Ode To Mr. Fingerprint

We can’t figure it out, exactly.  There isn’t one thing that we can point to and say, “Yeah!  That’s were everything became too much.”

But somewhere along the way, this little adventure piled up and reduced both of us to tears.  How the Army manages to organize itself enough to go around the world killing people – unless through excessive paperwork – still mystifies me.  But I can say that if they just stuck to the paperwork – threatened to attack the terrorists with administrative paperwork – world peace would be ho-hum news. 

“We give up!  We recant!  Never mind all that Allah stuff!  We’re Americans now.  Look, look, we’re buying Hummers and we all have flat-screen T.V. in our camel-skin tents with only CNN and Disney channels on them.”

I will say this:  With exception of the laudable fingerprint dude, I have never been to an Army office and gotten done what I came there to do on my first attempt.  Never.  And, for the guy to do my fingerprints that day, he had to overlook 2 reasons to send me away. 

If I’d had a trophy, I would have given it to him.  I DID sing his praises; describing his feat in a halting, emotional, too-grateful voice.

“I….I….I just want to let you know that.  *AHEM!*  Sorry, something in my throat.  Some sort of lump.  Anyway….”

Corpulent man in too-short square tie knit by kids in Taiwan R.O.C. funded by Wal-Mart stares dully, shifting slightly in his creaking office chair.

“You’re the first, EVER, to give me what I came to get on my very first attempt!  It’s a record.  Over the past 6 months, in dozens – maybe hundreds – of office visits my wife and I have needed to make just so I can do a job, you’re the first to not send me away on my first request.”

“Huh.  That’s good.  Fill out an I.C.E. card, alright?”

“What’s that?”

“A card.  You know, a card.  Tell ‘em how I’m doin’.  Let ‘em know I set you up.”

Right.  I.C.E. card.  I took that thing home, spent 45 minutes filling it up with love and gratitude toward the first man EVER to spare me making 2+ trips just to get a simple administrative task done.

Then I realized it would take another trip to that office to put the card in the guy’s box.

And I shredded the thing.

Dad + Doctor

You might think that medical training would be a great asset to any parent.  Docs are trained in all kinds of cool things like Heimlich maneuvers and laceration suturing.

Heck, if the wife got pregnant again (Nope…don’t even ask) and went into early labor, I bet I could spread out a shower curtain on our living room floor and just take care of everything right there.  Noo problem.  Doctor DAD!

But when does all that stuff actually happen (and do doctors anywhere really suture up their kids by lamplight in the kitchen anymore)?

What does happen to the kids much of the time is some thing or another that COULD BE TERRIBLE.  Everybody, even the cat, knows the incident, or symptom, etc, might be the end of famSW101 as we know it.  What the untrained blissfully don’t know…is JUST HOW TERRIBLE it might be.

So, in essence, the only difference between a doctor-dad and every other non-medical dad, is a stupefying knowledge of all the evil possibilities that could be behind a kid’s latest symptoms.

Headache for a few hours, some fever, woke up disoriented?  What do you think, honey?

Um.  Well.  Probably meningitis.  Have you ever seen a child die of meningitis?  We’ll be lucky if she keeps her limbs.  Could be coupled with flesh-eating bacteria, too.  Hopefully at least some of her face doesn’t rot off.  We may not even recognize her…if she miraculously survives the ordeal.  It’s ok, though.  We’ll still love her.  Help her set up a profile on Matchmaker.com even though she’ll be totally deformed.  Some saint of a man will learn to love her, unconditionally, like we do.

OR, saaay, it could be an absence seizure.  Maybe the first of many.  Maybe she’ll slowly have progressively worsening seizures until some galactically-renouned neurosurgeon implantes a permanent zaptrode into her medulla oblongata and calms the seizures but unfortunatley makes her arms twitch at 0.5 second intervals, often causing her to smack her own face.

“Probably just a cold, dear.  Check her every once in awhile, and keep me posted,” like, every 8-10 minutes would be nice, at least until I get home from work so I can sit at the foot of her bed chewing my nails down to the carpel tunnels until the last moment before I’m due back at work tomorrow.

Since the day I simultaneously got fired and quit my job (aka graduated, but that’s such a boring designation), I have been much more “Daddy” than “Doctor”.  Of course, this mostly has been great.  Lots of “back-ee-ball” with one particular boy.  Trips downtown to fairs and toy stores.  Swimming pools, squirt guns, stories.  You know…Dad-kid stuff.  Some good catch-up after 3 years.

