Pontificum Scriblerus

http://www.nytimes.com/2008/01/31/world/asia/31pharma.html?ex=1359435600&en=714cf4b400adc56d&ei=5088&partner=rssnyt&emc=rss They injected vincristine into people's spine?? That's the one that causes neuropathy???? Uh... And what are the distributors of the other higly controversial drug we get here from the same factory doing? Hiding. And what is going to happen to this drug in this country? We're not gonna get it anymore. Well, I'm against this particular drug as a doctor; but it's a patient's choice to use it. This can't be good.

Some say Bostonians have a chip on their shoulder, and well... it's true. But... http://www.nytimes.com/2008/01/29/sports/29boston.html?em&ex=1201755600&en=e809004b3df7c033&ei=5070 Goodness. That chip is huge. And bitter. And that is NOT a compliment.

I remember in high school AP English class, stumbling upon Sartre and Camus, and being utterly stunned. Existentialism is the idea that the human being, is not defined by the world around him, rather, the world around him is defined by the individual. "Existence before essence" is a key idea, meaning that your purpose is not pre-determined, and your nature should not be how others see it, but rather how you see it. The process of freeing yourself from others' influence is actually called "the existential angst," and that state of freedom, like the buddhist state of enlightement, is a life-long quest. Sometimes, removing yourself from context in that way borders on the absurd. What if everyone says you murdered someone? You know you did not. But everyone says you did. Camus. What if you woke up one day to find you were a cockroach? You still know you're you. But everyone else thinks you're a cockroach. Kafka. Genius. I have this vision of people spinning ...

9 pm. Sitting on the T with a to go box of food I "made" at the BCAE. In the evening zone, with headphones in, and Peter Sagal's Wait... Wait... Don't tell me on. Laughing to myself because - well, NPR is funny! I look up and a mustachioed 60ish gentleman in an argyle sweater and leather jacket is pointing at me. So I remove one headphone cautiously - sorry? "You're the only person I've seen smile on the T!" he says. I get defensive. Maybe, he thinks I'm crazy that I'm smiling to myself on the T. "It's NPR." I stammer. "They're very funny." "I just have not seen anyone smile on the T!" he says again, indredulously. Then I get aggressive. According to freshman psych, it is a defense mechanism. "Well, you must not be from around here! You're breaking the rules, you're not supposed actually LOOK at anyone!" "Sorry, I forgot. Tunnel goggles." He looks down at the floor,...

As most of my stories, this one takes place on the T, as you may have gathered. I don't like kids. I'm sure that my maternal instincts are intact, just dormant for the moment, and once I actually bite the bullet and have one of my own, I will make an excellently neurotic mother, but for now, I plainly don't like kids. I treat babies with slight distrust and caution, like interesting specimens of an alternative lifeform. Toddlers are something to keep away from my stuff. And I'm downright scared of teenagers because you never know what they might pull. Imagine my chagrin when I'm sitting on the T, in the morning "zone," and a loud squealing, screaming, chattering dissheveled Aquarium fieldtrip of 30 9-10 year-olds get on! I shrink into the back of my seat, and slowly, without making sudden movements, pull out my iPod and put it on, to block out all the craziness and try to get back into my "zone." I look straight ahead and don't make eye...

In a concerted effort to learn something about myself via my infamous diaries, I continued to read the scribbles I made throughout the years, and around age 14 or so, when things really started to get cohesive, I noted several salient motifs that appear again and again, and I gotta say, still! At one point I say to myself, "people just walk in and out of your life, fuck you up or teach you something, and then disappear. Life takes them away, or they do it on their own accord. And you have no control over it. You're just left to deal with fixing what they fucked up." I said that? How true. How did I come up with that so early on? Clearly, I have not solidified this nugget of knowledge over the last 15 years, because I am still surprised when people up and walk out of my life. I like to think I am less liable to get fucked up than I was back then, but even that is seriously open for argument. Fortunately, what I have is a new healthy sense of apathy towards things I cannot...

