Frivolity at the Family Practice

I’ve been going to the same family practice for primary care issues for over ten years. Evergreen Family Health is located in Williston, VT and isn’t really all that close to our house in Richmond, but we started going there years ago when we did live much closer.

We get along pretty well with an Evergreen PA (physician assistant) named Molly and so we always ask for her. She does a better job and takes more of an interest in our health than a lot of regular doctors do.

Today I went in to talk to her about the buproprion prescription she’d started me on a few weeks ago. When I walked in to the waiting room, the receptionist handed me a laminated form and a dry-erase marker so I could fill out why, specifically, I was there and if I had any questions. I assume it’s a way to jog people’s memory so they don’t get halfway home and then remember that they needed to get refills on their prescriptions.

I tend to have an imbecilic sense of humor when afforded the opportunity. Thus, today when I looked at the question “Why are you here today?” I wrote down “Buproprion medicine check,” stopped for a second, then added “Cha-Cha lessons” on the second line.

Last time I wrote “What is the capital of Burkina Faso?” on the line that said “Do you have any questions you’d like answered today?” Tip of the hat to my Blacksburg High School acquaintance, Christian Rojas, who had an obsession with the capital of Upper Volta (now called Burkina Faso) and wound up getting a question on his physics final exam demanding that he plot the vector from Blacksburg to Ouagadougou.

15365841_ml

When Molly came into the exam room, she had a medical student with her, a family practice intern who, as she put it, would be “all baked in about six more weeks and ready to go out into the world.”

Molly asked if it was okay for Kyle, the intern, to meet with me. I said “Why not?”

She said “I told him ‘this one’s a bit of a challenge.’” Then she glanced down at the laminated form and saw what I’d written and said “Annnnnd there we go!”

Not sure what it says about me that they use me for training family practice interns in what “challenging” patients are like. But hey.

 

 

 

Posted in Jay | Tagged , | 1 Comment

Iced Tea

Tropical Spice chai tea

I’ve tried in recent years to avoid pounding the caffeine as much as I used to. I gave up coffee altogether a few years ago but still drink green tea and the chocolate chai tea latte at Starbucks and have a Diet Coke or a Coke Zero now and then. So, no, I’m not totally abstaining, but I’m trying not to flat-out pound the stuff either.

The other day I had the urge to make a pitcher of brewed ice tea, using the Tropical Chai Spice Tea from Upton Tea Imports. I drank about half of it the other day and just finished the rest. Now I’m wishing I had a lot more. There’s something about the first day warm enough to open all the windows that just calls for a cold glass of iced tea, caffeine be damned. (“Warm enough to open all the windows” is Vermont-speak for 60 degrees Fahrenheit.)

Posted in Jay | Tagged | 2 Comments

My Prediction for the 2014 Atlanta Braves season

No one asked, but I’m going to go on record here anyway since today is Opening Day (at least as far as the Braves are concerned): the Braves will finish with a winning record, but only just, and finish 2nd in the National League East behind the Nationals. I’m thinking something like 84-78 would be about the best possible outcome. 81-81 wouldn’t surprise me at all. I’m mainly praying that the Braves don’t finish below .500.

The Braves’s starting lineup is decimated. The outfield has forgotten how to bat. Their catchers can hit, but are defensive liabilities. First base and shortstop are good. The bullpen is excellent if no more injuries mount up.

If it weren’t for the absolute detritus that makes up the rest of the National League East (the Marlins, Phillies, and Mets are even worse than the Braves), things would look even more bleak.

C’est la vie. I’m still looking forward to listening to games. (I have the MLB At Bat app on my phone and tablet so I can hear games with the Braves’ announcers calling the action.)

Posted in Jay | Tagged | Leave a comment

The Great Silverware Wormhole?

Does anyone else have silverware in their silverware drawer that you have NO IDEA where it came from, that doesn’t match the set(s) that you normally use?

Silverware!We realized today that we’d accumulated quite a bit in our silverware drawer, tucked in at the front where it was sort of a nuisance when you reached back to get to the actual organized silverware in their individual little knives/forks/spoons compartments. I hauled it out and Carole found the Ziploc bag in the basement where, over the last 18 years, we’ve been tossing other excess silverware whenever the amount in the drawer got to be too inconvenient. And wow, there’s a lot of it.

