“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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Happy New Year


Well. The office has been closed for a couple of hours, but I am still here, piddling, surfing the Net and taking phone calls. I'm on call tonight (I volunteered), which suits me fine - I've never been a big New Year's Eve fan. My favorite New Year's Eve memory is still from when I was seven or eight and went to a sleepover birthday party at the home of a classmate, whose birthday just happened to be December 31st. I remember their home clearly. My friend's parents were hip and young, or maybe they just seemed younger than my parents - they lived in one of the newer housing developments in my town, and their house had a wine cellar (a wine cellar! I'd never met anyone else who had one) and a sunken living room with a white shag rug. Every year they had an enormous tree, flocked white to match the rug, and it was the most glamorous thing I had ever seen. Bear in mind this was 1972 or so.

At any rate, we brought our sleeping bags and bedded down in the glamorous living room next to that flocked tree. We stayed up all night, or close to it, and I was pretty grouchy the next day due to lack of sleep. My party favor, a scented candle shaped like a pine cone, graced our bathroom for years afterwards.

It's odd to have such a clear memory of what was, after all, just a slumber party. None of my other New Year's Eves ever measured up to it, though; my second favorite Eve ever was several years ago and consisted of me at the computer with a bowl of M&M's while my parents went to the neighbors' boring party down the street. Tonight, I can tell, will not be a standout evening. I can hear the chants of Palestinian protesters from up the street while I fend off calls from neurotic patients (okay, they're not all neurotic, but I'm getting some real winners tonight). I didn't know the Israeli consulate was a block away from the office until this week, when the protesters started showing up.

Still, things are not bad. My parents are healthy - in fact, my entire family is healthy - and this is a major blessing. I have a job; knock on wood, I will continue to have one. Tomorrow I will go to Pasadena with my parents and my aunt to see the Tournament of Roses Parade, and the forecast is for nice weather.

Happy New Year to all the partyphobes out there, and remember, there's nothing like a bowl of M&Ms and the Internet on New Year's Eve. Unless you've been invited to a slumber party.

Labels: The Doctor's Life

posted by Dr. Alice at #

 
I've Been Tagged!



Thanks to Dr. Mabuse, who tagged me with the following:


1. Link to the person who tagged you.

2. Post the rules on your blog.

3. Write six random things about yourself.

4. Tag six people at the end of your post and link to them.

5. Let each person know they've been tagged and leave a comment on their blog.

6. Let the tagger know when your entry is up.


Hmmm, six random things. Here we go:

1. I read cookbooks for fun, and I own way too many of them - easily over sixty.


2. I'm a salt person - if you let me choose between potato chips and chocolate, I'd pick the potato chips every time.


3. I'm way behind on movie watching; I saw Titanic for the first time two nights ago, and it's eleven years old! (Thanks, V. for hosting the movie night!)


4. I celebrate Talk Like a Pirate Day every year. At work. It bolsters my reputation as an eccentric.


5. I'm a huge fan of conductor Christian Zacharias and have flown to New York and Philadelphia to hear him. I think that makes me a groupie.


6. If I find a character actor I like, I'll look up every film or TV show he or she has done on IMDb.com and then TiVo or rent them. Netflix is very helpful in this regard now that so many TV shows are on DVD.

Six people to link to... hmm. I'll pick the Kitchen Hand, The Food Whore, The Pissed Kitty, The Head Nurse, Anne, and Shauny.

Labels: The Doctor's Life

posted by Dr. Alice at #

 
A Holiday Activity Sure to Catch On

Fruitcake shuffleboard.

(Hat tip to Dave Barry)

Labels: Pop Culture

posted by Dr. Alice at #

 

The Rain in Spain Transcribes Mainly in the Plain

My struggles with using this dictation system continue. Although it works well most of the time, occasionally either my diction or the program slips up and the progress notes that result are, shall we say, interesting. One might almost call them surreal. For instance, "carb loading" comes out as "car bloating." Earlier today I used the word "incessant" and the program helpfully transcribed "incest and" instead. That could have been a disaster; thank goodness I caught it before I signed the note.

Sometimes you just have to take your humor where you can find it.

Labels: The Doctor's Life

posted by Dr. Alice at #

 
Merry Christmas! Please File my Advanced Care Directive



It's that time of year again. The time of year that primary care doctors get a shower of cards and occasional gifts from nursing home corporations, orthopedists, neurosurgeons and hospital administrators.

And patients.

Some patients still bring in gifts and send me cards for the holidays, which I find quite heartwarming. It's nice to get the occasional expression of gratitude. I think this tradition has tapered off a bit in these days of managed care - I remember when my father used to bring box after box of See's Candy home from the office at Christmastime. Most of it was redistributed to friends and relatives, but given half a chance my sister and I would go through the boxes first picking out our favorites. I think perhaps the Starbucks Gift Card has replaced the box of candy as the standard gift, now that caffeine is more socially acceptable than sugar.

I cherish the slightly off-the-wall gifts I have received in the past, such as the plastic doodad a physical therapy office once sent me. It had four arms all of which ended in knobs and turned out to be a back massager; my secretary demonstrated by grabbing it and running it over my upper back. Yeowch.

The cards are nice, too. The ones from specialists often come with calendars (especially useful, they go into exam rooms to help me figure out the date when the patient's symptoms started or the date they're scheduled to go back to work). The most touching ones are those with shaky signatures from my elderly patients. Some are so isolated that I may be the only person in their lives to whom they send a card.

But the funniest one this season has to be the card I got a few days ago, included with the patient's completed copy of an Advanced Healthcare Directive. The message inside? It became the title of this post.

Labels: The Doctor's Life

posted by Dr. Alice at #

 
Space Station Flyby

Per L.A. Observed, the space station will be passing overhead tonight about 5:21 p.m. Here's a diagram:




UPDATE. V. and I stood out on the balcony for ten minutes watching for the ISS to pass overhead. Never saw it.

Labels: Science

posted by Dr. Alice at #

 
P4P4P4P

We're deep into the madness of P4P (pay for performance) here, in case you're wondering why I haven't posted much lately. This basically means tracking down all patients who haven't had their diabetes checked/ gotten their pap smears/ had their colonoscopies/ etc. It is a huge amount of work; The Firm has a whole stable of employees who have been spending time doing nothing but referring patients to come in and get this stuff done. Why are we paying people to call patients all day?

• We get paid to do it. Managed care insurance companies have a fund of incentive money they pay to groups (maybe to individual doctors as well? not sure) who meet their criteria. Of course they keep raising the bar, so it gets tougher every year. They also add new criteria every year - for instance, if you treat somebody with bronchitis with antibiotics now, that counts against you. (It isn't as crazy as it sounds; most bronchitis is viral and responds better to inhalers. But that's another post.)


• The groups that do the best get good publicity. Every year the insurance companies publish their list of groups that provide the "best care." Of course this list gets lots of local publicity and winds up in the L.A. Times (for example) every year. This hopefully translates into more patients signing up with The Firm.

I hate P4P season - we all do. Not that I'm arguing against giving people good care and getting their cholesterol down, mind you. It just seems that the goal is lost in a paper chase: The statistics count more than the patients. Also, we always have those stubborn few who won't take their cholesterol lowering meds, aren't compliant with their diabetes treatment or hate mammograms. Such patients are anathema to any good paperchasing doc. It's difficult to look at these people and not think You're ruining my numbers!, horrible as that sounds.

