CPE Related Notes

The car is fixed, so if I get called in while I'm on call, I can use my own vehicle. It turned out that I didn't spear the oil pan with a random stick - said stick merely shredded the serpentine belt, which then whacked the whoozis out of the oil lines. The resultant mess required a new serpentine belt and oil lines, but no new oil pan. It did require a spa treatment to get all the oil off the Saab's engine, but now it's clean and well-moisturized.

In our group work today I accomplished something major for me - I told someone they were exasperating me. Shocking, aren't I?

Still not breaking through in conversation with the teen AIDS patient. If I were the patient, I'm not sure I'd feel much like talking with anyone either. It may be clinical depression. Slow going.

I'm leading a prayer and meditation service on thankfulness tomorrow. Once that's done, I have a presentation to make on child abuse in the congregational setting and one more verbatim to write. Remarkable it's almost all done.

Time to go upstairs and read Harry Potter. Don't know if I'll get through the full 100 pages I've been allowing myself nightly, since I'm pretty tired. Gosh, it's a good book! My daytime reading is Harriet Lerner's "The Dance of Anger." I'm getting in touch with my inner exasperatedness...

No matter how challenging the day has been, I still am so high over the birth of the grandbaby, nothing can get me down!

And it's Ben!

Herewith, grandbaby #4, who arrived yesterday, all 9 lbs 2 oz of him! To GrandM's eyes, he looks brilliant, alert, and ready to play linebacker for the Redskins.

God is good!

Random Dots of CPE - 16 Days to Go

...not that I'm counting.

Much.

• I'm on call this week. This was complicated by the fact that my car died in a dramatic way on Saturday. The shop called today and the good news was that it wasn't the most expensive problem, or the moderately expensive one, just the modestly expensive one. I'm hoping it will be done by tomorrow afternoon, so I can pick it up. Thus far this week, I've been holding my breath hoping I wouldn't be called in to the hospital until PH got home and I could use his car.
• I did get called in tonight (just as PH was finishing up grilling the burgers), to baptize a baby who will be operated on tomorrow morning. I'm told the survival rate for the surgery is less than 10 percent. Makes you look at the baptism in a different way.
• Being on call, and getting called in, has gotten so much less stressful. Having survived working in the ER and being on call before, I was surprised to discover that I was feeling grateful to be able to provide this support as I was driving in tonight. The first week on call, I was simply a basket case of nerves the whole time. Maybe I'm learning.
• I've given up on feeling personally attacked by the prickly member of our group. It's her problem if she misreads me and doesn't ask me what's up. Of course, when I notice her acting funny, I always have the option of checking it out with her as well. It took me a while to figure out that I don't have to stop being who I am just because I don't do things in her style. Old dogs can learn new tricks.
• A baby whom we didn't expect to live (multiple congenital birth anomalies) has opened her eyes and is looking at us, is being weaned off the ventilator, and may leave the intensive care unit to go to a step-down unit on Friday. For a kid one of the nurses said was as good as dead, this is pretty darned close to being a miracle for me.
• We have a new baby on the unit who was born with active leukemia. She is two days old and on chemo. Sheesh.
• I'm working with a teen AIDS patient. Hardest work I've ever done, even harder than with dying babies. It makes me wish for miracles and/or magic wands. Expelliarmus!

It was good having family visiting this weekend. I feel back in touch with my own world, rather than just focusing on the hospital. My house got clean, I ate and cooked good food, enjoyed conversation about things other than diseases and accidents and death. Next Monday I get to observe open heart surgery, and yes I am looking forward to it. Then I have Tuesday and Wednesday off - a mini-vacation. I am sooooo ready for a break. Actually, I am soooo ready for this to be over, but I can hang in there for the remaining days.

Oh, and I'm preaching a week from tomorrow. Just to keep the pressure up a little bit more...don't want to lose the edge, dontcha know...

