loose dogs and live grenades

Granada and The Lost Boys

2011-01-23T19:08:00.001-08:00

January 23
I arrived in Granada this morning, met up with the rest of the group of volunteers and got on another bus to Laguna Apoyo. It sits under Mount Mombocho, a dormant volcano. We swam, ate and generally chilled out.

Once back in Granada, we split up and a small group of us wandered around the mercado after a cup of lovely Nicaraguan coffee, mas fuerte!

After dinner we were standing in the hotel lobby and an American man approached us. He feeds some of the homeless boys and is working to help them stop sniffing glue. Two of the boys had a high fever, would one of us come take a look? There were eight or nine raggedy, skinny boys ranging in age from 8 to 13 or 14. Three of them had fever, sore throat, body aches, swollen lymph nodes, and a cough. One just had fever and lymph nodes. They all wanted attention and love. There wasn^t much I could do except hand out ibuprofen and hugs.

Grammatical caveat. The Central American computer keyboard has many subtle differences which is causing me to pull my hair out. So if you see punctuation that doesn´t seem quite right, just bear with me this week.

January 24

We started clinic today. The day started with a trip to a pharmacy to purchase medications to give out. All together I saw twenty five patients from the ages of 4 months to 80 years. Just a regular day. Paula, an RN from North Carolina, worked with me today. Boy was I happy to have her. After work, we went to a boy´s orphanage for our daily mass. It was in spanish today. My language skills are picking up! We took all the boys for pizza afterword. Tomorrow we go to a girl´s home called Calcutta. I wish I had time to record everything that´s happening here. Every minute feels significant.

Bienvenidos a Nicaragua

2011-01-22T20:37:00.000-08:00

There is a certain joy that comes with traveling to the tropics in the winter when one has been freezing their tushie for the last couple of months. I´m on the hotel computer at the Best Western hotel across the street from the airport in Managua, Nicaragua, waiting for my room to cool off.

There are all sorts of flowers blooming in the courtyard and the moon is up. In the morning Í´ll be catching a shuttle to Granada, where I´ll be staying for the rest of the week. The plane was loaded with Minnesotan women who were coming to volunteer with an orphanage through their church. All of them very blond and tall and thrilled to be leaving the artic temps behind. I sat next to a gentleman from Monroe, Louisiana who was here on his fourth trip to Acatal, bringing medical and building supplies. He still had a four hour bus trip into the mountains after reaching the airport.

It still feels unreal that I´m here and I´ve got that "just traveled for 12 hours" sort of manic feeling. A good night´s sleep followed by some Nicaraguan coffee should fix me right up.

Stay tuned. Hopefully, I´ll be able to get an internet connection on my laptop tomorrow. If so, there will be some photos!

Buenos Noches.

Birthdays, Triathlons, etc.

2010-12-09T19:34:00.000-08:00

First off; the triathlon! I finished and won first place in my age group. I'm pretty sure I was the only woman in my age group, but whatever. I didn't even know how to swim when I started training for this thing in July. The run was my fastest time ever, I was completely shocked. My bike, Fabio the Italian Stallion, developed a flat from a slow leak in the rear tube. This made the bike section but slow and excruciatingly painful. I still finished thanks to the handy-dandy CO2 cartridges that I was given and finished the swim in record time. Technology is our friend.

So I think I'll do another one. The people that I met were friendly and supportive beyond words. The feeling that I came away with is that my body, with the appropriate amount of preparation, would do anything I asked of it and that my mind can get around just about anything.

Tomorrow is my 40th birthday. I'm not sure what 40 is supposed to feel like but this is not bad. If this is the ramp up for the rest of my life, bring it.

2010-11-27T17:33:00.000-08:00

My family made the trek to Las Vegas for Thanksgiving. It seemed like there were a lot more of us than usual, but it was hard to tell until we actually all sat down for the meal. My father came from Albuquerque. His wife, Kay, stayed behind with her parents. My middle brother, Josh, brought his wife and all four children and my youngest brother Aaron brought his wife and three year old son. I think the final head count was around 10, but I only fed 8ish. The three year old was at the end of his rope by the time we ate and my nephew Jaden, who has Down's Syndrome, takes his meals through a J-tube.

It was complete chaos and I loved every second of it. Of course, I was in the kitchen the majority of the day. That meant that I didn't have to manage the children. My niece, Alyssa was a huge help. She set the table, snapped the beans, and took out the trash. My nephew Brandon peeled potatoes, took out the compost, and also helped with the table. Dad helped me cook.

My turkey was fabulous. I tried something new this year: a citrus salt rub on the outside. It sounds kind of strange but the salt seals all that moisture inside the bird so that it's incredibly juicy and tender. It was the first time I've cooked a turkey in many, many years and it was spectacular!

When it was time for people to leave, it was bittersweet. I was reminded all day of my sheer good fortune. I have so much love in my life, a beautiful family, great friends, work that feeds my soul, and great health. I only wish I'd taken more pictures.

2010-11-21T10:43:00.000-08:00

Self-medicating is the way in which people use mind altering substances to manage anxiety, loneliness, and depression. Schizophrenics smoke cigarettes at much higher rates than people without mental illness and have a harder time quitting. Let's face it; most of us have sub-par coping skills and need something to help us through the scary bits. This doesn't have to be getting high, getting drunk, or smoking. It can be religion, relationships, sex, food, shopping, or gambling.

I have a long history of getting involved with men who are addicts. They had the easily recognizable type of addictions: mostly alcohol and prescription painkillers. We'd do the usual codependent dance before I'd get dizzy and nauseous and then I'd be surprised when the relationship ended in disaster. I've been trying to sort out the reason why this particular cycle keeps repeating itself. It's because relationships and sex are my addictions. They are the way that I cover up the anxiety I feel, the darkness of loneliness and my fear that I won't be loved. That I'll die old and alone and my fifty german shepherds will devour my corpse because no one will notice that I'm gone.

One of the first things that a person who is self medicating has to do is stop doing what she's been doing because it isn't fixing the problem. The solution is making the problem worse. Then she needs to address the underlying damage, the "why". The why is low self esteem and fear. The real solution is love.

I'm not talking about more relationships, more sex. I'm talking about loving yourself and recognizing the love that's already there under our noses. Our friends, families (as dysfunctional as they are), our pets, your particular version of divinity. These are all sources of brilliant, warm, unflinching adoration and love. Holy cow! Most of the time we don't even recognize how lucky we are. It's an embarrassment of riches!

The other major part of recovering from addiction is abstaining from the thing that has been covering up the fear in such a self destructive fashion. Alcoholics have to stop drinking. Drug addicts have to stop using. Relationship addicts have to be single. We all have to go through a period of detox in order to deal with the frightening darkness. There's no way to deal with the darkness without the light of love.

I'm going to keep working on this. I'm no longer willing to do the codependent hokey-pokey. I'm going to learn some new dance steps.

I'm Ba-ack!

2010-11-18T17:22:00.000-08:00

Well, hello there. I'm sure all three of my followers have long since given up on me and my blog. I'd nearly given up on it as well. But it's been an interesting year+, I'm about to turn 40, and I figure there's some self examination coming due.

Here are the highlights of 2009-10;
1. Relationships with two lovely men that, in the end, I could not commit to for various reasons.
2. Bought the midlife crisis mobile, a 2002 sunburst yellow mazda miata.
3. Katie turned 16 and we went to New Orleans in July. Hot. No joke.
4. A couple of near-misses with family members. Fortunately, they are still with us.
5. Another trip to New Orleans last December and a Southern coastal odyssey in March that began in North Carolina and ended in Florida. We rescued that trip from the flames and don't ever want to repeat it.
6. Started training for my first triathlon.
7. Learned to swim to prepare for first triathlon.
8. Moved from my house in the country to a cute little place 4 blocks from work. It's not nearly cold here but it's only November.
9. Three patients died by their own hands.
10. Began to examine my spirituality from a different angle.
11. Rode 40 miles in the Santa Fe Century, farther than I'd ridden ever, then went to bed for ten days with the flu.
12. Chickens. Wanda. No Chickens.
13. Ran my very first 5k race, the Duke City Marathon. I started training for that race when I was twenty, hurt my knee, got distracted with several cute guys and finished with big 'ol grin on my face, faster than I though I would. With food poisoning and 3 hours of sleep.

What's Coming Up:
1. Polar Bear Triathlon. If there's a hard way to do something, I'll do it. A triathlon. In December. Non-standard distances. Instead of a 5k run, it's a 7k. Instead of a 12 mile bike ride, it's 20 miles. And the swim is at the end. My goal is not to drown.

2. My 40th Birthday. With it, a big party with friends coming into town from all over and free lift passes from Sipapu Ski Resort.

3. Big Christmas Vacation. Beach, Katie, good friends, fish tacos.

4. Living single for a while. Yeah, I know I've said that before.

Yes, it's been an eventful time. There are a few goals for the upcoming year;

1. Grow my community here in Las Vegas. I'm going to be here, it seems, for a while longer. The people that I've met are wonderful, warm, and fascinating and I want more of that. I'm not sure how that's going to work, but I'm keeping myself open to opportunities.

2. Compete in more races; triathlons, 5k's, 10k's, whatever. The thought of a 1/2 marathon crossed my mind, but let's not get crazy. Crossing that first finish line with the cheering crowds with the endorphins kicking in was an unbelievable experience. More of that, too, please.

3. 2011 is a travel year. The itinerary is a little vague right now, though.

4. Continue to explore the interesting turn my spirituality is taking. More on that as we go.

5. Take some time to really be alone. Previously, I've removed myself for three months from relationships. Now a year or more may be in order. This will be discussed ad nauseum for the next 12 months or until I get my head screwed on straight. Not for the delicate constitutions.

6. Rebuild my savings account. I'm not broke by any means, but my accounts took a few hits this year. A little more discipline is in order.

So, there.

See ya in a few days.

Where did I put my summer?

2009-08-12T16:42:00.000-07:00

I've been out of the blog-o-sphere for the last two and a half months. Katie came for the summer and it seemed like every waking minute was packed. We went white water rafting, she had friends come to visit, and we spend a few days in Pagosa Springs. Katie got some babysitting gigs and took art lessons. I got a new bike, a fabulous Bianchi Volpe that I ride all the time. I rode in two charity events in Albuquerque; one for the American Diabetes Association and the other for NM AIDS Services. In September I'm planning to ride the century in the Durango Fall Blaze and Celebration. Hopefull, 'll be up for the mileage and the crazy climbs!

My twenty year high school reunion was last month. Whoah! That was a little weird. There were a few folks with whom I was glad to reconnect, most I already had via the magic of Facebook, but others I didn't remember. It was like one of those strange dreams where you are supposed to be taking a test, but it's in a language you never studied.

Anyway, the activity isn't looking like it's going to slow down. I'll get some pictures up pretty soon and try and keep the blog interesting for the three of you who read it.

2009-05-23T09:15:00.000-07:00

New Mexico has some of the best weather in the United States. Over 300 days of sunshine, relatively mild winters at the lower elevations and, north of Albuquerque at least, summers that aren't painfully hot. Consequently we are weather wimps. We don't know how to drive with anything wet or white on the road. Most of us have dry rot on our windsheild wipers and umbrellas are something we buy when we get ready to go out of town.

Yes, we have our summer monsoon season; those lovely afternoon thunderstorms in the summer that cool things off and keep things green (as green as it gets in most of the state). But at most those storms last for about an hour. We consider them more like mood swings than real weather trends.

For the last few days, it has been cloudy and rainy here in Las Vegas. This is great because our moisture has been pretty sporadic since January and we were looking at a nasty fire season. A collective sigh of relief has gone up across Northern New Mexico. That sigh lasted until this morning when we looked out side and said "What the hell? Why is it still raining? When is it going to stop? Are we going to have to build an arc?"

The forecast calls for thunderstorms through the weekend and 80% chance of showers daily through next weekend.

WHAT?

My Stars

2009-05-18T19:53:00.000-07:00

This is my friend Lillian. Lillian is one of the most wonderful, formidable women I know. She's a single parent to a gorgeous, talented, athletic daughter. She's the second generation operator of a 1200 acre ranch east of Las Vegas. I'm not sure how many cattle she has but she tends them diligently. Her little cabin was a stone barn that she and her daughter restored, plastered, and expanded by hand. It has no electricity and no running water, just a cistern, a wood burning stove, and a lantern. The two of them created roadways on the ranch with a pick and a shovel. Whenever she and I get together we laugh like little kids. She was my first friend here in Las Vegas.

One of the interesting things about Lillian, but certainly not her defining feature, is that she has Multiple Sclerosis. However, she doesn't define herself by her illness. To her, it's a reason to creatively adapt.

Because she know's she won't be able to manage the strenuous responsibilities of ranching forever, she's created a plan. She's opened her ranch as a photographer's retreat and gives tours for other people as well. So far, besides the photographers, she's hosted botanists, hikers, and archeologists.

She's also restoring a one room schoolhouse on her property to serve as a bed and breakfast so that guests can stay for a while.

One of the things I love about Lillian is her cheerfullness. She always has a positive attitude, even when she's out of energy for the day. I think this is what has kept her mobile despite her illness.

So, if you're out our way, see if you can book a little tour with Lillian.

More Love Lessons from La Loma

2009-04-21T18:13:00.000-07:00

Mrs. R. came in today for an exam and a mammogram referral. She's been in to see me quite a few times for other things and we have a nice, relaxed rapport. The exam was "unremarkable" (though no woman wants to hear that her breasts are "unremarkable", even at 67). We joked a little bit and she made a comment about being a nun. It turns out that her husband of 48 years had a massive heart attack a few years ago and that was the end of physical intimacy.

Now, at this point I was running a bit behind on a very busy morning. So busy that I spent lunchtime working on charts and finishing prescriptions. But Mrs. R. kept talking and I kept listening. She told me about the love she and her husband had for each other. How they still make each other laugh after almost 50 years together. How they occasionally bicker about stupid things and annoy each other. But that's what you have to put up with for that kind of longevity and those kinds of rewards.