I foresee a day when these patients will form a tribe of outcasts, wandering from group to group and primary care doctor to primary care doctor, staying just long enough for the "care provider" (as we will doubtless be known) to find out that Patient X doesn't do mammograms or statins and then being expelled to blot the escutcheon of some other hapless M.D. That's what happens when you do cookbook medicine and the book in question becomes more important than the patient.

Labels: Medicine, The Doctor's Life

posted by Dr. Alice at #

 
Comment of the Day

From one of Ann Althouse's posts, about book clubs:

Every new book club should start with Sartre's "No Exit".

'Tis true: Hell is other people in book clubs. I belonged to one once, but quit due to several reasons: lack of time, dislike of the books chosen and the fact that one of the members viewed it as an opportunity to go on and on and on about herself. Not that she didn't lead an interesting life, but after the third session or so the monologue got to be a little draining.

I learned that I never want to read another book by Gore Vidal (but I did manage to get my fellow members to read Laurie Colwin, a favorite author of mine).

And, yep, I'm blogging again. Stay tuned.

Labels: Pop Culture

posted by Dr. Alice at #

 
My New Worknight Meal or: Play With Your Salad


Despite my best intentions I often don't cook ahead of time for busy weeknights. This means that if I don't have something ready to eat with minimal preparation I often wind up eating fast food for dinner. After years of watching my grand plans for healthy (and cheap) dining fail I have finally realized the secret to healthy eating: know your limitations and work within them. In other words, if you know you get raging hungry at 6 pm every day, plan for it. Pack something you know you will eat, or keep it handy in your fridge.

I would love to say that I eat salad on a daily basis, but that simply is not the case. Salad will not hold me for more than a few hours and it isn't interesting enough... Unless. Unless that salad has lovely ingredients in it like goat cheese, walnuts and other interesting things. Things that have protein. Things that are tasty.

I highly recommend perusing takeout menus for ideas for salads: California Pizza Kitchen, for instance, has a menu full of fabulous-sounding salad ideas. Or go to your nearest high-end grocery store or place that sells prefab, packaged salads for more ideas (i.e., Trader Joe's or similar). Read the ingredients list and steal their ideas.

All this leads to my latest discovery: Salad with Baby Beets, Goat Cheese and Toasted Walnuts. Do you think this sounds complicated? NO. Wrong. I timed myself today and made the salad in about ten minutes. The longest part was toasting the walnuts, and you can do this in advance - but I think they taste better freshly made. Here is how you do it, and the best part is that the ingredients can be purchased ahead of time and will stay fresh for over a week.

• Get a bag of shredded romaine (aka cos lettuce) at the store. Or you can wash and chop your own ahead of time and keep it in a sealed bag, which is cheaper.
• Get a little sealed bag of precooked and peeled baby beets (if your store carries them).
• Get a little log of goat cheese.
• Get a bottle each of balsalmic vinegar and olive oil, as good quality as you can manage.
• Get a bag of shelled walnuts (or chopped, probably cheaper) and keep them in the fridge.

Toast the walnuts in a dry frying pan - keep an eye on them, this doesn't take long. Best stir frequently. When done, pour into a saucer and set aside.

Throw the lettuce in a bowl, chop the beets into chunks - size depending on your preference - and crumble up some cheese. Dribble over some olive oil and balsalmic (proportions: slightly more oil than vinegar) and grind some pepper over. Toss salad.

Throw walnuts on top. Eat. It's delicious and it will hold you till the next morning. If not, consider adding more cheese/walnuts.

If you don't like beets, consider adding the following to your romaine instead: green seedless grapes and feta; add chunks of chicken or shrimp (put Thousand Island dressing on top and you have Shrimp Louie!); stuff your salad, with cucumber and radish/tomato/scallion, in a pita bread and put hummus on top; make a Southwestern salad with black beans, corn and salsa. Whatever floats your boat.

Labels: Ingestion

posted by Dr. Alice at #

 
New Frontier

Well, this is a first. I am actually dictating a blog entry. Last week, after months of waiting, I was finally set up with something called Dragon voice recognition software. I wasn't sure I would be needing it, but a few trials have convinced me that it's definitely the way to go. I'm getting through my notes much faster with it, although I am a reasonably good typist. I have had to go back and correct a few things, but overall I have definitely been impressed with the accuracy of this software. So naturally, I thought: Why not try it for blog entries? Hence this post.

It's a bit of a hassle saying "comma" and "period" all the time but overall it is well worth the effort. I am somehow being reminded of something P.G. Wodehouse once wrote on the one occasion when he tried dictating his stories to a secretary: He visualized the secretary saying to herself "Well comma this beats me period. How comma with homes for the feeble-minded touting for custom on every side comma has this Wodehouse managed to remain at large as of even date mark of interrogation." I wouldn't be surprised if this software feels the same way about me.

I hope everyone's Labor Day was good. I spent my weekend running errands and cooking; I now have quite a few lunches packed in the freezer awaiting their destiny. It was amazing how many things I managed to cross off my list, though I'm sure they will be replaced by new emergencies soon enough.

Since I'm running out of ideas, I shall sign off. I hope this doesn't mean all my future posts are going to consist of dictated drivel.

Labels: The Doctor's Life

posted by Dr. Alice at #

 
It's Finally Over

Today marks the last strip of Lynn Johnson's For Better or For Worse. It ended more or less as predicted, with the wedding of Elizabeth Patterson and Anthony Caine (or, as us FOOB-haters prefer to call him, "Blandthony") and spadefuls of hokey dialogue, not to mention bad puns. Over at the Comics Curmudgeon site the commenters have been weighing in like mad, mainly to indicate their disgust with the feeble ending and to state that they're glad the strip has come to an end.

Only it hasn't.

Johnson is restarting it; that is to say, she's going back to the beginning of the strip and redrawing it. Yes, she's telling the whole damn saga all over again. You can imagine how the FOOB-haters feel about that: Apparently, our venom has been significant enough to garner national notice, as witness this article. I'm so proud of my fellow snarkers.

I myself find this an odd decision. Johnson announced her decision to retire over a year ago, at which time she made the decision to end the strip. Sadly, her marriage ended right after that. I can understand her changing her mind, but in that case why not continue with an ongoing story? Putting yourself into your work is supposed to be therapeutic, but merely redrawing strips without new storylines doesn't sound very satisfying to me.

My favorite comment on all this was the following, from the CC site:

"My strip is gone"

cried Lynn the hack.

"But look - surprise!

It's coming back!"

Burma Shave

Labels: Comix

posted by Dr. Alice at #

 
Paris in the Rain

This is the second of my two days in Paris: I got in late Wednesday night and will be leaving for home tomorrow. Right now I'm sitting in an Internet cafe watching the rain pour down outside, trying to decide whether to continue with my plans to tour around or just go back to my hotel and sack out. The sack-out option is looking pretty good (it's a very comfortable room), but I think I'll soldier on for a little longer before going back.

I've been to Paris before so I don't feel the need to run to the Louvre or Notre-Dame; I've really just been wandering around the city, doing some shopping and so forth. I've found the city quite pleasant and have scraped together the remnants of my high-school French, though I occasionally find myself substituting Spanish by mistake (it's embarrassing to be saying "gracias" instead of "merci"). I also had a delicious choucroute garni for lunch yesterday, which is sauerkraut cooked with ham, sausage and various other meats; reason enough to come to Paris if you like sauerkraut.

My Internet time is about to run out so I'll sign off here. Next week it'll be back to the patients and paperwork, but I will be armed with a slightly better attitude thanks to the break. And Labor Day is coming up, so I still have a three-day weekend to look forward to.

