Wednesday, July 30, 2008


In the past five days I have felt deep joy and deep sorrow. Equally intense feelings, opposite poles. It got me thinking about the very nature of intense feelings and how, regardless of which pole they originate from, they invigorate us. Feeling anything with your whole self is being alive, painfully, exquisitely alive.

My family had a birthday party for me last weekend. The big five-oh. We finally celebrated officially, with bells and whistles. Dear friends gathered, from work, soccer, neighborhood, book club, even childhood. My kids showed a retrospective slide show they had put together. I felt lucky and loved, intensely happy, warmly alive.

Yesterday, I hugged my friends Patch and his wife Cookie, knowing it could be the last time I see Patch alive, or conscious, or talking. He'll have brain surgery on Monday to remove a recurrent tumor. Last time he came through it with flying colors. We all know it could be very different this time. Or it could be the same. I felt fear and sorrow, hope and pain. Again, intensely alive.

It seems odd to be grateful for heart-wrenching fear, yet I am. Right along with happiness and hope. I want to live this life, all of it, to feel all of it, to have every experience with my very bones. And that means being open to all of it. If you're open to deep joy, you'll get it, and the sorrow that may follow. And that is rich living. Give me no other kind.

Friday, July 25, 2008

Cat Bite Day

I haven't seen a cat bite in months. Tuesday, we had two, one right after the other! Different patients, different households, different cats. One was already infected, less than a day after the bite. The patient had fever and bodyaches, all from a little puncture in her finger. The other gal's forearms were covered with scratches and bites. Her kitten wanted a cupcake, believe it or not, and was not happy to be told "no!"

Eighty percent of cat bites get infected. This is in contrast to about fifteen percent of dog bites. Surprising, isn't it? You might think those nasty canines, who chew everything from your stinky shoes to roadkill, would have mouths teeming with germs. You might think precious, preening kitty has nary a germ on her tongue. The truth is the opposite.

Finger Puncture came back yesterday, much better on a simple antibiotic. Cupcake Withholder is doing fine too. I bet it'll be Christmas before I see another cat bite.

Thursday, July 24, 2008

Professional Distance

I have this patient. I wish she were my friend. But, of course, she cannot be my friend, because that would violate the principle of professional distance.

You know what that means, right? A doctor isn't supposed to get "too close" to her patients. Although that phrase is not well defined anywhere, there is a tacit understanding that getting "too close" or "too involved" is bad for both parties.

Bad for the doctor because you lose your objectivity and can't think straight. Not to mention, you might end up getting hurt if there's a negative outcome. And, of course, there's the time-honored practice of putting ourselves on pedestals, which is hard to do if you're down in the muck with the patient.

Bad for the patient because the doctor loses her objectivity and can't think straight. Not to mention, it's hard to fire a doctor if they're also your friend. And, of course, there's the possibly comforting traditional role of doctor as boss, abrogating you, the patient, of responsibility, which is hard to maintain if you're equals.

All that said, albeit somewhat with tongue in cheek, I find it hard at times to maintain this distance. This patient is a case in point. She came to see me a couple weeks ago. We clicked immediately. She's friendly, casual, comfortable with herself, funny, smart. I am seeing her for a minor but persistent problem that has required her to come back several times, and each time I have a really good time, as if we were meeting socially for coffee or something. Don't get me wrong: I am treating her, and successfully too. But the treatment gives us time to chat. I even told her the story about the time I spilled trichloroacetic acid on...but that's fodder for another post.

I know we'd be really good friends if circumstances were different. It makes me feel sad.

She's moving away soon, to the other side of the country, taking dilemma and possibility with her. I wish her well, and I'll miss her.

Monday, July 21, 2008

Eight Mile Run

We did it! We ran 8 miles. The longest run yet. Not only that, it was out in the country, on a rather hilly road. We started at Jemez Dam, for those of you in the know, and ran back toward Bernalillo. Here's the view from the starting point:

Coach Marc, a.k.a. "Iron Man" gives his customary safety speech. Only this one included "watch out for bulls!"

And we were off! Hard to complain about running in such beauty.

Thankfully, Scott, the photographer extraordinaire, took his photos at the beginning of the run, while we were all still smiling. That's me in the middle, with leggy Jen on my left and Coach Lori, a.k.a. "Tofu Lori," on my right.

We all finished, and were very proud of ourselves. Still hard to believe we'll be able to run half again as much in September, but I have faith.

Friday, July 18, 2008

Training for a Half Marathon

Round about December last year, I started to fidget. No exercise to speak of since my car crash in August, and I was getting soft and grumpy! My neck and back were feeling enough better that I really wanted to try something, anything, to get my bod moving again. After all, I'd be 50 soon, and we all know it gets harder to get in shape the older you are!

