Saturday, July 23, 2016

Take This Job and Shove It Except That It's Not a REAL Job in the Sense That I'm Unpaid Plus I HATE Country Music



Yesterday was a long and rough day at work. It didn't begin with the presage of being unduly lengthy, as the first surgery for which I was to be in attendance wasn't scheduled to begin until 6:30 a.m., which meant I could show up at some point between 5:00 and 5:30, which I did. Matters were not helped by my having picked up a cold at some point during the night, but such is life in the world of medicine. You don't skip surgery for a mere cold. You keep your stinking mask on all day even when you're not in surgery, but you show up and you stay there until you're kicked out of the hospital or surgical center by one of your superiors.Then some lady's fallopian tube exploded, and the surgeon who was to lead the surgery previously scheduled for 6:30 was suddenly out of commission. All of the other surgeries that were scheduled still happened -- just later than they should have started. I finally got away from the hospital at 8:05 p.m. 

I arrived at my condo to find Matthew at home with our living room full of his buddies eating pizza and watching -- of all things -- some ESPN program about how the 2016 NFL draft picks would fare in the upcoming fantasy football season. Jesus fucking Christ! Why doesn't ESPN just televise ants carrying food across kitchen counters? It would be a hell of a lot more relevant and equally entertaining.

I left to get an ice cream cone and briefly texted a friend, but almost as soon as I was handed my ice cream cone in the drive-through lane, I was overcome with violent gastric symptoms. I pulled my car far enough from any other cars in the parking lot so that I could drop the ice cream cone onto the pavement (I'm not usually a litterer, but I made an exception) and could empty the almost nonexistent contents of my stomach in relative peace. I then drove home, plugged my nose so that I wouldn't smell the pizza and beer as I walked though my living room, not that I could have smelled it anyway with the nasal congestion of my cold,  and put two towels at the bottom of my bedroom door so that the smell of the pizza wouldn't pervade my bedroom and make me sicker than I already was.

Work itself was less than delightful. One cannot expect it to be fun when experiencing cold symptoms, but a scratchy throat, headache, and sinus pressure were to be the very least of my troubles. During an exploratory laparotomy, the lead surgeon dropped a clamp. There wasn't another identical clamp on the tray, so he (the lead surgeon) hurled a few choice expletives as one of the nurses quickly hurried to grab another from an already sterilized set of surgical implements. The nurse handed the clamp to the surgical technician [who technically must be the one to hand every instrument, sponge, towel, or whatever piece of equipment is used in a procedure to the surgeon, and then must take it back if it is not something that is to remain inside the patient, because he or she is responsible for accounting for every piece of equipment and for ensuring that nothing is left inside the patient that isn't supposed to be left there], who inadvertantly dropped the second clamp. I was standing slightly behind and between the nurse and the surgical technician but had no physical contact with either, which made it most puzzling when the surgeon hollered, "Goddamn faecal encephalopathic!"

The O.R. tech gave him an ugly look, or as least as much of an ugly look as one person can give another with two-thirds of one's face covered by a surgical mask, and  commented, "You could have just said 'shit for brains.'  Everyone here  knows what faecal encephalopathy means. You weren't impressing anyone or sparing anyone's feelings, not that that you've  been known to spare anyone's feelings before." She paused for a breath, then continued. "And so I dropped a damned clamp. You dropped one before I did. No one felt the need to spout f-bombs when it was your fault."

"I wasn't directing anything at you!"  the lead surgeon retorted.

"So I'm the one with shit for brains?" the nurse who had retrieved the second clamp chimed in. Meanwhile, someone else had grabbed a third clamp and handed it to the O.R. tech, who wordlessly handed it to the lead surgeon, who miraculously managed not to drop it.

"Did I expressly identify you as the faecal encephalopathic among us?" he asked her, looking up briefly from the patient's open abdomen. (Radiological reports were unclear as to precisely what was amiss with the patient's organs, necessitating a full laparotomy as opposed to the less invasive laparoscopic procedure.)

"I handed the clamp to Lisa [the O.R. tech]," the nurse responded. "It fell to the floor. I handed off poorly, or she flat-out dropped it. You seem to be the self-proclaimed official scorer here, not that we've ever needed one before. If you weren't yelling at her, it must have been at me." 

"Try Option 3," the lead surgeon spat out.

"And what might that option be?" asked the assisting surgeon, a  third-year resident, an ordinarily soft-spoken woman.

"That would be Baby Bimbo standing right there between Thing 1 and Thing 2 who couldn't quite keep her hands to herself," the lead surgeon answered. My jaw dropped almost to the floor, though no one could have observed it through the surgical mask.

The O.R. tech and the nurse who handed the clamp to her both began heated responses to the lead surgeon when a voice came over the intercom. 'You have a patient on the table, Dr. ********,"  said what sounded like the voice of God through an intercom, but was actually the voice of the doctor charged with supervising surgical clerkships and residencies.  (Some surgical suites have viewing areas above them, which this one did. Those in the surgical suite cannot hear anything from the observation point unless someone presses the intercom button.  As often as not, the viewing areas are unoccupied, but a relatively  high authority stopped by to observe at a rather timely point in the procedure.)

The surgery proceeded in virtual silence, interrupted only by requests for instruments as needed. As the senior resident was making the final closing sutures, the lead surgeon looked up to ensure that no one was in the viewing area, then looked directly at me. "You cannot tell me, Princess Anorexia," his voice heavily laced with sarcasm, "that you didn't reach for the clamp and cause Ms. Herman [the O.R. tech; though she was known by "Lisa" to everyone in the room, I was, it seemed, unworthy even for a reference by her first name to be directed at me] to drop the clamp?"

As I was pondering the specifics of my answer, Lisa answered for me. "No, she didn't touch the damned clamp. I dropped it, it as you dropped the one before."

'What's this?" the lead surgeon countered.  "She can't speak for herself? Do you even have a voice?"

"Is this really necessary?" the senior resident asked as she made the knot on the final suture. "And by the way, things you've said in here have been precariously close to sexual harassment."

Peronally, I'm not overly concerned with verbal sexual harassment. For the most part, if they keep their hands to themselves, I don't care what questionable things they might say along the lines of sexual innuendo. I draw the line, however, at false accusations of any nature.

"I just want to know if she's capable of speaking," the lead surgeon continued. "I've heard no evidence that she has a voice."

"What do you want me to say?" I asked him, making direct eye contact.

"Anything!" he shrugged.

"Anything,' I responded.

Laughter broke out in the room as the lead surgeon rolled his eyes and muttered, "How intelligent!"

I made it out of the room and out of the scrubs and paraphernalia in record time. I didn't want to talk to anyone. Another surgery, thankfully with another surgeon, was scheduled for less than fifteen minutes from the time I made it out of the partial hysterectomy, and I would need to rush to be  scrubbed and ready in time to be allowed to be present for it.

