Gynecology Oncology: A Venting

I've had my fill of these smelly-vagina, blood-spatter-on-my-scrubs, 4:45-AM-wake-up-to-three-alarms, stand-in-one-spot-for-five-hours-without-a-piss, yessir-nosir-thankyousir-mayikissyourbuttsir, stickin-my-fingers-in-deep-dark-dank-unmentionable-places-to-say-i-felt-ovaries-i-didn't-feel kind of days.

Conversation w/ Psychosis

Student doctor Grizzle: sir, how are you feeling this morning?
80 year old Veteran: we're both deadheads right?
Dr. Grizzle: you mean like the band, the Grateful Dead?
Veteran: the Grateful Dead goes to my church.
Dr. Grizzle: what?
Veteran: we're going to give them the church because we have less than 35 members
Grizzle: what kind of church is it?
Vet: Presbyterian
Grizzle: so you're giving your church to the Grateful Dead?

Vet: Yes

Grizz: Who's in the Grateful Dead anyway?
Old Vet: There are about 120 children. They killed a lot of people in San Francisco.

Grizz: I see.....

A day in the life

My day:
Bike ride to work. Coffee.

substance abuse, borderline/paranoid personality disorder, generalized anxiety disorder, paranoid delusions with agitation sexual disinhibition and progressive psychosis with auditory and visual hallucinations. Quote of the day? "Kroger wants me dead."

Bike ride home. Glass of wine. Bedtime

Polo practice

Polo Practice. 5 stories up. 2 pbr. 1 bike 1 ball 1 mallet.

Rigor Mortis

This post is actually from a couple years ago when I was head over heels for anatomy and jogging, two equally horrifying pastimes.

There's nothing that can inspire you to run like a room full of dead bodies. I spent four hours today with my hands immersed in bowel and bile-- probing pancreas, massaging mesocolon, and oggling omentum. After standing in one spot over a semi-rotting body for so long, one feels the urge to move-- not only to flee the scene of decomposition, but also to exercise the right to exercise; a right that my donor no longer possesses. In a way, my run today was an homage to my benevolent instructor (the donor), who inspired me to "shake it while i got it."

However, for those of you who have not had the pleasure of jamming your appendages into the deepest darkest recesses of the human body...(I just realized that that introductory phrase could be misinterpreted as a euphemism for coitus. I am not referring to coitus, grow up)...for those of you who can not fathom the mystery of mesentery, you must understand that dead people, regardless of the preservation process, stink. The stench varies from body to body, and my donor emits (thankfully) a relatively tolerable odor. Relatively is the keyword. The scent is indescribable, but imagine an elderly recluse-- you know that musty "old person" smell?-- now leave that recluse unbathed for a solid ten years, add some feta cheese and fetid bacteria-infested sewer water, and you may begin to understand the complexity of this odor. Now, you must also understand that the smell of cadaver is remarkably clingy. It grabs your clothes, your hair, your skin, and sometimes it seems like it doesn't leave unless you scrub til you bleed.

That being said, I decided not to shower between my dissection and heading to the gym. Hence, I stanked. I stanked bad. I also have not washed my running clothes this week (and I have already put in a solid fifteen miles). So as I hopped on the treadmill next to a cute Middle-Eastern girl I became self-conscious of my stank. Would she notice the smell of death oozing out my pores with every stride? Would she mistake this nasty DBO (dead body odor) for regular BO? Luckily, I didn't care what this girl thought. As I reveled in my sweat, stank, and apathy for the girl next to me, my eye caught glimpse of a cute girl a few treadmills down. I had seen her the night before at the gym. She runs like a gazelle, and (though I've yet to be close enough) I presume she smells like cinnamon and sunshine. So the question soon begged itself: how far did my stench of death reach? What was my range? Would the gazelle be forced to suffer the DBO instead of my usual enticing musk? Would my passion for human anatomy and my overzealous approach to the peritoneum undermine my passion for beautiful women and my underzealous approach to flirtation?? My question was soon answered as the gazelle leapt from her treadmill and fled to an elliptical a few rows down. She had smelled me.

But who needs her? I have my education.

Photo trial

Sister Grace bites it in the bushes.

Just wanted to try posting a picture.

The Battle of How to Die Right

Mr. T is a far cry from B.A. Baracus of the A Team. He is a frail, cachectic Asian man with a bowel obstruction. He sinks into his bed to the point that he disappears. You would think he is dead until he eerily turns his face towards you and speaks in mostly inaudible croaks and groans. He has an NGT (nasogastric tube) pumping out the contents of his gut- bilious fluid that, for some reason, never fails to remind me of the "ooze" from Teenage Mutant Ninja Turtles.

In simple terms, Mr. T is about to burst. He already had one small bowel obstruction last month that required surgical resection of a portion of his 80-something year old gut. He's spent weeks trying to recover, but his tenuous convalescence was complicated by necrotizing pneumonia, abscesses, and underlying depression. And now he's obstructed again. About to take another spin on the merry-go-round. If he doesn't get surgery soon he will burst, perforating his small intestine and spilling bile, bacteria, and shit throughout his peritoneal cavity. Infection would set in quickly, and he would die a rapid but excruciating death.

Mr. T has chosen this. He is declining surgery, opting instead to embrace death, however unpalatable the process. His family wants him to stick around awhile, and thus the Battle of How to Die Right begins.

I was working with the psychiatry resident on call when were consulted on Mr. T-- a capacity eval. The gist of the question was whether or not Mr. T had enough neurons in his noggin to make the decision for himself. Is he of sound enough mind to decline the operation? We set ourselves to the task. We battered the old shell of a man with a barrage of questions and tasks, including gems like identifying a picture of a rhinoceros (the poor guy thought it was a hippo, he must be deranged! No points awarded, by the way).

After much contemplation and verbal hand-waving, we determined that Mr. T lacked capacity. We stripped his autonomy to give up on this world. So sorry Mr. T, but we simply can't let you die the way you want. We ain't in the business of lettin' folks die round these parts. Reflects poorly on our stats. Nobody dies on our watch, y'hear?

I believe it was the right decision to not let Mr. T make his own decision in the state of mind he was in. Nevertheless, why should he get surgery? What is the sense in prolonging this man's life? Is it to comfort ourselves so we can say, "we did everything we could."

He is old, decrepit, depressed, and disabled. Is it just of us to fix his bowels without fixing his brain? Is it inherently cruel to save a man from an imminent death only to destine him to a slower demise by depression? The Battle of How to Die Right rages on....