Sunday, December 30, 2007

How to Cry

If you're me,
1. Go into a dark room, alone.
2. Shut the door.
3. Put on headphones and listen to either
Ben Harper's "I Shall not walk Alone", Sufjan Stevens' "Seven Swans"
or just about any track from Sarah McLachlan's "Solace."
4. Accept that there's still only about a 5% chance this will work.

The London Daily Mail ran an article in April about clubs where Londoners can go to get their cry on. Forget the release of alcohol, the oblivion of cocaine, or the sweaty debauchery of gyrating with scantily-clad twentysomethings until dawn (well, don't forget it...but put it off for tonight). The ultimate release, in a hypermedicated and plasticized society, is that of genuine emotion, experienced with others who are 'going through' the same thing and thus are able to sympathize (or at least witness it without looking uncomfortably away). And screwed up as paying for entry to a 'misery club' may be, I understand why someone would do it. There have been periods of my life when I have gone literally years without crying, and the incredible energy that's released when tears finally come is mind-blowing. Imagine crying for the first time in three years. Imagine all the pent-up rage and frustration and sadness and guilt and shame and EVERYTHING that would be pouring out of your eyes. Like a lake bursting through a dam. Intense.

I'm still not a cryer. Often I'll WANT to, but won't be able to--probably too much information, and profoundly uninteresting, but I'll just say that it's frequently as if I can see my emotions in a glass case, like the one Snow White was kept in in the old fairy tale. I know they're there, and I can go up to the clear, cold pane and rest my hands against it; but I can't break through, no matter how much I pound. Is this my own psychopathology (yeah, I know it probably is) or is my Effexor and Depakote and whatnot, an iatrogenic numbing? When I was last in the hospital, I cried...let's see...about a dozen times in a period of three weeks. That is, by far, the highest day-to-sobbing-episode ratio I have ever managed. One of the therapists admitted candidly, "Your problem is that you don't cry enough. I'll just say it frankly: part of my job these next few weeks is going to be to try and make you cry." Awesome. My insurance is paying how much a day for someone to monitor my eating and try to reduce me tears?

But to anyone who's ever had a really good cry, I ask: what's better? It sucks at the time, and I hate the feeling of vulnerability, like I'm melting and pieces of me are sliding down my face, and I worry someone will see me and think I'm weak and hyperemotional and that's the last thing I want anyone to think when so much of my time and effort is invested in creating this facade of invulnerability and indomitable competence, but at the same time I also just want so badly for someone to come and stroke my hair and let me cry on her shoulder. You know? Maybe not. But then you're done, and hopefully you feel better, and for a while after that your breathing stutters every now and again (I have coined a term for this: the crygasm, appropriately enough, since I've had some sob sessions that were better than sex; whether this speaks more about the quality of the emotional release or the quality of the partners I've had is up for debate).

There's also a website, Crying While Eating, where people post pictures and videos of themselves (duh) eating and crying, with notes re: what they're eating, and what they're crying about. Reasons for tears range from "She really loved him" (awww...) to "He missed the biggest pizza party of the year" (for a guy eating a single pizza crust).

Bad, bad news (A Distressing Symptom (tm) Moment)

Let's say you have a patient, and that patient is peeing. Or rather, was peeing. Yesterday, she was a veritable fount of pale gold urine, the color of a nice Riesling. Today, she's barely put out 200 ccs, and it's closer to the color of a dark ale, or God forbid a merlot. What the hell? We can't serve that with fish! With salmon maybe, but not tilapia...oh, wait. The patient. Right.

You're looking at hematuria, my friend, from the Old Greek and/or Latin "Holy crap, they're peeing blood." Now, there are several kinds of hematuria--The first type is gross, in which you have actual red blood cells in the urine (there's an injury somewhere in the urinary tract, and whole blood is leaking into the system. To the person who said, "This all sounds gross," well, we'll see how funny it is when you come face-to-face with a foley bag full of merlot, young man). The second (sub)type is hemoglobinuria, where you have hemoglobin--the pigment that makes blood red and also ferries oxygen through the cardiovascular system--present, but no red blood cells running around in the urine. This happens when there's an excess of free Hb knocking around; if you drew off a blood sample and let it settle, the plasma would be red (normally it's a clearish yellow color). Last, there's myoglobinuria. Myoglobin is a specific kind of hemoglobin that's found in skeletal muscle, and it's liberated when there's trauma to a muscle, or the muscles begin wasting like crazy for some reason. In most cases liberation is a good thing; this is one of the times when it isn't. Why, you ask? One, when muscles start breaking down, you have a lot of protein rushing into the blood at once, and the kidneys have to filter all that crap. Does the liver bitch about that kind of stuff? No, of course it doesn't, but the kidneys do, and if they're peeved enough they'll shut down altogether (why your patient isn't the open tap she was yesterday). This is why, if you know any nephrologists, they're probably uptight and stressed out people. You would be too if you had to deal with kidneys all day. [Disclaimer: I have thus far been lucky enough not to know any nephrologists, so I have no basis for that statement. I'm just guessing].
So what do you do? Hang a bag of saline! And another! And another. Saline bags for everyone! Rhabdomyolysis due to malnutrition? Have a banana bag--and another bag of saline! NB: A banana bag is a solution of vitamins, especially thiamine and folic acid, and sometimes of magnesium too. It's yellow, hence the name banana bag.

Thursday, December 27, 2007

Tigers and Benazir Bhutto

I hate to say it...believe me, I really hate to say it...but surely everyone saw Bhutto's assassination coming from a mile away. Musharraf's people did it, whether he personally ordered it or not. There.
When she went back to Pakistan this fall, she must have known that she was coming back to die. Frankly I thought it was going to happen while she was under 'house arrest' at the beginning of November, but of course I hoped it wouldn't. I won't indulge in the posthumous deification/ vilification you usually see in political figures. She wasn't a saint, she wasn't a villianess. She was a very rich and privileged woman in a very poor country (she earned her degrees from Harvard and Oxford respectively), true, but couldn't the same be said for our own nation's leaders? She and her family suffered a great deal at the hands of the opposition party, but does suffering alone justify admiration?
She was the first woman to serve as prime minister of a Muslim country, and for that she deserves a place in the record books, and our admiration. Radiya 'Llahu'anha.

Second, apparently a tiger at a San Francisco zoo attacked three people, killing one and injuring two others. No one's sure how the tiger got out of its enclosure, but there's been speculation that someone taunted it into jumping and/or let it out of its holding area. The father of the man who was killed was on Fox News (again, it was on at the gym, and I wasn't going to get off the treadmill just because there was stupid sh*t on the TV) and he said, quote, "I don't care what happens, they could be throwing rocks at the tiger or whatever, the tiger shouldn't escape." Well, yeah. about not f'ing throwing rocks at the animals? How about if you do things like that you deserve to get your ass eaten? Not that I'm justifying people-eating (I don't want to send that kind of pro-violence message to the young tigers of America) but hell! Power to the tigers. NB: at the end of the story, the reporter added that there would now be a CCTV camera installed at many of the animal enclosures. Maybe they'll catch those pickpocket lemurs into the bargain.

Tuesday, December 25, 2007

Today I learned about myself, about the natural world, about art, and about the fact that people will put anything and everything into their orifices. More specifically, I learned...

That I have the same birthday as Tina Fey and Omar Khayyam (though not, obviously, the same birth year).

That the aurora borealis is caused by the induction of electric current in the Earth's magnetosphere by rushes of charged solar wind moving perpendicular to the Earth's surface (and for the first time in my life, the Electromagnetism unit from college physics was actually useful for understanding something). Wikipedia it, it's interesting. I'd like to see it in person someday. Apparently March and October are the best times to go north (or south, to see the aurora australis) and skywatch. Coincidentally, it was reading the Golden Compass series, by Philip Pullman, that inspired me to look this up; and it was my friend Amy who suggested I look into the series (thanks, Ames!).

Apparently, peppermint oil and human mucous membranes don't mix well. I got a Christmas call from a friend of mine who works in an ER...somewhere in the United States...and she said that a young woman came in a few days ago, or fifty years ago, or some vague unspecified span of time in the past, with a portion of a candy cane lodged in her vaginal canal. Couldn't get it out. Apparently the menthol really started to irritate her tissues, and she and the boyfriend were both so freaked out that they couldn't get it to budge from her holiday hole by themselves. With the aid of a speculum and a (slightly traumatized) intern it was retrieved...lucky for the woman, considering that otherwise she'd likely have been looking at a White Christmas, by which I mean massive discharge from a killer yeast infection.

That Natalie Merchant (and earlier, 10,000 Maniacs, the band she fronted) once did a song called "What's the Matter Here" that offers a pretty poignant look at child almost made me cry, honestly. And musically/artistically, it also has great merit: "I've heard the excuses/ everybody uses/ He's your kid, do as you see fit...but what gives you the right/ to do this/ to your own flesh and blood?"

That you can blow out your liver just as easily with NSAIDS (non-steroidal anti-inflammatory drugs) like acetominophen, ibuprofen, the cox-2 inhibitors etc, as you can with alcohol. Maybe easier, since most people know that knocking back a six-pack of beer every day isn't good for you but don't know that tossing back six Advil every day isn't so hot either.

Monday, December 24, 2007

Some poetry. And a song.

Female, 78, pelvic fracture

First of all her Hummel figurines
had fallen from the table near the place
where she herself had fallen,
her splayed hands
clutching at the carpet as if it were life itself.
A neighbor stopped to check on her and called
911 when he heard her moan
from be hind the door, festooned
with a merry wreath
which wouldn't yield no matter how he slammed
his shoulders into it.
How long has she been here?-I wonder, ask;
she answers, seven hours.
We check her pulse
and roll her like a turtle to her back.
She moans again: her hip is broken, leg
turned out as if into a grand plie, but for now
no leaps or arabesques for her.
Onto the stretcher, out into the cab--
her pulse is quick from pain, breath rapid too.

