quotes of the day

...from a patient with a completely, totally squashed fractured foot, on being told that he would need to pick up copies of the xrays he had done at our wee primitive local emergency room to take to his followup appointment with the orthopedist, so the orthopedist could look at them:
"I'm not fucking going to any appointment with a doctor who doesn't even have a way to look at my fucking xrays on a computer. I'd rather have the broken foot." What can you say? I said "Okay then."

...and as a runner up: "I just don't know what to do - they told me at Planned Parenthood that I'm six weeks pregnant with twins, and my boyfriend took off when I told him and hasn't been answering phone calls - I mean, he's not allowed to see his two other kids, so I guess it freaked him out a little bit, and we've only known each other like a month - and I'm really scared because I use cocaine and I drink like 10 beers a night - and I don't have a job and I'm not done with school, and if I had a baby I'd have to drop out of school, and I'm living right now on my friend's sofa because I can't afford my own place and it's really loud there and I wouldn't be able to stay there with a baby, but... I just can't decide what the right thing to do is." oh, sister. the right thing to do involves a suction device, a drug rehab program, and an industrial strength piggybank.

I also had one of my sweet lovely postpartum girls - in the agony of indecision about what kind of birth control she wanted to use - ask me what kind of birth control _I_ use. I was totally taken aback. She comes from a tiny little village in Mexico where you hang onto your virginity like grim death until you get married at seventeen, and while I'm not making any assumptions about what the men get up to, it's really, really unusual for the women to have had any partners other than their husbands. Once I'd turned pink and said, "er, nothing right now; I'm single," I didn't want to horrify her by then saying, "oh, but with previous boyfriends I've used xyz" because, really, who wants to know that about their doctor? eeuw.

okay, enough procrastinating. I still have seven charts to finish.... urgh....

items of interest

1. I can now moonwalk (sort of), thanks to an intensive rehearsal session at my friend Francesca's house tonight. We had to find an instructional video on youtube, and got side-tracked youtubing Michael Jackson's early performances and a couple of "So You Think You Can Dance" episodes, but I think I have the gist of it. I am very pleased that at the ripe old age of nearly thirtyfive that I am able to acquire a new physical skill, since so far my impression has definitely been that it's all downhill from seventeen, body-wise. I think, but am not 100% sure, that I could moonwalk when I was in first grade and Thriller came out and we had breakdancing days in gym class, but again, not totally sure. In the last 24 hours, I have biked to Occidental and back (38 miles, big hill), Sebastopol (24 miles), walked to the hospital and back twice (8 miles), and danced for two hours tonight, so I might right now be the very fittest I will be this decade. Hmm. That's a sobering thought.

2. We have a patient right now in the hospital (whom I am due to start rounding on tomorrow) who has TETANUS OH MY GOD. I'm bummed out for him (he cut his hand and then a few days later found he couldn't move his arm because it was all contracted and spasm'ed up) but very excited for myself because TETANUS!!!! CRAZY!!!! i have never seen real live tetanus!! it's almost like seeing the black plague or scurvy or something. Nobody gets tetanus in this country anymore - normally you have to travel to subsaharan Africa and places like that to see it.

3. I have now completed twenty two portraits. I am hoping to get up to twentyfive by the time I leave Seattle in mid September, and I think (if my call weekend isn't too dreadful) that I may be in with a chance. OK, that's not that interesting, but I wanted it registered somewhere other than in my head and on my kitchen wall.

4. Rally number two in downtown Santa Rosa tonight in support of a public healthcare option. Such mixed feelings about this: I do believe everyone should be publicly insured through a single payer health plan, but the quality of healthcare out there now (and I include myself in this) is so misguided, crappy, and expensive, that it's hard to argue with a straight face that everyone should get it. We spend gajillions of dollars on junk food and tobacco, and then gajillions of dollars more on diabetic foot amputations, cardiac catheterizations, etc., and it's just stoopid and McDonald's and Philip Morris and Pfizer end up with all the cash and no-one's any healthier.

