Monday, August 31, 2009

Big and Small Changes

For those of you sympathetic souls in cooler climes, please know that the weather has abated the past two days. We are a full 10 degrees cooler in our high and low temps. 93 may not sound cool to you, but when you are used to opening your front door and feeling like you walked into a convection oven, opening your door to 93 is like an oasis, a reprieve. In the mornings, it is nothing short of amazing to walk outside and feel like the morning is FRESH, not muggy and pregnant with potential heat.

We went to the pool yesterday and got goosebumps.

When there were no other little boys for Colin to play with today at ballet, I agreed to go outside with him and let him play in the little gazebo in back. In the shade, I didn't even break a sweat!

Speaking of Colin, he had his annual check up today. We discovered he has grown FIVE inches since last year (the nurse measured him twice). At 48 inches, he has broken the 4 foot mark. He is on schedule to become SIX FEET ONE INCHES. As our pediatrician said, "Uh, how tall is your husband?" He's 5'8", and I'm 5'2". Someday Colin will tower over us.

Later I was snuggling with him, and told him, "Can you believe you are going to be so big and tall? I don't want you to grow up!" Colin sagely said, "But Mommy, I will be able to help you do so many things." That, I will look forward to!

Thursday, August 27, 2009

Small TK Story

Hearing all the Ted Kennedy remembrances on the radio this morning, I was reminded of the story my high school government teacher told us.

She and her husband visited Washington DC the summer before I took her class. She visited our local representative -- we lived in Midland, Texas; I don't remember who the representative was, but no doubt he was republican and conservative.

My small town teacher was brushed aside by the staff of our representative. There was no way she could even get in to see him. Later that same day, she went by Ted Kennedy's office. He not only met her, he also took her and her husband to lunch. They discussed current events and topics important to her as a teacher. Pictures were taken.

Six months later, in her Midland classroom, most of her students were unimpressed. "He's such a liberal!" they proclaimed, since he did not belong to the only party that one could be elected in our county. But she remained touched that he would take time to listen to her, a person without power, not even in his district.

I think this was part of what made Ted Kennedy so beloved by so many, that he would meet with the small man, someone with no power or political pull, certainly with no lobbyist or PAC. This woman could never vote for him, and this lunch would never amount to much.

But he was a politician. Perhaps he knew that by being kind to this teacher, rebuffed by her own representative, her friends and students would remember his gesture, and maybe retell it. This was how he built his legacy, and how I remembered him today.

Monday, August 24, 2009

Summertime Blues

105 yesterday. At least 102 today. We avoid the outdoors, because even running errands in your car causes one to get hot, sweaty and cranky. The grass is brown, the leaves on the trees are shriveling, and even the mistletoe is wilting.

Today's laundry day. At first I told myself I'd take it easy and just use the dryer. But I hate to waste all that heat and sunshine, and it will dry my clothes faster anyway. I pinned up and took down three loads today. Taking down load #1 and putting up load #2 under the intense zenith sun, I did get a little dizzy from the full-on heat.

Tonight was "Meet the Teacher" night; first day of school tomorrow. We were thrilled to find out some of our favorite friends and neighbors with two kids our kids' age are all assigned to the same two teachers. We decided to take the excited kids to the park, to burn off some energy so that hopefully they will go to sleep early. If you sat still, in the shade, and caught the hint of a breeze, it was almost tolerable. Anna got cranky and tired first, and I was happy to walk her home, where she took a COLD bath. I stuck my dusty feet in to wash off before cooking dinner. It felt great.

So summer vacation ends, but summertime burns long and hot like a supernova here in Central Texas...

Thursday, August 20, 2009

4 generations

On Wednesday I took the kids to Waco to visit my grandmother Dulce and my great aunt Sudie. The people in the last decades of their life were amazed by the little people in the first decade of their lives, and vice versa.

Sudie was amazed by how much Colin could eat. A few hours after eating a large, Southern lunch in the dining room, Colin was hungry again (Grandma gave him peanut butter and crackers). I reminded Sudie that about an hour before lunch he also ate a huge bowl of sliced fruit that I'd brought him. "I would hate to have to feed someone every two hours!" she exclaimed. "Can you imagine, my mother had to feed 8 of us?"

Colin and Anna also had to go run around on the lawn after an hour of visiting, even though it was 102 outside. "What are they doing out there?" Sudie asked. "Where do they get that energy?"

Colin loved playing with the resident pool table. Anna wore her beautiful blue ballet recital costume to lunch as she did last year, and brightened many peoples' day. They both played some simple songs on the piano. You could not even see them behind the big grand.

Colin asked me, "What do old people like to do?" I told him they play bridge, and bingo, and Wii bowling (that would be my grandma). Grandma leaned over and said, "What are ya'll talking about?" I told her Colin wanted to know what people liked to do here, and she said, "People here like to SLEEP!"