Today, I got to take everyone to gymnastics.  Excellentcool.  I’m always working at this day and hour when not subsisting on the dole.

All 4 kids have their own class.  Each is good at particular things and they ALL have a blast.  10 minutes into it today, however, I see from the Parent Stadium, my 7 year old crying and sitting on the mat.  The instructor picks her up and carries her over to the parent area.

No problem.  She’s one of the more melodramatic.  We’re good.  All good.  Everything’s good.  I’m fine.  I’m FINE!

I saunter up to my crying daughter – James Dean vibe gushing in all directions – and find that she somehow hurt her knee.  Not sure how.  Didn’t bang it…probably.  But it’s so bad, she can’t bend it, walk on it or use her foot.  Instructor gets me some ice and goes back to her class.

Really?  You can’t walk, or bend it at all?  Like, at all?

Turns out she can, in fact, bend her knee…but every time she does, she screams in pain.  The noise she makes should be built into father-specific alarm clocks.  Set that thing to belt out a child’s scream of pain…and you could show up to a tax-code seminar at 4:30 am with a slight twitch and the retention capacity of a SETI cloud-processing computer.

Daughter is crying both because of the pain, and because she doesn’t get to climb the rope – her favorite exercise (because she’s the only one in the family that can do it).  Daddy knows Daughter would never miss rope-climbing.  You could nail-gun her leotard to the balance beam, and that kid would wriggle out of it and happily climb the rope freak-naked if she needed to.  For her, gymnastics is the rope.

And she’s the one who notifies me that she won’t be climbing the rope today.

*Sirens*

*Red Flags*

*Cow Bells*

*60’s ‘Nam Choppers overhead*

So the poor crying girl is immediately subjected to a bunch of physical exam tests that really should be reserved for the likes of LaDanian Tomlinson or Landon Donovan.

I try to get her to walk (she bawls).  I check her gait (more bawling).  Tippee-toes.  Squatting.  I look for knee effusions (more crying, sorry sweetie), patellar tracking, joint-line tenderness, patellar grind test (she loved this), Valgus/Varus stress tests, McMurray, Lachman, A/P drawer, pivot shift, Nobel’s, Ober’s, Wilson.

None of this, alas, helped with the tears.

Did she blow out her knee?  ACL maybe?  At 7?  She’ll need a walker by 35! Maybe the PCL.  You can usually walk on those and she’s moving around a bit.  Maybe bursitis, or one of the collaterals.  Compartment syndrome?  Nah.  What about a fracture?  Maybe.  Could be.  Jeez, she’s gonna need pins!  Oh!  Didn’t even think of gastrocnemius tear…poor kid! Or meniscal tear.  What about Plica syndrome…I don’t even remember what the heck that is, but maybe she’s got THAT!

I held her in my lap through the whole lesson.  Then I carried her out to the car afterward.  Once home, wife and I set her up with ice and Motrin (anti-inflammatories).

A few minutes after she settled into her at-home field clinic, she starts crying again.  OH NO!  It’s really starting to hurt.  Something terrible really did happen.  Oh, my beautiful child will never run again, maybe never walk.

“Where does it hurt, sweetheart?  What’s wrong?  Why are you crying?”

“I’m so BORED!”

“You’re bored.”  My eyes droop a bit.  I cross my arms.

“Can I puh-leeze get up now?  I had to sit all through gymnastics too.”

10 minutes later, the kid is throwing her brother’s basketball and chasing moths.  Her knee still hurts, to be sure.  But only a little.  She fully plans on climbing the rope next week.

Residency was tough, yes.

But this is why I’m losing my hair.

Retirement Ain’t So Great

As mentioned, I managed to complete residency.

That was a few weeks ago, and I haven’t stopped celebrating.

Minimal blogging.  No professional reading.  Lots of sleeping.  Ice cream pretty much whenever I want it…as if I’ve just had my tonsils removed.

I’ve gone surfing twice and will go again in a few days, after I buy the GREATEST BOARD EVER KNOWN TO MAN.

It’s a far-cry from a bohemian life of decadence – no absinthe, no scantily-clad pixies, no pleasure nymphs to speak of – but I don’t remember being this lax, this flatly averse to self-denial.

But, I have to say, after a week of this…workin’s cool.

I like needing to be somewhere in the morning.  I like having a schedule and trying to be efficient.  Mostly, I just like the purpose that a job provides.  With so many people out of work around the country, I can understand how hard it must be to deal with such a life change.  Aside from the financial instability (which I don’t have), just the dramatic shift itself must be really difficult to bear.