Processing

...attending the death of the little one I mentioned in yesterday's blog. It was my midday's work. It was heartbreakingly sad, and I was so privileged to be able to support the young mother in her grief. At the last, when it was done, the little one looked so at peace, and so very far away. Of course, he was far away; only his tiny (2.5 lb) body was still with us, a sweet boy at the last.

Of course, the chaplain then has to find a way to process it all.

My solution (one I've used since I was a teenager) was to clean the house when I got home. I'm a lousy housekeeper the rest of the time - my dust bunnies are unto the second and third generation by now - but when my heart aches, I clean.

Doing something tactile and finite seems somewhat Zen-like. It is something I can actually know I did, and completed, or something like that. And I used the real mop, not the Swiffer. There's a metaphor in there somewhere. I just can't think of it right now.

Tears do a good job of washing a kitchen floor.

Keep watch, dear Lord, with those who work, or watch, or weep this night, and give your angels charge over those who sleep. Tend the sick, Lord Christ; give rest to the weary, bless the dying, soothe the suffering, pity the afflicted, shield the joyous; and all for your love's sake. Amen.

Probably a Good Idea...

...to share something OTHER than just peeing and moaning.

I spent time today doing a commendation for a little one from whom care is being withdrawn tonight. He never had a chance, although he's undergone three surgeries since his birth two weeks ago. I spent a long time at his bedside, just stroking his head. He has been in an isolation room because he has been so ill and is (frankly) a little scary looking. I was thinking as I was saying the prayers of commendation how little I've seen anyone touching him, not prodding or poking, but touching him the way babies need to be touched. So I stayed, and held his hand, and stroked his tiny head, and thought a lot about the meaning of such a tiny, brief life, just a flash of a shooting star across the sky. I truly believe he is going to a better place. This work is such a privilege.

I also visited a youngster who has suffered brain-damage from lack of oxygen after a near-drowning. The family is hoping for complete cure. It seems unlikely. So today we prayed for a hundred little miracles, like him gripping his grandpa's hands, or moving his legs a bit, or appearing to looking meaningfully at his brother. We also talked about how God's time is not our time, as much as we'd prefer the big bolt of lightning that fixes everything right now, and how we also need to pray for patience.

I'm thinking a lot these days about how, when one of our children is desperately ill, we become children ourselves, petitioning our Father God for a parental fix. We think as a child. At some point, if it is an extended recovery, or less than hopeful prognosis, we become grown, and we put away childish wishes. Our interactions with God seem to change.

Another mother and her child (who is HIV positive) are struggling to balance hope with reality, and the child's kidneys are failing. The miracle talk has shifted into simple requests for strength.

Neither is good or bad, or right or wrong. It's just an evolution as we process the suffering.

Four babies have died on the intensive care unit in the past two weeks. My heart aches.

Extremely Crabby

I'm having a major-league problem with another group member in CPE. Can't talk about it - that would be a violation of the group covenant, but I'm crabby. I guess I'll have to address it during our next group session on Friday. Not fun to deal with someone who's unreasonable and extraordinarily prickly.

Damn.

A Bit of Harry Potter Silliness..Which Potter Alter Ego Are You?

You scored as Hermione Granger, You're one intelligent witch, but you have a hard time believing it and require constant reassurance. You are a very supportive friend who would do anything and everything to help her friends out. Hermione Granger 75% Albus Dumbledore 75% Harry Potter 75% Remus Lupin 65% Ron Weasley 60% Ginny Weasley 55% Sirius Black 50% Severus Snape 45% Draco Malfoy 35% Lord Voldemort 35% Your Harry Potter Alter Ego Is...? created with QuizFarm.com

Yes, it's silly. but it was a long day in CPE, with a movie on racism and a presentation of one of my most challenging and frustrating verbatims...

I find it odd that my answers yielded the same percentage for Hermione, Dumbledore and Harry; that certainly says something about the scientific nature fo the survey!

Besides, the book arrives on Saturday!

