I don't think it's done...

...but I wanted to write it, O Best Beloved, before I lost the dream.

Mystery flees,
    pursued 
  by the heavy hand of knowledge.
        The wonder of life,
     dissected, explained,
a hundred pages, a thousand, 
                   a library
              of words.
Mystery is fled.

I have held in my hands secrets,
       hearts unbeating and unbroken, 
    the very things of our being,
            weighed the measure of a man
      and found it not light.
                    But what then remains?

It is in the unfurling fingers
        and discovered hands,
              the cry and laughter of innocence -
   beyond the books,
        sharper than scalpels 
               and more real than I.

Mystery flees,
      and leaves itself behind.
                NsB 05-Sep-03 "jaheim"

Bobbie, you kick so much ass...

So gave me her number. And I made an emergency run to Wal-Mart, for reasons that are clear to those of you on the TMI list (option 2 was selected by Angel. Funny, that), and I walked in the doors and thought "Gee...it's after 9. I think I'll try this number." And we talked for the next 33 minutes, as I shopped. It was good. I feel...refreshed. And I feel I've bonded. And I have acidophilus capsules. Yay!

Things I have discovered today that you really didn't want to know:

1) When I'm on my period, I don't shave. Because if I do, and I wear a pad (which I do for backup even with tampons, after bleeding all over my shorts in 6th grade) I get ingrown hairs. This only slightly mitigates the awful awful thing that happens once in a while, where the pad somehow gets rolled back and the sticky stuff that's supposed to adhere to my underwear adheres instead to my skin. I hate this. I really hate peeling it off my skin. I hate it even more when it causes leakage. Fortunately, part the second was not significant today. 2) I think the antibiotics that I'm on for the bacterial superinfection on my cold are inducing the formation of yeast overgrowth in places where yeast Should Not Overgrow. Itchy. And I refuse to have a yeast infection on the two nights this entire week when I can get laid, but I think I might. So my options are (1) No sex for the Nykki this weekend, as if it is a yeast infection and goes untreated, I will be so fucking tender and sore that I will be unable to bear the idea of anyone even thinking about my clitoris. (2) Treat the infection now with a 1-day course of Monistat, even though I'm on my period and that's just the most disgustingly messy idea I can think of, plus I'm going to be sore anyway. (3) Hope really really hard that I'm wrong. I'm leaning toward (2), but I just can't bring myself to go put on pants instead of scrubs and buy something. I should. I know it's there. 3) They told us in anatomy, physiology, embryology, and pathology that baby boys are capable of getting erections. I believed them. I really did, and I even accepted this as a normal part of life. Not too much snickering, even, and I believe I am a relatively mature human being. However, there's a difference between knowing that little baby boys can get erections and discovering a tiny baby boner when one is doing a genital exam. I was caught between the strangely bizarre sort of "oh, isn't that cute" that afflicts me upon seeing babies do anything - even spit up - and a faintly embarrassed and uncomfortable sort of sensation. But I finished the exam, like a good girl. Okay, thanks. I had to share.

A few random things first.

Check out this post by . I have nothing to add, really, on that topic. And the alphabetic song meme...another time, maybe. Thoughts and love to you, ...I have your number stored in my cell, for future reference. Msg if you ever want to talk :) And the meat of the entry: Sent a call from Quin's parents to my voice mail last night. Had things to do, was in Do Not Traumatise mode. They're grownups, they'll cope. Went to bed at midnight. Tomorrow I will be having an Extremely Long day, so I will go to bed early tonight. Then, tomorrow, I will go pre-round on my patient at 7 AM, and then do work until about 4 PM. I will subsequently drive home to FW, where I will attempt to wrap up my campaign. Then I will turn around and drive back to Indy, planning to arrive between 2 and 4 AM. It's a little over 2 hours each way. I'll get up Saturday morning at 6 and pre-round at 7. I'll stay as long as they want me to stay, then come home to FW again. Because I miss my Angel that much. I can stay until Sunday evening, when I come back here again, and spend the week doing work and pretending I know what's going on. I'm getting better at it. And then, assuming it wasn't so bad this time, I'll do the same next weekend. The other alternative is to take Saturday as my day off, and just go back on Saturday night to round on Sunday. I haven't decided. What I have decided is that the new residents are pretty nice, especially JL. She's the only girl on the service, and is second in importance to JK, so when he's not around I report to her. Today was switch day - all the residents I was getting used to in the last few days sort of up and disappeared today, leaving us with a new group. I'll use nicknames. JL is known as "Stalker girl", as she has a psycho phone stalker who calls her in the middle of the night. R is "Flyer" for some unknown reason, and B is called "Lance," because Dr. M thinks he looks like Lance Armstrong. I spent most of the time I spent with anyone with JL, and we get along quite startlingly well. I like her. She showed me where to go to get my paper signed for my Special Wishard Computer Number (up to the mental health section, drug rehab wing) and offered me a ride to my car. A very cool woman. This morning, then, everyone got the Introductory Talk. This morning, I presented all three of our current patients: the ingestion kid, the LP boy, and a new admission, 1.5 years old with a frightened 17-year-old mom. It's his first time in the hospital for his asthma. This morning, I looked him over but didn't get much of a history, as mom was asleepish and not very talkative. Got asked a number of questions I didn't know the answers to. Felt silly. Must learn about Asthma. By the time I'd presented my three patients we were already discussing sending two of them home. The kid with the ingestion, after all was said and done, appears not to be in danger in his home. LP boy was feeling great yesterday, and as I was about to call Micro to get a 48-hour read on his CSF culture, JL showed up. "JH just called me. They paged him. D is enterovirus positive." Bingo. Called anyway. Cultures are negative. Got his discharge orders started, or someone did. It was all sort of mysterious. Ran into Dr. M, who commented that my admit H&P on the ingestion kid was very nicely done. Sat down and wrote my notes - two SOAP notes from pre-rounds, one admit H&P for the new one. Scampered over to Riley for noon conference, on growth curves in children. Grabbed lunch - taco salads in Riley cafeteria are way too big. Then the asthma kid was doing well, nebs to q4-5h instead of q3, and JL had me do the scut work regarding getting Mom set up for asthma education. She's working hard. Trying hard. My heart goes out to her. Got all of that done, finally, and found JK in the newborn wing. Ran a few errands for him, called in newborn appointments, M and I both did, something he calls "divide and conquer". It went fast. And then we got the paperwork moving on the ingestion kid. JK sat down with me and walked me through doing a discharge summary on the computer, which is much easier than doing it on paper, half the work is done for you. And he commented on how nicely I typed, and how fast I caught on, and I felt pretty good about the whole thing. I think I can do the next one, no problem. Just one more thing to do, he says. It was 3:30. We've got a new kid in. Go ahead and go do an H&P on him and you can run the service tomorrow just like today. It's nerve-wracking, knowing that you're the only person who's going to be presenting during rounds; that everyone's looking at you to find out what's going on with the patients. That's kind of a lot frightening. But Dr. M said I did very well. He pointed out the holes in my asthma presentation (Why am I so bad with asthma? I don't know. I need to remedy that.) but then said "Nobody ever gets everything in." I'm very much glad that I have Peds to work out my presenting and note-writing skills on before I have to do the high-pressure services. I went down and did an physical exam on the new baby T. He came into the Urgent Visit Clinic with his fifteen-year-old parents (baby is seven weeks now) saying he was fussy and feverish. Standard labs. Shot of ceftriaxone. Follow up tomorrow. At follow-up, they had new results: the blood cultures that had been drawn were growing S. agalactae. The kid's septic, with a blood-borne bacterial infection. The reason this was so surprising is because he didn't look all that sick. So then they did the sepsis workup, which includes a lumbar puncture. I see so many of them... That was reassuring. Now he's our baby, probably for the next few weeks, as we plan to do antibiotics out until a week after the first negative blood culture. He was asleep when I got there, parents somewhere else, so I sat down with the chart and got the history from it. Maybe they'll be there in the morning. As I was going in to see to the physical exam, the nurse pauses. "Don't you dare wake that baby up." I smile. "I'll do my best, but I've got to do a PE." She knew and I knew that I had to do my job. She shook her finger at me, playfully. I think the nurses like me. And then I went in. Newborn or very young child, you always start the physical exam with the things you can't do with them crying. Heart and lungs, listen and listen. Heart rate regular, if fast like all babies, and a very nice soft murmur with each beat. It's probably a flow murmur - a normal thing in babies, especially sick ones. Lungs clear. Then I unwrapped the little creature (So tiny. They're amazing...) and squeezed his tummy, looking for bumps or lumps or big liver and spleen. If they're crying, it's impossible except between breaths. Percussed across it, listened to bowel sounds, undid his diaper and peeked to make sure he had all the right parts in all the right places. Wiggled his legs but didn't do the full Ortolani and Barlow manoeuvres, which check for developmental dysplasia of the hips. I should've. Oh, well. Played with his hands and his reflexes. Peeked up his nose, waited for a yawn and looked in his mouth, carefully lifted him and checked his fontanelle. And then I pinned him down very gently, and looked in his ears. And he never woke up completely. He opened his eyes a bit, long enough for me to shine a light in them. No crying, no fussing. The nurse was most impressed. So JK and I wrote an admit note on the computer for him - I see how it's done now, I could do it again once I get my number, and that's when JL and I went away. All the way down to the (closed) Information Security office. Maybe I'll be able to find it again. I didn't leave until after 5, but I felt good about it. Came home, heated up a cup of soup and had a sandwich. Am now waiting patiently for Angel to get back so I can see him before I go to bed. Perhaps I'll write more of Jen's story. Or fill out the question and answers. I should learn about asthma, but I don't want to. This weekend: expanded H&P. Figure out what the everloving fuck Evidence-based medicine is. Try and sleep.

