Saturday, March 29, 2008

Still no pics

Greetings from Mobile Alabama! 3 states in 7 days! Not too bad. And I'd been in none of them before.
Well, I'll be home tomorrow so until then, bye y'all. I'm amazed but they really do say that down here. Plus I've been called honey and baby and not by guys hitting on me.
I've eaten so much seafood I think I'll stick to pasta for the next week or two. The sun burn hurts but at least it isn't snowing.
Back to vacation business.
Photos to follow when I'm back on my home turf. The hotel computer won't even let me sign on to Flickr. Such discrimination.

Wednesday, March 26, 2008

Internet connection problems

No time and no pics but we made it. Just spent 3 days in New Orleans--not on original itinerary and heading to Gulf Shores, Alabama today. Will post a lot when I return.
Thanks for reading and commenting.
The owls and alligators here say hello.

Saturday, March 22, 2008

Wish you were--O'Hare?

Or How I Spent My Spring Vacation

De-Icing the Engine--sm

The plan was fine--travel south for sun and beaches. Except for a minor weather delay. Trouble started yesterday morning when my e-mail revealed that our flight to Mobile, Alabama had been canceled. Bravely, I called the airline and sat on hold for 30 minutes. There was a little snow falling but nothing much compared to the other major storms this winter. Not enough to account for a canceled flight I thought.
Well, there weren't many flights available to points south since it is Easter weekend but luck prevailed and we found a flight to New Orleans, only 100 miles west of Mobile. And I've always wanted to visit New Orleans. I changed our hotel reservation and made a reservation for the first night in New Orleans. So far so good.
So a couple of hours later off we trek to the airport. We arrive in plenty of time, make it through security in near record time and have a leisurely lunch. The weather is starting to look exciting but my plane is still marked as on time. The kids and I enjoy watching the planes being de-iced.


We mosey on down to the gate and find that the plane is delayed. I can handle this I tell myself. Then there is a further delay and mention of needing to get a part. They'll let us know whether they need another plane by 3:00. At 3, the departure is delayed until 5 PM. I watch them de-ice the plane and tow it away, presumably for repairs. Younger son is getting cranky. I'm wandering around the terminal pretending to shop.


At 5 PM the flight is canceled. We all troop over to the "rebooking center". I have the bright idea that it might be better to call the 800 number than to sit in a 200 person line for the final 4 seats to any point south. I get a representative who tells me the next flight is Tuesday. I tell him I heard another airline has seats leaving a 6 PM. He tells me that they need to protect their "customer base." And that they have no obligation to book me with another airline in case of weather delays (never mind cranky kids, a ruined vacation and two canceled flights). He tells me over my objections that the other airlines do this too. I indelicately tell him that the fact that the other airlines are #!@#! too is no excuse. He says, "What did you call me?" I say, "Just do your job, sir." He hangs up. I call another representative who tells me that she can't get me on the other flight because it was due to leave 3 hours ago (true) and is no longer on her computer to book. She manages to find me a flight out to Baton Rouge Lousiana tomorrow. It will have to do.

Yellow is for delayed or canceled

We troop down to baggage claim and eventually get our bags. A cab takes us home. A nice 7 hour vacation to O'Hare International Airport.
So here I am after a good night's sleep in my own bed, all rebooked to Louisiana with a return via Gulfport Mississippi. I hope the plane leaves this time. I have my doubts since I couldn't get a seat assignment. I wonder if they overbooked? Given the thousands of stranded people at O'Hare yesterday, it wouldn't surprise me.
At least it makes for a good tale.

See It Sunday-door

Dunkin Door

Part of a new series of door photos I am working on--Not the usual picturesque doors but the run down decaying urban doors.

Saturday, March 15, 2008

Macroday--Odd Toys

I decided to have some fun.