Random Dots of Counting Down

• 23 more days of CPE. Not that I'm counting down the days or anything...
• lovely in-laws are coming for the weekend next weekend. Although I should be stressed about getting the house clean etc., I'm just so happy to have them here, I'm not worried about the state of the house (at least not much).
• I survived mid-unit CPE review. The perception of the group seems to be that I'm some great energetic mamma bear. My own image of myself is one of the Israelites murmuring in the wilderness and complaining about the manna.
• it was a blessed relief to go someplace different for church this morning and not have to answer questions about CPE. PH preached at a church I've never been to before (he was serving as supply clergy) and it was great to just be quiet and listen.
• I'm preaching at Big Old Seminary - we have Wednesday night Eucharist during the summer - on August 1st. First time I've preached there. It's the passage from Luke about Joseph of Arimethea retrieving Christ's body, putting it in the tomb, and the women anointing the body. I think I'll do a reflection on the way the ritual of the handling of the body is dealt with by the hospital when a child dies, and the power of ritual in that liminal space between death and the reuniting of the soul with God. Nothing like something heavy...the key will be the pivot into that joyful moment when the mortal body is left behind and the soul is with God. Don't want everyone to be going from the Eucharist to the post-Eucharist cook-out in tears.
• I'm also preparing a seminar for my CPE group on child abuse and how we address it in our parishes/congregations. If any of you out there in the blogosphere can recommend some good resources, I'd appreciate it.

So let's see, I've dealt with two deaths of babies this week, I've presided over an interfaith service on children who were victims of violence, I'm preaching on death rituals in two weeks, I'm teaching a class on child abuse. The upside of all this is that I'll be so cheerful when it's all over, the start of school (with Systematics, Homiletics, Church History, and Pastoral Theology) will seem like lots of happy talk!

Words fail me...

The little one I baptized a few days ago died last night. It shouldn't have been a surprise - she had many physical problems - but she had seemed better. I had seen her with her mom at her bedside yesterday at 5 pm.

This has been a bad week on the unit, with two babies who were in beds right alongside each other dying within a day of each other. Teen Mom (see below) whose little baby girl is still in many ways a medical mystery to the docs with her many congenital problems, didn't come in to sit by her child's bedside, as she usually does. I fear she's been shocked and horrified by the two deaths, and it is finally dawning on her how sick her baby is. I hope she'll be there on Monday so we can talk.

I've been assigned an additional unit, since one member of my CPE group has dropped out for medical reasons. I'm picking up the Respiratory Care unit (think asthma, cystic fibrosis, that sort of problem). Sick kids, usually past the baby stage so I can have some conversations with them, not so acute as the babies downstairs. Different challenges that will be good for me.

As much as I'm learning, I will be glad when these last five weeks are over. Poor PH is patient with my every-night tears, but I feel badly that his wife dumps all her emotions on him over dinner.

The cure? I had frozen custard after dinner tonight. I'm much better, even though my jeans are tighter.

Tod und Verklarung

One of our sickest babies died last night. She was born with many congenital defects, and in her ten months of life underwent a number of surgeries to try and help her. She finally could hold on no longer, and as she was about to be coded, her mother stepped to the bedside and said, "enough." So they undid the many tubes, and let her lay in her mother's arms. The pacer wires were still attached, so her heart kept beating. After a while, her mother said to remove the pacer wires. Her heart stopped immediately. They sat quietly with her for a long time, and after the last of the various pieces of equipment was unhooked, they bathed her and dressed her and continued to hold her in their arms. It was a moment of terrible poignancy.

This is a ritual that often happens in this unit when a baby dies - and babies do die here frequently because we do the most radical of surgeries, the true last-ditch efforts - that the parents stay with the baby, bathe the child, and spend time quietly holding their little one.

In the case of the baby that died last night, for the past few weeks, the mother had often said, "I just want to be able to hold her." There were so many tubes and wires it was impossible for her to be lifted off the bed and into her mother's embrace. Last night, finally, she got her wish.

I wonder about these rituals of washing and waiting. Certainly Scripture speaks of them after Jesus' death on the cross. Joseph of Arimethea collects Jesus' body, lays it in the tomb, and the women come to wash and anoint the body.