"Oh, that would be my fault," Sudie said sorrowfully. She is frail, and drops off at any moment, any lapse in the conversation. Her body and her mind have atrophied, but her sweet personality still makes contact.

My grandmother, always a powerful personality, is struggling with the loss of her vision and the decline of her sister. Yet she speaks rapid Spanish to most of the staff, and still can boss all of us around.

We had a great visit, and I'm sure they were exhausted from just watching and listening to us as we briefly burst into their lives. "Come back, come back, come back," Sudie said. If it were up to Colin, we'd be there again Saturday, for the ice cream social!

Friday, August 14, 2009

When the kittens are away the cats will play...

My parents generously took Anna and Colin for their end of summer visit. It is eagerly anticipated by all parties -- the grandkids are "spoiled" by their grandparents, my parents get time alone with my kids, and, of course, Anthony and I have childcare all week!

So we've been out every evening once again. Ah, childless and carefree! Its a little exhausting. But fun! Not so good for blogging.

Last night we went to a wine tasting - all obscure Spanish wines. We loved it, narrowed down our choices, and ordered a case. The nice older couple we were seated with had never been to a wine tasting before. This one was very unpretentious, but I don't think they liked it. Even though we only got tiny, taster portions, they left most of it in the glass, and exited immediately after the speaker was finished. No one was seated in the last chair at our table, and with them gone, Anthony and I plundered the extra seating's glasses to pinpoint our favorites. Score!

Thursday, August 06, 2009

Something for Nothing

I have a patient who is a very old Boxer, one of my favorites, forever young at heart. I like his owners, too; they are totally dedicated to him and call me often with updates on his condition.

Being a boxer, he has had many skin tumors, some benign, some that I've had to surgically remove. I've also sewed up some lacerations on him. He has a chronic digestive problem, and I have consulted with the owners via phone and email in between visits on how to manage this condition.

His owner called today to say that he felt a new lump, and asked the receptionist if he could bring his dog by and just have me pop out to the waiting room, feel the lump, and tell him if it was something he needed to worry about. It would take just 5 minutes of my time, tops.

For no fee, of course.

I asked the receptionist to call him back and let him know that on any new lump we recommend a small needle aspirate, a type of mini biopsy, which would obviously require an office visit. Make an appointment.

He called back to say the original receptionist got it wrong, its an old lump that was aspirated before, it feels different now. He just wants me to briefly feel it. He can come by any time tomorrow and wait in waiting room.

This is a lump that was aspirated 10 months ago. I sure don't remember how it felt then. Besides, you cannot make a diagnosis on a tumor based on feel alone. But what is worse is that he wants my expertise without paying for it.

I offered to do a brief exam, just examining the lump only for a much reduced office visit fee compared to the fee for a comprehensive exam, but he protested still. He got angry, threatened to transfer to another clinic, then asked to pick up his records.

I am sad that I won't get to keep seeing this patient after over 5 years, but I am more sad that the owner does not see the value of my time and expertise. He actually asked me a few months ago if he could bring his dog in on a weekly basis so that I could auscult his lungs (part of evaluating his chronic medical condition), and I said sure, make a 10 minute, $15 brief consult appointment. Then he could not believe I would charge him for it. "Couldn't you just make it part of value added service, based on how much we've spent here already?" He played that card again today, stating with all the past aspirates and lump removals he's had, he deserves a freebie. But this is a lump last checked nearly a year ago.

I suppose he also doesn't realize that every time he comes in, I have to make a note in his medical record. Its just bad medicine to give an opinion based on limited evidence. And in the end, I value the years I spent in school learning medicine too much to give it away.

I really wish I understood where this client is coming from better. Would he ask his physician to come out to the waiting room and give a brief, off the cuff prognosis?

Tuesday, August 04, 2009


There are lots of things to dislike about summer in Texas, especially this summer with weeks of temps over 100 and no rain. But I do like tomatoes, and basil. The tomatoes are almost exhausted, and we have had lots of salsa, bruschetta, margarita pizza, BLTs, and insalata caprese.

I've only made pesto once, though, so a few weeks ago I decided to make a big batch. I wanted enough leftover to freeze to use in the winter. It will season our soups and sauces and pizzas, at a time when a taste of summer will be welcome.

"I really need a new food processor bowl!" I moaned to Anthony. The last time I made hummus, I had to jerry-rig the safety, since all the plastic parts had broken off. I pushed it down with a butter knife and had Anna operate the button controls. Still safe but ridiculously laborious. "Uh huh," Anthony answered me distractedly.

I washed and spun all the basil leaves, then went to the pantry to get the Cuisinart. There, gleaming chrome in its place, was a handsome, brand-new model. Anthony had purchased it and placed it there without my notice. It was begging for a test drive!

I filled the bowl with basil leaves, pine nuts, olive oil, and parmeggiano reggiano. I had enough to adorn a pound of pasta and to fill an ice cube tray for later. It was extra satisfying to serve Anthony one of his favorite meals that evening.