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 maybe...you'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 partnership...you'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.

ANSWERS:
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.

So...how'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
Mudshovel--Staind
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...
I'm trying to quit smoking (again), this time with the assistance of the patch. I have to say, it's taken the edge off...about like a nail file would take the edge off an axe. Anyway, when the time came to go patch-shopping, I was cheap, so I bought the CVS brand instead of the more expensive Nicoderm (or even more expensive CLEAR Nicoderm). So when I take the patch out of its little packet, not only is it not particularly flesh-toned, it also has the words "Nicotine transdermal system, 7 mg over 24 hours" emblazoned on it. Might as well say, "I am a smoker who will try and give cigarettes and/or lung cancer to your newborn infant if you don't watch me." Sorry, EX-smoker (all the self-help booklets on quitting say it's important to begin thinking of yourself as an ex-smoker). So far I have one day 'clean.'

Did you know cigarettes are approximately as addictive as heroin and cocaine? And that more smokers that coke-users die from diseases related to the habit? Granted, hemorrhaging your entire blood supply out your nose or going into cardiac arrest is pretty dramatic (those cokesters are drama queens) but anyone who's seen a little old lady holding her portable oxygen tank in one hand and her cigarette in the other will agree that nicotine is a cruel mistress. PS- I have seen just such a thing, and I'm always afraid she's going to vaporize the whole block when the oxygen finally catches: "This is Bill Billingsley for KCTV news, and we're here outside St. Crucifix's hospital where an explosion took place only moments ago. Was it a terrorist, or the result of high-pressure combustible gas meeting an elderly woman's Winston? We'll be right back."