Like 2,000 spoons...

Recently, I was staying at a relative's house, and when I was having a bowl of cereal in the morning, I literally could not find one normal spoon. When I opened the silverware drawer, this was the array of spoons that I found:



Tell me, who buys 20 little tiny baby spoons, but does not have one normal spoon?

When Dogs Attack

In my attempt to get to 10,000 steps per day, I've been trying to take more walks around the neighborhood. I don't live in a big city or anything, and walking paths are hard to come by. So I can either walk around the center of town, where I'm likely to get hit by a car, or go to a more residential area.

The problem with the residential areas is that there are dogs. Not that I have anything against dogs, but it sort of disturbs my peaceful walk when I can't walk by any houses without a dog barking its head off at me.

The other day, I was walking through a residential area, on the sidewalk in front of a house, when a dog started racing down the lawn towards me, barking like crazy. At that point, I realized that this dog was not on a leash. I backed up a few steps, off the sidewalk, in what would probably have been a pretty meager attempt to not get mauled by this dog, if its owner hadn't come out and yelled at it.

Unfortunately, as I stumbled into the street, a car had to swerve and just barely avoided hitting me.

I was really freaked out by the whole thing. Seriously, if that car had hit me, Who would have been at fault? The car? The owner of the dog that didn't have a leash? Or me, for being stupid enough to dare to walk in front of a house that had a dog in it?

I swear to God, these 10,000 steps a day are going to kill me.

Book recommendation

For those of you who are looking for a medical thriller to read this summer, an indie writer I like recently came out with a new book called Dead Still. Be sure to pick it up today!

300!

Who wants to write the 300th review of The Devil Wears Scrubs? Which is inexplicably outranking House of God on Amazon.

Also, I'm proud to report we have raised nearly $5,000 from sales of 11 out of 10 for Deworm the World. That's a lot of parasites we've killed. Strong work!

Surgeons who shouldn't be surgeon

I was having a conversation with some colleagues recently about surgeons who really shouldn't be surgeons.

For example, they were talking about surgeons who just had clumsy hands or were bad at suturing. One person told me about a CT surgery fellow who had a HORRIBLE essential tremor.

The problem is that generally people are accepted to surgery residencies based on grades and research. And maybe even interpersonal skills. But how can you even tell if a med student is clumsy with his hands? Aren't they all?

I guess I feel sort of bad for a surgery resident who discovers that they really kind of suck at surgery. But what can they do at that point?

(Also, I feel sorry for their patients.)

Damn you, Dory

Recently, we took my younger daughter to see Finding Dory. She'd seen Finding Nemo many times, and it was one of her favorites.

As per normal for Pixar movies, I shed plenty of tears during the movie. But my daughter was totally stoic, as per normal for her.

Then as soon as we got out of the movie, she burst into tears. And didn't stop crying for two hours. Then that night, she said she couldn't sleep because she kept thinking about the movie and how sad it was. And intermittently, she's had trouble sleeping since then.

I've never had to deal with this before! I don't know what to do. She's intermittently terrified of being lost and sad for Dory.

Damn you, Pixar. Why do you have to pull heartstrings so effectively?

$60???

I think I've mentioned here that I've been trying to look a little nicer at work recently now that I'm getting freaking old. So for that reason, my parents treated me to a shopping spree at some nice stores for my birthday. Instead of my usual Old Navy and Target, I was told to go to nicer places like Ann Taylor and J. Jill. And for the first time since I was a child, I didn't even look at the price tags. I just got what I liked because my parents can afford it.

Until I got home.

I really couldn't help but gasp a little when I was cutting the tag off what appeared to be a plain white shirt and saw that it cost $60. Seriously, WTF? That shirt should cost, like, $7.

Who buys a plain white shirt for $60???? I never would have bought that with my own money! And I'm supposedly one of the wealthier people in this country. Who supports these stores? How are there enough people who want $60 white shirts when 2/3 of American don't have enough money to cover a $500 emergency?

Are there people out there spending more than 10% of their savings on a single shirt? I just don't get it.

Allergies

Recently, my daughter has become allergic to water.

No, not really.

But she started breaking out in hives whenever she went in our community pool last summer. It doesn't happen in the pool where she has swim lessons, so I figured it was too much chloride. But then she started summer camp a couple of weeks ago, and she breaks out in hives at the beach and even during a trip to a water park.

I called her pediatrician and they recommended Zyrtec. Which helps only slightly. So then they suggested allergy testing to figure out what's wrong and how to treat it.

We got a referral to their allergy clinic. I explained the situation.

Receptionist: "We can't test her if she's been on any antihistamines in the last week."

Me: "Oh man. We just gave her one on Thursday."

Receptionist: "Oh. So it's going to be a whole week until we can do it. And you can't give her any more."