For the interested:

Jen's backstory, such as it is, posted in . Link is here.

Morning report.

Left late on Tuesday, couldn't get moving at normal speeds. Arrived at the conference room to find everyone working on some kind of quiz. Isn't it a damn good thing I skimmed the GBBS papers? Went and found Dr. H, who gave me the quiz and my packet, told me I wasn't the last one to get in. It doesn't count toward grades, really. It more counts toward if we're on the verge between two grades, as a booster. If things keep going the way they have been, I might honours this thing. If I can just study. Orientation was largely aimed at the Riley kids, so A and I went over to find our places at Wishard. I got a whirlwind orientation, listened to rounds all morning, saw a whole two patients, one of whom was all in Spanish, and watched a lumbar puncture. There'll be new residents tomorrow. Otherwise, the next LP was going to be mine to perform. And if they don't mind, I'll still get it. "If you want," JK says. Do I want? No, I'm scared shitless. But I watched JH do the one on Tuesday and he had to stick the kid three times. I don't feel as bad now. We tried to go to noon conference, but there was no food left, so we left too. JK released me to go get some food, look over the chart for LP-boy (he's your patient now), and page him when I was done. I would've been done much sooner with all of that, except I had to go back to Wishard to get my wallet. And I forgot what floor the unit was on, so I went to second. And then fifth. And then fourth. And then third. And then I knew I was on the right floor, but all I could find was the NICU. And I couldn't get through the doors, and my card didn't work, and after 25 minutes or so, JH happened upon me. "Where are you trying to go?" He laughed. And gave me directions. And I got my wallet, and found my way to the other side of Wishard where the cafeteria was. And I had taco salad, next time to be put in a small cardboard thingy instead of a large cardboard thingy, as there was entirely too much of it for my hunger. And then I went back up to the wards, finding my way with a relative lack of missteps, and I looked over the kid's chart. D is 11, two months post-appendectomy, no significant history of migraines, and presented with a two-day history of headache and vomiting, unable tokeep anything at all down - including a teaspoon of water. Low-grade fever, photophobia, no sick contacts. (, are you thinking LP is a good idea by now in the history? Because I was.) He was seen in the ER, but lacked any signs of meningismus (no stiff neck, no Kernig's sign or Brudzinski's sign) so despite two consults with the doctor on call they didn't do an LP. What they did do, however, was start him on ceftriaxone. The question that comes to mind here is: If the ER doctors didn't think he had meningitis, what in the bloody hell were they treating with ceftriaxone? We got an LP the next day, after one dose of ceftriaxone. Beautiful crystal-clear spinal fluid (on the third try), opening pressure 24.5 cm, just lovely. And the cell count came back 150 RBC's, 350 WBC's, normal glucose, normal protein. Probably viral meningitis - the white cell count, while elevated, is below 500; the glucose and protein are normal (decreased and increased respectively in bacterial); gram stain is negative - but we don't know, since he got antibiotics. There's a PCR for enterovirus (the most common cause of viral meningitis) gone out, but it'll be a while. So we wait to see if his blood - the only thing we have from before antibiotics were started - grows anything. That'll be late tonight. By the time I was done looking through his chart, I had enough time to tag along over to the newborn side again, listen to a lecture on normal newborn exams, and talk through my expectations of the rotation and JK's expectations of me. I'm supposed to be a member of the team, and work through things with them, and present, and care for patients, and generally be useful. I'm good at being useful. Then I went to Muncie, spent some time waiting for Angel's mom to get out of the evil meeting, wrote notes to my old professors, and generally had a good time. Also Applebee's for dinner. Got home around 9:45 or 10, at which point I did my looking up and patient entry and panicked over the stupid little abbreviations. It goes like this: There are two common labs which have abbreviations for the relevant data. One is the CBC. And it goes like this:

    \ Hct  /
WBC ------- Plt
    / Hgb \ 

(WBC = white cell count; Hct = hematocrit; Hgb = haemoglobin; Plt = platelets) The other, the one that I can never remember, is the electrolyte panel. Abbreviation I copied down from the chart is as follows:

 Na+ | Cl- | BUN /
-----+-----+----- Glc
 K+  | Co2 | Cre \

(Co2 = bicarbonate level; BUN = blood urea nitrogen; Cre = creatinine; Glc = Glucose) But for some reason, I couldn't find the bloody thing. And I didn't look in Maxwell's. And so I had to wait for this morning because I'm too daft to know where they went just by normal ranges. Was running late this morning by 10 minutes (I hate having to be there at 7 AM), missed Grand Rounds because I was busy talking to JK, scrambled to make my presentation by the time we did rounds, and felt very stumbly over it all. But ultimately, it went well. It all went well. I was complimented on my presentation, especially on the impromptu one I was handed over the new overnight admission. J's patient, she saw him in the ER last night, but JK had me presenting him and she was happy to let me do so. And that, O Best Beloved, was a most interesting case. Interesting enough that I'm going to make a game of it. Read on: The patient is a four-month-old male. He lives with his mother, who despite a history of cocaine and marijuana use during the first trimester of her pregnancy, was clean after that (too bad so much development takes place then). He is a full-term baby with no known defects, spent 48 hours in the NICU after a difficult birth, all of his drug screens at the time were negative. Mother has two other boys, both in foster care, that she's working to be reunited with. He spends time with his father (who has several girlfriends, it seems) - and in fact, has been with his father for the last week. Mom picked him up at 1 PM yesterday. He was fine. He continued to be fine until he woke up from his nap around 10 PM, when she felt he was acting "not right" and brought him to the emergency room. That history is all from the father, who came to the ER last night and stayed with the baby while Mom went home to tend to the other kids. We didn't get Mom's history until the definitive labs were back. My PE in the morning concurred with the PE of the ER: a baby who is alternately irritable and utterly passive without much interaction. When blood was drawn he could localize pain and withdrew from it, but quickly fell back to passivity after that. He is afebrile (normal temperature). His head shows no signs of trauma, but his eyes have pinpoint pupils to 2mm or so, minimally reactive to light, and he won't open them spontaneously except for brief instances. During one of his crying spells, it was noted that he displayed horizontal nystagmus. This resolved spontaneously and did not recur during the next crying spell. His fonatanelles are flat, maybe even a bit sunken, his mouth is dry, and he's not producing much in the way of tears. Heart rate is regular, no murmurs, rubs, or gallops, and a sturdy 130 BPM. Brachial and femoral pulses are good. Lungs are clear. Abdomen is soft and nontender, no hepatosplenomegaly noted. He is moving all extremities, and grasps fingers. His skin is clean, a nice warm dark brown, and shows no bruises or marks of trauma. His LP site (they did one on him, oh yes) is clean and shows no signs of inflammation. We have on file a CT scan of his head (normal) and a chest X-ray (normal, although I went down and made the radiologist explain to me why the funny lines I saw weren't rib fractures from abuse). And here, O Best Beloved, is where you come in. Just for fun :) Let's put you in my shoes, and see what you can think of...before I tell you about his labs. No grading, just a little fun. I have a handful of Medically Minded people here. First things first was to look at the labs. I went through them all. They were all distressingly normal, even down to the LP results. It was a perfect tap: 0 WBC, 0 RBC. An unequivocally clean CSF. So we had to sort our differential: Ingestion vs. Seizure vs. Abuse. There are a number of other causes, but none of them were well-supported by the PE results. The next step then, already handled by J in the ER the previous night, was to run a drug screen. Preliminary blood levels of alcohol, aspirin, and Tylenol came back negative. Urine screening for the major troublesome drugs (marijuana, cocaine, meth, PCP, barbiturates, benzodiazepines, etc) came back negative. She ordered the 600-drug urine screen. We ordered an EEG to see if he was having seizures, also compatible with his symptoms. We ordered an EKG to look for cardiac syndromes. We ordered an abdominal X-ray to see if he was having GI distress. And we waited. I wrote my progress note on D and went to noon report, had a sandwich, and played Tetris while listening to a woman talk about breathing support systems. But it was a free sandwich. After lunch, my duties were to talk to D about his results and our plan, follow up on the EEG, write my H&P note on the baby, and then go follow C around the nursery. I wrote the note. I consulted D. I peeked at the baby - alert, awake, and responding to sounds appropriately now. Looking much better. Then I found JH and he sat me down. "Drug screen's back on the baby." Positive for metabolites of risperidone. Risperidal, a fairly potent antipsychotic medication. In a four month old kid who can't even crawl yet. This, O Best Beloved, is Suspicious. We finally got Mom's story, just before telling her what had been found. Her two younger kids take Risperidal for their behaviour. They had the medication with them last night. She denies giving the baby anything - she bathed him, he played with the others, she put him down for a nap. The staff at the rehab group she lives with gave the other two their meds. But it was a chaotic situation, and one I was glad to turn over to the social worker. The bottom line? Well, we still don't know who gave the kid the drugs. There are multiple possible routes. And Mom, assuming that she's innocent of trying to sedate a cranky kid with nasty antipsychotics, is now getting involved with CPS just as she's working to get her other two back into the home. And Dad's furious. And it's all a nightmare. And I inherited him as a patient from J, who goes to a new rotation tomorrow. After calling on the EEG (tomorrow morning) and checking in with JH, I was gone at about 4. Angel got the LCD screen for my uber-cute PS1, so I can now play DDR and Final Fantasy here. Now I'm pondering going to the store to buy some microwave dinnery things for quick meals, and get some more shakes, because I happen to like them for breakfast. And that, O Best Beloved, is that.

But WHY has the time gone?

The Gathering went very well. Will talk more about that another time. I watched the sun set as I drove to Indianapolis tonight. I watched the sky turn golden, clouds like a veil drifting dusty over the light, and then a pink, brilliant even to the point of shading the rain-drenched road in front of me with its hues. It was beautiful, spectacular, almost, the way the light plays and changes and flows over the road. Joe was not so impressed. Made my promised check-in call to 's parents this afternoon rather than this evening. Left a message. Forwarded my phone to Angel's. Resolved not to talk to them if they called later. It came to me as I was driving, something I'm still working on forcing myself to accept and comprehend. Something Jefe, bless his heart, has been scolding me for. They don't have to like me. They can't get me in trouble. Even if their whole church and peer group believe we're evil and doing awful things, so what? They have no power over me.

Through dangers untold and hardships unnumbered, I have fought my way here to the castle beyond the Goblin City, to take back the child that you have stolen from me. For my will is as strong as yours, and my kingdom as great. You have no power over me!

No power. It's like what Daddy told me. I don't have to let them manipulate me. I don't have to let them drive me nuts. I have a life to lead. Quin has a life to lead. And unless I'm much mistaken, the biggest stress on her right now is watching me and Angel react to her parents. It's fucking ridiculous. Stopped at LC and Aura's to pick up Joe's car. Popped in to use their facilities. "Have you eaten dinner?" No, of course not. Dinner? I don't eat, half the time, just for forgetting to. (The scale this morning said 216. I must've been dehydrated. I haven't been working on it at all!) So we got pizza and we chatted and we didn't leave there until like 9. And then I realised I'd forgotten my shoes at home. The only ones I have along are my sandals; no good for working in. So when left Joe at his place, I went to Wal-Mart. I bought myself new shoes (black, Lilylove, so now I have Black Shoes and Brown Shoes like a Proper Girl), a Little Tykes plastic drawer cart (in bright colours), a hamper basket, an umbrella, sheets and a blanket, and a fluffy pillow. While at Wal-Mart, looking at umbrellas, I heard two girls speaking in French. I glanced over, and made a comment in French about the cute umbrella she was holding. Two very startled looks went my way. You speak French? Oui, un peu. J'ai passé cinq mois à Strasbourg... We talked a bit, a few seconds really, just a "you're kidding" kind of chat. Are you from here? About two hours north. Yourself? West Ghana, Africa (I think I remember that correctly). Your accent is wonderful. You sound like a native. I worked hard when I was in France. I can tell. It worked. That made me feel so good, O Best Beloved. I bloody well still have it! Also saw today, for the first time in a long time. We were both tired, both just glad to see each other. Sat in silence and watched Quin play Devil May Cry (You're going to have to do it again, from the beginning, on a harder setting when you're done, you know) and just bonded in that strange subliminal way one can, when one has a friend who's close enough to be a sister. We didn't need to talk, really. It just felt good to be with her again. Think good thoughts. She leaves for Marburg on a Fulbright scholarship Monday. The dogs are making sleepy noises. It's early in the morning, and the laptop is at 25%. Soon - tomorrow, I hope - the signal booster will come from Best Buy, and I'll be able to do this from the couch in my room. There are several good reasons for wanting to be able to use my computer in my room, most of them involving not feeling obligated to be social. Some of them involving not having a Boy around to handle certain needs. And some of them being that I just want to be able to go to sleep watching my screen. But for now, O Best Beloved, it's late. And tomorrow is Inpatient Orientation at 7:30 AM, and I haven't finished my readings for the imaginary exam I might have soonish. I'm such a slacker. I need to start doing my readings. Maybe I'll tell you about something new I learned in my reading every day, or maybe I'll be too exhausted. We'll see. For now, good night.

Stuff later.

Fluff: Meme-Tracking Meme This meme was created to track how quickly memes spread through LiveJournal. Just copy/paste this, with these instructions, into your own journal, fill in the answers, post that bad boy, and then leave a comment on the following post: http://www.livejournal.com/users/etoilepb/248028.html. Your LJ Username: # of people on your friends list: 125 First journal you saw this in:

Answering questions...