I've been doing a bit of reading and thinking about being single and being in relationship. An article I read this morning about the tendencies of Gen X-er's to marry late or not at all said that we lacked the ability to commit, we're always looking for the end of the rainbow. If you've ever looked for the end of the rainbow, you know that it's elusive. So elusive that it doesn't exist. We're searching for a perfection in another person or a situation or a job that we do not have in ourselves. We have little tolerance for frustration. Ergo, we may have even less success at relationships that our parents, the baby-boomers. Hard to believe, I know.

So, committment means is standing still with an open heart. Not standing with one foot out the door, ready to run at the first sign of trouble. It's taking the laughter and the fear and the mess and the joy altogether.

Gearing up

2009-04-19T16:27:00.000-07:00

Sundays are sort of the abyss of the week. The weekdays are full up with work and preparing for work. Saturday is full of errands and social engagements. Sundays are different. There may be something going on in the morning, a walk or sunday pancakes or catching up with laundry. Towards the end of the day, though, it gets very quiet especially if your domestic partner is a dog. Thoughts of work start to creep into your head.

Last week was particularly rough, work-wise. We're out of cold and allergy season and people are actually coming in because they have real problems. Very real, very complicated problems. They are sick and scared and have been asking questions so difficult that I don't even know where to begin. On top of that, sometimes I feel that my grasp of basic medicine is not very firm.

Friday night I went salsa dancing with some friends in Albuquerque. It was a benefit for the American Association of Minorities in Medicine. We met up with a few other friends; Seema, who is rounding the corner of her first year in Physician Assistant school at UNM, and Jose, who was set to graduate the very next day. Seema is in the stressed out, ready to fall apart portion of PA school where the end seems so far away that you can't even imagine what it will be like when you don't spend every waking moment studying or worrying. Jose is in a rosier place than that. He's done with the worst part. Now all he has to do is prepare for the certification exam, pass it, get his license and then a job. No problem.

Then its the job. The first year of working as a PA you know a little bit off the top of your head and know where to look up the rest of it. A full year after my own graduation I know I love what I do, but sometimes I don't know if I know what I'm doing. My mentors, who've been practicing for 20 and 30 years, tell me this is a normal thing. Sometimes, after all these years, they still don't know what they're doing.

So, the trick with Sunday nights, and maybe with all of the nights is to stay in the moment and not worry to much about what's going to walk through the door the next day.

Like Ginger Rogers sang in "Swing Time"; Pick yourself up, dust yourself off, and start all over again.

The Dead Horse I'm Kicking

2009-04-14T18:35:00.000-07:00

Today was busy. At the La Loma clinic I saw twice as many patients as I usually do. This is a good thing. Our organization has been a little short on numbers for the last few months and there has been some whispers about being unable to keep the outlying clinic open if the trend continued. Rumors are worth the air they're spoken with but still... Its hard to believe that a clinic that makes its living from medicare/medicaid, state childrens health insurance programs (SCHIP), and sliding scale payments would find the number of visits slipping.

Several patients have told me that they can't get the medications I prescribed because their insurance will only cover a small portion or won't cover the cost at all. Even with the discounted medications at Walmart and Walgreens and our prescription assistance program we can't cover everything.

My freind and colleague A told me about his bout with malaria while he was in Kenya as a student. His stay in the hospital and medications came to a grand total of $90. He felt his care was a good as any he'd recieved in the United States. The same hospital stay here would cost thousands of dollars.

I'm not sure what is the best solution for health care in our country but we can't keep doing the same things and expect the situation to improve.

the single girl and the geographic cure

2009-04-13T18:34:00.000-07:00

I went to Colorado/Wyoming over the weekend to visit the Katie and my other crazy relatives. Wanda the wonder-shepherd rode shotgun and didn't vomit once! We got a homeopathic remedy for last fall that seems to have rid Wanda of motion-sickness and has radically changed the way we travel. She can now ride in the car longer than an hour without nausea and actually napped in the back seat!

Another milestone on this trip: my little red subie turned over 100,000 just south of Cheyenne. On the ride back through snowy Raton Pass I decided that I would drive the ruby-subie for another 100k then get a new one. Maybe by then there will be hybrid impreza's! That all-wheel drive is pretty handy on bad roads.

The first thing Katie and I noticed about Cheyenne, besides the wind of course, was the smell of the refinery. I must say I prefer the cow manure smell of western Nebraska to the gas refinery smell of southern Wyoming. However it did make for cheap fuel; $1.79/gallon. That's a full thirty cents cheaper than it is here in the other Las Vegas.

I have no pictures of this trip as I was depending on my mother's excellent communication skills and sense of timing and left my camera in my backpack which I left at her place. Oh well.

Katie and I had a nice, mellow time and she survived her nearly terminal boredom. We saw the family including my brother Aaron and his family. Funny how having kids will make you want to spend time with the rest of your family. I also got a travel buddy for Jazzfest! My uncle's girlfriend, Ruth, is going to go with me. Woohoo! I have a feeling she and I could get into a little trouble together...

ACK

2009-03-31T12:00:00.000-07:00

The wind commenced blowing one day in February and has not stopped. The juniper started blooming around the same time. So, besides the pollen which has saturated everything i own including the pillows where I rest my weary head, the wind has blown in piles of fine dust and has prevented any serious biking or hiking, or walking that one would normally do when the temperatures rise and the sun comes out. If I want to continue to eat pasta at this rate, then I will have to break down and go to the gym for the next few weeks until spring rage passes.

Here's the grand pronouncement of the day: I'm going to ride in the Santa Fe Century, a 100 mile bike ride in north central NM. No, I'm not going to ride the whole thing, probably the 25 or 50 mile loop. We'll see how the gym thing goes.

Just like any hobby there is a wide variety of very expensive bike accessories and gadgets. Since I'm really just getting into cycling I don't want to spend a lot of money to keep up with the cool kids. Sure, I'd like to have the super comfy harlot-wear padded, non spandex shorts and some izumi shoes and a nice camelback hydration pack but I'm also not going to drop several hundred bucks all at once. A few weeks ago, when I declared my midlife crisis on facebook, a friend recommended a red Buell bike instead of a MGB convertible. Wise advice.

Notes on Houston

2009-03-19T19:51:00.000-07:00

Mockingbirds in the spreading branches of the Live Oaks. Their ever changing song competes with the tropical notes of the grackles. There are layers of sound in the fog. I have strong coffee and watch the sparks tumble down the concrete from the construction site across the street. Later, I learn that coffee protects the liver from cirrhosis. This is good.

1927 recording of Gershwin playing the piano for Rhapsody in Blue while I write this in my hotel room. More longing in the opening clarinet notes than I've ever heard. It would be a good soundtrack for the exhibition hall; the medical people being wooed by the sales reps.

First dinner on the patio this year; humid breeze, cigarette smoke, happy hour beer. We toasted Erika's engagement and our first meeting in a year.

If ya can't get love, have pasta and red wine

2009-03-16T18:13:00.000-07:00

and jazz.

I'm off to Houston on Wednesday for continuing education. I haven't actually put my suitcase away from the last trip. Don't call it laziness, call it efficiency. All I have to do is throw some underwear and an iron into the bag. And my other stuff...

Wanda is going to be upset with me, but I think traveling is going to save my sanity this year. It such a great thing to be able to move freely about the country. This is the first time in my life that I've had the income to be able to travel without giving anything else up, like eating and paying rent.

I'll be meeting up with my lovely friends from PA school Alicia and Erika. That's going to be fabulous. I haven't seen Alicia since graduation and Erika since late summer (even though we work for the same company).

Shakin' the Groove Thang

2009-03-11T11:09:00.000-07:00

Salsa dance classes started a couple of days ago! Hooray for Adam, my dear friend and dance in structor and his very non-white-guy-from-Vermont hip shakin'. Seriously though, it's really good to get out of the house in the evenings, be with other humans, and move my body. I was starting to talk to myself and pretend that Wanda the wonder-shepherd was talking back. Not good.

The interesting thing about dance class is that there is one man; the intrepid Vince, a friend from PA school and now work. Why are men apprehensive about dancing and/or learning
to dance? There is nothing sexier than a man who knows how to lead on the dance floor. That sort of confidence and intimacy leads to other types of confidence and intimacy. If you know what I mean. Most women love dancing and are willing to look silly to learn how to salsa, ballroom, electric slide (well, maybe..) or two step.

I think men get impatient with learning and intimidated because it can look complicated. It's really not. Like most things, if broken down into the basics, dancing is not difficult. It does require surrender, though. Surrender to music, rhythm and a certain level of emotional intimacy. This can be scary. See "Dating Rule #2.

To me, skiing is scary. Riding a porch swing without a seat belt high up over a bunch of ice and snow followed by hurtling down a steep hill at high speeds while balanced on two waxed sticks. Um, right. Even while wearing heels, the odds of an injury more serious than a mashed toe are pretty low. However, I know some pretty athletic and graceful men who ski on a regular basis and are very good at it who are terrified of the hardwood. And by that I mean the dance floor. Get your mind out of the gutter.

Men have no idea how many romance points they get for knowing how to dance. Even making the effort and being able to laugh at yourself for missing a step will make your girl happy. And if the girl is happy...

Happy Trails

2009-03-04T19:19:00.000-08:00

Tuesday I attended the funeral of my father's older brother, David "Dutch" Baumeister in Paxton, Nebraska. He died last week at home, surrounded by his wife, children, and brothers. His wife, Joanne, did everything in her power to make his passing easy and painless. I wish I had some photos of him to share.

My Dad is the extrovert of the three brothers who grew up on that northern prairie. He's always cut his own path, tilted windmills, and talked a blue streak. Uncle Dave was darn close to silent. He kept his thoughts close and didn't like being the center of attention. But he was the bass player in a band and restored classic cars. He and my father exchanged pictures and sculptures of birds; Dad likes ducks and Dave collected eagles. All over the house that he and Joanne shared were eagles, soaring over rivers, mountains, and trees. He was a quiet romantic.

David was diagnosed with pancreatic cancer a month ago. He carefully considered his funeral arrangements. His meticulously restored cars were to be in the procession from the church to the cemetary. The music he chose was singular; "Ghost Riders in the Sky", "Ring of Fire", "Kalijah", "Islands in the Stream". All his favorites.

The church was packed with family. There aren't many Baumeister's left but my grandmothers family, the Emme cousins, were all present. My youngest brother Aaron was a pallbearer. Its so strange to see him as an adult; father, husband, and man. I brought Katie along. She hadn't met that side of the family before. My father drove Dave's pickup and his son in law drove the chevy convertible down the main street of Paxton to the cemetary. The American Legion Honor Guard gave a 21 gun salute that startled us all.

The next few hours we spent in the basement of the Lutheran church. The Ladies auxiliary had prepared a midwestern spread of ham, scalloped potatoes and green jello salad with plenty of iced tea. No Lutheran luncheon is complete without green jello salad and iced tea.

A funeral is as good as a family reunion. Cousins and family freinds who hadn't seen each other in years were telling stories and catching up. Katie played with my nephew, EJ. Both of them were gorgeous and charming. My stepmother, Kay was gracious and definitely out of her element. It was just so much fun to watch.

So thanks, Dave, for bringing us all back together on a grey Tuesday. I think it was exactly the party you would have wanted.

Back From the Frozen North

2009-02-27T17:50:00.000-08:00

Holy cow, Chicago is cold. I had such a great time with Amy. In our limited time together she showed me her city, introduced me to her friends and took care of me when the nasty bronchitis hit.

I'm really not sure how to move all the photo's around to make this a coherent story, so enjoy it anyway.

Angela's Dating Tip #3: Lap(top) Dancing

2009-02-17T18:12:00.000-08:00

Ah, online dating. Those of us who rely on the electronic cupid admit it a bit sheepishly. Who wants to admit that they're fishing in a barrel? With dynamite? Ok, just with big firecrackers, but still...

The bait for the hook is the profile. The profile needs to have an attractive picture showing the quarry in its natural habitat. It should make the prey look approachable, with healthy plumage and a nice nest. Remember, the point of the display is to attract a mate.

Some members get this. Their profile photos are pleasant, they smile, there are flattering shots of them in exotic locations. Sometimes they include their dog's or cats to show their sensitivity. Kittens, especially are a nice touch. They have also proof-read their profile text, checking for spelling errors and NEVER writing their profiles in all-caps or in text-speak.

There are also those that seem a little confused about the purpose of the profile. The photos look like mug-shots, with scowls and furrowed brows. One profiler that I saw even flashed a gang sign. Gentlemen, these things are not attractive. They are scary.

You attract more flies with honey than vinegar. Show those pearly whites. Use that spell-check if you really want to snag a smart girl. Think of a profile as a resume, first impressions count.

Conversations in Hot Water

2009-02-15T14:41:00.000-08:00

Going up to the Montezuma hot springs is one of my weekend routines. Get up in the morning, have a cup of coffee, check emails, go soak. I'm a lucky girl. Usually I go early enough that I'm there alone to listen to the river and the bird songs and watch the vapor rise off the water undisturbed.

Sometimes, though, I meet people. Interestingly enough, its never been the same person twice. I've met professionals, carpenters, hippy travelers, neurotic 20-something couples, obnoxious teenagers, eccentric locals, and people in transition. The first timers are easy to spot; nervously going from pool to pool, looking for the right spot, checking out the vibe.

The hot springs have their own rules of ettiquette. If a pool is empty, its fair game. If someone is in it, you always go to another pool. If they are full, you ask if you can share. In general, noise is to be kept to a minimum and conversation is entered into with an almost ritualistic respect.

Today I struck up a conversation with a very interesting man. We talked about the nature of relationships and love. We discussed the difficulties of independent people who value their space entering into romantic relationships and what has to be done to keep a relationship going.

