Thursday, October 18, 2018

An Open Letter to the Principal Occupant of 1600 Pennsylvania Avenue




Dear Donald J. Trump,

Because the Democratic Party nominated Hillary Rodham Clinton, who was considered undesirable to a substantial margin of the voting public, as their candidate for the office of president in the 2016 election, and because a frighteningly large segment of the voting public was both woefully ignorant and willing to ignore any moral principles of which they may have been in possession, you were elected.  A technical minority of voters in the election actually voted for you, but because of the antiquated Electoral College system, we are stuck with you in our nation's highest office until the next election at the very least [barring your resignation or impeachment, both of which seem unlikely]. 

As greatly as it pains me to accept such a thing, you may very well be re-elected, as the stupidity of the voring public is apparently difficult to underestimate. If, however, what seems to me to be a most unacceptable contingency actually materializes and you are re-elected, please do not give credit to the educated women of the nation. Whether you win or lose, very few of us will have voted for you.

Sincerely.

Alexis A. Rousseau






Saturday, October 6, 2018

Back in the USA




I am dealing with an ailment and also have overtime that needs to be comped, so I'm back in the states for another ten days or so. My physical capacity is presently diminished, and I've been reduced to watching live coverage of the Kavanaugh confirmation fiasco.  I'd rather be performing hemorrhoidectomies if I had a choice, but I don't have a choice.

When I return to Canada, autumn should be in full force. i'm excited to experience a real Canadian winter. i spent almost a week there in winter a couple of years ago, and I caught a few spring storms when I did my visiting clerkships there, but spending a full winter is an exciting prospect to me.






Thursday, August 23, 2018

While Watching the AntiChrist


This is Marlin, but I couldn't find the guys he put in his TV ad.



I'm waiting around to catch a charter flight back to my new home. Against my better judgment, I allowed my friend to turn the TV to Judge Judy.  local commercials for JJ and similar programming also feature local law firms, sometimes of the ambulance-chasing variety. The commercial I just saw was for Marlin Costello, Attorney of Law. The ad featured several men, presumably attorneys in a law firm, sitting around as very small table, discussing ways in which they could shuffle various cases, drag matters out, create new dealys, and so forth. When one of them picked up the file of a case for which the opposition was being represented by Marlin Costello, the consensus was that they should settle immediately -- that Marlin Costello was not an attorney with whom to trifle. Such may indeed be the case.

Marlin Costello's credentials and skills nothwithstanding, the gentlemen hired to tportray the opposing attorneys look like they were recruited either from some sort of halfway house or perhaps from the new recruit line to an A.A. meeting, long before  time to take any pledge (Do they do that at A.A.?) or learn a serenity prayer.  Whatever is the lamest law school in the nation--probably something online -- I have the most grave of doubts that any of the men protraying the attorneys could have successfully completed the forms to enroll in the diploma mill, much less to have graduated from it, however lax the requirements might have been, and subsequently passing the CA bar exam.  I don't run with an especially elite crowd, but with thirty minutes or so of notice, I could assemble a group of three or four men to portray lawyers in a TV commercial who at least didn't look as though they were just thrown out of a bar in Mendota or Hickman and were perhaps filmed before regaining temporary sobriety.

Perhaps I'm being picky, but I'm confident that you would agree if you saw the commercial. I tried to find a clip but couldn't. Sorry!

Wednesday, August 22, 2018

Back Home Ever So briefly

This picture is random.



I had overtime that needed to be comped, so I traveled with a friend to the Canadian Maritimes. I'm now in California because my aunt had invasive eye surgery, and I wanted to visit her. I also wanted to visit my new first-cousin-once-removed. i would share her picture but her parents and grandparetns are conspiracy theorists who think the child's identity will be stolen by publishing pictures of their neonatal infant.

Monday, July 16, 2018

Wood Eyes and Hare Lips



It wouldn't be one-hundred per cent honest to say that I haven't had time to author a blog post (I did re-post a link to a vlog just over a week ago) since the first day of June. It would be more correct to say that posting an update seemed an unwise use of the little time I have had between then and now. I traveled, then attended official ceremonies, followed by relocating and starting my new job. I probably should be sleeping now, but I slept this afternoon and am not sleepy at the moment.

I shall now share a rather random memory from my childhood for the purpose of illustrating just what a sensitive and odd child I was. My father sometimes tells jokes to my brother and me that aren't politically correct. He did this even when we were very young. He told us a particular joke during a car trip duing the summer between first and second grades, when I was six years old.  I shall retell the joke here, and I hope no one who reads it is offended. 

Once there was a young man who lost one of his eyes either to disease or injury. He wasn't a wealthy man, and so the prosthetic eye he used for cosmetic purposes was made of wood instead of the more modern acrylic. He had self-esteem issues related to his wooden prosthetic eye.

A friend of the man who wore the wooden prosthetic eye encouraged the man to accompany him to a dance one evening so that the man could meet and socialize with females. The man with the wooden prosthetic eye reluctantly agreed to go with his friend to the dance.

Once the two men entered the hall where the dance was being held, the friend pointed out a woman with a cleft lip and suggested to the man with the wooden prosthetic eye that he should perhaps ask the woman with the cleft lip to dance with him; because she herself possessed a physical defect, she might be less put off by his wooden prosthetic eye and more likely to accept his invitation to dance with her.

The young man with the wooden prosthetic eye approached the woman with the cleft lip. "Would you like to dance with me?" he asked her.

The woman's face lit up.  In excitement she exclaimed, "Would I!?! Would I!?!" (Imagine my father's best imitation of a the speech impediment of a person with a cleft lip.)

"Hare lip! Hare lip!" he responded.

My brother and my dad laughed almost hysterically. My mother said, "John, that's tasteless." I burst into tears.

"Alexis, whatever is the matter?" my mother turned from her seat  to ask me.

"Why did he have to say that to her?" I  cried. "She was just happy someone finally asked her to dance. She wasn't trying to make fun of him. Why did he have to be so mean to her?"

I could see my father shaking his head as he probably simultaneously rolled his eyes. My mother sighed, then said, "Alexis, it was a joke. A stupid joke, but still a joke. You don't need to cry about it."