Oxygen mask and morphine, and she sighs,
frail body melting into the cot
like a spring allowed now to unwind.
I take her hand--
"You're going to be fine."
Her skin is like rice paper, loosely draped
over a web of veins, a bunch of bones.
"Fine," she repeats, the morphine drips, eyes swim,
then close. "You know," she says,
"I used to be a dancer. When will I dance again?"
An honest question answered honestly:
"Not for a while, and please, keep your mask on.
You need to relax." I stroke her hair, grey gone thin in patches,
or all gone.
The lead medic snaps, "Check the supplies."
Is too much tenderness prohibited?
Still, I am glad to pull myself away
from that vortex of human suffering;
a reminder that even one as young as I
will someday age and fracture, fall and die.

Bread and Roses

I know that I need beauty
more than I need bread.
Bring home baguettes to admire,
then photograph;
food to write odes to.
But more important,
bring me roses
in the gentle curved clasp
of your fingers;
bring me your lips
arched like bows
and fire at will.

And a song...I still have to figure out the guitar part in its entirety:


It's three in the morning
I'm walking down Broadway
My friends and my neighbors have all gone to sleep
And from their apartments
the windows spill secrets
that during the daytime they struggle to keep

Insomnia does that, it sets you apart
It's the tension in eyelids, the seal on your heart
It's the kinship of coffee
and honey, believe me
Come meet me on Broadway some night and you'll see

I have a prescription
to help me drift off but
It doesn't work, I still toss, turn and moan
I don't care what the med is
'Cause anyway bed is
More lonely than sitting up writing, alone.


Some night I will meet you
at four in the morning
At that all-night diner on 39th street
You'll ask for my name
and I'll ask you the same
And we'll know we've been waiting our whole lives to meet


At last I am sleeping
I slip into dreaming
Of streets and apartments and coffee shops too
And though we haven't met
at least not quite yet
Awake or asleep I am thinking of you.
Now if only I could figure out a way to record it that didn't make the vocals sound like I was using a garbage can for a recording studio...

Friday, December 21, 2007

Hope I die 'fore I get old--some song

I just saw an ad for the new Jack Nicholson/ Morgan Freeman flick "Bucket List," where two guys have the chance to do all the things they want to do before they die. And it got me to thinking...what things do I want to do before I die?

1. See open-heart surgery
2. Make love to a beautiful woman in a beautiful place (Angelina Jolie? In St. Patrick's Cathedral?)
3. See Paris, Berlin and London (ooh, and China too)
4. Have a book published (not just in a compilation/anthology)
5. Perform one of my songs in public
6. Save a life
7. Give birth
8. Go parasailing
9. Fire a gun
10. Sleep in a treehouse

What do other people want to do? Shit, what do other people's lists look like? This isn't a top ten or anything, just 10 random things from a list a bazillion miles long. Also included: getting an MD, falling asleep in someone's arms during a thunderstorm, going to Michigan Womyn's Music Festival, finding a long-term partner, learning how to make angel food cake, knitting an entire sweater, running a marathon, finishing a triathlon, climbing a mountain...and the list goes on. Sorry this isn't interesting, but I swear this introspective mood will pass (how long does it take a twentysomething woman with an attention span X and a need, Y, to be adored for her wit and intelligence, to stop writing about her goals and dreams and start trying to amuse other people with interesting anecdotes and jokes about other less personal things? Solve for Z in terms of years of crushing loneliness).

Wednesday, November 28, 2007

I hate those motivational posters. "Successories" is one of the companies that sells them. Even the name 'successories' pisses me off, to be frank. I had to go see someone in HR at work yesterday, and the woman I spoke with (the very person who interviewed me for the position I currently occupy, in fact) had a framed motivational print in her office--'ambition' or 'committment' or something similar. Now, our entire HR office moved several blocks down the street from the main hospital in August. This leads me to believe that everything in her office was intentional--carefully selected. She didn't accidentally end up with this thing; she didn't inherit an office that had it bolted to the wall. It was on purpose. To which I can only respond: take this.

That's right, it's, home of the "demotivators" calendar. Go, and see, and laugh with fiendish glee.

Sunday, November 25, 2007

Coming out of the drug closet

Ok, ok...I'll admit it. I'm a pharmacology nerd. I don't plan on dispensing drugs like candy once I'm a psychiatrist, but I personally take a handful (not just a figure of speech--literally a handful) of psychoactives everyday. And I've tried a lot of other drugs, too, in the search for the combo that gets me un-suicidal but not manic or numb/depersonalized, un-manic but not suicidal, not too anxious but not utterly the way, I'm not talking about uppers, downers, all-arounders, pot, acid, mescaline--I'm talking about prescribed drugs, which (in one of the curious contradictions of the free market) are several orders of magnitude more expensive than weed or crystal, and in some cases, more expensive than heroin or cocaine.

So what have I tried?

First there was Zoloft. Which I took for eleven years, from the time I was eleven (50 milligrams) which was titrated upwards to 250 mg when I was 22--by this time I finally decided it wasn't working for me anymore, even at above-PDR megadoses. I stopped taking it a few months ago, switching it out for a large dose of Effexor (which, coincidentally, I'd previously been on in combination with Zoloft). I did a 'cross taper' to prevent debilitating side effects of discontinuation, and stilll ended up having crazy out-of-body feelings and some severely severe depression. For a couple days I avoided driving, because (hand to God) I felt like I'd had 2 or 3 beers. And for the record, I'm one of those cheap dates who's already bobbing and weaving after one drink. I knew I wasn't paying attention to the road as I was driving, but I couldn't MAKE myself focus; I just didn't care--"You're just staring at the clouds. I think you--I mean I--should be looking at the road. But I don't really feel like it. Wow, that cloud looks like a fillet of asahi tuna." And then, once the Effexor got leveled out (and the depression continued), that got titrated up too. I noticed that I was losing more weight than usual, but the psychiatrist kept ramping it up anyway, and now I'm on a crazy-high dose (375 mg--usually reserved for psychiatric inpatient therapy).
Also taking gabapentin--what we once knew as "Neurontin," and what some docs are probably still foolishly writing 'DAW' for more than triple the cost. It was prescribed off-label as an antianxiety and antiobsessive; it's approved for nerve pain, specifically an after-effect of shingles called 'postherpetic neuralgia.' Oh, yeah--I'm on Depakote XR, too, off-label again.
And between those early days of Zoloft monotherapy and my current polypharmacy regimen, there was Wellbutrin (made me manic), Remeron (made me sleepy, and when I wasn't sleepy, a bitch on wheels--my mother finally made the doctor d/c it, because as she told the psychiatrist, "I can't live in the same house with her much longer if she stays on this medication. If you want to keep her on it, fine, but you're going to have to take her home with you."), lithium, which made me much happier/more even-keeled but also made me gain 30 pounds, Lamictal, which made me break out in a rash (and since that could be a precursor of a serious allergic reaction called Stevens-Johnson Syndrome, also made my psychiatrist d/c like there was no tomorrow) and Seroquel, approved as an atypical antipsychotic but often given to anxious folks with insomnia issues to help them chill. And, prn, a gift from the Goddess called lorazepam, or Ativan. It's one of the most potent benzodiazepines out there (packing several times the punch of Valium and its cousins). It seems to operate primarily on the assumption that if you're knocked on your ass you won't be anxious. Which is true, it's hard to have a panic attack when you're asleep. Interestingly, it's also used in controlling seizures-- especially during DTs (alcohol withdrawal), or with status epilepticus (when someone has a continuous seizure for a long period of time). AND it's an antiemetic. Whew! Beat that, Compazine! Lorazepam has a high affinity for GABA-receptors (recognize 'GABA'? Yeah, it's the same neurotransmitter that gabapentin plays with, explaining why both these drugs have somewhat sedating effects). So I've taken atypical antipsychotics (no, I've never been psychotic), SSRIs, SNRIs, atypical antidepressants, and benzos. Back in the day I probably would have gotten ECT and Elavil, had memory loss and had to give up cheese and wine. In some ways times have definitely changed for the better.

So screw the stigma. I'm not taking these to brighten an otherwise mediocre life; right now I need these in order to function. I want to come off them at some time in the future, but for now I'm over a barrel with the depression and the pharmaceutical companies. I'm not pleased about this, but I'm significantly more pleased than I would be if I were catatonic in bed.

Wednesday, November 21, 2007

Be thankful for...your liver(!?)

The heart gets all the press, and for obvious reasons: when your heart stops beating, that's it. You're gone. The brain is a media darling, too, as are the lungs--and for the same reasons. If either one stops functioning (stroke or respiratory arrest) you're either dead or severely damaged if things don't get moving again in a hurry. Hell, even the kidneys and pancreas have stepped into the spotlight, what with the explosion in diabetes education. But for my money, the organ with the mostest--the brilliant but forgotten stepchild, if you will--is the liver. Often overlooked but desperately important, your liver is the kid in high school who finished group projects while the rest of the group jerked off; it's the person in your office who quietly works after hours without complaining about it the next day. It reads the memos about TPS reports (Office Space joke about anatomy and physiology--what's the nerd quotient for that? I guess it could be could've been a Star Wars analogy). Maybe I like the liver so much because I identify with it...a little too much. Is that healthy?

So what does your liver do, I hear you asking, besides processing those lunchtime martinis and after-work glasses of scotch (or, depending who you are, the gulps of the Jim Beam you keep in the bottom drawer at work, cleverly concealed beneath old memos about the company's drug and alcohol policy...yeah, everyone knows, and your breath mints aren't fooling anyone)? Well...

