Sunday, July 21, 2019

Happy Ice Cream Sunday!

On this National Ice Cream Day (the third Sunday in July), I present to you two portraits: one of me with chocolate ice cream in my face, and one with it on my face. This was the ridiculously large and unwieldy waffle cone I got at PNC Park after the rain delay Saturday night. It's got to be 5 scoops of ice cream: 2 in the cone and 3 placed precariously around the edges. Dear Husband got cookies N cream in a cake cone, which the server had the good sense to stack upright, given how quickly we had to lick them to keep ahead of the melting in 90+-degree heat.

Saturday, July 20, 2019

2019 Birthday Blast

This year our birthday celebrations lasted an entire week. The Saturday before, our respective parents drove into town for a meal of country-style ribs with homemade Asian peanut sauce (below), corn on the cob, green bean salad, and Dairy Queen ice cream cake--served on our best Mikasa china, of course. The next day Dear Husband played a splendid organ concert at St. Paul's Cathedral Church, and we celebrated some more with dinner at Alexander's Italian Bistro. The portions were so large that the two of us are still working our way through the leftovers.

His parents brought with them the "new" 2011 Buick Regal he had purchased from one of their neighbors a few weeks ago, as his old 2004 Chevy Malibu won't pass inspection this month.

On his actual birthday I had a little window in the afternoon to sneak away from the hospital for ice cream cones before finishing my notes and attending back-to-back dinner meetings.

On my birthday, I worked in both the hospital and the clinic, coming home in time for dinner. Then we cleaned up for a couple friends to come over to play Bananagrams and eat snacks.

Afterwards we opened cards and presents. We were blessed this year with many electronic and analog well-wishes. Our "haul" included a new suit for DH, a photograph of him in it for my future desk, another Pittsburgh Bits and Bites tour, a glass-mosaic flower pot, some lotion, and "mad money" that will probably go toward the cost of putting new tires on the Buick. The most unexpected and memorable gifts were original LIFE magazines from the months of our birthday, courtesy of out financial planner (?!).

Finally, Saturday I baked myself a strawberry cake with strawberry cream cheese frosting. Jenna over at Butternut Bakery convinced me to give up the (boxed) yellow cake with (dark) chocolate frosting and rainbow-colored sprinkles Birthday Cake I have had pretty much every year for as long as I can remember in favor of strawberry cake with strawberry cream cheese frosting. Although July is a little late for strawberries, this might have to become the new Birthday Cake. The cake itself is easy enough to make and comes out not particularly sweet. But the pink frosting has 3 (or 4!) cups of powdered sugar and covers up a multitude of sins, including one slightly burned edge. That's me pureeing strawberries while watching Fantastic Beasts and Where to Find Them: The Crimes of Grindelwald next to the recipe.

That night we had residency tickets to the Pirates vs the Phillies baseball game. On the way, we had to get around not one but two cars stopped in the middle of the road. The weather was SO. HOT: 104 with the heat index. It was too hot to sit outside, nevermind exert yourself playing baseball. There were a lot of doubles, and kudos to the pitcher who later came around and scored. I wondered if we could tolerate it for a whole 9 innings, when suddenly the ominous-looking clouds that had taken up residence above the stadium opened up. Rain delay! We hustled up the stairs from our second-row seats to the concourse. Soon it stopped long enough that we could join the line for ice cream. The temperature briefly dropped before the humidity really kicked in. In the bottom of the month inning there was some kerfuffle about a stolen base and a interference call, and the people sitting around us let the umpires know that the Pirates were going win anyway, and couldn't they just "play ball" do that the last out would put us all out of our misery?

Alas, the misery was prolonged by a concert letting out at the same time, and it took us an hour to get out of the parking garage, which was enough time to compose this post on my phone. However, we did come home with two bobblehead dolls, as the family next to us didn't need four of them.

Can you spot my new little flower pot with a drooping baby spider plant in it?

Sunday, July 14, 2019

What Residency Looks Like XLVI: beep BEEP BEEEEEEEEEEEEEEEEP!

Sometimes residency looks like being on call 24/14--as in, 24 hours a day, 7 days a week, for 2 weeks.

Sometimes residency looks like trying not to go stir-crazy by leaving the house at least once every day while also having to be ready to report to the hospital within 1 hour.

Sometimes residency looks like getting dressed every morning as if you were going to work--and stashing a pair of scrubs in the car, just in case.