"But she just wanted to dance with him. And he hurt her feelings!" I wailed.

"It never happened, Alexis," my mom continued.  "There was no man with a wooden eye. There was no lady with a cleft lip. And because there was no man with a woden eye and no lady with a cleft lip, he couldn't have asked her to dance. She couldn't have answered the way Daddy said she did. He couldn't possibly have called her a harelip! It never happened."

"Then why did Daddy say it happened?" I demanded.

"He didn't actually say it happened," my mom explained. "He told a lame joke that he probably heard at scout camp when he was about eleven."

I sniffed, and my mom handed me a tissue. "Are you sure?" I asked her.

"I'm absolutely sure," she answered.

"But it's still sad," I sobbed.

"Lots of things are sad," my dad chimed in. "Life is sad, Alexis. Get over it."

"That'll certainly make her feel better, John,"  my mom muttered.

"It's true!" my dad defended himself.

Even though it was only an hour or so before dinner time, my dad pulled into a roadside drive-in and let us order ice cream, which made my brother Matthew very happy.  For roughly the next five years, if we were traveling by car for any length of time, Matthew would ask, "Dad, can you tell that joke bout the guy with a wooden eye and the lady with a hare lip again?" 

Friday, June 1, 2018

A Rose by Any Other Name Would Smell as Sweet. . . Or Would It?



My dad's sisters, for the most part, are not known for possessing exceptionally high levels of intelligence or for using especially good judgment. They seem to have passed these traits on to their own offspring. This is often evident in the naming of their children.

My cousin Lyman, who is the fourth son and sixth child of Aunt Marthalene and her sticky-fingered husband Mahonri, recently announced the birth of his fourth child and first son.  He named the baby Sebastopol. For those of you who do not know, Sebastopol is the name of a tiny town near the the Russian River in northern California. My mom tells me that I've been there, though I have no memory whatsoever of the trip.  I do remember passing through both Guerneville and Jenner (thank goodness Lyman didn't name the kid Jenner), but I'm drawing a complete blank when it comes to Sebastopol. My dad said the family ate really tasty pizza there on a trip through the wine country. The trip happened when I was four, and pizza had not yet made it onto my list of acceptable foods. According to my dad, I had croutons for dinner that night.

The story I heard from my cousin Gina (the iconoclast who tainted the family's otherwise pure bloodline by marrying and coupling with a guy who is half Japanese) is that Lyman and Patience wanted to name the kid Sebastian, but Lyman's wife Patience's twin sister Harmony gave birth two days prior to Sebastopol's birth and named her baby Sebastian.  In Patience's family, it's considered verboten to use first names or middle names by which one is called (Mormons are fond of calling kids by their middle names, often with a first initial preceding the name) that siblings have previously used for their children. If I were Patience, I would have ignored the rule and named the kid Sebastian anyway.  Patience had told relatives during  all four of her pregnancies that her first son was to be named Sebastian. Harmony had four sons prior to Sebastian's birth. Had Harmony truly liked the name Sebastian so freaking much, she presumably would have given the name Sebastian to one of the first four.  The word on the street is that Harmony was just being her usual contentious self in stealing her sister's choice of names.  

Aunt Marthalene, Sebastopol's grandmother,  has been quite vocal in her disapproval of her son's choice of a name for his first son. Neither Lyman nor his Patience have been to California, much less to Sebastopol.  Marthalene sees no problem in saddling children with oddball names culled from The Book of Mormon (Moriancumr), from LDS history and family given names or surnames of her husband's ancestors, some of which qualify on both counts (Lyman, Reed, Boyd, Bradford, Porter, Joseph, Kinnard, Amasa, Kimball, Orson, Hyrum, and Parley), variations of her own name (Marthalette), and a rather outlandish combination of her own and her husband's first names (Rilene).  She has grandsons named Abinadi, Helaman, Ether, Mathoni, and Zeniff, to name just a few. (Marthalene has thirteen sons and two daughters, seven of whom have already begun the reproduction process themselves.)

My mom thinks it's a simple case of the couple attempting to give their child a unique name, though their original choice of Sebastian, while not one the Top Twenty list at any time in the past century as far as I know, is at least not a made-up name. If being unique truly was their aim, they succeeded. My dad thinks my cousin Lyman carries latent anger at having gone through childhood with the name of Lyman.  (My mom says their used to be a commercial for Sprite featuring a mythical fruit called a limon [pronounced like Lyman) that was half lemon and half lime.) Regardless, I'd probably prefer to be stuck with Sebastopol as a name over more than half of the names Marthalene and Mahonri glued on their own kids. i'm not quite sure why Marthalene thinks she has any grounds at all for moaning about it. Hell, I'd rather be named Blitzen Manx or Antarctica Meringue (the names of my Aunt Cristelle's first two children) than any of the names Marthalene used for her children. 
















Thursday, May 31, 2018

Sooner Than You Think: A Prophetic Guide to the End Times (NOT by Sid Roth, though)




I am adjusting to my temporary surroundings at least to a degree. My room is still too small and in too remote a location, but there is a cute little restaurant attached to the hotel, open from 11:00 a.m. to 10:00 p.m., that serves sandwiches on deliciously fresh made-down-the-block sourdough bread and brioche.  The restaurant is basically a crab restaurant, and I would not eat crab unless it was the only option other than Tamsen Donner steak. (That would make crab not technically on my Donner Party List, as only those food items I would reject in favor of death or the consumption of human flesh can be considered to be on the list. Crab is merely a close second to items actually on the list.) I had a most tasty grilled tomato and cheese sandwich on sourdough from the crab restaurant for lunch. (It sounds gross, but the tomato slices were incredibly thin, and the sandwich was actually quite good.) I told the waiter I was allergic to crab, which is a total lie, to ensure that no one would sneak any crab into my sandwich. There's also a very nice bakery, on the same block and same side of the street as the hotel, that serves both baked goods (Duh!) and breakfast and lunch fare. I'll grab something there for lunch tomorrow. 

