oh, my poor dear neglected xanga! i came to the library with earnest intentions of preparing for our clinical seminar tomorrow. we have to diagnose and treat a hypothetical 49-year-old male with high cholesterol and triglycerides who came to the emergency department with abdominal pain, nausea, and vomiting. his labs are fairly unremarkable except for crazy-high amylase and lipase. his presentation is textbook pancreatitis, but i don’t remember off the top of my head how to treat it. ergo, the library visit.

but somehow i’m just not feeling too inspired, perhaps because he is hypothetical. yesterday i got to see real people and they’re more interesting and important any day. at twenty past seven Nick dropped me off at a chronic pain center affiliated with a local hospital, and i grabbed my polka dot medical bag and my folder filled with HIPAA clearances, immunization records, and background checks and walked right in the door without even waving goodbye because my stomach was tied in knots and if i hesitated for a minute, i thought i might hop right back into the mustang (his new pride and joy) and convince him to drive me home. at twenty-five past seven i had stashed my bags in the receptionist’s locker and the medical director had introduced himself and my heels were making a ridiculous amount of noise as i followed him down the hallway to the procedure room, but i was already too excited to care. and i loved every minute of the four-and-a-half hours i spent there. it’s a small clinic, with just one doctor, one PA (who graduated from duquesne this year!), and several nurses, and it has such an uplifting atmosphere. no inspiring pictures on the walls, no frou-frou about the waiting room, but the staff are optimistic phlegmatics who take a balanced view of their patients’ pain. they don’t demean it or get too worked up about it; they just discuss the treatment options with obvious conviction that something will help each situation. i learned a lot about herniated discs, spinal stenosis, arthritis, complex regional pain syndrome, and opioid and narcotic therapies, but i had the most fun just chatting with the patients (who all were surprisingly amenable to me playing fly-on-the-wall during their check-ups and even their nerve block procedures).

moral of the story: don’t be nervous for your next clinical encounter. and invest in a good pair of dress flats.

on a completely different subject, let me just tell you that john banville’s novel the sea is amazing. like, so amazing that i picked it up at 11 a.m. on saturday morning when i woke up, and put it down at 4:30 p.m., finished with the actual reading part but still relishing the sweetness his words leave in my brain. and was still in my pajamas. one of my favourite parts of the book won’t exist in any copy you buy, though. it’s the inscription penned by my Nick, which nearly makes me cry when i read it. and that’s all you get to know. however, you are entitled to know that he played a fantastic performance of Rheinberger’s organ concerto no. 1 in F major on tuesday night, accompanied by the duquesne symphony orchestra. this girl was on her feet after the piece came to its thundering finish! i wish you all could have heard him.

well, i suppose it would be amiss for me to leave the library without even attempting to accomplish what i came here to do. and one of these days, that hypothetical man with pancreatitis will be a real man with pancreatitis, and i bet he’d like me to know how to handle it. so happy 2008 to all of you, and i’ll try to give xanga some more consistent loving!!