One more week before I'm on holiday: six days of hospitalist, an ER shift, and then I'm a free woman (and an ancient one. thirtyfive! how did this happen?).

iceland pics - installment numero four

cool glacier patterns
eggs at the market!
rock formation that is supposed to be three giants pulling a shipwreck in to shore who got frozen like that because they didn't make it before the sunrise
J. standing on top of cliff
most stylish and comfortable way to descend a glacier

view to other side of glacier, skaftafell nat'l park
waterfall, skaftafell
more cool rock formations
going for a hike with chairman mao
wowee glacier
WOWEE BIG GLACIER

pretty purple fleurs
maison typique

iceland pics - number three

ice fields!
iceberg chunks, jokulsarlon
close to achieving tree pose
starting to attempt tree pose
arty farty pic of sky
getting the timer function on the camera figured out
river valley
hooray for something
trekking across the hitherto unexplored snowfields
cool rock formations
right after the nuclear bomb fell
bubbling mudpots!
oops. needed: one civil engineer

iceland photos, installment the second

tromping across snowfields, again name lost to posterity
pussywillow buds
jumping for joy at the prospect of lunch
path marked out down the volcano with zigzag strings (attempt at monochromatic artyfartiness

at the top of volcano
spooky underground geothermal pool, nearly boiling, with sunlight filtering through cracks in rocks
standing next to bloody great crack in the earth
lake myvatn, first thing in the morning...

iceland pics upload numero un.

international road sign for person relaxing in hot tub
geothermal pool lovely lovely
at godafoss
more godafoss
horse sticking tongue out at napping tourist

valley near akureyri where we rode horses
drive into akureyri

some photos off the iphone...

geothermal pool at lake myvatn - this is where we came at the end of our lava field day to soak. the water's a scrumptious 100 degrees-ish, plus or minus a few depending on where in the pool you are, and the little hut is a steam sauna you can go into. i sat on the edge of the pool and drank my orange Fanta and pretended I was an Icelandic mermaid.
ice chunks at jokusarlon (pic does not do it justice). This is where one of the glaciers ends and breaks up into water and icechunks, and it is truly a spooky spooky place. we climbed the little hill overlooking it, and listened to the Verdi Requiem on our travel ipod speakers, and it was quite magical.
BIG glacier with ice cap at the top.

godafoss waterfall. godafoss means "god waterfall" and supposedly it is the place that the icelandic viking chieftains came and chucked all their pagan images into when they decided to all convert to christianity.

so we are now in reykjavik, last day (i leave tomorrow morning early). we went for a spectacular dinner last night, and i am probably never going to need to eat ever again as a result. Here is a catalogue of everything we ate yesterday:

breakfast: porridge, rhubarb pastry thing, orange juice, toast with jam

lunch: salami cheese cucumber tomato sandwich, end of Penrith fudge, yoghurt drink

mid afternoon snack: carrot cake, haddock and roast potatoes (from reykjavik's lovely organic fish and chip shop. really yummy. no napkins or utensils, however :))

dinner: chef's tasting menu at sjavarkjallarinn ("seafood cellar restaurant"), which had so many courses that i would be hard pressed to remember everything BUT there was tuna, springbuck, foie gras, salmon done various different ways, monkfish, haddock, two different puddings, and we killed a bottle of gorgeous rose champagne (that J. had trekked all the way from SF) between us as well as predinner aperitif (kir cassis pour moi, campari & soda for J.). The whole thing took three and a half hours, and I was completely and totally sauced by the end of it. We went for a walk around Rekjavik (still mostly light at one a.m.) and watched all the trendy drunk people stumbling in and out of bars and then we were in bed by a relatively respectable responsible 2 am.

the plan this morning, so far as there is one, is to go to a recreation of a viking longhouse, possibly to go and look at some old medieval vellum manuscripts (guess who wants to do that one) and eat hotdogs at the number one hotdog joint in iceland (which is apparently the number one hotdog country in the world; guess who wants to do that one).