I have my phone back. The valets are not low-life thieves. My faith in humanity, Donald Trump excluded, has been restored.  Then again, perhaps Trump is sub-human and therefore needs no exclusion.

Speaking of Trump, I watched Tom Arnold's suprisingly lucid appearance on AC360. I had mistakenly believed  that he is an idiot. He had interesting insight concerning the relationship between his ex-wife Roseanne and Donald Trump; he attributed her downfall in part to her having bought hook, line, and sinker into Trump's bizarre conspiracy theories He also said Trump has spoken quite disparagingly of her in the past and was feigning affinity with her solely as an opportunistic measure.  I can believe that. 

I was texting a relative today, and I mentioned in the text that most of the people who work at this hotel bear uncanny resemblances to one or another of the Kardashians or their hangers-on. I left the h out of Kardashian. My freaking phone offered an automatic correction for Kardashian. Can you fucking believe it?  My phone doesn't even recognize the alternate spelling of theatre for theater, yet it apparently knows who the Kardashians are and how their surname is spelled. If we previously lacked evidence that the world is circling the drain of the universe (though I couldn't say as to whether if it is circling in a clockwise or counter-clockwise direction), we now have all the evidence we need in the knowledge that my phone's text-messaging apparatus apparently knows who the Kardashians are. 





Wednesday, May 30, 2018

Earning Money So That I Can Almost Immediately Spend It

I'm not as bad as this guy, but I am suffering mild withdrawal symptoms.


I finished a week of filling in for a calculus teacher in a high school.  In order to be able to pay anyone who was capable of teaching calculus enough to entice the person to take the brief job, I had to be designated as a consultant rather than as a substitute teacher. I was initially a bit intimidated regarding spending a full week teaching high school students, but they wanted to score well on the final exam. They were not out to harass me. 

In just a few days I shall take what I would consider to be a major vacation. I'll be gone for roughly two weeks. I will talk about it after I return.

At the moment I am at a rather swanky "boutique" hotel, though the particular room I was given is less impressive than a room at the local Holiday Inn would have been. The university at which my mom is teaching is hosting numerous students from a university in St. Petersburg (Russia, not Florida). A few faculty members including my mom are hosting the overflow of students. The dorms could accommodate only so many. My bedroom is being occupied by someone else.  No one told me until after I drove here.  My dad went on Hotwire and got a room here for me. He took one of those  "Secret Deals." Next time I shall book my own hotel room.

I would take a picture of the hotel room to underscore just how unimpressive it is except that I mistakenly left my phone in the car.  I'm too cheap to tip a valet to retrieve it for me in the valet-only parking garage but not quite crass enough to ask someone to get it  for me without tipping. I'll have to get through the night without it. (I hope the valet didn't have figuratively sticky fingers.) I'm not nearly so attached to my phone as are many of my contemporaries, but still I feel a bit lost without it.  

I will survive.

St. Petersburg

Monday, May 28, 2018

The Hypotheses of Life



I watched several episodes of The Facts of Life this evening.  I'm certain that anyone reading this is seriously impressed by the cerebral TV fare with which I amuse myself.  Beginning in July, I will have little to no time for frivolity. I'm making up for it now with a vengeance.

A question arose concerning the character "Blair Warner," played by Lisa Whelchel.  I get that the character is totally vain. Are we, the viewers,  however, supposed to consider her to be a total bombshell, or is the joke supposed to be on her in that regard?

Also, I'm curious about her hair coloring. In most episodes, her roots were conspicuously darker than the rest of her hair.  It didn't look like a weave. Instead, it appeared to be a grossly overdue touch-up. The character was quite wealthy. She presumably could afford  hair-coloring job whenever she needed or wanted one. Was sporting noticeably dark roots considered fashionable during the time interval (very late 70's through most of the 80's) in which this show experienced its original run? 

I'm not meaning to take shots at Lisa Whelchel with either question. The scheduling and manner of her hair coloring treatments while on the show was presumably not her personal prerogative. furthermore,  I understand that she took a bit of abuse from the show's production staff over her very normal late-adolescent weight gain.  It happens with a whole lot of girls. If TV production staffs cannot accept it, perhaps they shouldn't work with adolescent females. I certainly have no desire to add to Lisa Whelchel's grief even decades after the fact. I'm asking both questions in all sincerity.

Please respond if you have answers to either or both of my questions.

Saturday, May 5, 2018

The Repugnant Donald Trump


the famous Trump pout


I am most un-fond of the political posts of others, yet I am exercising my first amendment right to post one of my own. In a way, though, the nature of the post isn't especially political.  My utter disgust for Donald Trump is every bit as much personal as it is political, if not more so.  Virtually nothing about the man is acceptable to me.  I grasp the concept that I have no say whatsoever in determining the worthiness of anyone to walk upon the Earth and to breathe the same atmospheric air as the rest of us, but I don't have to like it. With each succeeding item or anecdote I read about him, I am less amenable to the idea that Donald Trump is entitled to a place on this planet or even in this universe. My utter abhorrence for him is such that it cannot be characterized in a single blog entry. I could type all night and still not convey the essence of my feelings about this most deplorable individual a substantial minority of the voters in our nation saw fit to place in the role of chief executive of the United States of America.

I recognize that not every vote cast in favor of Trump was, in actuality, a vote for Donald Trump.  Hillary Clinton was, to some voters, every bit as deplorable a candidate for our nation's highest office as Trump was to me. At the same time, I cannot comprehend how anything short of, for the sake of argument,  gassing  six million Jews or perhaps having every child under the age of two slaughtered, could render Clinton less fit for the presidency than is the barely human creature who poked fun at individuals with disabilities or makes references to a female TV journalist with ". . . blood coming out of her whatever . . ."

I'm unsure as to the feelings of others in this regard, but to an extent I don't have a great deal of concern what the U.S. president does in his or her private life. If the person is molesting children or doing something similarly nefarious, I could not condone having the person serving as president, but regarding a whole lot of other behavior, I'm not tremendously concerned. I am concerned, however, about what the person says in his or her official capacity. 