"What if" he proposed, "you could find someone that didn't expect you to change, even subconsciously, who you are, who wanted the best from you and you felt the same. Someone who encouraged your eccentricities and you did the same. What would you do then?"

"That would be great" I said. "But the difficulty is getting past expectations."

"Expectation minus reality equals disappointment" he returned. "And in the end if we are open to possibilities we are always changed by our encounters with others."

Then I went home and made pancakes.

Clean up on aisle 5

2009-02-12T17:53:00.000-08:00

Thursday afternoon is my time to clean up after Uncle Sam. That's when I see veterans. Most of the time this is Geezer patrol, my favorite demographic. The WWII guys are generally a lot of fun, they've had time to deal with the horror of their experiences and we're dealing with their cholesterol, diabetes, and arthritis just like the rest of my geezers. The vietnam era guys are usually in some sort of substance abuse recovery, are starting to deal with some of the geezer issues of old age and generally have some sort of chronic pain.

Then there are the folks coming back from Iraq/Afghanistan. These people can't sleep at night between the physical pain and the nightmares. Some of them can't hold a job because the PTSD symptoms of anxiety, irritability, and hypervigilance get in the way. Looking into their eyes is looking into anguish.

When one signs on with the military, one is "guaranteed" health care for the duration of their service. If a service person is injured while in the military, they are guaranteed healthcare for the rest of their lives. The staff of VA hospitals and clinics are quite good and quite committed to their patients, as committed as those found in civilian clinics and hospitals. The problem is the beaurocracy and the lack of forethought on the part of the government when the current wars were budgeted.

Here is an example from today. A 30 year old man came to my clinic for back pain related to a service injury. He also suffers from depression, insomnia, and anxiety. He has scars on his face and neck from burns. He is able to go to physical therapy once a month at the VA hospital in Albuquerque, two hours away. He would like to go to counseling for PTSD. This referral will take approximately 3 months to complete. I requested that he be able to go to a local provider for weekly PT in Las Vegas. It is highly unlikely this will be approved.

The next man was a 45 year old man. He'd had rods inserted into his spine, one of which had slipped and was moving up his back. He told me that since the psychiatrist had given him the right meds, he didn't have to retreat to the woods behind his house to work out his nightmares. He could now manage a long grocery line and a traffic snarl. The surgical referrals I wrote today were for the "Invasive Spinal" clinic, orthopedics for a carpal tunnel release as well as a dermatology referral for laser therapy.

These guys were perfectly healthy, sane, and productive young men before their national guard units were called up. They are the victims, along with the civilians in Iraq and Afghanistan, of the hubris of W, Dickie, and Rummy. Its a picture of waste and half-baked schemes. If you weren't already against the war, an afternoon in my clinic will change your mind. And I don't see the worst of it. We'll be paying for this one for a very long time.

Angela's Dating Rule #2 and Other Minutiae

2009-02-10T11:32:00.000-08:00

Pre-date nervousness is natural and, if managed correctly, can even be endearing. There's bound to be awkward moments, butterflies, and sweaty palms. It's ok. If you don't allow the jitters to be overwhelming they can show your date that you are vulnerable. Vulnerability = attractiveness, especially if you are a man. Chicks dig vulnerable guys.

What is not ok is telling your date that you are intimidated by them. If you are out with someone that intimidates you it's time to do a check-in;

Do you think your date is out of your league? Then thank your lucky stars they asked you out/agreed to go out with you! And for crying out loud, don't admit it! That's just saying "I really don't have a whit of self-confidence". Sexy.

Are they doing something that makes you uncomfortable? Its probably time to cut things short and move on to greener pastures. Life is too short to voluntarily be around people that are weird or judgemental or smell bad. Go home, open your favorite beverage, turn on some Sinatra and give yourself a pedicure, even if you are a man. Nice toes are sexy.

Update: My mother is home from the hospital and doing ok. She left with a lot of hardware, 4 cardiac stents, and will have one more placed in a few weeks. I dealt with my mini-breakdown by taking a deep breath and reminding myself that no one was actually dead yet.

2009-02-05T18:29:00.000-08:00

I'd really rather write about the fact that George Gershwin was 38 years old when he died but had already made an indelible mark on American music. I'd rather write about the SCHIP (State Children's Health Insurance Plan) bill that President Obama just signed. The wonders of modern antibiotics, the color of the sunset tonight, the white cows that escaped into the dun colored pasture across the river (I followed their hoofprints tonight in the half-light of dusk).

My mother, who is 58, had two cardiac stents placed this afternoon. She'd gone to the emergency room late last night after two days with chest pain. There are a total of 4 partial blockages in her arteries. Tomorrow the cardiologist will decide whether 2 more stents will need to be placed. Given the possibilities for disaster, this is really pretty good news. I just didn't expect the collision with heart disease to happen so soon. However, if she takes her cardiac rehab seriously she should have many relatively healthy years ahead of her.

My relationship with my mother has always been difficult. I don't think I've ever left that adolescent same-sex separation stage. My mother has never had anything but unconditional love for all of her children and grandchildren, really for just about everyone around her (except my father, but that's a totally different story). I, on the other hand, love my mother but often wish she was a different person. A more responsible, more energetic, more together mother. I'm sure I seem to her odd, and cold, and hard. But she loves me anyway for being her odd, cold child. Our arguments haven't begun because she was pushing me. They happened because I was pushing her. Now I'm faced with the fact of her mortality. I don't care for that idea at all.

I called a friend tonight to talk about all of this. Her mother has recently moved back in with her at age 87 with all the mother-daughter baggage. My friend has been practicing buddhism for many years and reminded me of the impermanence of everything, including those we love. I'm pushing back hard against that pillar. This, I suppose, is a natural reaction. We think that by holding on tighter to the things we care for that we'll get to keep them. We're greedy. The more we kick and scream, well we just kick and scream. It doesn't change impermanence. I don't like that either.

Hallucinating

2009-02-04T10:01:00.000-08:00

While I was sick in bed yesterday, nursing a ridiculous fever and bellyache, I was tossing around blog ideas. I probably should have been resting my little fevered brain rather than hallucinating about the blog but at least I wasn't hallucinating about little green monsters nibbling my toes. On the flip side, I could have conjured up images of Liam Neeson bringing me soup and cool washcloths for my hot forehead and telling me that even with the sweaty chills and morning breath I was still gorgeous. Then maybe he could have nibbled my toes. Apparently I have to be in a state of reasonably good health to come up with that one. Damn. That could have given me hours of enjoyment.

I've been doing a bit of dating over the last few months, both the online and offline varieties. I have learned a few things about what makes for a good date and what I look for in a dating site profile. You, my lucky readers, are going to reap the rewards of my experience, the good, the mediocre, and the ugly.

This is how its going to work; I'm going to continue to write about the things I usually write about. This would be the stuff about work, about family, time with the dog, etc. Interspersed with the regularly scheduled programming will be Angela's Rules for Dating. You can also send me your dating rules and tell me why they are important to you.

Here comes rule number one.

On the first date it is acceptable to mention, in passing only, the previous relationship/marriage. It is date DEATH to spend 20-30 minutes discussing the reason the above mentioned relationship/marriage failed. Save that for later. There will be a time when you will want to work through issues that may have cropped up before. The first date is not that time. The first date is for investigating issues such as intellectual and physical chemistry, for discovering you both have a passion for the hokey-pokey or that his love of neopolitan ice cream turns your stomach. Giving too much information too soon does two things: 1) shows that perhaps you aren't as over that last person as you thought you might have been, and 2) makes the person sitting across the table from you feel a little uncomfortable and/or bored. Don't bore your date.

2009-02-01T08:04:00.000-08:00

You know that job interview question "where do you see yourself in five years"? Its a good question. It asks about long range planning and the ability to set goals. These thought processes are important to organizations. Planning and goal setting allow them to improve productivity, create new products and services, and maintain a budget and staff.

But right now if you asked me about my five year plan I'd have to say I have no idea. I know I want to keep practicing medicine but where that will be or what form it will take is a mystery. Community health is intensely rewarding but I'm finding myself very good at women's health (which I never thought I'd like). I'd like to be in a position to travel more, learn more, dance more.

I keep saying that I don't know where I'll be in 5 years because I would never have put "live alone and work in Las Vegas, NM" on the plan. I thought I'd be happily married, Katie would be living with us, and I'd have a orthopedic surgery job with a big practice, and we'd be either putting an addition on the house or moving into something with a little more space, maybe in the North Valley.

PA school was the big goal, it was Mount Everest. I got down with just a little frostbite but with all my fingers and toes intact and now my mountain climbing predilections are temporarily quenched. Whats a goal oriented, hyperfocused girl to do? I guess its time to enjoy the warm tent and the abiltiy to breathe without an oxygen tank.

How do you spell committment?

2009-01-28T11:16:00.000-08:00

I'm coming up on 7 months of employment at El Centro. My application for the National Health Service Corp loan repayment for service is due at the end of the week. Its a two year obligation for paying of about 50% of my student loan debt. This is a good thing, something to be especially grateful for in rocky economic times. Why am I freaking out about it?

It would mean that if I decided to leave my job for any reason before my service obligation was complete I would have to repay the amount dispersed plus 150% interest. The government is pretty serious about this stuff. It means I'm here. I'm committed. I'm nervous.

This should not be making me uncomfortable, but it is. I have itchy feet, mid-winter restlessness. The bloom is off the rose. Everything would be fabulous if I could move to another city, preferably somewhere warmer/cooler/closer to family/farther from family/higher in the mountains/more urban. What do you mean the geographic cure is a placebo?

I've decided not to buy a house. I just don't know if I want to stay here after my service agreement is up. I'm apprehensive about potential relationships; what if something gets serious and they are unwilling to consider relocating? What if that person has a small child (as has been the case with a few men I've dated recently)? Katie will be 18 in three and a half years, and legally I don't need to stick around and hopefully she will fly the nest and be off to college (though I'll still help out financially if I can). Do I really want to spend another 8-10 years helping to raise another child?

Most likely there is too much analysis going on here. I have contradictory needs for consistency and plenty of room to change my mind. What would Buddha do? He'd just sit with the feeling of restlessness, see the fear that it comes from, acknowledge it and let it pass. Let's see if I can do that.

Interesting Measures of Success

2009-01-22T16:56:00.000-08:00

So, the last couple of Thursday afternoons I've been going to the nursing home in Las Vegas to look after a few of the residents. The environment is pretty depressing and some of the patients, I think, would be better off without a lot of the "life-saving" measures we give them. What life is it exactly we're saving?

One of the residents, Mr. A., has been creating a fuss at the home. He's been aggressive with the staff, a few visitors, and apparently the chaplain. Usually if an elderly person has a sudden change in behavior it means that they have a urinary tract infection. Its a simple matter of getting the patient to pee in a cup (or emptying their catheter bag), dipping a stick in it, and giving them some antibiotics and, voila'!, instant behavior correction!

I gave an order for a urinalysis. This was complicated by Mr. A. swinging his walker at the nurses aid sent in with the specimen cup. When I got there this afternoon, the nurses station was abuzz with tales of Mr. A.'s attitude problem. I asked about the urine sample that was requested a week ago. Never got it. Mr. A was headed straight for a psych eval and sedation.

Suddenly, or at least as suddenly as a guy who's had a stroke and uses a walker can go, he was standing in front of the desk. I grabbed my specimen cup and followed him down the hall. It was time to use my advanced clinical skills.

"Mr. A., how are you today". I gave him my biggest smile. He smiled and babbled back.

"Do you remember me?" More smiling on both sides.

"Can you give me a urine sample?" Smiling, babbling, walking towards the bathroom.

"I have a cup right here, will you fill it up for me?" Smiling, nodding, babbling.

He handed me a cup. Half-empty, half-full, didn't matter. It took two minutes to get a urine sample from dangerous geezer. I capped the cup, thanked him sincerely, helped him tuck his shirt into his pants and took my prize down the hall.

The charge nurse on duty saw me coming with the cup wrapped in a paper towel.

"You're kidding!"

"Nope, got some test strips?"

Two minutes later we had a positive test strip for a bladder infection. Mr. A. cruised down the hall and said hello with a big grin on his face. There were no walkers thrown, not even a cross word spoken.

There a couple things to be learned here. If you smile, say please and thank you, and treat people with respect, you'll generally get what you want. This is especially true with people who have lost a good portion of their dignity and freedom.

The other lesson is that old guys love me. I am far more successfull with the 80 and over crowd than I am with men in my own demographic.

At Last

2009-01-20T19:16:00.000-08:00

At Joe's Ringside Bar here in Las Vegas the Rio Gallinas School held an inauguration ball. The students of the 2nd grade to 8th grade school dressed up and crowded the dance floor while footage of the actual inauguration ball in Washington DC place on the big screen.

Barak and Michelle danced to Beyonce singing the Etta James classic "At Last", which happens to be one of my favorite songs. It is longing relieved, prayers answered, romance and sweetness. It was the perfect song for a couple that seem so in love with each other and the perfect song for a nation looking for a hero. I got a little verklempt.

http://www.msnbc.msn.com/id/28760822/displaymode/1107/s/2/framenumber/1/

Give the dogs a bone till tomorrow. Tonight is all magic.

Back From the Not So Frozen North

2009-01-19T18:29:00.000-08:00

All I can say is: Thank goodness for the Montezuma Hot Springs. After a 5 hour drive, getting the kinks out was priority #2 after greeting Wanda the Wonder Shepherd.

My visit with my brother and sister in law was great. They really went out of their way to make us comfortable, well-fed and slightly tipsy on great wines. My brother Aaron is a bit of an oenophile and is passionate about finding unusual wines that are quite delicious. My favorite from the weekend is "Plungerhead" zinfandel. I'm not usually one for zins but this was super tasty and worth stocking up. Here's a review: http://webmarin.com/blog/2006/05/plungerhead-dry-creek-old-vine.html

Katie and I had a wonderful time. I don't think I've been that relaxed for an age. We wandered around, saw the Celestial Seasonings plant in Boulder, listened to music on the Pearl Street mall, and saw "Marley and Me". We bawled our heads off at that one. In the ladies room after the movie we saw one woman after another with running mascara and sniffles.