Labels: Travel

posted by Dr. Alice at #

 
Now This is a Reality Show!

In a sense my vacation has been misspent. I have watched more television in the past week than I have in the past several months. But, I tell myself, I am gaining a valuable insight into the British psyche by doing so. I have learned the following:

• British soaps are telecast in the evening, not early afternoon. The storylines are real-life and revolve around the working classes; not a scrap of glamour is to be seen.
• Britcoms continue to be the best by far.
• Britons love their reality shows, oh yes they do. Both "Big Brother" and "X Factor" (the inspiration for "American Idol") are on right now and garnering big ratings.

Last week here saw the premiere of a new reality show called "Maestro," in which nine celebrities learn to conduct an orchestra. Each week they are assigned a piece of music and take turns conducting the BBC Orchestra, with one or two competitors getting knocked out each week. The winner gets the chance to conduct a real performance of the orchestra. As far as I'm concerned this is a brilliant idea: who hasn't conducted along with the radio and fantasized about directing an orchestra? I've been gripped by the show, enjoying the music and watching the efforts of the competitors to learn an entire piece within a week. Most pleasant of all, they aren't jostling for money or fame. They're doing it for love of music.

I hope this show is successful. It would be nice to see more reality shows with a higher tone about something besides scrabbling for cash.

Labels: Pop Culture, Travel

posted by Dr. Alice at #

 
Checking In

Vacation has been great fun, considering I was stupid enough to check my work email a few days ago only to be greeted by the news that one of my partners is quitting. Which means the fall will be a slow ongoing disaster. Never mind.

Brighton, where I am staying, is a beach town and very fun: Lots of pubs, lots of shops, the Prince Regent's summer palace to tour and so forth. The palace was built in the late eighteenth century, is known as the Pavilion and is right in the middle of town. It's a pile of Indian-styled domes and peaks and looks as if an architect had designed it while under the influence of a dysenteric fever dream. Today I walked down to the beach with Jess and watched the waves crashing - the surf is very high for August, so she tells me - and we wound up having a full English breakfast for lunch. So I guess it was brunch.

The classic full English breakfast is a cardiologist's nightmare: bacon, sausage, toast, two fried eggs, baked beans and a grilled tomato (to balance all the meat). But it's very delicious. I requested my eggs scrambled but apparently this is unheard of: they arrived sunny side up with scary quivery yolks. Solved that dilemma by just eating the crispy whites.

I'm off to Paris in a day or so and hope to post more then.

Labels: Ingestion, Travel

posted by Dr. Alice at #

 
Stock Up on Those Pens


I first heard the news a couple of weeks ago as I was leaving a restaurant. I had been a guest at a dinner sponsored by a pharmaceutical company (a.k.a. "drug dinner") with an informational speaker. As we headed toward the door, the representative ("rep") who had invited me mentioned that in the future pharmaceutical companies would be instituting new restrictions on promotional events like dinners, and then added, "And they won't even let us give you guys pens any more, either!"

"What?" I responded.

"As of 2009, no more pens."

"You can have my drug pen when you pry it from my cold, dead fingers!" I responded dramatically.

Then I came across this article confirming the sad news. No more baseball caps or coffee mugs. No more Post-It pads shaped like lungs or kidneys. No more (sob) pens.

The cold hard truth is that American drug companies spend quite a lot of money on product promotion. They used to spend even more; I recall in the past going to Staples Center once or twice to see the Lakers, courtesy of a friendly drug rep (they can't do stuff like that any more). Are drug companies doing this to influence doctors' prescribing choices? Of course they are. They start early, with medical students getting a free stethoscope and "sponsored" lunches, and escalate their marketing efforts from there.

My view of drug marketing has always been pretty pragmatic, in case you haven't figured it out by now, but I have to admit I've heard of freespending promotions in the past that gave me pause. I got this attitude from my dad the retired M.D., who never met a drug rep he didn't like. Mostly I feel that the drug companies write all this off as a business expense. As long as they're throwing the dinners, I might as well go. I usually learn something at these functions, as they feature excellent speakers. Whether it's hypertension, cervical cancer or asthma, these docs know what they're talking about and their speeches are quite a bit more than nonstop shilling. (Full disclosure: doctors these days are under a lot of pressure to prescribe generic drugs as well. This pressure comes from insurance companies and - if you are a member of a large practice like The Firm - from the administration. Generic drugs make perfect sense in many, if not most, cases, and I have been assured during my performance reviews that my prescribing habits are not out of line. So doctors are getting pressure from both directions, not just one.)

Do all doctors agree with me? Definitely not. I've heard of projects such as the pen exchange where docs bring their drug pens to trade for ordinary unlabeled pens. I know some docs who resolutely refuse to talk to drug reps or accept any of their offerings. And that's fine; if you aren't comfortable accepting these things, then don't.

But I have to admit I'll be sorry to see the tchotchkes go. My all-time favorite was the Levitra pen which slowly unfolded to its full length when the user pushed a release on the side. In case you don't know, Levitra (vardenafil) is used to treat erectile dysfunction. I've heard rumors that these pens were sold on Ebay. I gave mine all away to friends - wonder if I can nab one or two more before the big crackdown?

Labels: Medicine

posted by Dr. Alice at #

 
Weekend Links

If you're looking for an excuse to web surf, the Blogspot home page can be a fruitful source of links to interesting blogs. (You do have to have an account.) Here are a few:

• It's Lovely! I'll Take It! - a listing of hideous photos of real estate. Extremely funny.
• Ikea Hacker - this blog is a cornucopia of inventive ideas for Ikea products: Cool storage ideas, inexpensive ways to personalize the stuff you buy so it doesn't look so assembly-line and so on. It's a fun read.
• Junk - two guys go all Kon-Tiki, build a raft from plastic bottles and a Cessna engine and sail from California to Hawaii. Really.

Labels: Pop Culture

posted by Dr. Alice at #

 
White Trash Nicoise


Salade Nicoise is one of those classic summer recipes. It exemplifies the more approachable side of French food: simple to make, not fancy, just really good. You can pay $15 for a plate of it in a bistro or you can make it yourself for a lot less. The basic ingredients are potatoes, green beans and tuna - you don't have to use tuna; I know one excellent food blogger who likes his with grilled swordfish - but this is my Nicoise. And we are not using the grill, we are going with canned tuna. You can feed up to six people with one can of tuna! Here we go:

First start with the dressing. Get a jar and put in some olive oil and red wine vinegar - or you can use lemon juice. Proportions should be about twice as much oil as vinegar. Peel a garlic clove and cut in half and add to jar. Add some pepper and mustard (either dry or prepared is fine). Shake it up and set aside. You do this first to allow the garlic to infuse the dressing.

Get the potatoes boiling. For four to six people I'd suggest five medium potatoes. Give them about 20 minutes (you don't want them too soft), drain, cool and peel. Slice them up and throw in a bowl.

Prep the green beans while the potatoes are cooking, cut in bite size pieces and steam until done. You will want about three generous handfuls of beans, depending on how many you are feeding and how much you like beans. The balance of the salad can be either in favor of the starch (potatoes) or the green (beans); it is up to you. When beans are done, cool under running water, drain and throw in the bowl with the potatoes.

Somewhere out there I hear a voice raised: "Isn't a proper Salade Nicoise plated?" Indeed yes, it is what is known as a composed salad, and you can take the time to build a pretty construction out of it if you like. We are not going to do that. Now drain the tuna (12 ounce can), flake it and add to the bowl along with some freshly ground pepper. Put several spoonfuls of capers on top. The capers really make the salad. Now get your dressing and dress the salad somewhat generously. You don't want to drown it, but the potatoes will drink up a fair amount of dressing. Start low and then add a little more if you need to. Toss the salad (gently! You don't want to mash the potatoes) and serve.

