small news

Our Christmas tree is still up, and if that's wrong, I don't want to be right.
Fire hazard or not, we do not feel finished enjoying this year's dazzler.

I am finally succeeding in securing IV's...thank the good Lord above.
The most hilarious patients in the world cross my path. A salty priest, a jabberbox undertaker, a granny. All hilarious. I wish I could tell you more about them.
I laughed hard with my colleagues over an ultrasound machine today. It just became funnier and funnier.


This is the hepatorenal recess: Morison's pouch. We found out via today's ultrasound jam session that Adam K's, Pearlann A's, and mine are all really perfect - ample reason for pride and joy. 
Yes, we're all exhausted.

Adam K himself. you can't tell by looking, but he's internally perfect as far as we can see on ultrasound.

Both kids are brushing up on their math facts.
JJ is becoming a giant: Giant JJ. He is still so cute. We love him.

It's been cold and/or rainy for a long time now. I'm thinking about midwinter in the dirty south.
Practically the only solution to winter in the dirty south is a grotesque outdoor lights display.

And there is our family's celestial being - as in cherubim with 1000 eyes. It has now collapsed under the weight of its own wet branches, but it was stunningly beautiful for a short glorious while.
XOXO going to bed.

only photos

Birding

Happy woods-creek time

Caroling with friends

KidV receives a big gift

Mookie Mookie faces

Nostalgia songs I need you now

Tonight I was rolling down Ponce de Leon in 3 a.m. style (which means unobstructed by any other traffic whatsoever) when I heard that song, "Don't Bring me Down" on the radio. Yes, by ELO.

"You're lookin good just like a snake in the grass.
One of these days you're gonna break your glass.
don't bring me down-
no no no no no no no no.

Who can forget that jam? All that snake imagery? Free snakes, captured snakes... Dang.

I can't forget it, try as I might. It's a JAM. Then guess what came on? Burning down the house. And then It's the End of the World as we know it and I feel fine.

Hear me out a moment. I remember Dean Eley recounting a story about his intern year in Lecture Room 110, and to emphasize the point he was making about how tired and overworked he had been he said, "I hadn't had a creative thought in three months." It's been considerably less than three months for me, but it's true - intern year is about work. Hard work, work you are not sure how to do, and in my case work that won't let me get to sleep once my head hits the pillow at any odd hour.

Here's what happens when I try to go to sleep: I recycle procedures and patients again and again. I dreamed that Dr. Dente gave me a cholecystectomy without consenting me. I looked down upon myself from a Gross-clinic-esque riser in a dim room as I, insensate, had my gallbladder out at the hands of Dr. Dente, who in real life taught me cholecystectomy as a med student. I dreamed about decapitated twins that did great after surgery. I dreamed about inserting a line again and again and again like Sisyphus and the stone. Lots of times I only half-sleep, eyes closed but roving with my brain over all the stuff I did that day. Often I wake up and check stuff in the computer in the middle of the night. I called the attending at 3 a.m. night before last to tell her I'd forgotten to print a prescription before I left. She scolded me and told me not to call for such insignificant details again; I should be asleep. But this is how I am wired. I have to get through this until it gets easier. To quote a different genre of song, "It's like that. And that's the way it IS." I do not have creative thoughts; I have perseverative problem-solving thoughts.

So the three songs whipped me back to different times and different places all in the space of a ride home. These times: Riding on a sticky-hot vinyl car seat with my mom at the wheel. Running through a talent show routine over and over with Anbar. Dancing in a Kroger parking lot with Erin. Three songs later, time and space had contracted enough for me to see out of this week's box for a moment.

But now I am home to my sleeping sweet family and hoping to get to sleep and just sort it all out in dreams with none of that waking-up-in-a-panic stuff.

By the way, it IS the end of the world as we know it. Always such flux.

Also, don't cry for me argentina because last night I actually dreamed that I was choosing the most bestest kitten from a big room full of amazingly cute and personable kittens. Obviously I can't be TOO stressed.

Hard lessons of the past 48 hours:

1. You have to double-check that an HIV test has been drawn. Not sure why, but this one doesn't happen in a timely fashion. Dr. Beck told me to "make sure it gets done" and I didn't heed her advice until it was too late.
2. When you're intubating, curve your stylet yourself. I had to cede an airway because of a crook in my stylet I wasn't expecting. I freaked. Not to worry folks, patient got intubated just fine - just not by me.
3. Go fast when you're getting an ABG. You can't poke gently. It's more of a stab. It hurts, but it doesn't work otherwise. (ABG kits are in respiratory cart in old asthma room...which is just one of about a zillion Grady secrets)
4. Do not order blood cultures in the ED unless the patient is admitted. Period. There is no systematic way for following them up and then they end up "floating out there."
5. Know ALL nurses' names caring for your patients. As hard as I try every shift to do this, I end up retaining about one per shift, which just isn't enough. Also find their hangouts - not obvious.
6. Do not get involved in ANY junk, even benign-appearing junk. Once a patient begins telling you about what their girlfriend's mother's cousin sells (this actually happened tonight), you're not going anywhere for a while unless you reroute that train fast.
7. Don't even get into a patient's detailed description of a tiny segmented brown insect and how many of them there are unless it happens to be a spider.
8. Quit at quitting time? This seems to be possible? I can't.
9. CHECK OFF YOUR BOXES.
10. If you think a patient is having a STEMI and you need a repeat EKG and the EKG tech rolls by and you say, "Oh, hi, um, I just ordered an EKG for the patient in room 7-" and he cuts you off and says, "Well you got 'bout 3 or 4 people in front of you then you'll get your EKG," you are completely within your rights to say, "I am very concerned this patient may be having a cardiac event and he needs his EKG to come before the others."
11. You can reduce a rectal prolapse by sprinkling sugar on it. Teaching point of the evening.

* Numbers 6 and 7 were the funniest things I heard all night and I wish I could just walk around and ask people their stories.

Why everything is beautiful

Because it doesn't matter
Whether you have this BMW SUV
Or that hatchback corolla from back when the body was boxy
Frost is on them both
Catching the streetlight
And sparkling.

Mr. Handsome changes his look and more

Before

After

Decatur nature: David Schwartz 1980. Four years we've lived here and this moss has just now grown.

Precious walkers on Post-Thanksgiving Friday. We call it Delicious Friday.

Precious readers and me looking REALLY excited at my own selfie/othersie