Every once in a while, it's useful to re-iterate the obvious. http://www.sciencedaily.com/releases/2008/01/080124200913.htm Here you go. Amazing!! Doctors keep sane in their emotionally taxing work environment by using humor! Now, my jaded cynicism and inappropriate patient stories that I think are funny but my husband, my voice of reason, would not let me publish, have a scientific basis. I KNEW IT! It's my DISEASE! Being a snarky biatch is naught but my MEDICINE! But everyone is a critic, so, of course, maybe not everyone thinks the same things are funny. Therefore, I especially like the paragraph on how if you're not particularly funny per se, self-disparaging behavior is a good way to incorporate humor into your everyday routine. OH - as long as it's not excessive... Verbal autoflagellators, wooot! Also don't underestimate the use of props - oh as long as it's not distracting. So, rubber chicken = funny HA HA. RUBBING a chicken... Funny "weird." ...

Ok, people. So, the initial fun of being "SICK" at home has gone. Now I'm just sick, not "SICK." My nose hurts from the inside, I have no appetite, I can't walk up a flight of stairs without tachycardia and dyspnea on such strenuous exertion, and I'm real sick of this apartment. REAL sick of it. No one is around to kill time with me, and even gchat is failing to provide entertainment. Consider this the official bitch and moan post of this week.

When I was about 7 years old, I decided I didn't want to go to school for a few days, and the best way to do this would be to get sick. So I sneaked out onto the balcony in the dead of winter barefoot in my nightgown, and ate some snow. This is partly the reason I don't believe that cold weather doesn't cause colds; this brave venture bought me a serious pneumonia. I was even hospitalized. Being in a Russian pediatric hospital is another post for another day. Suffice to say, 10 days of penicillin injections in the bum were NOT fun... Whenever I would get sick, the routine was such: as soon as said illness was established, my grandma would immediately change all my sheets to clean ones, get me changed into clean pajamas, set up camp in the living room on the foldout couch (more room, closer to the kitchen, where she was, plus, possibility of TV) with markers, paper, several books, tissues, and a tiny bedside table whereupon she would place the customary sick person food, de...

When I say I'm a philosophizing graphomaniac, I ain't kiddn! When I was 7 years old, someone auspiciously gave me a vinyl-bound 96 page lined notebook. Hereon started my life-long battle, or rather, relationship, with graphomania. Yes, I had a diary. Starting at age 7. Now I possess a total of 10 filled notebooks, each one put to use to chronicle the daily or weekly or sometimes even monthly events in the life of - well - me. I sat down and started re-reading them last night. They start out as scribbles and doodles, and random "I hate mom" without explanations, as well as a 7 year old's attempts at fiction: there is a full and finished science fiction novel, witha love story in the middle and a cliffhanger at the end setting up a sequel. It's comical. In fact, it's so funny, that an adult could not possibly have written it that way on purpose. My mom still quotes it once in while: "The team removed their spacesuits, and, giggling and laughing, put on ...

Classmates are so important when growing up in Russia. Schools are organized differently: usually, you are placed into a class in the first grade, and you stick with the same people for the next 10 years, often, sitting side by side with the same "partner." The experience turns them into family members; even the strange ones end up being yours and you come to love them. The relationships you form have the intensity of summer camp, but if it's a good school, and you find a common link, they're friends for life. Seriously for life. So it happens, that, for example, were I to suddenly locate someone from the 6th grade here, I wouldn't really care all that much. In fact, I have seen people I used to know around, and almost always, I have dodged them just to avoid the awkward smalltalk. And, I know for a fact that I have stood on the T face to face with people who were in my homeroom for 4 years to have them blatantly not recognize me - only affirming the fact t...