My next and final surgery for the day -- a thyroidectomy -- went without incident. I just felt sorry for the patient for having to wait so late in the day for the procedure. Few things are more agonizing than waiting as a patient for a surgical procedure. Fortunately, it was short and to the point, everyone inside the O.R. behaved professionally, and the patient came through recovery with minimal discomfort.

So I made it through an especially arduous day, made all the more difficult with the symptoms of a cold, only to be hit with a gastric illness, and, unless someone else who lives in this condo has acted in a most uncharacteristic manner, a messy living room and kitchen with which to deal. Matt will likely pull the martyr act and say that because he is on call for Saturday while I have the weekend off, all the clean-up chores should fall upon me. If I open the door this morning to find the downstairs area not cleaned to my specifications, I will telephone the complex's on-call cleaning crew and arrange to have the entire downstairs area  be made spotless at Matthew's expense. If he doesn't fork over the money willingly, I'll call my dad and rat him out, and the money will be deducted from his next month's spending allotment. It shouldn't be a problem for him, as my grandmother sent him a hefty check for his half-birthday (?!?) last month.

P.S. I received a text message at 1:06 a.m. from my preceptor telling me that I am to meet her at her office at an early time this morning. (She indicated the time, but for security reasons, I can divulge neither the precise time nor the specific location.) She mentioned the importance of punctuality, as others besides her self may possibly be present as well. I didn't see the text at the time it came, but I checked my phone just while ago when it dinged for another reason, and then I saw her message. I've never been asked to meet with her except  regular scheduled-well-in-advance meetings, and certainly never on a Saturday. She's a psychiatrist and almost never works Saturdays.  This cannot possibly be good. I suppose I may as well give up on the idea of sleep for the rest of the night.


Thursday, July 21, 2016

Life sucks, and then you die.











Work  is good now. Everything else pretty much sucks. I could blog about the sucky stuff in my family. Most of it, for the benefit of anyone who really cares, is not my immediate family in particular. They're peripherally involved and I don't necessarily appreciate the ways in which they're dealing with it, but neither my parents nor my brother are the direct impetus.

I'm choosing not to air the specifics of my family's dysfunctionality as it relates to me in this particular instance primarily because any discussion of it in this forum would be a source of mirth to some of my least favorite relatives. While it might seem as though I have delusions of grandeur (and perhaps I do to an extent, but I'm not exaggerating in this particular context), extended family members who dislike me would be amused by the knowledge that my feelings have been hurt -- perhaps carelessly but perhaps intentionally, and even if it wasn't intentional, the person most certainly should have known that his or her actions would have been perceived as hurtful -- by a member of the family. Some would say that I'm harming myself more than I have been harmed by the person whose actions have offended me. This may or may not be true. Nevertheless, I refuse to deny my feelings at this time. I won't bury them and go along with the good old Mormon adage that all is well when all is not presently well with me.

The surgical rotation is fascinating. I learn several new things each day, which is as it should be. Were I not learning new things on a regular basis at this point of my career, something would be seriously wrong either with me or with the system. Those I am working with are, for the most part, decent human beings. Such will not always be the case, but it's a blessing that for the present, I don't have to deal with a-holes at work.

I'll have at least the next two weekends off. It sounds somewhat contradictory to say that work is delightful and then to express my gratitude at having weekends off, but I've found that almost nothing is made better by sleep deprivation. For now, I'll take every weekend off that I can get, and I'll be happy about it.

I'm sorry to come across as such a Negative Nancy right now, but it's not the most joyous time of my life, or at least I hope it is not. If this is as good as it gets, I'm not sure what is the point of anything.




Tuesday, July 19, 2016

Families are Forever, Fools Rush in Where Angels Fear to Tread, and Other Cliches That I Hope Have No Basis Whatsoever in Reality



Right now my life is in the midst of its own sort of "horse latitude" cycle. The doldrums have struck, and have done so in a rather cataclysmic and convergent fashion. My description is metaphorical, of course. I'm not on a ship, and the ship that I'm not on is not stuck in one of the Intertropical Conversion Zones of low pressure and calm winds -- either the calms of Capricorn or the calms of Cancer. Furthermore, I am privy to the knowledge  that the idea that horses had to be thrown overboard for the purpose of preserving ships' rapidly dwindling water supply -- hence the sobriquet horse latitudes -- is largely a term borne of folklore, which is not to say that there was never even a single instance of a horse being thrown overboard when water supply diminished rapidly during the calms of subtropical latitudes. The point here is that I took the same undergraduate physical geography course covering weather and climate that nearly every other university student did. No one needs to feel obligated to consult Wikipedia, then to use the "comments" section of this blog to "educate" me or other readers concerning the particulars of atmospheric circulation, disambiguation, and other features of the Intertropical Conversion Zones. Most of us already know as much as we care to know about the topic.

The one bright spot in my life, thank God,  the Flying Spaghetti Monster,  the Great White Blood Cell, or whomever is responsible, is that my personal issues are not interfering with work, and that work is continuing to move along smoothly. My supervising attending physicians and residents  have thus far liked me and have been pleased with my work, as have the interns supervising me. The word on the street is that the surgical rotation is the one in a which a third-year medical student  should not begin his or her clerkship. Nonetheless, someone has to start out here, and I figuratively drew the short straw. The work is physically demanding, and that's the very least of the drawbacks associated with the surgical rotation. Through a combination of over-preparedness and sheer dumb luck, I've been able to overcome most of the stumbling blocks of having gotten stuck with surgery as my first clinical rotation. For that matter, I'm finding it fascinating and am having a blast with it. 

After an organ that is not to be transplanted is discarded, third-year students often get to use it to practice incisions and sutures. This probably sounds bizarre and disgusting to anyone not actively involved in the allied health fields, but it's an excellent way to get the feel of incising and suturing live tissue when the stakes are very low. The organ is useless, so we can't do any harm. We've all done our time in anatomy lab, but cold, embalmed bodies have a much different feel to them than do living (or recently living) tissues. I've done well enough with my discarded organs that three of my supervising surgeons have allowed me to do just a bit of work on the actual surgical patients. The real surgeons are right there on the tips of their toes, poised to jump in and to repair anything that I might screw up, but thus far that hasn't been necessary. Knowledge of this has to be far from comforting for anyone who is or whose loved one is facing surgery at a teaching hospital in the near future. Still, training must happen, and until someone comes up with a mannequin remarkably similar to the human body, we doctors-in-training must practice on actual patients. If whoever operates on you or your loved one hasn't had adequate training and practice, the surgical patient is in a world of trouble.