Hormonal Toys

Too Many Toys

Wednesday, March 12, 2008

Wordless Wednesday



One thing you learn early on as a doctor is to show no fear. Patients don’t feel comfortable if their doctor looks scared. Occasionally I will tell a patient they are scaring me if they need to realize how their behavior is affecting others. Rarely, I will end a session if I am feeling scared. Even more rarely I will call the police. I had to do this once when a patient threatened to break my f-ing neck. I didn’t think he meant it but the risk of violence was too high and the person wouldn’t deescalate.
The most fear I ever experienced as a doctor was early in my training. There was the frequent “Please don’t let me kill anyone,” prayer. There was the feeling of being incompetent, exhausted, unsupported and overwhelmed.
My second or third call as a medical resident was one of the worst. All psychiatrists are required to have basic training in Internal Medicine which was what I was doing at that time. I was covering at a VA hospital and was only two or three weeks out of medical school. When you begin a call night, the residents who are going off duty hand you a list of their patients that you will be covering with the bare essentials of their illness, medications, labs that need checking and so forth. Then they head home leaving you with a pile of papers regarding some 20-50 patients for whom you are responsible, depending on the night and the hospital. Some of the patients are pretty sick.
I was training in a system that was pretty sick itself. In medical school I had become used to the notion that green residents get plenty of back up and support. Not so where I was training. When I found myself in over my head I tried to call on my back up resident. No answer. I tried to call my back up attending physician. No answer. I was on my own.
I had a crappy pager. This may not seem like a big deal but it was a voice pager, sort of like a walkie-talkie. The nurses paged me on average every couple of minutes. Many of them were foreign and it was hard to understand them through my pager which had poor reception and no voice mail. I’d frantically try to scribble down information, a call back number, a ward number, a patient name. If I was already busy, e.g. placing an IV, I had to miss the call and they would keep calling back and getting more and more irate.
On call if I was lucky I would get 20 -30 minutes of sleep. Sometimes I had time for dinner if I didn’t mind eating mystery meat in the same cafeteria as the psychiatric patients from the addictions unit. Or I got the peanut butter and jelly sandwich on white bread to go, under the assumption that at least I wouldn’t get food poisoning. The jelly was always that cheap, see through, grape stuff.
But the worst night was that second or third call. The pager hadn’t stopped. The emergencies had piled up. Maybe that was the night I tried to put a nasogastric tube in the fellow who had been vomiting blood and I just couldn’t get it to go in. You can’t force that procedure. The tube can to in someplace it doesn’t belong. There was no one to help. I had only observed the procedure a few times in medical school. My back up didn’t answer. So the patient didn’t get his tube. Keep praying I don’t kill someone. Another guy had a seizure. It took a lot of medication to stop the seizure. Then he wouldn’t wake up. I didn’t know if he was overmedicated or had just had a stroke. We wheeled him down to the CT scanner where I was responsible for giving the patient the contrast dye. I looked up the dose of epinephrine in my little pocket guide in case he had a (potentially lethal) allergic reaction to the dye. There was no radiologist, only me and a technician. The film would have to go to a different hospital to have a radiologist on call interpret it if I couldn’t. It might be hours before I learned if the guy had a stroke or not. More praying.
At two or three AM, I was checking on a patient in the pulmonary step down unit (for cases one step below needing an ICU). I started to feel I just couldn’t take it any longer, that I couldn’t do it. I looked at the pile of sign out sheets in my hand and seriously considered putting them down, walking out of the hospital and never returning. I was ready to abandon . . . everything. And a male nurse walked up to me and started rubbing the back of my neck. Normally I don’t like strangers touching me but he seemed to sense the extremity of the moment and that one brief empathic gesture turned things around for me. I stayed put. The pager stopped ringing for a few brief moments. I caught my breath, controlled my fear and kept moving.
I finished my 6 months in that dysfunctional system and then got back to where I belonged, to my psychiatry training. It had its bad moments too but that night was the worst. It was the only time fear overwhelmed me to the point where I thought about quitting. I’m glad I didn’t. I’m eternally grateful to that one nurse. He probably has no idea how much he helped me.

Tuesday, March 11, 2008

Well that explains it.

Hoh River

"The drinking water for Washington, D.C., and surrounding areas tested positive for six pharmaceuticals." From found on March 10, 2008.