We knew who this idiot was before the election.  It's not as though he lived his life in anonymity until campaigning for the presidency, and then we were hit with who he really is after the election. We've known all along, yet enough fools voted for him anyway to give him in excess of the minimum of two-hundred-seventy electoral votes. 


I'm also cognizant of the premise that Vice-President Pence's political stance is possibly to the right of that of the late Barry Goldwater, but I'm willing to deal with the fallout from having Pence elevated to the presidency. If a decent percentage of the eligible voters goes to the polls in the midterm election and votes wisely, Pence could be stripped of much of his power.  Yes, I'm concerned about the fitness [for the presidency] of anyone who would agree to appear on a presidential ticket with Trump, but it's highly unlikely that Pence could be quite so purely evil as is Trump himself..

Trump has boasted, when he was in second grade,  having punched a music teacher in his school and having blackened the man's eye. No one else who would have been present when this alleged assault happened seems to remember it having happened; the account is almost surely a lie. Still, it speaks of Trump's long-standing disrespect both for teachers and for lawful conduct. We already knew that Trump had low regard for teachers, having described them in a deposition as being "very stupid."

I take offense to Trump's statement that teachers are stupid. My mother was a public school teacher for two years while she was in the process of completing her graduate education.  I know what her IQ is. I do not know what Trump's IQ is, but I would wager that my mother's IQ is 1.5 times higher than is his at the bare minimum.  If teachers in general are stupid, as Mr. Trump has asserted, he is, himself, far more lacking in intelligence.

In addition to what I allege is Trump's deplorable lack of intelligence, he is overwhelmingly morally bankrupt. He quite possibly has major sanity challenges as well. Please, get this cretin out of the White House and out of our lives ASAP. 



I don't have photographers following me everywhere and capturing my every expression, but one would assume Trump has to be accustomed to being photographed on a regular basis by now. He frequently has this expression on his face in photographs. I found dozens of shots with his mouth in this formation from which to choose. Does he know that this look is not attractive? (If not, someone please advise him of it.) Why does he not look in the mirror as he makes this pout-like formation of his lips, then make a mental not of what it feels like as he makes this expression, then avoid making this face?  

In all seriousness, Trump's appearance should be the very least of any of our concerns, yet still, this obnoxious pout-like mannerism is most vexing to me.

Wednesday, April 11, 2018

Pictures of Celebrities That Cannot Be Autographed AND How Many Fingers and Toes Do YOU Have?



Several exciting or at least mildly interesting things happened near me in the past ten days or so, and I really can't share any of them, which truly sucks. This is the first week in well over two years that anything in my life has been bona fide interesting enough be mentioned in a blog. Obviously a whole hell of a lot of things have been mentioned in this blog in the past two years or so, but even I don't pretend that any of them were honest-to-goodness interesting enough to have merited space in even a forum so obscure as this blog. 

In one instance, I read an X-ray of a  grandson of someone famous.  The radiologist was at home asleep when I first viewed the CT scan. I knew instantly what it was.  I called and woke up the radiologist of record because the surgeon would want a more precise reading of the images before cutting into the child. I then hand-carried the copies down to the first floor, alerting the E.R. physicians. 
When the lead surgeon arrived about fifteen minutes later, I managed to be strategically in his direct line of sight. he remembered me from my sub-internship and invited me to scrub in for the surgery. I called my supervising radiologist, who  graciously allowed me to vacate my shift about half and hour early in order to observe the procedure. The diagnosis was a volvulus or twist of the ileum, which is the final section of the small intestine, just before the reversal of direction of the intestines, where the ileocecal valve separates the ileum from the cecum, which is the very first portion of the colon,  near the appendix. 

What was interesting about the particular patient, in addition to her age of nineteen months, and her grandfather, who is famous and who shall remain nameless here because I do not wish to lose my license to practice medicine before I even have it, was that her internal organs were not in the customary places. She had (and still has; it's not a condition a surgeon is going to attempt to repair) situs inversus. In layman's terms, her internal organs are reversed. With situs inversus, it can be  a total mirror image, with all organs reversed, or just some of the organs can be out of the usual arrangement.  With modern medical technology being what it now is, a child in a first-world country doesn't typically reach the age of nineteen months without medical professionals bringing him or her into the world being aware that the orientation of his or her internal organs is reversed laterally.  The vast majority of the small number of babies  (one in ten thousand is the current rate of prevalence reported for the condition) who are born with reverse internal organs are now diagnosed as such prior to birth. Images obtained via ultrasound examination from mid-pregnancy on will usually allow the condition to be detected if the radiologist is alert depending also upon the quality of the ultrasound equipment or the number of organs involved. 

The nineteen-month-old child is an identical twin. If identical twins divide relatively late (Day 5 or later following conception; for reference, dividing at Day 10 or later results in conjoined twins), they have a greater-than-average chance of being mirro-image twins. This happens in roughly one-fourth of monozygotic, or identical, twins. in other instances, situs inversus can be associated with genetic syndromes or abnormalities. Sometimes it happens with no other abnormalities. Donny Osmond has lateral situs inversus; his reversal was discovered when he underwent surgery for pain on his left side, with turned out to be appendicitis. (Appendicitis more typically presents with pain in the lower right quadrant. Osmond's appendix ruptured before it was removed, most likely due to the situs inversus causing his pain to be on the "wrong" side for appendicitis.)

If an ultrasound exam takes place either at a physician's office or at a business that provides ultrasound exams for essentially novelty or recreational purposes, it may be that no radiologist ever reviews the footage.  A competent obstetrician -- even one who spent the bare minimum of time in radiology rotations during med school, should be able to spot fetal organs that aren't in their usual places from the mid-second trimester of pregnancy. The people running what are essentially portrait studios for the not-yet-born offspring of those among us who have more money than brains  and fall for all sorts of schemes designed to part the fools of whom I write from their money, should not be expected to contribute medical information based on the ultrasound exams they perform.  The training of these photographers, ultrasound technicians, or whatever one would care to call them, varies from place to place, but in no instance of which I'm aware are the people working these spa-like ultrasound studios actually medical doctors, much less either OBGYNs or radiologists. I would take even gender identification from them with the contents of a large scoop of salt and not merely the proverbial pinch.

