Le soleil revient.

And here I am at my desk, an unexpected break in the day's ferocity , a day dotted with one relapse after another.  

Doing. Absolutely. Nothing.

Why, in the face of a thousand things which need doing on my desk,  is the allure of that blue sky outside so alluring?    I'm sure there must be some evolutionary reason.

"Not every wrong, or even every violation of the law, is a crime."

Michael Mukasey, current Bushie Attorney General, regarding violations of the law by Republican staffers who froze out Democrats from non-political Justice Deparment  jobs, and why he will not be bringing charges. 

Unbelievable.  

Can you imagine this happening with the American team?

Ever since moving into our townhouse with our dimnuitive backyard space,  I have come to learn to love gardening.  Our space is just the right space for my tastes-- enough room to allow some variety and constant dabbling, but not too big to be a chore, and with size limits to place some semblance of restraint on the trips to the nursery.    When springtime comes, I look forward to those first trips to the nursery the way I looked forward to trips to Six Flags as a kid.  I think the source of most of this excitement is the sense of expectation, of the promise of blooms and growth yet to be seen.  I look out every morning for new petals poking out, new bulbs bursting forth.

By August,  I'm over it.  That sense of expectation is gone.  The garden actually looks great, there are still lots of blooms, all the leaves look healthy, enjoying our unusually cool and wet summer.  But the sense of excitement is gone.  There is nothing to look forward to, nothing to anticipate, to check each morning.  I am ready for the earth to start to reclaim this ebullient growth,  to let loose the forces of decay.

What a maddening quirk of human nature.  It's difficult to enjoy the beauty and wonder of the present, even when all is going well.  Instead,  we are programmed to look forward, past the present, to want to see the next step, to move on, restless.  I suppose it's a product of darwinism, bringing us out of the caves.  But I fear it leaves us a little irrational, and prone to melancholy.

I  have just discovered a new reason to get out of bed.

I firmly believe in a separation of work and non-work life.  I don't think I could ever be a person who lives for my career. 

But there's no denying that we spend a huge chunk of our waking hours at work, with co-workers, living work.  And work has weighed heavily lately.

One of the oncologists in the group just died of cancer today.  It has been coming now for a few weeks, and has been casting a pall over the staff.  This event also emphasizes the all-too-obvious fact that we as physicians are subject to the same "enemy" we face every day in our patients.  Some might attribute the mere consideration of this thought to a weird narcissism and god complex in doctors.  I think it stems from the very nature of allopathic medicine, as described by Michel Foucault in The Birth of the Clinic.  He talks about the development of allopathic Western medicine, and the concept of disease as the "Other", apart and separate from the real or essential, healthy physical being as we all see ourselves.  In this way, I don't think this conceptual struggle with cancer is unique to physicians, but also to most Western patients as well.  But I still wonder how I'll face the eventual decline in my own health, especially with inside knowledge of how that decline will happen.

The other terrible event was the sudden death of the mother of two of our nursing staff who are sisters.  This was not too unexpected, just more rapid than had been forseen.  One of the sisters had a wedding planned that was to happen in time for her mother to be there.  Unfortunately, four hours after her mother died, the sister's house burned to the ground, including all her wedding gifts and wedding dress.  

At a place where we deal with death every day,  these events have been difficult to absorb.  I have nothing more to add.

ethical dilemma.

This from a conversation I just had with a new patient, who otherwise was very pleasant, and actually superficially looked very hippy-dippie-I-live-on-the-island:

She was reading a People magazine waiting for me, looking at the pictures of the transgendered man in Oregon who just gave birth, to which she commented:

"can you believe it?  a transgendered person having a baby!  I just think that's one of the biggest sins against man, changing your sexual orientation. . . . "

My response?  

"So any problems with your bowel habits?"

I'm conflicted on a couple fronts.  Why didn't I say anything? Medical-ethical-hippocratic problems abound.  

Then I'm embarrassed to say that  I then thought "well she probably meant changing your sex, rather than your sexual orientation."  Apparently that would have been OK to my subconscious mind.

I then considered whether I should keep seeing the patient.  On one hand, there a lots of patients I see whom I'm sure have vastly different views than I do.  Probably a fair number of homophobes.  It just usually doesn't come up.  And I signed up to heal the world, right? Including bigots?

I will probably keep treating her.  I just hope that I don't let my underlying disgust with her comment gets in the way of my care of her health problems. . . .

from pollster.com:

Unfortunately, I have been lagging on the blog as of late-- so much so that Ralph beat me to the commentary on Saturday night's festivities, and I am left unable to make any talmudic commentary on his post without being overly sarcastic or catty.  Moreoever I feel absolutely devoid of any witty quips.  I am therefore stuck with commenting on such exciting subjects as economics exams.   

I took my Microecon final tonight, at long last.  What suprised me is how relieved I feel.  This course has virtually no significance to me, as I enrolled in this UW course as a sort of appetizer, just to make sure I really was interested in economics as more than just a passing fancy, and also to ensure I could handle doing individual coursework.  

Both seemed to work out OK, and the course was not very challenging, so it became a little bit of a chore to try to get through it.  I had told myself I had to finish the course before I could complete the final enrollment in the London program.  But now it's behind me, and on to the real thing.  I'm very excited about this project, and more than a little nervous as it, as it requires an extended commitment and I sure want to make sure I can complete it in a timely fashion.

Then to the next project. . . .

So yesterday was supposed to be the first day of the new exercise and diet regimen.  I even prepared an Excel spreadsheet to give me a linearity to follow and a new daily goal weight.   (I am embarrassingly bad at Excel, having never had to use it between medicine and Letters).

But today, even with rowing and 2 sets of tennis, and what I saw as a light food intake and no alcohol, weight loss=0.  To the decimal point even.

So I know, I know, one day does not a weight loss program make.  That's the whole point of the line, right?  But ten years ago, this weight would have slipped away.   Like butta.  This is rather tragic, as it imples less food, more exercise, and less alcohol are on the horizon.  And right at the height of summer.  

Life is getting in the way, per usual.  Ralph's mom and aunt (cuchi!cuchi!) are making their triumphal re-entry into Seattle tonight, and festivity is required.  I suppose moderation is an option, although I am not familiar with its ways. 

This will certainly be the last post on what is a stultifyingly boring subject to anyone but myself, but I will be tracking progress in a more subtle way in posts to come. 

Another page from the Oklahoma County Commissioner's campaign comic.  

I guess I can't wear my toga out anymore when I'm campaigning to be a boy scout troop leader.  Damn.

And for God's sake, what about spell check?