Hmmm, let me see:
Valium--see no evil, feel no evil
THC--they didn't inhale!
Prozac--for the rose colored glasses
Oxycontin--they don't feel your pain
Ritalin--too late, they never did pay attention in school
Viagra--enough said

For the real story, go to the link.
The sad thing is that doctors were always told to flush expired sample medications down the toilet. Only recently did I learn that pharmaceuticals are supposed to be otherwise disposed of. The question is where? In the trash that the homeless regularly dig through in my neighborhood? One article suggests that you mix the used medications in with something unsavory like used kitty litter. What an awesome idea. Quick, let's mix up a batch right now! Even the rats won't eat that!
Of course it isn't medication samples that are the main source of the problem. It is the other stuff we flush. All the medications we take and then excrete unmetabolized. Who woulda thunk it? I always assumed that sewage treatment took care of it. Turns out if our livers don't break it down, our sewage plants may not either. Water filters like Brita aren't effective either.
Of course there is no reason to panic. The amounts are minute and we have no evidence they are harming us. But still room for thought. Oh, and bottled water may not be any better. Besides think of all the plastic waste the bottles generate and all the trucks, boats, trains and planes moving all that tap water across our planet to give us the placebo effect that it is better liquid than what one can get for free at home.

Speaking of THC, I'll close here with a final quote from that bard and social historian of the sixties (and he sure did inhale) Tom Lehrer.

"Lots of things there that you can drink,
But stay away from the kitchen sink.
The breakfast garbage that you throw in to the Bay,
They drink at lunch in San Jose."

If you haven't already seen it, watch Lehrer sing it on You Tube. It will brighten your day.

Sunday, March 09, 2008

Experimentally Speaking

Da Vinci Sculpture
Sculpture honoring Leonardo Da Vinci in his home town, Vinci, Italy.

I have done so many experiments in my day—shouldn’t a piece about them come readily to mind? Shall I recall the day I finally cloned the gene that allowed me to complete my dissertation? I revisit my graduate school days in my dreams periodically. The theme is always the same. I have one more experiment to do. I have left one lead unpursued, one question unanswered. I need to get back to the lab.
Perhaps it is this feeling of unfinished business that keeps me away, the nagging sense that I have left some work undone, incomplete, that other people have “scooped” me. If only I had persevered. . . . Would I now be famed in my field? Respected by my peers? Published in Nature or in Science? (My dissertation work was completed by another student and finally published in Cell which is respectable in itself).
Now we are getting into the regrets that lead to alternate universe thoughts. I’ll stick with my present universe, thank you. I chose my current path and, I think, did so wisely. I enjoyed the planning and idea stages of research but bench work was not for me. I didn’t have the methodical nature to excel at measuring small quantities of liquids into small tubes. Add yet smaller amount of purified enzymes. Centrifuge out the debris. Add to a gel form and subject to an electrical current. Bind to a radioactive compound and image the result as a series of bands which I then interpreted. And repeat. Because in science everything must be repeated. Much of my research was like making a soufflĂ© but with more precise measurements, many more steps, varied ingredients and more uncertain results. Sometimes what came out of the oven distinctly smelled awful and was highly inedible.
A postdoctoral fellow I knew once commented that a monkey could be trained to do most of what we did in the lab. Perhaps the monkey would have had more patience. I spent around 7 years of my life doing experiments during my Ph.D. work and a brief postdoctoral fellowship. I exposed myself to substantial quantities of radiation and toxic substances. I haven’t developed cancer (yet). I have few regrets but still I dream.
I have two kids, a nice house, financial stability, a small independent clinical practice. So why the dreams? Perhaps they are merely the residue of many years of hard labor. Perhaps they reflect the greatest experiment of all—one’s own life. Hypothesis: If I follow a certain course, at the end of my days, I will close my eyes on a life well lived. Results: TBA.

For more biographical writing on my dissertation, go to this post.

Saturday, March 08, 2008

No Exit

Today's quote is from the research I did for last week's talk on depression. Nothing should be construed of my mental state from this.