A classic Nicoise contains anchovies, but I really don't like them, so I left them out. It will also contain hard boiled eggs, which I didn't bother with today - it was just me for lunch - but I do think the eggs are a good idea as they will stretch the salad. Just serve a halved egg on the side of the plate. You can also serve the Nicoise on salad greens, which will stretch it further and up your vegetable intake. Leftover salad makes a great work lunch for the next day.

Some thoughts on capers: I love them and they are a great addition to this salad. If you like capers, try to buy the biggest jar you can find and you'll save money. I actually found a one-quart jar of capers at Surfas, a restaurant supply store. It will probably take me the rest of my life to finish it, but hey! Cheap capers!

Labels: Ingestion

posted by Dr. Alice at #

 
Don't Bring Me Down

I learn from my patients. I think most doctors do, if they pay attention. This past week I saw a patient for something very basic - a blood pressure check - but on reviewing her old records she began to tell me about the terrible dermatitis she'd had in her ears for a long time. I don't mean ordinary itchy ears, I mean something severe enough to weep or bleed. She saw a lot of doctors for this and tried a lot of medications, till she saw an ear nose and throat specialist who finally figured out the problem.

She was allergic to down. As in feathers. Her pillows, her comforter both contained down; she went home, bagged them up, got rid of them and her problem disappeared. This story impressed me quite a bit.

"I know lots of people are allergic to down," I commented, "but I thought it only gave people respiratory symptoms or itchy eyes."

"No," the patient responded definitely. "This guy was a genius. He said down was causing my ear problems and he was right."

This is the sort of thing I try to remember, because you never know when someone with really irritated ears is going to walk through the door.

Labels: Medicine

posted by Dr. Alice at #

 
Morbid Memories

Recently on GruntDoc I came across the following amusing story:

GLENDALE, Wis., July 23 (UPI) - Patients at a Milwaukee-area hospital say the last thing they want to see while facing surgery are vultures perched outside their windows.
Yet, that's the view from some patients' rooms at the Orthopedic Hospital of Wisconsin in Glendale, Wis., the Milwaukee Journal Sentinel reported Wednesday. It said patients about to go under the knife can watch up to six turkey vultures sitting on ledges of the three-story building.

This brought back memories of the hospital I worked in as a medical student in Camden, New Jersey. The residents' call rooms had a lovely view of the cemetery next door; on moonlit nights I used to wonder if the zombies would be coming for us. I also recall a memorable post-call breakfast there during which a funeral home's van pulled up and the staff loaded a sacked-up body into the back of the vehicle (the doctors' dining room looked out on the ambulance court). Ah, good times.

Labels: Medicine

posted by Dr. Alice at #

 
Netflix Review


Rejoice, readers: it's another useless film review from Dr. Alice. Lately I seem to have rediscovered my interest in watching movies. When I was in medical school in Philadelphia I was lucky enough to be within walking distance of a South Street video rental store which specialized in art films and the esoteric; I worked my way through a lot of Ealing comedies and early Peter Sellers films back then. I've been a Netflix member for a while but the DVD's would sit for months before I managed to watch them. I think I've seen more movies in the past six weeks than I did in the previous year.

At any rate, I suddenly realized that the films I've seen recently share one characteristic: a treasure hunt of some type figuring into the plot. This may be the focus of the film (National Treasure) or it may get relatively little attention compared to other plot points (The Rundown) but it keeps cropping up. So let's compare and contrast.

National Treasure - the whole movie is one long hunt for a treasure hidden during the Revolutionary War, rather cleverly done. I enjoyed it. Extra credit for the presence of Nicholas Cage, whom I like. I keep thinking of him as the modern version of James Stewart. Also liked the location shots of downtown Philadelphia. Downside: Cage decides to steal the Declaration of Independence and pulls it off in just a few days?! Did he and his sidekick get all their fancy surveillance equipment from the Acme Company that supplies Wile E. Coyote? And did they get it on credit? Oh well, never mind.

The Librarian: Quest for the Spear - a very pleasant surprise. This film, a parody of the Indiana Jones type of adventure movie, stars Noah Wyle of ER as a guy who's been in college for fifteen years and knows, literally, everything. He becomes the librarian of a top-secret library containing the Ark of the Covenant, a unicorn and the Holy Grail among other things (the library support staff consists of Bob Newhart and Jane Curtin, both of whom are great). When the Spear of Destiny is stolen he has to go after it, develop self-confidence, use various bits of esoteric knowledge he's acquired in the course of his studies, etc. Extra credit for the great cast and the humorous take on the plot. Wyle gets a couple of good lines in. My favorite, uttered after he's been trying to figure out what dialect an Amazonian tribe is speaking: "It's Portugese! I was overthinking it!" Downside: terrible special effects. Well, it's a made for TV movie. Would be good for kids.

The Pacifier - tough SEAL officer Vin Diesel guards/babysits five kids while hunting for a missing secret missile guidance program, eventually loses his tough persona and bonds with the kids, etc. You can write the script on this one yourself: pleasant but predictable. Upside: an annoying little bedtime jingle he has to sing to get the toddler to sleep turns out to be a classic "in plain sight" clue to the location of said secret program. Downside: not only is this plot reminiscent of The Sound of Music, the writers actually worked a performance of Sound of Music into the movie. Gah.

The Rundown - best of the bunch. Stars The Rock, or Dwayne Johnson, or whatever he's calling himself these days. He's a sort of glorified repo man who really wants to be a chef; the opening scene has him taking notes on recipe ideas while waiting in his car on a stakeout. Loved it. A local criminal hires him to go down to the Amazon and fetch back his son, who's there looking for a priceless relic. When Rock gets there he finds himself in a gold mining town run by Christopher Walken, who's also after the relic. Things escalate from there and the film ends with a classic Western shootout. The actual finding of the relic doesn't take that long and is almost a side issue. The real treasure here is Walken's performance; he plays the owner of the town like Colonel Kurtz on LSD. The scene where he lectures a bunch of armed thugs on the Tooth Fairy is priceless. Downside: there isn't one. Rent this movie.

Labels: Pop Culture

posted by Dr. Alice at #

 
Just Because It's Typed, It Doesn't Mean it's Readable


The electronic medical record system has made things much easier for the specialists in our group, who formerly made entire careers of complaining that they never got timely access to labs or legible consult requests on the patients who were sent to them. Now that all the docs in the group have access to the charts, if you have a question you can just dip into the chart and read the notes and labs. I have to admit that this is an improvement, as is the fact that all notes are now legible (because they are typed). One problem still remains, however: no one has yet been able to solve the odd lingo that doctors create for themselves while taking notes. Abbreviations save time and minimize typing but often are understandable only to the person who created them.

V. recently sent me a puzzling notation she'd picked up from the chart of a patient on whom she'd been consulting, wondering if I could decipher it. The notation in question read:



I'll spare you the speculation we went through on that one, until I finally realized that NF stood for "nonfasting" and "a little fruit" referred to what the patient had eaten that day. (If you're checking cholesterol and blood sugar, this could be quite relevant.) Once you figure it out it makes sense, but a better solution here would have been to use the QuickText application. This allows you to preprogram various abbreviations, so that if you typed .nf and hit the enter key you'd get "nonfasting" typed out as a full word.

But then we'd have missed all the fun of trying to figure it out.

