That is the sort of automatic assumption about body sizes that we all make and don't realize until something like this happens. When I was in the Far East, light switches and doorknobs were always 6" lower than I was expecting. We automatically reach for them as being at about a certain height above the floor. Nom, being a tiny Asian woman (well, tiny on the outside), grew up here, so reaches for switches/doorknobs at the expected western height.
Camping out at home. Moved 2 large mattresses together on the floor of the Blue Room (WS's bedroom), so we could also sleep together. Brought in HF's new nightlight (Sky from Paw Patrol), not to mention all the pillows, blankets, and of course, books. Normally, we put them to sleep separately, and this is way they usually settle down fairly quickly and easily. Unfortunately, putting the kids together, they stimulate each other: bouncing around, shrieking, running in circles, and generally behaving like maniacs (eg normal kid behavior). By the time we did get them calmed down, I was stimulated, and after everyone else eventually fell asleep, I repaired to the Red Room (master bedroom) and eventually managed to get to sleep myself.
Snow removal. Oddly fascinating. During the snowfall, they hastily plow the streets (and sidewalks), but that just piles huge amounts of snow to the sides of the street, leaving them only marginally passable, plus there's a limit to how much can be piled throughout the winter. Eventually they have road construction machinery and plows move it into neat-ish lines, then another machine pulls it up and blows it into waiting dump trucks to be carted off to somewhere it can sit until it melts in late spring (eg: Canada Day).
Book review. Jeeves and the King of Clubs by Ben Schott. I grew up adoring the Wooster and Jeeves stories by P.G. Wodehouse. This novel, approved by the estate, claims to be an homage to body of works, but could equally be a sequel, pastiche, parody, or all of the above. Overall, I liked it. Some of it went well outside what Bertie Wooster's world would have allowed, and some of it made too liberal use of the mannerism embedded in the stories, but overall well done. I hope he'll write another one, which P.G.W. can't, what with being dead. Such state being an handicap to writing, although not necessarily to being published, and certainly not to being read.
Skiing - not an unmitigated disaster
We're not skiers. This is unfortunate, because (a) it's one of the national passtimes (besides fighting about languages), and (b) it would make winter more bareable. Nom never skied. I tried once or twice, but essentially never did.( Read more... )
By this morning, all schools and daycares were announced closed, and even university classes were cancelled. I'm told that there are about the same number of snow days for schools whether you're in the far north of Canada, or the mid-Atlantic region of the US. The difference is how much snow it takes to close things: a few meters in Nunavut, down to a few millimeters in Virginia. I did go to the hospital for my regular clinic in the afternoon. T was supposed to come also (she's updating our database and taking pictures for lymphoma clinic), but she texted me early this morning that she couldn't even get out of her driveway. I ended up taking the metro. I wasn't bad, maybe 45 minutes, but not crowded. Clinic was reasonably full. I suppose partly b/c no one can ever get through by phone to cancel, plus since it's hard to get an appointment, people actually keep them come hell or high water. There were a few no shows & cancellations, but we replaced them with people who showed to book an appointment. I had 6(?) trainees (3 residents and 3 students), so clinic went really quickly, and I got in some good teaching. Definitely worth going in.
Last night, after I got the kids (and Nom) to bed, I wasn't really tired, so I read and played on my computer, and generally relaxed. At one point, I poured a glass of something nourishing, sprawled in an armchair, and looked out the window at the falling snow, our street having a pleasant picture-post-cared glow about it.
Weather is incredibly beastly. Not so much cold, as really biting wind. Went to the Family Day in the park. First stop was ride on horse-drawn sleigh. Hard to enjoy while huddling into your hooded coat, turning face away from the wind. Then bounce castle, which the kids enjoyed (and it kept them warm). Then sugar on snow, which is basically maple syrup poured out onto (clean) snow, let it congeal slightly, then wrap around a stick to eat its gooey sweet yumminess. Then hotdogs and hot chocolate, but at least in the small warmed shelter.
That night, there was a mysterious banging. Someone trying to break in? Ghosts? Picked up one of my swords (not so useful for ghosts) and explored. Couldn't find anything in basement or first or second floor, nor any windows open/loose on any floor. Oddly the banging was almost inaudible in the basement, and less audible on first floor or front of second floor. Eventually figured it was from the attic, the stairs to which are in the back of the house. In winter, I put Plexiglas sheets across the bottom of the skylights' light wells. The skylights are vented at the top. One of them, the one in fact at the back of the house, near to the stairs down, is older, and has a different type of vent. The wind running over it was so strong, gusts were causing a Venturi effect and pulling up the plexiglas, which would then slam back down. I put some weights on the Plexi for now. I'll have to see if I can adjust the vent later.