Unfortunately for me right now, life consists of more than just work.  My family hates me. Okay, that's probably an overstatement. Most members of my family are angry with me. I shall not air the dirty laundry in this forum. I initially messaged a friend with the details, but then thought better of it and erased the messages. We all have problems. My friend surely has issues of his own with which to contend. Probably the very last thing he would choose to do with his finite free time is to read about the dysfunctionality surrounding my family. Even if he read about it, what could he really do? I can't exactly see him calling my relatives and telling them how wrong they are even if he did agree with my points in the dispute, which isn't necessarily a given. 



/



On top of everything else, I'm dealing with a bit of a situation in the domain of romance. While I'm in the league of neither Tesla nor Einstein where raw intelligence is concerned, I'm not so lacking in gray matter as to believe that now is a good time to involve myself in any sort of affaire de coeur. Lamentably, these things sometimes happen anyway, even to otherwise intelligent, or at least otherwise not overwhelmingly stupid people. The upside to the situation is that it is temporary. This, too, shall pass, and probably sooner rather than later. In five weeks the subject of this relationship and I will be in different rotations and may not meet up again in another rotation for a long time if ever.

The family situation will not likely work itself out with quite such ease. Blood is thicker than water (and speaking of blood, some blood types stain clothing more persistently than do other types; some things one has to learn the hard way, and I will never again wear non-hospital-issue scrubs into surgery), and these things usually eventually work themselves out, though not always without resultant scars. All I can do is stand my ground where I think it is absolutely essential that I do so but not be so stubborn as to hold out in ways that hurt myself more than anyone else solely for the purpose of making a point. 

Sayonara, and I hope that your summer is sailing along more smoothly than mine is.




Wednesday, July 6, 2016

Nurses vs. Doctors



I've observed something in the hospital setting that will come as no surprise to many of you, which is that many doctors and nurses don't like each other. Part of this can be explained simply with the suggestion that some doctors are pompous a-holes, while some nurses (male and female) are bitches. These particular doctors and nurses probably don't get along well with their bank tellers, their children's teachers, or the people who are unfortunate enough to inhabit residences with them, either. It's not surprising that they would have trouble getting along with one another.

I've written before about the hierarchy that exists in hospitals. In practice, we third-year medical students are on the lowest part of the bottom rung of the hierarchy. Theoretically, we outrank nurses at least in terms of orders concerning a given patient. If we give an order, in theory a nurse needs either to abide by the order or to contact an intern, resident, or attending physician to override the order given by us. In practice, third-year medical students usually want the input of nurses before even doing so much as turning light switches on or off, much less in formulating patient orders. 

In my current surgical rotation, I have fewer opportunities for conflict with nurses than I will have in most settings of my career.  A substantial portion of my time is spent preoperatively, in surgery, and in in post-op. I don't have to make much in the way of decisions concerning patient care. I talk to patients, record vital signs, insert IVs, and observe surgical procedures.  It's not an environment conducive to conflict with nurses. For this I'm grateful. While eventual conflict with a nurse is an inevitable part of this job, neither do I look forward to it.

My brother is in a pediatric clinical rotation. A nurse derided him him because he left her to clean a bed of a patient who had defecated. Because I'm a total wimp and I want the nurses to like me, I probably would have stuck around and helped the nurse to change the bedding and clean up the patient. My brother chose to alert a nurse and to move on to his next patient.  He was within his rights to act as he did. Cleaning up patients and changing bedding are duties of nurses, not of physicians, except in the most extreme of situations. Would there have been anything inherently wrong with my brother helping the nurse with the rather unpleasant task? No. Was he obligated to don his rubber gloves and clean up the mess. Again, no.

The nurses in the hospital make a monthly "Shit List" (no pun intended) of med school students and interns. Matthew would have had an excellent chance of making the list for the month of July had his conflict with the nurse happened later in the month. As it is, he still has three weeks to flash dazzling smiles at the nurses, most of whom will think he is a reincarnated Ben Casey, assuming either the fictional Ben Casey or the actor who played him have moved on. Chances are that by the end of the month, even the nurse he left to deal with the soiled patient and bedding will have forgotten all about Matthew having been less than chivalrous.

Meanwhile, I'll toil away and try as far as possible without surrender to avoid offending anyone.



Saturday, July 2, 2016

The definition of minor surgery is surgery that is happening to someone else.



I don't have to be at work quite so early today, so I've had the luxury of playing musical instruments, reading, and watching a little TV. Falling asleep quickly is an art I haven't quite mastered, but I've been so exhausted from the 13.5-hour workdays beginning early in the day that most days this week I've been lucky to have made  it home without having falling asleep on the five-minute drive to my condo. Having yesterday and today to catch up on sleep has been like a gift.

I've scrubbed in for a lot of surgeries this week. The surgeries I've seen thus fafr have been abdominal surgeries. Most of what I'll see in this rotation will be abdominal and lower thoracic surgeries, though I'll have a  week each of cardiac and neurosurgical procedures. If I'm interested in more, I'll need to request elective rotations in those sub-specialties.

I scrubbed in for a procedure that I won't see much of in this rotation, which was a c-section. C-sections are normally performed in the surgical suites in the maternity wing, but all four were in use when membranes ruptured in an expectant mother of twins with placenta previa. The OB-GYN wanted to get the babies out sooner rather than later. The babies (boys) were big as twins go - 6 lbs, 3 oz. and 6 lbs.10 oz. They were in separate sacs, which could mean dizygotic (fraternal) or monozygotic (the OB-GYn predicted monozygotic or identical, but said it would take further testing to determine with certainty) and have the same blood types. The delivery proceeded with no complications. I would have liked to have followed one of the babies, but the intern supervising me wanted me to see the entire surgical procedure. When I have my OB-GYN rotation in a few months, I'll get to see lots of deliveries and will have opportunities to follow the babies as they are evaluated. 

Personnel in surgery risk being sprayed or dripped on with every body fluid. I wear goggles even if I'm told there's no chance of being near enough to be doused, because there's never any guarantee of not being hit; the human body has amazing ability when it comes to expelling body fluids. I put double plastic bags over my shoes before covering them with surgical booties because I know too many people who have had perfectly good shoes ruined. It's not even the expense of replacing shoes that would bother me; I don't have the time to buy more.


Tuesday, June 28, 2016

Beware of People Wearing Short Lab Coats

She looks even younger than I do, which is because she's not an actual medical school student. 


People who wear short lab coats are typically medical school students. It behooves you to remember this, particularly in the next few weeks, as teaching hospitals everywhere have been inundated with rookie third-year medical students. There's nothing unusual about this year.  The same thing happens from mid-to-late June of each year.

We've been trained to insert IVs and to perform a few other routine procedures. Everything else we need to know, which is a whole hell of a lot even in my case, and I'm arguably one of the higher-functioning third-year med students a patient might encounter, we will learn at the expense of our patients.  Isn't that a comforting thought? 