Sometimes residency looks like the strange utilitarian calculus of trying to accomplish as many tasks as possible that would not be catastrophic if they were interrupted by a sudden call to come in to work a shift.

Sometimes residency looks like going to bed on time every night, because you know that the interns sign out at 6am, so you might be getting paged at 5am.

Sometimes residency looks like wrapping your pager in your towel on the side of the pool in case it goes off in the middle of swimming laps.

Sometimes residency looks like checking that your pager sound is on and the battery not dead because it hasn't gone off all weekend (no morning report or noon conference pages on Saturday or Sunday!).

Sometimes residency looks like letting your cat "hold" your pager, because you are so tired of having it on your person.

Sometimes residency looks like having the best first jeopardy that any of the chief residents can remember--because the one time another resident called off, you had clinic, so they asked the resident on second jeopardy to come in instead.


Saturday, July 6, 2019

Devastatingly Beautiful Memoir about Love, Intellect, and Disability

Image may contain: 2 people, people smiling, people sitting, table and indoor
Photo from A Life Beyond Reason's Facebook page. I do not own this image.

I have just finished Chris Gabbard's book, A Life Beyond Reason: A Father's Memoir (2019), and I am absolutely devastated. Gabbard describes the birth, life, and death of his son, August, and how August's impairments and disabilities changed Gabbard's outlook on everything from fatherhood to living with a disability to modern medical science to the Enlightenment to his belief in God (or initial lack thereof). While I found the writing somewhat thin at times--perhaps because it is intended for a general audience rather than literature professors such as himself--Gabbard tells August's tale, which begins and ends with medical malpractice, through his perspective as an atheist and an intellectual, with flashbacks to explain how he came to hold various beliefs. A birth injury, for which Chris and Ilene never successfully sued, left August with cerebral palsy and spastic quadriplegia. In his father's eyes this made August "monstrous" in the medieval sense of inspiring awe and (eventually) connection with the divine. In the eyes of many others, unfortunately,  it made him "monstrous" in the Enlightenment sense of defying nature, to the point at which some people could not bear to even look at August.

Perhaps most curious (or frustrating) to me as a medical provider and one who wants to work with the CP population is Gabbard's habit of not naming names--hospitals, doctors, and especially the medical device company that made the intrathecal baclofen pump that was promised to make everything easier but finally broke both August and his father's faith in medicine. I assume this was a legal recommendation. In addition, Gabbard spends a considerable part of this short and effective book rehashing the electronic fetal monitoring (EMF) of August's birth, which indicated fetal distress but was dismissed by overworked and/or overly optimistic birth attendants. But he never comes out and says that retrospective studies have shown that increased fetal monitoring has increased the rate of Cesarean sections to 33% of all births but has not changed rates of cerebral palsy (1:500 live births). Perhaps as much as 70% of CP comes from prenatal causes. Nevertheless, after two nonreassuring fetal stress tests, 39 hours of labor, and 12 days post-dates, maybe a Cesarean section would have prevented (more) damage. We will never know. It was more optimistic doctors (who may have had ulterior, career-minded reasons) who talked Chris and Ilene into implanting an intrathecal baclofen pump, although oral baclofen and Botox injections had not yet failed for August. Thus began his years-long death spiral of complications that ended abruptly with overwhelming pneumonia.

While Gabbard has grieved and will grieve for a lifetime over all this, I am still raw just from reading about it. What Gabbard wants us to know is that he is not sorry to have had the exquisite pleasure and pain of having been August's primary caregiver: waking him in the morning, bathing, changing diapers and clothes, hand-feeding, transferring from bed to floor to wheelchair to stander, and tucking him in at night. The two of them enjoyed each other, and August helped Gabbard realize that the high-intellectual tenets of his youth--namely Socrates' dictum that "an unexamined life is not worth living"--was a farce. Contra John Locke, the fact that August and Chris and Ilene and Clio and all the college students they hired as caregivers lived interdependent lives proved August's humanity. Along the way, Gabbard provides light disability theory and reviews a veritable who's-who of secondary literature on parenting a child with a disability and on modern medical practice.

I can recommend this book to a wide variety of readers, from curious laypersons to self-interested caregivers, and from pre-health-professional college students to practitioners in fields such as pediatrics, rehab medicine, and all the therapies.

Editor's Note: The book author is a colleague of an old friend from graduate school. I don't think this biases my judgment but does make me grateful I found out about the book so soon after publication!

