Category Archives: teamwork

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Food, food, food

When I get pneumonia, I drop ten pounds the first week. Since I had influenza viral pneumonia in 2003, I don’t run a fever. I just have a fast heart rate resting and get short of breath walking across the room. With Covid, I needed oxygen.

Each time, it takes longer to gain the weight back. Then I go over my normal weight and eventually have to rebuild muscle. This time I did not gain any weight back for over a year. But now it’s been three years and I am in the muscle rebuilding and weight loss section.

It does get harder as I get more mature. Older and wiser, right? Well, maybe. At any rate, I am trying to lose weight without any drugs or injectables or herbs. I am trying to eat the way the diabetic educators tell us to: half the meal should be vegetables. Every meal. A small grain and a small protein and not too much fat and vegetables. Corn really falls into the grains.

In clinic I often do a diet history of the day before. What did the person eat? I think about half of the histories come back with almost no vegetables. Pizza is NOT a vegetable, it’s mostly in the grain department. Grains are plants, I agree, but they send blood sugar up a lot more than celery and kale and collards.

Meanwhile, where is CHOCOLATE on that plate half covered with vegetables? Darn. My dessert could be a small piece of chocolate with a carrot on the side? Chocolate dipped carrots? I honestly do not like celery. Celeriac yes, celery no, though I have it in the curried chicken salad I made yesterday. That chicken salad is not half vegetables. It has some celery for crunch but it also has grapes. So, I ate it last night with an equal amount of mixed lettuce and sugar snap peas from the Farmer’s Market.

I do not have diabetes, but if I am recommending a dietary change, I think I should be able to do it too. We shall see. I think right now my diet is about 1/3 vegetables. Fruit does not count as a vegetable for this.

The other thing about vegetables is you have to cut them up. Ok, wash them too. And it’s not like one doesn’t have to cook beans or rice or meat, but vegetables do take time. If I have a person with low blood sugar or who is feeling awful, saying make half the meal vegetables may not be realistic. When someone is really frail or ill, it may be that getting out of bed, washed and dressed and to the table is overwhelming. Cut up vegetables? Cook from scratch? Maybe not.

For the Ragtag Daily Prompt: lunch.

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Coping or manipulation?

I see someone in clinic with a difficult boss.

This brought up work stories. Now, are these coping skills or manipulation or a bit of both? You decide.

Long ago I work in a lab at the National Institutes of Health. We are super busy and doing a lot of overtime and have some media pressure as well. Our boss gets us together and gives us hell, about making mistakes. I am annoyed, because I’ve been really careful. I stew. I write a letter, what I think he should have said, which is telling us all great job, you’ve worked super hard, we are under pressure and also we need to not make mistakes. I circulate it to the four other lab techs, who enjoy it. The lab cheers up a bit. Eventually I get brave and give it to the boss. He likes it and reads it to everyone, who try not to laugh. A year after I leave the lab, I visit, and he has that letter up on his bulletin board.

Long ago I am made chief of staff at a hospital. My goal is to finish the monthly meeting in an hour. I have two senior doctors who always blow up about something in the meeting. I decide to be proactive and go to each one before the meeting and prime them. I pick a topic, say I am worrying about it, and what do they think? They each then blow up in the meeting, but now they have no opposition so there is no brawl. I prime them about something that is not really controversial. I do get the meetings done in an hour.

One year I go to the lake with my family. My children are small. My father has been drinking heavily. I call ahead and say, “Will you treat our tent site like my house and not come there if you are drinking?” “You don’t own the lake land,” says my father. “We don’t have to come.” I reply. He agrees not to drink at our tent site.

He is angry, though, and pretty much won’t speak to me. I ask if he would come to a family sing at my site. He says no. I think about it for a while and ask my cousin to hold a sing at her cabin. My father agrees to that, not knowing that I am the instigator. He is happy at it because he’s said no to me and yes to her, and I am happy too, because I love to sing and sing with him.

My father was one of eight people to start Rainshadow Chorale in 1997. I sang with him in the chorale from 2000 until the year he died.

Where is the line between manipulation and coping with a difficult person?

I think this is a time travelogue, so let it be my Ragtag Daily Prompt for today.

The photograph is of my father in 2012. He died in 2013.

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Covid Morph

So far I have gotten positive Covid tests on one patient a week, all with really different symptoms.

One older person who was short of breath walking, tired, coughing and loose at the other end.

One young one whose only symptom was profuse throwing up.

One with a sore throat, nasal congestion, cough and feeling fairly awful and about to go on a trip, darn it.

There isn’t a nice pattern to tell me what the local strain is doing. It can do any darn old thing. I have also seen someone with strep throat and another couple who had similar symptoms to the others but did not have Covid. It’s morphing like an AI, I swear. I am masking in clinic but so far so good.

The Ragtag Daily Prompt is essential. I think it’s pretty essential for me to wear a mask in clinic, in crowds and on airplanes, since I am quite tired of pneumonias.