I'm in a test-taking mood, having just scored a Perfect on my EKG strip matching, and a 91% on the ACLS exam. Hence, I will now answer (1) my interview meme questions from and (2) the Friday Five :) 1: The Meme. Interviews go like this: If you want to be interviewed, leave a comment. I'll reply to the comment and give you five questions to answer. You update your LJ with the five questions, include this explanation, and ask others five questions. Etc, etc, etc. 1. Why did you choose to pursue medicine as a career? If you ask my mother, I've been doomed to be a doctor since I was very very young. As a child, I was the one who would splint or bandage broken dolls or ponies, hoping they would heal. All of my Barbie dolls from my youth have a matte finish, dating from the days when I poured red nail polish over them and played "accident scene". The acetone that cleaned them up also took off the shine. I thought I would be a veterinarian, at first. Becoming a doctor never entered my mind as a young girl. I wanted (this is the introvert in me) to work with animals, where I wouldn't have to spend so much time with people. I worked with a veterinarian in the area, shadowing him and following him even to the OR, and discovered that I wasn't so sure about veterinary medicine after that. The medical and scientific aspects, however, were fascinating to me and I set about making them my own. I suppose that's when I knew I wanted to become some kind of doctor. A fascination with novels and an aversion to patient contact sent me first in the direction of forensic pathology - a coroner with an M.D., essentially. And until my junior year of college, that's what I thought I would be. And then...(and then...and gentlemen, and then... [Now, Pippin, now!]) I went to France. And while I was in France, Doctors Without Borders won the Nobel Peace Prize. It was all over France. And I started thinking. And then I went to Nicaragua with Manchester. And I fell in love with seeing patients and their faces. And that was it. Since then, everything's just fallen into place. 2. Is there any particular moment of epiphany you recall, a point where at that moment you knew your life was clearly never going to be the same? I've had a number of mini-epiphanies in my life, moments when I realised what I was being guided toward and what I was to do. There was the night in Madrid when Angel proposed, and we went out on a walk through the city in the middle of the night, too excited to sleep. And I looked around me at the people whose language I didn't speak, whose customs and culture and food I had only the most superficial understanding of, and I knew it didn't matter to me, that at that moment I loved everyone in the whole world. And I don't think, since then, that I've ever really lost that feeling. That was an epiphany. And there was the darker, less enlightening epiphany of looking into the mirror at the hospital when I was in seventh grade, and seeing the bruise on my face where a random stranger had forced my cheek into the gravel, just before running away, leaving me so weak with relief that I hadn't been raped that I'd just laid there in the snow and the dirt before pulling myself together. That was an epiphany, too. I've survived, and moved on, and I deal with the things that have changed, but I've never been the same, since. I'm sure there are more. 3. What are the benefits, do you suppose, of being an astronaut? You're asking someone who's always wanted to go up in zero-G, to look out on the stars without any impeding clouds or planes or houses or trees, to see the world a marble beneath me. The simple chance to claim a vision of the grandiosity of existence, unbounded and unbarred by the changes we've imposed on the world... Plus, I want to play with floaty food. 4. What kind of influence has music had on your life? Music has been so core to my life that I don't know if I could quantify the kind of influence it has. I sing, I play clarinet, and used to play recorder. I have a hacky hand at the piano...I study to classical, I work out to everything, I live surrounded by lyrics and thoughts and pieces of song. My father sang to us to wake us up in the morning when I was young. My vice, of course, being the Broadway Moment; in which I will suddenly burst into song, having been reminded of a lyric or phrase. I listen to everything...even, sad to say, a bit of country and the occasional rap lyric. 5. When you dream of your future, what are the things you dream of? Beauty, Freedom, Truth, and Love, of course. I dream of making a difference in the world, in the lives of those I come into contact with, I dream of spending the rest of my life with my Angel, raising children who have the same desire to love and change the world, and having enough money to be sure my family is not in need. Preferably enough money to be able to make many helpful and charitable donations. 2. The Friday Five. Shorter answers, hence no LJ-cut. 1. Are you going to school this year? Yes. 2. If yes, where are you going (high school, college, etc.)? If no, when did you graduate? Medical school (third post-graduate year). 3. What are/were your favorite school subjects? I've always been interested in writing, reading, and 'rithmetic. Also all the sciences. Also band and choir. Also recess. Really anything but the answers to the next question. 4. What are/were your least favorite school subjects? Social Studies. Gym. Anything with a boring teacher. 5. Have you ever had a favorite teacher? Why was he/she a favorite? Dr. Shamanoff, my third grade teacher, who is a tiny woman with a bun and glasses. She never raised her voice. She never had to. I have never forgotten her gentle scolding when she caught me roughhousing, admonishing me to be more of a lady. I had dinner with her and Mom, not so long ago, and she told me I'd grown up into an admirable young lady. I'm still carrying that with me. I don't know why she was my favourite, except that the respect and understanding she showed me was far above and beyond what I had experienced with my other teachers. And she read us Shakespeare, and taught us long division, and never ever let me work an inch below my capabilities. All that with a smile and a soft voice. It has been determined that I have until 6 PM or so to kill, now. I think I'm going to go get some food and perhaps my mouse so I can play Alice all afternoon or something. Maybe I'll even study.

An addendum...

To mom, who reads my journal, and Daddy, who would if he weren't so busy: I was talking to someone earlier today, about my frustrations. And I had to add that at least I knew my parents believed in us. And it dawned on me just what that meant, and how much it meant. It means a lot to me to know that you're willing to listen, to discuss, and to offer your honest opinions. It means a lot to me that I can come to you and know that the advice you give or the concerns you raise are given to me in love and in trust. I know that I can call you when I'm troubled, and hear a friendly voice, and ask my questions and cry my tears. I see so many of my friends whose parents are unwilling or unable to accept them as adults with free will and free choice...and I look back at my life, and I wonder if there has ever been a time when you did not. I am blessed, so blessed, to have you as my parents. I hope in time that when I have children I will be able to raise them with as much trust and love as you have done for me. I love you both.

No stuff, just fluff.

what do they really think of you by purple
lj name
sex
age
your best friend thinks	you'd taste good with ketchup
your family think	you're sweet
strangers think	you're just a cuddly bear
Created with quill18's MemeGen!

