Quick Trip

I was asked to attend a meeting in DC yesterday. I was flown from LA to DC on Friday night, then back to LA Saturday night. I was in DC for 18 hours. DC, other than Chicago, is the one place that when I get there, I truly feel like I'm home.

This meeting was put together by a pharmaceutical company. They brought in 12-14 hospitals - mostly academic medical centers. Each center was represented by a senior faculty person and a junior faculty or fellow. The focus was HIV. The goal was to anticipate what the future of HIV is going to be - who are the patients, what are their problems, what will doctors need to best treat them. We discussed what resources we, as physicians, are missing in dealing with HIV patients. We discussed our "wish list" of what we want. We discussed patient programs we'd like to see, social workers we'd like to have, and electronic medical records we'd like implemented. I met a lot of great people who are also passionate about fighting this disease.

I don't know that I am much of an expert, although I have a lot of opinions for sure. :) I was flattered to be asked to join this group. I hope my input, and the meeting in general, will help this company come up with ways to help physicians treat people with HIV. I came across a quotation by Seneca (a Roman philosopher in 1st century AD) in a magazine on the plane ride home: "Luck is what happens when preparation meets opportunity." I think this quotation is great because it reminds me that people who take advantage of situations and are able to turn them into success stories are people who worked and prepared so that when that one opportunity comes, they can make it a "lucky" one.

So, don't feel guilty that you got the promotion and someone else didn't. Alternatively, don't make yourself the victim in a situation that doesn't go your way. We all have to be working hard and preparing ourselves daily for that chance that happens to come - you never know when your "luck" will change.

Back at It...Soon

My vacation ends in a few days. This last week has been nice - a few errands to run each day, a little bit of work to catch up on, but all in all not much to do.

It's nice to wake up without the alarm going off. It's nice to go for a run and not rush through my post-run stretch. It's nice to make lunch at home and sit in my kitchen and eat it.

I thought I would get bored. Maybe there were a few stretches were I got restless. But, there are so many books to read, so many trails to run. I would always want to work in some capacity. But, it would be nice to take a week off every now and then. It would be nice to have my evenings not full of articles to prepare. I know that day is going to come soon...it was nice to get a glimpse of it now.

Still Cold

The race is over. It's been over for 8 hours. I'm still cold.

We got up at 3a to catch the shuttle to the race at 3:30a. I layered on running tights, dry-fit long sleeve shirt, dry-fit short sleeve shirt, cotton long sleeve and a hooded sweatshirt. Not to mention gloves and ear warmers. The sweatshirt was my Brother's - thank goodness I wore it. It was 34 degrees. I saw a few snow flurries.

We stood out in the windy cold for two hours. Wow, I was chilled to the bone.

Then we got to our corral and waited some more. Soon the freezing rain started. Eventually the fireworks went off to let us know we could start! We ran 4 miles into the sleet. My plan was to shed the sweatshirt after a mile or so, but I kept it for the first 5 miles. I saw my Sister-in-Law's parents who were there to cheer us on. I gave them the cotton long sleeve and the hooded sweatshirt. The next mile or 2 was awesome. Through Main Street, into the Magic Kingdom Castle. We saw Cinderella and Prince Charming and the whole Royal Family outside the castle! It was still dark out, so the lights were all on. We also saw a lot of the Disney characters around the park. Peter Pan, Wendy, Captain Hook and Smee. The Bears. Captain Jack and the pirates. So many more. It was awesome! Those 2 miles were the best by far.

Then I immediately wished I had my sweatshirt back. The last 6 miles had the wind at our backs, which was better. My hip started to hurt with about 3 miles left. The rest of the run was fine - rain began so we got wet. At the end, we got Mylar wraps which usually toast you like a baked potatoe - unfortunately, you need the sun in order to really make them effective. In the end, they just worked to keep the rain off.

We got on the shuttle bus to go back to the hotel. For some reason, the bus was frigid. I don't know why the bus driver didn't have the heat on. We got back to the hotel and ran (literally) back to our room. I didn't think I had another 10 feet in me, let alone a few blocks. I couldn't get the water in that shower hot enough. My toes are still cold.

We got cool Donald Duck metals, and we finished the race in just over 2 hours. Not bad for below-freezing temperatures. If I do this again next year, I hope it's a tad bit warmer.

I thought Florida was the Sunshine State

So, it's race time. Tomorrow is the Disney Half-Marathon that my Brother and Sister-in-law and I are running. When my Brother asked me about doing it, I thought, "How fun! Running around Disney World in the Florida sunshine with my family...what could be better?" I've never been to Disney World, but it seems to be like Disney Land - warm, Mickey Mouse, sunny, happiness on a stick.