Your liver stores iron. When you're sick especially, your liver 'sequesters' iron so that the little beasties invading your body don't have access to the mineral they need to survive (which is one reason why you may have heard not to take iron when you're ill). Before you're born, at which point your bone marrow starts to kick into gear, your liver makes a lot of your blood. It stores 'quick energy' for your body in the form of a complex carbohydrate called glycogen, which is then released during physical activity when your blood sugar starts to drop; thank your liver that you don't have to eat every twenty minutes to keep your blood sugar relatively steady. Your liver also makes and regulates clotting factors, keeping you from bleeding to death when you get a paper cut or that monthly visit from much-despised Aunt Flo. It releases hormones that affect where and when you store or release fat (though please don't blame your liver for those love handles). It manufactures and releases cholesterol, a certain amount of which is necessary for the smooth functioning of your various parts--your cell membranes are largely made of cholesterol, if you'll think back to freshman biology. In addition, Madame Liver manufactures and controls the release of bile from the gallbladder, enabling you to digest the fat in your Dunkin' Donuts Pumpkin Spice donut (DD has recently arrived in Missouri, and though I had vague memories of it from the summer I spent in Philadelphia, where they seem to be almost as numerous as Starsucks, and the drive-through on Highway 13 in Ithaca which I never even drove through, I have to say I'm duly impressed. Still not as good as Krispy Kreme, but hey, what is?). And, of course, your liver breaks down all the drugs (of course, you only take the legal, prescribed ones...right? Oh, it's OK, your liver isn't going to call the cops if it has to deal with a little THC now and again) and mildly poisonous substances you come into contact with over the course of an average modern day.

So give your liver some appreciation today. It's located under your ribcage, mostly on the left side (I mean--right; left is just where you feel for hepatomegaly and tenderness, I think)--give it an affectionate little pat for all it does.

Monday, November 19, 2007

The pneumonia now cleared from my system (thanks, Z-pack! Thanks, doctor who was willing to prescribe a broad-spectrum antibiotic because no one does outpatient sputum cultures!), I have...a cold. Not a bad cold,'s that first little bit of a cold, the foreplay of a cold (but much less fun than traditional foreplay). Thank God I'm not a hypochondriac or anything, with all the furor over Adenovirus-14.

So I'm taking zinc gluconate (the only form double-blind studied for treatment of rhinoviruses), bulking up on the vitamin C (yeah, the 'proof' for its efficacy is equivocal, but I still believe Linus Pauling...OK, maybe it can't cure cancer, but oranges do taste good) and drinking an herbal tea that's a mix of lots of botanicals that are good for such infections. Totally unproven. So you see my approach to illness runs the gamut from well-proven to witch-doctory.

What's that? You want to know what's in the tea? OK, I'll tell you, but first let me say (duh) I'm not a doctor; I don't even play one on TV since Kate Walsh edged me out for the spot on Grey's Anatomy. Thus, I'm not advocating that you go to your local co-op and buy loose herbs to make this mix, nor am I suggesting you put it in a tea ball and steep it for 3 to 5 minutes. And I will certainly not warn you that it tastes like ass, and that it will require the liberal application of honey or Splenda or whatever your sweetner of choice is. Talk to a qualified herbalist before you start drinking weird stuff, tell your doctor what you're taking, and be especially careful if you're pregnant or breastfeeding. OK. Enough with the equivocation.

Holistic Cold Killer
Comfrey, Catnip, Cayenne, Hyssop, Horehound, Licorice, Mugwort, Sage, Yarrow, Peppermint and Cinnamon. Go easy on the hyssop and sage, f'real.

Ho ho ho! OK, now that the puns are done (feminist or anti-feminist? From whose point of view? When is it acceptable to point out that people may be participating in their own oppression, and when are they engaging in what some would consider 'degrading' activities of their own free will and for their own enjoyment? Discuss, keeping in mind that Gisele Bundchen--the one in front, in the sparkly bra-- is one of the highest-paid models in the world)...
Does the Victoria's Secret fashion show make ANY woman feel good about herself? I read recently that after a mere three minutes of looking through 'fashion' magazines, 76% of women reported feeling 'depressed, guilty and ashamed of their bodies.' Supposedly 2/3 of Americans are overweight--surely being confronted with the titanium abs and steel buns of Brazilian teenagers with D-cups is a little distressing for them? And estimates for the number of Americans with eating disorders run from 8 million to 10 million--I can guarantee more than one anorexic flips through the Victoria Secret catalog to compare her body to Adriana Lima's, rather than to look at the bras. So if this form of advertising makes everyone feel shitty about herself, why is it still around? Why do women still allow themselves to be kicked in the teeth by messengers of 'the perfect body,' then stand back up and pay for the opportunity to get sucker-punched again? Never mind that the average model weighs 23% less than the average woman, and often falls into the 'anorexic' range for BMI (body mass index). We're sold the picture of sexiness and health by women who, almost by definition (here I'm quoting from years of eating disorder literature) lack libido/sex drive, probably aren't menstruating, and are losing the fat tissue that makes up 'real' breasts (hence the need for implants). Of course there are more serious, non-cosmetic health problems too, but really...
Granted, the Victoria's Secret girls look marginally healthier than the ladies on the high-fashion runways, but that's like saying having pneumonia is great because it's not lung cancer...

Friday, November 16, 2007

So, I came out to a bunch of people at work the other day. We were sitting at lunch, and my boss and I were discussing the recent visit of the Dalai Lama to the US (and to Ithaca, of course, where I had the excellent fortune to see him speak--he's indeed an inspiring and holy man). My boss, M, brought up the contrast between his visit and the recent appearance of Ahmadinejad (I think I spelled that right--and without looking it up anywhere! Who's the shit?) at Columbia University.
"It's amazing that we could have two such different people visit our country at the same time," he said, "The Dalai Lama talking about peace and love, and then this crazy man who denies the Holocaust and says there are no homosexuals in Iran..." First, let me hip you to something: anyone who uses the word "homosexual" rather than gay or queer is either a psychiatrist/ psychoanalyst in 'professional' mode, someone who not only isn't gay but doesn't have many 'gays' in their close circle of friends, or else is so deep in the closet they're finding next year's Christmas presents. That aside, I used the opportunity (why the hell not?) to out myself in front of roughly ten people in the break room.
"My first girlfriend was Chinese," I said, "And she tried to teach me some of the language--now I can say hello, 'I love you,' and order a few items from a menu. Anyway, she asked her mother, 'Mom, what's the word for a man who likes men, or for women who fall in love with other women?' Her mother answered her, after a long pause, 'That doesn't happen in China.'" I guess it went over well. The conversation didn't come to a grinding halt or anything, though I could feel a few people making a mental note: Homosexual, check. Just adding it to their list of attributes about me. I guess it helps that I've only been there a few months, so not many people have a really solid mental picture of who I am outside (or inside, for that matter) work. They're still piecing together, "German studies major. Former oboe player. Echo research assistant. Homo. OK, cool."
The only bad thing about being out to people who I suspect may not know a lot of gay folks (or who, for religious reasons, are opposed to that 'lifestyle'--which, by the way, I think is a hilarious way to put it--it makes me think that there must be a gay/lesbian lifestyle catalogue out there somewhere that I'm missing, a la Martha Stewart Living, with Indigo Girl CDs, flannel jackets, Danish Modern furniture and Subaru Foresters) is that then I feel oddly responsible for being a stellar example of humanity, for the sake of the 'family.' If I fall behind on a project, then the whole queer community suddenly becomes lazy or incompetent. If I snap at someone because I have PMS and they took the last of the coffee on a Monday morning, it's because all lesbians are bitchy and aggressive. I'm sure not everyone does this sort of thing consciously, but I know I do it myself sometimes, or poke fun at myself and others for some stereotype: When I'm jamming to Melissa Etheridge, painting an, ahem, yonic-looking calla lily (look up the word if you don't know it, it's fabulous), and a friend walks in and laughs; my Jewish friend who always scours the racks for the lowest possible prices when we go out shopping together; my Irish buddy, in the Marines, who puts away the stout and lager like it's going out of style.
Ultimately (here comes the PSA--public service announcement, for those in the medical field, NOT prostate-specific antigen) life's too damn short not to be who you are, not to move from your center just as you are, whether that puts you in the line of fire of hateful idiots or puts you in lockstep with inane stereotypes occasionally. Be you, because if you don't, there isn't anyone else to do it.

Wednesday, November 14, 2007

Hello, everyone out there. I can see the counter. I know someone's coming here. Why not be a chum and leave me a note? Provide me with some much-needed ego gratification? Besides, I wanna know who you are...for purely non-creepy purposes, of course.

Speaking of creepy purposes, did anyone catch the recent spate of news stories on Taser Parties? As many of the stories have noted they're like tupperware parties (after all, what could be more quintessentially feminine than buying expensive crap to put the food you've cooked for your family in?), but (duh) with Tasers. Ha ha! Women with weapons!, the anchors seem to say. Women with the power to defend themselves instead of just cooking! Wow, that's just *crazy!* Ha ha! Bob, what's the weather looking like tomorrow (squirms uncomfortably)?

I can just imagine--

Hostess:Now, Jane, the invitation explicitly advised you not to be late. Would you put down your purse and come up here for a demonstration, please? *Zaaaap*
Jane: Aaaaaaarrrrruuuuuuugh.

Apparently they're available in a range of colors, including metallic pink. Get a new Barbie or Dora the Explorer Taser for the young women in your life! (Ok, I just made that up, but still--metallic pink? This is a weapon, dude. Would anyone buy a metallic pink Beretta? Maybe I don't want to know the answer...) Many problems with this. How best to tackle them...