Found myself referenced in , which was an obscurely pleasing event. And now on to non-fluff stuff. Today was ACLS training, day one. Today, I successfully completed my AED and CPR testing. From noticing a person down, to establishing responsiveness, to rescue breaths and chest compressions and using the AED within 90 seconds of receiving it. I got it all right. Although those mannequins have got to be easier to compress than real people. Because I've seen a code. Morning was...well, tedious. And overall, well, overwhelming. Too many drugs and doses, no way to learn them well. So we sat and listened and stared at him. I highlighted all of the drugs he talked about, like agood medical student. But I slept through a lot of it, due to extreme inability to stay awake. And there was a point in time where one of the lecturers was standing there, talking about using the AED, and right there on her chest, perfectly centred, is ''No Signal" and a countdown timer. For some reason , I found this to be terribly funny. Afternoon: First station was the CPR/AED station. Because everyone asked me, an AED is an Automatic External Defibrillator. It's a cute little box that's designed for absolutely anyone to be able to use. You take it out and turn it on, and a synthesized voice says "Attach pads to patient and connect to device." And you take the pads and peel them off their backing, and you stick them to the patient's bare chest where indicated (there's a little diagram on the back of the pads). And then you plug the other end into the machine. It only fits one way, and there's a little flashing light to direct you. And the voice says "Analyzing rhythm. Do not touch the patient." And everyone gets back, and the AED decides if a shock is required. And if it is, it charges to the right amount and tells you to make sure the patient is clear, then to press the "Shock" button. Bang. And so on, and so forth. The idea behind these little wonders, besides them being much lighter for paramedics to tote around, is that your Average Human Being can now become a lifesaver. Prior to the introduction of the AED, the survival rate for an out-of-hospital coronary event was around 5% or less. In areas where these are available to the public, the survival rate has increased to 50-80%, simply because the response time is so much faster. There are even some models that will walk you through performing CPR. 90 second limit, baybee. I had it out, on, and shocking in under a minute. Station two was on how to use a Real Defibrillator. "Who wants to try?" And everyone stood around for a bit, and I finally said "I'll do it." So we practised learning the voltages (100, 200, 300 and synchronised for V-Tach, unless it's pulseless, when you start at 200, and you might as well do it synced; 200, 300, 360 for V-Fib) and applying the paddles and shocking. And they had real current (just 20 joules or whatever) running through the mannequin, so it was all dramatically realistic. "Everyone clear?" Station three, just as much fun, was on intubation. We learned how to use the blades, both kinds, and why the straight blade (Miller) is good on a mannequin but the curved one (Mack?) is better on Real People (the curved one pulls the epiglottis back instead of going over it, something that works well in humans but not in rubber throats. And we learned something about the combi-tube, and intubating infants, and I only made my mannequin make funny noises (meaning that I would've broken teeth in a real patient) once or twice. And I only missed the trachea and intubated the stomach once. Not too bad, for a beginner. Station four was the Respiratory Arrest Case. And we all stood around the mannequin and she said "Who's going to be the code leader?" And nobody volunteered. So I finally said "I will." And so I got to stand at the head and tell everyone what we were doing. None of us knew. But with a little prompting, we got through the respiratory arrest, and I successfully intubated him after bagging him, and his labs came back with a K of 2 and a magnesium of 1, so gosh I wonder why he was having trouble. And we got him into ICU and corrected his 'lytes, and then it occurred to me: We have a COPD patient here with a relatively unknown medical history, because the EMT's only got his COPD status and not even his med list before he quit breathing and thus quit being able to answer questions, because they were apparently playing cards on the way to the hospital since he only went into respiratory arrest when he entered the ED. We should've gotten a bloody finger stick. I've seen a patient who was mistakenly intubated for respiratory arrest when her glucose was....oh, about 8. It's okay, though, we didn't get yelled at for it. And I got my signature, which is all that matters. and : We watched a video on acute stroke, and we all wondered something. The setup of the video was a bit cheesy: mother and daughter walking through the mall, mom says "Oh, oh my...my arm is weak...and my leg..." They sit down, girl says "Are you all right, do you want some water?" and mom says "No, call 911, I'm having a stroke, my doctor warned me..." and so on, and so forth. They call medics, medics arrive, and there in the middle of the mall, in front of Lazarus, the medics sit down with the woman and get her BP and do a Cincinnati Stroke Scale and chat up her daughter a bit. And then they load her on the cart, and put her in the ambulance. Is this the normal sequence of things? Or would you do the vitals and stroke scale in the truck? We thought they should've put her in the truck first. Came home, took a nap, had a shake for dinner (good Nykkit). Got a call from , his car was dead and could I come perform some kind of rescue? Be glad to. Especially since he'd been on his way up to FW. Which meant that I got to see Angel in Gas City where we split the hundred-mile drive. Even that little bit...as small as it was...helped. Plus, I took a half an hour of it to study for the exam tomorrow (we had a 33-question pretest. We'll have a 33 question posttest that is "very similar" to the pretest. Three guesses as to what the posttest is going to be like). The cards have all the answers I need, for drug dosing and such. I'm going to be fine. And then down to the aeroport to pick up Seron, and then home to the Gathering. And hopefully tomorrow Angel will work things out with Keith, so when we call Saturday afternoon it will be a simple matter of telling Quinby's parents what will happen. Today, O Best Beloved, I feel better than I did yesterday. And tomorrow I will feel better yet, because I will have my Angel by my side again. Plus, I get out of class at 12-ish. And I love being able to do anything but sit in class. I think I will take Shain with me, and sit in the student lounge, and kill some time before the aeroport. I forgot to bring a stuffed aminal. Is lonely. I don't even have my plushie stomach. Maybe that's why I had such bizarre dreams last night. It was a time-travelling romance novel plot, where the main characters were always in the wrong century to wind up with their correct partner. A strange dance.

De profundis clamativi ad te, Domine!

I will cast all my cares upon You. I will lay all of my burdens down at Your feet. And any time I don't know what to do, I will cast all my cares upon You. I must've sung it twenty times in the car, on the way to the office this morning. And it helped. Made me feel better. Reminded me, as do your words, O Best Beloved, that I am far from alone. And that God has never let me down. I just have to live the life I'm called to live, rather than the easy life, the safe life, the alone and uncaring life. In other news: Got an appointment this afternoon with the doctor's office to make sure this lingering stuffy nose, cough, and congestion isn't a case of bronchitis or sinusitis that I need to be treating. Since Dr. TD is a little concerned, it having been going on for nearly three weeks now. When I left the office, I was given a compliment that made me really glow inside. You're a very bright girl, Dr. TD says, and Dr. MD nods. You have a very solid grasp of what's going on. And then he got to the good part. My physical exam skills, I was told, are excellent for someone at my educational level. Both doctors were most impressed - especially, it seems, with my ability to pick up on subtle things. And my ear skills. And that was the thing that made me feel best: that they think I'm seeing and hearing and noticing the things that need to be seen and heard and noticed. That they think I'm doing - not just well, but superbly well. You look at ears better than a lot of the family practise residents do. Hallelu. Stories later. Doctor's appointment now. Pineapple-orange Slim-Fast Soy is really damn good. And I still love you, Quin, and I don't resent you, so stop thinking you're more trouble than you're worth.

Stop my mind, please. I want to get off.

Quinby's parents called last night. They wanted to talk to me. Did they ever want to talk to me. And I did my best to be patient and understanding and listening and reasonable, and it was all going quite well - if exhausting - right up until the topic of my absences to Indy came up. They're not comfortable or happy with the situation. And they're specifically not comfortable or happy with two things: 1) They're concerned because their understanding is that I'm the one who has the deep emotional relationship with her. And so I'm going to be gone, and with this, that, and the other...they're afraid she'll be alone when she needs me. This is no different than it would be if I were here. I'm going to be working long hours through the winter, and those long hours make things crazy. And I think...I think, for once, that their concerns are overamped. 2) The appearance of things. Angel, who's 23, home alone night after night with Quin, 20. And he's a youth director, and what will our youth's parents think? They're certain that their church would never allow it. They don't want her to spend her life thinking that these kinds of situations are all right. I understand the appearance issue. And at midnight, all I could say was "let me think on it and we'll see what we can do," because they have a valid point. And it's a valid concern. And I don't want Angel to get in shit for this, and I want Quin's parents to be able to accept and come to peace with it. And I don't know what the fuck I'm going to do. And this morning after the alarm went off I laid there and didn't sleep for half an hour, thinking. Trying to think. Trying to decide, to figure out what to say or do or be. My mind is stuck in circles, and I can't make it stop. And dear God: You've never let me down, never given me a problem that I couldn't find the solution to. And I believe - I really do - that what we're doing is what we're supposed to do. So I guess, now, it's up to you. Give us the inspiration to find a key to this problem and help us do things according to your will. Because it's never let me down this far. [Edit: I'm so bloody upset I forgot how old Angel was. How frickin' awful is that?]

Bad kitty. Lazy kitty.