Talking about the unfortunate dysfunctional status of the current healthcare system is so en vogue that it's boring, but sadly, it's based on something. The system is broken. Thinking about it induces such intense anxiety in me that I prefer, risking harsh judgement by conscientious others, to live in a little bubble; take care of my little patients as best I can; play by the rules and try the ignore the brewing storm outside. I cannot change the way the system is built on my own. All I know is that playing by the rules gets you very jaded very quickly, very disappointed, and very poor as well. I spent two days fighting the system while dodging abuse; here I thought residency was the sacrificial lamb in the medical space-time continuum ,where you consciously went in daily expecting abuse, but I was wrong. I'm a big bad attending now, and honestly, I'm experiencing the same shit different pile phenomenon. Overcrowded hospital with unnecessary overly cautious admissions t...

My dad's family story gets even more interesting. But first, a little perspective. This is from the Encyclopedia Britannica: KULAK:(Russian: "fist") Wealthy or prosperous landed peasant in Russia. Before the Russian Revolution of 1917 , kulaks were major figures in peasant villages, often lending money and playing central roles in social and administrative affairs. In the War Communism period (1918 – 21), the Soviet government undermined the kulaks' position by organizing poor peasants to administer the villages and requisition grain from richer peasants. The kulaks regained their position under the New Economic Policy , but in 1929 the government began a drive for rapid collectivization of agriculture and "liquidation of the kulaks as a class" (dekulakization). By 1934 most kulaks had been deported to remote regions or arrested and their land and property confiscated. And - they were also executed, depending on HOW rich they were, exactly. On with the stor...

Poor damsel Magret was worried that her short life would be wasted, and her breasts would go without fullfilling their purpose of feeding people... Fortunately, she was rescued. On a whim, a cooking party for two was put together at Chez Sasha. The bone china coffee cups and Bohemian crystal wine glasses were in attendance. Menu: duck, H20-town special mashed taters, simple salad of mixed greens, Rioja, latte and biscotti. Now look here. No one is pretending to be a chef, and I wouldn't dare post recipes like I know what I'm talking about, but let's say, accidentally, you asked me exactly what we did to the damsel Magret? I would tell you, that from a combination of google, epicurious, mom and Gordon Ramsay, this is what we came up wtih. Magret 1 Moulard duck breast (enough for 2 people) salt and pepper fresh thyme 1/2 cup red wine vinegar couple of tablespoons sugar (we put 2, but could have used a bit more) juice of 1 orange a bit of orange zest take duck, wash and pat dr...

My deepest apologies for the staccatto posting today, but this is an excellent vent outlet for various examples of the ridiculousity that is my life sometimes. Needed to borrow the car today from my parents - so called them, put them in the know, they agreed with a heartfelt, sure sure, take the car, sweetheart, anytime anytime. I get into their parking lot only to realize that the mushroom of virgin snow in the second spot from the left is actually the car I'm meant to borrow: has not been cleaned since the Noreasters had commenced! So, natch, it's covered with a crust, under which is a heavy layer of packed powder snow, under which is another layer of sturdy crust. I have not shoveled anything since I got married and bought a freaking condo. It's alright. Like riding a bike. Then, adding insult to injury, when I finally get in the car 20 minutes later, sweaty and riding high on endorphins, ping! The little orange "hurry up and get some gas" light comes on. Now I...

Who knows what I'll mess up in the kitchen left to my own devices tonight and tomorrow, as the love of my life travels to West Bumfuck for work, and on such short notice too. The Magret de Canard that was waiting to hop into the oven for a romantic dinner for two, suddenly turns into a lonely feast for one. Stay tuned!! It will either be amazing, or a royal fuckup. Can't wait to see which.

People from Russia, especially of our grandparents' generation, have a steely sense of what's best kept secret (everything); a sense which apparently, instilled by the iron glove of the communist government, lasts well into old age even when living in the capitalist feathery fluffdom of America. For example, we never knew that my grandmother didn't go to college. We knew that she was an economist, "the boss" at some big factory, but the fact that she had only a high school education remained a secret until my mom was well in her 40's - when she was finally really quite safe from dropping out of college herself, lest this secret give her any ideas. That's what grandma said: Do as I preach, I was worried if you knew, you might not go to college. She had started, but had to leave, because a sister wanted to go to college; plus, the war started and she had to work in a factory. One day, shortly before grandma's death, mom and grandma were walking around s...

