Homework Assignment!

Yes, for you!

Do you have a favorite short story? A favorite book? Etc?

Your assignment, in the next week or so, is to write a quick note to the author of that wonderful book or short story, and let them know that you really enjoyed it!

Why?

Because a couple of my friends sent me really nice messages today saying how much they liked my published fiction.

And I had been having a really bad day.

And now I feel much better.

And I’d like to share that feeling with other people.

I’m going to send out a few messages.

Wanna help me?

Thanks in advance! You guys rock!

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Published in: on September 30, 2010 at 12:40 am  Comments (8)  

I’m A Twit.

I am!

To prove it, I am pleased to announce that I’ve joined the 21st century, and put up a Twitter account!

So, for everyone who commented and emailed me and things asking me to set one of these up….here it is!

Since there was apparently an arbitrary number of letters I was allowed to use, and since DrGrasshopper was taken (fist shaking-itude commenced at that point) and DoctorGrshpr and DrGrashoper looked equally silly, my twit-nom thereby became:

@DctrGrasshopper

Now…..um……..what did you want me to do with it?

Guidance would be appreciated?

Published in: on September 27, 2010 at 11:32 pm  Comments (7)  

You May Have Noticed…

…that it’s been a good number of days since I’ve posted an Actual Article.

Yes, friends and other kind givers-of-attention, I have once again run out of pre-scheduled articles. I blame two straight months of ward service. That’ll eat right through your inventory.

But that’s going to change soon….I switch onto Neurology for two weeks (though I may not have much downtime with that service), and then I’m on VACATION! Wheeeeeeeee!!! And then an Ambulatory service! Which basically I’m working banker’s hours for a month! With *gasp* weekends! WHEEEEEEEEEEEEE!!!!!

So, you can expect me to try and get back up to snuff sometime before the end of October. And maybe I’ll be good and dedicated enough during my break months to write enough articles to carry us through my upcoming ICU-and-ward block, which is looming at the whole December-January axis.

I’ll keep posting my little commentary-one-offs, though, just so you don’t get TOO bored with me.

Thanks for your patience.

Dr. Grasshopper

Published in: on September 25, 2010 at 2:00 am  Comments (2)  

Results:

Acellular specimen. No assessment possible.

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Shit.

Published in: on September 22, 2010 at 4:39 am  Comments (7)  

Waiting For Biopsy Results

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Published in: on September 20, 2010 at 9:55 pm  Comments (10)  

Lessons From Wards: Karma

Express not thy rage at the universe, young Grasshopper, lest the universe bestow YET ANOTHER PATIENT WITH PANCREATIC CANCER onto thy service.

Published in: on September 17, 2010 at 3:39 am  Comments (8)  

I’m Thinking About Pancreatic Cancer Today.

This post contains no information. This post contains no answers. It’s just me howling at the universe. Feel free to move on for now; I’ll be back to generating writing-relevant content soon, I promise.

But I’m not thinking about writing right now. I’m thinking about pancreatic cancer.

It’s because we think one of my patients might have pancreatic adenocarcinoma.

That’s one of those diagnoses that just punches me in the gut and makes me feel like I’ve just been shoved off the top floor of a skyscraper by someone I trusted with my life.

Seeing those words in a patient’s chart drops the bottom out of my universe.

Pancreatic cancer is nasty. And sneaky. By the time it causes symptoms so you’d actually think to look for it, it’s already metastasized. And the prognosis is like 6 months to a year. Five years tops. Barring miracles.

As a med student, I had a patient whose life was basically saved because instead of developing one pancreatic cancer hidden quietly in the body or tail of the pancreas like people normally do, he actually grew TWO. And one of them was in the head of the pancreas, where it could actually cause early symptoms. They found the two tumors before either one of them metastasized, because the symptoms that the head tumor caused made the patient go for a CT. We took his pancreas out, and his life was saved. (Of course, he’s a brittle diabetic who has to take a pill with digestive enzymes before he eats anything…..but at least he’s alive…..) I can still see his nonchalant shrug at his follow-up appointment, (yeah, it’s hard getting used to the medication regimen,) and his fingers intertwined with his wife’s.

The residents I’m working with assure me that they have had mean and unpleasant patients with pancreatic cancer, and that assholes with pancreatic cancer actually do exist. But all of my patients have been the nicest people you could possibly imagine. It’s like all the meanness they never put out into the world gets concentrated into a little ball in the core center of their bodies and eats them alive from the inside out.

My current patient has three kids, she’s smart and kind and in her fifties and she may be dead in a year, and she spends her time teasing me about how awful “my cooking” (ie: the hospital food) is. And her husband works at my hospital.

She knows she has a “tumor in the pancreas”. I don’t think she knows exactly what that entails. And I dread the moment that understanding dawns on her face.

Today one of my med students looked me in the eye at the nurse’s station, and said “So what you’re telling me is, don’t get attached.”

I wanted to pat her shoulder and assure her that either (a) all was right in the world and that such an evil, nasty thing couldn’t possibly exist or (b) that as a “seasoned” physician, I have developed a healthy detachment from the fates of my patients, that nonetheless does not mar the veneer of my compassionate interactions.

Neither one is the case. I don’t think you ever stop deeply giving a damn. And the amount of damn you give seems to be directly correlated with the direness of the situation the patient is facing.

I have a small glimmer of hope; we did an MRI today, and the appearance of the mass in her pancreas was “atypical for pancreatic adenocarcinoma”. It recommended a biopsy to see what kind of cells are actually in the mass, and suggested it might be one of a number of less aggressive tumors.

And I have to wait until tomorrow to schedule the biopsy. And then I have to wait a day (at the least) for it to actually happen. And then I have to wait three days (at the very least) to get the results.

And she will have to wait. Terrified and in pain.

If my burning hatred could kill, it would kill pancreatic cancer.

And I have to say this, because 30% of pancreatic cancers are associated with tobacco use:

Don’t smoke, okay? Please? Just don’t smoke.

Published in: on September 16, 2010 at 1:02 am  Comments (14)  

I Might Just Die Of Anticipation

Apparently they’re talking about doing the Dark Tower Series as a COMBINATION of feature films and bridging TV series!

This news seriously affected my physiology. Holy crap! Like, HOLY CRAP ON A STICK!

HOW COOL IS THIS GOING TO BE?!!!!!!!!!!!

(It’ll be better if they end at Wizard and Glass, though. You know, to cut out the massive suckage that came afterwards….)

I have no idea how I’m going to be able to tolerate the wait.

Published in: on September 13, 2010 at 2:35 am  Comments (8)  
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For The Lit Geeks In The Crowd….

….this may just make your day.

How the Wikipedia article for If On A Winter’s Night A Traveler should read.

Published in: on September 9, 2010 at 2:26 am  Comments (12)  
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My Liddle Brudder Luvzes Me.

So, my little brother is not a geek. He has his mildly geeky side (you can totally get his goat by pooh-pooh-ing the Wheel of Time series), but in general, he’s pretty solidly settled in the mundane world.

But the other day he managed to muster up enough geek-enabling cred to post this adorkable LOLcat on my Facebook page:

It totally made my day. And I think he knew it would.

So, kudos, Liddle Brudder!

(Minus a half a point for forgetting that I kinda grew out of Star Trek in junior high…..but plus several thousand for the sheer and unexpected awesome-itude!)

Published in: on September 5, 2010 at 7:24 pm  Comments (6)  
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