Even with all the strange new of the weekend (there's more that I can't really write about at this time), it was a wonderful time to bond with Katie and Aaron. I'm looking forward to the next trip in March.

Save the Last Dance for Me

2009-01-18T16:26:00.001-08:00

This New Years Eve I went to the historic Plaza Hotel with two freinds for dancing and champagne. This years resolution is to dance more. And boy, did I. A man named Micheal Esquivel twirled me around the dance floor till the band packed up. He looked eerily like Jim Belushi, had played semi-pro rugby in New Zealand and had moved back to Las Vegas to be near his elderly parents.

Dancing with Mike made my New Years. It was joyous, graceful, spontaneous and altogether wonderful.

Today while I was in Boulder with Katie, I got a call from Francis, a friend from work. Mike had been killed in an accident with a train. The man who, two weeks ago, was dancing with me and ringing in the new year with balloons and champagne is just gone.

I'm so grateful to have danced with him. It was joyful and life-affirming. That will be my memory of our brief acquaintance. I hope it was a happy memory for him too.

Keeping the Heart Open

2009-01-15T18:19:00.000-08:00

Today I received the pathology report on a woman diagnosed with a particularly aggressive variety of breast cancer. When I called her, she didn't cry or fuss or any of the things I would have done. She thanked me for the pain relievers I'd given her earlier today and said she was just glad to know what was happening to her. After we finished speaking I went to the office of a colleague, a woman with many more years of experience than me who had helped me with the case. I sat down and cried.

I suppose after enough time in medicine this sort of thing will stop being so painful. But I hope that I don't stop feeling. Pema Chodron's book "The Places That Scare You" says that its easy to shut our hearts down in the face of discomfort (dis-ease), become hardened and cut off from the source of love. The more difficult path, and more rewarding, is to sit with dis-ease, observe it, and allow it to move through us and past us on its own. She talks about the boddhichittra, having a tender place like an open wound where compassion originates. Gratitude for the experience.

I'm grateful that most of my work is not so emotionally wrenching. It's wonderful to live in a state, for all its shortcomings, that provides healthcare for women with cancer. I'm happy that my patient still has options. I'm grateful for the support of my colleagues and for the grace with which my patient is moving forward.

decisions, decisions

2009-01-14T09:03:00.001-08:00

Once again, I'm considering purchasing a house. I love my current place. Its out in the country next to the river. There are hawks and owls and kingfishers that hunt in my backyard. Its peaceful and the stars are beautiful. The rent is also fairly high (especially for a single girl). The wonderful 18 foot ceilings and wall of windows make heating the place expensive and my landlords have made it fairly clear they don't appreciate me asking for repairs on the house. I've spent some wonderful mornings drinking coffee on the porch in my pajamas watching the birds and listening to the quiet.

Right now there are two real estate possibilities. One is a little 1940's bungalow in town. It needs a new roof and probably could use double-paned windows but has a fabulous interior and is really convenient to work. The other place is a little farther outside town from where I'm at now. Its passive solar, has a great view of the valley but is a bit small and has a smallish lot. Both of them are in the right price range for me and with a few improvements will most likely have a good resale value.

It really gets into my committment issues, which is a bit ridiculous. One of the reasons I'm in Las Vegas is so that I can get the National Health Service Corps loan repayment for rural health care providers. That's a committment of at least 3-4 years. Basically, I'm an indentured servant. If I walk away before the contract is up I'll have to pay something like 150% interest on the monies paid by the government. Buying a house should be a financial decision, not emotional. But I don't have a tattoo for the same reason... What if I hate it, what if I change my mind, what if the floor sags?

A friend from work is looking at houses right now. I'm going to call his real estate agent and see what comes up.

Woohoo, Jazzfest

2009-01-12T18:05:00.000-08:00

I have booked the big trip for the year. I'm headed off to Jazz fest in New Orleans with my freind Julie and maybe, just maybe, Amy too (we're working on her resistance, she's trying to be all fiscally responsible on us). The three of us havent done a girls weekend for almost 2 years. We're renting a little carriage house that's only 5 minutes from the fairgrounds and about 15 minutes from the quarter. Its absolutely wonderful, has a kitchen and a clawfoot tub. This is going to be a ridiculous amount of fun. Girlfreinds, Aretha Franklin, oysters and New Orleans the muse; it doesn't get much better.

Short post. Here's a picture of the blizzard the day before Christmas Eve.

my pretty flowers

2009-01-11T18:33:00.000-08:00

Katie and I picked up an orchid at Trader Joe's before she left. It seems to be very happy here. I've always been reluctant to get an orchid plant, because I thought they were high maintenance. Not true at all.

Duke Ellington and All That Jazz

2009-01-10T19:14:00.000-08:00

I'm not sure where the day went, but it sure left in a hurry. Now its the end, lots of things got done and I'm working on making space. Not the "cleaning the closet" sort of space but the "cleaning out the head" sort of space.

One of my mentors, way back in the day, told me that there is fertility in emptyness, that until there is a void, creativity is stifled. When he told me this I was seventeen years old. I thought I understood what he meant. That was before I acquired emotional baggage and furniture and a file cabinet full of check stubs and tax returns from the last seven years.

Being single after a couple of decades of serial monogamy is a scary proposition. It means sitting still and not chasing the wind. Its learning to sooth that anxious feeling that comes up from the pit of the stomach when it would feel so much better to call someone, anyone, to feel some sort of connection with another human being. It means walking through the dark alley of longing and regret without panicking about the boogy monster (who is me anyway).

Buddhism teaches that suffering is caused by desire for anything other than what we are or what we have in this moment. Now is perfect, it is as it is. I have always had some difficulty with this idea. Isn't suffering also caused by circumstances outside our control? If we didn't have desires, how would we educate ourselves, feed ourselves, take care of our loved ones, or create art? Those things stem from desire. They are all good things.

I think the difference is this: does the desire cause unhappiness or joy? Does the desire come from a place of compassion or fear? Compassionate desire can save the world. Desire that comes from fear has nearly destroyed it.

By no means have I got this all figured out. I get angry, petulant, resentful, depressed and a host of other negative emotions. I feel sorry for myself sometimes. But I'm working on it.

Another reason to be grateful for good health

2009-01-07T17:43:00.000-08:00

In the rural medicine rule book, section a part 2, we read that patients with heart complaints may not present to the clinic until 30-45 minutes before the close of business. This ensures that any plan that the health care provider, nurse, or office manager may have had at the end of the day are thoroughly smashed.

Part 3 of the same section states that the amount of time that the 911 dispatcher needs to decide where the patient should be taken is directly proportional to the amount of oxygen that the patient requires to decrease his shortness of breath.

It must also take 30 minutes for the EMT's to establish an IV in a hypotensive patient with chest pain.

Emergency vehicles will be in violation of said rule book if they follow the route to the hospital that they took to the clinic, thus making their total time from dispatch to hospital less than 3 hours.

Did I mention that I do a lot of praying these days?

Big Ball o Crud

2009-01-05T19:05:00.000-08:00

I stayed home sick today. My sinus passages are loaded with mucus, I have a barking cough that is reminiscent of the mating call of a leopard seal. I'm alternating between sweating through my clothes and shaking chills. Sounds like fun, huh?

I caught up on my daytime tv including the Anthony Bourdain marathon. Love that guy, there's something about a tall, neurotic, intelligent man who can cook that just turns my crank. Lots of risk taking behavior and a smart ass attitude. That's more testosterone than you can shake a stick at. It's not the healthiest archetype, but it sure is fun.

It would be great to say that I spent the day soul searching and considering my new years resolutions but that would be dishonest. I spent the day stoned on nyquil, dozing in and out of consciousness, eating soup and leftovers. I'm going to pop a few more of those bad boys before bed and hopefully be well enough tomorrow to hit the ground running.

A Dr. Zhivago kind of day

2009-01-04T10:56:00.000-08:00

Its snowing again. There's 2-3 inches on my porch, no wind and I'm trying to decide if I should head off to the store now or take the chance that its going to clear up later. Braving the weather might keep the melancholy at bay for a bit longer.

Katie went home yesterday. We had such a wonderful visit and I always hate taking her back. It leaves a void that I can't fill. There have been shifts in my relationships that need accomodating and a great, aching need for healing. Moving up here has given me the chance to rest from the chaos of PA school and my divorce. Now I think its time for the rehabilitation.

One of my goals for this year is to go deeper into meditation and yoga, hopefully to become less susceptible to the emotional winds that push me off balance. I'll have to cultivate some discipline or at least unpack it from that PA school box that I put away. I don't have any problem creating structure in my life but there are so many distractions and no sense of urgency. I suppose that sense of urgency will have to be created as well.

Right. Off to the store with me.

This is hard stuff

2008-12-29T20:00:00.000-08:00

I work in a clinic with low income, medically and socially complex people. On average, the patient load is between twelve and twenty two per day. The pace is fast for primary care. Its not the ER, but its no cake walk either. I've adjusted, so far, pretty well to the pace and level of complexity. I think that this is because my life has been pretty stressful up til now. Now, I have to do two things really; work and take care of myself. Cake walk.

For those of you who don't really know what a Cake Walk is, here's your explanation. During a street fair in small town mid-west, the Ladies Aid Auxiliary or whoever makes a bunch of baked goods. A circle is marked out with numbers on the street. A flock of cake-loving contestants stand at each number and, while music plays, the contestants walk around the circle. Suddenly the music stops with each person on a number. A member of the LAA calls out a number and the one lucky person standing on that number wins a cake. Yay, cake!

But I digress.

So, the other thing I'm working on these days is forgiveness. It's a long story. But for the three of you who read my blog, you know what I'm talking about. I don't know if a person can really move forward and live without forgiveness. I stumbled upon this exercise on Pema Chodron's website (http://www.shambhala.org/teachers/pema/tonglen1.php.) Yeah, I didn't know that Buddhist monasteries had websites but here ya go. It is powerful.

2008-12-28T11:07:00.000-08:00

Wanda and I took a walk by the river this morning. It's 54 degrees, sunny, and get this: windless! Gotta love New Mexico. Five days ago we had 6 inches of snow, howling winds, and freezing temperatures. If ya don't like the weather, wait a few minutes.

Its the same way with teenage girls. We've had a high pressure front building for a few days that finally became a full-fledged storm last night. Ten minutes later it passed and there were blue skies again. The conclusion is that I need to nag less and she needs to show more responsibility.

There is something exhausting about constantly needing to re-set boundaries. That's relationships for you, though. Its always a new bone to chew on, or maybe its the same old tooth marked bone that's been buried and dug up again for the 100th time.

What goes up must come down

2008-12-26T07:13:00.000-08:00

Merry Christmas! I've been out of the bloggers loop for most of December, not due to lack of inspiration but more to lack of sleep and other complications. So much for my goal of continuing three posts per week.

Katie has been here since last Saturday and we've really been having a great time. It makes me miss her even more when she's gone. Her freind Crystal stayed with us on Monday and Tuesday. We had intended to drop her off on Tuesday but the interstate was closed because of snow and ice. She ended up taking the train back down to Albuquerque on Christmas eve.

We went to the Sipapu ski lodge for Christmas eve and Christmas day. We had a white Christmas, with snow falling most of yesterday along with that ridiculous mountain wind that never seems to stop. The big highlight of Christmas was snowboarding lessons and an attempt on the mountain.

Katie and I got our lift tickets and were fitted for boots and boards by some very patient employees and waited for our lesson outside in the snow. Our instructor, a twenty-something guy with cheekbones that could cut paper took us through the basics. Katie, of course, picked it up right away while I spent a good portion of the lesson on my ass. This theme repeated itself through the day.

We took a break for lunch and naps and went back to it. The beginners slope was set to one side of the mountain, obscured by a line of trees. The lift that served that slope was an old-fashioned platter lift. Basically, it's a disk about 8 inches across attached to a single post that drags its victims about 200 meters up the mountain. The platter is spring loaded and is not meant to be sat on. The skier/snowboarder places the platter between their legs and holds onto the post for dear life while heading up the slope.

So, up I went. Katie didn't want to snowboard after lunch so her job was to stand at the bottom of the lift, take pictures and taunt me. I attempted the lift a half dozen times with no success. The farthest I traveled was about 20 yards. Did I mention that one needs to be strapped into their skis or snowboard and be well balanced when riding the lift? After the 6th attempt at the lift and landing square on my tailbone I decided to give it a rest. When I returned to the base of the lift in humiliation I was informed that Katie, either out a well develope sense of competitiveness or out of the shame of watching her "old" mom try to go up the hill while she stayed safely at the bottom, had gone to retrieve her board. She did some practice runs down the lesson hill and came to join me on the lift of doom

I was completely determined that I was not going to be defeated. I attached the safety leash and binding of my rented snowboard and hopped up to the lift. I clung to it with the ferocity of a person clinging to the side of a cliff. For three quarters of the ride I stayed more or less up right but lost my balance about 20 meters from the top. I decided I'd be damned before I'd let go and made the rest of the trip on my backside. Katie joined me about three minutes later. That's when we both realized that Sir Edmond Hillary was right; "Its the getting down part that is the trick".

We had a moment of panic. In front of us stretched the intermediate practice slope and to the right was the beginners slope. Katie opted for the intermediate slope and used her snowboard as a sled. I opted for the beginners slope. Now when I think of "beginner" it is a nice gentle slope with no real turns. Something easy. This was not the case here. The beginners' slope was just as steep as the intermediate side and had the added bonus of a cliff on the right side that dropped through the trees into the river below. It must have taken me a good 15-20 minutes to reach the bottom, most of that time on my rear. The same people passed me three times, included an 8 year old boy shushing along who asked if I was ok. Damn kid.