Lucky for me, I’m working some moonlighting shifts at nearby practices.  So, we’ll have enough money until I start a real job next month.  And I have quite a few things to keep me busy until then also, because my next job will be in Germany.  So preparing takes lots of energy.

But after even just a week away from the job, I can see that I’m too young to retire.  There’s lots of things I would change about my last job, and I’m not depressed since leaving or wishing to go back.  NOT AT ALL.  But I am looking forward to many of those intangible things that a daily job brings.  Some people are built to work.  In many ways, I guess that’s me.

Graduated – No Crying

The last days of residency passed – perhaps with a bang, and certainly no whimpers – and I am now full into my first week as a real, live doctor.

Everything feels the same, but with more sleep.

My graduation ceremony occurred 4 days ago, on Saturday.  For as emotional as I felt that night, I managed to survive the entire ordeal without much blubbering.  This had largely to do with my particular approach to the ceremony itself, which involved a skateboard, a wacky helmet and some iffy poetry.

Since there are only 6 graduating residents from our program, each of us enjoys (or endures) a sizeable amount of limelight as we graduate.  It starts with a picture slide show of us from our earliest days up to the present.  Some of my shots were strange, if not embarrassing, as you might imagine.

We are then introduced – for an agonizingly long time – by a faculty member.  Here our history, foibles and dreams are put on display for all in attendance to see.  This part can also be rather painful too.

It was then my turn to speak.  We aren’t given time-limits on our speeches.  As mentioned, there’s only 6 of us, so I guess we have the berth and he right to ramble a bit if we want to.

I survived the process with almost zero public display of emotion.

I’m not sure why this was some sort of goal for me.  I’ve always been a lousy crier.  I’m good at complaining, whining, moaning and bellyaching, mind you.  Rather too good.  But my crying skills must have atrophied somewhere in my childhood.

If I were to guess, I suppose it happened when I was about 5 years old and my biological father had just punched his girlfriend in the face.  He then leered at me and asked, “You gonna cry about that like a little girl?” in a drunken haze.

“Nope.”  I said.  And I never have.  These days, I can only cry when Ariel gets her statue of Eric blown up by King Triton, or the Broncos trade their franchise quarterback to the Bears.

So, I have some issues.  Fine.  I’ll bet you do too.  Intellectually, I admire the Roger Federers of rhe world who can stand on the international stage with unabashed tears streaming down their cheeks when they lose (or even win, sometimes) their latest tennis match.  Emotionally, I want to smack them with their own tear-stained pink hankies, tell them to find their purse and go back to the parlour where life doesn’t hurt so much.

Anyway, I wasn’t going to cry.  Smash my thumb with a hammer…we’ll talk.  But for this?  No way.

So, my approach was to first ride my Sector 9 longboard skateboard up to the podium wearing a tin foil-wrapped, overly-festooned bike helmet.  Why such a rather dumb graduation display?  Why, especially, at a solemn ceremony for a new practitioner of the healing arts?

Aside from the fact that medicine is frequently too pompous and full of itself, I figured that if I could keep it fun and light, I could keep my eyes dry.  Plus, I ride my longboard to work most days, and I religiously never wear a helmet of any kind, much to the dismay and consternation of virtually every person I meet on the hospital campus.  For 3 years I’ve put up with near-constant haranguing to wear a helmet.

Why don’t I wear a helmet?  Well, I just figure that anyone traveling less than a mile, at about a mile an hour, while less than 3 inches off the ground…should garner me the right to feel the wind in their hair.  Granted, there isn’t much wind at that speed…and I don’t have much hair.  But that’s my metaphorical argument, people, and I’m sticking to it.

I also think that Americans are too stupidly safe these days.  We think we have allergies to things that 6000 years of humanity had no problem with.  We pad every corner in our houses and put seatbelts on our T.V.’s just in case the wall trembles and pushes that deadly thing over on a kid.  We have warnings on things like plastic 5-gallon buckets and nylon shower curtains.  Frankly, the fact that my children will never ride barefoot in the back of a bouncing pick up truck, screaming like golden-haired eagles as the wind whips wildly into their eyes, brings me no end of sorrow.

I grew up burning leaves, shooting bottle-rockets out of my hand and hunting fish with a whittled stick.  I think life is risky, and living life is an exercise in managing that risk.  Knee-jerk safety measures without true analysis of risk leads to heard-mentality that rarely leads to anything but really really bad groupthink: racism, genocide, militant nationalism, day-glo, Milli Vanilli, toilet-seat-shaped pillows for airplane flights that everyone carries around airports but never actually use for more than 10 minutes, to name a few.