Labels: Medicine

posted by Dr. Alice at #

 
You Be the Judge


Here's an interesting scenario: the "King of Spam" is being sentenced in court and one blogger is inviting commenters to submit their ideas for appropriate sentencing. Robert Alan Soloway is apparently only the second person to be sentenced under the 2004 federal law against sending spam and is estimated to have sent 90 million emails. (One commenter who used to run a mailserver suggested drawing and quartering Soloway.)

The defendant's attorney is arguing that Soloway suffers from "oppositional defiant disorder" for which he takes medication and can't help himself when it comes to defying the law. Therefore he deserves a lighter sentence. Gee, I never knew that being a jerk merited extra consideration when you've broken the law repeatedly...

(h/t Instapundit)

Labels: Pop Culture

posted by Dr. Alice at #

 
Last Weekend


I'm sitting here coping with telephone calls tonight, so I might as well take a few minutes to tell you about last weekend (Fourth of July holiday weekend) and how I spent it with the Southern Mafia. Let me enlarge on this.

The daughter of old family friends - in fact, I went to school and to the prom with her elder brother - got married at my parents' house last weekend. They (my parents) have a lovely yard with a bricked patio and a gazebo, and she had asked years ago if she could get married there someday. They told her, "Of course!" Which only goes to show, never make a sentimental promise that you aren't willing to keep.

But I kid, at least to a certain extent. My folks went to some trouble performing building and grounds upkeep and planting flowers prior to the wedding, but then my mother said optimistically, "I'm not in charge. We're just going to relax, enjoy and have a good time." Let me be the first to tell you that if you are hosting a wedding there is no way you are going to relax, enjoy or have a good time. For one thing the bride was two hours late, and for another, the caterers had been hired for a very specific amount of time. Which meant that they kept interrogating my mother, what should they do next? When should they start with the hors d'oeuvres? Should they serve the cake now? All of which drove Mom nuts.

But in the end all went well, the ceremony was lovely and the catered dinner was really good; in fact, better than good (I've been living off leftovers all week). The best part for me was getting to spend the weekend with my mother, her sister (who came into town for the wedding) and their friends. You see, Mom and my aunt were born and raised in Tennessee. My mother met my dad at William and Mary (she was in college and he was in the Navy) and eventually they got married and moved to southern California, where my mother found herself marooned in Orange County in a 1960's suburb, raising three kids.

In those days you met people playing bridge or if your kids went to the same school, which is how my mother knocked into two other women from the South. We will call them M and V. They are both from North Carolina originally, got married, moved to California, wound up meeting my mom in that very same suburb and they've been close friends for more than forty years. It was V's daughter who got married last weekend. The three of them have dealt with divorce, widowhood, illness, family dysfunction and God knows what else and have done all this with grace and humor. The whole clutch of us sat at one table during the reception, and one of M's sons referred to the three of them as "The Southern Mafia," which caused me to double over. He was right; you can call them Steel Magnolias, Southern Mafia or what you will, these are strong women who have kept families and traditions together in one of the most socially ephemeral parts of the US you can imagine. My sister and I still keep grits in the house (and we eat them!) Our families are still close. My mother and her friends still celebrate each other's birthdays and take trips together once a year or so.

After the wedding my mother's friends stayed overnight and we celebrated with a big breakfast the next day (of course, grits were included). We reminisced, read the paper and drank way too much coffee. It was great.

Labels: The Doctor's Life

posted by Dr. Alice at #

 
Potato Soup


This is a dish I was raised on from a child. You can eat it any time of year, but because the preparation is so easy it became a summer supper tradition in our family. This is potato soup at its most basic: onion, potatoes and water. (And salt and pepper.) My grandmother used to thicken it with a flour-water paste, but my mother quit doing that ages ago and it does not seem to make one whit of difference. No dairy is required: this is not vichyssoise. The soup has an earthen, potato-ey taste which is quite good. It does need quite a bit of salt, but potatoes generally do. Did I mention it's incredibly cheap to make?

Proportions are as follows: chop one large onion to, maybe, four large potatoes. You can change this ratio based on what you have or what you prefer. Peel the potatoes, halve and slice them. Cover all of the above with water and cook on a low flame for a long time - more than an hour, at any rate. What you want is for the potatoes to go mushy and break down, thus thickening the soup with their starch. If the taters are holding their shape the soup isn't done yet. The onion will disappear, or nearly so, by the time the soup is done. Season generously with salt and fresh ground black pepper.

Serve with fresh hot cornbread, preferably baked in a cast-iron skillet, and a platter of sliced tomatoes, green onions (a.k.a. scallions) and cucumber. Iced tea to drink. If you need to stretch this further serve a platter of deviled eggs as well:

Hard-boil six eggs, cool, peel and slice in half. Sieve or mash the yolks and mix with a dash of white pepper, 1/4 to 1/2 tsp. salt, 1/4 tsp. paprika, one tsp. each of prepared mustard and white vinegar, and 2 tablespoons mayo. Stuff the mixture back into the egg halves and chill. Sprinkle paprika on top. These are, officially, the World's Best Deviled Eggs (and you can ask V., who is not a big fan of eggs generally but loves these).

You can refrigerate leftover soup, but because of its heavy starch content it will resemble wallpaper paste when cold. Do not panic, just add a small amount of water and reheat slowly and it will be fine.

Labels: Ingestion

posted by Dr. Alice at #

 
101 Yummy Ideas

Mark Bittman, food blogger for the NY Times, has done it again. His latest "101 items" list is up here and this time it's 101 ideas for picnic food. If the site asks you to register (it probably will) and you don't want to, go to bugmenot.com to get some passwords for the New York Times website.

Many of the commenters are begging Bittman to put together a cookbook of 101 lists; I'd buy it for sure. These ideas are versatile and could be used for a lot of other occasions besides picnics. Buffet meals, potlucks, side dishes... give the list a look and I'm sure it will give you some ideas.

Labels: Ingestion

posted by Dr. Alice at #

 
Talk to Me


Talking to my patients about their lives and what they do is actually what I love most about my job in primary care; the time constraints I work under are the most frustrating thing about it. I've been fortunate to have some interesting conversations with patients lately. A couple days ago I was seeing a (rather anxious) patient with a lot of different complaints. I sifted through as many as I could and asked her to make a follow up appointment for this coming Friday for further discussion.

"Well, I can't make it that day," she responded, looking a bit self-conscious. "I have my ukulele practice session that day."

"Really?" Ukulele?

"Yes." Before my eyes this woman began to brighten up, lighten up as she talked about her hobby. "I heard this recording of --" she named someone who's apparently pretty proficient at the instrument, but his name escapes me -- "and it just amazed me. There are so many styles of playing! I got my roommate interested, and it's just a lot of fun. I live in an apartment building and we can't have pets."

"But you can have ukuleles," I finished. "I imagine there are a fair number of people around here who play. There's a significant Hawaiian population around here, especially in the South Bay."

"Yes, but you can go on line - there are tutorials, and videos..."

I stared at her. "I've been living under a rock, haven't I?" I asked.

The conversation stayed with me for the rest of the day and I later shared it with V., who instantly broke into an imitation of Tiny Tim doing "Tiptoe Through the Tulips."