If you're planning to be injured, ill, or otherwise in need of hospital services for the next month or so in particular, it may be in your best interest to steer clear of teaching hospitals. Perhaps, however, you are the adventurous sort of person, who likes to live close to the edge and enjoys the opportunity to roll the dice and to take his or her chances on occasion. If so, come on in! We'll be more than happy to practice on you!

I've survived the first two days of my rotation in the surgery clerkship.  I inserted  six IVs (on the first try fives times and on the second try once) and scrubbed in for eight surgeries including two appendectomies (one laparoscopic and one w/ laparotomy), two cholecystectomies, three miscellaneous intestinal surgeries (one with colostomy, which should be resected following healing of the lower colon), and one pancreatiduodenectomy.  

Third-year medical students are on the very lowest of the low rung of the patient care ladder, ranking somewhere beneath candy stripers  (everyone actually treats us as though we know less  than hospital volunteers except that except that they expect us to insert IVS). In fairness, they shouldn't treat us as though we know much, since we don't. I would like to think, on the other hand, that most of us already know how little we know and don't have to be reminded of it multiple times every half hour. I may be wrong there, though. If we didn't know our places, some of us might grow complacent. 

Not only are we the lowest of pond scum in this place. We also have to be on duty before anyone else in the surgical team. Nurses work whatever shifts they work irrespective of scheduled surgery times. MDs and future MDs arrive in reverse order of our rank and importance. We're expected to be here at least ninety minutes before our first surgeries, and are expected to know everything about the patients including history and current stats in order to update fourth-year students, who update residents, who update attending physicians.  

Those who outrank and supervise the other third-year students and me are a microcosm of relatively-educated-to-educated society as a whole. Some have over-sized egos or are otherwise jerks,  some are in-between, and some are nice and go out of their way to be helpful. This is what I would have expected. 

It's exhausting work, but it's also incredibly exciting. I'll share more when I get twenty-four consecutive hours off in a few days.

Friday, June 24, 2016

The Apparently Cognitively Demanding Art of Naming a Child



When I was in third grade and lived in the northern California community of Fairfield, I had a friend named Brooke. Brooke was an only child of two moderately eccentric parents.  Brooke's mom was a part-time English teacher for the local high school district. Her father was a pharmacist at a local drug store. Brooke's parents and their aberratons could probably make up an entire abnormal psychology dissertation, but I'll save the dissertation for another occasion. I'll just discuss the birth of Brooke's baby brother tonight. 

Brooke's father, Mr. Pierce,  made himself and his strangely contentious tendencies known in our community in multiple ways, but one way in particular, which happened when I was still living in his community and was still a close friend of his daughter, stands out in my memory.  The Pierces had their second child -- a boy --  in December of the year Brooke and I were in third grade. Despite being in the Pierce home frequently, I had no idea Mrs. Pierce was expecting a baby. The baby was born about six weeks before his due date, which might have explained why Mrs. Pierce did not yet look like a beached whale, but I'm still not sure how they managed to keep all of us so thoroughly in the dark. Mrs. Pierce taught high school students, and even they were supposedly surprised by the addition to the Pierce family.

I didn't see Brooke at all during Christmas vacation. Then Brooke came back to school after Christmas break with her exciting announcement and with spread-eagle action shots of her mom pushing a kid out of her nether regions, followed by the obligatory breastfeeding photos in which Mrs. Pierce was nude from the waist  north. Our teacher, Mrs. Cole, was seated at her desk as Brooke held up each photo from her baby brother's  "birth story" and  couldn't see as Brooke held up the pictures for the children in the class. Mrs. Cole was in the process of completing and submitting her master's thesis that semester and took every available opportunity to rest on the district's dollar. Eventually she lifted her head off her desk for long enough to notice the class' s too-rapt attention to what Brooke was sharing, and wandered over to have a look for herself. The sharing session was abruptly halted. Mrs. Cole very likely had to field parent phone calls that evening concerning the rather explicit photo-sharing opportunity, though I don't recall anything every coming of it.

What I do recall was that, as she was helping Brooke to gather the photos, which she held in her desk for safe-keeping for the remainder of the school day, Mrs. Cole absently asked Brooke what her parents had named the new baby boy. "They haven't decided yet," Brooke answered.

Not too many days later, Brooke was especially excited as the class filed into our classroom. "Mrs Cole!' called out eagerly, "May I share?"

"Do you have any pictures to share this time?" Mrs. Cole asked with understandable apprehension.

"No, I just want to tell everyone something," she said as Mrs. Cole let out a sigh of relief.

"My mom and dad thought of a name for our baby!" she blurted out. "We're going to name him Adam!"

"Very nice," Mrs. Cole said absently.

The next day, Brooke half-dragged her feet, half-stomped them as we made our way into the classroom. Mrs. Cole asked her if anything was wrong.

"My dad said we can't name the baby Adam," Brooke responded.

"Why?" someone in the class asked.

"Because it's from The Holy Bible,"  Brooke explained. "He doesn't like any names that are from The Holy Bible."

"Didn't he know yesterday that Adam is in the Bible?" someone in the class asked. 

Brooke just shrugged.

A few days later, Brooke was once again enthusiastic as she arrived for school. She again asked to share with the class. "No pictures, right?" Mrs. Cole asked before granting Brooke permission to share.

Brooke once again took her place at the front of the classroom. "We found a name for our baby," she declared. "We're going to name him Todd!" 

One of the boys asked if there was anyone named Todd in the Bible. "Not that I know of, " Brooke replied. I remember not being particularly fond of the name Todd, but was relieved nonetheless that the poor child was finally getting a name.

The next day Brooke was once again less than cheerful as she entered the classroom. She didn't even wait for permission to address the class.  "We're not going to name him Todd, either," she muttered.

"What's wrong with the name Todd?" Mrs. Cole asked.

"Too many drug addicts are named Todd," Brooke explained. Mrs. Cole stifled a  laugh. Mr. Cole was named Todd.

A week or so later, Brooke was once again visibly excited as school began. "We found a name!" she enthused.

"What is it this time?"  Mrs. Cole questioned her.

"Jeremy!" she announced.

The next morning Brooke wore a frown as the  school day began. someone in the class asked, "Did your dad find something wrong with the name Jeremy?"

"Yeah," she snarled. "Too many black people are named Jeremy."

"Really?"  Mrs. Cole queried as the walked over to the white board, picked up a dry erase marker, crossed Jeremy off the bottom of a list of three names and left blank the space for the reason as she glanced nervously at Michael, the sole African-American student in our class. I hadn't noticed the list before. I didn't know when she started it.