Such a banal title, I know, but I say it tongue in cheek, because "wonderland" does not apply when you have to shovel and/or shlep to work. I do remember, though, when snow meant fun and not annoyance and fear. First of all, with first frost, when all the little puddles would solidify, how much fun was it to go and step on them with the heel of my boot? They made the most satisfying crack. Kind of like popping bubble wrap, similar type of inexplicable pleasure. The goal was to get to the puddles before the other neighborhood children would. You just don't get the same quality puddle ice around here! Then, outside my school, school # 205, there was a big playing field and you had to descend a large hill to get down into it. Every winter, the upperclassmen would dump buckets and buckets of water down the hill to make an ice slide, and during breaks between classes (15 minutes back then) we'd run out illegally without our coats and frolick. The slide never melted because...

Voila the ENEMAN Pontificating Pooper Trooper Ok I've had some time to think. Yes yes, it sucks not to sleep. But at least, I rarely have to deal with other atrocities of being a resident any more. Without getting into the arcana of how a hospital day is organized, between 10:30 and 12 are attending teaching rounds, where the boss attending teaches the team something. You see, residents are not there for cheap labor, sorry, not just there for cheap labor, they are also there to learn the art of practicing medicine. 10:30-12. This is the only protected learning time we have in the day, and nurses are supposed hold their pages unless it's an absolute emergency. In theory. There we are learning about the intricacies of sepsis, or endocarditis, or lupus, or something equally dangerous and interesting. And the following exchange takes place. 10:40: Pt. C. has not had a BM in 3 days. Can she have a Fleet's enema? thx ;) 10:55: Pt. C extremely upset and agitated, i think it's...

c'est moi. This, of course, is nothing like what I used to endure as the senior resident in the ICU, up for 36 hours and my every step subject to scrutiny by an academic attending, not to mention sick as shit patients' lives AND a moldable young mind's education in my shaky hands... I used to be pretty good at it. Medical "Je ne sais quoi" they called it. But, OH my god, not sleeping at night, even if it's in your own house, sucks major balls. After hanging out in the hospital until midnight, I got home and collapsed onto the magic blue couch so as not to disturb my life partner in the bedroom. Proceeded to be paged basically every hour. "Um yeaaaah, we got this guyyy...." That's ER code for: "Yeah, we're passing this patient to your service so YOU can figure it out." Of course, that's better for the patient, but it means no sleep for me. Double edged sword. I'm not complaining about this, god forbid, I love patients and car...

It's late and I'm saying to myself, why aren't you going home? But I couldn't leave before jotting down how great my patients were today... I may have been here twice as long as I needed to just because they were so cute. One gentleman, 77 years of age, was surrounded by ladies when I walked in. He made a sweeping gesture around the room and said, "These are the Mrs's." Someone had noted in his chart he had a "much younger wife," so I wasn't sure which lady was the actual Mrs, but I don't judge, I just said, "Are you a polygamist, then?" He didn't bat an eyelash. "SUuure! What are you doing on Saturday?" Now, we're talking, a guy with a fake valve, fake hip, fake teeth an aneurysm in his belly, and a high fever. Now that's spunk! The other gentleman, 83 years of age, told me he wasn't feeling that hot - I should think not, witha hemoglobin of 6! During the social history part of the interview, he said...

I had made a deal with myself. A serious faustian deal: I sold my soul to be able to go home and take that nap yesterday, and today I HAD to go to the gym, no matter what. So, I dragged myself over there by my own bootstraps, in the wind, up the hill both ways. I get there, and, as is custom, start rummaging through my bag for gym clothes, cursing and spitting. One sneaker, plunk. Two sneaker, plunk. Pants... Supportive foundation garment... Socks.... No shirt. No shirt?! Perfect excuse to go home! Can't work out without a shirt! In just a foundation garment! I start packing my shit back in the bag, while humming the Marsellaise. In go the socks, the foundation garment.... Then, at the first sneaker, a pang of conscience suddenly stops me. Apparently, the devil has come to collect on my nap from yesterday. We said no matter what . Mwahahaha! Gosh darn it. SO I became one of those girls who works out in just a bra. In the winter, too. This may have gone over ok in the morning whe...