Other Battle Cries:

• Yea, verily: Who is that, prowling across the tundra! It is Whisper, hands clutching buzzsaw hand extensions! She howls apocalyptically: "I'm going to contort you until you can no longer smell pretty things!!!"
• Prowling along the candy store, swinging a jeweled meat hammer, cometh Vita! And she gives a mighty cry: "I'm going to hack into your brain, and type FORMAT C: !"
• Prowling through the wasteland, brandishing a piece of chainlink fence, cometh Nykki! And she gives a spectacular howl: "I'm going to exfoliate you to the bone!!"

which member of something positive are you? quiz created by heatherbat Was added as a friend by , which bewildered me no end. So I didn't add them back, because while I am arrogant and self-serving enough to think that everyone in the whole world should find me fascinating, even when I'm a lazy kitten and don't tell my stories for days on end (inpatient peds is next; may be interesting indeed)...I don't find the whole world fascinating just by virtue of them being there. So I waited. And I peeked at it today, and I saw how all the entries were made of sentences from other people's journals...and then I cheated and looked at the memories and it was revealed to me that is somebody. And he makes his entries by hand, not harvesting in an automated manner, and he reads them. Permanent accounts, because we represent a "core" of LJ somehow. Even, I suppose, people like me who are willing to pay just because my vanity demands I post an obscene amount... And I was enthralled. What a fascinating idea. What a way to drain my free time into oblivion, reading more journals. I'm such a voyeuristic addict. It's 12:40 and I haven't done anything on my list except read the Neonatal Bilious Vomiting case study (I want more of them!) and sitting on my ass. But I did get the case study done. You know what would be fun? Fun would be to do case studies in an LJ. Hmm. I suppose first on my list, thought, is to go out and (1) pay my library fines (2) get my oil changed (3) go job-hunting with Quinby (4) go to the IPFW bookstore with Quinby (5) get Mom her stuff she needs, like a 300W power supply instead of a 180W. Then see what time it is, and go from there. Will throw Curves clothes in the car. All right. It's 1:20. I'm going.

I HAVE A PLUSHIE STOMACH!!!!!

What Is Your Battle Cry?

Stalking out of the steppes, wielding a jeweled meat hammer, cometh Ayradyss! And she gives a low bellow: "You in some shit now, muhfuh! I shall fill the world with the stench of death!!!"

Find out! Enter username: Are you a girl, or a guy ?

created by beatings : powered by monkeys

Today's highlight of the day was discovering the plushie stomach models that the Prevacid people had brought, and being told to take one home. "Take a couple. They're annoying." So I did. Plushie stomach! Also saw a list of things, which I am not going to enumerate now, as it is almost 1 AM and I have been playing DDR (and getting better!) and typing up that miserably long journal entry. There'll probably be an addendum to it, if we finish blue-booking in time for me to write one. Things to write about (bother me for these!) Name that rash, with Dr. MD. And today's follow-up: What the hell is that rash? Metatarsus Adductus, and the baby foot reflex. A point of congratulation. J, who has chronic sterile osteomyelitis and a $4,000 bill from the Mayo Clinic thanks to her insurance. (research note: Look up SAPHO syndrome). The poor kid with anismus. The little girl I saw the other day with bilateral colobomata who was, unusually, exceptionally bright. Tomorrow, I have the day off. Am considering drenching the bottoms of the couch with insect killer, so as to root out any spiders that might be lingering therein. They seem to follow the couch. Am also going to take Quinby to fill out job applications, go to Curves, and do my newborn sepsis paper, my neonatal bacteremia paper, and my pretest for ACLS. Oh, and work on the living/dining room. And buy my mom a power supply and a video card that isn't a Banshee. And catch up on my stories. I'm going to be busy on my day off. Wednesday, I go to Indianapolis. Thursday and Friday, I learn to Save Lives. This makes me more useful than when I could just Write Journal Entries and Diagnose Ear Infections. I like to be useful. And then the Gathering. Which, quite simply put, is a bunch of total strangers coming to our house to eat junk food, play games (LAN and console), and have a generally good time. I'm in a tizzy about this; I want the house to look clean and nice, and I know the guys won't care, and I know on Monday I have to leave for Indy for the winter. Inpatient Peds-Surgery-OB-Surgical Specialty. It's going to be long. I'm dreading it. I don't want to leave my Angel alone. It's late. It's very late. And if I want to Get Things Done on my Day Off, I had best Get Going. Sleep first. Sleep in, even, maybe.

For the morbidly interested...

