warriorsavant

I no longer worry or wonder about the road not taken. I took the one I took, it's a pretty dang good one, whatever ups-and-downs. ("Mistakes, I've made a few… but I did it myyyyy way.") However, I am lately been having some down feelings about what I didn't achieve on some of those paths.

I used to have multiple levels of "to do" lists. Sometimes in writing, sometimes just in my mind. (Yeah, I'm a little over-organized at times.), The lists were something like "do ASAP," "do this week," "do this month," and "do this lifetime." A lot of those have dropped off the list, like "go back to taking piano lessons for the first time since 3rd grade." Just not going to happen, and don't care anymore. No just that I have much higher priorities, just don't care. Some things have dropped off because I do have higher priorities, like learning multiple languages. It would be cool, it would have very some minor practicality, but just not worth the immense amount of time it would require.

I'm a bit down about some things that I would really have liked to achieve, but didn't, and simply isn't going to happen now. Some of those things I actually wouldn't want on a practical level, even if they were handed to me on a silver platter, but ego often overrides common sense. Example, I wouldn't actually want to be Derm Division Chief at McGill. It's really a lot of paperwork, meetings, and bureaucracy for minimal prestige, very little real authority, and no money. And for what? Another line on my CV or maybe my obituary? (This is ignoring the fact that I tend to tick people off and they wouldn't offer it to me anyhow. Not sour grapes, realistic appraisal.) A bigger one is that I didn't make general in the Army. I was a Colonel and a Brigade Commander, which is way further than most people get, but you always want that one more/one last step. What triggered those thoughts was looking something up about the current structure of military medicine, and seeing that 2 people I knew had moved far up in the military and civilian hierarchy. One I used to work for, and I respected. One had worked for me, and although competent in some ways, was rather a jerk. (Come to think of it, someone else I recall who had worked for me also made Brigadier General, but she was really, really good.) There are some other minor things, but these are the two glaring ones right now.

I think it's an age thing. (Getting old? Who me?) At one point I would have liked those things. Even after I'd missed my realistic shot at them, I still used to fantasize about them, but can't even do that any more. Bah.

As noted, miserably cold in these parts. Over the weekend, we turn down the heat in the office since we're not there, don't want to waste. Not down to zero, but low. Monday, it took hours to come up to "room temperature." Tuesday, even though we'd left the heat on overnight, it was still cold. Partly it was just so cold outside, partly every time someone opens the outer door, cold air spills in (there is an entry area, but not perfect), and partly the heat in the common areas of the building (my office is in a 7-story condo building) was out, so we had cold walls on all 4 side of my office, and our heating couldn't keep up. By noon, with the day having warmed up a bit, and the sun coming down, it was a bit better. I left the curtains open in the exam rooms (unless someone was actually undressing) to get more sunlight (and therefore heat) into the rooms. Even at home, despite the house being well-insulated and having a good heating plant, the rooms still didn't come up to proper temperature (although much better than the office). I turned up the heating in the basement, which helped. The basement has separate baseboard heaters; we usually keep the temperature lower there than the main floor (again, why waste), but with its being that cold, turning up the heat in the basement warmed up the floor of the ground floor to normal temperature. Today I brought a space heater into the office so Evil Secretary (who faces the entry doors) could keep her feet toastie, but it is warmer today.

Herein a grab bag of posts that I'd half-written, but didn't get around to posting. Have a number of half-formed ideas and half-written posts that I'm going to finish and post. I hate back-logs.

"Papa knows…" This soon?
( Read more... )

Christmas? Bah humbug (belated, but so be it).
( Christmas? Bah humbug (belated, but so be it). )

Back to the future (coin names).
( Back to the future (coin names). )

Software updates at gunpoint.
( Software updates at gunpoint. )

Yeah, that would be the euphemism for yesterday's office; this is a family publication, Gentle Readers. As follows, with whimsical and dark humor.

( Read more... )

Busy day at the office, but I'm feeling dissatisfied. Things felt too routine. Yeah, first world problems. I should count my blessing; most of everything that everyone does is routine, and at a far less interesting level than I do. That is true, but also irrelevant.

Cancer is a scary word, but there are cancers, then there are cancers. The most common form of cancer of any organ system is the basal cell carcinoma (BCC) of the skin. It is also the least serious, and barely qualifies as a cancer. Put it this way, if you could put cancers on a scale of 1 to 100, this is a 1. It grows slowly, and almost never metastasizes. In short, it would take years, if ever, to kill you. That having been said, an oozing ulcer 6-inches/15-cm across is unsightly and unpleasant. *understatement* Still, when they are small, it's fairly routine to destroy them, maybe 5 minutes.

Squamous cells carcinoma (SCC) is a notch up. However, the first stage, "in-situ," also called Bowen's disease, can sit at a completely superficial level for 20 years before invading. And that having been said, nobody could say if a given one will sit for 20 years, or invade tomorrow, so certainly worth treating, but again, fairly routine to destroy, maybe 5 minutes.

Actinic Keratosis (AK) is considered "precancerous," but that too is an exaggeration. Maybe 1:1000 per year will turn into an SCC, but probably 300:1000 will just resolve spontaneously. Again, the catch is not knowing which one will convert. Still, having that risk, Medicare will pay to treat them, but scarcely exciting.

