Friday, November 18, 2016

The Continuing Saga of the Lost Tribes



It's official. Cousin Dan is tracing the roots of many of the followers of Menno Simons. He'll start out by flying to a region of Paraguay known as the chaco, or, more properly, el chaco. From there he'll hit Europe  -- first the Netherlands and Switzerland, then on to west Germany and east Germany and the Ukraine and parts of Russia, then will fly (supposedly first class) back to North America via Canada, then down into the plains states and to Pennsylvania. Though he believes the Amish, who are also part of the same Anabaptist movement from which the Mennonites sprang (I believe the  Amish form of worship and of lifestyle came from Menno's teachings as well) re also a part of Israel,  he will not be concentrating on them on this trip. He has an idea that the Amish might be descendents of Levi, who doesn't technically have a tribe despite being a son of Jacob (Israel), but instead fills the large group's quota for priests, except that they're all lost . .  . in theory, anyway . . . What good is a priest to anyone if no one knows where to find him? 

Then Dan is coming to California. He's not coming all that close to where I live, though the timing is such that I may be on vacation and be a considerable distance away by the time he gets here, which is good, as he's probably prepared to drive half the length of the state to try to track me down in order to siphon money from me. He's not getting any [money from me] and I would have no problem telling him that in person, but I would just as soon not waste my rare free time telling him anything. He's traveling to the Fresno area because a particular denomination of Mennonites , the Mennonite Brethren, have a seminary in Fresno and are somewhat concentrated between Madera (north of Fresno) and Reedley  (southeast of Fresno), though the other major U.S. Mennonite denomination. Mennonite Church  USA, has a sizable chunk of membership in the central-to-southern San Joaquin Valley as well. (FYI. the Mennonite Brethren denomination exists in Canada as well as in the U.S. I believe the Mennonite Church USA has a counterpart denomination on Canada.

In any even, Dan is convinced that these people are all part of the Lost tribes, but he's not certain that they're of the same tribe. It's one of the mysteries he aims to solve on this mission trip, which may have him gone from just after Thanksgiving until possibly after Christmas. that seems awfully convenient, in my opinion. He's leaving it to his wife to worry about how to pay the rent and the gas bill while simultaneously coming up with something resembling Christmas gifts for their six offspring. I assume his parents will go into debt to get gifts for their grandchildren. Either than, or Mahonri will fall back on his old habit of appropriating the possessions of others. I don't really care as long as it's just Walmart from whom he steals. The owners of Walmart are every bit as bad as Mahonri. It wouldn't kill me to see a few toys stolen from them so my little first-cousins-once-removed get presents at Christmas. My mom says she'd love to fund their Christmas but that she feels that she's sending the wrong message to Dan each time she provides something for his family that he should be providing by his own labor instead of chasing (or pretending to chase if my good friend is right)  the Lost Tribes all over the planet.

The word on the street is that no one from the family funded Dan on this most recent venture. He supposedly found some Cliven Bundy wannabe with more money than brains, and this guy may very well prove the old adage of a fool and his money soon being parted by continuing to finance Dan on his harebrained ventures. Dan already has a few additional trips in the works -- all, after this one, conveniently located in warm-weather venues for the months of January through early March.  

My family, myself included,  plans to be in Europe in late December and early January. I shal be very quiet about my locations for travel, because I can see Dan showing up and pretending to be penniless (it may not even be an act; he's been known to go through money much faster than does the average traveler) on the doorstep of one of our European hosts' homes. They may feel obligated to contribute to his preposterous cause even if my parents tell them not to give him money.

I'm working the night shift and will leave shortly for work. Of late, my schedule has been changed at least as fast as cousin Dan's youngest baby's diaper is changed. I was to fo ahead with my pediatric oncology specialty. Now, since my dad told someone that he's checking on a few European hospitals while we're there , the powers that be have decided that doing that will be more instructional for me than spending the better part of two weeks in  the children's oncology ward here. We'll get most of Thanksgiving week off. I'll then spend the remaining weeks until Christmas break finishing up with Internal Medicine. As a specialty, it is foundational to much of what we do. If anything is to be cut short for me because of my various reasons for mission rotation time, Internal Medicine is probably not what I should skip. Besides, i'm enjoying the rotation.Then, after Christmas break, I'll get a fresh start with my OBGYN rotation. I'm very happy to start it after break and not to have it broken up by the holiday break. I'm most excited to fulfill my OBGYN clerkship. Who wouldn't be?