Office & Staff. Evil Secretary was actually out sick for almost 2 days. She takes sick days about once every 7-8 years. I came in Monday and she looked green, told me she'd just thown up, and needed to go home. Fortunately we have T on board now. Even though she's here as a nurse, she has secondary duties of filling in when ES isn't here. Also fortunately, it was a little slow, so she jumped in and did just fine. Yeah, lots of small things weren't perfect, but so what, this isn't her primary job and she's only been here a month. ES had initially told me she thought she'd need to come in for 1 day to clean up whatever mess was left, but there wasn't any. Good. Not having reliable back up of ES has always been a slightly worrisome issue for me, but this is another instance of T seeming to work out well.
RAMQ, fighting with. That's the government medical insurance bureaucracy in Quebec. Despite all our complaining (both as patients and providers), they generally get things done with a minimum of fuss. Had a couple of issues that I had to fight with them about yesterday, which is to say had to get on the phone with someone. Doesn't happen often (as best I can tell, most doctors in US spend more time fighting with gov't and/or insurance companies than actually seeing patients), and at least I got to speak to a human being.
The Good. A patient who was falling between the cracks. He has horrible psoriasis, was put on one of the new biological medications with great results when he lived in Ontario. He moved back here, and the requirements are a little different, and I've been trying for > 6 months to get him approved. Discussed with them for 10 minutes, and today got the approval. They generally figure that if a doctor is willing to take the time to call them directly, it must be important.*
The Bad. Only "medically necessary" acts are insured, which is reasonable. (Some of the backstory is not reasonable, but irrelevant here.) For example, a cyst that is not inflamed, infected, or physically troublesome is not covered for removal, so the patient has to pay. They may not like the cyst (or other benign growth), but the world is full of things one doesn't like, and that doesn't mean someone else has to pay for it. Anyhow, removed a cyst from a patient this past summer, duly warned him he'd have to pay for it, which he seemed to accept, duly charged him… and then he complained to RAMQ asking for reimbursement. Last fall they sent me a nastygram, asking for my notes on the patient and my justification. I sent that back, including a direct quote from their manual. They just sent me a letter saying basically, "illegal charge, we're collecting it back from you with a penalty." I spoke to someone who took the info, "and will get back to me." This is seriously annoying, but I am going to smack them down. If I let it go, besides the money immediately involved, it sets a really bad precedent. I've gotten the Assoc. Derm. Quebec involved, and they will help me for the same reasons. We'll win, but annoying.
*More on fighting for patients. It's part of the job. I'd hate to have to do it for every patient. Frankly, wouldn't have time to earn a living if I had to do that, but every 2-3-4 weeks, something comes up and I need to do it. It comes with the turf. Sometimes it really shouldn't be my job on a particular patient, but if he/she has been bounced around enough times, and is sitting in my office, I figure that morally it has defaulted to being my job, and I'll at least take the time for find out who should really be the one to see him/her, and make sure it happens.
Modern life being what it is, everyone we know works, so we held it Saturday midday. Having small children, midday is much better for socializing than evenings, or even late afternoons, so we made it for 10-2. We also actually invited people by sending around formal, engraved invitations. Well, its modern variant, known as email and text. The basic concept of 'drop by to chat, and have a bit to eat and drink, but not a formally organized party,' was maintained. I must say it worked very well. We're not very sociable people, but we actually had fun, as apparently did all our invitees. We're going to do it again weekly. Well, monthly. Well, sometimes. Who knows, at this rate, we might even end up having a social life.
We've never been very sociable, and generally loathed parties. As I've gotten older, I realize that I disliked most parties for the same reason I dislike the bar scene: there are a large number of people I'm not in the least interested in talking to, because they are not interesting. (So Gentle Reader, you know you've made the cut into a select group.) On the other hand, I'm more and more enjoying the company of a smallish group of people that are actually interesting to talk to. We are gradually building up a circle of friends, and will be having regular, if never frequent, social events.
"Okay, you just went from near top of the 'favorite patient' list to the bottom."
"No, I mean I thought you were in your 40's."
"Wow. Okay you're back near the top - in fact at the very top - of the list."
Maybe she's just a poor judge of ages, being a mere slip of a 30-something, but I'll take it.
