.

    2. The latest complication in this recertification farce is that two of my home-study modules have been fired back at me; apparently I failed Rheumatology and Cardiology. (Ironically, I had a cardiologist helping me with most of the answers to the damned test!) So I have to get those done and resubmitted before the end of the year � the saving grace, though, is that I don�t have to redo a new sixty-question booklet, just the ones I got wrong. The Board tells you which answers you got wrong, so it should be easy enough to go back and fix them. I�ll get to that after the test is over.

    3. I almost got denied access to the stupid test because the Board managed to lose my admission card in the mail. The only reason I found out about this in time to do anything about it is because my friend V. is taking her Endocrinology recertification exam on the same day and called to ask if I�d gotten my card. (�What card?" Cue the panic.) I called and begged for a new card to be sent to me and only received it yesterday. God bless V. She�s the only bright spot in this ordeal. We�ll both be in Pasadena all day on Wednesday � wish us luck.

    4. Hmm, so Gene Robinson got ordained. I had been following this whole issue with interest until about a month ago, at which point Test Panic overtook me and I turned into the most self-centered person on earth. Screw the ordination� what about my test?? At this point, I�ve more or less elected not to think about anything controversial or distracting for the next 72 hours. As always, Jack has an impressive number of links handy if you�re interested in following this issue. I will say this: it�s not over. Any optimists who thought the ordination of Gene Robinson would put an end to the controversy, think again. It will be interesting to see what happens within the ECUSA and the Anglican Communion as a whole over the next six to twelve months - but in much the same way that a train wreck is interesting. No, I'm not leaving my church. I have no desire to; more importantly, I feel I was called there and that's where I belong. If tensions arise locally - and I must say, so far I've seen no signs of that developing - I hope I can help in some way. Constructive, not obstructive; that's my motto.

    That's all, folks. Back to the books.