The next name to be added to the list, if I recall correctly, was Franklin. Franklin was crossed off because Brooke's dad thought too many communists were named Franklin. Chad was added then removed because too many Okies were named Chad. Justin was axed because almost every homeless guy Brooke's father had ever met was named Justin. Bret didn't survive the cut because it was a very common name for male hairdressers. Too many homosexuals were named Evan. (One little boy asked what a homosexual was. "Someone who is gay," I gladly contributed to his knowledge base as Mrs. Cole cringed.) Too many criminals were named Nathan. A disproportionate number of religious zealots were named Stanley. Too many Canadians were named Jeffrey or Geoffrey. Too may welfare recipients were named Aiden. Too many child molesters were named Caleb. Too many Catholics were named Anthony. Too many truck drivers were named Keith. Too many pimps were named Jerome. (I doubt anyone in the class other than Brooke knew what a pimp was, but we all sensed it was a good idea to leave that one alone.) I remember Mrs. Cole saying "I saw this one coming from a mile away" as she crossed Kevin off the list because it was too Irish. 

Mr. Pierce's list of prospective names and the reasons for rejecting them the next day, in and of themselves, comprised an entire course in sociology. One night at dinner as I was sharing the latest name and Mr. Pierce's reason for rejecting it, my mom mused aloud that she suspected that Mr. Pierce was sober in the morning when he or someone else in the family came up with the name, but then threw the name out for the first reason that popped out once his blood alcohol content reached 0.24. In retrospect, there was probably more than a shred of truth to her theory, although, considering Mr. Pierce's line of work,  a substance even more potent than alcohol may have been the operative agent. My dad didn't say much of anything as I recall. He and Mr. Pierce had once bonded over a bottle of Atomic Fireball whiskey, which they took turns passing back and forth and pouring into their fruit punch as they sat through an especially tiresome class presentation of an obnoxious parody of Snow White. My dad was one of the few adults in the community to whom Mr. Pierce spoke voluntarily.

The list grew so cumbersome that it practically took over our entire front white board. (When Open House was held the last week of April, Mrs. Cole discreetly papered over the part of the white board containing the list with a display of our Mother's Day haikus, but Brooke enthusiastically tore our haikus from the wall the next day as she came in with her latest name addition to the list.)  When the list reached the point that Mrs. Cole could no longer put our daily oral language assignment on the white board, she carried a long strip of turquoise butcher paper from the office, which she attached to the wall next to the front white board. The children with decent printing (every girl in the class except I and one boy in the class named Ian) took turns transferring the names and the reasons for their eventual rejection onto the butcher paper. By the next-to-last day of school, the list extended from the ceiling almost to the floor. There was room for one more name if it was printed in tiny letters.

On the penultimate day of third grade, Brooke arrived with one more name. She seemed especially excited as this one rolled off her tongue. "Robert is on both sides of the family. William is on both sides of the family. Harrison  was my mom's last name before my parents got married. Pierce is our last name!" I recall Brooke being as proud of the compromise that her family had reached in composing this masterpiece of a name as she might have been if they had come up with the Magna Carta or the quadratic formula. 

Mrs. Cole said something to the effect of "Don't get too comfortable with the name. There might be too many Quakers named Robert William Harrison Pierce," as she knelt on the floor to print what would be the final name submission. Much to Mrs. Cole's and to many of her classmates' surprise, Brooke didn't announce a repudiation of the name when she arrived at school the next morning. I'm not sure at what point the name became legal, but Will, as he was called by the family, is now thirteen years old and is still Robert William Harrison Pierce.  

Brooke took the butcher paper list of all of her brother's potential names home with her on the final day of school. Mrs. Cole was concerned that Mr. and Mrs. Pierce might be offended, but Brooke assured her that it her parents were not easily offended. If Will were born today, he would probably have an entire Facebook page dedicated to his potential names and with anyone in the cyberworld who had an opinion weighing in with it in the "comments" section. Alas, as he had the misfortune of coming into existence even before MySpace, the saga of his name is memorialized only on butcher paper and now in this blog.

Interestingly enough, Robert William Harrison Pierce is only one of two children I know who had teeth in place well before their parents got around to naming them. My parents' friends the Ratzlaffs took almost five years to come up with the name Michael for their little boy. 














Saturday, June 18, 2016

Graphically Violent Fiction



The content of fiction is essentially without inherent limitations, at least as adult authors are concerned. The First Amendment to the Constitution of the United States of America protects any person's right to dictate the content of any work he or she creates. In practice, this carte blanche extends only to adults. Constraints to content may also be enforced by anyone who wields control over any given forum through which any given work may be presented: a publisher generally publishes what the publisher desires to publish, or the owner of a website chooses what may appear at the website, for example. Furthermore, a minor's right to freedom of expression extends only as far as the minor's guardian allows it to extend. For the most part, however, as long as the creation of a work of fiction is neither an act of plagiarism nor of libel, the author's will reigns supreme.  Just because anything can be written in the name of artistic license under the banner of fiction, however,  does not mean that anything under the sun necessarily should be written.

I'm rapidly approaching a chapter of my life in which leisure time will become a distant memory. Any extra time that I'm fortunate enough to find will probably need to be devoted to sleeping, studying, or taking care of absolutely essential business. Consequently, I've been trying to spend almost every spare minute in these past few days either practicing one of my musical instruments or reading.
I've used a few gift cards as well as my Kindle Prime account  to access and read nearly forty books in the the last seven days.  Not everything I've read this past week would impress an internship/residency interview panel. In fact, some of my recent reading material has been the literary equivalent to junk food or worse.  Even with my very relaxed standards at the moment in terms of what Kindle books were worthy of my time, a particular Kindle book has caused me a bit of concern. I will not  name the book or author, or provide too many identifying details here, as I don't want the author to google himself and come across my blog. I'd really prefer to stay off the person's radar screen. If you're interested, feel free to email me or to otherwise ask, and I'll be happy to be more specific.

The book that is bothering me me tells the story of a young man who went through an LDS temple ceremony and was bothered by parts of of the temple ritual.  Other forces as well seemed to be conspiring against the young man. He dealt with his cognitive dissonance by returning to the LDS temple [a year to the day after his initial visit] and shooting everyone he found there.  The descriptions of the action in this shootout in the temple are every bit as graphic and sensational as one might imagine.

I'm not trying to serve as the arbiter of what should or should not be written or published.  Moreover,  LDS temples are far from my favorite places in the universe. I suppose that, on some level, perhaps I can understand why,if a fantasy mass murder has to happen somewhere, an LDS temple would be as good a venue as any.  Nonetheless, I'm not sure it's prudent for modern fiction to feature mass shootings. With terrorism hate crimes of all sorts happening almost everywhere a person looks, and likewise with the inability of some perpetrators of crimes to come up with original ideas for their acts of violence, it might be better not  to provide such challenged individuals with ready-made plots for the Lifetime movies in which they hope to be featured posthumously. 

