Category Archives: photography

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Fit, function and frustration

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.

For the Ragtag Daily Prompt: desk.

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Last on the card: hot

The cover picture is from the hike with my daughter at Beaver Creek, last on my Panasonic.

This is from my cell phone and cracked me up. 19 Crimes and Martha Stewart?

And for our song track, we’ll have another Martha: Martha and the Vandellas, from 1963. Fabulous!

For Brian’s Last on the Card.

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Sisyphus

Sometimes clinic feels a bit like Sisyphus must feel. Rolling the stone of illness up the hill but it is eternally rolling back down. I can’t stop it. People age and people die and otherwise there would be no room for young ones.

The last two weeks of clinic has worn me out a bit. A friend says that I take too much of it home, worrying about people. How to let go of this?

I make connections in clinic. Not all the time. Sometimes I fail. I made a connection with more than one person with diabetes this week, but one was funny. The connection is that he mentioned that he is an elk hunter. Oh, and flies to California to fish and has a very lot of fish. I said that I’ve had elk and like it. That was when the connection engaged: he was very pleased that I am not horrified by hunting. Hunting elk is not at all easy or cheap and cleaning the animal and carrying it out, well. He is coming back about his diabetes and left cheerful.

If I go home trailing those connections and spend my time worrying about this people, I’ll wear out. I don’t want pneumonia number five. So how do I connect but let it go when I go home?

I will think of the connection as much smaller than the boulder that Sisyphus deals will. Not a boulder. A small piece of the rock. I can suggest how the person can lighten the load a little. Then I must stand aside and let them go. They have to decide what to do about their health. It is between them and the Beloved, they can try what I say or not.

Now it is not a boulder that I am trying to keep from rolling down a mountain. Each person has their own mountain to climb in their life, their own habits and histories, good or bad, trailing them like Marley’s Ghost in A Christmas Carol. I can suggest a tool to loosen a link of diabetes, or a slightly different trail up the mountain. Then it is up to them. I can’t carry them and should not carry them. Maybe they are approaching a patch of scree and I can suggest an easier or safer path. And then stand aside, stand down, let the people go.

Now I am not pushing a huge rock. I am standing on my own mountain, quiet, and looking at the path behind. I am resting a little and on my own path. I don’t know what will be around the next bend in the path. But I love the mountain and the forests and the birds and the ocean. All of it.

Thank you, oh Best Beloved.

For the Ragtag Daily Prompt: olympics!

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Volcanic fire

A friend and I travel to Hawaii in March 2018. The lava in the caldera had dropped on the volcano and the road around it was closed because of the gases. The changing eruption happened over the next few months. We found a place to wait for nightfall to take photographs. It is way more dramatic in the night, isn’t it? We could see fire rising up in the day too, but at night the smoke is lit up as well by the lava below. A scene on fire, beautiful and terrifying.

The smoke from forest fires has dissipated in Grand Junction. I stayed mostly inside for a few days, which is not hard on work days. The clothes I wear are backwards from the ones I wear on the Olympic Peninsula in Washington. There I have a windbreaker and layers for outside and I think my heat pump has had the air conditioning on once ever. Here I need the warmer clothes for the air conditioned inside. I get cold at work by lunch time and go outside to warm up! Very strange.

For the Ragtag Daily Prompt: fire.

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Favorites

Let’s see: I am going with two favorite writers.

My favorite female author is Laura Ingalls Wilder. My favorite male author is Walt Kelly.

Louis Carreas wrote about how descriptions can be cages, here. WordPress won’t let me comment on his blog (Hi, Lou!), saying that I have to be logged in. Even when I AM logged in. Ah well, maybe the AI has a sense of humor and is messing with me. Anyhow, his comments make me think of the DSM V, the list of behavioral health symptoms defining them into disorders, fifth version. We humans make them up, these lists. My daughter pointed out years ago, “We make up all the words.” It’s all an effort to communicate and we make it all up.

Walt Kelly is my favorite master of playing with words and word silliness. One time Howland Owl and Churchy are trying to make a bomb. They need a certain material. They have a small yew tree and a geranium. They both fall over and CROSS! Owl and Churchy dive for the floor. There is no explosion. Howland Owl says, “The natural born reason we didn’t git no yew-ranium when we crosses the li’l yew tree and the gee-ranium is on account of cause we didn’t have no geiger counter.” They decide against an A-bomb and put a honey bee hive in a shoebox, making a quite effective B-bomb.

Laura Ingalls Wilder starts the book about her youngest years explaining that she tries to be good but she just can’t be as good as her sister Mary. There are ways they are supposed to behave and she fights with her sister and misbehaves on Sunday and runs around. They are also not supposed to talk about certain feelings, but the feelings show through the events. When I read the books to my son and daughter, I found myself a bit appalled and editing the bits about the blackface minstrel show that they do and about Laura’s Ma talking about “dirty Indians”. Mrs. Wilder edited her life quite severely for those books, but I too chafed under the cage of society’s rules and what feeling I was and was not allowed to express.

Now there are series based on Laura’s mother, grandmother and great grandmother. I like them though the feelings aren’t as authentic to me. Not quite. My daughter loved the books about Laura’s mother and I think is like her. My daughter objects to Anne’s behavior in the first book of the Anne of Green Gables series. “No one is like that!” she says. I mention a classmates name, who is very very extroverted. “Hmmm,” says my daughter, “Ok, she is like that.”

The photograph is from 1965. My maternal grandmother, me and my sister. I do not know who took it.

And a favorite carol:

For the Ragtag Daily Prompt: favorite writer.

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Wheels and gears

Ah, wheels! These photographs are from the Great Port Townsend Bay Kinetic Sculpture Festival, from October 2023. All of the machines are human powered and have to go on land, up a big hill, be able to brake, go through water (the Port Townsend Bay is COLD) and through a mud bog at the fair grounds! They have to have a theme, bribes for the judges, support teams (usually on bikes), a teddy bear on board and I think duct tape is required too.

It is three days of costumes, physical work pedaling the human powered machines, a parade, a dance, a Kinetic Kween, a brake test and the challenging trip through the water, the race itself (most mediocre wins) and the mud bog. There are many wheels involved and quite a lot of fabric and glitter. Some machines are thoroughly engineered and others involve more duct tape and improvised floatation attachments.

It is the Pacific Northwest, so there might be giant slugs too. Are there wheels involved in this tail or not?

For the Ragtag Daily Prompt: wheel.

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Talk

Today I will interview people in clinic, but yesterday I hiked alone. Well, no, not really alone. I spot movement and freeze. A silent interview of this rabbit, with the help of my zoom camera. There was a very young bunny further on, about 6 inches long, who hid behind a bush a year from me. I did not want to scare her, so did not get a photograph.

Lizards and crows, too. Chipmunks and a squirrel who was noisy until she realizes that I have spotted her in the small tree, barely taller than me.

I climbed the Serpent’s Trail which is an old road. It goes up and up but is never terribly steep. At the top, I can see the haze: smoke from forest fires in the Pacific Northwest and Canada is coming down. When I got home I closed up the house to keep the air cleaner. It is smokey today with lots of small particulates, not good. We will see more asthma, allergies, eye problems, emphysema and the smoke makes people headachey and irritable. I hope it doesn’t sit in the Grand Valley for a long time.

Meanwhile, the bunnies and the crows and the lizards and the squirrels, can’t go inside, can they?

For the Ragtag Daily Prompt: interview.