Sunday, June 30, 2019

What Residency Looks Like XLV: Third-Year Bloopers

I've made a tradition of exposing my foibles with an annual blooper list: second year of residency, intern year, medical school parts 1 and 2. Here's the third year of residency, at least what I could remember to write down.

Top 10 Bloopers

10. The night shift I tried to save a disposable cup by using my travel mug with a drink machine and ended up splattering hot cocoa everywhere. It looked like I had violently murdered a chocolate Easter bunny.

9. The time I set my alarm for an extra weekend shift at 6:50am, figuring this would give me a good 40 minutes to wash, dress, pack a lunch, and enjoy some pancakes before heading to the hospital with plenty of time to spare. Except I was supposed to show up no later than 7:00am. Dear Husband happened to be getting up early for church, so he woke me up at 6:30am and then helped me throw some food in a lunchbox just in time for me to run out of of the house at 6:45am. Whelp! I wish I could say that was a lone incident, but two other times I picked up extra weekend shifts, only to lock myself out of the house at 6:30am, only to have to call Dear Husband to wake him up to come let me in to get something I had forgotten (like my car keys).

8. When I diagnosed pelvic inflammatory disease in a woman who had had a hysterectomy.

7. When I accidentally walked into a construction zone because just the day before a consult patient had been on that ward. Even though there was a sign hanging on the door "authorized personnel only." I am so used to being "authorized personnel" that I entered anyway. Oops.

6. The day I let my co-resident go home thirty minutes early at the end of our otherwise quiet night shift, only to be called to a C-section for an unstable baby, parents who wanted to refuse vitamin K, a cold baby, parents who wanted to refuse erythromycin eye ointment, a baby who needed to be transferred to another hospital and could I tell the parents, a baby who needed an ultrasound (at which point one of the on-coming nurses sniped that I should have made sure the baby was already in the triage area, although nobody had ever told me this was my job), and oh by the way, this other one's blood sugar is 29, and no one knows whether the mother is okay with bottle feeding.

5. The first time I trimmed a newborn baby's umbilical cord and splattered blood everywhere, including on the nurse who was helping me.

4. When a patient asked me to rewarm her homemade heating pad of rice in a sock in the microwave for 1:30. She didn't know the setting, so I did it on HIGH--which cooked the rice and burned two holes in the sock. Not only did the floor staff wonder what was burning, but when I returned to the workroom my nightshift colleagues could still smell the smoke on my scrubs.

3. The day I complained when I didn't hear about new admissions all day until the ED attending texted my attending that they hadn't been able to get ahold of me for hours...because I had forgotten to sign in my pager that morning.

2. That night in the adult emergency room when I did a rectal exam on a patient who was concerned that his partner had left a foreign object in the patient's rectum, and then he critiqued me on my technique: "That's why girls aren't allowed back there!"

1. Once while overseeing conscious sedation of a girl in the ED getting her broken arm casted under twilight sleep, I noticed that my vision was starting to black out. While it was uncomfortable to see her arm being manipulated to get both bones back in place, maybe I had locked my knees while leaning over the gurney, or I hadn't snacked enough that night. I told the attending physician, "Jenn, I'm feeling faint." She promptly took over the sedation, sat me in a chair while someone fetched cold OJ, and forbid me to do anything else. Afterwards the Orthopedics resident smugly asked, "First sedation?" "No," I replied. "Second."


Sunday, June 23, 2019

What Residency Looks Like XLIV: DANGER DANGER

Long-time blog-readers may be familiar with my obsession with toilet and bathroom technology. So of course I snapped a picture of this sign next to a commode at the hospital where I was moonlighting.


I could see the utility of posting such a warning in the janitor's closet, but why did they feel the need to tell the average toilet-user not to put their hand(s) in the toilet? Are toilet-induced hand injuries that common? If so, why have I never seen one in either the pediatric or the adult emergency room? The fact that somebody thought a sign was necessary suggests that these flesh-eating toilets are capable of inflicting the kind of the damage that would require an emergency room visit, rather than the kind that you swig a little alcohol, wrap in some gauze, and hope looks better in the morning.

Anyway, in case it needs to be said, keep your appendages out of the bathroom fixtures.


Tuesday, June 18, 2019

What Residency Looks Like XLIII: I'd watch that sitcom!

Two strangers become friends while undergoing the wacky hazing ritual that is a medical residency in the United States. Actually, there are two other trainee doctors in their cohort, but one has an evening ED shift and the other is working night shift. Typical that all four couldn't be together to celebrate the end of their third year together. Coming soon: third-year bloopers!