Not today. Not tomorrow.

Weather.com tells me the high tomorrow is 38 degrees ("feels like 29") with rain likely the whole morning. Not exactly what I signed up for. Good thing I packed running tights and long-sleeve shirts. I have no rain slicker, so we'll just see how it goes. It has the potential to be the most miserable 13.1 miles I've ever experienced. At least my Brother and SIL will be there to whine with.

Stay tuned for the post-race recap!

Family Time in The Region

I got to spend a few days with all my siblings. This is not an easy thing to do, because we're spread all over the place. While I live in LA, my brothers live in Orlando and my sister is Northwest Indiana - affectionately known as The Region. People from The Region are (affectionately?) known as Region Rats. Do with that piece of information what you will.

It was great to see them all. I won't pretend that we grew up sing Kumbaya together every night, but for the most part we got along. We've grown closer as we've gotten older, and I think we appreciate each other more now. We definitely cherish our time together. And we love spending time with the kiddies - my sister has a little girl and boy. As you can see in the picture, some one made sure Uncle Dude was cozy with more than enough stuffed animals during his nap.

This time off has reminded me to stop and smell the roses - metaphorically, of course, since it's 3 degrees here right now. I hope to remember this lesson when I get back to the bustle of LA. In the mean time, though, the Disney Half-Marathon is in a few days...there I'm just hoping to make it across the finish line.

Best Christmas Ever

So, imagine that it's Christmas Eve. You're with your wife and 2 grown daughters. They don't live very far, and they've come over for brunch.

Your pager goes off.

Except that you're not a doctor. Or a fire fighter. You're a patient with end-stage liver disease and that pager means a new liver. You call the transplant coordinator, and she tells you that there's a local match. It's time to drive down to the Hospital and prepare for surgery. Good thing you hadn't eaten that brunch yet.

So, after approximately 10 hours of surgery, you got a new liver. It's nearly midnight and your family is in your ICU room. It'll be a few days before you're extubated, so you're going to miss Christmas.

Somehow, I don't think Mr. H will mind. He and his new liver and doing well. He's not out of the woods yet, but the first critical days are going by smoothly. Even though his memories of Christmas 2009 will be foggy at best, something tells me it'll go down as the best Christmas ever.

"It's been a good experience"

I did some moonlighting today, so I saw some patients who aren't normally mine.

One is a 54-ish year old guy with newly diagnosed lymphoma. He's been in the hospital for a few weeks - he says he was a terrible mess when he came in, but he looks good now. He pointed out that I hadn't seen him back then but if I had it's night-and-day compared to now.

Right now, he's 20lb heavier from water weight - though he points out that he was up 40lbs a week or so ago, so it's improving. Right now, he's yellow. Right now, his liver and spleen are riddled with metastatic lesions, though some of the MDs comment that it's looking better. Right now, his white blood cell count is in the toilet, making him at high risk for infections. He quickly points out that he's not having fevers anymore, so that's an improvement.

Right now, his 27-year-old daughter is at home, having just flown in from DC where she works. She doesn't know how sick her dad is. He has gotten a few rounds of chemo and was deathly afraid of losing his hair. He's not vain, he just wants to ease his daughter into this diagnosis. His nightmare was having her walk through the door to see a yellow, swollen, bald man claiming to be her dad. He called Patient Relations a few days ago and asked them how he can get a hair cut. He wanted it to be short (but not shaved), in case he did start losing his hair. He figured it wouldn't look as bad if it was patchy and shorter.

Whaddya know - Patient Relations called up Al the barber. I didn't know we had a barber. Apparently, Al comes in and cuts hair for those patients who can't leave the hospital. Al's daughter was (is?) a nurse at the hospital and got started doing this awhile back. Al is 82. My patient said that Al did a great job with the tools in his little black satchel, jumping over IV tubing, ducking antibiotic bags, etc. He is really glad his hair hasn't started falling out yet (it might never), and he was extremely happy to have had Al come by.

Mr. T looked at me and said, "You know, it's been a good experience, being in here." I just looked at him - jaundiced, edematous, belly full of over sized organs. His prognosis is up in the air, mostly because his type of lymphoma is so rare there's not a lot of data on it. Mr. T looked at his wife, who smiled, and then looked back at me, "I know that must be weird to hear me say, but it's true. You, the nurses, Al...it's been a good experience."

I wished him a merry Christmas with his daughter and complemented his hair cut. Then I left before I started to cry in front of him.