I belive that some of it is to lend tactile truth to the death. When you have touched a dead person, child or adult, you know they are dead. You can feel there is no life in them. Some of it, too, is an honoring of the person by washing them, anointing them, preparing them to step away from this world and into the next. It is the last gentle act of love you can do.

I used to think that rituals like wakes (I grew up in an Irish Catholic family, and the wakes were Joycean) were barbaric. The number of times I heard someone say at the side of the casket, "Doesn't she look good?" is more than I wish to count. Spending time sitting with a body? Having the dead person dressed up and laid out for all to see? Awful!

Now I start to see the wisdom of ritual to lend reality to what has happened, although the embalming and making up of dead bodies still seems wrong to me. I wonder if we can visualize a going up to heaven without the rituals that bid the person, or at least the person's mortal body, farewell.

I believe in another place after this one, a place of peace and rest. I don't know what it is like - none of us do - but I know it's there. When I die, I hope my loved ones can bid my body farewell as gracefully as these parents did, knowing that I am well and truly gone from them, and know, too, that the "I" of me is gone on to that other mystery for which there are no words.

Rest in peace, little M. Rest in peace in that mystery place for which there are no words.

Whoa!

So Friday the CICU was rockin' - lots of sick babies plus a couple of sick adults with congenital heart defects. I had spent some time with new anchor mom (the beautiful, fully made up one) and we talked about grieving the perfect birth and homecoming she had planned for her little boy. When you're a master (or mistress) of the universe, you think everything's going to go your way, and when it doesn't, it's a shock. A long and interesting conversation, and she was able to cry about it, which was a very good thing. The good news is that her son's problem is very fixable, and although the start of his life was not what she hoped for, the rest of his life most likely will be. On the other hand, mye xperience with my own children tells me that they tend to do follow their own path, not the one I laid out for them. Nevertheless, she is fortunate.

Then the social worker came to find me and said "We need you to do a baptism NOW." It was a baby I had prayed with before - the family is Catholic and Hispanic, and mom speaks very little English. I suggested she might prefer to have the Catholic priest come down...and was told that the baby was crashing and they were about to rush her up to the OR to try and fix what they believed was the problem (the baby had already had several heart surgeries and was recovering from her latest) and there was no time to page the priest. So I baptized the little one (who had every square inch of her body covered with tubes, leads, etc) reaching past the four nurses who were packing her up with all her equipment to go to surgery. Even with all the work they had to do, they stepped aside for a moment to give me access, and a few said some of the prayers with us. One of the nurses said to me, as I was by the crib, "You better do some extra prayers for this one. It's really a long shot." Nothing like a little pressure. We had an interpreter translate as I baptized the baby, and they recited the Lord's Prayer in Spanish as I did it in English. Then we brought in the two siblings, aged ten and six, to kiss their baby sister before they took her up. We had to gown and glove the brother and sister, which they thought was great fun. The only thing they could reach to kiss was her little foot.

Suffice to say it blew me away, and I had to step out after they took the baby up to compose myself.

An hour later, she came back down from surgery. The problem was not as acute as they feared, and was fixable. The baby still has a long road ahead of her, but she got through this one. I'd like to believe the Lord (and my clumsy baptism) helped. At the very least, it was a comfort to the mother and to the staff who (remarkably) thank me when I pray with a baby.

Intense.

The other biggie: the newborn baby of a teen mother (both baby and mom have a raft of problems) was taken up for surgery unexpectedly - we thought she would be waiting until next week for her repairs. She was in surgery for twelve hours, on heart bypass for over five. She will still need more surgery down the road. It's miraculous that they're able to do these repairs, but it raises a number of ethical questions as well. Teen Mom has been leaning on me (as has her mother, a grandmother at 36) so it has been a challenging week. I expect this family will be with me for the rest of my time in CPE this summer, and I already feel very close to them. I don't know whether their reliance on me is a good thing or a bad thing, but I'm certainly learning a lot in the midst of it.

Plus we have a preemie who has just had his first heart surgery despite the fact that he weighs under three pounds.