Tuesday, June 4, 2019

What Residency Looks Like XLII: Cool as a Cucumber

Sometimes residency looks like listening to live-streamed medical lectures from your back porch in order to enjoy the beautiful early summer day before working third shift in the pediatric emergency department. DH joined me for lunch and to read a book.


Thursday, May 30, 2019

Next stop: Soggy Bottom

Here's a recipe I wanted to like that didn't quite turn out like the picture in the co-op mailer.

1. Preheat oven to 375F.

2. Grease an 8x8" baking dish with an old butter paper.

3. Mix 2 cups rolled oats and 1/2 cup chopped walnuts in a large bowl.

4. Blend 1 large chopped banana, 2 cups almond (I used cow) milk, 1/2 cup maple syrup, 2 tsp vanilla extract, 2 tsp cinnamon, 1 tsp baking powder, 1/4 tsp salt. 

5. Add 2 tbsp ground flax seeds, if you have them. (I did not.) 

6. Pour over oat-nut mixture and stir thoroughly.

7. Fold in 1/2 cup fresh or frozen blueberries.

8. Spread in pan and bake for 30-35 minutes. 

9. When the bottom is still soggy, bake for another 10 minutes.

10. Give up an just nuke each piece, upside down, before you eat it.

I don't know if almond milk has a lower evaporation point than cow's milk, or if the flax seeds would have significantly soaked up some of the liquid, but this was not as crumbly as I had anticipated. Next time I would use maybe 1 1/2 cups of milk, and maybe a little more maple syrup. The frozen berries had thawed slightly, giving the finished dish a slightly purplish hue.

Wednesday, May 29, 2019

I spy with my nefarious eye

"BWA-hahahhahaha!" boomed the pastor. 

"MWA-heh heh heh heh heh!" I responded, rubbing my hands together.

We were practicing our evil laughs while playing a spirited round of Nefarious during Game Night at church. In addition to trying to take over the world with mutated viruses and talking robots, we practiced other godly virtues like deceiving our neighbors with the card game Spyfall, in which players ask and answer questions while one spy has to try to guess a location (e.g. a bank) before the other characters figure out who the spy is.

The laugh for this game was different, though, as we got out our jitters by cavorting with false bravado after each deal:


Despite the deluge of rain, a good time was had by all.

Monday, May 27, 2019

Veggie Pizza Pizza

I always admired this dish when it was served at events at our old church in Illinois, so when the pastor's wife posted about it on Facebook recently, I decided it was time to figure out how to make it myself. It's pretty easy! I combined Pillsbury's Easy Crescent Veggie Pizza with the Reduced-Fat Crescent Veggie Pizza based on the ingredients I could find. Because the recipe(s) supposedly produce 30 servings, I made us only half of the recipe at a time, which for us was 4 dinner-sized servings or enough for 2 meals with sides, typically carrot sticks, green salad, or fruit salad.

1. Heat oven to 375F.

2. Lay one canister of 90-calorie Pillsbury crescent rolls out flat on an (un)greased pan. I pressed down the seams, as instructed, and tried to make something of a crust on a flat sheet. That part was marginally successful.

3. Pop crust in oven for ~15 minutes.

4. Meanwhile, chop vegetables. You can use whatever you like: broccoli, tomato, bell peppers, onions, cucumber or zucchini, radishes, asparagus, etc. Shave 1 small or 1/2 a large carrot.

5. Remove crust from oven and place on oven mitts or trivets in the fridge to cool. (I didn't want to have to wait half an hour, as it was already nearing 7 o'clock.)

6. Mix 4oz (reduced fat) cream cheese with 4oz (reduced fat) sour cream, 1/2 tsp dill weed, and 1/8 tsp minced garlic (the recipe called for garlic powder). You might have to soften the cream cheese in the microwave briefly. The low-fat version called for cottage cheese, which I thought would be too lumpy.

7. Spread cream cheese on crust. Sprinkle carrot on top, then gently press the rest of the vegetables into the cream cheese.

8. Cut into quarters and enjoy about 45 minutes after starting prep.

N.B.--If you enjoyed this vegetarian recipe, you might like the following (in increasing order of difficulty): chickpea saga spinach as a side dish, these kohlrabi fritters for an entree, and/or a green grain gourd salad best for for a holiday dinner.