That was the end of our snowboarding adventure. Neither of us were willing to fight the lift and risk life and limb getting back down again. We packed up our things and came home. We'll probably try it again after our aching muscles have recovered but it won't be anytime soon.

The Happy Birthday Edition

2008-12-11T05:16:00.000-08:00

Yesterday I turned 38. If this is what pushing middle age is like- WOW, bring it on!

I had been feeling really lonely lately and was being a little whiney. I was trying to envision my life with 50 cats and it just wasn't making me very happy. Yesterday, though, my wonderful family and friends reminded me of what a wonderful life I have. Starting at 6am I received emails, phone calls and text messages. Even my brother Aaron, who generally maintains radio silence, sent a birthday text. I got flowers from a new beau, had dinner with Vince (a classmate who has come up to work at El Centro) and Katie called and said she'd be staying for the entire Christmas break. All in all a fabulous day.

We try so hard to be independent and emotionally sturdy but its wonderful to be reminded that one is cared for in this world. Here's my favorite of the Thanksgiving pics: Those are my brothers Aaron and Josh and Aaron's baby EJ. I have edited out the wine glass...

Can't Trust the Weather man

2008-12-04T20:33:00.000-08:00

Today was just plain ole cold. The temperature stayed in the low twenties all day. It didn't warm up, the sun didn't come out, the wind didn't stop blowing. Just frigid temperatures all day and into the dark night. Flurries were forecast for the late afternoon and evening. That would have been nice. A little picturesque coating of white over the trees, a little winter wonderland to complement the twinkling Christmas lights on the plaza.

Did we get snow? NO, we did not. The sky isn't clear but the bright reflective light of a snowy night is absent. So all we have is cold. Great.

Anyway, on the bright side I've no longer got the funk. My energy level is up and I'm upsetting as many applecarts as I can manage while keeping my job and not getting arrested. I'm blowing off my family at Christmas to take Katie to Sipapu ski resort and learn to snowboard. What the hell, I've got health insurance. Its a little more complicated than that of course but I'm not sure I want to get into the whole thing. In a nutshell, it's about getting out of the box I've squeezed myself into trying to please other people. Nutshells are for composting, not for living in.

Over-analyzing My Navel

2008-12-03T09:16:00.000-08:00

So I've still been feeling fairly cranky the last few days. Since it's more interesting to poke at the dead snake with a stick and watch it squirm rather than to say "look, a dead snake. I think I'll just let it lie", I'm obsessing over my poor outlook.

After talking to my daughter's stepmom last night, I realized that the anniversary of leaving my 2nd hubby was imminent. It's been nearly two years and both Katie and I have had major improvements in our lives. We don't have to deal with the daily stress of living with a person who's unpredictable behaviour wreaked havoc with our sense of safety, well-being, and self-esteem.

Every day I work to let go of the anger and sadness of that time. For some reason, its not getting any easier. This morning, my father told me that I should throw a party and celebrate my liberation. Maybe that would be a good idea; have some food and a bonfire, invite some friends. It sounds pretty cathartic.

What color is blue

2008-12-01T19:39:00.000-08:00

I've fallen pretty squarely into a funk. Thanksgiving was wonderful. Wanda and I went on a couple of great hikes over the weekend. There was a bright spot over the weekend and the house got tidied up and I had some wonderful couch-surfing guests. We soaked at the Montezuma hot springs while the snow fell. Work today was fine, had a great lunch with my colleagues. Wanda and I had a nice walk at sunset. I talked to Katie about Christmas and we did not have an argument (though she's being a little evasive about this boy she likes at school). My favorite cousin, Shad, is coming in from Alabama and we're going to meet in Santa Fe for dinner this week. I have an appointment at Ten Thousand Waves (www.tenthousandwaves.com) for my birthday. Really, there's no reason for it at all.

Its cold and dark. I'm in this weird cycle of hot and cold romance (which has not been blogged about) with a man which is making me a little crazy. My bike still has a flat tire and I haven't ridden in a few weeks. I've been feeling under the weather and have cramps. Blah Blah Blah.

So I'm resisting the urge to go immediately to bed. I practiced my flute and will do a little yoga and take some more ibuprofen. I'm going to start going to the gym with one of the girls from work and not answer my phone for the rest of the week.

Bed sounds pretty nice right now though.

I'm grateful for coffee

2008-11-27T07:00:00.000-08:00

I'm also grateful for the rain we're finally getting this morning. Its been a while and we really need the moisture. I actually have quite a lot for which to be grateful. All the usual stuff; health, nice solid roof, happy healthy child, good friends, my dog and my family. I'm grateful, as always to be in the time and place that I'm living. Every day is a gift and I try very hard not to forget.

This is Wanda, expressing her gratitude by rolling in the sand at McAllister lake.

Thanksgiving, Families, and all that jazz

2008-11-25T18:10:00.000-08:00

El Centro Family Health, my employer, has a dental clinic here in Las Vegas. Unfortunately we have a hard time keeping a dentist and our clinic is temporarily closed until a new torture specialist... I mean dentist can be lured to the banks of the Chicken River. Kudos to our management, though. Instead of laying off the staff until further notice, they are spreading the dental assistants and receptionist around to fill in at other clinics. Today, Theresa went with me to the La Loma clinic.

On our long ride to La Loma (which isn't in the middle of nowhere, but you can see it from the front steps) we spent some time getting to know each other. She asked me where I was from, if I traveled a lot, where my family lived. She has always lived in New Mexico, has only been to California, and her entire, enormous, extended family lives in Las Vegas.

My family is small, we gypsied around till we landed in New Mexico, and I've traveled a fair amount though not as much as I'd like and not as much as many of my friends. I'm considered a bit of an oddity up here, at least among my hispanic friends. I'm a single woman who left her family behind to live in a place where I knew not a soul. Of course, they expect white folks to be a little wierd like that.

I asked Theresa about her holiday plans. She said she has seventeen cousins who all live in town and the family gets together for each of their birthdays. Thats about 1.4 birthday parties a month, not counting the folks that married into the family and their kids. So Thanksgiving dinner is not such a big deal for them as it is for those of us who don't see our nuclear families regularly and may only see our cousins at biennial reunions, if we go.

Theresa is curious about the big wide world but has reservations about wandering out in it for too long. She thinks its because the extended family is a blessing and a curse. They love and support you so well that you don't really know if you can make it without them. And so sometimes you don't try.

I'm headed down to Albuquerque for Thanksgiving. Both my brothers will be there with their families. My sister-in-law's family will probably be there too. In my family, at least my father's branch of it, we're independent to the point that my brothers and I often don't see each other for months at a time (though my brother Josh lives 90 minutes away) and I'm not sure of the last time I spoke to my youngest brother Aaron. My father is staying in town for Thanksgiving for the first time since 2003 and that's just because their dog is dying and my father's health isn't stable. Otherwise they'd probably be in Mexico again, eating fish tacos instead of turkey.

We love each other very much but support is rather loose. There's definitely no pressure to stay put. In fact, my father and stepmother strongly suggested that I leave New Mexico after graduating from PA school. Maybe I will, later. For now, my debts are getting paid and I'm recovering from a lifetime of tough lessons.

Anyway, I was hoping for a strong ending to this post, but I'm sort of wandering and am not sure if I'm getting anywhere. So, au revoir... I've got to cut up the bread for the stuffing.

A Girl's Best Freind

2008-11-23T18:26:00.000-08:00

I've just finished watching Gentlemen Prefer Blondes. Its the movie with the iconic Marilyn Monroe number "Diamonds are a Girls Best Friend". Norma Jean did her best booty shake and breathy man-flattering but the real star was Jane Russel. Now that was a woman who could turn heads. While Marilyn turned her attention to any man who could give her a little hard currency, the equally curvy Jane made 'em work for it. A fella had to have more than half a brain to keep up with her and enough nerve to prove it. This was a woman who had the entire men's Olympic team doing a special workout for her benefit. You go, Jane!

Jane Russell as Dorothy Shaw in Gentlemen Prefer Blondes (1953).

Where the hell are these women now? Jane had brains and a body. Not some stick figure figure, either. She had hips and breasts and a teeny waist (helped, I'm sure, by a good foundation garment). Quick wits and a hot bod, she's my new heroine. These days we're all supposed to be thin as rails with big boobs and a flat tummy without the aid of a girdle. Thank god for Jennifer Lopez's ass. Of course we can't all have a personal trainer to work out with 2+ hours a day. We have things like jobs and budgets the preclude that sort of thing.

There's been talk about the affect Michelle Obama will have on feminism. Michelle is fabulous: brilliant, gorgeous, and utterly devoted to her family. An article on slate says that she embodies the ideas of feminism so well that she surpasses them. She's another heroine of mine. Jane should have had an effect on feminism too. She showed that a woman could be beautiful and smarter than everyone else in the room.

Update on random stuff

2008-11-22T06:07:00.000-08:00

There are a bunch of loose ends on the blog so lets tie them all up (or in knitting parlance, weave in the ends). I'm still not finished with the "snowdrift sweater" I'm stuck on the cabled section of the sleeves. But I have finished a pair of mittens and a hat for myself from the purple alpaca I bought at the Taos Sheep and Wool festival. I've nearly finished spinning the shetland fleece and I've started a pair of christmas mittens for one of my nephews/niece from some green and blue bulky yarn from my stash. Stash busting, so satisfying.

I've got 9 gallons of fruit wine fermenting in the guest bedroom. It has gotten to the point that in order to make more I'd either have to buy more 1 gallon glass fermenting jars or wait till I bottled what I've got going. Since a) I'm going to run out of room if I keep going like this and b) the holidays are coming and a gallon of wine is not really an appropriate gift for Katie (maybe when she's older) I decided to wait. Midwest Supplies sells some really great winemaking kits that I'm considering including a bordeaux and a malbec, but they require a 5 gallon bucket to start out and they make about 30 bottles of wine. I'd seriously have to reconfigure my storage space but how cool would that be!

This morning I'm heading out to help with the Thanksgiving Gallinas Cleanup in which folks go out and pick up the trash that's accumulated on the Riverwalk. Since I really enjoy that area and have seen some nice wildlife right in the middle of downtown I'm happy to help out. Also, I've been here almost six months and haven't taken many opportunities to get involved in much of anything besides work and really am feeling the need to be more sociable. In fact, I'd better get my breakfast together so I can get there on time.

Belated weekend update

2008-11-20T18:19:00.000-08:00

Somtimes it takes a few days to digest one really great day. Saturday morning Jon From The Office invited me to go to his brothers farm. "Dress dirty" he said. After I retrieved my mind from the gutter, I threw on a pair of old jeans and my fifty cent flea market sweater.

The drive east of Las Vegas never fails to amaze me. Jon, his two super-cute little girls, and I piled into the range rover and cruised out along the flat, empty mesa-top for fifteen or so minutes, turned onto a paved county road for a while longer. Red tail and Harris hawks wheeled overhead and perched in the pinon trees. Suddenly the terrain dropped in front of us. We wove along the side of a deep canyon. Amara, Jon's five year old, told me all about the dinosaurs that lived down there, and pointed out a boat on the canyon floor. All those years of racing up and down the I-25 corridor, trying to get to Denver before lunchtime and I had no idea this lay on the other side of the road.

Two or three ranch gates down the road and we were at Mark and Amy's place. It's a sixty acre island in a gigantic ranch. The Gallinas river (the little river that flows past my place) cuts through the middle of their land. When Mark bought the property, the house was four stone walls, more or less intact, and half a roof. He and his wife, family and freinds rebuilt the roof, stuccoed the outside, plastered the inside walls a cool sherbert green, installed plumbing and gas. Their electricity is solar with a back up generator. They have a few horses, a pack of silly dogs, and the clear blue sky overhead. That perfect, tourquois, endless, New Mexican sky.

Amy and Alisha (hope I spelled that right), Jon and Mark's mom, made bisquits and gravy. Jon gave me a tour of the greenhouse and showed me the edge of the mesa over the Gallinas edged with cottonwood trees and. We found a few arrowheads to add to my collection. It always surprises me to find these bits of work. So many pieces of someone's time, laying around for us to pick up as we will.

After stuffing ourselves on a good, old fashioned breakfast, we laid assault to the walls of the new section of the house. This was the reason I needed to "dress dirty"; we would be laying adobe bricks. Jon and Mark's parents mixed the mud morter, Amara and I were in charge of plopping the morter on the last course of bricks, and the boys laid and leveled the next course of bricks. Amy is in her first trimester with their first child. She sat under the portal and peeled the skins off the garlic bulbs they were preparing to plant. Amara and I had a system. I scooped up the mud and placed it on the bricks and Amara did a belly flop onto the mud to squash it into place. When we started, her coat was off-white. By the time she finally said "Uncle" she was stained the same red as the cliffs.

It was a wonderful lesson in staying present. Normally, I would have been all business. We have a goal and that goal must be reached, no matter what. No monkey business. Its some hold over from my german anscestors, most likely. Amara showed me that it wasn't an urgent situation. Her family had a nice snug stone house and this was an expansion of their love. I took a deep breath and we fell into a rhythm of scoop and squish, scoop and squish. A while later, Mark and Jon got out their guitars and played while the little ones napped.

I wanted to stay there, in that gorgeous afternoon, for as long as possible.

Lessons from too much time spent sitting

2008-11-19T18:23:00.000-08:00

I'm going to get disciplined about this thing and start writing at least three times a week. It worked last week and possibly the week before. I can do routines and discipline... it just takes routines and discipline.

Today was desperately boring. Everyone from the main clinic had to sit in on a mandatory mediation. Apparently there are some pretty be troubles right here in River City. Fasten your seat belts, its going to be a bumpy ride. Actually not that bad. We at El Centro like to think of ourselves as a family. A big, squabbling, funny, dysfunctional family with messianic tendencies. And yes, I think we will save the world. At least our little bit of it. Today was all about getting to know your neighbor and talking about their strengths, the beauty of their character and the value of their experience. All of the times that you wished to grasp your neighbor firmly by the throat, rather like a rat terrier, and shake the life out of them- these instances were definately off the agenda.