We washed it all on a sani cycle before sorting it out, with the thought of throwing some away and donating some of the rest to whomever takes excess silverware (Goodwill, I guess), and it really was something to behold. Maybe four or five spoons that are in that mess are there because they fell into the garbage disposal and got battered around a bit before we could intervene, but the rest is just accumulation from God knows where. Eighteen years’ worth.

If anyone’s missing any, it’s possible that yours fell through a wormhole and wound up in our house. If that’s so, perhaps you got our missing socks in return.

 

Posted in Jay | Tagged , | 2 Comments

Kitty Anxiety and Prozac?

IMG_3394We brought home a long-haired black kitty and a short-haired black kitty from the shelter last June. They had always been together, at their previous home, at the shelter, and then with us. I think that they may have been abused at their original, pre-shelter home.

The short-haired kitty, whom we named Marie, has started climbing into laps and being affectionate, but is still skittish. The long-haired kitty, whom we named Jacqueline (Jacquie for short) though, is still extremely skittish, and runs like hell and hides whenever we come into the room. We made her a special “cat cave” under a table with blankets and we almost never disturb her in there. We know safety is important to cats. But here we are, 9 months later, and she’s really basically just as terrified of us now as she was when we first brought her home. We’ve tried using a Feliway diffuser in the room, and that didn’t seem to help either.

I asked a tech at our veterinarian about this over the phone today and the vet tech said “Sometimes we use stuff like Prozac. We can go over it in more detail when you bring her in for her shots on Monday.”

But that said, has anyone else out there had any issues like this, and used tranquilizers or anti-anxiety medications or Prozac or anything? Did it work? Was it a long-term thing or a short-term thing?

Posted in Jay | Tagged | 3 Comments

The Unbearable Lightness of Ice Cream Cakes

Carole really likes ice cream cakes. I mean she really, really likes ice cream cakes. Even though I can take them or leave them, she used to try to twist my arm into consenting to have an ice cream cake for my birthday every September. It just seemed like such a waste to have a cake-eating occasion and not have ice cream cake. So, as a result, I try to order an ice cream cake from our local Ben and Jerry’s scoop shop (theoretically, it’s Ben and Jerry’s Store #1, although it’s not at the location of the original one a couple of blocks away) now and then, often for contrived holidays like “National Squeakin’ Day”. They always give us a $4 Off Your Next Ice Cream Cake coupon, which sort of traps us in an infinite loop of ice cream cakes. (Carole says “And your point is?”)

I couldn’t think of a good faux holiday that coincided with last Saturday, although technically it was my parents’ wedding anniversary (56th). Celebrating their anniversary two and a half years after my mom’s death, with my father not on hand, seemed pointless, so I just plain winged it. Thanks to B. Kliban, may he rest in peace.

That’s a layer of “Hazed and Confused” (hazelnut and chocolate) and a layer of “Chocolate Fudge Brownie”, in case you were wondering.

Carole pronounced it “gooooood”.

Posted in Jay | Tagged , | Leave a comment

Lasagna!

IMG_4815

Posted in Jay | Tagged | Leave a comment

From the vault: Mindsets and You

(I wrote this in the early 1990s when I was a humble student in the Master of Public Administration program at Virginia Tech. Be gentle. That was a lifetime ago.)

Here we are now, some years after…

Suppose you’re out at the grocery store one Saturday after­noon, dressed in jeans and a work shirt, picking up a few grocer­ies. You’re probably thinking about things you’ve got to do at home, what you’re going to have for dinner that night, what you’re going to do after dinner, that kind of thing. No big deal.

Then, you hear someone calling your name. You turn around and there’s someone you work with, also out at the store to pick up a few things. He or she comes up to you and you talk about the weat­her, the day, and maybe a few things about work that were at the very back of your mind. Almost without realizing it, you’ll drop into your “work” mindset; instead of being in the mindset of your core personality, the one who was at the grocery store just picking up a few things, you’ll suddenly be in the mindset of your “work” self, the self who knows this other person.