Well, there's the fact that women still need such items in the first place; but because the world isn't going to change overnight (though castrating sex offenders might be a step in the right direction--ahem), the fact that companies are preying on women's fear of attack/sexual assault to sell such a product is also disturbing. I guess what bothers me is that these are emphatically WOMEN'S events; the idea of using tasers to defend yourself has been thoroughly feminized in this instance, made into a fun little get-together in order to strip women's need for self-protection of all political and social overtones. The problem isn't that you live in a society where one in four women will ultimately be sexually assaulted; the problem is that you don't have a bright pink Taser. Use your power as a consumer rather than your power as a activist, your power as a mother or sister, your power as a woman. Enough with "Sisterhood is Powerful." What's powerful is 50,000 volts to some guy's junk (which is undeniably true, but doesn't make the former any less important).

What would I like to see instead? Passion Parties. A make love, not war kinda thing. Put down that Taser, that Mary Kay, that Pampered Chef whatever, and pick up a Jack Rabbit vibrator, a silicone butt plug, and a bottle of Lickety Lube (though I've gotta say, all the flavored lubricant I've ever been, shall we say, fortunate enough to encounter has tasted like a cross between cough syrup and saran wrap). Or there's Pure Romance. Of course, these aren't always the highest-quality sex toys...for those, go to Blowfish or Good Vibrations. Come to think of it, my old Good Vibrations catalogs are probably still coming to the co-op I left last year. Hmmm. Maybe one of the freshmen will find a catalog in the mailroom and get a little education.

Monday, November 12, 2007

Oh my Jeevis, is it that time again already? I think I feel the stirrings of surging progesterone and my estrogen done fell off a cliff. To those not endocrinologically inclined, it's PMS time. And thus, time for another rousing edition of Things (and People) that Piss Me Off.

1. Nameless guy at the gym who gets on the treadmill, cranks it to 10 mph, and then holds on to the grip bar with one hand (pounding LOUDLY and in an inconsistent rhythm) like he's had one arm amputated and just managed to catch the door of the bus to The Free Money, Beer and Sex Club with the other. Dude, you're not conditioning yourself in ANY way. You're teaching your body bad habits. You're asking to either have your arm ripped out of its socket or your knees reduced to cartilage pudding. I've tried being a good example (look, I'm running at 8 mph but my hands--ta da!--are nowhere near the grip bar! See how cool and un-annoying that is?), I've tried glaring. I thought maybe I was alone in my loathing until the girl at the front desk told me, "Man, I hate that guy." Vindication!
2. Mitt Romney. Not because he's Mormon, not because he's Republican, but because he's a tool. Ok, maybe a little bit because he's Republican.
3. The writer's strike. I want my Daily Show and Colbert Report, dammit. Couldn't care less about Letterman et al, but don't deny me Jon and Stephen! They make an otherwise bleak social and political system livable, like the underground leaders of Potterwatch in H.P. and the Deathly Hallows (yes, I think that's an apt comparison, and yes, it's probably not the most academic example I could come up with, but screw it, maybe I'm on strike too).
4. The following grammatical errors/ words and phrases: "irregardless." It's not a word. Stop using it. "Pacifically." Unless you're discussing the ocean between California and Japan, you're using the wrong word. "Whenever" confused with "when," as in, "She got out of surgery whenever they finished fixing the hole in her heart." Unless they fixed the hole in her heart multiple times, you want the word "when." See the difference?
More to come. I'm tired.

Sunday, November 11, 2007

And the attempts to recruit subjects for clinical research trials continues. The next phase of the study has started up, and with it the relentless search for more patients. First, only people who have had two very specialized and expensive tests in the past month are eligible; second, these people must have a sufficiently severe heart condition to justify this testing, but not have really really bad heart disease, lest the 'stress' part of the trial--using a drug that dilates blood vessels and thus makes the heart beat harder and faster to compensate--could actually push them into having a heart attack. Needless to say, the procedure is pretty damn safe, which is why it's the standard cardiac stress test protocol, but there's always the chance that someone with pulmonary hypertension or sever aortic stenosis or a 90% LAD blockage will end up on the wrong end of it, and we don't want that to happen. So, long story short, once I make sure that people are sick but not too sick, I check to see they've had an angiogram and a nuclear stress test. If they have, then I go on to see where they live. Since our hospital is kind of a big deal, people from all over two states get life-flighted to us. Someone who lives 50 miles away is probably not going to drive up for an appointment and two follow-ups. Next, I assess age: people under about 60 are usually working and either can't get away from work or don't answer my (daytime) phone calls anyway; people over 80 are generally considered too old to be in the study. So that narrows it down. Of course, the unemployed 45-year-old is a good option, since he has time and would probably like to have the study stipend. And that makes me feel like a horrible person, an exploitative asshole. A lot of the people I recruited last time were unemployed or disabled. Of course, they didn't get hurt, they got paid for their time, and in the end it was a mutually beneficial partnership. However, once this technology makes it out into the real world and physicians are charging a couple hundred bucks a pop to use it, unemployed folks without insurance aren't going to be the ones benefiting from it. One of the principles of human testing ethics is that the people who are ultimately going to benefit from the drug/procedure should be adequately represented in trials, and people who aren't going to use it shouldn't bear much of the burden of testing it. I dunno. Am I still young and idealistic? I guess.

Wednesday is our department's "Spirit of Thankfulness" catered lunch. Which means everyone else will eat turkey, and I will make a meal of cranberry sauce, green bean casserole, and stuffing. Which is fine with me; when you don't eat the main dish, you can get away with taking more of the side items (which are usually what I REALLY want, anyway). That's the calculus of the buffet line, right? Or am I committing some horrible breach of self-serve etiquette? And why can I not remember how to spell etiquette? Oh, right. It's 2:14 a.m.

Several people at work are really bummed out. One guy's dad died; a woman who shares my office has been taking time off to be with her dad, who's dying too. I know there's not a cure for grief other than time and loving care...but in the interest of superficially sprucing things up, I'm thinking I'll make hand-turkeys for the other women who share my office (there are five of us--it'll be like third grade!!) and possibly bake some pumpkin bread for the bereaved. Because baked goods heal all. Unless you're diabetic.

Saturday, November 03, 2007

Today, fresh-baked POEMS.

Naked and Terrified

You are asking me to go
into the world
naked and terrified,
a Godiva without
so much as a horse.
And so I am valiantly
peeling off
as much of my dead
skin as I can manage,
thick translucent sheets
the color of granite,
cring out every so often
as burn victims do
when charred tissue
is scraped off
(and the pink below
is exposed
to the rush of

Nothing to Fear (after Hafiz)

There is nothing to fear,
and there never has been.
You have always been wrapped
in a mantel of light,
despite your best
misguided efforts
to tear it away from your body.
It's true,
you have fallen,
but always into
the hands
of Love.

Prince of the Air (EMS)

Both his hips were broken
in the fall--
or rather, I should say,
his pelvis shattered
upon impact, as did everything else--
Conclusion of a multi-storied trip
between the kingdoms
of the sky and ground.
Bystanders said he stood
up on the ledge
for twenty minutes,
never looking down,
before he dove, and was a Prince of Air
for two full seconds, constellation dark
against the seeting swarm of stars above.

His limbs, spread at odd angles, must remain
as such until the coroner arrives,
proclaims him dead, stamps him a suicide,
so we can load him in the ambulance
and drive him, sirens silent, to the morgue,
this one past saving:
the one that flew away.

Wednesday, October 31, 2007

It's a horrible cheer!

Give me bilaterally reduced breath sounds! Give me persistent cough with green sputum! Give me pleuritic pain of two days' duration! Give me decreased blood oxygen saturation and fever! What does that spell? Pneumonia! Yaaaaay! I mean, hrgh-haaaaakkk-hrrrrrrghh!

The day at work passed relatively quickly, if only because I was fever-high enough to stare at the computer screen for minutes at a time before realizing that I was supposed to be looking up patients' information, or that the facesheets I'd been waiting to get from the printer had long since emerged from the machine's maw, and were now sitting--cold and desolate--in the out-tray.

So how does a healthy 22-year old woman get pneumonia? Short answer--she doesn't. It's immunocompromised people--whether because of extreme age/youth, chronic illness, or, hmmm, OVERTRAINING--who have problems with it. So what am I gonna do? Gonna take me my Zithromax and steroids, take a toot of that albuterol, grab some chik'n noodle soup and an Eddie Izzard DVD, and lay my ass down. On second though, screw the soup and the DVD. I feel like I may actually be dying (that or the room suddenly tilted by 90 degrees, which is pretty cool considering nothing's fallen off my bookshelf). I think I'll just go to bed.

So what was I for Halloween? A bioweapon. I licked your toothbrush last night after you went to sleep.

Wednesday, October 17, 2007

I've done a fair number of interviews in my time--from the interviewee side, but also from the vantage point of the interviewer. Frankly, being the interviewer makes me only marginally less nervous. And yes, I am ashamed to admit that on more than one occasion I have used the "What do you consider your greatest weakness?" line. It's not a very good question, in and of itself; its usefulness lies primarily in that it lets you see a)interviewee's bullshitting skills, eg, "I have a tendency to work too hard," or "My perfectionism is an issue sometimes"; b) interviewee's willingness to be idiotically, breathtakingly forthright with someone they've known for fifteen minutes, eg, "I don't like people, and I have issues with authority. Also, I steal." or c) interviewee's ability to squirm like a worm impaled on a hook for minutes at a time without actually answering the question--"I guess it would be my inability to present a full picture of myself in a twenty-minute interview. Ha-ha! But seriously..." It weeds out the obvious brown-nosers and total idiots, I guess, but aside from that it's just a form of torture sanctioned by the Geneva Convention.