Saturday, May 25, 2019

With a mulch, mulch here, and an oink, oink there

Today Dear Husband and I planned to help the Western Pennsylvania Conservancy plant flowers up in Butler, PA, an hour from Pittsburgh. Alas, the starttime on the website was incorrect, and we were straggling this morning, so we showed up 1.5 hours late--just in time to spend an hour toting and spreading mulch. It turned out to be a planting with the Butler AM Rotary Club, and Clint, the one-man welcoming committee, confessed that he had also mistaken the start time. He was friendly and persistent, and managed to extract most of our life histories in between buckets. Reportedly this is sort of a rough area of town, so the garden really livens up the traffic patterns. Although as more than one person asked, why do they have to choose to annuals every year, when perennials would be mulch less work?

Afterward we went to a friend's house to clean up. The four of us carpooled over to a new BBQ place, When Pigs Fly. What a hidden gem! A little divey but the food is totally worth it. Locally owned, with plenty of eating space inside and out, all decorated with flying pigs. We enjoyed the beautiful weather and a radio under the umbrella at a picnic table outside. (After the owner warned us that the table without an umbrella was right under a nest of poopy birds!) The kitchen was fast, and the portions were generous. DH polished off a whole half-rack of juicy ribs, while the rest of us ate pulled pork and brisket sandwiches stuffed into hotdog buns. Neither the pineapple jalapeno nor hot sauces was particularly spice. We tried four different sides: collard greens, candied yams, potato salad, and macaroni salad. If I had had any more room, I wanted to taste the mac and cheese. Apparently they do catering and take-out, as well as sell sodas and walking tacos to the kids getting out of school up the hill. I left them an excellent review on Yelp and hope they prosper.

On the way back south DH and I stopped for ice cream at Hammer's, just like last time we drove to Butler, although we didn't bother trying to ask for a discount this time. We had a quiet afternoon and evening after getting home, the hard labor, heat, and so much food pretty much killing our desires to be productive, practice, go to the grocery store, or even cook, so we settled for take-out from the Middle Eastern restaurant down the street and hanging out with Rosie. Good thing there are still two more days this weekend yo get all those things done.

Wednesday, May 22, 2019

I don't use military metaphors in medicine lightly

"In the Trenches"
A poem published in the Ad Libitum section of the Annals of Internal Medicine

Feel for the teenaged girl who cuts
herself so she can control some-
thing in a divided household
but cannot bear the dozen pricks
of the thin lidocaine needle
so she will not feel any of
the one hundred twenty stitches
needed to lace her wrists back up.
Sutures march like rows of barbed wire
across this no-man's land of skin.
Her mother whispers in her hair,
while her father stands guard, arms crossed,
watching from the foot of the bed.
My hand cramps around the forceps
as I bend down to sew again.

I don't use military metaphors in medicine lightly, despite their ubiquity: we talk constantly about "fighting cancer" and "beating the disease." In graduate school I did a research project on the use of contemporary geopolitical language in the earliest days of bacteriology (~1880s). Because non-white, non-Western bodies seemed to bring diseases with them (especially cholera), terms such as "invasion" and "colonization" reflected both fear and the vacuum of an entirely new field that needed a vocabulary. What this sometimes overwrought language did, however, was pretend like nineteenth-century European and North American cities weren't also already filthy places to live.

While military metaphors seem normal now due to their longevity, the anthropomorphization of unthinking malignant or infectious cells is not inevitable, as Susan Sontag wrote in Illness as Metaphor (1978). She described how being encouraged to "fight" her breast cancer made it seem like her clinical outcome depended more on her state of mind than on the biology of the cancer or the efficacy of the available therapies.

In this poem I invoke "the trenches"--of World War I, of a family at war with itself, of front-line healthcare workers threatened with burnout. I think it's important to point out that burnout can happen if a nurse or doctor becomes overwhelmed with all the tragedy around them--essentially if they feel too much for their patients--and it can also happen if the long hours and bureaucratic red tape prevent them from feeling anything for the vast majority patients who come seeking aid without ulterior motives like pain medications or a free turkey sandwich.

One last note: as I counted up the syllables to make them even in each line, I realized that 15 lines x 8 syllables = 120 beats/stitches.

N.B.--Other poetry you might enjoy include this little Ogden Nash ditty, and this more somber verse about the relationship between the Pacific Ocean and the coastline.