Between everyone there, we had a total of perhaps 1.25 Scotsmen, but still great fun. Some food (limited what can be eaten on a keto diet; but a small amount of haggis won't ruin the diet). Some chat. Some scotch (just a wee dram… or four). Some poetry - actually my favorite part last night (even if I cheated and recited Dave Van Ronk). There was something fascinating about sitting in a cozy living room, reading poetry from 2-1/2 centuries ago, with people of 3 (4?) generations. The dark, warm, comfy feeling of being immersed in a warm, slow river of history.
We've been having icy rain. At least not a million below zero, but equally unpleasant, plus snarls traffic really badly. It took me over an hour to get home from the hospital last night, a trip that usually takes 20 minutes. This morning the driveway was a sheet of ice, patients were late, and even Evil Secretary was late, which happens about once every 7-8 years.
The fire part? Well T put some instruments in the autoclave (sterilizer - normally Evil Secretary's job), and didn't know she needed to put the wrapped instruments on a special rack/tray first, so the wrappings were touching the hot interior of the autoclave and caught fire. No damage done, but an unpleasant odor lingered for an hour or so.
That, and some discussions here about taking pictures of the eclipse the other night made me think about photographic apparatus (apparatuses? apparati? thingies to take pix) in general. When I was young, daguerreotypes were just coming into vogue, but they were very combersome... Okay, more seriously, when I was a kid, my father was a bit of a Popular Science / Popular Mechanics / gadget guy. I suppose getting the latest camera was the equivalent of being a tech-gizmo-nerd. Polaroids were a big thing! Before that, we had a Kodak Brownie camera. (Dang, those items would be worth a lot of money as antiques now.)
I'm actually very good at composing shots. (Photos, I mean, although very good with a side arm also.) Partly that is my artistic eye, which I inherited from my mother, partly because with film, every shot you took cost money. Dermatology is very visual, so as Residents (early 1990s) we were encouraged to get a good camera, with a macro lens and ring flash. (That I still have somewhere.) It took really good 35-mm slides, and I had quite a collection. In 2005, I was mobilized to Walter Reed Army Hospital, and was asked to give a talk. I asked the Residents if they had a slide projector anywhere. They nearly died laughing, and claimed they'd have to borrow one from the Smithsonian. A little while after that, I decided to digitalize my whole collection. Even that is barely worth it now, as so much high-quality stuff on-line, but if giving a talk it is cool to have MY picture up there (with copyright notice).
Patients often insist on showing me pictures of their skin conditions. *Sigh.*
First, you are sitting right there in the flesh and full-sized, why would I want to see a tiny image of you?
Second, you stink as a photographer, especially a medical photographer, and the image on your phone is terrible. All that having been said, although I do have a small digital camera in my office, like as not, when I want a picture, I use my phone. (But remember that thing about knowing how to compose shots? It really matters.)
I don't take many pix of generic skin disease, but am getting better about documenting before- and after- for the small amount of cosmetics I do, also we're trying to build up a file for our Cutaneous Lymphoma clinic patients.
I woke up just before the alarm rang, shut it off, and walked around the house to see what windows it was visible from. Answer: a bit from tiny spare room, but best from dining room, and even from there only at the right angle. When the eclipse was actually starting, woke up Nom, who duly noted a notch was taken out of the left edge of the moon, then went back to sleep. Then woke up Hedgefund, who sleepily acknowledged that she wanted to see it. Basically, still at that age where pretty much everything is fine as long as she's with Papa (*dote, dote, dote*). Then she went back to sleep, so I carried her downstairs, set up a comfy chair by the window, with a blanket and phone and binoculars. She noted the bite taken out of the moon, then went back to sleep in my lap. I stayed up watching. Well, reading "The Economist" on my phone, and watching intermittently. When it was closed to full eclipse, I woke her up again. She again noted the change in the moon and went back to sleep.
I saw the super moon, and the eclipse, but can't say I saw the "blood moon," it was just too overcast. When the moon was almost completely eclipsed, I could just about make out the eclipsed part, but as a faint, dark brown through the cloud cover, nothing reddish about it. When it totally eclipsed, it completely disappeared from my view. I carried Hedgefund back upstairs to bed, then went back down, dressed, and went outside. Nope, still couldn't see a pale red moon, or any moon, (and fortunately still now ravening wolves) so went back inside and went back to sleep.