Faeday, 17 Entropy. I don't even fucking know where to start. Start with getting back to campus after having to fend off Plax's attacks, his magic gone completely wrong? Start with that bedamned link between myself and Typheous being the thing that let us search the library at Tybil even while fighting Plax? Start with the debriefing, or the snow, or Vance being a total asshole even now that he has a second chance? Or him saying Alex and Mer were fucking, or me finding Mer and how she's changed? I'm fucking overwhelmed, confused, exhausted. And then there's the real issue that's clouding my mind...what happened tonight. I didn't need more things happening. I needed to come back to campus and look at my classmates living their normal, petty, uninterrupted lives - remember what I'm fighting for, why I'm doing this, what I'm bothering to try to save. Not pay Typheous back on his walk and wind up with just more questions... I should be above this, better than this. I shouldn't be acting like one of these godsdamned simpering girls who follow him fucking everywhere. Not giggling and blushing and kissing - I kissed him, or let him kiss me - twice. No, three times, if you count the first time when I almost jumped off the bed in shock...And the worst part is that after that first time, I think I enjoyed it. Just like I'm starting to enjoy his company. I don't want all of this shit. It's the weather. And my crazy fucked-up mood. And coming back to campus and finding things so strange in some ways, and the same in others. It has to be - I'm just so off-balance I'm not acting right. We came out of the debriefing (looks like we'll be going back out with Lady Del'zenivras to try and stave off the end of the world. The end of the world isn't going to fucking well happen until I'm old enough to fucking do something about it. End of sentence.) and right smack into a snowball fight. And there was Vance, telling me that Alex and Mer were fucking... Took off to find her, and I did, in Barliman's room, cuddling, maybe more. And I wondered then what'd changed, and then I talked to her, and I started to get worried. She looks different...better. Still plain, still ungainly, still Mer - but cleaner, more confident. And talking to her....Typh told me Alex said she went out looking for me after we disappeared, outside Wyzdin, and came back after a few days, changed somehow. She stopped taking shit from people - and started taking revenge. Seems she got scary about it, scary enough that Karlos took it into his head to "de-shrewify" her. And I guess she led him on, cock-teased him, and then when he pushed the issue she kneed him and then took him apart with a pair of sewing scissors. A fucking pair of scissors. Fucking killed him. What a fucking waste. And she told me the story, and looks at me and says she's sorry she wasted the time she could've spent making him suffer in killing him. Gods...I couldn't even say anything, I was so shocked. I don't understand how anyone can want to torture someone like that, how she can actually desire to make him suffer. I...gods, it twists me up so badly I don't even have the words to express it...makes me feel like I'm going to vomit with disgust. This isn't Mer. I don't - I can't - imagine what's changed her so much, but I don't like it. Something's wrong, terribly wrong, for her to be so casual about the suffering she's willing to inflict. I never thought I might wind up wanting - needing - to clean up after her, but she's flippantly talking about dropping Barliman. How she "just hates" to break his heart, how he's "so fragile"...I need to talk to him, much as we've never gotten along, find out what his side of the story is. He was worried about her, I felt it. He knows something - something more. I need to know what it is. I can't put this together without knowing more. And then...then after telling me all of that like it's some kind of happy sleepover-secret, she tells me I was right, she's never been happier than since she started standing up for herself. And then she says goodnight. And leaves. Leaves me standing there, wondering if I'm going to be able to walk without vomiting. She got this from me. Somehow, she thinks this is what I taught her. How? Calm down , Psyche. Breathe. You can start trying to mend that tomorrow...after the rest of this is somehow figured out. After all, Mer isn't the immediate problem, is it? It's the boy sitting behind me on my bed...the one I can sense even though I'm blocking, the one whose position, whose health, whose fucking thoughts I always know. The one who completely turned me inside-out tonight. I can feel him worrying, even though he's trying to block just as hard as I am, and I'm touched and frustrated and annoyed and...fuck. I had to talk to someone...I had to do something besides go back to my room and cry or chase her down and strangle sense into her. It's strange...the more things happen to me, the harder it is to be alone. It's the fucking hormones, I swear it is. And Typh didn't go out with Alex on a pub crawl like he was threatening. Said Alex was acting quiet...withdrawn. Not really interested in going out. Which meant that he was more than willing to take me up on that walk. Except that it was too fucking cold out, and it wasn't like he wanted to kick Alex out to talk in his room. We have enough fucking rumours that're going to spawn because we disappeared together. So we went to my room. I have a single. That was the first fucking bad idea. He...he backlashed, and was seeing nothing but redcaps, and every fucking time someone is unhappy, I have to fucking feel sorry for them. And then we started talking, really talking. Not trading arguments about how to run the world, or spitting insults at each other, just...talking. Trying to figure out what was going on, why it seems like things are so different with us now that we're back. When we came through into Wyzdin from the monastery, there were a few minutes when he was on one side of the pocket dimension and I was on the other. A few moments when I got what I'd been asking for for so long - he was out of my head. And I felt so fucking empty. So fucking...it was like part of me had gone missing. I don't understand it, but I can't argue with facts, and the fact is I missed his presence. Enough that when Lady Del'zenivras sounded like she wanted someone to go back out with her I couldn't even consider it if he didn't go too. Somehow, the facts are starting to line up: I'm stuck with him. For the rest of my motherfucking life. I could live with that if he hadn't said something else very true...something I didn't want to and still don't want to admit. I like him. I've gotten so used to having him around that I didn't even notice that I wanted to have him around. And admitting that... It's not so much that I don't ever want to like anyone. It's not that at all. It's that this is...different. Too different - so much so as to be alien to me. And while I was so off-balance, trying to figure out what that meant he meant and where he fit into my world, that's when he kissed me. And I almost jumped off the bed, there was such a shock, him touching me. And he was sorry...he even asked me if slapping him would help, said he should leave...and then I couldn't kick him out, didn't want to. And he kept talking, and what he said made sense. It was something we hadn't tried yet, since fighting seems to be harder and harder to really mean, and running away is too cowardly. I'm more than running away would make me. And...and it was a little embarrassing to react like he'd bitten me...when I know he didn't mean to. And what choice was there but to try again, when I was expecting it? I don't know how he doesn't feel the shock when he touches me. It's the strangest feeling, something that twists my stomach and more than my stomach. Something in my bones, in my soul. It...I can't explain it. All I know is that it never goes away. Even when we were holding hands, I could feel it the whole time, something different about me. And that fucking well scares me. A lot. I have a purpose, a job. I have a purpose that requires me to be able to weigh the facts and make a decision that is at once correct and defensible. It's not going to be easy, and the last godsdamnedfucking thing I need is to get my emotions involved in anything. All they do is muddle my judgment, make me vulnerable, susceptible. Fallible. (there is a smudge of ink here, something now illegible, obviously water-damaged and blotted.) And they make me fucking cry on my journal. And now I'm fucking...godsdamnit, this is almost as bad as walking with him. I can't think. I can't fucking think straight. Why can't I think? What's fucking wrong with me? And a good cry later, I'm still stuck. We went on a walk to clear our heads - both of us were, are confused, how could we not be? This is anathema to what we've always both headed for. And somehow he took my hand, and we walked out to the park holding hands, and I didn't mind. It felt...right. For no fucking reason. And then it struck me how badly I wanted to hear what he really thought, and how as far as his eye could see he was talking to a redcap. And you can't be sure when you're seeing an illusion. Which is how his hand wound up on my cheek, so he could at least feel my face. And that's when I kissed him. And it was...I wish I could fucking give myself a little lie, say it was nothing, okay even. But it wasn't. It felt good, felt right, and it blew all of the bits of fragmented thought I had started to put together into little tiny pieces. And...I panicked. Just like I did a minute ago. That's what happened. I'm panicking, just like I did in Ironridge. Every single time I get my well-ordered framework of a world shaken up, I panic. And I run away, go hide in misery and self-doubt and shame. Why didn't I see it before? Am I so arrogant, so blind, as to think that the world is going to just fall into place because I think I know what's best for it? I have to learn to keep my footing when things turn chaotic, or I'm never going to get anywhere. I'm never going to be able to understand what's going on if I fall apart every time my equilibrium's shaken. So what does that leave me with? It leaves me with a funny feeling around Typheous, something that doesn't maybe fit into a nice neat box. And something that I can't quite think about in a logical way. But most people don't think logically. How can I work to change things if I don't know how things are? Better question: if I panic when things don't work just right, doesn't that leave me at a disadvantage? So maybe this is a chance to figure out how not to panic. Maybe I should look at it like that, and quit trying to figure out what's so wrong with me. Maybe there's nothing wrong. And maybe it's okay to turn around and talk to him. He's not drawing any more, I can feel it. He's just waiting for me to finish. This is so fucking weird.

Or I could spend the whole weekend sleeping.

Friday night RP went well, I think. We started late, but everyone seemed to have fun. Quotes will be posted under separate cover. Party is about ten minutes from being assaulted by the Home Guard, which will probably eventually result in their capture. Although, they're currently engaged in getting ready to hold out again. Will eventually arrive at Herring's place. Eventually. Schedule came out for inpatient peds. I am the only person on Pediatrics/Newborn at my hospital. I am responsible for three night calls (4-10 PM), which I may schedule at my leisure. How much better does it get? They say we either have saturday or sunday off. Hopefully I can work this out to my advantage. Hopefully I can find my ACLS pretest, my schedule, and all the information that tells me where to be and what to do so that I'm prepared for ACLS on Thursday and Friday. My BLS certification expires in September anyway, so I was going to have to take a refresher. Went out yesterday and bought DDR-Disney Remix. Today, bought DDRMax. Have been using both pads as Angel, Quinby and I trade off. We all suck. My great achievement is being able to make a D rating on a three-foot song. But what a workout. Much fun was had. The living room is starting to be emptier. Putting out a call for tables. Does anyone have a few long tables we could borrow? However, not as much was accomplished this weekend as potentially possible, due to the reassumption of the Mage campaign. I have missed playing Psyche. A lot. I've missed the interaction between her and Typheous, missed having a character who's in a setting where she can really grow and change. Furthermore, I've missed playing under , who will always be my model GM, someone whose skill I only hope I can eventually live up to. Plans for the Gathering next weekend (roleplayers, there is NO campaign next weekend) are going well. I think I'll dig out my B-movie collection and find some pre-genned characters. I can run a one-night B-movie campaign for the Gathering, and amuse the hell out of everyone. Yis. There was more this weekend, but I don't really remember what. I'll figure it out eventually. But for now, I'm going to settle back to roleplay and enjoying the rest of the evening before I go in for my last three days of outpatient peds. My last three weekdays in a row in FW until who knows when. I have vacations hither and yon, and a month of ambulatory medicine if I get my request. I hope I get my request. But this winter, O Best Beloved, is going to suck. A lot.

I make a liar of myself...