Saturday, May 18, 2019

That's So Pittsburgh: High Tea with Sherlock Holmes Afficianados

Today Dear Husband and I celebrated the end of two weeks of night shifts with a date for Sherlock-Holmes-themed high tea with the local Britsburgh Anglophile group. It was hosted at the Omni William Penn Hotel, the fanciest hotel in the world when it was built in 1916, at least according to the maitre d'. The chandeliers behind us were gifts from the queen of Austria and are worth $50,000(!). The organizers chose this hotel in part because of the fancy-schmancy atmosphere of the Terrace Room, and in part because Sir Arthur Conan Doyle himself spent one night there when traveling through the United States lecturing on spiritualism and the paranormal.

The invitation encouraged guests to get all dressed up and ladies to wear hats, and we happily complied. We ended up sharing a table with a slightly older professional couple. Sheila is a runner, and Frank likes organ concerts, so there was a lot to talk about. DH chose the mountain berry tea, while I opted for Earl Grey. We enjoyed a variety of finger sandwiches but could not manage to finish this impressive display of fruit and desserts. The china was a beautiful, classic, floral rose-on-white pattern. Service took over an hour, however, so the special lecture was delayed.

The guest for the day was Sherlockian Jim Zunic, who described himself as someone who has "an inordinate interest in Sherlock Holmes," and it made me wonder what constitutes an "ordinate" interest. He has read all 4 novellas and 56 short stories, watched the television and film knockoffs, and collected a variety of ephemera. It was a short but very interesting lecture. Zunic reminded us that many details associated with the famous detective in popular culture are not "canonical" from Conan-Doyle's original writings: the deerstalker hat, the curved pipe, and the phrase, "Elementary, my dear Watson!"

One last thing: the Terrace Room is overseen by a mural of George Washington recapturing Fort Duquesne (now Fort Pitt) in 1755. The hotel maitre d' pointed out a number of intentional inaccuracies, from the depiction of an elderly GW for recognition's sake, although he would have been 33 at the time, to the Plains Sioux headdress on the Iroquois Native American man in the foreground. The soldier on the left is General Braddock, not Governor Pitt the Elder, for whom the fort and later city were named.

Editor's Note: If you enjoyed this edition of That's So Pittsburgh (TSPGH), you might like the World War I commemoration we attended, or this post about other historic murals.

Sunday, May 12, 2019

What Residency Looks Like XLI: Llamapalooza

Sometimes residency looks like a houseful of pediatricians and their dates/families hiding from the rain in an old farmhouse, crowding around the potluck table and grilled meats, and darting out to the barn to feed the llamas and pet the friendly barn cat. The llamas are all named Jackie, and the cat's name is Twinkie. The hostess and her husband used to have as many as 35 llamas; now there are 6. In the spring they invite the department out for a party on their farm an hour outside of town, complete with legendary grilled salmon, music over speakers from the second-story porch, multiple mixed drinks, and a bonfire once dark fell and the rain relented. If the weather hadn't been so wet, there would have been cornhole and frisbee. As it was, the 5 dogs had the time of their lives. The llamas had no comment, although one deigned to eat a little cracked corn out of my hand.

You had better believe that when the first guy to feed the fire left, yours truly, Girl Scout Extraordinaire, continued to nurse it.


Wednesday, May 8, 2019

That's So Pittsburgh: Mystics in Motion

One night at Mystics in Motion (the Wednesday night service formerly known as Worship Jam), we made sock puppets. The idea was that while we might show one face to each other, God knows our innermost selves. So we decorated socks and then turned them inside out and decorated them again. And because this is a group of creatives, we went around the circle to name and describe our characters before and after their transformations. (That's my sock with its two different personalities above.)

Because I waited too long to write this post, I can't remember any of the details, but that's probably just as well, as many of them reflected their creators' personalities and interior journeys. I will say that I was struck by the fact that no one's sock puppet had the same shape as anyone else's: one was tall, another short, one with a long nose, another short, and so on. That diversity and the safe space to open up to one another--to do crafts, and sing/dance, and have the faith of children--is one of the reasons we enjoy this group so much.

In an effort to be conscientious, the socks were undecorated and donated after we finished with them.