Let’s put it this way: instead of being a person at the store who happens to work at a certain place, you’ll be a person who works at a certain place who happens to be at the store. Your attitudes, tone of voice, and body posture will instinc­tively chan­ge, if only a little, to reflect the fact that you’ve switched to your work persona. If the person you’ve encountered is a subor­dinate, you may find yourself treating him or her as a subordinate, even though neither of you is at the workplace. If the person you’ve encountered happens to be your boss, you may find yourself being a bit deferential. Even if the person is just a co-worker, you’ll start thinking in work terms. You may cross your arms to cover up your sweatshirt logo, you may stand in front of your cart to hide the fact it contains a six pack of Pabst Blue Ribbon beer and a couple of bottles of cheap fortified wine (MD 20/20, Thunderbird, Night Train, Ripple, that kind of thing). Maybe not. But regardless of how your mindset happens to chan­ge, it will change. It’s automatic (if you remember to keep the batteries charged).

You don’t think this happens? Remember when you were a kid, and you went to the grocery store with a parent? Your parent woul­dn’t normally have paid too much attention to what you were up to, so long as you didn’t break anything or bother strangers. What happened when someone that your parent knew from work happened along? Didn’t your parent suddenly start acting differently and didn’t your parent tell you to cut out whatever it was you were doing? Your parent had dropped into a different mindset, one where the presence of a child was not a normal variable. Therefore, your parent began to act as he or she would’ve if you’d suddenly come barging into the place where that persona normally operated. Maybe the other person even committed the sin of calling your parent by his or her first name. Suddenly, you began to wonder what had happened to your Mom or Dad, and where this strange person who looked like your parent but talked like a stranger had come from. The change may not have always been very great, but if you think, you’ll realize that it was there. And, of course, when the other person left, your parent would change back to being your parent again (in most cases. There are always a few unfortunate incidents in which this fails to happen. Some Government agency is in charge of hushing things like this up).

Put yourself back in the supermarket again on that Saturday when you were out picking up a few things. Suppose that instead of someone from work coming along, the person who happened along happened to be from some club or organiza­tion that you belonged to. Then, of course, you’d drop into that mindset. Even if you couldn’t care less about whatever the club was up to lately, you’d start discussing it anyway. You’d probably find yourself starting to feel a vestigial interest (It’s generally a good idea not to go around feeling other people’s ves­tigial interests. Keep your hands to yourself) if one didn’t already exist. Or sup­pose you ran into an old college friend (and, with a little luck, you’d be able to convince the in­vestigating officer that it was the other guy’s fault for not seei­ng your turn signal) for whatever reason. You’d probably start trying to remember how your alma mater’s foot­ball team was doing so you could discuss it. Maybe not, but you’d start thinking in something resembling your old college mindset.

The change in mindsets that occurs at strange times is more than just a shift in conversational patterns (look at Clark Kent, a.k.a. Superman, for example). Your basic concepts of right and wrong may shift slightly. Your concept of reality itself can change to some degree. Thin­k! Don’t you behave dif­ferently depending on which group of people you’re with? Aren’t you more reserved in one group than in another? Aren’t you more for­giving in one setting than in another? Each organiza­tion tends to shape people to fit a pattern of behavior; there will be variations from person to person within this pattern, but this instituted pattern will exist. You can hardly help but change somewhat no matter how hard you try not to.

The number of mindsets that people have can be very large. Think about it: if you’re married, you have a mindset that operates when your spouse is around (maybe you also have one for when your spouse isn’t around and your lover is). If you have kids, you have a kids mind­set that probably spends a lot of time sighing. You have a work mindset. You may have several club/organization mind­sets, depend­ing on how many clubs or organizations you belong to. If you hap­pen to belong to more than one branch of a single organization, you may even be carrying around variations on a main mindset; one vari­ation for each of your multiple memberships. If you went to col­lege, you probably have an old college mindset that you fall into once a week or so when you look at the sports section of your news­paper on Sunday mornings. If you’re the sort of person who occa­sionally sits around thinking or talking to oneself, introspecting as it were, you have still another mindset on your roster.