Labels: The Doctor's Life

posted by Dr. Alice at #

 
With a Twist

There's a phrase in Hollywood that's probably used every time somebody's trying to sell a movie: that it's a romance/horror film/character drama "but with a twist." With Bon Cop, Bad Cop the twist is that it's Canadian and bilingual. Otherwise, it's your standard buddy cop shoot-'em-up movie, which was released last year and apparently broke box office records all over Canada. Why did I rent it? - because it stars Colm Feore, of course. To be more precise, it stars Colm Feore as the uptight English speaking cop from Toronto and Patrick Huard as the loose-cannon Francophone from Montreal. I watched it this past weekend and found myself really enjoying it, explosions, serial killer and all. The movie's makers were meticulous about giving equal time to both actors, both languages and both locations (in fact, the first victim is found on the Quebec/Ontario border, with half of him on each side).

The plot of Bon Cop, Bad Cop is formulaic - I guessed a lot of what was going to happen early on. That doesn't make the film bad, just typical. The fun is in the details: the acting (both Feore and Huard are very good), the dialogue (overlapping and fast. Learning these lines in two languages must have been quite a job), and the funny scenes that get thrown in along the way. At one point the two police officers, having found the killer's hideout and another body, then manage to blow up the house when one of the officers trips an alarm protecting the killer's marijuana crop. No, it doesn't make a lot of sense, just go with it. They manage to escape the fire but wind up with a contact high from the burning plants. Watching these two giggling helplessly while they're getting chewed out by the Montreal chief of police is worth the price of the film all by itself. Another good scene involves a motormouth coroner who speaks French so fast that not even Patrick Huard can figure out what he's saying.

There are some parts I could have done without - the gratuitous sex scene where the Montreal cop gets it on with the Toronto cop's sister comes to mind - but the bonding bits are good and carry some genuine emotion to them. Both men are divorced, raising their kids as best they can, and they get to meet each other's families in the course of the case. This part doesn't feel forced to me. At any rate, if you're in the mood for an escapist buddy movie with guns, car chases, humor and subtitles you could do a lot worse than Bon Cop, Bad Cop. And it sure is nice to see Colm Feore in a starring role for a change.

Labels: Pop Culture

posted by Dr. Alice at #

 
A Somewhat Odd Recipe

Yes, another one. This is how it came about. I bought too much shoepeg corn for the Taco Soup and was wondering what to do with it, so I did a web search and quickly found a recipe (or rather, several variants of the same recipe) for a casserole using shoepeg corn. I decided to give it a try, since I had most of the ingredients in the house - minus the canned green beans, but a simple trip to the store remedied that one. Here we go.

One can shoepeg corn, drained
One can French-cut green beans, drained
One cup sour cream
One can cream of something soup (mushroom, chicken, or celery - your choice)
One cup shredded Cheddar cheese, as mild or sharp as you want
Chopped celery and onion - proportions range from one-half to one cup each

Mix all ingredients, put in a casserole dish and bake at 350 degrees F for 30 minutes, then top with crushed crackers or breadcrumbs mixed with melted butter and put back in oven for 5 minutes or so. I had leftover Pepperidge Farm stuffing crumbs from Thanksgiving so, hey, guess what I used.

I should emphasize here that I really didn't know how this would turn out, but when you find several variants of the same recipe it is a safe bet to make it. No matter which variation you try it will likely be good. And this was.

Hmm, not bad, was my initial thought. As I found myself returning to the kitchen for a second helping I remedied that to hey, this is pretty good. It is rich, though. It would feed six to eight people as a side dish easily, maybe more. It is much better than the traditional canned-green-bean casserole, which I really can't stand... it has more crunch and character (though I still like my beloved celery casserole better, more veg and less rich).

I know what I'm going to bring to the office for lunch the next few days, let's put it that way. Not that that's a bad thing: some fruit and carrot sticks, and you're done.

Labels: Ingestion

posted by Dr. Alice at #

 
Send Me Back to the Office



Traditionally the practice of medicine and working from home have never gone together (except in the old-fashioned situation where the doctor's office is located in his or her home, an arrangement rarely seen these days). Thanks to electronic medical records and Citrix, I have been able to try this concept out for the first time in my life. I now am able to access lab results and telephone notes from home via my computer, which comes in handy with my (now) four-day workweek.

The thing about working from home is this: I don't think the "working" part is emphasized enough. The phrase "working from home" is too often uttered in tones that imply perfect freedom and efficiency. The whole idea has become some sort of Holy Grail... the peace, the lack of meetings, the freedom to get up and get a snack whenever you want, working in your pajamas...

...the feeling that you're marooned on a desert island and the rest of the world has forgotten about you. Okay, maybe that last part is just me. Truth is, I have found working from home to be more difficult than I imagined it would be. Going from a very schedule-driven workday to being completely on your own can be difficult if you aren't used to it. How often should I check my messages? How do I force myself to write that disability letter for a patient that I've been putting off for two weeks because their chart is two inches thick and their history is more complicated than the plot of War and Peace? What's going to stop me from surfing the Net or IM'ing everybody I know instead of working?

These aren't unusual questions, I know. Every business section of every paper in the country has probably done an article on this topic. I had to write about it because when I first tried working at home I felt as if I'd gone from a blissful 80 mph on the interstate to a frustrating 10 mph on a back road, stuck behind a tractor. It's humiliating when your staff has to warn you to keep out of the office on your day out.

"We have a locum tomorrow, Doctor. He's going to be using your office." So stay the hell away, is the implication.

Despite my grousing, have I given up my free day and gone back to the office? Of course not. After a grinding Monday, Tuesday, Wednesday it's a respite to know I don't have to leap out of bed at 5 a.m. Thursday. And it's extremely helpful to have an unscheduled day when, as last week, I had to call the plumber to fix a leak. And my house is getting steadily cleaner and more organized. Faced with that disability letter I found myself willingly, nay, eagerly cleaning out the back bedroom, boxing junk and taking it to Goodwill. I even wash windows. I have cleaned the refrigerator. I find that a task I absolutely loathe is exactly what I need to get stuff done around the house. (Yes, I did eventually finish the letter, too.)

Sometimes I even blog. I started this entry last week... on my day off.

Labels: The Doctor's Life

posted by Dr. Alice at #

 
The Expense of Spirit in a Waste of Shame...

... is lust for crochet. (As Shakespeare did not say.) But somehow that quote was the first thing that came to mind when I saw this site. It certainly involves wasting time, energy and money on something that will cause you untold shame if you wear, exhibit or give away these crochet projects.

Hat tip to Tim Blair (congratulations on the new site, Tim!)

Labels: Pop Culture

posted by Dr. Alice at #

 
Travels


So what have I been doing for the previous three months?

Well, for one thing I was here:







I was also here:

My houseguests arrived in April and a busy time of it we had. Lee, a friend of mine from Australia, was my travel companion to Yosemite and the wildflower reserve in Antelope Valley (that's the second picture); she arrived just in time to see the flowers at their peak. The flower viewing fluctuates from year to year depending on the winter rainfall, and this was a good year thanks to all the rain we got in January and February.

After Yosemite we arrived back in Los Angeles in time to pick up my other houseguests (from England, Texas and Louisiana) and we spent the weekend seeing Hollywood Boulevard, Mulholland Drive, The Grove, In-N-Out Burger and the Sunset Strip. My friends are rabid Battlestar Galactica fans, so when they heard that Bear McCreary was giving a concert at the Roxy the weekend they were in town they were mad to go. The music was great, but I could have done without the standing for three hours. (No seating! The managers at the Roxy must be insane!)

We also got to take in a play at the Skirball performed by L.A. Theatre Works. They specialize in recording plays for radio, which are then broadcast on NPR. This particular play, Boats on a River, was the rationale behind this visit. My friends and I are 24 fans, and the play was to costar Gregory Itzin and Jean Smart, better known to us as the characters of President and Mrs. Logan from 24. Sadly, Ms. Smart had to drop out at the last minute, disappointing all of us (we originally met online as part of a 24 fan group focused on the Logans). But the play was terrific and Mr. Itzin did a fantastic job.