Friday, May 3, 2019

What Residency Looks Like LX: Starzl's stare

Sometimes residency looks like listening to interdisciplinary rounds with the intestinal care team under the watchful gaze of Thomas Starzl (1926-2017), the famous liver transplant surgeon. He was recruited to Pittsburgh from Colorado, where he had grown tired of opposition to his pioneering but as-yet unsuccessful operations to save the lives of patients in liver failure. At Pitt he developed a highly successful transplant service, training fellows who went on to populate the field. This was back in the 1980s, when transplantation was still so new that Starzl had to fly in a rented private plane to the various hospitals where a donor had died, harvest the organ, take it back to Pittsburgh, and implant it--there just weren't other surgeons who could do this kind of surgery. According to Burden of Genius, the well-done documentary I watched on the IMAX at the Carnegie Science Center, he was a no-nonsense perfectionist and difficult to work with. But he got results. There was scandal about the way he let wealthy patients from the Middle East pay their way, but he also operated on any patient, regardless of their ability to pay. A government investigation found him innocent, but he burned out of the OR after 10 years here and turned his attention to researching immunosuppression regimens for preserving organs after transplantation. Click on the link above to see some great photographs and watch the doc-trailer.

p.s. Pittsburghers, you have two more chances to see the film at the Science Center, May 19, 4pm and 7pm!


Tuesday, April 30, 2019

What Residency Looks Like LIX: Poop Deck

Another entry in my log of bathroom posts. One of my colleagues bought this sign and accompanying door handle charm for our workroom/lounge. Seems self-explanatory.

When I was a third-year medical student, I observed/assisted in an operation with the colorectal team. One of the PAs laughed when I made some comment that suggested I wouldn't deal with poop as a doctor, since I hadn't chosen colorectal surgery. She was right. It is inescapable. I also gave up calling it "stools" or "bowel movements" pretty quickly, because some people didn't know what I was talking about, but everybody knows what you mean when you ask, "When was the last time you pooped?"

For instance, while shadowing an ER physician in medical school, I developed a simple "review of systems" questionnaire, 6-8 questions I ask all my patients to make sure I'm not missing something that impacts their daily lives: eating/drinking, peeing/pooping, sleeping/playing (or working). We also prefer that our patients are walking/talking before they are discharged (or whatever the developmental/ functional equivalent is).

Ahoy, matey! When was the last time you pooped?


Tuesday, April 23, 2019

What Residency Looks Like LVIII: An Oasis

Sometimes residency looks like checking email under a gazebo in a rooftop garden oasis in the middle of an urban hospital complex on a warm and sunny spring day while hidden birds loudly chirp their business to the world. I'm on campus on a vacation day to hear a Grand Rounds presentation about current trends in medical education.


Sunday, April 21, 2019

Happy Easter 2019 + bonus recipe

 Happy Easter! Dear Husband and I celebrated with a lovely service at church with music that was much nicer than the weather outside. Then I spent a second day in the kitchen, this time preparing to host small dinner for work colleagues. The menu included a McCormick & Company shrimp and dill pot pie, pineapple angel food cake, fruit salad, and a delicious white German wine. We ended the night with a game of Settlers of Catan.

Frau Doktor Doctor's Easter Dinner

1. Saturday morning, go grocery shopping with half the neighborhood. Sunday afternoon, realize you're still short the shrimp, half-and-half, sugar snap peas, and angel food cake mix. Send DH.

2. Begin to prepare the pineapple angel food cake by messing up the crucial step of substituting 20 oz of crushed pineapple for the water.

3. Strain the cake mix over the sink, add the pineapple, and bake as directed at 350 degrees for 30-40 minutes.

4. Meanwhile, saute 1/4 of an enormous yellow onion, chopped, and 1/2 of a 3-pound bag of shrimp in butter.

5. Realize the sauce won't fit and divide the mixture into two pans.

6. Take the cake out after 30 minutes. Should have left it in another 10 minutes so the top wasn't so tacky. Increase oven temp to 400 degrees.

7. Whisk 1 1/2 cups of half and half, 1/4 cup dry white wine, 1/4 cup flour, 1 tsp dill weed, 1/2 tsp salt, and 1/4 tsp thyme. Divide between the pans and bring to a boil while stirring continuously.

8. After sauce thickens, pour into a 2 qt dish. Stir in a package of sugar snap peas. Cut a roll of pizza dough into slices and arrange like shingles on top.

9.  Put into the oven 20 minutes before your guests are due. 10 minutes later, turn off the oven but leave the dish inside. 10 minutes after that, decide the top isn't baked enough, so turn the oven back on to 400 until you smell the juices overflowing onto the bottom of the oven and burning.

10. Dig in! Too late you realize the shrimp still have their tail shells on. Good thing it's so delicious!

N.B.--While I was writing this post, I looked back for the last time I used dill weed--only to discover that I had made this very same recipe 3 years ago. I asked why DH hadn't reminded me, and he said it was because afterwards I had become violently ill! Thankfully no guests were harmed in the making of this blog post.