Now, back at this hypothetical supermarket, you are talking to the person from work. You may be conscious of the clothing you have on, if it’s the sort of clothing that you’d never be caught dead in at work. You’ll probably apolo­gize for the way you’re dressed and make some sort of self‑deprecatory remark. And then, as the other person is apologizing for the way he’s dressed, you hear a voice. Someone else is calling out to you, and you turn to find that it’s someone else you know, but not from work. It’s somebody from some club you belong to. Ordinarily, you like this person just fine, but all of a sudden you may find yourself resent­ing his or her pre­sence. You perform intro­ductions between the person from work and the person from the club; they nervously size each other up, and while they’re doing this your mindsets are bat­tling it out for supre­macy. You have to make an unconscious decisi­on about which mindset to be in: the one from work or the one from your club.

Who are you? Are you a person who belongs to a club who just happens to have run into someone you know from work, or are you a person from work who just happens to have run into someone you know from a club? (Or are you Murray Jones, who runs the deli on the corner of Elm and Lenox? Who knows?)

And what if still another person comes along, one of your neigh­bors? Are you a person who lives on your street who just happens to have run into two people you know, one from work and one from a club? Are you a person from that club who happens to have run into a neigh­bor and a co‑worker? Are you a person from work who happens to have run into a club‑member and a neighbor? Which set of mannerisms do you use? Which standard operating procedures does your mind begin operat­ing under? Which set of unconscious assumptions? Which set of ethics and morals? (Of course, sometimes you don’t really have a choice. Family reunions are a good example of this, where you just have to use that set that Aunt Millicent knitted for you last Christ­mas.)

This can go on all day, but what I’m trying to get across is that you do have multiple mindsets if you’re at all normal. Im­agine what it’s like to be a policeman, who has to be stern, fair, and impartial when he’s at work, uphold­ing the law and dealing justice. At home, however, he occasionally gets toge­ther with some of the neighborhood men a couple of times a month for a nickel­-and‑­dime poker game. No one ever wins or loses a lot of money and it’s fun. The neighborhood man (who happens to be a policeman some of the time) never worries about it, but the policeman (who happens to be a neighborhood man some of the time) would not approve of such things (usually). It all depends on what mindset he’s in.

Kids in fourth grade like to sit around and talk about what they’ll be when they grow up (of course, they also like to mix their strawberry Jell-O with their green beans, but that’s besides the point. Kids do strange things). Some­times they even imagine what the world will be like twenty years in the future, when so‑and‑so is a nurse, and so‑and‑so is a fire­man, and so‑and‑so is an astron­aut (and Ralph is in jail for that ugly, failed scheme to get rich selling swamp land in the Mojave Desert to retired couples from Hoboken). They create mental images of the world as they imagine it’ll be twenty years later. In their mental images of this twen­ty­‑year­s‑later world, the kids, all grown‑­up and completely ma­ture‑looking, are wearing the uniforms of their occupations. They usually have kindly, respon­sible looks in their hypothetical eyes (except for Ralph). Sometimes, there’ll be a crowd of hypothe­tical co‑workers (in Ralph’s case, these would be his cellmates in the State Pen. Crime does not pay) standing around each kid’s mental image, respectfully waiting for the grown­‑up nurse or fireman or astrona­ut to honor them with a few words of wisdom. No matter what the mental images work out to be like, one thing always seems to be true: even though many years will have passed, those adult images will still be readily iden­tifi­able as the kids from that class.

When any such group of kids grows up, regardless of what jobs they choose and where they wind up living, they’ll always be, in one small, disused corner of their iden­tities, the kids from that class. An invisible bond, rarely felt, will still unite every single one of them. Once in a while, each one of those ex-kids will remember those days in elementary school, will wonder what his old class­mates were off doing, might even wish to return to those days. The percei­ved distance between the present and those long-ago moments would seem to be just a thin film, to be brushed aside if you could figure out how.

You are many people in one, and you switch from one to the other at the strangest of times. There may be people inside you who are never seen anymore, but still exist. If you were a Girl Scout Brownie once, many years ago, you are still a Girl Scout Brow­nie of whatev­er unit you were in, whether or not you ever think of yourself that way, whether or not you ever hearken back to those years.

You have dozens of mindsets that will never come back to the surface agai­n, but there may be other people operating under very similar mindsets, who do remember you and that you had a place in a group.

