Good morning! I hope you are having a happy day today! I am up and having tea and reading and listening to music, waiting for the rest of the household. They may be a while.
I arrived at my son and daughter in law’s on Sunday. The glitch was that my son and I couldn’t find each other in the pick up area and got frustrated. Turns out that I was at National Airport and he was at Dulles, which does make it more of a challenge. I took my bags and hopped the metro out into Maryland, and they picked me up at the station. Whew.
We are talking, eating, wrapping things and climbing. We went to their climbing gym yesterday and I did a respectable job on some 5.6 and 5.7 climbs. Today my arms want to fall off. Last year my climbing style was panicked sloth. This year I am much better since I have been going to my climbing gym once a week. Arm muscles! How amazing!
We are going to continue wrapping today. My daughter and her boyfriend arrive late tomorrow so we aren’t going to tear paper off stuff until Friday morning. My inner little kid suggests that we unwrap today, wrap it back up, and do it AGAIN on Friday. This waiting frustrates her! Oh, well. No, dear, we aren’t going to do that.
Have a lovely today and tomorrow and day after tomorrow!
The naughtiest postcard I ever sent was to my friend B, when he was living the romantic life of a government tax economist in New Zealand. He had been working for the US government, but went off to work for New Zealand’s government for two years. I felt rather jealous. Uprooting as a physician with a husband and two children to go work in a foreign country seemed a bit insurmountable. There was an awful lot of difficult family drama and illness going on, so that is the real reason that I did not do it.
Anyhow, naughty postcards. I sent B a postcard from Georgetown. It is black and white, a man lying prone looking up. A sheep is standing over him, so that no naughty bits can be seen, but one certainly suspects that the man is nude. He and the sheep are looking at each other. The caption is “No more sheepless nights.” Eeeeee. I bought two of that one, because it made me laugh.
B sent a letter back, along the lines of, “Cut it out, you are getting me in trouble with the postman.” I desisted. I did not have any more postcards like that one.
I have bought and kept blank cards and postcards over the years. Good thing, too, now that cards are a whopping $4.00 to $7.00 each. People must buy them, right? I have picked up blanks at garage sales too, once in a while. And the ones I don’t like can go out in the Little Free Library for other people.
I plan to make a calendar and maybe some postcards of Elwha’s cat art. He did it more than Sol Duc does. The photograph is one of the designs, from February 2023. I did see both of them adding to it. Perhaps there was some sibling rivalry going on, I don’t know. This installation is quite complex, with two toy mice, the earbuds, one of those glittery balls tucked under a mouse and the toy made of pipe cleaners.
The clinic that I have been in now since a week or two in July is an older clinic. It does not have wall mounted computers in each room and in fact, there is no desk at all in the exam rooms. As the temp, the other two doctors have priority over me in picking their rooms. I do not like the exam table in one room. It isn’t a regular exam table. It turns out to be a table for a DO to do adjustments. I am an MD, not a DO. The table might get switched out but it has not been yet.
Meanwhile the desk. We have laptops that plug into the desktop in the offices that we each share with a medical assistant. The desktops have a standard keyboard. The laptops are small, and my laptop that I am typing on now is in between the two. At first my fingers had trouble switching between three different keyboard sizes. Now it is pretty automatic.
So, no desk in the exam room. I do most of my note in the room and don’t dictate. I type reasonably fast. But I hate a laptop on my lap and anyhow, we are all sitting too much, so I stole one of the two Mayo trays from the procedure room. Mayo trays have adjustable height, are stainless steel so they can be cleaned after surgery, and they are a pretty good desk for a laptop. I choose to stand while typing in room one.
Next it turns out to be inconvenient to drag the Mayo tray back and forth from room one to room two. I am leaving it in room one. Room two has a standard exam table, so I pull out the “pull out leg rest” (yes, I looked up the name), push the step in and then I can sit on my stool and use the “pull out leg rest” as a desk.
The medical assistants have adjusted, mostly. The patients blink at first, but they seem fine with it. Sometimes I am attempting to find something and also attempting not to curse this particular electronic medical record. The other day I needed an ankle-brachial index test. Ok, not under ABI. Two were under ankle-brachial index. I chose the one that was not in our clinic, since we don’t do them. I got a message back that that was wrong. I chased the other doctor down. She called a third provider who remembered. The one I need is under “us ankle-brachial index”. Really? Hopefully I will remember that annoying local electronic medical record filing quirk, but I may not. If you are wondering what it is, it is a test for arterial disease in the legs, comparing blood pressure in arteries in the legs with the arms. The “us” stands for ultrasound.
The photograph is Elwha supervising on my desk at home.
No, Elwha has not been found. I have lots of photographs. He was a funny cat. Ate too much and then tried to trade toys for food when I decreased what I fed him. He loved boxes and he loved tummy rubs. He seemed to think about food, tummy rubs and sleep, mostly. He would like to catch birds. He was not sedentary but was expert level at relaxing.
Traveling from Washington to Colorado, Elwha did not like the car and the unfamiliar places. I took the cat carrier apart in the hotel room and he decided that it was safer inside it than out, even if it was in pieces. Sol Duc did not enjoy the car but is less worried about it all.
And here is Sol Duc in a virtual cage, a shadow cage. She likes the back yard a lot. I have had the house closed up because of the smoke for the last two days, but there is less today.