Tuesday, April 9, 2019

What Residency Looks Like LVII: Sunshine, at last!

Sometimes residency looks like the first nice day of spring when you aren't busy, so you slip outside for an hour of reading articles about medical student evaluation for Evidence-Based Medicine Morning Report the next day, and also just eating a snack and basking in the warm sun, until the wind chases you inside to get some emailing done before the Diversity & Inclusion committee meeting. You know it's warm because I'm wearing footies instead of socks or stockings.


Friday, April 5, 2019

What Residency Looks Like LVI: Time/Travel

Sometimes residency looks like starting the day by waking up early to work on your comments for a conference panel with the oversight of certain feline...

...and ending the day 6 hours away at a friend's house eating homemade curry and Pittsburgh Popcorn, and playing German card games. So much winning, despite the losing.


Friday, March 29, 2019


Sometimes marriage looks like sleeping on the couch for 4+ nights in a row while your spouse hacks up a lung in your conjugal bed in the pest house formerly known as your joint bedroom. Dear Husband been laid low with what we suspect is influenza, but he felt too poorly to go to the doctor to get tested, so we've been treating him symptomatically with Day/Nyquil, ibuprofen, and whatever food or drink appeals to his diminished taste buds (mostly Gatorade and orange slices). He's starting to sound more like himself, so he's probably over the hump and on the mend for the next several days.

p.s. Yes, that is a canister of bleach wipes. I've been using them twice a day on door knobs, light switches, faucet handles, etc.

p.p.s. "Flu season" peaked late this year, with influenza A cases only starting to decline this past week; influenza B hasn't even started its ascent yet. If you haven't gotten a flu shot this winter, it's not too late! Remember that it takes 2 weeks for your body to respond to the vaccine, so sooner is better than later.

p.p.p.s. If you happen to be laid up with the flu, let This Podcast Will Kill You's influenza episode will entertain you will the history and epidemiology of this disease.

p.p.p.p.s. Wash your hands/cover your cough!

Tuesday, March 19, 2019

What Residency Looks Like LV: Stanley Two-Brick

Sometimes residency looks like a new board game, good food/drink/music, and the company of 2 co-workers and 2 rambunctious cats (not pictured). It's too rare that this happens, and it's so wonderful when it does, even when you lose the game.


Saturday, March 16, 2019

Recipe for Dirtying Every Pot aka Milos's Lentil Soup

I got this recipe for lentil soup from one of my graduate-school colleagues many years ago. Milos was from Eastern Europe and studied urban history; we've unfortunately lost touch after he left Facebook. The recipe has been sitting in my hand-copied cookbook just waiting for me to remember how much I like the idea of lentil soup. One of my New Year's Resolutions the last two years has been to cook more from my recipe collection than from the internet, so I decided to seize the opportunity to make a delicious cold-weather dish that was can eat from for the next week. According to Milos, you can make this with browned beef, but I decided to go vegan and leave that out. It's really creamy and delicious! The process left something to be desired, however...

1. Figure out how to buy 1.5-2 cups of split yellow lentils (labeled mung dal at the co-op). Also pick up 0.5 pounds fresh green beans, a couple of plum tomatoes, 3 large carrots, and a medium white onion. Assume you have tomato sauce at home.

2. Listen to the radio while chopping the carrots into thick rounds, the onion into little dices, and the green beans into ~1-inch sections. Soak the lentils in a pan, then drain. Put it all in the fridge for later. Discover the tomato sauce has become a fungus farm.

3. Two hours before dinner, turn on the radio again. Decide 8 cups of water aren't going to fit; transfer lentils to large pot. Add 3 bay leaves, the rest of a jar of sweet paprika (just over 1 tsp), a little black pepper, and some salt.

4. Realize you need to saute the veggies before combining with the lentils. Start heating olive oil and garlic in a small pan. Change to large saute pan. Cover veggies and some salt with a lid until onion is translucent, then add to lentils.

5. Improvise 0.5 cups tomato sauce with last week's cherry tomatoes, the dregs of a watery jar of salsa, some olive oil, a pinch of sugar, and a little water. Add to lentils once cooked down.

6. After an hour, turn the heat on the lentils way down. Ask Dear Husband to put the green beans in and stir. He will do this with a clean spoon instead of the ladle on the stove. Cook another 40-60 minutes. Add a bunch of basil shortly before serving.

7. Burn some bread in the broiler.

8. Spoon soup into bowls, add a spoonful of yogurt, sprinkle with parsley, and serve with a nice Greek salad.