It was an incredibly fun week.

Labels: Los Angeles, The Doctor's Life

posted by Dr. Alice at #

 
Where the Wild Things Are...


...evidently, they're hanging out at my house. A few days ago I was awakened at 4: 30 a.m. by a ghastly noise coming from beneath my bedroom window: A growly, squealy sort of noise, definitely not emanating from fighting cats. Grabbing a flashlight, I leaned out of the window, stared down and saw a huge raccoon sitting at the base of the tree in my front yard. This thing was big - the size of a medium sized dog. I shone the flashlight in his eyes and he took off.

That same afternoon as I came home and headed up the back steps I was stopped in my tracks at the sight of a good-sized lizard splayed across the mat at my back door. It's always impressed me how lizards can sit and look at you, giving the impression that they haven't moved in days, but as soon as you come too close to them they'll zip away so fast that you can hardly see them. This lizard was no exception. I didn't have to fight him for the territory of the back steps as he buzzed away and left them to me.

Then, finally, there is a tree that grows outside my breakfast nook, now in full leaf. I had never realized before that it was a fruit-bearing tree, though I've lived in this house for years. I realized it this week when I saw a fat squirrel climbing through the tree. His goal was the tiny golden fruit I suddenly saw hanging on the branches (apricots? peaches? Some sort of stone fruit, anyway). Suffice to say the fruit is no longer there, though I rapped on the window to try to get him to cease and desist.

For an urban area, Los Angeles has its fair share of wildlife. I once saw a deer heading up a hillside as I drove along Mulholland Drive; V., who lives just off Mulholland, has seen them more often.

Labels: The Doctor's Life

posted by Dr. Alice at #

 
Garbage Plates

Naturally, it took a post on food to drag me out of my self-imposed hiatus. To be exact, the topic in question is leftovers, courtesy of Mark Bittman's blog. Some of Bittman's dissertations on food are too high-end for me; when it comes right down to it I am a very basic cook looking to get the job done fast with cheap ingredients. I keep reading his blog because once in a while he or his fellow contributors post a fun, creative and low-tech topic. Then the commenters mix into it and the fun really starts (you've got to read the comments on this one, for sure). And it's of universal interest: who doesn't have to deal with leftovers once in a while? Some of the more popular ideas shared were soup, frittatas, hash and a couple of really creative barbecue sauces.

The article also references a real garbage plate, if you will, apparently a specialty of certain restaurants in Rochester, New York. If you want to find out what a garbage plate is, go here. As several commenters noted, they taste best when you've been out drinking and the bars have closed.

Labels: Ingestion

posted by Dr. Alice at #

 
"Fra-JEEL-e!"


Thanks to Hall of the Revels for linking to the annual Washington Post Marshmallow Peeps Diorama Contest. This is what Easter is all about. My personal favorite is #18, a reenactment from A Christmas Story (hence the quote above), but they're all good and wildly inventive. Take a look.

It's a bit out of season for me to say this, but "A Christmas Story" is one of my favorite movies, with Darrin McGavin (the father) as the highlight. It captures the eccentricities of family life and the highlights and dark sides of childhood better than any film I've seen, plus its take on life in the 1940's is pitch perfect.

Labels: Pop Culture

posted by Dr. Alice at #

 
The Way I'm Feeling Post-Call? Yes!




I do love these LOLCat pictures; they have one appropriate for every mood.

Labels: Pop Culture

posted by Dr. Alice at #

 
Weekend Roundup

I promised myself I'd do some blogging this weekend, yet I don't have anything really exciting to tell you. I spent the weekend on call. Not so bad really, except that due to a Citrix "upgrade" I lost the ability to access office and hospital records from home, so spent a good chunk of yesterday and today at the office. This system has spoiled me - it feels so awkward not having access to patients' charts!

Citrix, in case you aren't familiar with it, is some sort of program that creates a liason between work computer systems and employees' home internet access. It turns out my sister's office uses it too. Sad to say it is somewhat temperamental and I made the weekend on-call computer types quite miserable trying to get me back on the system. As of tonight they still haven't succeeded.

Church? Didn't get there. I don't even try when I'm on call, knowing I could get paged out every five to ten minutes. I did get around to making my standby green cheesecake though, tomorrow being Saint Patrick's. V. always throws a party for St. Pat's, good Irishwoman that she is. (Since St. Patrick's Day falls during Holy Week this year I asked her if we would be celebrating in sackcloth and ashes. Her response: "Hell no.")

I did get a bit more housecleaning done, orgainizing my cookbook shelves in the kitchen and taking all the Internet recipes I've printed out for the past few years and filing them in a binder. The cookbook cupboard looks much better now.

That's it. Stay tuned for more thrilling updates.

Labels: The Doctor's Life

posted by Dr. Alice at #

 
A Busy Winter

I've been telling myself to post here for a while, but what with the flu decimating both patients and staff - not to mention ramping up the number of patients I see daily now that we've been on this electronic chart system for six months - it just hasn't happened. Let's review.

• About a month ago, I took a lovely but brief trip to Philadelphia specifically to see this fellow perform. Should you ever get a chance to see him, I highly recommend that you go; he is outstanding. He's going to be performing at the Hollywood Bowl this summer and my parents and I are already getting our tickets.
• On my return from said trip, I had a Hell Week where one of my office partners was out on vacation and the other was deathly ill with flu and walking pneumonia on top of it. I was sick as well but made it through the week without collapsing.
• I saw a great show in Hollywood called "Cartoon Dump," which I'll try to tell you more about later.
• I am expecting five houseguests in a month, so most of my nonworking time has been spent at home cleaning and organizing. I've thrown out or donated a ton of stuff, hung a lot of pictures and moved furniture and knick-knacks around to good result - the place is looking much better overall.

And now back to my regularly scheduled patients. More later.

Labels: The Doctor's Life

posted by Dr. Alice at #

 
Thanks To Mr. Gygax

I was never much of a Dungeons and Dragons player, but out of curiosity, I decided to take this quiz. (Tip of hat to Mr. Ockham)


I Am A: Lawful Neutral Human Cleric (5th Level)

Ability Scores:
Strength-8
Dexterity-10
Constitution-11
Intelligence-16
Wisdom-11
Charisma-13

Alignment:
Lawful Neutral A lawful neutral character acts as law, tradition, or a personal code directs him. Order and organization are paramount to him. He may believe in personal order and live by a code or standard, or he may believe in order for all and favor a strong, organized government. Lawful neutral is the best alignment you can be because it means you are reliable and honorable without being a zealot. However, lawful neutral can be a dangerous alignment because it seeks to eliminate all freedom, choice, and diversity in society.

Race:
Humans are the most adaptable of the common races. Short generations and a penchant for migration and conquest have made them physically diverse as well. Humans are often unorthodox in their dress, sporting unusual hairstyles, fanciful clothes, tattoos, and the like.

Class:
Clerics act as intermediaries between the earthly and the divine (or infernal) worlds. A good cleric helps those in need, while an evil cleric seeks to spread his patron's vision of evil across the world. All clerics can heal wounds and bring people back from the brink of death, and powerful clerics can even raise the dead. Likewise, all clerics have authority over undead creatures, and they can turn away or even destroy these creatures. Clerics are trained in the use of simple weapons, and can use all forms of armor and shields without penalty, since armor does not interfere with the casting of divine spells. In addition to his normal complement of spells, every cleric chooses to focus on two of his deity's domains. These domains grants the cleric special powers, and give him access to spells that he might otherwise never learn. A cleric's Wisdom score should be high, since this determines the maximum spell level that he can cast.