I'm really hoping my interview next week goes well. I have a tendency to freeze up a bit in those situations--I find that I'm suddenly unable to form a coherent sentence, much less follow a line of thought across multiple sentences; I sweat so much that I can literally feel a stream of water running down my spine as I sit in the 'hot seat.' I've seriously considered taking, I don't know, an airplane-sized bottle of Jack Daniels with me and guzzling it before the interview. Alcohol frees the tongue, after all--in vino veritas. Just not TOO much veritas, please; total lack of inhibition can be just as unattractive as crippling self-consciousness. As in, "So, what's the medical school's policy on students sleeping with faculty?" or "Where's the nearest gay bar?" or "How much would I have to pay you to get a good recommendation to the committee? No, I'm not trying to bribe you. I just want to know what the price of your soul is."

Tuesday, October 16, 2007

Meryl Streep has nothing to do with this post, but she was just on the Daily Show and I was reminded how much I would like to get to know her, have coffee, become emotionally intimate, join our souls as one, paint the guest bedroom together...and, of course, have lots of sex. That is all.

Art is not just for show.
Two artists I've recently discovered--meaning I've come to know them, after a good portion of the world (the "art world" especially) have known about them for years. Because I've been busy reading the last of the Sandman decology (that's the '10' version of a trilogy, right?) and getting hepped up on the newest news in healthcare policy, the better to defend my liberal commie positions when it comes time to discuss healthcare reform in my medical school interviews (it's coming, man. I know it's coming. I may or may not be straightforward with my opinions--depending, perhaps, on the quality of the interviewer's tie, or whether they have a "I love Bush--the president, not the innuendo" lapel pin). Strangely, the little bit of time I spend watching the news on the treadmill at the gym has gotten me up to speed on Lindsay Lohan's rehab shenanigans and Britney Spears' access (or lack thereof) to her children, but not on the Blackwater torture scandal or whether Bob Jones University's invite to Mitt Romney indicates they're pulling their support from the McCain candidacy. Priorities, eh?

Chris Jordan's work is a look at American consumerism, and the effects that has on the world at large. A field of toothpicks representing the trees felled to make US junk mailings every month; the number of plastic bottles we discard every minute; cigarettes representing the number of teens who start smoking every month. And all that aside, his work is hauntingly beautiful--especially his pictures of the post-Katrina New Orleans.

Edward Burtynsky is affiliated with a movie called "Manufactured Landscapes" that mirrors his work: he does large-scale pictures of quarries, recycling yards, factories, mines and all the rest of the gorgeously ugly necessities that keep modern life humming along. Unfortunately, the factories that give us light bulbs and batteries, the mines that give us coal for power and gold for jewelry--chew up the landscape of other countries, poison the ground, drive the local populace into poverty or servitude to the factory bosses (or both). The man can make tailings (the streams of detritus--aka, crap--left behind after a mineral or metal has been refined) look beautiful. I'd include an image of his "Nickel Tailings" here if I didn't think I'd immediately get an email from his lawyers.

Friday, October 12, 2007

Three books you have to read. Right now.

I just got these from the library, and these are some of the best books I've gotten hold of in a long time.

Hello, Cruel World: 101 Alternatives to Suicide for Teens, Freaks and Other Outlaws by Kate Bornstein. This book will save lives, I have no doubt of it. Some of her alternatives may seem flip, but the introduction alone (which discusses dealing with societal oppression, homo/transphobia, the bully culture that encompasses not just middle-school sluggers but corporations and governments, depression, and a lot more) is worth the price of admission. Her alternatives to suicide include seven self-evident steps suicidal youth/outlaws can take...calling a suicide hotline or a friend, going to an ER, visiting a therapist or alternative medical practitioner, or joining a support group. After that, things get both more playful and more difficult: she suggests making art to express feelings, meditating, asking others for help, providing help for others, accepting your own sexuality (and having sex--orgasms are great mood-boosters!)...but also more self-destructive options that she specifically labels as last resorts. For example: drinking, doing drugs, starving yourself, or cutting. Anything that keeps you alive. Of course, she encourages her readers to try more loving versions of self-care first, but as someone with a history of these sorts of difficulties (suicidality, eating disorders, etc) it was really validating to hear someone say, "I've been there. I've cut. I've been anorexic. I've done drugs. It kept me alive, and that's good. And if it keeps you alive, that's good too." Buy it for you, for the troubled teen you know, for the twenty year old woman you know who was born a man, for the depressed communist omnisexual you do shifts at the co-op with. This should be required reading for everyone who is, or works with, or loves, an adolescent.

Second, Persepolis, a graphic-novel memoir of Marjane Satrapi's childhood in Tehran during the Iranian revolution. It's several years old, and there's a Persepolis 2 on the shelves now, too. Simultaneously poignant and hilarious, thought-provoking and entertaining, this book looks at larger sociopolitical issues like revolution, poverty, religion and war through the eyes of the author's young self--through the eyes of a kid. We often forget that big geopolitical conflicts affect human beings; that each casualty, civilian and soldier has a human face. Persepolis is the perfect antidote.

Last, The Jesus Machine: How James Dobson, Focus on the Family, and Evangelical Christians are Winning the Culture Wars. Let me just say for the record that I think James Dobson is a total douche. He doesn't shout crazy shit from the rooftops like Falwell or Pat Robertson; he tries very hard not to give the impression of being politically involved. The image he projects to the world is that of a loving, patient but firm therapist/father figure who wants what's best for his "children" (ie listeners and those who read his books). In reality (says Anne, who hated him all through middle and high school but didn't have the tools of theoretical feminism in order to mount a proper critique and explain to herself exactly what her dislike stemmed from) he's an old-school Nazarene Patriarchy-Man who suggests that women are happiest as wives and mothers ("It's just biology, the way God created women, and it's a beautiful thing," he says, simultaneously putting women on a pedestal so they can't escape and encouraging subservience to husbands, fathers etc.), that parents need to break their children's wills as early and as completely as possible (in his book Dare to Discipline he opined that spanking with a belt or a switch on occasion was not only acceptable but often neccessary; the belt should be left on prominent display in the child's room as a reminder of the consequences of 'disobedience.') My parents had copies of Dare to Discipline and The Strong-Willed Child, both by Dr. Dobson; I for one hold him partially resposible for my mental f*cked-upedness. Since when is a strong will a bad thing? What is the purpose of exercising such control over one's child? Preparation for them to submit to the powers that be after they've grown up, ensuring they never rebel against oppression? For mere convenience, so that parents don't have to deal with childhood exuberance? I won't even get into his stance on homosexuality, but suffice it to say it's SO last-century. Read this book to see what all he's up to; he's a secretive little bastard with a lot of influence in Washington, and the great thing (for evangelicals) is that a lot of folks outside the hardcore Christian community have never heard of him, and so have no idea who or what they should be protesting.

Those are the recommendations for now; more personal stuff to follow.

Thursday, October 04, 2007

The Secret!

So, a while ago (I realize fully that I am always at least a week, if not a month or more, behind on pop-culturey things...but I knew the same day when Ahmadinejad came to the US, dammit, and I know that the Dalai Lama is coming to the US next week, because I'm going to be seeing him...basically this is an attempt to defend myself and assert that I am not utterly utterly clueless about what goes on in the world) Oprah ran a show about a movie/book called "The Secret." Here's what the Oprah website had to say about it; I'm sure there was something in the magazine, too, and perhaps she even beamed press releases into people's brains while they were sleeping. After all, Oprah is everywhere, and Oprah knows all. In essence, The Secret is that you can create the life you want by being intentional about it and wanting it really badly. It's what Rhonda, the author, calls "the law of attraction." Like attracts like (which is true, except--y'know--in physics, one of the fundamental building blocks of the physical world. What with negative ions attractign positive ions, and positive poles of magnets attracting negative poles of magnets, and what not). When I first heard of this, my bullshit detector began blaring at a volume I usually associate with late-night psychic commercials and emails about herbal "male enhancement" pills.

As she says on the website, "What we do is attract into our lives the things we want, and that is based on what we're thinking and feeling. We create our own circumstances in life." Um. I agree that there's something to be said for setting goals, for deciding what you want and going for it rather than drifting aimlessly through life like a rudderless ship cut from its anchor. I have used visualization when training for races, when practicing speeches, when preparing for interviews. Affirmations can be positive, if cheesy, additions to someone's coping repertoire: "I am competent and charismatic." "I will get the job that's right for me." "I am fast and strong." However. Saying that we attract ALL the things that happen to us, while not demonstrably false (that's the interesting thing--this claim is impossible to prove or disprove) is also not demonstrably true. And how could it be? The scientist in me says, "The Earth is not a closed system. Too many variables. I don't have time to be calculating chi-squared and p values (it's a statistical analysis thing) for the whole universe. Do I look like a supercomputer? Screw this, I'm going to have lunch." So, is Rhonda Byrnes saying that the people in the Twin Towers weren't thinking positively enough? Was it some guy on the eightieth floor who'd been having bad thoughts, therefore had bad stuff coming his way, and just happened to carry three thousand other people down with him? Did Paris Hilton somehow choose to "manifest" wealth in her life? In addition, by the way, to what I think may be herpes encephalitis, which gives rise to erratic behavior and is what happens when herpes somehow gets into someone's brain? I'm not trying to be mean; I'm actually trying to give her the benefit of the doubt by saying that she's sick rather than mind-blowingly stupid.
Never mind that The Secret focuses a lot on acquiring THINGS--abundance, which is a watchword for "money and material possessions;" a job with greater prestige or better pay, etc. Furthermore, the emphasis is solely on the individual. In fact, in one of the Secret videos, a self-help guru proclaims, "It's not your job to change the world; it's your job to go with the flow of the Universe." In other words, you have official permission to stop stressing about the AIDS epidemic in Africa, the 40 million uninsured American citizens, the global warming crisis, or on a smaller scale, the fact that your next door neighbor just lost her job and is going to be having a hard time buying Christmas presents for her kids this year. She wasn't thinking positively, and it's not your job to help her out. The universe helps those who help themselves; leave those other losers in the dust and focus on getting yourself a corner office and a new car. It's the height of self-centeredness and lack of empathy.

