Very soon

Tonight is the night. The Boss and The Sammy get home from their long voyage across the country, and I get my family back. I'm pretty excited. In the mean time, I've had to satisfy myself with photos while they have enjoyed the company of all manner of relatives on both sides of our family. Boss' Mom and Dad were agreeable to stopping my folks' place en route to Washington. My neices and nephews were able to see Sam for the first time in a year and half. I'm glad they all got to spend time together.

Oncology

My first rotation is almost over. In fact, today was my last full day. It has been an amazing month.

One of my first patients came in the hospital with some pain and didn't realize he had advanced cancer. He passed away within a week or so. I went from joking with him when he was first admitted, oblivious to the widespread metastases, to watching him try unsuccessfully to get a really good deep breath. Watching a person die is unpleasant, certainly. But watching a family watch their loved one die is heart-breaking. He had come from out of town to visit. And then, just like that, he was gone.

Since that patient I've seen lots of variations on a theme. People who are ready to die, people who are desparate to try anything to avoid it, people whose family understand that death will come, those that can't accept it. Somtimes I stop and feel a little surprised that this is the patient population I've chosen for myself. And then I remember that I find peace in the idea of helping people gracefully leave one part of their eternal life to enter the next. It won't always be happy, but it can always be hopeful.

Missed girl

It's always nice to take a break from playing in the park to snap a photo of one's toenails, right Boss? I've been flipping through the photos and I miss you guys a lot!!! 

Missed boy

I miss Sam and Boss a lot. Without Sam, who will resist me when I try to brush teeth? 

Scut monkey

I've just finished my third week as an intern, and it has been a wild ride. Sure, I've seen interns in action for the last few years as I tagged along, the medical student in-tow, but it's a whole different game now that I actually sign my own orders and write prescriptions. This morning I was paged over the PA system in the hospital: "Dr. Coach, please call 84441. Dr. Coach, please call 84441." This is the same voice that announces code blues and trauma alerts. It was kind of a surreal.

There have been a lot of crazy experiences and I keep wondering which if any are appropriate to blog about. Well, I'll try to keep blogging about my crazy experiences as they happen whenever I can do so without breaking confidentiality. I tend to think that as long as I don't share anything with details that make it personally identifiable it should be okay. We'll see.

The real story of the year is that being an intern is a lot of work. Since I still don't know much, my life consists mainly of doing everyone else's paperwork. When the patient comes in, I do the busy work and sort of pay attention to the senior and the attending as far as what the plan will be. With enough exposure, I guess, the idea is that the treatment plans will become reflexive. Basically, I'm a trained monkey. Doing what we refer to as "scut work". But being a scut monkey is important. It helps people live and get better.

Plus, the Boss likes monkeys.

Remote Access

A recent post on Dr. Peanut's blog revealed that both she and Coach are both a little bummed to be missing all the festivities currently underway here at the Reid Ranch in lovely (and remote) Fruitland, Utah. I've been bummed too, because I've missed them both a lot. So I was excited to learn that the ranch has recently become less remote; they've gone wireless! It makes it seem like the doctors (Peanut and Coach, that is) aren't so far away.

If only the MTC would let Daisy and Javich online every now and then. Then we'd really stay connected.

We love and miss you guys. And don't worry. We're hardly having any fun without you.

Sugar Mack

Last week my mother asked me to update the photographs she has hanging in her living room. Each of her children is represented by a photo collage depicting the years from childhood to the present. Except as of last week, none of the photos were more "present" than 2002. So my job was to add current family shots, as well as shots of all the grandkids who've come along since the last update. This task was a lot of fun; I had the chance to pore over lots of amusing photos and reminisce about family adventures. But it was also difficult because adding new pictures meant I had to replace some that were already there. Tricky stuff.

This task was particularly hard for my brother Sugar Mack's* collage. For one, his kids are too stinking cute. (See evidence here and here and here and here.) There's no way I could take out any of their photos. The shots of his sweet wife, Spanky Fish*, were all keepers too. And all the pictures of Sugar Mack by himself were perfect representations of his personality: There he is, putting the barber into barbershop, hamming it up at a Christmas concert, playing the piano while friends and family sing along. He's this funny, musical, show-stealing guy who makes every get-together more festive. And while the ultimate winner (?) of our family's sibling silly contest may be in dispute (*cough*Harvey*cough*), I don't think anyone would argue that Sugar Mack is the most likely to put the silliness to music.

And on top of just being fun to be around, Mack is the kind of guy every kid wants for a big brother--the guy who'll stick up to bullies, give good advice, and even tell you to shape up when you need it. I recall one instance when I was 12 or 13 and I wanted to borrow something from him. He said I could use it as much as I wanted, whenever I wanted, if I'd remember to treat my younger siblings with the same courtesy. I won't horrify you with details, but you should know that at the time, "courtesy" did not typify my relationship with my younger siblings. Sugar Mack was an amazing example in that regard. Where some of the rest of us had trouble getting along, he was a peacemaker.

But he ain't a wimp. Take the time several years ago when I'd been involved in a minor car accident that turned out to be a major hassle. I'd been rear-ended, and there was no dispute about who was at fault. But the other driver's insurance company still balked about providing me a rental car while my car was in for repairs. When I'd argued all I could, and tears of frustration started to spill, Mack took the phone and calmly asked "is there a problem," in a way that made it clear to the guy on the phone that if there was (a problem, that is) he'd better find a way to solve it quick. It worked. Mack took me to pick up the rental car the next morning.

He's rescued me many times before and since--from the time I passed out after a long day at Education Week to the months I stayed at his house while I figured out what I was doing with my life. He's the guy you go to for help when things are bad, and for laughs when things are good. (And Mom has the pictures to prove it!) Like I said, he's the big brother you always wanted. And I sure am glad he's mine.

I love you Sugar Mack! Happy Birthday!



*Names have been changed.

Getting big

Sam is coming up on the big number 2. And today I was gratified when the lady in the bank recognized what a genius baby he is as he correctly named all the capital letters he could see.

With growing age we look forward to more inconsolable tantrums and perhaps more specific rules than we ever thought were necessary (Sammy, you may not use your toy otoscope to drink from the dog's waterbowl.). It's exciting though.