When I described the movie to my mom, she talked about attending an educators' conference of some sort at which a presenter addressed the topic of graphically and explicitly violent student writing and artwork.  It was all the more ironic after the fact, my mom said, that the presentation was happening just before 10:30  (PDT, one time zone away) on April, 20, 1999. As Dr. Anita Archer of San Diego State University was discussing explicitly graphic student writing, Klebold and Harris were opening fire on the students and staff of Columbine High School. The timing really couldn't have been any more eerie. If that were to happen today, someone would be accessing news on a phone almost as it unfolded. In 1999, though, phones with Internet access were in their early stages. It was extremely unlikely that anyone at that central California event had one.

Dr. Archer told the school personnel something to the effect that a common thread among perpetrators of heinous crimes was that many if not most of them had written disturbingly violent material as students. (Klebold and Harris both had histories of including explicit violence in their writings for school assignments.) Dr. Archer told the educators, among other things,  that they should not allow student writing or artwork graphically violent in nature, and that it should be turned over to proper authorities if it was submitted.

While schools have far more latitude than does society in general in banning graphic violence in written work or artwork, some discretion is obviously in order. Going so far as to say that no one can ever be hurt or killed in any story written at school or for school purposes would be a mistake in most instances. Allowing unlimited explicit violence would be erring equally in the opposite direction. An educator with an IQ approaching 90 should be able to find an acceptable middle ground.

I have no idea what the author of the story described earlier hoped to accomplish with his account of the young man exacting revenge at a Mormon temple. In a perfect world, a person could write a work of fiction with a disconcerting plot. It would be fiction, after all. Writing a work of fiction in which an event takes place shouldn't have to be considered one and the same as condoning the happening of said event.  On the other hand, the world we live in is anything but perfect.  

Stephen King writes all sorts of stories in which characters behave in a deviant manner and commit bizarre crimes. I haven't noticed a lot of psychos imitating the stories of Stephen King in real life.  Perhaps it's just crimes with shooting sprees about which many of us are extra-sensitive now. I only know that if I were a seventh-grade English teacher grading that story as a writing assignment, I would be most uncomfortable. And if it's not OK for a seventh-grader to write it, is it really any more OK for an adult to write it?  Where do we draw the line?



  








Friday, June 10, 2016

Red Alert!



I wouldn't ordinarily wake people up just before 4:30 a.m. to make an announcement (I know I'm not actually waking anyone up by posting a blog, and that you don't all have alarms set to sound as loudly as sirens at any time a new post appears on my blog so that you  can all run to your computers or grab your phones to catch every word as soon as i hit the "Publish" button, but please humor me in this moment, as my present level of distress is so intense that I deserve to be humored right now), but this one is big. REALLY big.

I have an acne blemish on my forehead. An honest-to-God pimple has dared to invade my heretofore unviolated skin.  It's the real deal -- a zit measuring nearly one millimeter in diameter.

i woke my dad up to demand an Accutane prescription. He said no. (I won't share his precise wording because I've thus far managed to maintain a more-or-less PG13/TV14 rating on this blog, but suffice it to say he denied my request.) When I refused to be so easily dismissed, he got his lazy butt out of bed to find a prescription pad and to scrawl out a prescription for a weaker retinoid, which he insisted was still the dermatological equivalent to treating a hangnail with chemotherapy, but he knew that sleep for him tonight  would have  been a lost cause if he had not written me a script for something

Retinoids used for treatment of acne reduce inflammation and inhibit pore-clogging. In the event that anyone feels the need to log onto WebMD or Wikipedia for the purpose of  acquiring and sharing the knowledge that retinoids are Vitamin A-based, are used for multiple skin conditions including but not limited to wrinkles, age spots, and types of skin cancer, and have been known to be associated with birth defects when used by pregnant women, please keep in mind that I've completed two years of medical school and could have authored the Wikipedia article myself if I had felt thus motivated.

I drove to a twenty-four hour pharmacy and had the prescription filled, and have applied it to the nasty excrescence, which is not a whitehead but, left to its own devices, could easily have turned into one before dawn. I also ordered express delivery of basically every product that the Proactiv company markets. I'm declaring nuclear war on acne. If I had an important event tomorrow, emergency remedies exist to wipe out a single zit in less than twenty-four hours, but since I don't have to leave the house, I won't demand such extreme measures just yet.

I am accepting any and all expressions of sympathy.



Wednesday, June 8, 2016

The Book of Mormon in Real Life, People Who Drink Wine, and the Best and Worst of TV



I am so amazingly in vacation mode that my brain is on vacation as well. I'm functioning with what little IQ it takes for a person's autonomous body functions to be  more or less in order plus still maintain the physical ability to manipulate the TV/DVR remote. A friend from med school is here with me. If the truth is to be told, she's functioning not much if at all higher mentally than I am tonight, and we really haven't even had much to drink. OK, I  haven't had much to drink. She's had plenty. 

We're watching some of the greatest and worst TV we can find on any source, including HULU, Netflix, old borrowed or stolen DVDs, and YouTube. In a few moments I'll announce our personal awards for the very best and worst TV has ever had to offer.

But first . . . my mother very graciously offered to accompany a couple of Mormon missionaries this Sunday while they sing some lame-ass song about the Mormon religious bullet point du jour, which is The Atonement. I'm not making light of The Atonement, really. It was a very gracious thing for Jesus to have done. I just think the Mormons are a bit confused about it. I think they even believe it happened in the Garden of Gethsemane (Is that in the Middle East, or is it in Missouri like the Garden of Eden is?) as opposed to on the cross. Regardless of how literally or figuratively a person takes any of this, what would have been the point of Jesus dying such a horrific death on the cross if he had already atoned for the sins of the world in the Garden of Gethsemane? I don't get it.

Anyway, back to my mother and the eighteen-year-old mishies. . . when they were supposed to practice with her this evening, they totally no-showed. I don't know if they realize that my mom was offering them for free what she normally charges something like two-hundred dollars per hour. (I'm talking about her piano accompaniment, by the way. My mother is not a whore,  and you need to get your mind out of the gutter if that was the direction in which your mind was headed.)  So my mother sat at the piano and practiced for about thirty minutes  -- not their lame-ass song, incidentally. She, or I, or probably even my brother's cat Ashley Madison could have played that stupid song in its full arrangement with just one hand (or paw) while blind-folded and wearing earphones blasting Black Sabbath, but instead something by Bach, which, if I recall correctly,  was The Goldberg Variations. After thirty minutes, my mom got tired of waiting for the Mormon missionaries, so she opened a bottle of wine and poured a glass for herself. (My visiting friend also helped herself to a glass of the wine.) By the time the mishies got around to calling a couple of hours later to say they "forgot," my mom and my friend had polished off the bottle and were midway through a second.  Suffice it to say that my mother was not at her most circumspect when she took their phone call. C'est la vie.

I shall return to the main topic of this post, which is my friend Wendy's and my television awards. The worst TV series in history, we're pretty certain, is 7th Heaven.  The casting is horrible, the acting is worse, and the writing is worse still. 