Whoa, indeed!

Six more weeks.

Movie Recommendation

If you love to cook, or love to eat, or love general good-hearted silliness, may I recommend you go see the new animated picture "Ratatouille?" Beautiful animation, charming story with a good message, and lots of good stuff for the foodies amongst you. Ian Holm as an evil chef, Peter O'Toole as a mean-spirited critic, Brian Dennehy as the ghost of a famous and big-hearted chef. It's my understanding that the writers and animators spent a great deal of time with renowned chef Thomas Keller of the French Laundry, Bouchon, and Per Se, and it shows. Not for under 7-year-olds, I think, even with the G rating, but otherwise even your Great-Aunt Sadie would find nothing objectionable.

I'm still smiling...

CPE Random Dots - Week Four +

Today was a short day - I had a funeral of an elderly friend this afternoon. I spent the morning doing clinical visitation. I've got tomorrow off, too - a blessed relief.

Here's what's happening:

• more very sick babies on my acute unit. We are all braced for the inevitable sadness with a few of them. It affects the whole unit.
• I am getting a rep as a "baby whisperer," good at calming down fussy little ones. I claim to have grandma hands, and I can sing a whole bunch of lullabies. And yes, I do pray a lot with them.
• the dad of one of our babies is a news anchor, and he and his wife are too gorgeous for words (the baby was born less than a week ago, and she is back into her original jeans, and shows up on the unit in full makeup - the only sign of recent birth is a luxurious bosom, which makes her hips and tummy even tinier). We all feel like schlumps in comparison. On the other hand, they're not surgeons or nurses or repiratory therapists or baby whisperers, so I guess even in our schlumpiness, we're useful.
• a baby with (literally) half a brain, can still look in your eyes and you can feel the connection.
• I'm getting better at talking desperate parents off the ledge when things are getting really rough. And I'm getting braver at asking the hard questions (do you understand your baby is really sick and may die? kind of questions) plus the follow-up hard questions (what's happening in your relationship with God with all that's going on?). No one has smacked me literally or figuratively yet.
• anointing a sick child is the most transcendent thing I've ever done.
• teen moms are not necessarily immature. Mothers of teen moms are not necessarily mature. No generalizations, just an observation.
• some of the staffers are so goal-oriented, they forget they're working with people.
• if I trust my instincts, I'm generally okay. If I worry about what someone else thinks, I'm generally not.

Tomorrow should be a quiet Fourth. PH is going on a long bike ride with his buddies, I'm going to attempt to sleep in, and we're going to see "Ratatouille" in the afternoon, then grill some steaks on the Weber. I should do my ethics project, but somehow I think I need a completely non-CPE day. Gosh, this is exhausting work.

CPE Random Dots: Week 3.5

• Sometimes the smallest babies are so fierce - they fight the nurses who are trying to give them various kinds of treatments. Food, however, is NEVER refused. It may be spit up, but it's never refused.
• Not having any Spanish is really frustrating for me. I have to use the interpreters and one of the other chaplain interns to translate. As a mother, I know what the Hispanic moms are asking by their body language and where they're pointing, but I am unable to respond. Bah!
• Parents telegraph their anxiety to their kids, and it makes it harder on everyone. I wonder how much I did that when my own kids were in the hospital for one thing or another. One dad is worried his child isn't get enough attention, and gets pretty hostile with the staff. His wife is sitting there, and is giving off a vibe that says, "Please don't punish my child just because my husband is out of control right now." I wish there really was a "chill pill" we could give them to calm their fears, but all I can do is pray and be a calm presence.
• I'm grateful I've been assigned a less acute unit in addition to the Cardiac Intensive Care Unit. It's a relief to go talk with families where the kids are getting better rapidly after spending time with ones where the kids are dreadfully sick and will probably only get marginally better.
• I will really need a vacation when this is over.

Hot Time, Summer in the City

Yes, summer has arrived here in your nation's Capitol.

One of my trauma pages at two in the morning was for a child whose injury was identified as GSW: gunshot wound.