It's a Trump-esque philosophy--take what you can from the Universe, get ahead as you're able--wrapped in the trappings of a "genuine" spirituality. What about the primary tenet of ALL major religions (to my knowledge), which is that the most important things in life aren't things, but people? That love will beat covetousness any day of the week? That relationships, whether with other people or with the Spirit, are the supreme good? So, yeah, I know The Secret, and I think it's bullshit.

Saturday, September 29, 2007

What have I always said, class?

"Um, that the revolution is coming?"

"No justice, no peace?"

"That you really need a diet Coke and a cigarette?"

No, no, no. You haven't been paying attention. Or've been paying TOO MUCH attention. Anyhow, what's I've always said is: There are usually simpler and better ways to help people than by handing out prescription drugs like Rush Limbaugh on Halloween ("Oh, you're a scaaary monster! Have a Percocet. And you're a typical yuppie blue-state voter--have a handful of OxyContin, sweetheart, I like your style.") Not just pain meds, either--in fact, I think there's probably a tendency by most general practitioners to underprescribe narcotic analgesia (unless you're like my primary care doc, who offered me a script for Tylenol 3 when I came in with a small abcess in an embarrassing location. No, dude, it doesn't hurt that bad, I just didn't want it to spread and start eating away my entire ass. My gluteal real estate is already prime; there's not a whole lot of it, supply and demand, see?). I'm talking about the everyday drugs, the 'lifestyle' drugs if you will. The statins for cholesterol, the antihypertensives (ie, blood pressure meds), the "mood brighteners" prescribed for people who aren't clinically depressed, exactly, but who feel that something has gone wrong in their lives and are consumed by a basic feeling of...not being all they could be. Perhaps--and I'm going out on a limb here--that's because they're NOT being all they could be. Maybe they work long hours at a job they hate and have no time or energy for doing the things they love, like spending time with family, painting, gardening. Maybe they're not doing the most basic things to take care of themselves physically and emotionally--they live on coffee, soda, vending machine crap at work, and fast food on the way home; they don't have time to exercise or get enough sleep but manage to watch three hours of reality TV a night; they have friends, but they spend more time discussing the lives of distant celebrities and non-existent television characters than the vagaries of their OWN existences. So, tip: before you start slinging the Zoloft and Celexa, or badgering your doctor to do same, give exercise, healthy eating, sufficient sleep and relaxation techniques a try. Lifestyle interventions: maybe difficult, but essentially free. Drugs: easy as hell, but upwards of $150 per prescription. That's per month, son. And while exercise, sleep, etc. have no negative side effects, drugs do, and furthermore a lot of these compounds just haven't been around long enough for us to know what happens (in the long term) to people who take them. Not to mention that a lot of drug companies conceal study results that show drugs are...ahem...less efficient than they might want people to believe, or that there are side effects that most people would consider intolerable.

Zyprexa, for example, is an antipsychotic that the folks at the eating disorders treatment center were really jazzed about; I was prescribed it once, but d/c ed it as soon as I was discharged. They liked it in part because it chills you out, and a lot of anorexics are high-strung folks with sleep disorders. Secondly, it is well known for its hunger-inducing and weight-increasing effects. It's not unusual for Zyprexa to plump someone up to the tune of 40 pounds. From a clinical perspective, in this very particular environment, those might be selling points (or an anorexic patient suddenly confronted by weight gain and/or rabid hunger could turn bulimic or redouble her efforts to resist food because the underlying emotional issues haven't been adequately addressed...but hey, insurance companies look at weight gain, not at quality of life!). It's good for treating obsessive thoughts, too, or so the manufacturers say; anything from OCD to psychotic delusions to the anorexic litany of calories in/calories out. In the general population, though--ie, people who aren't initiating treatment 30 pounds underweight--that kind of weight gain can cause real problems, up to and including what a lot of patients I see call "the diabetes." Not to mention the inability to find cute halter tops in the summer. Yet somehow the diabetes/crazy weight gain connection didn't get much press until Zyprexa had been on the market for a while. I shouldn't say "much press;" it still hasn't gotten much press, to be frank. Last time I saw The Psychiatrist and told her the new antidepressant (rhymes with Beffexor) was making me lose weight--and oh, by the way, my sleep cycle has gone to hell, but at least I'm catching up on the 2 am Golden Girls reruns--she said, "Hey, let's try Zyprexa." There was a brief conversation in which I expressed my desire not to take antipsychotics, especially not one that makes you "fat and sleepy," and in which she told me she didn't think I was psychotic, and hey, why didn't I take 5 months worth of samples and give it a try--no obligation, as they say on infomercials. So I got a little baggie of samples and a pamphlet called "Building a new life" or something similar, which really should have been called "Platitudes and Stock Photographs of Smiling People and Birds and Stuff."

That said, there are people who need drugs to function. Most psychotics, for example, or people with severe and intractible depression, or some other psychological disorder of a crippling nature. That's why I want to be psychiatrist and not a psychologist or art therapist or social worker: I want to be able to prescribe the drugs (though I know there have been rumblings about giving psychologists with PhDs prescribing privileges; that's a whole different post). And I loved my, uh, Boloft for years, and my Bepakote has been a godsend. They're not lifestyle drugs for some people; they're fixing a neurological/chemical dysfunction that has very real potential to kill (30% of folks with schizophrenia attempt suicide at least once, and 10% finish the job eventually; about 18% of bipolar people kill themselves; 15% of people with anorexia die of their disease). I'm not a drug-hater by any means--they aren't bad in themselves (well, except cyanide, and a few others...the ones that hang around street corners after dark, stealing cars and whatnot...). It's the responsibility of doctor and patient to use them judiciously and correctly.

Wednesday, September 26, 2007

Mixed Nuts

First, I have to say that Ambulance Driver's explanation of the cardiac conduction system is the coolest medical thing I've seen since I learned about IV ethanol. When an SA node and an AV node love each other very much, and decide they want to create an electrical'll see, it's hilarious.

As for IV ethanol, it's only officially indicated for cases of methanol poisoning (methanol and ethanol compete for enzymatic binding sites and breakdown; ethanol wins, as it has a higher affinity for alcohol dehydrogenase). In essence, there's an enzyme that breaks down alcohols. Both methanol and ethanol are alcohols; that's what the -ol at the end of the name means. For instance, a lot of sugar-free products are sweetened with 'sugar alcohols.' Look at the ingredients on the next pack of sugarfree gum you buy. I bet you a fiver malitol, sorbitol or some other -ol is on there. Anyway, methanol itself--grain alcohol--isn't terribly poisonous. However, when your liver breaks it down, it produces formic acid, which is the same thing that's in a fire ant's "sting." Needless to say, formic acid isn't good for you, and this is what makes people go blind (if they're lucky) or dead (if they're not). So in comes a patient with methanol poisoning, and the clever ER doc, after figuring out what they've done (perhaps smelling it on their breath--it doesn't smell like booze, that's for sure) hooks 'em up to an ethanol IV. Par-tay indeed, if metabolic acidosis (having overly acidic blood, which is exactly as good for you as you'd imagine it to be), vomiting, diarrhea and other assorted symptoms are your idea of a ripping good time. Of course, I knew some people in college who didn't consider a night of partying complete until someone hurled (I miss you, Bruno) so who knows.

But this is not merely a repository of medical knowledge! Fie! So, what else have I been up to? Of late I've been starting to hear back from med schools (OK, just UCSF so far, but they want me to do the secondary app! And I'm not even Californian! Boom shaka-laka! And c'mon, it's in San Francisco--the Motherland, the place from which gayness comes, wafting over the country like rainbow-hued fairy dust borne by the jet stream...). I've been re-reading the Sandman series by Neil Gaiman, which I highly recommend; at first I was hesitant when, my freshman year, my friend N. hooked me up with the full series. Fantasy? Comic books--I mean, graphic novels? C'mon, man, we're in college now. But no, this series has better writing than a lot of 'real' books I've read--even some I've had to read for classes--and the artwork itself is sublime. When I start to feel dispirited, in fact, and as if I've been wandering these past few months without producing/doing much of value, I look at my reading list. Then, of course, I remind myself that I've been writing and painting, too, and working, and training for a marathon, and applying to medical schools...and then I feel like less of a loser. The drive of the perfectionist is a difficult thing to kill. So, here are a few books from this summer's reading list that I'd like to recommend.

The Opposite of Fate-Amy Tan
The Secret Life of Bees-Sue Monk Kidd
From a Sealed Room-Rachel Kadish
The Naked Brain-Richard Restak
Mozart and the Fighter Pilot-Richard Restak
Harry Potter and the Deathly Hallows (sigh)-J K Rowling
Reading Lolita in Tehran- Azar Nafisi
The Cook's Tour-Anthony Bourdain
Lolita-Vladimir Nobokov
The Places In Between-Rory Stewart
The Bookseller of Kabul-Asne Seierstad
Gilead-Marilynne Robinson

I tried to read The Satanic Verses by Salman Rushdie, but I just couldn't do it. I made it 150 pages before I just said "screw it" and returned it to the library. It wasn't what I expected it to be (and no, I didn't expect incantantions or necromancy or Islam-bashing...I just didn't expect what I got).
Oprah, eat your heart out...was I the only one who felt a near-physical pain when she started adding classic works of literature to her book list? Faulkner et al? On the one hand, it's good that people are reading works from the literary canon--if not because the canon itself is of intrinsic worth (which I sometimes doubt, given its tendency to be dominated by dead white guys) then because the canon offers a sort of cultural common ground for discussion and reference that doesn't involve Beyonce or Dancing With the Stars. On the other hand, I hate to see people acting like Oprah zombies, whatever the good of their actions, and I wish it didn't take the involvement of a multimedia superconglomerate to get people to read good books. Meh.

Monday, September 24, 2007

Once upon a time, in some hospital far away (no HIPAA violations for me, no sir)...