The worst reality series, while most are bad, is probably anything with the Duggars in it. It was heinous before we knew there were perverts and victims right before our eyes pretending to be wholesome and mentally healthy. Once the real scoop was dropped like a bomb, even watching commercials for it became unbearable.

The worst food show is anything with Bobby Flay in it. I'm pretty sure it is physically possible for a person to contract an STD just from watching Bobby Flay on TV.  That's the story my cousin used to explain his STD, anyway, and he's sticking with it.

The best rerun to watch when you're drunk or stoned is something from the Law & Order genre. There's so much crossover between actors who played perps in one show, victims in another, then cops or ADAs in another that you think you are drunk or stoned when watching it even if you're not. You have to be drunk or stoned to be able to delude yourself into thinking Angie Harmon is anything but an aging model or perhaps a crash-test dummy, besides. Has the woman ever had an acting lesson in her life? Where did they find her?

The best TV courtroom show is Judge Alex. No explanation is necessary. Just watch it when it becomes available in reruns soon.

The stupidest yet most compelling medical drama or whatever it is ever to be televised has to be House, M.D. The entire premise on which the show is based is so utterly asinine that it's pointless to try to justify the show's existence except that the acting is incredible and the writing is even better. It is also the source of my nickname (Cutthroat Bitch), which sticks to this day.

The greatest sitcom episode in history is the Greg Pikitis episode of Parks and Rec. If anyone ever erases it from my DVD either at home or at the condo, I may be forced to commit premeditated execution-style murder.

My mom left her cell phone in my room. The Mormon missionaries are still texting her. I thought they were supposed to go to bed at 11:00 or something like that.  Maybe they're texting her from their beds. They probably have serious hots for my mother in a sick, sordid, "Mrs. Robinson" sort of way. I don't know if I should leave well enough alone or text the missionaries back pretending to be my mother.


a still shot from the famous Greg Pikitis episode of Parks and Rec





Monday, June 6, 2016

I should have just taken the easy way out and read OH THE PLACES YOU'LL GO.



Did I ever share that speaking in public is, for me, about as high on my list of Things I Want to Do as is transporting a hornet's nest from California to Utah with my bare hands? If I didn't, it's just something that slipped my mind, because it's the absolute truth.

I  mentioned about a year ago that the high school from which I graduated had asked me to speak at its commencement ceremony  this year. It's a tradition for my alma mater to pick a student from the graduating class of five years earlier who would seem five years after graduation to embody the qualities for which the high school's administration would wish for its current crop of graduates to strive. The choice of a graduate speaker is tough at best, as we're at a point at which most of us are either barely embarking on careers or even still in school of some sort. The choice can be political. For whatever  reason, local community leaders are competitive in regards to whose offspring has been invited to speak at graduation and whose hasn't. 

To the high school's credit, the administrative panel who makes the choice as to whom to extend the privilege of speaking at the commencement ceremony hasn't been overly exclusive. Two years ago, the guy who spoke was a community college graduate who had founded and funded a nonprofit organization that filled in some of the gaps of social services in existence for foster children aging out of the foster care system. Higher education isn't something at which to be scoffed, but in all seriousness, I could join my father's foundation, and we might someday achieve our ultimate dream of finding a cure for lymphocytic leukemia, yet I'm not at all certain that what we would have accomplished in doing such would have been greater than or even equal to what the guy who helps foster children in transitioning to adulthood does on a daily basis.

One of the very last things I really want to do with my free time is to deliver a speech of any kind anywhere. Yet there is a concept  known as obligation.  I received a quality education from my high school, and perhaps I owed it to them to show up and to say a few words on behalf of the graduating class, not that it mattered to any of the graduating seniors in the least if I did or didn't. Someone else would have shown up to speak had I not done so. In the end, I did what I thought was the right thing to do, and I showed up. I suppose maybe it did matter to the graduates that it was i who  came because I used up only five of the ten minutes allotted for my speech, so the grads escaped the confines of their ceremony and were free to party five minutes earlier than they otherwise would have been.

To me, the very idea if choosing someone just five years out of high school to speak to graduates is a ludicrous idea. People of my age and experience level little of substance to share with kids just leaving high school. And, for that matter, the administrators could end up making themselves look foolish, as they did four years ago, when the person they invited to be the alumni speaker less than a year later ended up in federal prison for having used his computer and printer to manufacture counterfeit cash. 

I tried to get Matthew to deliver the speech for me. He said he'd go there with me, but that  he was not giving the speech this time. If they had wanted him, he said, he would have been the one they invited.

I could have told funny stories about high school, but the stories I might have told would probably have been no more or less funny than the ones the with which graduates themselves could have come up. (For those of you who are grammar purists who have a nearly anaphylactic allergy to ending sentences with prepositions, I wish to ease your minds by reminding you that "come up with" is not technically a prepositional phrase, but, rather a phrasal verb.) i could have preached at them about everything people in their age group were doing wrong, but I'm only five years ahead of them in school and only three years older than most of them; my age group is guilty of the very same sins.

I chose to tell the graduates just a very little bit about college and university that they might not yet have considered. I asked for those who planned to become preschool, elementary, or high school teachers to raise their hands. Out of the eight-hundred or so graduates, probably ten raised their hands. Then I asked that the two people on either side of those had just raised their hands to raise their hands along with those of the prospective teachers, then shared that, statistically, odds were that the actual number of teachers would be closer to the number of hands raised the second time than the first.  I mentioned that not everyone who goes to college, or even everyone who completes his or her originally planned degree program, will end up working in that field. For whatever reason, when life doesn't work out as it has been planned, many people end up as teachers. If life works itself out in such a way that one finds himself or herself doing the very last thing many people ever thought they would do, which is to teach, one has the obligation to be the very best teacher he or she can possibly be. The fact that it may not be a career choice but instead may happen by default  will not be the fault of the future students, who deserve and need the very best teachers they can possibly have.

I condensed everything else into five bullet points, some longer than others but all relatively brief. (I'm mildly hyper-thyroid; those of us who have thyroid functions in the high ranges tend to talk fast.) In the end, I wrapped it up in four minutes and fifty-four seconds from the first word to the last. I received a standing ovation, more because of the brevity of my speech than because of anything else, i'm quite sure. Last year's speaker exceeded his allotted ten minutes by an additional six.

Bullet Point #1 consisted of my opinion that the guy I would consider to have achieved more than any other graduate in the history of our high school (and we have Nobel prize winners among our alumnae) only went as far as junior college. We can all earn PHDs, but ultimately someone has to remove trash from the streets and repair broken  refrigerators. Education is a good and noble thing, but neither should any of us be education snobs.