Benign lesions are no longer covered by Medicare, as part of the changes they abruptly initiated Jan 2017. (I don't disagree with dis-insuring them, it was the abrupt and chaotic way they did it.) Since not insured, I can charge the patient for it, and I never object to getting money, but again, completely not exciting.

Short attention span and easily bored. My kids must be rubbing off on me. Okay, I've always been that way. Not sure how I made it this far. That most be why I'm constantly doing other things at the same time: teaching, military, now trying to get into research. Can't really complain even if all I did was sit in my office: it's more interesting and pays better than most gigs, but today just felt totally unsatisfactory.

I think they are getting these things solved, but spent far too much time on the phone the past few days. Don't want to go into details, but some generalities apply. First, I really, really hate voice menus. I'm feeling negative if I have to call them, because I'm calling because I have a problem. By the time I've gotten to speak to an actual person, I'm in a worse mood. Then half the time, they person on the other end of the phone doesn't know what they are doing, or can't solve the problem. This is besides when they decide that they will try to sell me up on another service. Hey, you can't even handle the existing work, why should I give you more? The worst is when this is not the first call I've made about the issue. *Growl*

I'm told one of the signs of "getting old" is that you wake up and something hurts for no good reason. (That and you make those little, quite, involuntary noises when you bend or move. I've been consciouely refraining from doing that, but it takes a deliberate effort.) It starts sporadically in your 50's, then gets worse/more frequent from decade by decade. Probably year by year. Possibly day by day. Oy.

About 4 days ago woke up with achilles tendonitis in my left foot. No reason, just woke up with it. Makes walking difficult. Just falling apart. Maybe that's why people eventually die, they either just fall apart one bit at time, or they just get tired of dealing with it.

Add to that everyone here has been sick on-and-off (most "on") for the past month. I've been that in-between state of not quite sick, not quite well.

Good stuff has been happening too, but this is a whiny post and I'm going to just whine, and am hereby doing it. (So there!)

In Patrick Taylor's Irish Country Doctor series, the young protagonist, Dr. Barry Laverty, is introduced to his mention, Dr. Fingal Flahertie O'Reilly, when the latter physically evicts a patient from his office because he hadn't washed his smelly feet before wanting them examined. I'm not sure the College des Medécins would appreciate my doing likewise, but it was tempting today. There's a reason we keep a bottle of air freshener handy.

Don't sit in my chair. Really, it's not hard. The chair in front of the desk is mine, it's my office, you don't sit in it. Also, don't move the furniture. I thought carefully about the layout of the office, and the placement, and there's a reason why things are where they are. Don't move them. Not even moving the patient's chair, especially not 2-3 feet backwards. But really, keep out of my chair.

It's rare that a patient faints, but does happen. Super rare that we don't see it coming. Usually they're still in the exam room, I see them looking pale & sweaty, and quickly have them sit or lie down. Rarely they make it up to reception, and Evil Secretary is very good about spotting the signs and running around the desk and having them sit down. Only once that I can think of did someone give no warning. He (she?) was standing at the reception desk, talking, looking perfectly fine, and suddenly went out. Today it was the daughter of an elderly patient. Daughter looked at me, said, "Mom is feeling faint, can I get her some water." I said there was a glass by the sink, while quickly helped mom to sit down… when daughter fainted without warning. She was fine besides being embarrassed, but only second patient in this many years to faint without warning.

Third World: Diarrhea. (I once made up a list of "you know you are in the Third World when…" "Bowel movements being considered proper dinner table conversation" was high on the list.) We all have gastro. Wallstreet came down with it first, likely picked up at the day orphanage day care. (Mixed feelings about that? Who me? That's another story.) Anyhow, he was completely miserable (as were we, cleaning up diarrhea and vomit), but is mostly over it. Then Nom and Hedgefund got it (although not as bad), then I did. It was great having to run to the bathroom in between each patient or so (darn good thing I put in that private toilet - and got it fixed to flush properly - and had good ventilation installed). We'll survive, but no one happy.

First World: Our dishwasher broke. Can't reach the repair service on the weekend. Both Nom and I at some point in our lives were used to doing dishes by hand, and were fine with it. Dishwashers, like any piece of technology, once you get used to having one, you can't imagine doing without it. Another big factor is having bambini, so many more dishes to do than being single. Also, Nom only recently (past few years) learned to cook, and like all new-ish cooks, somehow manages to use every pot, pan, utensil, and dish in the entire place… and that's just to boil water. My parents had a dishwasher when I was growing up. At some point it broke, and they never fixed it and didn't care, but all of us kids had flown the nest by then.

Coffee is one of the 4 essential food groups, likely the most essential. Yesterday had lunch at home in between my office and JGH (Jewish General Hospital, where I'm teaching staff). Was going to make a cup of coffee and bring with me in a travel mug, then said to myself, “naw, I’ll just get one at the hospital.” Forgot it was Passover. I really suck at being Jewish. When got there, went into instant withdrawal. Almost decided to chew on one of the resident’s arms to see if there was any caffeine in their bone marrow. Managed not to do so, what with being highly controlled and professional... and one of the techs having a spare cup of coffee she gave me.