I was walking to the cafeteria for lunch (probably something from the soup and salad bar, given the other offerings on the menu--why do hospital cafeterias consistently offer such fatty, salty fare? But that's a rant for another time...). A few paces ahead of me in the hallway were a mother, father and son. The son was maybe five years old, and he was sitting in a little wheelchair--a wheelchair shrunk to child-size proportions, and personalized in ways that made me smile. It was obviously his cool-mobile; the handles were neon green, as was the matching trim, and the storage space on the back of the seat had a decal reminiscent of a racing number. A little pair of crutches were hung from one of the handles, and they too had been spiffed up to requisite coolness specifications. I assumed he had some sort of musculoskeletal disease, or maybe a nervous dysfunction, but as his family stopped at the elevator I discovered otherwise. One of his legs was gone below the knee. Maybe it was congenital, I told myself. Maybe he lost it before he could walk, and so he was never thrown off balance--literally or metaphorically--by its loss. In high school I knew a girl who had an above-the-knee amputation before she was a week old. She got around on crutches, and even became a cheerleader; at football and basketball games she left her crutches in the stands and performed all the cheers everyone else did, with one leg (as it were) tied behind her back. She was probably one of the most well-adjusted people I've ever met.
Of course, I couldn't just stop thinking about it there. My brain kept wandering, and wondering--what if he had it amputated recently? How could a five-year old even process something like that, and what about his parents? How could you explain to a little kid that, in the interest of his health (or survival), doctors were going to cut off his leg? That he'd go to sleep intact in the OR and wake up in the recovery room minus a limb?
As they got into the elevator, his mom turned the chair around and I got a better look at him (don't worry, I didn't gawk). Clutched to his chest was a little prosthesis, with a metal foot and a plastic calf covered in the sort of colorful graffiti you might see on the deck of a skateboard. "Why don't you put on your leg, Timmy?" "I don't wanna right now." Scowl of the sort only a young kid can really pull off. And the doors closed.

Forget 50 cent or ZZ Top or Nancy Pelosi. This kid gets my vote for badass of the year.

Friday, September 21, 2007

Further true stories from Hospital X.

Yesterday I was walking down the hall to the cafeteria, to hook myself up with the excellent salad bar (now 98% e. coli free!). Right ahead of me was a guy wearing a full EEG (electroencephalogram) setup under his baseball cap--all these electrodes and wires flowing down his back, like some sort of robo-hair-extensions. I guess he needed to pee or was really jonesing for a snack or something, so they just unhooked him from the machine and sent him to the john. It reminded me of when I had my EEGs--having what felt like gritty K-Y jelly smeared in my hair, and being left to fall asleep in a cold room, in the equivalent of a dentist's chair, with a crappy thin blanket. I'm really not eager to do that ever again. Perhaps EEG guy just told them he needed to pee and was in fact making a break for it. In which case, hey, good for him.

Thursday, September 20, 2007

What's Important to You? or, Are You an Average American?

Quiz One

1. To whom does "TomKat" refer (two people)? Bonus point: what is their child's name?

2. This season will be the --th season of America's Next Top Model.

3. What's the name of the rehab facility where Britney Spears stayed most recently?

4. Justin Timberlake's first solo single was ...?

5. Paris Hilton's little dog is named -----.

6. Name three famous members of the Coppola family.

7. Where was the first season of Survivor filmed? Who won?

Quiz Two

1. How many millions of Americans are uninsured (to the nearest ten million)?

2. Name three infectious diseases that could be easily treated in the developing world if cheaper drugs were made available.

3. Name one of your state's senators.

4. Name the current president or prime minister of three foreign countries.

5. True or false: When prisoners are put to work in department of corrections shops, they must be paid state minimum wage.

6. This is the court decision that legalized contraception in the United States.

7. True or false: the United States is the only country in North America AND Europe to allow the death penalty.

Quiz 1
1. Tom Cruise and Katie Holmes. Daughter, Shiloh.
2. 9th. I think.
3. Promises--wasn't it?
4. I honestly don't know.
5. Tinkerbell.
6. Sofia Coppola, Francis Ford Coppola, Jason Schwartzman
7. I really don't know. Didn't Richard Hatch win?

Quiz 2
1. 40 million (43 million).
2. Malaria, AIDS, Dengue fever
3. For me, Claire McCaskill.
4. Vladimir Putin, Russia; Angela Merkel, Germany; Felipe Calderon, Mexico
5. False. Most make about 60 cents a day.
6. Griswold vs. Connecticut
7. True. Other death-penalty countries include the likes of China, Cuba, Nigeria, and North Korea: ie, countries with histories of atrocious human rights violations.'d you do? And how do you think the average American would do? Keep in mind that more people voted in the last season of American Idol than voted in the 2000 presidential election, almost twice as many people can identify Arnold Schwarzenegger as can identify Nancy Pelosi, and ONE IN FIVE people couldn't name the current vice president. For real: look here.

In other interesting news, people who watched the Daily Show or the Colbert Report were among the best informed of all citizens; Fox News watchers (ha!) among the worst. Draw your own conclusions. I, for one, feel ill.

Wednesday, September 19, 2007

Calcium has been proven at least as effective as Serafem (ie, repackaged, once-again-under-license Prozac) in treating symptoms of PMDD--premenstrual dysphoric disorder, or PMS as it was called before Eli Lilly realized that there was money to be made if only a new name could be invented to make all this sound more terrifying and unmanageable. Yes, PMS can be a bitch. I, for one, when 'the Communists have landed' (that's my favorite menstrual euphemism EVER) sometimes feel like offing myself, toppling governments, crying in the fetal position until I die, etc. You think I'm kidding, but I'm not. And then the floodgates open, as it were, and there's another theme park of fun symptoms: blinding migraines, cramps that only Vicodin has ever been able to touch (as I learned after taking one of the few I saved from having my wisdom teeth extracted), vomiting...good times. So, yes, it sucks sometimes. But medicalizing it and making ordinary women's cycles their doctors' business instead of their own? I call BS. I'm not talking about endometriosis, or pelvic inflammatory disease, or anything like that...just good ol' fashioned uterine goings-on...once upon a time (like, waaaay back, like Neolithic times), women's bodies were something women dealt with. Midwives. Herbs (yes, including THAT herb...cannabis is supposedly very good for cramps. I wouldn't know, what with the meds I'm on, but my friend A swears by a small joint and big glass of wine). Abdominal massage. Going out to the menstrual hut with all your other women friends and chiiiilling for a few days. I used to think of menstrual huts as symbolic of feminine oppression, evidence that women were devalued and trampled underfoot in such societies. Now I think, damn, wouldn't it be awesome to have a little hut in the woods, get six or eight of my best girlfriends, and spend a week together every month? Cooking for each other, having wine (and other things?), talking until late, knitting or painting or doing whatever creativish things we felt like...away from men, and jobs, and bullshit. Yay. Sorry, tangent...calcium. Yes.
So, I've been having some GI problems of a personal nature, and one thing calcium is known for is exacerbating this particular problem. So--do I want to resolve this problem, or do I want to potentially allay my PMS? What do I do?

Sunday, September 16, 2007

So my run went really, really well. I didn't make my goal time--I actually came in at 32:01--but that means I still maintained an 8 min/mile pace on an essentially cross-country run, with lots of hairpin turns, etc. If it were a straight shot, or a track race, I might have done better; that's basically the excuse I'm trying to make here. And at nearly a pack a day, it wasn't shabby at all.

So, now that I've gotten a taste of delicious, delicious racing, the headlong rush into marathon training begins. I'm planning to do the Olathe Marathon, which is at the end of March. And since training will mean at least a few 20+ mile runs, I need to have a good playlist to carry me through. When I'm really going balls-out, I like to have pretty hardcore music at my disposal; thrash, metal, punk, alternative-type stuff. Here's what I've come up with so far, playlist-wise; anyone with suggestions, make 'em. And yes, I realize that I need to quit smoking sometime in the very near future if I'm going to make a marathon happen.

Killing In the Name; Testify--Rage Against the Machine
Trippin' on a Hole in a Paper Heart--Stone Temple Pilots
Smells Like Teen Spirit; You Know You're Right--Nirvana
Everything Zen; Body; Monkey--Bush
Rebel Girl--Bikini Kill
Die Die Die my Darling--Misfits
Anarchy in the UK--Sex Pistols
Firestarter; Breathe--Prodigy
Down With the Sickness--Disturbed
Living Dead Girl; Dragula--Rob Zombie
Black and White; Bled for Days; Destroyer--Static-X
Party Up--DMX
Better Version of Me; Criminal; Limp--Fiona Apple
TKO; FYR; Fake French--Le Tigre
Spiderwebs; Happy Now--No Doubt
Happy and Bleeding; Meet Ze Monsta--PJ Harvey
Head Like a Hole--NIN

Not all the music I listen to is like this, obviously; this in fact represents one of the extremes of my taste--the very loudest, thrashiest and angriest. I also have every Loreena McKennitt and Dar Williams album that has ever been made, have great love for Gustav Holst's "The Planets" and listen to Gregorian Chant before bed every night to help me get to sleep. It's just that sometimes you need your music to rock you to sleep, and other times you need it to kick you up that last long hill.

Saturday, September 15, 2007

I love the smell of human in the morning.
Smells like...breakfast.

Run...It's the Orangutans!!!

OK, now I'll explain. Today (in about 3 hours, actually) I'll be doing the Kansas City Zoo run (oops, I just revealed my location on the Internets...hell, I think I've already said at least once that I live in Kansas City, so never mind. The cat's been out of the bag a while already). This year, the proceeds, or donations, or whatever you're supposed to call them, are going to the orangutans. It's a different endangered species every year; last year it was the elephants, the year before, the rhinos (but WHICH rhinos? The white? The black? Dammit, why does it have to be a racial thing?).