You may or may not have guessed, I'm technically not from around here. More about immigration will come later, I'm sure. This story, however, happens after immigration as an active process had ended, and assimilation had commenced. Now, my family and I arrived in Boston in April, 1990, at the tail end of the immigration wave of the late 80s. "We are the last wave," was the moniker under which we slid under the curtain, and over the border, via Vienna and Passoscuro, Italy, and right into a dank basement apartment on Beacon Street, under the wing of then-friends who took us in. The basement was part of the typical Brookline apartment complex of the courtyard construction. 2 entryways on each side and in the back, plus 2 basement apartments in each corner. Courtyard with trees in the middle. Like a college quad. Our hosts were long-time friends from Russia, and the daughter had been my bosom buddy since birth. They had arrived 9 months prior, and already had a couch and...

There is a line above New York city or thereabouts, maybe more like Connecticut state line, that God drew and said, "let there be terrible and confusing weather above this line, especially here in the city of Boston." And we pass our days in suffering. We suffered last week, and the week before, with plagues such as snowfall, and temperatures at which your spit freezes. I wore a sleeping bag to go outside and tried not to breathe. Acceptingly, because I know that by electing to live above the said line, I was electing to endure the consequences. Once in a while the curse is lifted, and we step outside, confused (just like God said), and ask each other, what, pray tell, is this strange golden orb in the sky? I am not familiar with such brightness.... And we rejoice. Today is one of those days. I rejoiced all the way to lunch throwing off my winter robes and squinting at the sky, producing vitamin D left and right. Short-lived joy. Because come 4 pm, the golden orb disappeared ...

Internal medicine sounds exciting (...or not...). Have you seen Harrison's Internal Medicine? It's a freaking bible; so many diseases, and all so interesting and so dangerous, and you get to diagnose them, and cure them and stuff. In reality, most of your patients are quite geriatric, and very very chronic, and frankly, bread and butter sans exotica, and you're really not about to cure anyone. If you're lucky, you make them feel better. When you DO get a "curable" patient, they're usually young, and that is never good, and almost always sad.How easy would it be to go absolutely insane in this sort of work environment? Very. What keeps us sane? Hospital surrealismus. What is that? Hard to explain. Better to show you with examples. Hospital surrealismus isn't always about patients. One prime example is the unforgettable variety and degree of diversity of ghost personnel, aka, personnel we always hear about but have never seen. From our end, it is a true ...

What is it about dinner parties that makes you so stressed out? My mom and I are both the same way. If there are more than 4 people, even if they happen to be immediate family, craziness ensues and heart palpitations attack mercilessly. So it happened that I got recruited to help out for a small dinner for 10 at Chez Maman. She prepped and made the cold apps, and then I cooked the hot stuff, and the only dessert I know how to make (actually, one of two, now that I know how to organize a flan), while she cleaned and set the table. The best was when she went out for ciggie, came back in, eyed me for a while as I watched sugar and butter bubble and turn into caramel, and said, "Wouldn't it be cool if I had a cook/servant? You could just stay back here, and serve us, and then, at the end of the night, I'd bring back some leftovers for you..." Hilarious. The dinner was a huge success. Elegant, they called it. The dishonesty was in that I took all the credit, even though t...

Mice are common experimental animals in biology and psychology because, like humans, they are mammals, and share a high degree of homology with their more sophisticated classmates. The genome has been sequenced in its entirety, and almost every gene has a human homolog. Unlike humans, however, it is possible to manipulate mice in ways considered unethical with humans. After years of inbreeding and genetic manipulation, laboratory mice have regressed such that their behavioral patterns are much simpler than those of their wild counterparts. They do, however, maintain a strong sense of smell which helps them remain depenedent on pheromones for interaction, and an acute sense of hearing, making them sensitive to ultrasounds. They also maintain a circadian rhythm, and need 12 hours of light and 12 hours of dark to function properly. Lab mice are a good option for laboratory experiments because they are cheap, easily maintained and reproduce quickly. EXCEPT in the winter. In the winter, mic...