Glad I did it. Didn't take any pix, because in the past, when have taken pictures of eclipses (sun or moon), they really didn't look like much: just a blob of light with a notch in one corner. Both Nom and Hedgefund claim they were also glad they saw it. Not sure she actually understands about how an eclipse works (Hedgefund, I mean, pretty sure Nom does), so tonight I'll have to rig up something with a lamp and two balls in a dark room.
How's everyone else holding up with the massive pan-continental storm/cold snap.
*That isn't actually an obscene reference to the gonads of a metallic simian. In the days of wooden ships and iron men, when the traditions of naval service included rum, sodomy, and the lash***, iron cannon balls for ready use were stored on a triangular brass frame, known as a brass monkey. In cold enough weather, the brass contracted more than the iron, and the balls "froze" off. That that this phrase sounded obscene, was entirely not coincidental.
**No clever hidden meaning there. Straight out crude. And probably anti-wiccan. I'll continue blogging after my being turned into a newt gets better****.
I'm scarcely fat, especially by N. American standards, but just before the holidays I realized I was the heaviest I'd ever been. My weight has been fairly stable for most of my adult life. (In rounds numbers, it's been "none of your business.") It went up several pounds after I got out of the Army -> exercised less -> had kids -> exercised less. Still, I was never a huge exercise buff. Most of my life, I kept my weight down by depending on good genetics/high metabolism. The past few years, that hasn't been working as well. (Not entirely sure how gray hairs effects one's metabolism, but they seem to.) No matter what I tell myself, I'm just not going to be exercising that much more, so decided to tra keto diet. My own doc pointed out (and in past I agreed with this statement), that any diet works for 6 months. That having been said, a close friend tried a keto diet with great results. He was seriously overweight, and within a year has slimmed down to merely somewhat heavyset. Nom and I decided to dive in and try it. She's scarcely fat either, but she's no longer a "size 0-0-0" (I'm not sure I believe that's a real size, but she has clothes that claim it is.) On the other hand, "you done have a baby (or two), miz scarlet." On the other, other hand, I have no objection to how she looks. On the other, other, other hand (we seem to need an octopus to keep up with the discussion), it is futile and possibly dangerous to tell one's wife anything about her weight, pro or con. Anyhow, starting New Years Day, we started.
So far, good results. Have started shedding the excess. The diet is a bit monotonous, and sometimes I just don't like the fatty mouth-feel, but some of that will improve as we figure out different recipes. In the long run, we shall see.
*gizinta = that which giz (goes) inta (into) your body/bank account.
*gizouta = that which giz (goes) outa (out of) your body/bank account.
This is a children's book, about how little Leonard, whose grandfather is The King of Beasts, and now going senile. I think it's meant to encourage understanding of the phenomenon and to care for your frail grandparents, but I found it very depressing. I kept thinking about my father, and his dwindling to nothing. Then I kept wondering about how long I have. I know I talk about "not retiring until I put the kids through medical school," but really not that many people can keep up the pace, or even be functional that long. I do have one colleague who is still going strong in his late 80's - well, at least going reasonably - but the "super seniors" are still the exceptions to the rule. Some time ago, ravensron did point out to me that we really don't know what the "normal" is for people in their late 80's and older, because this is the first generation where we are having large numbers of people live that long. I do see many patients that old, but truly being hale and hearty at that age is the exception.
Warrior Rising by Chris Linford.
Initially came across this book referenced in another excellent book, Marc Dauphin's Combat Doctor. Dauphin was a Canadian Forces Medical Officer, and had been the company commander ("officer commanding" as opposed to "commanding officer" in Canadian parlance) of the last Canadian roto for the Role 3 NATO hospital in Kandahar Afghanistan. That book was impressive enough, and the volume of casualties they saw in one roto - heck, in 1 month - is more than I saw in my entire career. To be honest, most careers are nothing like war movies, probably even if you're special operations, you don't see as much "action" in your whole career as is packed into a 2-hour war movie. Most people don't see even that much, most of the military life is routine, and many people, even in wartime, don't see a shot fired in anger. Even understanding that intellectually, it does make me feel a little insignificant to read about how much Marc Dauphin had seen and done. And that, wasn't a patch off what Chris Linford had seen and done. He was a Canadian Forces Medical Office at the Role 3 in Kandahar, which was his last assignment. He'd also been in Rwanda, Bosnia, and several other places. He was eventually put out of the Canadian Forces on a medical discharge for severe PTSD. Considering what he'd seen over his career, he was entitled to enough PTSD for 5 people. Much like combat, very little PTSD is anything like you see in the movies, but he had a textbook case of the most severe form. Very humbling to consider what he'd done and what he experienced.