It's a 4-mile run, which is kind of a bizarre distance. A 5-K is 3.1 miles, a 10-K--remember your elementary arithmetic?--is double that, 6.2. And of course there's the mother of all races, the marathon, which is a hearty 26.2 miles of muscle cramping, vomiting, chafing and hallucinations. Seriously, one of my friends who's run a marathon said she started seeing things at around mile 20. I think the human body is just, in general, under the impression that it's never going to be called upon to run 26 consecutive miles. Just a hunch. Of course, the very fact that marathoners are crazy, badass mothers is the very reason that I'm aiming to do one before I head off to med school. Honestly, for the next ten years or so (med school, internship, residency) I might not have time enough to blow my nose, let alone set aside an hour or two or four at a time for training. I'm not planning to be a lifer; I just want to do one, and say I've done it. "You could just say you've done it." Shut up.

So, I spent my childhood being yelled at NOT to run around in the zoo ("Dammit, stop running or we're going home!" "But I want to see the monkeys NOW!"), and thus it should be a refreshing change of pace to be hauling ass around the monkey enclosure, the tiger display and the meerkat colony. I wonder, though, if it distresses the animals at all--or if it excites them. The tigers, for instance. What do they chase/catch/eat? Running things. And here come all these running little entrees dressed in running shorts, their drumsticks on display...imagine being in an old-school pizzeria where they have all the pizzas behind the counter where you can see them, then being told, "Oh, sorry, you can't eat those." That's cruelty. Which is why I recommend that next year, rather than a Run For the Tigers, there be a Run From the Tigers. Like the Running of the Bulls in Pamplona, but with Panthera tigris instead. You wouldn't have to be terribly fast, you'd just have to be faster than the person you were running next to. Or carry chunks of raw meat in your pocket to chuck over your shoulder when the tigers got too close.

I'm hoping to keep up a 7:30-mile pace for the duration of the race, which would put me at a healthy 30 minutes. We'll see.

Thursday, September 13, 2007

Physicists and Mystics

Ok, so I've known/suspected for a long time that science and religion aren't at odds in the ways that most of the world assumes. The fundies are full of it, the scientists who assume that all religious/spiritual people are idiots and sheep are full of it, as well as those who assume that neither are important or enlightening ways of looking at the world...and today, leafing through a book on quantum physics, I saw further affirmation: Bell's Theorem.

Basically, all parts of the universe are interconnected: there is no such thing as a person, a photon, a wave, or a thought in isolation. What happens in one part of the universe can and does affect objects millions of parsecs (light years) away, instantaneously. For this interaction to occur (virtually) instantaneously, whatever 'does' the communicating must move faster than the speed of light. As anyone who passed college physics can tell you, though, nothing moves faster than the speed of light--that's why Bell's theorem baffled/ pissed off Einstein, he of e=mc2. Seriously, read about it. Crazy stuff.

And speaking of e=mc2, and not to sound like a crazy crystal-wearing hippie (I prefer larger crystals, the kind you keep on your desktop): this equation correlates mass and energy. Mass is essentially stored energy; that's what makes nuclear fusion and fission work as energy sources, yeah? (To those who don't know: yeah, it is). So in high school physics, your teachers lied their asses off; "Mass is neither created nor destroyed." "The sum of kinetic and potential energy is always conserved." Bullshit. Lies. At a macro level (ie, big enough to see with your naked eyes), yeah, it's true. But once we're talking about atoms, neutrons and electrons, that stuff doesn't always hold. 99.9% of the time it does, but NOT always. However, the sum of energy stored in mass, and energy of motion or potential motion, is always the same. At the most basic level--the energetic level--nothing is ever created or destroyed. Everything that has been has always been and will always be. But Anne, my thermodynamics textbook says entropy is always increasing. Isn't something being destroyed? No, energy is just being released in an unusable form. Still the same stuff. Everything is energy. Everything is eternal. Everything is connected as if by an invisible, energetic web. Whoa. Did I just blow your mind? 'Cause I think I just blew my own.

Tuesday, September 11, 2007

Things I have learned in my 3 months at St. X's Hospital:

Interventional cardiologists have balls the size of mainland China. You kind of have to, if you're going to be essentially killing people and bringing them back to life all day long. That's what you do during bypass surgery; you cut into someone's heart, for God's sake. This ballsiness sometimes spills over into other areas of their lives.

From stories told by nurses: anyone who shows up with something weird stuck in his or her rectum (and is there anything not-weird that you can have stuck in there?) will inevitably say they 'fell on it.' Weirdest item removed, that I've heard of: a Maglite flashlight, still on. Was this an attempt at bargain colonoscopy, or what?

Nurses and doctors, for the most part, are in separate corners of the ring and operate under the assumption that the other party does nothing while they do everything.

If someone is a smoker and able to haul themselves out of bed, they will find a way to go outside and smoke. I've seen people in wheelchairs; with full spinal braces; with nine-month-pregnant bellies; dragging along their IVs; carrying oxygen tanks. Yesterday, hand to God, I saw a twenty-ish looking guy with a chest tube lighting up outside. There was reddish drainage in his tube, too. I wanted to tell him that if he was recovering from lung or heart surgery he should probably be laying off the cancer sticks, but even with a chest tube and one hand carrying the drainage pump, he looked like he could kick my ass. And I am nothing if not non-confrontational.

It is possible, though not necessarily desirable, to construct sentences made up 50% or more by acronyms and abbreviations. Ditto long, incantatory-sounding Latin words. Para ejemplo: I need an ABG, CBC and Chem-20 on the AMI we got in from the ED last night--he's in the CCU. Translation: Do these blood tests on this person, who just had a heart attack and was moved from the emergency department to the cardiac care unit last night. OR, She's para 1, gravida 2, and this time it looks like placenta previa. Translation: She's given birth once, she's been pregnant twice, and this time it looks like the placenta's going to be delivered before the baby (a dangerous condition that usually necessitates a Cesarean).

Tuesday, September 04, 2007

People you'd think would be really boring, but are often quite interesting:

Librarians: They read a lot, which is always cool, because reading gives you more crazy stuff to bring up at cocktail parties. They're usually smart. As a rule, they will not leave their dirty clothes all over your apartment, whether in their capacity as a roommate or a lover.
Professors: Also smart, which is sexy. If you happen to be proficient in their area of expertise, you can talk for hours. Many professors are heavy drinkers, and drinking (as we know) is cool. Warning: as you light up those cigarettes in bed, they may tell you you've earned "A B+ overall, but an A for effort."
Priests: Some of the most nonconformist, radical people I know are priests (see: Daniel Berrigan et al). Catholic priests often drink and smoke without compunction. Anglicans let women be priests, and also let priests marry. Which means you can totally flip your Catholic friends out by saying, "Well, my priest's husband..."
Psychiatrists: They have the best stories, though of course due to privacy laws they can't tell you any names. Psychiatry is hands-down the craziest profession out there, narrowly beating out alligator wrestling and working as an FBI mole in the Russian mob. Seriously, as a group psychiatrists have one of the highest rates of mental illness and suicide. Hopefully any psychiatrists you befriend have one of the 'fun' mental illnesses. Oh man, I'm going to hell.

On the other hand, there are also people you'd think would be super-awesome, but who actually nurse incredible personality defects. Many teachers (mostly at the elementary school level). Performance artists, almost invariably. Then there's the kid behind the counter at Baskin-Robbins whose green hair and artfully applied 'smoky eyes' give the impression of an intellectually daring, outre individual, but who you discover (after about five minutes of conversation) is merely a Hot Topic addict out to annoy his parents and hide his latent homosexuality.

For the record, I apologize for this entire post.

Sunday, September 02, 2007

Disease of the Day: Listeriosis!
Ok, so the picture of a wheel of Brie is somewhat misleading. Soft cheeses are the most notorious source of the Listeria bacterium, but you're about as likely to get it from unwashed produce, poorly cooked meat (ie, not cooked all the way through--the fact that your dad thinks everything up to and including filet mignon is improved by a slathering of barbeque sauce has nothing to do with your susceptibility), or contact with sick farm animals. Of course, since soft cheese once caused a big outbreak (these days the few cheese-related cases that do occur are linked to queso blanco, the Mexican equivalent of farmer's cheese) pregnant women and those with weak immune systems are advised to avoid soft, flowing, delicious Brie et al. altogether. Which is a pity. This is also why you can't get cheese aged less than 60 days, or raw-milk cheese, in the US. That, and the USDA is full of crap. Oh, but I'll bust their chops another time. You can support factory farming and use the government school lunch program as a dumping ground for federally subsidized overproduction of high-fructose corn syrup, but when you keep me from having raw-milk Camembert you've gone too far! Just kidding--factory farming and making America's children hyperactive and obese is also not OK. But at least it's profitable! Hey! I'll be here all week...try the veal.
Why all the fuss? Because listeriosis in pregnant women is nasty, that's why. Not so bad for the average, healthy adult--most people get a little fever, maybe a headache and some nausea--but pregnant women can pass it to the fetus, which may then be born with septicemia (ie, a blood infection...Very Bad News) or encephalitis (an infection of the brain-al area...also Very Bad News), or may just be stillborn outright. Immunocompromised folks may have the same symptoms. Treatment is pretty simple: a course of penicillin, or erythromycin if the patient can't have penicillin for some reason. Cephalosporins (my personal favorite antibiotic class, since I get skin infections on occasion from all the sweaty running I do) don't work for listeriosis, so don't go trying to prescribe Keflex for it.
Next time we do the Disease of the Day feature (I need to put up some more poetry and possibly do another Lesbian Pulp Fiction day before we do any more diseases) it'll either be a hemorrhagic fever or a parasitic infection. Lassa fever or Leischmaniasis? Hantavirus or hookworms? Stay tuned...