Usually GSWs go to the Grownup Hospital Center next door, which has (sadly) ample experience with them, but since children are not just small adults, my assumption is that this victim of violence was under 14.

Jesus weeps.

CPE: Random Dots at the end of Week Three

• I now know more about congenital heart defects and the surgical procedures used to try to repair them than I ever would have thought possible.
• I'm getting better at extemporaneous prayer, but when I'm feeling sketchy, I revert to the little green "Ministry to the Sick" prayer book. Thank you, Church Publishing!
• At the end of a very sad week, one of the little ones who is recovering from surgery was awake, sitting up, bouncing a little despite IVs and EKG leads and such. My heart unfolded with joy. Even the mother of another child who had suffered serious reverses this week came to her bedside to smile at her. She gave us all some hope on Friday, waking up as she did the day before her first birthday. I'm hoping her mother got her wish to give the little one a bit of birthday cupcake today.
• Seeing a baby's heart , no bigger than a small apricot, beating through an open incision while the heart recovers from surgery is awesome, in every sense of the word. I think of Dame Julian of Norwich: "And in this the Lord showed me something small, no bigger than a hazelnut, lying in the palm of my hand. . .In this little thing I saw three properties. The first is that God made it, the second is that God loves it, the third is that God preserves it."
• Baby's hearts aren't the only broken hearts in a children's hospital. This is hard work, every day.
• I'm on call until Monday. I haven't gotten called in yet. Today the pager beeped for a number of traumas that were brought into the ER via helicopter or ambulance, but they didn't page me, which means no one thought their child needed baptism or was in imminent danger of death, thus needing the prayers and support of a chaplain. I'm embarrassed to say I'm grateful I wasn't called in. Of course, the pager may well bid me come tonight or tomorrow. Part of me says I'm glad I wasn't called because it means no one is in that bad shape, but the cowardly part of me says it's because I'm afraid I'll be found wanting if I am called in. Yes, I trust God will equip me, but still...

I love this work, but it felt really good to chill out at home today and putz around the house and do some cooking. We're going to a friend's house for a Caribbean dinner this evening (can't have a foo-foo drink since I'm on call) and we'll see if I can stay for the whole thing or if I get paged to go to the hospital. Once this on-call thing ends on Monday, I'll be so grateful to get a solid night's sleep without the pager announcing the traumas and such. There were enough of them that the battery on the pager started dying last night (at 2 a.m.) and I had to get up and replace it - thank goodness I had a AAA battery in the kitchen. I should have another short stint of on-call before CPE ends in mid-August, maybe four more days, but the seven day thing has worn me out. The only comforting thing is that the young people in my group are just as exhausted during on-call as we ancient crones are.

Shockingly Small World

So PH and I went to a military retirement party for a friend who will start seminary this August with me. I don't know him really well, but he's part of my postulancy group so we've become casual friends.

In the course of the evening we talked with friends from his church, a couple who are about 10 years older than me. We were all sitting in the living room and my buddy's wife told how his British mother ended up in El Paso (WWII bride). PH asked me to tell how my parents met in France - both in the Army in WWII, both from the same home town, but had never dated there - they started dating in Alsace and married after 6 dates after they were both discharged from the Army. Some details came out in the conversation, and suddenly the woman of the older couple paled visibly and said," Where in [home town] was your house?" I replied, "It was xxx Avenue, across from Lincoln Park." She said, "I earned my Child Care badge in Girl Scouts babysitting you when you were four." We both burst into tears and hugged. It was sort of like finding one's long-lost big sister. We compared notes about some of the wacky neighbors and who was still alive and who was dead - sadly, most were dead - and it felt like fifty years had just fallen away. I told her husband, "I've known your wife longer than you have!" We all laughed uproariously. An amazing moment.

One of the other guests said that if I were a mathematician, I could calculate the odds of our meeting. I said I was a theologian, so I didn't have to do any calculation - it was all about the Spirit working in mysterious ways. For me, that's a much more satisfying explanation.