“The weather of depression is unmodulated, its light a brownout.”
William Styron, Darkness Visible

Friday, March 07, 2008

Speaking of Planet Earth:

For Photo Friday--surreal


Taken in Yellowstone

Planet Earth Reading Challenge

Well, I figured I was overdue for a reading challenge and stumbled across this one which inspired me. In honor of UN International Year of Planet Earth Classical Bookworm created a challenge based on 4 spheres of earth science: the lithosphere, atmosphere, hydrosphere and biosphere. The charge is to read books from each domain or several geology books. For this challenge I have chosen the following:
Lithosphere (geology)—Krakatoa by Simon Winchester
Atmosphere—The Cloudspotter’s Guide: the Science, History, and Culture of Clouds, by Gavin Pretor-Pinney
Hydrosphere—Hell and High Water by Joseph Romm

Three books—one major disaster (a volcanic eruption), a bit of weather (maybe I’ll remember details from the meteorology class I took some 30 years ago), and an even more major disaster (global warming). Should be fun reads.
I’m already 135 pages into Krakatoa. We’re kind of volcano fans in my family. My older son started collecting volcano facts when he was around 4, visited Mauna Loa and Kilauea shortly thereafter and watched every National Geographic video ever made about volcanoes at least 30 times. And they make for exciting viewing! We made our trip to Hawaii when younger son was around 4 months old so I missed some of the fun since long hikes across unshaded lava fields isn’t recommended for infants.
While he has since moved on, no one can deny that volcanoes are cool. I personally have a dim memory of watching that classic movie Krakatoa, East of Java (it turns out it is west of Java) as a kid. Actually, all I remember is the name of the movie itself. But I’m sure I saw it.

If any of the three books gets too boring I may yet switch to a different book. And since I have not yet picked a representative of the biosphere, I may be adding to the list. Thanks to Classical Bookworm for a great idea.

I’ve also decided to institute a quote a day on my blog. I’ll try to pull things from my daily reads but in a pinch might resort to a quotation site from the internet.

Today’s quote is from the Kilauea Daily Update, the eruption report from Kilauea:
“The TEB pahoehoe flow entered the ocean about 11:30 pm March 5. Seismic tremor levels and sulfur dioxide emission rates continued elevated to several times background levels at Kilauea summit.”

Pahoehoe is one of my favorite volcano words. It is a Hawaiian word referring to smooth lava flows (as opposed to jagged, sharp flows—known as a’a’). The mnemonic I learned for remembering a’a’ is that it is the sound that one makes when stepping barefoot on a dried a’a’ flow. As Greenlanders have many words for snow, Hawaiians evolved a vocabulary of lava. For more on volcanoes, and a photo glossary of volcano words go to the USGS web site: or read Krakatoa.

Thursday, March 06, 2008

Stuck Truck

Stuck Truck

So I'm walking down the street looking for things to take pictures of and there is this truck stuck under the el tracks. I snap a few pictures and move on. Next I noticed these knitted things on a pole and decide to take a picture of this new fad in urban adornment.

Pole Wrapped

Some homeless guy notices me and tells me I ought to be taking pictures of the truck. He thinks I could make $300 for the pictures. I really want to tell him that #1 I wouldn't make any money for the shot and #2 Butt out! I don't like pushy panhandlers. When I'm out and about I prefer to be left alone with my camera and my thoughts. Instead of saying anything, I pretend I have no interest in the truck (which I already have 5 pictures of), roll my eyes and walk on.
The truck was stuck on a major downtown intersection and was already causing a bit of traffic. I saw the driver check the tires and now I know that letting some of the air out might be the solution. I wish him luck.

How Tall is This Truck

Tuesday, March 04, 2008

Signs of Spring?

Cold Wind

This morning I felt a certain evidence that spring might yet appear here in Chicago. The morning was bright and I had less trouble waking up than usual. I heard a cardinal singing his heart out. The never ending snow has finally melted except in a few shady spots.
Of course, the grass is still brown--it will be a few more weeks before it starts to green again. My backyard looks more like a swamp than a yard. I'm still missing the robins, white throat sparrows and migrant finches. The trees won't leaf out for at least another month, maybe more. And it will, inevitably, snow on April Fool's Day.
The calendar says spring will be here in less than 3 weeks. The clocks change (spring forward) next weekend. The days get longer and longer. Catalogs and magazines are featuring Easter. College kids will soon be studying for finals. My father is bugging me about our summer plans.