On the whole, I think it was a great exercise. How often do we tell the people in our lives how much we value them? The most interesting person, I thought, was the janitor. He's a grizzled biker dude with a wisp of a goatee, multiple black and grey tattoos, and for riding his Harley he wears a headscarf that covers his face with a leering skull. He vibrates with energy and you can tell by looking at him that he's been in some unsavory situations. The clinic is also the cleanest its been since I got there. He has a smile and a good thing to say every afternoon. Today he had some really beautiful things to say about the importance of trust, respect, and open communication.

Damn, I did it again. I made assumptions about our biker dude before I knew a thing about him. Every time I do that I get a jolt and I'm ashamed of myself and my firmly middle-class assumptions about appearances and what they mean. You'd think I'd learn this little lesson by now. Thats why we're here I guess, to learn and relearn to love our fellow travelers.

Waxing Philosophical... Again

2008-11-18T04:53:00.000-08:00

Its been a very intense few weeks with some very sick people coming through the office. Hopefully, I've done all the right things for them. Most of what we do in medicine is listen, at least it should be our main job. Sometimes all that can be done for a patient or for anyone is to listen. Close the chart and pay attention to what they are saying. There's time for writing notes later. That brief appointment may be the most important part of someone's day. It could change the course of their life.

People are not an accumulation of their symptoms, they are the best written novel you've ever had in your hands. Even more interesting: when they come to my exam room I become part of their story. All the elements are there; birth, love, disappointment, joy, struggle, fear, courage and death. What more could you want. Of course, you have to be willing to get your hands dirty.

But I like that kind of thing.

Friday Night at the Cinema

2008-11-14T19:53:00.000-08:00

Wanda and I are watching movies tonight. Katharine Hepburn film "Long Day's Journey into Night" is playing on American Movie Classics. It's Ms Hepburn at her most vulnerable, most fragile but its a wonderful ensemble film. Her morphine addicted matriarch of a dysfunctional family was a risky role. I love her for that. Of course, at that point in her career she could afford the risk both financially and emotionally. Usually Hepburn played strong, smart women next to equally powerful leading men: Cary Grant, Spencer Tracy, Peter O'Toole, and even John Wayne. Under her characters' thick layer of confidence and brilliance was a deep desire to be loved.

We're waiting for the snow that's supposed to come tonight. Its awfully cold again but the sky doesn't have the right look. I think its bluffing again. Soon, I hope, we'll get something besides cold.

Snake Oil and Hair Tonic

2008-11-13T18:02:00.000-08:00

I'm all about prevention, personally and professionally. Prevention keeps bad things from happening. It's the fence that keeps the wolf from the door. It's the observant freind that picks the banana peel up off the floor before disaster strikes. It's seatbelts, vitamin C, and condoms. An ounce of it equals a pound of cure. But that depends on who pays for the study proving that the cure works.

Its all over the news today that giving Crestor, a statin drug that decreases low density lipids (bad cholesterol), to patients with no cardiovascular risk factors (in other words, no discernible reason why they should have a heart attack or stroke) in order to prevent heart attack or stroke. At first glance, this looks like great news. Think of all the lives we can save with just one little pill taken daily. Another great discovery brought to us by the pharmaceutical industry. Better living through chemistry.

What they don't tell you is that the study was funded by AstraZeneca pharmaceuticals. These are the kind folks that make Crestor, as well as drugs to treat high blood pressure, cancer, gastric reflux, pain, schizophrenia, asthma, and allergies. I prescribe their products every day to keep the wolf from my patients' doors. For the most part I think these are good and useful chemicals that help people function at a higher level than they would without these medications.

The NPR piece on Crestor today interviewed residents of Framingham, MA, the site of the longest running study on cardiovascular health ever. The good citizens of Framingham have been giving up their corpuscles to scientists for over 30 years for to help us all prevent early demise from heart disease. Through this epic bit of science we've learned that eating right and exercise can help us tremendously. We've learned that an aspirin a day keeps the cardio-thoracic surgeon away. And today we learned that Crestor will keep us from the monsters lurking under the stairs, waiting to snatch us in the light of day when we aren't looking.

Another missing detail in the NPR story was that the study was funded by AstraZeneca. They didn't let us know that the retail price of Crestor is $320.00 (costco pharmacy online) for 100 tabs (a three month supply). For a mere $32 dollars a day, lives are saved. Of course, crestor is approved by most insurance plan formularies, lists of drugs that insurance companies will cover.

I'm not saying that this isn't valuable information. We should be doing everything we can to prevent disease and disability. I want my family members, my freinds, and my patients to be vital and healthy for as long as possible. If this medication could really do the trick, I'd be handing it like a snoopy pez dispencer.

I'm a little tired of health care being run by Gordon Gecko. Maybe I'm a little bitter that the pharmaceutical industry no longer allows the sales staff to bring us free pens or take us out to lunch. I don't have a problem with the free market, but I have a problem with the free market practicing medicine.

Primun non nocere.

2008-11-10T04:59:00.000-08:00

It's Monday morning, lets do a swan dive into controversy to get the blood moving. One of my clinic duties is to take care of patients at the local university student health. Most of the time this includes a lot of colds, sports physicals, pap smears and STD checks. Its generally pretty light duty. The patients are young and healthy and just don't involve the level of complexity that I see at the other clinics.

Since its been a couple of months since classes have started, the girls have started to come in for pregnancy tests. The last one (fortunately not pregnant) had only a vague idea how pregnancy happens. Most of our time together was spent discussing how the process actually works. She understood that sex=pregnancy/STD (good) but that's as far as her knowledge went. She didn't know what ovulation was, didn't know the timing of the menstrual cycle (she wasn't even late), and was not really sure how fertilization happens. This led to a great deal of fear and panic.

Eighteen year olds are allowed to vote on our elected officials and this year came out in massive numbers to elect the first multi-racial president. They are able to drive a car and most are expected to take drivers education classes in high school so that they are safe behind the wheel. They are able to join the military and/or be drafted, learn to carry a gun and kill someone before their frontal lobes are even finished developing. But we don't teach them about their bodies because, as a society, we think its "too dangerous" and leads them to increased sexual behaviour. That makes about as much sense as giving the keys to a sports car to a person who doesn't know the brake pedal from the gas and the turn signal lever is just there to make that rhythmic clicking sound.

According to the Journal of the American Medical socity (no citation, sorry), kids today are actually engaging in less risky behaviour than we did in the wicked 1980's when I was a teenager. They are waiting to have sex, using condoms more frequently and smoking and drinking less. The rate of teen pregnancy has actually gone down in the last ten years. However HIV and syphilis infections are actually going up. The places that are still having problems with teenage pregnancy and sexually transmitted diseases are where sexual education doesn't happen at all or where abstinence only (same thing) is taught.

Teaching kids about sex doesn't necessarily make them want to go out and fornicate like rabbits. If done correctly, it will make their hormone soaked brains think twice now that they know the potential consequences of unprotected sex. It leads to an understanding of how their bodies work which decreases fear. We're curious primates, fear only works as a short-term motivator. We are designed to have sex. Telling kids to wait has never worked all that well. Sure, in the past it kept the majority from bonking before they were married, or at least getting caught. But there were always a few daring souls who had their hands in the cookie jar.

Sexual education is like drivers ed. We don't really want these kids in a car. They are inexperienced, have short attention spans, and have more auto accidents than any other demographic. But if we can say "this is the seat belt, this is a stop sign, this is how you keep from getting hurt on this crazy road" its better for all of us.

2008-11-07T04:46:00.000-08:00

Its 18 degrees this morning. That's pretty darn cold. I've got the woodstove cranked up but I'm not sure how fast its going to get warm in here. My house is a bit deceptive. I have giant floor to cathedral-ceiling windows with south-western exposure which are great for collecting sunshine but the house is primarily heated by a little woodstove on the first floor. So its been warm and snug when I get home from work even if it's getting dark way too early. I think I'm going to have to make a fire before bed and bank it up nicely so that I don't get frostbite in the morning. Its hard enough to get up when its dark without forcing myself from a nice warm bed into the cold air.

The weather has snuck up on us. Just four days ago, it was a balmy 40 degrees in the morning. Snow is forecast for this coming weekend. Snow. Yes, I know I've moved to a town in the foothills of the mountains. Yes, I live in the river valley. But I wasn't prepared for 18 degrees in New Mexico during the first week of November. This makes me a bit concerned about the temperatures in February, when its really winter. I'd better get some more sweaters.

Let me just say, one more time

2008-11-05T04:58:00.000-08:00

WOOHOO!!!!!!

Today there will be celebrating, maybe a little gloating, and a whole lotta joy. Its Christmas and Easter and New Years Eve all rolled into one. But its not just about Obama and his brilliance, it about us and our awakening as a nation.

Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it's the only thing that ever has. Margaret Mead

Chop Wood, Carry Water

2008-11-04T22:18:00.000-08:00

Well, my freinds. We've finished an election year. We have done the thing that was declared impossible. As a nation, we aimed for something greater than ourselves. Something greater than Barack Obama. We moved beyond our fear into the unknown. That is called faith. Faith is greater than an affiliation with any group. Faith is the belief that beyond the trials of now, we can do better, we can create a world that transcends color, that transcends religion, that transcends our daily bread.

So will we wake up tomorrow and find that the sky is a different shade of blue, that our coffee is better, our lover more beautiful, our finances magically fixed? Most likely not. The hard work has just begun. We, as a nation, have signed up for a tough job. But the important thing is that we've signed up.

I don't know if President Obama will fix everything. I firmly doubt that he is the messiah. But I do think he is a leader. I do think his mind is one of the finest of our time and I think he has the stamina and the gifts to pull us through this time. As he said in his acceptance speech, its time for all of us to lay aside our cynicism, put our shoulders to the plow, and take responsibility for ourselves individually and as a whole. We are our brother's keeper.

One of the labors of Hercules was to clean the stable of King Augeus. The king kept a herd of gigantic horses there. Gigantic horses make... well, you know. Apparently the king had a difficult time keeping farm hands. The horses were ill tempered, had huge iron-clad hoves, and made a huge pile of manure on a daily basis. The mortality rate among the farm hands was more than the king's liability insurance could handle. Ergo, piles of shit higher than the towers of the palace. The king required that the cleanout occur in one day, and if completed, Hercules would receive 1/10 of the kingdom.

Rather than pick up a shovel, Hercules was able (by virtue of his divinity) to divert the flow of two swift rivers through the barn. Of course, this was a completely unexpected approach to problem solving. King Augeus did not want to pay for the unorthodox approach to barn maintenance and things did not end well for him.

The point is that a) we have a big pile of feces in front of us that needs cleaning and b) a shovel and wheelbarrow aren't going to do the trick. Barack Obama may not be Hercules, though. Maybe we are, collectively, Hercules. And by applying creativity and elbow grease, we can meet the labors before us.

A Monday by any other name is still a monday

2008-11-03T18:46:00.001-08:00

Today I had two separate cases of the opposite of sibling rivalry. It was love and unselfishness and forgiveness of any childhood injury inflicted. I'm a fortunate soul to be witness. Let me preface the rest of this entry by saying that today was by far the worst Monday I have had in quite some time. It lived up to its reputation of being complicated, awful, and exasperating. It was a three martini sort of day, if I drank martini's. Which I don't because they are even more bitter than Mondays.

In the midst of the complicated patients who seemed to be on the verge of death or as I like to say "One foot in the grave, the other on a banana peel" and others who were fogged over by their psych meds, and even a couple of angry folks (because they were scheduled behind the lady with acute heart failure and they weren't at the front of the line), were a pair of sisters. I'd seen the "healthy" sister (let's call her Maria) for a heavy case of ear wax a few months ago. Today she was wheeling her older sister (let's call her Bernadette), age 74, in for follow up after being released from the hospital in Albuquerque. The Bernadette started out with a heart problem and come out with half her colon removed. Both were diabetic, but Bernadette had upped the ante by developing a tricky heart, scar tissue in her belly from previous surgeries which blocked her colon, and a host of other medical issues. Neither of them really understood the reason for the emergency surgery or why the Bernadette had diarrhea and I didn't either because I couldn't get ahold of her physician in Albuquerque until they were long gone.

What was really beautiful about this whole mess was that Maria was managing Bernadette's diabetes beautifully. Maria was changing Bernadette's diaper's, bathing her, making sure she got all the right medications, all the right food, and all the other things she needed. She took Berna to all her appointments, to the pharmacy, cooked and cleaned for her. It didn't matter any more what had happened in the hot days when their parents were alive, when they were young and pretty. The unconditional love was laid out like a table, full of food carefully prepared and presented. A gift that they may not have known was in them to give.

Another pair was a brother and sister. The sister was mentally disabled, probably from the seizure disorder and the polio and who knows why really. She was in the clinic for a pre-operative physical exam. She needed a new hip because the old one had rotted in it's socket. Don't really know why that happened either. Her brother brought her in to see me. I think he also took care of their elderly mother. He looked tired, washed out. But he answered all the questions and asked all the questions. He was gentle with his sister's inability to pay attention to the exam, reminded her to to stay in the present. It was his time and effort that would get her to the cardiology appointment I had to schedule and him who would take her for her surgery and interpretted my explanations about abnormal EKG's and abnormal kidney function. He was the one who steered her down the hall carefully as she veered from one thought to another. I felt like I was cutting down the last tree in their forest. Bad heart, bad kidney's; can't wait to see what the orthopedic surgeon says when he see's her labs.

But there he was, probably a role he's played all his life. Don't leave your sister alone, she's fragile. How long had he been taking her by the elbow, making sure she didn't careen into the walls? What had he given up to the altar of unconditional love and protection? How long will he last once his mother and his sister have slipped this earthly coil?

In this middle of all this mess of monday: the frustration, the diplomacy, the irascible nursing staff is this shining light of love and sacrifice. I hope I can find something like that in all my days here.