I'm veering off-topic here, and I'm doing so without the blessings of any of my lecturing or supervising professors (I technically write this entire blog without the blessings of any of these people, but such is especially the case with regard to what I will say next).  It is my opinion -- and I'm very much a voice in the wilderness in this regard -- that both medical professionals and  expectant parents should approach the use of ultrasounds with more caution than is the current norm.   Ultrasound technology for prenatal purposes has been around since the 1950's, but didn't attain much popularity here in the U.s. until the 1970's.  Since that time, the medical community has studied potential cause-effect of fetal/maternal ultrasound exams against just about everything under the sun, and have yet to find correlation or causation between ultrasound examination and anything. That does not mean that some link won't be found in the future. It would be very sad, for example,  if a link were eventually found between ultrasound exams and autism.  I really doubt that such a link will ever be found; for one thing,  I suspect it would already have been found by now if there were anything linking the procedure with the condition.  Still,  if I ever become pregnant, I will have ultrasound exams only when medically indicated or maybe one extra exam to determine the baby's sex. As cool as it is to know who or what a baby looks like months before it is born, which is possible in 3-D and 4-D sonogram procedures, I'm personally not going to shoot for an entire album of prenatal photographs of the baby. I can wait until the child is born for that.

In another instance of prenatal ultrasound examination, I was able to point out syndactyly (third and fourth finger of the left hand were conjoined by skin) before my supervising radiologist mentioned called attention to the condition in a  twenty-nine-week fetus.  The radiologist and I  were, of course, not in the presence of the family when I made this discovery. (If we had been in the presence of a family member, I would of course have needed to have kept my moth shut and would have let a person more skilled in patient- or parent- communication broach the topic. The time for me to make brilliant and unexpected dianoses from the various images I see is not in the presence of patients or family members.)  This was interesting to me because I had, on several occasion in recent months, discussed the condition of polydactyly with a friend of mine. My friend has a physician friend who invented a device to sever a child's extra digit if there is no bone in the extra digit. (Sometimes the extra digit found in cases of polydactyly is essentially a full-formed digit with osseous and ligamentous tissue [bones and associated connective tissues], but in other cases the digit is little more than a skin tag.) It's obviously easiest to remove the digit if no osseous or ligamentous tissue is present.  The condition of polydactyly can exist by itself or can be one symptom of many in several syndromes. 

After stumbling across cases both of volvulus and syndactyly, I assumed that my excitement for the immediate future was over. Then I had a case that was not medically all that exciting, but small-town girl that I am, I could not help being at least a little bit excited to review the CT scan of an extremely well-known person. I cannot disclose the person's identity because in a civilized society,  hospital personnel do not exploit the sick and injured who come to us for relief. We can boast that we treated someone who is really famous.  We just cannot identify the famous person. I don't even break it down by category (politician, athlete, actress, singer, and so forth) because it would be too easy to give it away if the person on the other end of the conversation happened to guess correctly.  Perhaps when I reach the age of sixty, I'll be less scrupulous about this sort of thing, but for now I play by the rules. Trust me (or don't). She is really famous.





If it never occurred to you to express gratitude for something as simple as having been born with the usual number of fingers and toes . . .


.  .  . It's not too late to begin doing so now.


Saturday, March 31, 2018

Practicing To Be a Practicing Physician, and Watching Vintage Judge Alex Cases on YouTube



For anyone who doesn't know and actually cares, I'm technically in school -- medical school, to be more precise -- but I'm beyond the classroom phase of my education other than the occasional seminar, which even licensed physicians are required to sit through on occasion.  My education now consists of on-the-job training with close supervision and a liberal amount of critiquing.  I actually perform some patient procedures, but I don't have the power to determine any treatment or course of action for a patient. I have to go through all the motions as though I'm qualified to make those life-or-death decisions, but in the end, someone smarter and more powerful than I is there to confirm or to overrule any decision I make.  Even though I'm mere months away from graduation, I have no more power than I had a year ago because each clerkship rotation is in a different area of medicine, and each one is new to me. 

The nice thing about my current rotation -- radiology --  is that much of the work is done behind the scenes. If I make an incredibly stupid error, I'm corrected in relative privacy rather than right in front of a patient and his or her relatives. I don't make tons of incredibly stupid errors, but the possibility of my doing so does exist. It's much less stressful to know that, should my diagnosis be laughably off the mark, the audience of witnesses will be very small.  It is a consolation, however minuscule. This year, for the most part I have only to worry about making a fool of myself, though there are exceptions.  The stakes, however,  will be higher next year, and even more so the following year, when I'll be  in the actual position of potentially killing someone with my screw-ups.  Even this year there's the possibility of doing considerable damage if I bungle a procedure, but the program does everything it possibly can to provide a safety net. They do this for the good of the patients and not for the preservation of my honor and peace of mind. Where my fellow med students and I are concerned, if the system could give us more responsibility with less support, they would do so, as we would learn more quickly (and the hospitals would get more free labor), but patient well-being has to come first.

Teaching hospitals face a difficult balancing act. Prospective physicians have to learn to perform the procedures they will need to perform once they are licensed. A medical school or hospital cannot simply wait until a physician is licensed, then expect him or her to know how do do all the things he or she will need to be able to do without any actual hands-on experience. They do what they can to give us simulated practice. We performed our first incisions on cadavers. We do computer simulations. We also have access to remarkably life-like dummies that give us the opportunity to perform many invasive procedures on them before we get our hands on their genuine living and breathing counterparts. 

At some point, however, all of us have to take the plunge and perform procedures of all sorts on live humans. It's frightening for us, and it would really be frightening for them if they knew it was our first time at the procedure, but of course they never know that. Sometimes they don't even know it's the student who is performing the procedure. I certainly wouldn't want to know if I were they. 

The first time I did a lumbar puncture, I very nearly passed out. I had to stop right after the initial puncture. A nurse held the needle in place; the supervising physician would have taken over if necessary for patient safety, but she chose to treat the situation as if it would have been treated had I been the actual physician and not merely a student, so she allowed the nurse to hold the needle for the fifteen seconds or so that it to me to stabilize myself. I sat and put my head down until the light-headedness left me, then continued without a hitch. 

