No Method, Just Madness

My bloggless month of April crescendoed with the acquisition of a rather fastidious GI virus that then resulted in an impressive fecal meltdown and, subsequently, one work day spent conducting the business of surgical residency with an IV in my right upper arm, IV fluid running through me, followed by several more nauseated, bloated work days wishing someone would follow their “you don’t look so good” with a “you should maybe go home and get some rest.” It was a shitty way to end a predominantly shitty month spent working entirely too much.¹

Spoiler Alert: May’s not turning out much better. (Albeit significantly less “literally” shitty.)

May has found me in Reno where I’m rotating at an affiliate hospital for this month and next. I’ve come to the conclusion that Reno isn’t so much “The Biggest Little City in the World” as it is the Littlest Little City in the World with the Most Stripmalls. I’ve polled the Reno locals (n=4) on what there is to do in this town and have been met with just as many blank stares and one silent nudge in the general direction of Harrah’s. So I’ve revitalized my relationship with my surgical textbooks and renewed my Blockbuster membership. Note: Surprisingly, many patients who’ve suffered TIA’s have CT evidence of stroke and Pineapple Express has its funny bits but is generally shit.

Which leads me to something else that’s shit. Cancer. If last year was The Year of The Wedding² this year is certainly The Year of Cancer. I’ve already mentioned The Love Muscle’s stomach cancer but The Brit’s aunt was diagnosed with colon cancer, I just got word the other day that one of my aunt’s brother’s has a pancreatic mass, one of the nicest patients I’ve ever treated just got diagnosed with throat cancer, and, also, a wonderful couple The Brit and I know are getting a divorce which isn’t so much literally cancer as it is figuratively Stage IV Marriage Cancer so I’m throwing it in there anyway. It’s my blog.

Things with TLM’s stomach cancer have taken a turn for the worse…its spread throughout his abdomen. This has left us all simultaneously paralyzed and racing against a timer whose countdown is indecipherable. Daily, I find myself trapped in a variation of the same scenario: scrubbing into this case or that, fake smile plastered across my face while pretending to listen to my attending’s monologue about this, that, or how fantastic the back yard will be once the hideously expensive 40 ft pool is finished and the imported palm trees have been planted…all the while resisting the temptation to make a run for the Reno airport and hop on the next plane to Portland (but not before pelleting my attending with my chlorhexidine soaked scrub brush and telling him/her what they can do with their imported fucking palm trees). (Hypothetically, of course.)

I warned you.

1. The pun wasn’t intended but it did work out rather nicely.
2.  Not only did The Brit and I get married but so did, like, a billion of our friends.

What would you say might be appropriate punishment for an accountant who…umm…GROSSLY miscalculated what you owed in federal and state taxes?  Because I’m thinking that I might dip said accountant in honey, spray him with bird seed, and then hang him from his scrotum in the yellow bellied sap sucker bird exhibit at the Academy of Sciences Museum during peak business hours for precisely 12,000 seconds.  And then mention to him, say, around second 11, 999, that I really only meant to hang him there for 1,500 seconds. 

Oops, indeed.

The Brit left this past weekend for a two week business trip to Asia, leaving me alone to contemplate the subtle layer of blubber that crept up behind me and latched onto my arse these last few months. Not that I was surprised to find it there…one should expect these things when one makes the administrative decision to respond to stress by wrapping every edible thing in sight in prosciutto and pan frying it in olive oil. It didn’t strike me as problematic until I considered wrapping prosciutto in prosciutto and pan frying it in olive oil. Delicious, yes…but only worth it if I commit to elastic banded pants for the rest of my life.

So I decided to suppress the prosciutto habit by replacing it with another one – Yoga. It’d been a few years since my days of Bikram Yoga, but how hard could it be, am I right? Surely it’s just like getting’ back in the ol’ saddle…or in this case, a long, narrow, poorly ventilated studio with a bunch of half naked, hairy hippies all striving to achieve inner peace by way of assuming the Downward Facing Dog position. Weeee!

There’s a yoga studio right in my barrio, around the corner, in fact, so I went. Anticipating that I’d embarrass myself by sweating and grunting like a greased-up pig penned in for the big pig-chase event at the county fair …I got there early enough to get a place at the back. And then proceeded to enter through the door at the front of the studio. This boded poorly. I ended up front and center, directly under the loving gaze of our radiant instructor whose slender, chiseled body seemed backlit in an ethereal glow that I imagine is bestowed only upon those who’ve achieved the yogic strength and flexibility to fellate themselves. I’d probably glow too.

