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.
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.
"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. )
Anyhow, the key line missing from all the instruction manuals is "first remove the two toddlers from your house…" Really, if I did that, all of the assembly would be 3-5 times faster than with their helping me.
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.
Adding to this, I finally hired a nurse (which I'd been contemplating doing for 20 years). Who quit after three weeks because the workload was too much, or possibly too little, or because she actually wanted to work in an OR.
I don't drink much anymore, so gathered up cheaper bottles of wine that people had given me over the years back to the SAQ to get store credit. Most were too old, but they took some back and I used the credit to get a good bottle. Took that plus the really good bottle that I had to open first, with the mediocre stuff as backup. Took whatever cheese I had on hand, bought some extra, and got prepared.
Sent out about 30 invitations. Heard back from only about a quarter of those, so expecting 8 people. Half of those cancelled at the last minute (held up by death, disease, or traffic). Only 1 person actually showed up. Since it's business, don't really care, but some little part of me is personally miffed. Over the years, have managed to have zero people show up at personal parties, so there is some resonance to that. Also, if a colleague invites you, you should at least have the courtesy to respond. And if you do respond "yes," then show up unless you have a good reason why. Anyhow, had a nice chat with the one guy who did show up. I thought having a reception needed to be done, so did it. The rest is history.
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!)
Second a metaphorical one. Had a message to call lawyer xxx at firm yyy. Calls from lawyers rarely good. Especially when I googled firm yyy and noted they were "Un cabinet au service des usagers du système de santé du Québec" This is French for "Ambulance chasers." Turned out they were looking for someone to do Medical Expertise for Dermatology. Sorry, folks, but keep looking. One could argue that they are in the service of justice and I should help them, but "service of justice" sometimes is the same as "hired gun," depending which side of the table (courtroom) one is sitting on. It's rather like Satan asking the Preacher Man for help harvesting souls, "because they're sinners and they deserve it." We have an adversarial legal system, and they're the adversaries. Come to think of it, I believe the literal translation from the Old Hebrew of Satanactually does mean "Adversary." It is actually Ha Satan, "The Adversary." From my admittedly limited readings of the Old Testament, Satan is not the adversary of God, but of Man, more of what we would call today (un-ironically), a "Devil's Advocate."
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.
Commuting: the garage door on my office building jammed (again) the other day. I was going to go home for lunch, but couldn't drive because couldn't get my car out. The concierge told me there was a taxi office just up the street. Went there. Long story short, "you have to get the app to call us." Jerks. I'm standing right there, you have drivers and taxis just sitting around, but you won't take my business because I don't have the "app." Fortunately there was a taxi from another company nearby so I went with them. Borrowed Nom's car to go back to work, then back home at the end of the day to get her and the kids. The next morning took the Metro to work. Not really bad, but just that little bit longer and more annoying which reminded me why people usually don't take mass transit when they have the option to drive: walk to the Metro station, wait for the train, (fortunately didn't have to change lines), go 2 stops, walk from the Metro station. Three times longer than point-to-point driving. In nice weather, if I'm feeling energetic, I might walk to work some days, it would be 30-40 minutes.
Cappuccino: The commercial unit across the hall from my new office had their "soft" opening. That is to say, they were sufficiently moved in that if you walked in, they would accommodate your business, but not fully up and running. It is a bicycle rental/repair shop, convenience store, and café. Not as weird as it sounds. They are on the side of the building that fronts the scenic bike path along the old Lachine Canal. The owner has bike repair/rental place about further up the bike path, but this is meant for higher-end bikes. Also, being on the path is a good location if bikers, joggers, or strollers want a cold drink, a snack, or a coffee. I'm happy to have a place in my building that offers same. I have a fridge and a coffee maker in my back office, but they have cappuccino. Frankly, not the best cappuccino, but it is there. They will have a terrasse outside. Montreal is big on terrasses during our - limited - good weather. Their main entrance is from outside along the path. However, if you live or work in the building, and have key fob for the front door, it will also let you into their store directly from the inside hallway. Very clever on the owner's part, as it makes him the convenience store for the building too.