I don't think anyone would argue with the idea that it is at patient expense that medical students master the procedures that comprise their jobs, but if we didn't learn them, everyone would suffer. We at least have the benefit of the dummies for practice. A couple of generations ago, once everything that could be done on a cadaver had been done, it was on to real live patients with no in- between. One couldn't have paid me enough to be a patient in a teaching hospital back in the day. It's treacherous enough now.

After a long week (I was officially on duty for eighty-two hours in the hospital this week; I was physically present for considerably more hours), I needed a diversion. For that diversion, I went to YouTube and found a few vintage Judge Alex cases. Those old classic episodes were the perfect venue for unwinding after a difficult work week. One case in particular -- Bidwell versus Hale -- was quite a hoot. Megan Bidwell, a lesbian (not that there is anything wrong with being a lesbian; it's merely worth noting that an avowed lesbian would unintentionally conceive a love child after the personal and public confirmation of coming out. Her reason for it was that she was drunk; it would take a whole lot more than mere alcohol to compel me to do anything that could possibly lead to the conception of a baby with Mr. Hale, and I'm heterosexual), was suing the father of her child, David Hale, over charges made on a joint credit card. The case would have been mundane to the point of boredom were it not for the litigants and their companions (with the exception of the plaintiff's companion, Kathryn Moore, who appeared normal as far as I could tell and was smart enough to say essentially nothing), who looked to me like haphazardly constructed puppets. When they spoke, they gave me the strong impression (which I really hope was a false impression) that they were the products of consanguineous relationships. I'm speaking of serious dueling banjos here. Again, because I do not wish to be sued, I must clarify that this is nothing more than an impression I had. I have no evidence whatsoever to support the proposition that any of the people featured in this case were the products of brother-sister or even aunt-nephew relationships. They merely appeared to be such.

Ms. Bidwell described for the audience and for all of us in TV Land how she made it to her child's gestational age of twenty-three weeks without knowing she was pregnant. This is far from any sort of record; you may have caught an episode or two of TLC's I Didn't Know I Was Pregnant, where women show up in emergency rooms with acute abdominal distress, only to be told that they're in labor.  Perhaps I should be less judgmental, but I don't quite understand how any sound-of-mind woman with cognitive function approaching the normal range could make it much past the first trimester of pregnancy without harboring at least a suspicion that she might possibly be, as the French would put it,  enceinte.  Ms. Bidwell next complained that, upon discerning an "awkward feeling in [her] belly" that he (it's not entirely clear, but I assumed the male pronoun was in reference to Mr. Hale) wouldn't "take me to any doctor or anything to find out if I was pregnant." Why would she have needed someone else to take her to a doctor to find out if she was pregnant? Did she lack the capability to seek medical care for herself? And while I'm the one of the last people who would disesteem the importance of medical care by professionals, home pregnancy tests are available at almost every pharmacy or supermarket. The bottom line for me is that if I were incapable of acquiring medical care without the assistance of such a a numbskull as David Hale, I would give up and consider myself as good as dead at the first sign of a medical emergency.


Megan Bidwell and her comparatively normal-appearing significant other, Kathryn Moore

Defendant David Hale spoke with an impediment I have no idea how to describe. Judge Alex made reference early in the episode to dental work Hale had done recently as being the alleged cause of his speech anomaly. I obviously have no idea what was done to the defendant's mouth or what he sounded like before the dental procedure.  Dental work notwithstanding, he's an odd duck, though not nearly so odd as was and presumably still is his wife/witness.  She was easily the most bizarre character featured on that particular day, and would quite possibly find a place in Judge Alex's Top Ten Most Idiosyncratic Litigants if such a list were to be compiled. She reminded me very much -- in speech and mannerisms --  of some of my cousins' cousins' cousins in Oklahoma, minus the heavy Oklahoma drawl.

David Hale and his bride and would-be P.I., Angela Brown

At some point during the case, when David Hale's bride of one month, Angela Brown (whose boobs appeared to droop at least three-quarters of the way to Antarctica; I'm not meaning to be catty in saying this, because she at least has boobs, but in all sincerity, I don't know if she went bra-less in attempt to seduce Judge Alex, or if she was wearing a bra, yet gravity still had such a potent impact on her anatomy), was telling a rather convoluted story of how she had attempted to conduct her own investigation of her then-future husband by contacting Ms. Bidwell through Facebook, bailiff Mason Burroughs failed to contain his laughter. He turned his back to the litigants and to the gallery of the courtroom as he wiped his eyes and at one point snorted. Judge Alex eventually lost composure as well. The audience laughed throughout the entire fiasco. Then the litigants and witnesses began to laugh. I had the strongest of urges to walk through my television screen to tell the litigants and witnesses, "They're not laughing WITH you, morons [and morons may very well have been a literal if not euphemistic term of address for the individuals featured in this case]. They're laughing AT you. There IS a difference." 

I suspect one of the reasons Mason laughed so boisterously was because white people on the program made more thorough fools of themselves than had any of the black litigants. I wouldn't accuse black people in general of behaving any more outlandishly than white people do. In real life, uncivilized behavior is something on which no single ethnic group holds anything resembling a monopoly. On TV court shows, however, the producers somehow find more people of African-American ethnicity that they are able to persuade [with money or with whatever it is that producers of court TV shows use to entice people to appear on their programs] to air their grievances in ways more emotive and flamboyant than are typical of the Caucasian litigants. This case, however, belied that entire premise.

In attempting to check these people out,  I googled their names. Ms. Bidwell was charged with assault and battery in May of 2017. Her mugshot was reprinted in a Virginia publication entitled Gotcha!. Gotcha! is a weekly periodical from Richmond, Virginia, which is comprised solely  [except for the obligatory advertisements; God alone knows who or what would choose to advertise in such a rag] of mugshots. How does such a publication have a large enough circulation to be sufficiently profitable to remain in print? Seriously, who buys this shit? I might possibly purchase a single issue if someone I knew was included in it, though I certainly wouldn't subscribe. Maybe that's the point. Perhaps many of the residents of western Virginia know so very many people who are arrested that to them, reading Gotcha! is like thumbing through a high school yearbook or family photo album. Perhaps it's the closest thing to a high school yearbook or family photo album that some of the readers will ever own.


