Category Archives: water

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Canyon Brook

Welcome back, Cee! Glad you are healing!

I am living near Slope Creek and Canyon Brook. However, I have not found the creek or the brook. These are street names. The wildflowers here are blooming along this concrete ditch at the farm kitty corner to me. The farm has cattle and sometimes I hear roosters in the mornings.

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Morning ablutions

I took this with my Panasonic F150, zooming in, walking part of the Blue Heron loop along the Colorado River. Wow! Not truly ragged, but think if instead of combing our hair, we had to clean and arrange all of these fantastic feathers! The heron demonstrated many spectacular neck positions and can fan out the feathers in amazing ways. I tried not to disturb her too much.

Done for now.

For the Ragtag Daily Prompt: ragged.

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There’s a boat here somewhere

Two of the ferries, that cross Puget Sound from Port Townsend to Whidby Island, are in this photograph from January. But it’s the sky that distracts. The ferries and the dock look small in the sound and the sky.

I do miss the Salish Sea!

For the Ragtag Daily Prompt: boat.

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Long way

I am a long way from my ocean and from home.

I looked for a job close to home and then the temp company mentions a job in another state. “Where?” I said. They told me and I said, “I’m interested!” We started the process. I always forget what the process is like. It is hella annoying. There is miles of paperwork. We had a delay from the state, because I need a license for each state and they weren’t meeting until after the start date and then they said, “We’ll let you know in two days.” and THEN they said, “We’ll let you know in two days to two weeks.” So I had three weeks of being half packed and trying to just flow with it. I finally got word, yes, ready, two weeks ago Monday. By Friday morning the cats and I are in the car and headed out.

Now I have worked for a week here. The US currently has 500 different electronic medical records and I supposedly learned my 8th (or 9th) on Tuesday. About six hours of training on the computer and my brain shut down after four. However, the support on Wednesday was good and I started seeing patients. I was careful to say, “If I look grumpy, it’s at the computer, not you.”

So far mostly good. Except, one cat got out two days after we got to our destination. He is chipped and I am still walking miles and calling. The local lost pet group is trying to help. I miss him quite terribly. The door popped out of the carrier when I put it down. I feel like a cat mom failure, but things happen. Elwha is big and strong and I may yet get him back. Sol Duc was sensible enough not to run, but I had to secure her before going after him.

For the Ragtag Daily Prompt: flow.

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I am Elwha

Mother is cutting our food again. Sol Duc and I would rather eat through the day whenever we feel like it AND out of each other’s bowls. She picks up my bowl sometimes! Then the other bowl is empty and there is NOTHING!

As you can see, I continue to offer my favorite things in exchange for food. Mother took platy, but she just rinsed her in the sink. I got her back when she dried. Sometimes if I drop toys in the puddle, the little ants come. They do not taste good. They are not good food. Sol Duc and I persist, though.

I may put the finger box back on the small noisy sky thing setting. Since Mother won’t give us more food. She did get a new water thing. I am not sure about it. I would rather have food.

Ragtag Daily Prompt: puddle.

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Tenacity

Two skills needed in primary care are tenacity and listening. That is a combination that can make a diagnosis. Here is an example.

In residency, many years ago, I have a patient with developmental delay. He lives in a group home. He can’t talk though makes some noises. The group home staff bring him to me. His head is misshapen because his mother had measles in her pregnancy.

The staff says, “We think his head hurts. He just isn’t behaving right.”

“Did he fall?”

“We don’t think so.”

“Fever? Nasal congestion? Cough?”

“No.”

“How long?”

“Over the last week.”

I do an exam. I really can’t see his tympanic membranes because of his skull shape.

“Maybe he has an ear infection. I can’t see. We’ll try antibiotics, but if he is not improving, bring him back. In five days.”

They bring him back. “He’s no better.”

I get on the phone. I need a CT scan of his head and the group home say he won’t stay still. I need anesthesia to sedate him for the CT scan. It takes two tries and quite a bit of phone explaining with both the anesthesia department and the radiology department. Persistence. I am looking for a subdural bleed in his head from a fall, or a sinus infection, or something.

It is done and I get a call. Not from radiology or anesthesia but from the ear, nose and throat surgical resident. He is very excited. “Your patient!”

“Yes,” I say.

“He has a pseudocyst! In his sinuses! He has abnormally large sinuses and this is the biggest pseudocyst anyone here has ever seen!”

“Um, ok.” Honestly, I’ve never heard of a pseudocyst. It turns out to be packed nasal drainage in the sinus. Bad ones can erode through bone into the brain. Certainly that seems like the cause of the headache!

“We are taking him to surgery!”

Residency can be pretty weird, when someone gets really excited about a rare disease or interesting trauma case or whatever. I found that I was entirely happy just doing health maintenance exams and encouraging people to quit smoking and exercise and drink less. However, I was also good at finding weird things.

The ear, nose and throat surgeons in training were very happy about the surgery. The group home staff were happy too. “He’s back to his old self. Thank you!”

It took tenacity to set up the head CT. It’s important to listen to the families and caregivers too, because they know the person better than I do. They were right: his head hurt. And we found out why and were able to treat it.

For the Ragtag Daily Prompt: tenacity.

Water is tenacious too, wearing down stone and wood and glass.

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Dock and gangplank

As the tide comes in, the dock and the boat rise with the tide. The rings rise up the pipes of the pipe dock.

The gangplank is hinged so it can swivel. Stairs would not make sense, because the angle would change as the tide changes.

No hinges or swivels on the bridge!

I took these yesterday in La Conner, Washington. This is the Rainbow Bridge over Swinomish Channel.

For the Ragtag Daily Prompt: swivel.

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Painted sky

I think the sky and water here are more sophisticated than I anything I can imagine.

After my mother died, I wrote a poem about her and my kids. Her part:

I keep wondering
what the art supplies are like
and if you work on sunsets
or mountains
or lakes

The rest of the poem is here https://drkottaway.com/2021/09/23/painting-angels-2/.

For the Ragtag Daily Prompt: sophisticated.

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Air and water

I took a wonderful limnology class at the University of Wisconsin, Madison in college. The study of inland aquatic ecosystems, lakes, reservoirs, ponds, rivers, springs, wetlands and so forth. I loved this course because it is such a generalist course. We talked about the chemistry of water, the physics, the ecology, the geography. The plants and animals, microscopic to bigger than us. And lakes that freeze, the ice floats on top, because it is most dense at 4 degrees C and less so at 0 degrees C. This oxygenates the entire lake as the water turns over until the entire lake is 4 degrees. Tropical lakes do not do this.

The photograph is of the Salish Sea, so not an inland space. The liminal space for me is the surface, the border between water and air. Sometimes swimming, if air and water are both warm, it’s hard to feel the exact liminal space, wet skin in the air and then the water.

For the Ragtag Daily Prompt: liminal.