Do you know the poem by Ogden Nash, The Tale of Custard the Dragon? The chorus is as follows:
Belinda was as brave as a barrel full of bears, And Ink and Blink chased lions down the stairs, Mustard was as brave as a tiger in a rage, But Custard cried for a nice safe cage.
I love that poem! And I love the lines:
Meowch! cried Ink, and Ooh! cried Belinda, For there was a pirate, climbing in the winda.
Ogden Nash was perfectly happy to bend words to fit the rhyming scheme and to heck with spelling!
I still have not heard about Elwha. I hope that he has moved in with an older couple and spends most of his time on their laps. I can see him crying for a nice safe cage.
I thought there must be a song of it, but so far I like this tenth grade rap version best!
Sol Duc is quite a cat. The other morning I let her into the fenced back yard. I went back in to get my tea.
There is a knock at the front door. I open it and there is Sol Duc. “Meow!” which I hear as “Mom, I’m not supposed to be in front of the house without you.”
She comes in and I take my tea to the back. Oh.
Yes, I see the problem. She went into the neighbor’s yard and then around to the front. But she didn’t run off, she knocked. Apparently the storm was pretty hard on the fence.
This morning, after two days of rain, there were lots of small frogs singing to the sunrise in the man made run off space across the street. There is about a foot of water in it and the small frogs were all singing to their true loves. They continued to sing as the sun rose. Guess they better make hay while the pond is present, or something like that.
Sol Duc is a tough cat and smart. I think she still misses Elwha too, especially when I am at work, but she is careful not to run off.
It is difficult to screen for ACE scores for the same reason that it is difficult to screen for domestic violence and to talk about end of life plans. These are difficult topics and everyone may be uncomfortable. Besides, what can we DO about it? If growing up in trauma wires someone’s brain differently, what do we do?
I don’t frame it as the person being “damaged”. Instead, I bring up the ACE score study and say that first I congratulate people for surviving their childhood. Good job! Congratulations! You have reached adulthood! Now what?
With a high ACE score comes increased risk of addictions (all of them), mental health diagnoses (same) and chronic disease. Is this a death sentence? Should we give up? No, I think there is a lot we can do. I frame this as having “survival” brain wiring instead of “Leave it to Beaver” brain wiring. The need to survive difficulties and untrustworthy adults during childhood can set up behavior patterns that extend into adulthood. Are there patterns that we want to change and that are not serving us as adults?
This week a person said that they blow up too easily. Ah, that is one that I had to work on for years. Medical training helps but also learning that anger often covers other feelings: grief, fear, shame. I had to work to uncover those feelings and learn to feel them instead of anger. Anger can function as a boundary in childhood homes where there are not adult role models, or where the adults behave one way when sober and an entirely different way when impaired and under the influence. There may be lip service to behave a certain way but if the adult doesn’t behave, it is pretty confusing. And then the adult may not remember or be in denial or try to blame someone else, including the child, for “causing” them to be impaired.
What if someone had a “normal” childhood but the trauma all hit as a young adult? I think adults can have trauma that changes the brain too. PTSD in non-military is most often caused by motor vehicle accidents. At least, that is what I was told in the last PTSD talk I went to. Now that overdose deaths have overtaken motor vehicle accidents as the top death by accident yearly in the US, I wonder if having a fentenyl death in the family causes PTSD. Certainly it causes trauma and grief and anger and shame.
I agree with the American Academy of Pediatrics that we should screen for Adverse Childhood Experiences. We need training in how to talk about it and how to respond. I have had people tell me that their childhood was fine and then later tell me that one or both parents were alcoholics. The “fine” childhood might not have been quite as fine as reported initially. One of the hallmarks of addiction families is denial: not happening, we don’t talk about it, everything is fine. Maybe it is not fine after all. If we can learn to talk to adults about the effects on children and help people to change even in small ways, I have hope that we will help children. We can’t prevent all trauma to children, but we can mitigate it. All the ACE scores rose during the Covid pandemic and we are still working on how to help each other and ourselves.
The photograph is one of Elwha’s cat art installations. He would pile toys on his bowl. Two bowels because I need to keep out the little ants. Sol Duc would do it too but not as often. I fed them in separate rooms. They would pile things on the bowl whether there was food left or not.
Elwha is still missing, sigh. That is a wound. The photographs are from March 2023.
I took this somewhere along the 1217 mile trip with two cats from Port Townsend, Washington, to Grand Junction, Colorado. Idaho, I think. This a view rest stop as I drove up out of a valley.
Elwha and Sol Duc weren’t too sure about the trip. We started with them in the back and a net between the from and the back. I had to stop within an hour because they could get by it. Elwha wanted to ride by my feet and Sol Duc under the seat.
So then I set up their crate in the back seat and put both cats and the catbox and water into it. They didn’t love it but it worked. I would put their harnesses on and then put them in the carrier to go in to motels.
It was pretty exciting to check into a motel with two cats.
Discover and re-discover Mexicoβs cuisine, culture and history through the recipes, backyard stories and other interesting findings of an expatriate in Canada
Engaging in some lyrical athletics whilst painting pictures with words and pounding the pavement. I run; blog; write poetry; chase after my kids & drink coffee.
Refugees welcome - FlΓΌchtlinge willkommen I am teaching German to refugees. Ich unterrichte geflΓΌchtete Menschen in der deutschen Sprache. I am writing this blog in English and German because my friends speak English and German. Ich schreibe auf Deutsch und Englisch, weil meine Freunde Deutsch und Englisch sprechen.
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