Megan Bidwell's mugshot (photo credit - Gotcha!)

Here is a link to the episode for your viewing pleasure.




Saturday, March 10, 2018

Thank God I'm Not Married to Medicine



One side effect of having in excess of an entire month off is that I have had the opportunity to watch at least one TV program that I previously didn't know existed. Married to Medicine is a reality program on the Bravo network featuring  women who are MDs and women who are married to MDs or who are MDs married to MDs. A slight twist on the premise of the show is that all of the regulars on the show are African-American. 

I've been supervised by and have worked with African -American women who are doctors and nurses, and none of them conduct themselves as do the women on this program, at least at work. I'd be willing to bet a month's mortgage payment on the condo in which I reside (my parents, not I, make the payment) that they don't act that way when they're off the job, either.  The women on this program are only half a millimeter more civilized than the Real Wives of the various upscale communities, and most of these women have earned doctorates in medicine. Call me prejudiced (not racially in this case) but I expect more of medical doctors than what I have seen of these women. A few of them are merely married to doctors as opposed to being physicians themselves, but I would assume that even they have attained some post-high-school formal education. Maybe some of the women are osteopathic physicians. That's another of my prejudices; I hold osteopathic physicians to a lower standard than I hold MDs.

Doctors are not inherently perfect people. If the producers of a reality show came to me and asked me to help them locate  a given number of doctors who are unrefined, classless, and generally jerks, I wouldn't have any trouble accommodating the producers. I would be hard-pressed, however, even if I had access to my entire medical school community including all its students and professors, as well as every intern, resident, and attending physician working at any hospital affiliated with the medical school, to come up with six women of any race or creed who were as lacking in decorum as are the women featured on Married to Medicine. I would assume such is also the case with the spouses of those with  whom and under whom I work, though I don't know most of them well enough to state definitively that such is the case.

My guess is that participation in reality programs such as Married to Medicine is a highly lucrative second career. Money will persuade some people -- even ones whose level of education and presumed level of intelligence should exclude them from possession of the lack of judgment usually associated with agreeing to air one's shortcomings on TV.  Physicians are typically well-compensated enough that they wouldn't ordinarily be tempted by the lures offered by the production staffs of reality TV programs. Nonetheless, there are those among us for whom no salary is sufficient to support the lifestyle they have adopted.  Professional athletes are prime examples of this phenomenon. At least once a week I come across a hyper-linked story on present or past professional athletes who earned seven-figure salaries yet who are now either broke or bankrupt. 

While the incomes earned by most physicians are, at least in the short term, dwarfed by the incomes of professional athletes, the IQs of most professional athletes are, for the most part,  dwarfed by those who have successfully completed medical school. (Obviously not all professional athletes are of sub-average or even of average  intelligence. David Robinson of the U.S. Naval Academy and later of the NBA is often the first name to come to mind in any discussion of intelligent athletes. His son Corey is said to be similarly athletically and intellectually gifted.) While obviously not all professional athletes are dullards, and while there are obvious exceptions to this rule, the average college or professional athlete would not gain acceptance into an MD medical school program (perhaps many of them would be admitted to  osteopathic medical schools;I really don't know) if he or she were measured by the same standards as are other candidates for admission. 

It's conceivable that some or even most of those who agreed to participate in Married to Medicine did so because of financial difficulties and the need to moonlight for extra income.  I possess still another prejudice -- this one in terms of the intelligence, common sense, or self-control of anyone who cannot live comfortable on the salary typically  earned by a physician.  We all need to learn to live within our means. While I feel genuine  sympathy for those trying to remain financially solvent while working at minimum wage jobs, I don't feel all that sorry for doctors who cannot make ends meet. While sometimes divorce with its resulting family support/child support payments could cause a physician to have to scale back his or her lifestyle, a reasonable person can support a family on a physician's salary. In some cases with the Married to Medicine cast, they're living on not merely one but two physicians' salaries.  Even if  circumstances have caused a reduction in earnings of a doctor, the salary of a physician in the U.S. is still a living wage. Perhaps the physician's family can no longer afford a full-time house-keeper. Perhaps the number of and the expense of family vacations needs to be drastically cut, or maybe the number of restaurant meals a family eats needs to be reduced, and possibly an expensive home needs to be sold in favor of a more modest home in a more affordable area. Still, unless a physician's circumstances are highly unusual (perhaps a man fathered twenty children by eighteen different women and is required to provide financial support for all of them, or perhaps a woman married such a man; stupidity in regard to how one lives his or her life is not without consequences), adjustments can be made so that one can live with his or her spouse and/or family within one's means. It's feasible to make necessary adjustments to one's lifestyle in order to subsist on the fruits of one's labors rather than selling one's dignity in order to remain financially solvent.

Then again, perhaps it's not just money as a motivating factor where some of those featured in such reality programming are concerned. Among us are those who relish the prospect of celebrity for themselves even if the end result more closely resembles infamy than actual fame.  I don't understand it, and, for the most part, many of the people who have signed on for the lack of privacy that accompanies  participation in reality television probably don't fully comprehend just what it is that they're signing on for when they agree to allow their lives to be broadcast into living rooms across the nation.  I've yet to see anyone who has agreed to long-term participation in reality TV emerge unscathed. A very few families with large numbers of multiples allowed themselves and their offspring to be filmed for just a few segments, then took the money for whatever they needed it and went almost immediately back into obscurity. Those families appear to have beaten the system.  For the most part, however, if there's not something bizarre or at least highly quirky about at least one member of a family, the networks producing reality shows have no use for a family. Airing a person's or family's weirdness on national television isn't much more beneficial to the person's or family's overall well-being than airing the person's or family's soiled underwear would be.