Occasionally I get sentimental and cheesy in spite of myself. Today seems to be one of those days. Don't know what brought this on. Maybe, it's the fact that my cubicle is smaller than ever, and there are tumbleweeds in the office as the holiday season continues. Maybe, it's this old picture of 5 year old me I've never seen before. Maybe, it's because today is my friend JD's birthday, and I remember exactly where I was last year today; I don't understand where this year, or, actually, where the last 24 years have gone, and all that's happened could have fit into such a seemingly tiny slot of time... My little world from back then has been turned upside down and inside out, and I was NOT prepared, despite the fact that it was pretty much etched in stone and inevitable. My cubicle is frigid and unresponsive to my current state of mind. This is lost on the cubicle, but I'm feeling maudlin and sweet right now. This doesn't happen a lot. I'm givin...

Because I was born that way! Can you spot me? How about now? Am I.... flirting with the photographer? Mom's friend found this picture from a private puppet theater show that was performed for the privileged kids at a morning matinee at the Dostoyevsky museum in St. Petersburg, circa 1983. All are looking at the show; I, and another child, are drawn to the cameraman. She looks scared and I look curious. Attention seeker! People never change!

Isn't Boston just the cutest little toy city you've ever seen? Maybe it's not so cute for some people, but it's definitely toy. It certainly doesn't qualify as a real city, like New York or Chicago. Maybe that's why I have such issues accepting that real city things happen here. Like, the fact that for 3.5 years I've been getting out of the T at Boylston station any time between 6 and 7 am, and walking down Tremont street, past the infamous Tam (already open, mind you), and Jack's Joke Shop (which is no more), and a host of suspicious tattered characters on the corner of Tremont and Kneeland. They looked moderately to severely homeless, and, knowing that there was a shelter nearby, I had always assumed they were homeless people let out of the shelter waiting for the bus. One day, the routine changed on me. I got out of the T, and the road was blocked by a small herd of unmarked cop vehicles. There appeared to be a lineup happening against the wall, with ...

More on disturbing art. When we went to the Pompidou in Paris, there were two pieces that really jumped out at me. One was the Woman with Throat Cut sculpture (below). This is the other. Alice , by Balthus. According to the plaque next to the painting, the model for the painting was the wife of a friend of the artist, one Betty Leyris, who was scandalously recognizable when the painting was first displayed in 1934. (don't quote me on the date). I was looking at this painting, knowing that there was something... something... very unsettling about it, something making me recoil away from it and evoking some very unpleasant feelings, the origin of which I couldn't quite place. Seemingly, it's just an image of a young woman brushing her hair. But look at her. Separately, the features are lovely: the blond hair, the light eyes, sensual breasts, full lips. However, put together, it creates a very unpleasant feeling. The thick legs support a too-thin waist; the outlined belly bu...

I awoke on this first morning of freshly baked 2008 to find that a hurricaine has been through my apartment. We got home last night and wading through a bibulous haze, fell strai ght into bed without paying much attention to the surroundings, and breaking my number 1 rule of dinner parties: no matter how tired, clean house before bed. Now we have to do it while hung over. Excedrin, please. The menu was loud, but the effort was minimal for the most part: roast duck (2, actually), warm goat cheese salad, various small apps, and a fine flan for dessert. I went as far as to brine the duck like a a pro because advised by a pro, but when it came to making the fancy l'orange sauce... well let's just say, that by the time it was time to get crackin' on that, we were one bottle down and happier than one should be when making something for the first time, so, ya know. It tasted decent, but the simple sherry reduction my husband made earlier in the day, while sober, had less ingredie...