I have yet to be on time to the pediatrician's office. I always beat the doctors in. Yesterday morning, Dr. TD was at the hospital dealing with a patient in breathing difficulties. Dr. MD disappeared after talking to the intern for a bit. And for the next hour I just sat around looking confused, until T called over to me, telling me that Dr. TD had called from the hospital with something for me to learn about. So I looked it up. And then I waited, and finally Dr. TD came in and then we had to rush through the exams. So (gasp, choke) I just got to go in with him and look at the kids while he was talking to the parents instead of doing the whole thing and presenting the patients. But I still got to see them first, and if I talked fast I could present my findings to him before he did a physical. At lunch, he took me aside and apologised to me for not letting me do enough. I wasn't offended. I completely understood. This has been one of the best clerkship experiences ever. A quick survey of what I've seen recently: An infant with a facial hemangiomata in the opthalmic region of the trigeminal nerve division. : what disorder are they concerned about? They don't know yet whether she's got it; the current concern is the bilirubin of 14. She's got a bili-blanket, which I want to see. What do they look like? A little girl who has Osler-Weber-Rendu syndrome, an incidentally finding as she was being evaluated for a two-month history of fatigue and malaise. Apparently, her previous doctor just kept giving her antibiotics. Her mom is understandably miffed. Dr. MD thinks she has mono. Her blood tests show a malnutrition-based anaemia. I suggested parasitic infection. Possibly. I also asked, based on the rest of her history, whether she might have immunodeficiency. That's a good thought. He wrote: "Consider immune deficiency" on her chart. Lots and lots of little kid ears. And noses and throats. Did you know that 25% of visits to paediatricians are for routine physicals? I've found several unsuspected ear infections, including the event today where I went in to do a followup visit on a little girl. "I think she has fluid behind her eardrum, which is normal following an ear infection, but it looks good to me. I'll have the doctor check." And then I went out and told Dr. TD that I thought she had fluid behind her eardrum, but that it looked good. And then I got pulled in to play "name that rash" with Dr. MD. More on that in a moment. When I came out, he was in the room. I popped my head in, and got a very wide grin from the normally ebullient Dr. TD. Good eye. She's got a resolving otitis media with effusion. A lot of people don't ever learn to pick that out. More on "name that rash" tomorrow (later today?). I want to post, so I can sleep, so I can go to the BMV and get my licence address changed; get a new cell phone and better plan; spend more money. Wheefun. Plans for the Gathering are beginning to progress. Also wheefun. Glad that Quinby is going to go with James to the housewarming; Aura and LC are so great. And now, to bed.

No, Mom, I don't have diabetes...

Update on my doctory-stuff is coming; it's sitting at home. Going out to eat last night took precedence over typing. So, on a more personal note: Called the doctor's office back; they'd left a message to call on Angel's phone. My lab results are in. Fasting blood sugar: 81. Well within normal ranges. Notably not hypoglycaemic either. Lipid profile: Total cholesterol, 219 (should be <200). Triglycerides, 211 (should be <150). HDL (good cholesterol), 46 (should be >60, especially with elevated other lipids, even though the official guideline is >40). LDL (bad cholesterol), 139 (should be <100 optimally, <129 for above optimal but not too high). Which makes my ratio something like 4.6, which is unpleasantly close to the out-of-whack value of 5, and too far above the optimal value of 3.5. As the nurse put it: I'm too young for that. Nothing good can come of having elevated cholesterol at 24. So orders are diet and exercise; low-fat, low-cholesterol, oatmeal (yes, Angel, I have to get up for breakfast), switching my Country Crock for Benechol, and increased exercise. Repeat lipid profile in 4-6 months. In random thoughts: Studies have tentatively shown that a Mediterranean diet not only reduces cholesterol but reduces the risk of heart disease disproportionately to its cholesterol reduction. And olive oil is good for you, as is fish oil. I like fish. Also, 4-5 ounces of wine a night may raise HDL levels. Furthermore, losing weight is now a health mandate, as I have no intention of allowing myself to be medicated for something I shouldn't need to be medicated for at my age. And at 5'7.5 and just over 220, I have a significant amount of weight I don't need to be carrying, no matter how good some people think I look. I'm sort of amused by the whole thing, in a morbid way. After all, I ought to know better, have known better. I'm a freakin' medical student. So it's my own bloody fault. Bad nykkit. But all the same, this is just about par for the course. It's always got to be something else that motivates me. Someone kick me a couple of times, or I'm going to do nothing at all over the winter while I'm in rotations. Plus, I forgot to put my rings back on last night after dying Quinby's hair (something that took the rest of my updating time) and now my hand is naked. I only have my cross ring. And now I'm waiting for the doctors to get here - I have yet to arrive on time, and yet I beat the doctors D&D here every morning. Perhaps I'll give up on this keyboard with its partly-broken T and go do something else. Such a strange world. Wish me well, O Best Beloved.

Jen: The story so far.

< b_lover> everyones going to be there tonight, jeno.  too bad your such a mommys girl.  were going to be out after 10.
< jenouflex> fuck my mom, i do what i want.  tell me where and when.  ill see u there.
< leathermartini> good girl, jeno.  mabe i should bring u a pacifier and a blankie for nighttime?
< b_lover> catacombs at 11.  wear something hot.
< jenouflex> if thats all u got for me to suck on, leather, mebbe u should.
< jenouflex> something hot? u sure u can handle it?
< leathermartini> o, think your a woman now, jeno?  
< leathermartini> little girl’s shouldnt make promises they cant keep.
< b_lover> i can handle anything u got jeno.
< jenouflex> well see tonite b wont we?
< jenoufles> o shit, g2g.  see u tonite.
* jenouflex (jenouflex@a-woman-scorned.is.yourhell.net) Quit (Connection reset by peer)

Jen powered off the computer without bothering to shut it down, inwardly wincing at the abruptly-terminated hum of the processor fan as she grabbed a random book from her bag and flipped it open in front of her, dropping onto her bed. So much for cracking that bank database. I’m going to have to start over. “No, Mom, I’m not on the friggin’ computer again.” Stupid piece of shit, hardly worth having a processor fan on it. What the fuck age does she think we live in? “I’m doing my homework.” “Don’t swear, Jennifer,” came her grandmother’s sweet, perfectly modulated voice in response. “It’s not becoming of a lady.” "I'm not swearing, Grandma!" There was a mumble from downstairs, probably her mother responding, and then the sharper sound of her grandmother’s unintelligible answer. Well, fuck. If she wasn’t going to come upstairs and check, I could’ve— Her thoughts were cut short as her mother did indeed poke her head in through the door. “Jenny, your grandmother’s only going to be here for a few days. Won’t you at least come downstairs and do your homework? Be social, dear. Humour her.” “Humour her? Mom, she’s a fu-” Jen broke off. “She’s a freakin’ relic! What does she think this is, eighteen-hundred?” The protest, more for the sake of appearances than anything, was made as she gathered up her bag and her books. “All she’s going to do is lecture me on how I look and how I should take my earrings out and wear dresses and talk like some sort of—” “—of decent human being, instead of whining like a spoiled girl?” Her mother shook her head, the wooden beads at the ends of her braids clicking together, sounding disturbingly like a snakes’ rattle. “I wish you would take your piercings out; it’s not good for your chi to have metal stuck every which way in your body. No wonder you’re unstable.” One beringed hand waved Jen toward the stairs. I’m not fucking unstable. You are, you pothead freak. How come I wound up at the bottom of the reject mother bin? “I’m not unstable. I’m moody. I’m a freakin’ teenager.” Jen descended the stairs at a noisy clunk, making sure each fall of her combat boots hit the squeakiest part of the boards. She could hear her grandmother’s lecture begin even before she made it to the front room. The sitting room. “Madeline, I don’t know where I went wrong with you, but it’s clear I failed to teach you even the most basic responsibilities of motherhood. Letting poor Jennifer run around like a hoyden, dressed in such a scandalous fashion. And those metal things all over her body…” “They’re called studs, Grandma.” Jen cut in. Amalthea shuddered. “Such a tasteless word. They use that for breeding horses, you know, not for things that a young lady should be wearing. And where did you find those shoes? Didn’t your mother teach you anything?” Jen flopped into the couch, dropped her booted feet on the armrest, and pulled her math book out of her bookbag. She taught me how to smoke pot and drop acid, neither of which has ever done me any good. I don’t see why she thinks her mind is so fucking liberated. “I like my boots, Grandma. They’re comfortable and functional.” And that said, she opened a notebook and began doing her homework in earnest, blocking out the sound of her grandmother’s continuing soliloquy with the soothing regularity of calculus. Eleven. Do the trains run that late? Mom’ll be sure to wake up if I take the car. Fuck, how do I get from Greenwich village to Catacombs? And what am I going to wear?