Find out What Kind of Dungeons and Dragons Character Would You Be?, courtesy of Easydamus (e-mail)

Labels: Pop Culture

posted by Dr. Alice at #

 
Chaucer Comes for the Archbishop and Decks Him One

You may or may not be familiar with the latest brouhaha regarding the Archbishop of Canterbury and his silly remarks re: introducing Sharia law to England. If not, try going here, or here to read Ruth Gledhill's response. His remarks have created a hue and cry all over the Anglican world, but the best by far has been Iowahawk's take on the matter. Not only is it a sharp piece of commentary, it's a brilliant parody of Chaucer. Goeth and readeth itte.

(Props to Chris Johnson)

Labels: Episcopaliana

posted by Dr. Alice at #

 
T-Shirt of the Day


I saw a patient with back pain today for follow up. He requested a narcotics refill, which I felt was warranted and which I gave him. What cracked me up, though, was his T-shirt displaying the following slogan:

I'M PROBABLY LYING.
I considered thanking him for being upfront about it, but chickened out. Seriously, is that the message you want to convey when you go to see your MD?

Labels: Medicine, The Doctor's Life

posted by Dr. Alice at #

 
Um, Hi Everybody

Welcome to everybody directed here by Stand Firm. I'm glad you're here. I'm in the midst of another busy day but will try to post more later.

Labels: Episcopaliana

posted by Dr. Alice at #

 
How To Knit a Dr Who Scarf


I once dated a guy who had an authentic Dr Who scarf in his possession and would wear it at every possible opportunity - as in every Halloween, campus party, etc. (I don't mean "authentic" as in "it was on the show" but as in "knitted to those specifications.") I forget who knitted it for him - it certainly wasn't me. Just for nostalgia's sake I went online to see if there might be instructions for knitting said scarf, and what do you know! There they are. (Oh, who am I kidding? This is probably one of the first things ever posted on the Internet.)

I am not exactly an experienced knitter but I have tried my hand at a couple of scarves, which are what every neophyte knitter starts with. Should you be having a long slow winter and care to have a go, be my guest - just click on the link above.

::starts to hum Dr Who theme::

Labels: Pop Culture

posted by Dr. Alice at #

 

Labels: Los Angeles

posted by Dr. Alice at #

 
Dr. Alice Has a Camera; Be Very Afraid


At least once a month and sometimes once a week I spend a significant chunk of my weekend driving around the city rounding on my nursing home patients. When my patients go to SNFs (skilled nursing facilities) or wind up requiring long term care, I follow them there; it's part of being a primary care MD. Two weeks ago as I was rounding I realized that I still had my digital camera sitting in my purse, where it had been living since my vacation. I decided to liven up my drive by taking random pictures around the city and had so much fun that I plan to do this every time I round.



Wilshire Boulevard, Beverly Hills, early Sunday morning




Los Angeles in January (when we're lucky; right now it's raining cats and dogs.)




LET MY PALM TREES GO!! - a shot taken though the parking lot gate of one nursing home



An arty close-up of the cinderblock wall, same nursing home


It definitely livened up my day. I'll try to do this again.

Labels: Los Angeles, The Doctor's Life

posted by Dr. Alice at #

 
Picture of the Day





Aah, Los Angeles in winter. You gotta love it.
(Thanks to L.A. Observed for this one)

Labels: Los Angeles

posted by Dr. Alice at #

 
Dilemma (Minor)


I'm home. Had a lovely vacation, thank you, but I managed to come down with a sinus infection during the second week - this seems to happen nearly every time I travel. Whether it was the change in climate, spending time with five kids (several of whom had respiratory infections) or my allergy to something in the Baja California environment - or a combination of all three - I traveled back sick. I finally knuckled under and started antibiotics, which have made a difference already. Now I just have to shake this cough.

The dilemma I mentioned above is: do I go in to the office today and start clearing out the two weeks' worth of deadwood on my desk, or shall I stay home nursing my cold? I fully intended to go in but the temptation to stay home is growing, especially since we've had a weekend's worth of rain and we're supposed to get more today. Hmm. I did stay home yesterday... I'm probably going to go in. First, though, let's catch up.

I spent the week after Christmas in San Jose del Cabo with my parents, my siblings and their families - twelve of us altogether. It was a lot of fun, but given that the kids range in age from nine years to eight months there was not a whole lot of partying going on: I think on New Year's Eve we were all in bed by nine-thirty. I was awakened at midnight by the sound of fireworks, went out on the balcony and was rewarded with one of the most beautiful firework displays I have ever seen, held over the ocean with similar displays up and down the coast and not a speck of fog to ruin it! I've been in other parts of Mexico at this time of year, namely Zihuatanejo and Cancun, and found the humidity plaguing. Unlike these areas, Baja California Sur is a desert climate: there was very little humidity in Cabo and a nice breeze. It's definitely geared to tourists, though rather low key. I believe Cabo San Lucas, the sister town about twenty miles away, is much more "touristy" but we didn't get over there to check it out.

What really struck me about Baja were the real estate advertisements everywhere; condominiums are being built all over town and the English-language press is chock full of photo spreads and articles about new real estate developments. Interestingly, the Cabo airport has a space for private jets between its two terminals and that space was packed the day we left. I think that in the last fifteen to twenty years the Cabo area has really exploded as a tourist and retirement destination. The people who've been here since it was a collection of small towns in the Seventies have either adapted and built businesses or they've moved on to smaller, more isolated areas.

Interestingly, I ran across this article about crime in Baja after we returned. From what I can gather the biggest problems are in northern Baja, especially near the border, and many crimes are directed at surfers or take place on the toll roads. We had no problems whatsoever, but we were in a relatively well-developed area with a large population and we did very little traveling around. Also, the beaches in our area are no good for surfing or swimming, with warnings about strong undertow currents plastered everywhere, therefore there's no real beach population to prey upon.


I do want to tell you about spending time with one of my nephews, who's five years old and possessed of a remarkably morbid imagination which pleases me no end. For example, as we were reading an article about whale watching in the Gulf of California I showed him a picture of a whale right next to a boat full of tourists. His first question: "Can a whale kill you?"

For a millisecond I considered explaining the plot of Moby-Dick to a five-year-old and then came to my senses. "No."

"But if it was really, really big, could it kill you?"

I held up my thumb. "Whales eat plankton. They can't eat anything bigger than this," indicating my thumbnail. "They can't kill you."

Later that day, in the hot tub next to the condo's pool: "Is it true that if you fall asleep in a hot tub you die?"

I stared at him in disbelief. "Why are you asking?" I managed. "Where did you hear about this?"

He pointed to his older brother (who's seven) and who chimed in, "I did hear that."

"Well," I began, "you could, but only if it was really, really hot and you spent too much time in there and you didn't drink enough water. Then you could faint and drown. That's why hot tubs have limits for how hot they get."

"What happens if it's one degree too hot?" And so forth. I find it tremendously fun to answer their questions, but I did run into trouble with my sister a few times. When she shrieks at me, "THEY DON'T NEED TO KNOW THAT," I know it's time to stop.


Speaking of stopping, I guess I've put off going to the office for as long as I possibly can. Catch you later.

Labels: Pop Culture, The Doctor's Life

posted by Dr. Alice at #