I'm eagerly awaiting snow drops, garden planning, pansies, goldfinches, the dawn chorus, late sunsets, pumping up the bike tires so we can ignore them for another year. In the meantime, I need to get a sweater; I'm cold.

Sunday, March 02, 2008


Flags over fortress

Flying over El Castillo in Puerto Rico.

SS--Time Machine

Clock 2

Happy 100th to Sunday Scribblings:

Here I have traveled in time to the year 2061.

It’s hard to believe she turned 100 today. Gran is the oldest person I have ever met. When you look at her you can tell she is that old. Her skin is wrinkled all over and has those age spots everywhere. When you touch her, though, her skin is soft, so soft. Not like a baby’s. A baby’s skin is soft but plump with all that lovely fat just under the surface. Gran’s feels like a fine thin cloth tossed on a bed, with wrinkles and folds scattered randomly. The baby skin is warm to the touch and Gran’s is cool. I always want to hold her hands and transfer some young warmth to them.
People in 2061 live longer than they used to but Gran is still pretty old. We have discovered that science and improved diet can help people live longer and stay healthy but that eventually the body just starts to shut down. Even without cancer, heart disease, strokes and diabetes, people just plain get old and die. I don’t want to think about Gran dying. I’m not sure what I’ll do without her.
I’m amazed at how sharp Gran still is. I love it when she tells me stories about her youth. The technology back then, or more aptly, the lack of technology back then was amazing. I can’t even imagine what her life was like. Back then there were only a few television channels and the first TV’s were in black and white, sort of like an antique photo. You couldn’t record television, there were no DVD’s or CD’s and no one had their own computer at home. The internet didn’t even exist! They actually had to go to the library and look at books to do research for term papers. Of course, without the internet it was a lot harder to catch people who plagiarized too! Nowadays you have to be so careful to use your own words!
Gran taught me to read books. I already knew how to read but I had always done it electronically. Gran has an enormous collection of old books. She is a bit of a pack rat that way. Her house is full of bookshelves. So she would read to me when I was a little kid from books by authors from long ago. The pictures were so much more amazing on real paper. She let me hold the books as long as I promised not to tear the pages. Imagine, pages that can be torn! Later she let me browse her shelves and take home whatever I want to read as long as I return it. I know that antique stores would give a fortune for her book collection so I am very careful with her books.
Gran also tells me stories about her childhood. I like hearing about her grandparents and parents and about her two kids who are really my grandfather and great-uncle. They are pretty old now but her stories and pictures make me feel like I knew them when they were kids.
Gran’s stories about learning to be a doctor in the 80’s and 90’s are so funny sometimes I feel like they are science fiction. Psychiatry was really in the dark ages back then. I can’t believe the “treatments” they used. Maybe it was the best they had at the time but still. . . !
Gran kept working part time until she was 80. She still talks like a shrink from an old TV movie. (Yes Gran got me hooked on some of her favorite old series which we watch for hours together). Her voice is soft and soothing and she always seems to have the right thing to say. It is hard to imagine her being young and green and doing all the foolish things she says she used to do. Hardly anyone does talk therapy anymore because hardly anyone seems to want it but every time I visit Gran I feel calmer and more centered.
I hate to think of losing Gran but I know it could happen any day now. She seems not to be too worried about death. She says that it is something that you learn to accept as you get older. She says that she will live on through me and her other great-grandchildren. I know she must be right but the world will not be the same without her.
In the meantime, I am helping Gran write her memoirs. She told me she had wanted to do this since she was around 20 but never started. Her voice is a bit unsteady and sometimes it is hard for her to dictate so I help after school. Some of the things she says make me a little uncomfortable. You know what I mean—when she tells a story about her first sexual experience, stuff like that. But I feel happy to be part of keeping the past century alive. I’m looking forward to the first electronic edition. Too bad it can’t come out as a paper book. Gran would have liked that!

Saturday, March 01, 2008

Another church

Loving Spirit

I found a new street for photographing churches but didn't have much time. I'll go back soon.