Bullet Point #2 was that that while college is supposed to be a time of broadening one's horizons and exposing oneself to new and different ideas, college or university success is also about a series of hoops through which one must successfully jump if one wants to earn the piece of paper conferring a degree. In each course of somewhat subjective subject matter, every professor has something he or she wants to hear. The job of the student is to figure out what it is that professor wishes to hear and to tell it back to him  or her in every paper and on every test. A student can make every course a battle ground and can butt his or her head against a wall in a twice-weekly basis and  can walk away with a C at best in every course, or can make the system work for himself or herself. It's a personal choice, but an easy one for anyone with common sense  One will have a whole lifetime to practice the Shakespearean principle of being true to thine own self. For now, take the grade.

Bullet Point #3 was  that conversate is not a word that is even spoken, much less written, by educated people. Its popular usage sprang from the clientele of Jerry Springer, Judge Judy, and Judge Alex. 

Bullet Point #4 was that anyone who planned to attend college had the option of affiliating with a Greek system or not doing so. To pledge or not to pledge is another  entirely personal choice, but one should not be so foolish as to operate under any delusion  that fraternity or sorority membership would in any way make a person better than he or she was without fraternity or sorority affiliation or superior to anyone who did not have such an affiliation. 

Bullet Point#5 was that however rough a day, week, or year anyone is having, chances that are someone else is having it even rougher. Sometimes you don't know who that person is, but if you open your eyes just a bit, you will see. Offer a kind word. Offer a granola bar or a meal if a fellow student is hungry and still waiting on funds. No one expects anyone to empty his or her bank account for anyone else's benefit, but a piece of fruit or a package of ramen noodles won't set a person back very far. Sit by the person in class that no one else usually sits near. Help to explain a difficult concept to a struggling student. Don't be the asshole (I didn't actually say asshole, BTW) who asks deliberately confusing questions in class just to show off when others in the class are doing everything they can to understand even the basic subject matter. Above all, be kind to others whenever one can. I've never once regretted any act of kindness I've committed.

I'm just hoping now that I don't end up on Youtube. I didn't say anything profound enough really to merit such a posting, but then, I've seen a whole lot of stuff on Youtube that wasn't particularly profound.







Tuesday, May 31, 2016

The test is finished!

Have a LifeSaver . . . It'll make you feel better.


Security concerning the USMLE is tight, and so I cannot say much here about it. I had a bit of trouble with vomiting before and during the test. Because I tossed my small breakfast before the test, I knew when the waves of nausea began to hit as I was preparing to enter my testing room that I needed accommodation in the form of a wastebasket into which to upchuck. The monitor initially dismissed me with an "Everyone here feels that way. Get over it." I promptly hurled into the trashcan that was at his feet. There wasn't a great deal left in my stomach, but there were just enough gastric juices remaining to impress the monitor.

The monitor/proctor's first course of action was to attempt to get me to reschedule and even said he was reasonably certain the rescheduling fee (not cheap, by the way) would be waived since I had vomited in the presence of a testing center supervisor. It reminded me a bit of middle school, when a kid had to barf in the presence of an adult to be considered sick enough for a parent to be called. Even physical evidence of the vomitus itself wasn't sufficient. For all the school health aide knew, it could have been a can of Dinty Moore beef stew that a kid opened and poured at some opportune location in order to get out of school.

Nauseated or not, I didn't push myself this far to skip out the morning of the test and prolong the agony for another three to twenty-six days. I know my rights, or I at least pretend really well to know my rights. I was determined to take that damned test today. With my gastritis limited to my oral cavity, the test was doable. 

The testing center goons first had to determine that I was not risking anyone else's health with my presence. It's never a great idea to be around anyone who is throwing up, as fluids from the healthiest of bodies are germ-laden. Still, I was not carrying any more contagious germs than was the average person. Mine were just flowing out of me a bit more freely than were those of my co-test-takers and proctors.

A testing supervisors paged a physician's assistant who was on-call with the center. He (the PA) concluded that I had no fever and no evidence of norovirus or any other "stomach flu" type of bug. He said that if I was to throw up nearly constantly, however, I would have to give up on  the test for the day. I requested his definition for throwing up nearly constantly. He said that what I did in the privacy of the bathroom on my breaks was my own business, but I was allowed only three more incidents of vomiting in the testing center. At the sign of the fourth episode of puking, I would be forced to leave. I made it with about two minutes to spare. Not thirty seconds after exiting the testing center building, I was tossing cookies into an area overgrown with foliage.

The PA didn't want to prescribe anything for me (although he gave me lots of Lifesavers to suck on and water to drink), but I convinced him to call one of the many doctors who have treated me so that one of them could tell him that I can take Zofran safely. He made the call, and about thirty minutes later, someone arrived with the tablets that dissolve in one's mouth. Without them, I don't think I would have kept my throwing up incidence to the maximum of three episodes.

One might wonder why in hell I wanted to continue with a test when I was too ill to hold down any food. Have you ever had one of those days where, despite whatever might be wrong with your body, you knew your brain was working at maximum capacity? I totally had my mojo, mentally speaking, today. I suspect I could take that test ten times and not score as well as I probably scored today. We will not get results until three to eight weeks from today, but I'm not worried. If anything, I may have over-scored. If you do too well on a medical test (MCAT, USMLE), sometimes interview panels for programs get the idea that you're too cerebral to relate to the population in general and are thus not good physician or surgeon material, at least for their programs, except in cases of rare specialties (neurosurgery et al) where eccentric-to-abnormal behavior tends to be the rule rather than the exception. 

My MCAT was higher than was comfortable for some of my interviewers. On the other hand, I have what my dad describes as  a "gift" of not coming across as tremendously intelligent when I speak. It sounded more like an insult than a compliment when my dad said it, and it probably was intended as such, but I get from where he was coming. With my dad, it's very difficult for him to disguise his high intellect when he talks unless he's drunk, and even then, he usually just just sounds like an exceptionally bright drunk. My mom, on the other hand, is almost as intelligent as my dad, but doesn't have to make it obvious when she speaks that she's operating on a higher plane than about 98% of the people around her. She can speak "academese" with the best of them, but she can also sound like a typical soccer mom if such is her intent, though such is not usually her intent. Perhaps in some way it's a form of  dialectical giftedness to understand and to be able to converse  both in academic and in less formal language -- to cross seamlessly from one linguistic world to another --  to be able to turn the Nikola Tesla vocabulary on when needed or off when the vernacular is more useful or appropriate. Then again, maybe I sound stupid because I am stupid, and my test scores and grades are all fallacies.

Soon enough, I'll be going through the interview process again -- this time for an internship/residency position. I'll then find out if my scores are high enough to pose a problem for me (to me it sounds like a lovely problem to have; I'll
be happy to have a decent score, period) and if my common manner of speech is either sufficient to put the panel at ease concerning my supposed humanity (what other than human -- unless it's sub- human -- could I possibly be?) or so lowbred as to convince panels that I'm not suitable for the practice of medicine. As with so many other things, time alone will tell.