Me: "Fine. We can wait."

Receptionist: "Okay, so, our first appointment is.... September 1."

Me: ".... But the whole summer will be over by then."

Receptionist: "Well, it will be useful information for next summer."

First of all, why did they ask me if she'd had any antihistamines this week if they were booking two months ahead??? Just to torture me? Second, I feel like all specialists have zero appointments within a two-month window. So if you have any urgent need for a specialist, then... I guess you're just shit out of luck.

It sucks that my daughter has like three water-related trips per week at camp and every single one of them makes her break out in itchy hives, and she can't be seen by an allergist until the summer is over. I'd probably be even more pissed off if I actually thought the allergist would be able to do anything to help her.

A Case of Left neglect

You can't pick your parents and you can't pick the side of your brain that you damage.

I always thought that injuries to the left side of the brain would be the worst, because that's where the language centers generally are. And talking is basically all I do. But after seeing uncountable numbers of strokes and brain injuries, I've changed my mind. Right brain injuries are worse.

The right side of the brain controls attention, memory, reasoning, and problem solving. Very often, people who have an injury to the right side of their brain have very bad insight into their deficits (anosognosia). Let me tell you, it's really hard to recover from brain damage if you don't even recognize that you have a problem. Also, many people with right brain injuries become absolutely obsessed with their bowels. Even more so than my elderly parents.

But one of the most striking deficits that you can see with a right brain injury is left hemineglect. That happens when you basically stop paying attention to the left side of your world... like it doesn't even exist! (It can happen on the right, but it's less common and less marked due to redundant processing of the right side.)

A while ago, I had a rehabilitation patient named Lucy with horrible left neglect. When I first met her, she was lying in bed, her head cocked over to stare to the right. When I stood on her left side to talk to her, she wouldn't turn her head no matter what. I finally gave up and stood on her right side.

"Lucy," I said to her. "Can you lift your left arm for me?"

Lucy glanced down at her arm. "Oh, that's not my arm."

"It's not?"

She shook her head. "No, that's the arm of the patient in the bed next to mine."

Granted, our hospital can be crowded, but we generally do try to keep two patients out of the same bed.

We worked with Lucy to improve her left neglect. She improved, but it was still pretty bad. Lucy would walk into walls on the left and only eat the right half of her lunch tray. But the most intense moment in Lucy's recovery came a few weeks into her rehab stay. A physical therapist named Jim went into her room to treat her, and she started screaming her head off. We'd never heard her shriek like that, and several people came running.

"What's wrong, Lucy?" a nurse asked her.

Lucy pointed to Jim. "That man is a rapist!"

Now even though Lucy had a brain injury, that is a very serious accusation that we had to take seriously. After all, people with impairments are often a target of abuse. We got Lucy calmed down, and we asked her what Jim had done to make her think he was going to rape her.

"It says right on his badge that he's a rapist!" she cried.

Jim's badge said "PHYSICAL THERAPIST." Because Lucy had a left neglect, she didn't read the left side of that phrase. So all she could see on his badge was "RAPIST."

Jim was acquitted of all charges.

(If you enjoyed this story, you should check out my book Brain Damage.)

The Demented Attending

There was this attending I worked with in residency who we were all certain was getting demented. He was about eighty years old and he always talked in a voice twice as loud as anyone else. Plus I would have interactions with him like this:

Dr. Old: "Fizzy, there's an article I really want to show you about neurogenic bladder. It's excellent. I'm going to bring it in for you."

Me: "Okay."

Next day:

Me: "Did you bring me that article on neurogenic bladder?"

Dr. Old: "No, I forgot. I'll bring it tomorrow. I promise."

Next day:

Me: "Did you bring me that article on neurogenic bladder?"

Dr. Old: "I forgot again. I'll definitely bring it tomorrow."

Next day:

Me: "Did you bring me that article on neurogenic bladder?"

Dr. Old: "What article?"

Generic

I'm a big believer in buying generic brands of products. I don't understand why the generic isn't as good as the brand name. But sometimes... the brand names really are just better.

Like recently I bought some generic brand butter. And the butter was... weird. I couldn't detach it from the wax paper wrapping it. It was just an odd texture.

And I'm currently getting burned by some generic paper towels I bought. I'm beginning to realize that toilet paper and paper towels are two things that you CANNOT cheap out on. The generic paper towels were two-ply and I thought they'd be okay. Like the Sparkle commercial says, "Do you really need a paper towel that can hold a bowling ball?" No, but you need something that can clean up a tiny spill without using like ten paper towels. (Sparkle brand sucks too.)

While it isn't generic, I feel like Scott paper towels should be called out for the awfulness of their toilet paper. I didn't realize how bad toilet paper could be till I used Scott.