With regard to  Married to Medicine, I take exception to the use of African-American physicians and their spouses in the program.  I should make it perfectly clear that I am in no way jealous or covetous of those who were selected to appear in this program, and no amount of money could persuade me to trade places with them. While presumably no one was compelled by any sort of force or extortion to participate in this project, I don't think it's a coincidence that African-American couples were chosen to participate in this program or these programs (there may have been a spin-off in a different location than the original; my schedule doesn't allow for me to follow any TV series, so I really don't know). Those of African-American heritage are often a bit more flamboyant or colorful (seriously, no pun was intended here) and perhaps more interesting than are their non-African-American counterparts. A reality show featuring my parents and their white and Asian physician acquaintances wouldn't hold the attention of many viewers for long. It seems almost as though Bravo scoured medical communities all over the nation for the loudest and most ostentatious physician families they could find.  It's probably not a coincidence that the couples chosen for this project have been African-American.  Those who participated are adults and as such legally entitled to make their own decisions regarding participation in such a project, but still, to me it reeks of exploitation.  

As a future physician, this program is an embarrassment to me. If I were an African-American prospective physician, it would be an even greater embarrassment to me.



Wednesday, February 28, 2018

Vacations, Jobs That Make Work Seem Like a Vacation, and How to Obtain One of Such Jobs




This vacation is running the risk of ruining me as a future doctor and is causing me to look forward to the vacations I will be able to afford later in my career more than I am looking forward to the actual career itself.  C'est la vie. It's a secret to which I would have been privy eventually, anyway.  The opportunity to take high-end vacations is a reason you should remain in school, study hard, and choose your course of study and future career wisely, kids.  If you can find the perfect but often elusive career that allows you to feel as though you are on vacation much of the time when you are at work and also compensates you well enough that you can take dream vacations at least once every two or three years, don't let the opportunity pass without grabbing it.

The problem for many among us is that we make decisions when we are relatively young which impact our options for the future. While the algebra course you're taking in eighth  or ninth grade (while Common Core pushed algebra up to ninth grade in many places, I think they're still offering it for eighth graders in some places) may not seem to be of tremendous importance, flunking it and having to repeat it next year reduces the number of math courses you'll be able to complete before college. This, in turn, may impact your admission to the university or program of your choice or the quantity and quality of your scholarship or grant offers, which, ultimately, will impact your post-graduate options. 

While tonight's homework may seem almost optional, if you skip one assignment, you probably will not skip just one assignment. It's incredibly easy for blowing off school work and homework to become a habit.  And while a person may think he or she can slide through middle school and high school without meeting basic expectations but will get his or her academic act together later, all too often it doesn't work out that way. Choices young people make will begin to impact the quality of one's vocational  and/or professional future  sooner than one would like to think.

I'm not suggesting that if someone blows a science test in fourth grade, he or she may as well give up on a dream of becoming an engineer.  Such would be ludicrous.  We're all sufficiently resilient to withstand a few failures in both school and in life, and failure can, if managed well, provide  tremendous opportunity for growth.  Furthermore, we all know people who were academic screw-ups until sometime early in high school, and who, for various reasons, chose to change courses and to succeed in school.   If a person hasn't found what works for him or her in terms of navigating the system of school by eleventh grade, however, the odds will have begun to work against that person in terms of future academic and likely professional-status career success. 

If a person is fortunate enough to have greater-than-average mechanical skills, those skills can often be parlayed into decent-paying jobs.  In future years, with the growth of technology, an increasing number of jobs previously performed by humans are going to be done for us by machines, but for now, auto mechanics, welders, and plumbers are still in demand.  Likewise, many students who attended my high school's rival school were the offspring of California State Department of Corrections employees.  Some of their parents earned six-figure salaries with having completed no education past high school. Most of these people loathed their jobs, but they were paid well enough and had enough time off that they enjoyed a decent lifestyle while not at work. They lived in relatively luxurious homes, drove expensive cars, and took  nice vacations. Most of them dreaded going to work every day that they had to work, but they had the resources to thoroughly enjoy their time off.  Such a job is, in my opinion,  far superior to flipping burgers for minimum wage, but still comes with a heavy price to pay in return.

The idea of being able to support oneself at a job  one actually enjoys doing is a relatively modern idea. There may have been some element of choice involved, but I don't think many people in my grandparents' generation had the luxury of choosing work based on personal fulfillment.  A person's job back then, for the most part, was based on skills a person had, what sort of farm or business the family might have owned, possible family connections to training for a particular vocation, or if a family had the means to fund the education of offspring.  I'm not sure if its onset followed  WWII or maybe even the Korean War, but the GI Bill afforded many people to obtain college educations who previously would not have had the means to seek higher education. With an increase in education came and continues to come an increase in options.  

More education is usually better than less education unless a person goes into heavy debt  to obtain a degree that doesn't typically lead to a decent-paying job.   If there's  little to no debt incurred, any degree is better than no degree. 
If a person is going to wind up with in excess of forty-thousand dollars of debt,  it might behoove the person to study something a little more practical than, say, art history.   Unless the holder of the art history degree is unusually lucky,  he or she has little chance of finding a job related to an art history degree that pays much more than minimum wage.  My cousin's other grandfather  got a degree in art history, but he waited until he retired after practicing for more than thirty years as an orthopedic surgeon.  By then it didn't matter that he couldn't find a job related to his degree. He was too old to work, anyway.  One of my uncles who is a banker has a degree in musicology. He got very lucky and found an employer who wanted to hire a college graduate, but the employer didn't particularly care in what field the degree was earned as long as it was a bachelor's degree from at least a moderately reputable institution.  

I had originally planned to remain in this vacation destination for only about ten days. My ten days have come and gone, yet I have no intention of leaving this place anytime soon. The people who manage this hotel say I can extend my stay as long as I want throughout the first three weeks of March.  I need to be back home by the day before the Match Day ceremony on March 16. I can afford the daily rate here for another two weeks. My bodyguard  has left, but I only kept him around because he had already been paid. I don't need that sort of around-the-clock protection.  

If you're in school and doing very well, that's great.  If you're not doing quite so well, you might want to consider increasing your effort. School isn't the only thing in life even when you're young, but if you give it too little priority in your life now,  later in your life you may lose out on the opportunity to take really cool vacations like this one I'm presently enjoying.