I've been plagued for the past couple of days with my second kidney stone of my life. i was a bit saddened by his development. A single kidney stone may be a fluke. If a person has a second stone, chances are he or she will have more. It hurts (really hurts) when it gets lodged somewhere and causes a blockage, and it hurts to some degree when it moves as well. A stone, or calculus, was the likely suspect to my discomfort and illness yesterday, but I already knew it was a stone. If a person has had one, he or she will know what it is when the next one hits. The presence of the stone was confirmed by a simple kidney-ureter-bladder x-ray. (I really didn't want a CT scan when i already knew what the problem was and that chances were that a simple x-ray would detect it. I've had and will continue to have enough reasons for excessive radiation in my lifetime without getting CT scans when a simple X-ray will do the job.

Some people have gall bladder problems. (My gall bladder was taken out when my spleen was removed because it looked as though it was going to be problematic in the future; I never had symptoms from it.) Some people are diabetic. Some people get cancer. Some people have horrible allergies.  Some have serious back problems. Some of us are healthier than others, but few of us escape everything. In addition to a bit of rotten luck in terms of injuries, which could have happened to anyone but did happen to me, I have colitis, a tendency toward croupiness, and occasional migraine, slightly low immunity, and now, it appears, a tendency to develop kidney stones. That's life. I would not be willing to be throw my list of maladies into a basket filled with the illnesses of others from any given group, and to take my chances on drawing out and dealing with someone else's conditions. I'll gladly live with my own. There are some narcotics involved with suffering through kidney stones, but I'm pretty good at monitoring my use of narcotics. The hospital monitors it for me when it's an IV thing (typically fentanil or dilaudid). When I'm out of the hospital, it's Vitamin V, also known as Vicodin. I don't take anything stronger (i.e. percocet or morphine)that is available orally. Vicodin in the recommended dosage has to do the job, and I'm careful even with the recommended dosage. My body is far from opiate-naive, but I understand that opiates at their recommended dosages are no longer effective if a person has become accustomed to taking them whether or not they're needed. 

I worked last night after taking the recommended dosage of Vicodin. My supervising resident gave me the equivalent to a field sobriety test, which I passed with flying colors. I had to take an anti-emetic along with the hydrocodone because I was having trouble keeping things down and didn't want a shot or an IV. The anti-emetic, ondansetron, can impair a person's faculties as well, but I functioned fine with it. She said I needed another field sobriety test following each dosage of either drug, and that if I were given anything stronger than Vicodin for pain, it was an automatic end to the shift.  I've missed enough work that I'm not eager to miss more just because of the drugs needed to maintain functionality during  a kidney stone, though I certainly don't want to jeopardize a patient. In all truth, I'm not actually given enough free reign with patients at this stage of my career to cause any real harm to them, but the same standard needs to apply to med students as to interns and doctors. Above all, patients shouldn't be worried that they're being cared for by loopy doctors or doctors-in-training.

I pay close attention -- actually much closer attention than most of my peers do -- to the yearly drug lectures. We're right now slightly less than two-and-one-half years away from the legal ability to prescribe medications of any type without supervision. We'll become MDs in just under eighteen months, but we will not be licensed physicians until we've completed a year of internship. As interns we will prescribe to some degree, though our prescriptions will need to be overseen by licensed physicians. We will not be allowed to prescribe for ourselves legally, but that sort of regularion is very easy to get sround. Doctos desiring to circumvent that rule prescribe for friends and family when it is they  themselves who need or want the drugs. Whether its antibiotics, benzodiazepenes, or narcotics, we have the power to cause ourselves irrevocable harm by freely prescribing medications we don't need.  Lives and careers have been ruined over this practice. i'm very much aware of the problem, and i take it very seriously.

Because of my various maladies, my shrink, Chairman Mao, holds my narcotics prescription form. I ask any doctor who prescribes a controlled substance to me to email him with the information. I also try as far as possible to use the same pharmacy, though such is occasionally not possible due to availability, though I report it to my home pharmacy and ask them to keep a record when I obtain drugs of any kind from another pharmacy.  I have conditions requiring (in my opinion according to my personal pain tolerance threshold) the use of occasional strong drugs.  This could be a problem now, but it's not because I am cautious as are all of my doctors. The peril will grow worse with my ability to prescribe, but with caution, narcotics or other substances need not interfere with any aspect of my life, including my ability to practice medicine prudently and safely. Pharmaceuticals exist to improve our lives. If we're sane about it, such will be the case. 



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