I have been the only “provider”, that is, doctor, in the clinic for the last two days. The medical assistants and front desk and I are starting to work as a team. I ask the front desk person how to communicate with her from the clinic room most efficiently. Something was weird about the refill system and it kept refusing refills. On Tuesday I had over 100 “documents” in the computer “box”. Lab work, specialist reports, refill requests, x-ray reports, nursing home things, surgery reports, wound clinic, emergency room, and so forth. I am trying to skim them, but I can’t say that I will remember person A’s dermatology report after skimming 60 others. If you go to your primary care provider and have had some major medical thing recently, remind them. They may have gotten and read the note, but gosh, it’s hard to remember at 100+ per day. Right now I have not met most of the people, so it is even harder.

The photograph is just for fun, taken a few weeks ago on the trail that runs by the Colorado River. Lovely!

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Tinker, tailor

Tinker brought up this rhyme for me:

Rich Man, Poor Man, Beggar Man, Thief,
Doctor, Lawyer, Indian Chief.

It turns out that another version is

Tinker, Tailor, Soldier, Sailor,
Rich Man, Poor Man, Beggar Man, Thief

And I had forgotten AA Milne’s version called Cherry stones:

Tinker, tailor, soldier, sailor, rich man, poor man, beggar man, thief,
Or what about a cowboy, policeman, jailer, engine driver, or a pirate chief?
Or what about a ploughman or a keeper at the zoo,
Or what about a circus man who lets the people through?
Or the man who takes the pennies on the roundabouts and swings,
Or the man who plays the organ or the other man who sings?
Or what about the rabbit man with rabbits in his pockets
And what about a rocket man who’s always making rockets?
Oh it’s such a lot of things there are and such a lot to be
That there’s always lots of cherries on my little cherry tree.

Now I’m going to have to play with a version with some current jobs:

What about a tweeter, a twerker, a medical AI?
Influencer, programmer, cooker of meth highs?

Oops, that might not be the children’s version.

For the Ragtag Daily Prompt: tinker.

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Seeing rain

I like it when you can see the rain coming, the cloud in the distance with the rain coming down in lines and strands. I can smell the ozone and everything waking up in the rain, as if all the plants are talking to each other. “Oh, here it comes and I am so thirsty!”

“Wait, that’s a bit too much!” “Eeeee, hail!”

For the Ragtag Daily Prompt: rain.

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Hi ho, hi ho

This is zoomed in to the Colorado National Monument in the early morning. The light and shadows are wonderfully dramatic and change by the minute.

I won’t trudge to work today. I was mildly sick the last two days and am better today, so I am happy to go. Hoorah for feeling better.

For the Ragtag Daily Prompt: trudge.

And two songs from The Yes Yes Boys, 2004, here.

I do just what I please:

Make it easy:

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Tough cat

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.

For the Ragtag Daily Prompt: tough.

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Useful

I admire this orange sculpture outside the local library and then realize that it’s useful. Bike tools and a pump, in a central location and orange too! Very nice! I like it up against the darker orange of the building.

I’ve been haunting the library about twice a week, taking out piles of books. A new friend has also lent me a kindle, to read all of Lois McMaster Bujold’s Penric and Desdemona series. And what else will I find in it? It is like exploring someone’s bookshelves!

I have managed to acquire a few books and I am now watching for Little Free Libraries to pass the ones that I have read on to someone else.

For the Ragtag Daily Prompt: sculpture.

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Cool

I am still wearing sweaters to work.

It is high desert here. One morning it was really pretty cold when I walked Sol Duc in her harness. Really she walks me. Cats are like that. But I wished for mittens. The temperature was 38. The last few days the low is in the high 40s or low 50s. Two days ago it was 90 driving home from work.

The consequence is air conditioning. I do not have air conditioning on the Olympic Peninsula. My house is from 1930 and well designed to stay cool in the summer and we rarely hit 90 anyhow. Two summers ago my heat pump switched to cooling when we had one hot week, startling me. We did hit 100 one day in Port Townsend, but it still dropped thirty degrees at night because of the cool Salish Sea surrounding us. My patients would complain of the awful heat when we got to 80 degrees. It’s all relative, right?

Here in Grand Junction, we are just starting to heat up. The hottest time appears to be around 4 or 5 pm.

I was cold at work all day two days ago. I wore a linen shirt over another shirt and it was not enough. I went outside at lunch and heated up nicely in the sun. Yesterday I took a wool jacket with me. Air conditioning is very strange.

This morning it is 51 now and projected to reach 85. The high desert temperature change of 30 to 40 degrees is not that different from home, but the air conditioning is different.

For the Ragtag Daily Prompt: ambivalent.

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Dance!

I took this at the 2023 Swinging by the Sound Dance weekend in Port Townsend, Washington. This is the dance contest at the live band dance in the evening. The ballroom is at our American Legion Hall and has a fabulous floor to dance on. I was volunteering, since my lungs still were not up to that much dancing.

I do love to dance, though, and plan to for as long as I can. It helps with balance and reduces fall risk, too! My ex says it’s the most fun you can have with people standing up.

Jonathan Doyle led the band and they were and are fabulous.

For the Ragtag Daily Prompt: ballroom.