For someone like me, whose family of origin is pretty much all gone, it was bittersweet. It would have been nice to be able to call my mother and say, "You'll never guess who I met at a party last night." Somewhere, though, I think she's smiling.

CPE:Random Dots Week 2.5

• being able to say "asalaam aleikum" to a mother of a patient from the Middle East opened the doors to a very rich and unexpected conversation
• if you give your students unclear directions, telling them you're "disappointed" in them when they misconstrue what you said doesn't help
• on the other hand, if you're willing to say you overreacted, you're a grown-up
• "hoping for a miracle" is sometimes the saddest phrase in the world, when a baby is being kept alive by artificial means and has never known the bliss of sleeping in its mother's arms
• a child that's sick and a child that's dying look very different
• grandparents who are doctors sometimes slow things down when a child is being treated in the trauma bay...because they can always imagine the worst case scenario
• twelve hour days are tiring for all, young and middle aged alike
• the tiniest, sickest babies sometimes show the most extraordinary personalities, as when a little guy was unhappy because the nurse was seven minutes late for his feeding. One angry little dude!
• this work is a privilege. God guides my words when my own feeble attempts fall short.

Thursday CPE Dots

• Going on rounds with the docs is interesting, even though I only understand about five pct of what they say. They are very patient with me tagging along.

• Sometimes people just don't want to talk with you.

• Some sick kids are not going to get well. That rots.

• I can handle just about any kind of trauma except third-degree burns.

• Having a glass or two of wine and conversation with a dear friend that makes my bedtime 11 pm is not good (as much as I've missed talking with said dear friend) when I need to catch the 7 am bus the next day.

• CPE group conversations where we're reminded we're inherently racist somehow don't seem helpful to me.

• If I have to listen to much more New Age mediocre music for Prayer and Meditation Time I may trash the boombox. Yes, I'm a music snob. I suppose I should be glad it's not "Jesus is my boyfriend" praise music.

• I better lose some weight quick - my clothing choices are very limited right now, and it really stinks.

• My favorite 7 year old prophet and his little bro (the patient) may be going home tomorrow. Some day I'll tell you the story in a way that protects their privacy.

• When it's 90 plus degrees out when I come home at 7 pm, I'm not exercising. Just don't have it in me. So if I'm not as thin as a sylph by September, suddenly I just don't give a flying wazoo.

CPE Week One

It has been a busy three days since I started CPE. Most of the time has been spent in lectures, plus a couple of tours. Next week we'll begin clinical visitations. I've been assigned the Cardiac Intensive Care Unit, the Emergency Room, and the Short Stay Unit. I can only assume that I appear to be a "non-anxious presence."

At Children's, their philosophy is to have family members be able to watch what's going on when a child is being treated in the ER - there are observation rooms with a glass wall alongside the treatment bays. I was a little surprised by this, but the logic of having people see how hard the staff is working on their child does make sense. I asked if they triage these cases, but they don't. It's the family's choice whether they want to observe treatment.

I'm looking forward to actually doing the work, getting out of the classroom.

The days are long - with the bus, the Metro (changing from the Yellow line to the Red line) and the shuttle from the Metro to the Hospital, it's between and hour and an hour and a half in each direction for the commute. Makes for a long day. All part of the learning.

The good news is that I'm slowly continuing to lose weight and I'm exercising each evening. The bad news is that it's hard to stay awake long enough to spend time with PH in the evening when he comes home from work. Oh, well, we'll figure it out.

Speaking of PH, he's down in Historic Rockefeller Town, having finished the first day of the two-day MS 150 bicycle race. He and his buddy rode the long route (100 miles instead of 75) from The Capitol of the Confederacy today and felt quite good about it, and were headed into the massage tent when he called to check in. He'll do another 75 miles tomorrow, then drive two hours back here. Remarkably, that's his idea of a fun weekend.

It's always strange when he's not here in the house with me.

On the other hand, I rented "Memoirs of a Geisha" from Blockbuster, so I think I'll mosey on downstairs and stretch out and watch it, and try to stay conscious...