Contemplation on the Human Animal and Solitude

2008-11-02T06:39:00.000-08:00

Since I've moved to Las Vegas, my social and romantic situation has changed. Being the new kid means that I'm still working on creating a social millieu. I'm also not currently in a relationship. Having gone through marriage (rather like having gone through "the war"), long term relationships, graduate school with a cohort, raising my daughter, and living with my family of origin, this is the first time I've really been alone. Its a strange feeling.

On the one hand: I don't need to check in with a partner or a parent or get a babysitter if I decide I'd like to do something. I can play torch songs as loud and and frequently as I please. My wine making projects can hijack the spare bedroom and my wool can sit anywhere it wants. If I don't want to clean the kitchen/livingroom/bedroom, no one complains. I can make decisions on money, vacations, and everything else without consulting anyone. That's nice. It's an enviable amount of freedom.

On the other hand: It's sometimes lonely.

So, why does loneliness bother us, meaning me? I think it's because humans are mammals, specifically primates. All animals have social constructs. This is for the protection of the individual as well as the health of the herd or troupe or flock. The worst thing that can happen to an animal is to be separated from the group. It leaves them in a vulnerable position, open to starvation, illness and predation. In primate groups and horse herds, if a member misbehaves they are pushed to the fringes of the circle until they show that they are sorry for their behavior.

In Celtic society, there was no corporal punishment. Instead, offenders were exiled, usually to Scotland. Solo travel was greatly discouraged in most countries until the 19th century because of the dangers lurking behind every tree. These were very real dangers that included banditry, animal attack and sexual assault. Women who had been widowed and lived alone were targeted by their neighbors as witches. Individuals in abusive relationships will stay even to the point of death in order not to be alone. It has always been safer to live in the herd or to be coupled than to be alone.

The benefits of the herd are numerous. Sharing the food, the labor, the childrearing. We need laughter, music and storytelling. We help each other with building shelter, protect each other in times of danger and share our individual gifts to make life better and richer.

So, aside from the reproductive imperatives of coupling up with a mate to make more of ourselves we are also hardwired to need to be part of a group of some kind. The medical evidence shows that people with active social lives are healthier and live longer. Married men are healthier and live longer (married women not as much). If we could all find ways to keep these social needs met in a supportive way that doesn't lead to destructive behavior, it would lead to healthier, happier members and a happier, healthier world.

Are we there yet: a tale of election year fatigue

2008-10-31T09:05:00.000-07:00

Four days to go and I'm ready for President Obama to be inaugurated so we can get on with the work of fixing the big hole in our national roof. There was an article in Newsweek about "election addicts", people who spend 20 hours a week and more following new reports, polls and Obamamercials. These folks are apparently worried that they will have a difficult time adjusting to a campaign-free lifestyle. Instead of getting their nightly fix of Fox's fair and balanced reporting, they are contemplating ways to fill the post electoral emptiness.

I have to admit, I'm watching the Daily Show more regularly than usual. But secretly I'm in love with Jon Stewart. Funny, smart, handsome: what's not to love. However, I'm skimming over the election coverage every where else and change the radio station when campaign ads come on. I missed Michelle Obama when she came into town, which was disappointing. She garnered a pretty big crowd, the size of which is somewhat disputed, and gave a great speech (though it was pretty similar to the DNC speech given in Denver).

But really, I'm ready for it to be over. I've been hosting a campaign volunteer since early October. He's the perfect houseguest, he's never around, doesn't make a mess and, when I see him, is very pleasant. I'm ready to have the house to myself again, though. Tip toe-ing around in the morning isn't fun. However it's forced me to use the automatic feature on my coffee maker so that the bean grinding does not disturb. That, my freinds, is the most wonderful invention of the modern world. Its like the coffee fairy came in the middle of the night and made my morning cuppa. Its absolute bliss to smell that coffee in the early dark hours before I'm even out of bed and just stumble down the stairs to fill my mug. The only thing that could possibly top that is to have an attractive man prepare the beverage exactly the way I like it and bring it up the stairs so that I could drink it in bed. Then the attractive man would make breakfast, clean up and leave until the next morning.

But I digress.

It'll all be over soon and then we can watch to post election analysis until inauguration, then the post inaugural analysis and then...

Its a Lovely Holiday with Wanda

2008-10-26T19:06:00.000-07:00

I've just gotten back from three days at the Black Range Lodge (www.blackrangelodge.com) in Kingston, NM. Kingston is about thirty miles wast of Truth or Consequences which is 300 miles south of Las Vegas. Look at a map.

The Lodge is one of the few original buildings left of the silver-mine boom town that went teats-up after the US went from a silver-backed currency to a gold-backed currency. All that remains of a bustling town with 20 saloons, one church, and a semi-famous Madam named Sadie Orchard is the Percha bank (now an Art Gallery, thank you Bonita, resident artist extraordinaire), the Assay office (a private residence) and the Black Range Lodge. The Lodge is 120 years old and is run by a very lovely couple, Katherine and Pete. It's property lines are adjacent to the Gila (hee-la) National Forest, full of pinon, juniper, and mountain mahogany.

Thursday night after check in, I'm snuggled up in my sheep pajamas under the down comforter reading "Henry and June", relating a little too well with Anais Nin, when I hear something similar to a jet taking off outside my window. I keep reading, cuz I'm dumb that way sometimes. A few moments later I hear someone calling my name outside. The handyman, Dan, is banging frantically on my door "Angela! Fire!" I throw something that won't be laughed at in the morning, grab the dog, my suitcase and the CD's and run out the door. Dan lit the path down to my car with a flashlight but he needn't have bothered. The back of the Lodge was completely engulfed in orange light and sparks where whirling into the dry juniper trees around us. We got Wanda into the car and the three of us moved across the street just as the emergency vehicles where coming into the drive. Fortunately the volunteer firehouse is just a few doors down and neighbors were quick to act. I watched from the car as flames shot up over the roof of the three story building. When I looked away from the fire, I saw a falling star. This is it, I thought, this is the end of 120 years and the end of Katherine and Pete's dream.

When the smoke cleared, the Lodge had been just slightly damaged, but the workshops in the back as well as an old fig tree had been completely immolated. The hillside hadn't gone up in flames and no one had been seriously hurt. The old hot water heater had exploded. It could have been a tragedy. Twenty feet from the flames sat two propane tanks. All around the Lodge lay construction materials; wood, straw bales, and miscellaneous scavenged items. It all could have burned to the ground and taken the national forest and all the neighbors with it. Good neighbors, good angels.

Katherine offered to give me my stay for free, which I declined. I stayed the entire weekend, as planned. Wanda and I walked for miles in the forest, picked pinon nuts, saw javelinas in the broad daylight, and deer on the hillside. None the worse for wear and I have a dramatic story to tell on Monday morning.

Vote Early, Vote Often

2008-10-22T11:33:00.000-07:00

Ok, all four of you who follow my blog, hopefully you've all sent in your "vote by mail" applications and have received your mail-in ballots. Its time to break out the black ball point pen, fill out that bad boy and send it off. One of you has warned me of the possibility of vote theft by the bad guys (no name dropping, George). I'm not sure whether to succumb to the paranoia and hand deliver my ballot to the county clerk's office or drop it into the Anton Chico mail box.

Don't blow this off, voters. If you don't make your opinions known now, you can't bitch about not getting what you want! And, for crying out loud, if you receive any kind of social services, have family in the military, have to choose between your utility bills and your medical treatment, are concerned about the economy, care about your neighbors, drive a car, or heat your house you need to think very long and very hard about whether the status quo has worked for you.

Consider-Your-Mortality-Monday

2008-10-21T14:03:00.000-07:00

I had to take some time yesterday afternoon to sit by the river with the dog. We watched a kingfisher fly, screeching, along the water. We watched the fading light change on the yellow leaves as the sun went down.

It was a draining day. One of my morning patients had recently been diagnosed with breast cancer. She was still reeling from the recent suicide of her son. Her grandchildren had been taken out of state by their mother. My patient sat in the exam room in tears, apologizing for making a scene. She lives alone in her little house in the mountains, only coming into Las Vegas for food and doctor's appointments.

I told her to make a scene. A big one.

At lunch, I recieved a text message from my father "atrial fibrillation. Pres ER". I panicked. I was calculating how long it would take me to get home on my bike and drive the two hours to Albuquerque. I was trying to sort out who could feed the dog. When I was finally able to get ahold of my dad, he was stable and in the process of being discharged, and had an appointment with a cardiologist. This morning he sent a text message that said he felt great.

I made a big scene.

Atrial fibrillation is serious, but not fatal if corrected. Its a fairly easy to manage cardiac condition in which the electrical system is disrupted and the normal, regular heart beat is short-circuited. The rate increases and the rhythm is jerky. That's how I was feeling, short-circuited and jerky. But, though this is a condition that should cause concern, its certainly not panic-worthy. Unless its your father and you are two hours away.

If this was a patient, I would very calmly give some oxygen, call the ambulance, and take the other appropriate actions. If this was a patient, I would explain what was happening in a rational, calm matter, being certain to reassure them and their family. It wasn't, though, and I lost my cool.

So, Wanda and I spent some quiet time on a ledge above a bend in the Gallinas river, feeling the wind, and watching the storm blow in.

Its Official!

2008-10-14T19:55:00.000-07:00

Fall is here. It was cold enough today that I had to light the wood stove. Holy Cow, that thing heats the house fast. It was rainy and cold and dark this morning and if it weren't for work, I'd have stayed home all day in my pajamas.

I've nearly finished Katie's arm-socks (fingerless gloves), all done but the cast off. And let me just say "Its about freakin' time". The next time you get a hankerin' for making custom-knit arm-socks from custom spun silk yarn, think hard. I started these things in June. It is now mid-October. I'd do the happy dance with Wanda, but...

Yawn

2008-10-08T11:32:00.000-07:00

I have come to the realization that, in spite of the great content, my blog is BOOOORRRIIING. No pictures, no links, no fancy stuff. This needs to be remedied. Therefore, my goal for the weekend is to fancy up the blog-space. That is, if my computer comes back from Best Buy before then in working order. I'm driving down to Santa Fe tonight to get the bike tuned up and the rack attached by people who know what they are doing (the nice folks at the new SF REI), then to drop off the computer with the geek squad boys. Then maybe dinner at Dhara Thai. When I have a restaurant craving these days, its for Indian or Thai food. Neither type of cuisine can be found in Las Vegas currently. I'll miss my bike for the rest of the week, but I can feel the gears slipping and it just needs doing.

Wonderful weekend and doggie update

2008-10-06T18:27:00.000-07:00

First the doggie update: The dogs that have been harrasing me for the last three months have finally been tied up after the very prompt and courteous attention of the San Miguel County Animal Control department. While I'm not thrilled about dogs being tied up, it's better than being allowed to run in the streets being a danger to themselves and others. On my way home from work today, I saw someone's little dog lying dead in the ditch. This is the sort of thing that happens when dogs are allowed to run on the road. Hopefully the owner of the little guy will pay attention and take care of the rest of his animals.

My weekend was a whirlwind and absolutely wonderful. My dear and old freind Paul (whose birthday is today) brought Indian food up from Albuquerque. Miraculously, it was still warm after a two hour journey in the car. Aaaahhh. Is there a patron saint of Indian food, or a goddess of the kitchen or some such thing. Next day we went to Taos with Arthur, one of my co-workers. It was the weekend of the long anticipated Taos Sheep and Wool festival. The drive through the Sangre de Cristo Mountains to Taos was breathtaking. The aspens are turning brilliant shades of gold and red in the midst of the deep green ponderosa pines. It was like driving through an impressionist painting of fall.

The guys, naturally, ditched me the minute we got to the wool festival. Never mind then. Today Arthur asked me to knit him a sweater and then realized he could have chosen a fabulous one of a kind yarn. Ha, said I, you should have stuck around! Anyhoo, I picked up a lovely shetland lamb's fleece: white with brown tips and little bits of grey. Also, after much deliberation, I found a wonderful yarn called "wicked". It's a bright purple alpaca plied with white alpaca. There were bits of acid green wool accents. Perfect for some outrageous mittens, say I. It was a perfect fall day in Taos. It was a bit overcast with just enough chill in the air to remind you of the date.

Sunday we went out to Lillian's ranch. That deserves its own post. Hasta manana.

wait a minute while I find my soap-box

2008-09-30T11:13:00.000-07:00

I love dogs. My current domestic partner is a canine. If there is such a thing as reincarnation, I'd like to come back as my dog. She has a soft bed, high quality kibble, lots of lovin', and all the rabbits she can chase. It's my job to take care of her. This means I feed her, make sure that her water dish is clean and full, and take her to the vet when she needs it. It also means I keep her away from the street. This is not only for her safety, but for the safety and security of other dogs and people.

Not everyone will agree with the dog:child analogy, but here goes. Children have the same sort of requirements. Food, safety, good health and love. Parents should also be obligated to ensure that their children (or pets) know how to behave in society. This also ensures their safety and success.

Let me now make a big ol' caveat. I love living in Las Vegas, NM. The people are freindly, I have amazing view of the mountains, my job is great. Basically, I'm a pig in poo. There is, however, a giant black mark on the town report card. Irresponsible dog owners. These are the folks who let their dogs run out into the road, terrorizing their neighbors, getting hurt. Generally not taking care of their obligations as dog owners.

It doesn't matter if you go for the "dog as surrogate child" approach or the "dog as owned object". Either way, the person who owns a dog (or has a doggie family member) is responsible for its actions just as they would be responsible for the actions of their human offspring. If around the clock care and responsibility is not your cup of tea, don't have kids and don't get that puppy. Neither one stays cute forever.

2008-09-26T11:54:00.000-07:00

Most days we have "theme days" in the clinic. We'll have a whole run of chest pain or a couple of guys with erectile dysfunction, or a bunch of kids with colds or a slew of nervous moms. Its a funny phenomenon seen in almost every clinic setting. Even when I was a massage therapist there would be weeks that 10 out of 30 clients would have similar problems.

