Monthly Archives: December 2024

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Solo vessel

A duck is a sort of a vessel, isn’t it? Can you nap while floating in the water? I can’t. I hiked part of the Connected Lakes Trail and spoke to a member of the local Audubon Society yesterday. I did not have binoculars but he shared. I used my Panasonic DMC-FZ150, zoomed all the way in. It is still a bit difficult to identify this bird.

Now the pair are both awake. I think they are a female and a male ruddy duck, but it is a touch blurry and abstract. I like the photograph anyhow. The water and ducks and grasses and reflections were so beautiful.

For the Ragtag Daily Prompt: vessel.

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Busy clinic

Clinic has been hopping. I have been at the present site now for six weeks, so I am starting to know a few of the patients. That is, the ones that are sick and I am worrying about. It is best if your doctor’s pupils don’t dilate when they hear your name.

I have been getting helpful calls back from specialists. I have a person who has high liver tests where hepatitis and overweight and alcohol don’t seem to be the cause, so I needed an updated list of what labs to send for some of the less common liver problems. Thyroid disease, hemochromatosis, alpha one antitrypsin deficiency, smooth muscle antibodies, various other antibody disorders. The list is quite a bit longer than in the past. I warn my patient that some will come back right away and some may take a week or two. The patient is anxious and wanted to go right to the emergency room, but I ask them to wait: I get a call back from gastroenterology within 24 hours to set up the current laboratory order list.

For liver tests, we ask about alcohol intake first. Then look at weight: a high body mass index can cause fatty liver disease. Unfortunately, that can lead to cirrhosis and liver failure, so it is not trivial. We check for hepatitis A, B and C. Then we start looking for the less common causes. My person is relatively young, but that is with me taking care of age 18 and up. I tell my person not to take any supplements, I look at any prescribed medicines. No alcohol for now.

The list of tests changes quickly. If I have not worked this up recently, it’s good to check in with the specialist. The gastroenterologist may not be up to date on ankle sprains, but they are tracking the changes in their specialty. My specialty is everything, so sometimes I need a current update. Most of the specialists are just fine with this phone call.

Occasionally I do this by message. I have a new diabetic who has a cardiologist already. Diabetics are usually put on either an ace inhibitor or an angiotensin receptor blocker to protect kidney function. I message the cardiologist and get a fast answer. Start an angiotensin receptor blocker and the suggested dose. Also very helpful.

A patient tells me on the phone that I get an “A” for the day. I called them to check on them two days after changing a medicine dose and to say that the other specialist wants even MORE laboratory tests. The patient says she has not gotten a call from a doctor before. The “A” made me laugh, but it did feel good.

I am learning the local medical pathways and how to get things done in this particular medical system. The functional bits, the dysfunctional bits, and how to work around them.

For the Ragtag Daily Prompt: functional.

Sol Duc really likes staying in her pillow fort. Sometimes I want to hide in a pillow fort too. So much for being “grown up”.

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Cliff collapse

This is taken on Marrowstone Island, going south from East Beach. The king tides take down sections of cliff and whole trees every years.

The island surfaces in the low tides and the seals rest and sun and ignore the ships.

For the Ragtag Daily Prompt: collapse.

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Austere choice

What could be more austere than rock?

Taken in Echo Canyon in the Colorado National Monument, Thanksgiving, 2024.

Austere choice

Why do I still feel sad when I think
that I am best off with my cat
and that I should eschew dating.
Why do I feel like I am rejecting love?
I don’t have that sort of love.
It’s not like I am rejecting anything.
I am rejecting looking for it.
I am rejecting active interest in a partner
other than my cat.
What is wrong with that?

I do not ever want to reject hope.
I am not trying to reject wanting.
Hope and want are the deep and terrible ache
for the Beloved. I do not reject that.
I am still open, Beloved, to what you send,
though getting more particular in middle age.
A writer says that he uses a pencil and a pad,
because no better tool has been invented.
I take the same approach to wanting love.
If the relationship is more work than my cat,
for less love, why bother? It seems silly
and until I go home to the Beloved,
so far, I am best off with my cat.

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The first thing Sol Duc does when we go out for a walk, is roll on the sun warmed dusty sidewalk. The house faces south.

For the Ragtag Daily Prompt: austere.

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Vision

What will peace look like? People
will still disagree often
but like my parents they will appreciate
evidence and science. They will listen
to each other with interest, with respect.
They will bet a penny or a quarter or a million
imaginary dollars and one will go to look up
the correct capital of Azerbaijan, while
the other argues that they MEANT back in 1478,
really, so they do not owe one million imaginary
dollars and they both start laughing again.

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The photograph is of the ice in Echo Canyon, two days ago. Or maybe it is angels, waiting.

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Surreal failure

I am still thinking about Friday’s Ragtag Daily Prompt: failure. Now that I am middle aged (by my clinic definition, which put over 90 as older), I think the biggest failure of my generation is a peaceful world. For me, a peaceful extended family. I am good friends with my father’s family and my ex-husband’s family. But the maternal family, well. I have thought about that for the last two days: could I have changed that?

Yes, but at what cost? My sister followed the “family rules” on that side. She is dead from cancer. My mother also followed the rules and died younger than me from cancer. I can’t say that the rules cause cancer. But doesn’t our culture say over and over, be yourself? To fit in the family diaspora, I would have to play the triangulation game and gossip about others as they have gossiped about me. No, thank you, no. I don’t want to. They seem to need a family member to hate and have chosen me and labelled me and call me angry. I think they are silly and emotionally immature. At the very least, I would have had to keep my mouth shut and accept them gossiping about me.

The family failure and untrue gossip, with no one ever asking for my viewpoint, mirrors the US culture. Split and needing someone to hate. At this rate, we’ll need the hippies back, with flowers and joy and counter culture and dropping out. Someone fun, at least until the drugs wear off. Someone to say, we need joy back, we need friends, we need love.

It’s not just my failure though. The family failed. They make cruel choices and target people. It happened in my generation, my mother’s, my grandparents. I wonder if it is happening in my adult children’s generation. Who is the next target? Who will refuse to counter-gossip and fight with each source? My adult children are not part of it at all, because I had less and less interest in spending time with mean gossips and I did not want to expose my children.

Lies and drama and meanness and gossip. I hope my adult children’s generation does better. We went to Wicked on Thursday. I did not like it much. Too much drama. Why do we want drama? The world seems more and more surreal. Give me the lovely hike we did on Friday instead, Echo Canyon.

For the Ragtag Daily Prompts: failure and surreal.