She asked those of us who weren’t regulars to raise our hands and introduce ourselves.

“Hi,” I said, “I’m La Cubana Gringa.” And I have a Prosciutto Problem.

What transpired thereafter remains hazy. Suffice it to say that two Ommmm’s, five downward facing dogs, and one “here, let me help push you a little deeper into that stretch by placing my surprisingly strong hands on the small of your back and forcing together two surfaces of your body that Mother Nature never intended to come into contact with each other” later, I became acutely aware of the room closing in around me and the voice of God telling me to move toward the light. He didn’t outright say it but I got the distinct impression that if I followed the light, I’d be rewarded with fresh-baked chocolate chip cookies. I regained consciousness in the downward facing dog position. No chocolate chip cookies in sight. Clearly the hand of Satan was at work there.

I limped home in a post-ictal state and then came to the realization that all the light and the voice of God and the warm cookie business wasn’t so much a delusion as it was a prophecy. It couldn’t have been a coincidence that within my pantry cabinets were all the necessary ingredients for chocolate chip cookies. Which I then made.

Namaste.

Checking voicemail rates highly up there on the list of things I’d gladly trade for the chance to have hot accupuncture needles jabbed into my eyeballs.  It’s right up there with euthanizing lab rats, running uphill, and listening to any song (rap, opera, yodeling or otherwise) that violates the rules of syntax and grammar for the sake of having the lyrics rhyme.   (I’m going to go ahead and call you out on this one, Juvenile, the words “ass” and “bad” cannot be made to rhyme by just adding “yeah” to the end of them.)  So, anyway, what I’m sayin’ is, I don’t enjoy checking voicemail messages.  Don’t ask me to rationalize it, there’s no explanation for it.  Just…no me gusta. 

The only reason I mention this is because the other day,  I unexpectedly got out of work early enough to go to the SF municipal transport office (to see about getting a residential street parking permit) before it closed.  I took a number and the only remaining empty seat in the room only to realize moments later that I’d wedged myself  between a guy who was checking his voice mail ON SPEAKER PHONE and another guy who was listening to his headphones loud enough for the entire waiting room to hear the atrocities being perpetrated against grammar in the particular song he was (we were)  listening to. 

I’m about to strip and I want it quick
Can you handle me the way I are?

You have SEVEN!! new messages!!  Message number…one from… four…one…five…three…three…nine…two…four…seven…seven on Monday…March twenty…third at…four…fifteen…pee…emmm:  Hi Doug!  DUDE!!!  Are you coming out tonight or WHAT???…[DELETE] Message number…two from…four…one…five…

Somewhere, out in space, the planets and the stars were aligning against me.  Surely a litter of innocent lab rats minding their own business was being brutally murdered somewhere while Celine Dion* was signing to the tune of something Kenny G* was playing on sax…ALL AT THE SAME TIME.

* Also on the list.

I have this distinct memory of sitting in a GI lecture in medical school.  We were learning about different anastomoses (pleural for “anastomosis”, the medical term for the surgical joining of  two organs or spaces that are not normally connected).  As one who has performed countless numbers of these since med school, the term “anastomosis” is now part of the language that I speak routinely…but at the time, it was a shiny, brand new word.  My friend, E, was sitting next to me in lecture, scribbling furiously in his notebook.  He wasn’t predisposed to feverish note-taking so I leaned in to see what he was up to.   He’d drawn his loose interpretation of an anastomosis, an image that I will never likely forget.  Behold, my dear three readers…below is my recreation of E’s original drawing: 

That shit still makes me laugh.  (Thanks for that, E.)

I’m not sure how we arrived at the topic but I was telling my colleagues about E’s drawing today while we were scrubbed in on a case.  The attending surgeon I was working with chuckled and then mentioned this one time when he was proofreading a transcribed operative report that he’d dictated.   He’d made mention in his dictation of the incidental finding of “fibroids in the uterus” of the patient.  But that’s not what the transcriptionist heard.  Below, I give you my schematic recreation of the transcriptionist’s interpretation…

Fireballs in the Eucharist.  That was actually transcribed into a patient’s medical record.  And she thought her biggest problem was a few benign tumors in her uterus?  Little did she know that what actually sprung forth from her loins was ARMAGEDDON!