Cold's and flu's in the fall don't count as part of a theme day. Regular procedures, like PAP smears don't count either. Common maladies have to be out of season. Generally the problem needs to be a little bit of a head scratcher. And there has to be more than one, but more than two is better.

Today, so far, is not a theme day. But it is Friday and it is half over.

mail order blues

2008-09-25T05:17:00.000-07:00

The winemaking kit from Midwest Supplies came in on Tuesday. I did the appropriate happy dance on the porch. In my head, I've already made several batches of yummy wines, they all taste wonderful and my freinds and family are duly impressed. Then I did something very unusual. I read all of the instructions straight through. This is what's known as a buzzkill.

In the basic kit, you get a bucket and a big bottle, known as a carboy, tubing, a stopper and airlock for the carboy, and enough yeast and stuff to make 15 gallons of wine (wait, did you hear music?). However, it did not come with a little device called a hydrometer. The hydrometer is used to measure alcohol content and helps the vintner to know when fermentation is finished. This is important. I also realized that I would need more than one carboy, some corks for my finished bottles and something to put the corks into the bottles. Bottles I've got. An embarrasing number of empty wine bottles. Sigh.

Also on my online shopping spree was a rack and a set of folding baskets for the back of my bike. Since my bike is my primary week-day transportation, this is imminently practical. The amazon.com listing stated that the bicycle accessories were easily installed and were universal in fit. That should have been the first warning. The rack must be installed first and the baskets hung from the rack. The rack comes with a set of three screws and a bracket in case the universal fit isn't.

After 15 minutes of searching for a hole in which to put the screw (insert double entendre here), I managed to align the screws and the openings. Let me tell you something. Size Matters. The screws were too short to pass through the rack and the hole on my bike and grab the washer and nut on the other side. Off to the hardware store during my lunch hour.

Another Amazon order gone awry. I place an order for a couple of books and a CD a few weeks ago and recieved double copies of everything.

I think I'll stay off the surfboard for a while...

Domestic Goddess

2008-09-22T05:12:00.000-07:00

Lately, I have been spending a good portion of my weekends cooking and preserving food. My spinning wheel has been whirring along and I've got the back of the "Snowdrift" sweater finished. If I added actual house cleaning to that list, I'd say my nesting instinct was in full bloom. But lets not get carried away.

Saturday I hit the farmers market and bought some gorgeous yellow squash, leeks, and apples. There was also a woman selling the sweetest, most beautiful peaches in the world and I bought two big baskets. Half of the peaches got canned yesterday. They have the most beautiful golden orange color and look stunning in their little pint jars. I saved a few for eating and the rest for the wine making kit that should be here in the next few days. The squash got sliced up and frozen and I haven't even touched the apples, let alone the pears from last week.

My neighbor, Lillian, brought me a quart of goats milk when she came to dinner on Saturday. Since I'm not a big milk drinker I think I'll make some goat cheese. I found the directions on the internet. You can find anything on the internet. Lillian is the soul of independance. She runs a 1200 acre ranch by herself, the house has no electricity, no running water and an outhouse. During the week she lives in town so that her 15 year old daughter can attend the high school here in town. She has a little herd of dairy goats and 3 1/2 chickens.

All this domestic activity leaves me very little time to engage in my favorite pity-party fantasy: I will end up being the crazy old lady who lives with 50 cats. I understand that this is completely irrational. I've started seeing a lovely man who makes me laugh my butt off. And I don't like cats (other people's cats are fine). My single german shepherd makes enough hair for all of those fantasy cats and I don't need more animal hair in my life.

pure as the driven slush

2008-09-16T14:20:00.000-07:00

I've been working on the Snowdrift cardi from "Inspired to Knit". However, while the sweater in the pattern book is white, mine is being knitted in a charcoal grey handspun corriedale with little silvery bits. Its working up very fast and easy. Since my brain seems to be still somewhat addled from graduate school, fast and easy is something I appreciate.

My ambition of finishing all the unspun fibers in my stash before the Taos Sheep and Wool festival (first weekend in October) may have been a bit, well, ambitious. I still have a pound or two of the corriedale and a little over an ounce of silk to finish out Katie's gloves. In the world of fiber-stash, this is practically microscopic, but I'm trying very hard not to accumulate stuff. On the other hand TSW comes but once a year. Here are some yarn/fiber buying justif... I mean reasons:

1. I can use the TSW purchases to make and/or give away as gifts

2. Improving one's skills (in this case, spinning, knitting and weaving) are helpful for maintaining good mental health

3. I'm supporting small, local businesses

4. Supporting these small local businesses helps to keep traditional skills allive

5. It will be a lovely fall day in Taos and I will have driven all the way up there

6. Sheep and Llamas and Goats, oh my

7. I really really like string

8. soooo sooooffft

Excuse me, I think I drooled on myself...

new knitting book!

2008-09-11T21:40:00.000-07:00

My new knitting book came in! Yay! Its called "Inspired to Knit". Katie and I found it when we were at the Alpaca show in Estes Park, Colorado two weeks ago, but it was a bit pricey and I'd already spent a bundle on that little short trip. I think we spent less money in Mexico eating in restaurants and staying in a nice ocean front hotel than I did for tha jaunt up to Estes Park. Anyway, its one of the few pattern books that I've found that I would actually make every single item in the book. Even better: I got it on sale on Amazon. Gotta love Amazon.

There was a wonderful, soft fall rain tonight and I watched "Love in the Time of Cholera". I wept at all the appropriate times. I wasnt' sure about how the movie made me feel. Was I crushed that there was no one who loved me enough to wait around 53 years and change? Should I be heartened by the thought of love in my last days? Should I sleep around till my true love becomes available? Wait, I don't have a true love, should I sleep around anyway? Too many messages...

Anyhoo, it was a wonderful film. Marquez is a poet. Javier Bardem is spectacular. He has supplanted all others except Jon Stewart for my affections.

Mondays are for...

2008-09-08T19:25:00.000-07:00

So Mondays are the day that everyone that had a sniffle or a drinking binge or just a bad weekend comes into the clinic with all their saved up ills. Monday is also the day when we need that little bit of extra caffeine or a cocktail or something to keep us going till five o'clock. the morning seemed manageable, but the afternoon swirled around me. I spent most of the time not knowing who was where. I hate mondays.

Good news this afternoon though. A patient who was diagnosed and treated for pancreatic cancer last year came in for a blood pressure check. Pancreatic cancer is often a death sentence. She'd been sliced, diced and irradiated and is so far in the clear. A month ago, she came in for pain in her abdomen. I adjusted her blood pressure medication and sent her off to the CT scan already scheduled with her oncologist. I felt like I was arranging deck chairs on the Titanic. She brought in her results and her CT scan was as normal as we could have hoped with no sign of cancer. I exhaled.

She had told me what a difficult time her adult children had experienced with her diagnosis, how they worried and and fretted over her and grieving the possibility of losing their mother. She told them (and me) "we're born to die, I'm not afraid to die but I'm not dead yet. We have to live until we can't".

Little bits of immortality and light to be found among the ashes of the day.

Yay! I'm off to see Katie

2008-08-28T17:23:00.000-07:00

Tomorrow I travel to the far north to pick up my girl. I haven't seen my daughter Katie since I put her on a plane July 5. She's living with her father and step mother and their other children in Parker, Colorado which is on of the many suburbs of Denver. I'm starting to get used to her absence, not comfortable but more like an amputee. Yes, I can get around and I'm learning to compensate for my missing limb but what wouldn't I give to have that piece of myself back. I've talked to other women whose daughters moved away from them as teenagers. They all say their relationships changed for the better, their girls all came back to them. I don't necessarily expect this but it doesn't change the quality of the longing.

I'm reading the biography of Dame Freya Stark who started traveling in the middle east in the 1920's at the age of 36 and wrote about the religions and cultures she found there. There's a wonderful quote from one of her letters about the nature of relationships

One is apt to think of people's affection as a fixed quantity, instead of a sort of moving sea with the tide always going out or coming in but still fundamentally there: and I believe this difficulty in making allowance for the tide is the reason for half the broken freindsips.

So perhaps this is the key to the cultivation of love. Keeping the bonds loose enough to allow for movement.

the $700billion question

2008-08-25T20:29:00.000-07:00

Yes, we know, Michelle Obama was brilliant, moving, elegant; basically everything you'd want in a first lady. Barak's video entrance was charming, the kids were cute. If they'd had the family dog in denver (or better yet live via teleconference from Alaska) it would have been perfect. Beyond perfect.

But here's the real deal.

The war in Iraq/Afghanistan has cost the American taxpayer $70 billion dollars and some experts are now saying we should look at $1 trillion to cover George and Dicky's little kegger on the beach. That doesn't count the amount of euro's and pound's sterling thrown into the kitty. It also doesn't take into account the amount of money spent to blow things up over the ocean just to see how well they spread mercury into our tuna steaks.

Well, here in New Mexico I had to tell an uninsured woman that to definitively diagnose her with Multiple Sclerosis, she needed to have a $6000 MRI. This was so that I could see whether she just had a cold or a chronic degenerative disease which would slowly incapacitate her, burden her family (if she had one) and eventually lead to her early death. Thirty minutes later I had to search the Wal-mart $4 drug list to see if there was something that I could give a single mom, who was going to school full time and working, with bronchitis and what is likely untreated asthma. The woman who was in tears because even with the sliding scale co-pay at our non-profit clinic was not sure she could afford to be treated and still cover the groceries for her and her two year old.

So folks, where are we going to go this year? More of the same? Putting up 8 foot fences around Mexico? Blowing up our freinds and neighbors? Or will we wait till those freinds and neighbors are us.

wait, wasn't June just 10 minutes ago?

2008-08-20T19:20:00.000-07:00

From my porch I have a view of the Bosque del Rio Gallinas. For the rest of you gringos that's the woods along the Gallinas river (Gallinas means chicken... funny name for a river, I'd love to have been hanging around the day they named that one). Its filled with cottonwood trees that are older than the United States and perhaps where saplings when Coronado was busy getting lost on his way to Kansas. There's an old apple tree, some wild plums and roses, red willows and fragrant red clover. The little Gallinas river that flows behind my house is full of fingerling trout, big bull frogs and mosquito eating spiders that spin their webs over the swift flowing water.

Today I looked out at the trees and the cottonwoods were starting to yellow. I smelled roasting green chile on my ride home from work. This means fall is creeping in. Soon, the aroma of pinon wood smoke will be coming up from the sleepy chimneys in the morning. The birds at my feeders will head south, to Mexico and other warmer places without hard mountain freezes.

Fall is my favorite season in New Mexico. The oppressive summer heat has passed, the hardness of the unremmitting sunlight and perfect turquoise sky slips into something more comfortable. The smells change from the sweetness of clover and sage to the spice of chile, woodsmoke. Every year I go through the same shock. As if I didn't know that the chamisa and astors wouldn't fill the mesas with gold and purple and the pueblos wouldn't start their feasts and I wouldn't start bringing out the mittens and sweaters. My porch sitting days are numbered.

oh, by the way...

2008-08-13T06:09:00.000-07:00

So everything was going along swimmingly yesterday at the La Loma clinic. Not too busy, plenty of time to finish charts, do a few Continuing Ed on-line courses, read a little fluff at lunch. At quarter to four a mom and son come in to see me. Son, a precocious 8 year old, has a cold. Piece of cake. Mom says she has same symptoms but is a bit worse. Also has a recurring gyno issue. No problem. I whip out my winning combo of western medicine and nutrition/supplements. Ta-da! Score one for the home team. I can still get out of the clinic by 4 o'clock.

As I'm getting ready to send her out the door, she says to me,

"I've been having this chest pain"

"Excuse me?"

I go through all the standard chest pain questions: sweating, nausea, pain in other locations, stress level, digestive problems, cough, weight loss... No clear picture was emerging. Great. I can't really let her leave without checking out an EKG. She doesn't have insurance, of course.

4:15

I send my nurse, the fabulous Antonia, in to do the EKG. Five minutes... NOT! Our EKG runs the single lead strips instead of the nice, neat 12 lead page.

30 minutes later: I come into the exam room to see poor Antonia tangled up in about 12 feet of EKG paper. If we both hadn't been so frustrated, it would have been hilarious. Fortunately, there wasn't anything scary looking on the rhythm strip. I gave her the appropriate precautions and sent her on her way.

So, if you have chest pain, make sure that's the first thing you tell your health care provider...

And we begin

2008-08-11T10:42:00.000-07:00

So here is the blog I've been threatening to do for the last year! I'm a single, long distance parent, a brand new Physician Assistant, and a dabbler. Since graduating from PA school and starting my job, my real primary occupation has been porch-sitting with Wanda the Wonder-Shepherd, bird watching, and wine drinking on said porch.

Where did the title come from? I've recently move to Las Vegas, NM, a city of 14,000 souls 2 hours north of Albuquerque. It still retains the aroma of the wild west, and no thats not just the cows you smell. There are hundreds of dogs running loose around here (note to self: talk to the humane society/animal control about spay-neuter programs), a few who chase me down the street while I ride my bike. I've made friends with some of these fur-balls but some require a shot across the bow with a little pepper spray. While I've never made actually pepper-spray contact, its nice to know I've got it if I need it.

The live grenade part... During my second week at work I stopped off at Dick's Liquor's (I'm not making that up) to buy a nice red that would go well with porch-sitting. There were several police cars blocking traffic a block or so down the street. Hmm, interesting. As I was standing in line with my selection I overheard a conversation between some other customers. Apparently the owner of the pawnshop down the street had bought a box of junk from someone but hadn't gone through it at the time of purchase. When he finally decided to sort through the box, he found a pair of live, vietnam era hand grenades. Needless to say, downtown Las Vegas was (mostly) evacuated, the bomb squad brought in, probably from Santa Fe and the ordinance disposed of properly.

That's when I knew I wouldn't be bored...