So, in truth, I don’t wear my helmet when longboarding because I’m determined to not become a Nazi.  Gotta admire a guy like that, right?

Anyway, I understand that most of you dear readers will find fault in my little tirade, and will probably want to admonish my opinion about helmets just like all of the faculty, nurses, staff and freaking maintenance workers I see.

But take heart!  You don’t need to worry!  I rode to the podium in a helmet for the first time.  Just to make everyone happy.  Just to acknowledge that I’ve finally heard the message.  I give up.  It’s time to be responsible and extra-duty safe.  I’m a doctor now.

‘Course, my helmet was covered in tin foil and had sticks extending from it in every direction with tinfoil balls on the end of the sticks…but it was a helmet.

Then I delivered a poem.  It was supposed to be a rap – with a thumping beat and maybe a couple of dancers and lights flashing/spinning with everyone on their feet, their hands in the air all hip-hoppin’ on the floor.

But I’m white.  I’m a doc.  I’m in a tie.

Forget it.  It’s a poem.  A really bad 1-2-3-2 rhyme sequence that rhythmically scans like ice cream might feel if you were dumb enough pick a pile of it out of a sandbox and eat it.  But, in honour of my creation and the initial inspiration for it, I allowed that I would not in fact be delivering a rap, OR a poem that night.  It would be an amalgam, a mixture…a PAP.

This is fitting, of course, since we were all gathered to celebrate my new status as a fully-trained family medicine doctor.

My Pap made my mom cry.  I think my Dad too.  Kinda my wife.  And most of the people I talked to afterward said it made them a bit misty.  My goofy, two-bit hyper-syllabic tossed salad?

Cool.  People cried.  I didn’t.  I was too busy looking goofy, or saying goofy things.

Dear old Dad would be proud.

Saturday Night Quotes I Like – March 1

A compendium of quotes I’ve noticed over the past week that were provocative, thoughtful, interesting, funny or patently absurd.  Sent out (’Lord tarry and the creek don’t rise’) every Saturday:

• Health nuts are going to feel stupid someday, lying in hospitals dying of nothing. – Redd Foxx

• Astounded, I pointed out the obvious. “Your wife died, you stopped eating, cried or slept all the time…and prayed to God that you would die? Sounds like you are very depressed.”"No, I’m not depressed,” [my patient] said. “I just don’t want to live anymore.” – Fat Doctor

• After saying she found her “voice” in New Hampshire…we’ve had Experienced Hillary, Soft Hillary, Hard Hillary, Misty Hillary, Sarcastic Hillary, Joined-at-the-Hip-to-Bill Hillary, Her-Own-Person-Who-Just-Happens-to-Be-Married-to-a-Former-President Hillary, It’s-My-Turn Hillary, Cuddly Hillary, Let’s-Get-Down-in-the-Dirt-and-Fight-Like-Dogs Hillary. – Maureen Dowd

• Buckley was arguably the most important public intellectual in the United States in the past half century. For an entire generation he was the preeminent voice of American conservatism and its first great ecumenical figure. – George H. Nash, American conservative movement historian.

• “Even if one takes every reefer madness allegation of the prohibitionists at face value, marijuana prohibition has done far more harm to far more people than marijuana ever could.” – William F. Buckley, Jr.

• “I won’t insult your intelligence by suggesting that you really believe what you just said.” – William F. Buckley, Jr.

• Buckley’s greatest talent was friendship. The historian George Nash once postulated that he wrote more personal letters than any other American…He showered affection on his friends, and he had an endless stream of them, old and young. – David Brooks

• Faith, which is the belief in the supernatural despite lack of evidence, is, in the terms of some theologies, a gift from God. It is the belief in things not seen…Anyone can believe in a God who walks the Earth. – PalMD

• A physician who treats himself has a fool for a patient,” – Sir William Osler.

• …New physicians view medicine more like a job than a calling [while]…politicians and the public have decreasing respect for the profession. In addition, the constant siege by the lawyers is taking its toll…in such hostile times, why should doctors sacrifice more to the profession than they already have? – Kevin, M.D.

• Today, thanks to the Internet, we are all physicians. And potential fools. – Andre Picard

• Intubated COPD patients are generally stable patients..[with a] protected airway…[in a] controlled environment… Except when they aren’t. – Happy Hospitalist

• When I was a child, it was an easy time to dream. When you turn on your television set and men are landing on the moon, anything is possible, and we should never lose that spirit. – Randy Pausch, professor at Carnegie Mellon currently dying of pancreatic cancer. See his final lecture on following your dreams here.