I went to my friend Sue, a marathon runner who is 54 and looks 44, to ask her advice. See, my usual exercise "regimen" included playing adult soccer once or twice a week, and that was about it. I know the value of exercise and keeping in shape. I am an educated medical professional, after all. But, I tell you, if it isn't fun, I simply won't do it. Laps at the pool? Bo-o-o-ring! Routines at the gym? Spare me.

I wasn't sure I was up for soccer yet. The only kind of soccer that goes on here in winter is indoor soccer, which is notoriously rough and risky. I figured I better start with something kinder and gentler. I was hoping to be back in good enough shape for the Spring women's soccer season.

I might have predicted Sue's response. "Try running!" Ugh. Running was right up there with pool laps and machine weights.

"Wel-l-l," I waffled. But Sue persisted. She told me about the program and group that got her running. Albuquerque Fit.

I checked it out. Their beginner program is called In Motion. They met every Saturday for an hour, starting in January. I decided to go. The first day we "ran" a half hour as follows: run for one minute, walk for four minutes, repeat. Wow, I thought. I can do this. So I continued.

The next week, we ran for two minutes and walked for four. And so on. Bit by bit, the running time increased and the walking time decreased. We hardly noticed our muscles growing and our endurance increasing. By the end of the program, 11 weeks later, we were running for eight minutes and walking for one.

By then I was hooked. Not only did In Motion give me people to run with once a week, they gave me a proscribed schedule for running during the week. This, I failed to mention, is the other way to get me to exercise. Tell me what to do. Give me instructions, a task, a schedule. Make it so I don't have to motivate myself and I'll do it. Of course, I still have to get my own rear out the door and move it, but having a formula really helps me. Get up, go do the run, check that one off, shower, go to work.

When that program ended and the next one, Albuquerque Fit, began, I stuck with it. ABQ Fit trains you for one of three races: marathon, half marathon or 10K. The coaches, who are regular guys and gals who started just like we did, encouraged us to aim high, saying it was easier to shift down than up partway through. So I went for the half, thinking from the beginning that I'd probably end up changing to the 10K, but secretly hoping I could make the grade for the half marathon. It just seemed so perfect. This is my half century year. Running a half marathon in honor of that was fitting.

So here I am. Several weeks into it, and still hanging in there. People do drop out, by the way, naturally. But a couple weeks ago Coach Mike informed us that, statistically, of those of us who had made it to that point, over 90 percent of us would finish our target race. We had made it over some kind of hump.

Tomorrow, our long Saturday run will be 8 miles. I have never run that far in my life. But, thanks to the incremental training technique, I have run 6.6 miles, and 7 miles. My weekly totals (long weekend run plus three weekday runs) are now up over 13 miles. Now I run for a mile before I walk for a minute, because the run/walk technique is what they teach. We're aiming to finish, not to break any time records here. So far my old bod is holding up pretty well. A few aches and tweaks here and there, but --knock on wood--nothing that has laid me up.

My target half marathon is in early September. Wish me luck! I'll let you know how it goes.

Wednesday, July 16, 2008

Butt Boil Day

Today in clinic it was Butt Boil day.


You know how they say things come in threes? It's true. At least, in medicine it is, or seems so much of the time. Weeks will go by with not a pimpled posterior in sight. Until suddenly, one day, boom, boom, boom! Three in a row.

Did these people know each other? No. Did they all sit on the same seat on the bus, or bench in the park? I seriously doubt it. So why did they all develop boils on their behinds today? It's a medical mystery.

We've had other odd days as well. Among others: Eye Scratch Day, Jock Itch Day, and, my personal favorite, Ingrown Toenail Day. (What can I say? I love procedures. I'm a wannabe surgeon at heart.)

Wednesday, July 09, 2008

Stereo Mammograms

The other day, our local paper had a story about a new and improved, up and coming technique for imaging the breast. See, the way they do it now, a mammogram, is two-dimensional. And the breast, of course, is three-dimensional. Yes, in spite of all their efforts to squash it into one less dimension, it remains stubbornly round. Well, once it recovers from the mammo, that is.

This new technique involves taking two mammograms, from two slightly different angles, so as to create a stereoscope of the breast. The result is two pictures, slightly off kilter from each other. The radiologist, in order to read the two mammograms as one round image, will don a pair of those weird stereo glasses like from the 60's. I kid you not. Remember those things? Or the plastic binocular-shaped gismo that you'd pop a round slide card into and look through, to ooh and ahh at the 3-dimensional image inside.

I had to laugh. And, at the same time, shake my head. Why on earth didn't someone think of this sooner? We had higher technology for our toys 40 years ago than we do for our breasts today. What is wrong with this picture?

The Authors of "50 Ways" Interview on KCHF TV

50 Ways to Leave Your 40s TV interview with Phoenix' Pat McMahon