Think! Across the world, there are ten or twenty fellow Girl Scouts (or members of whatever group you were in, don’t worry if you weren’t ever a Girl Scout) living their lives, connected to you by an invisible thread that you may never be aware of. Do you feel nostal­gia at this thought? Confusion? Dis­tance? Regret? Longing for a time when things were simpler? Any and all of the above would make sense. You can, and you can’t, go home again.

People tend to put on masks to help them deal with the strange world we live in. Sometimes, it helps if you think of your work mindset, for example, as a “mask” you can put on and take off when you go and come from work, a set of attitudes and behaviors, inhibitions and preferences, that helps you survive in the work environment. The trick here is not letting the mask stick to your face, so to speak, to avoid letting the mask become you. Remember that. If you are going to make the conscious decision to “put on a mask,” changing your mindset to help you deal with a situation or an environment, the most important thing to remember is there’s a time to put the mask on and a time to take it off. Sometimes people forget this. Don’t. Don’t become faceless.

Regardless of however many mindsets you possess, and regard­less of how many of them you actually use, have you ever stopped to wonder which of them is really you? Which one of them is the one you’d use if all outside pressure to conform was removed? Which one of them is the one that you’d really, uncon­sciously, prefer to be in? Who are you? (Your birth certificate may be of some help here. At the very least, it will tell you your birth name and all that.)

Posted in Jay | Tagged | Leave a comment

The Dark Side of the Dewey Decimal System

I worked at a public library in Christiansburg, Virginia between 1990 and 1993 — not full time, by any means, since I was also in graduate school at that time. Working at the circulation desk gave me an excellent, but mildly disturbing, view of the habits and tendencies of my fellow Virginians.

Yes, there were kids from high school who came in with a reading list and expected us to go get all the books for them. Yes, there were kids who came in with an essay assignment and expected us to write the essay for them. But I imagine you get those everywhere.

We had people who came in to reserve our public meeting room for meetings advocating the immediate closure of all public libraries. This was before the Tea Party existed under that name, but the don’t-waste-my-tax-dollars-on-intellectual-crap people were thick on the ground even then.

We had people who had apparently lived in areas where libraries also carried a lot of videotapes and just couldn’t believe that our library had chosen to spend its budget on, well, books. Because after all, who reads books or expects to find books at a public library? I once spent the better part of ten minutes carefully explaining to a patron that no, really, we didn’t have any videos. No, not any non-fiction videos. No, no how-to videos. No, no recent Hollywood releases. No, really, no videos at all. The patron eventually left, still looking around suspiciously as though to spot the dark corner of the library where we had the videos stashed away.

Card catalog

While some libraries already had computerized their card catalogs, ours had not. We were just beginning the process, but at that point, everything was still on paper cards in wooden drawers. You know, just like Fred Flintstone used. The woman in charge of our branch of the library system told me that she saw no point computerizing the card catalog and circulation system because the End Times were just around the corner and would surely arrive before the project could be completed.

The RaptureBut the oddest thing about working at a public library in southwestern Virginia was which books the patrons kept in heavy circulation. There were a few call numbers every librarian knew by heart from dint of repetition to inquiring patrons. Chief among them was 364.14.

True Crime.

If it documented the sordid murder and dismemberment of a busload of cheerleaders, it was guaranteed to spend little, if any, time sitting calmly on the shelf. If it had a picture of Charles Manson, Ted Bundy, or Ed Gein on the front cover, it probably wouldn’t even hit the shelves; patrons would search the reshelving cart and snatch the books before our library pages could even get to them. I lost count of how many books we had that had “Fatal” or “Dark” in their titles. Joe McGinnis, chronicler of the Jeffrey MacDonald murders, would have had lines out the door if he’d showed up for a book signing.

Axe murderer

One idly wondered if my neighbors were sitting up nights plotting the perfect crime. Making charts and diagrams and going “See, Mabel, here’s where Son of Sam screwed up.”

Of course, this led to the occasional dissatisfied patron. Our locals expected quality when they checked out true crime books. If a book wasn’t grisly enough, we’d hear about it. One guy came up to me one evening and slammed down a book by Joe McGinnis titled “Going to Extremes“. He was upset, he said — the title had showed such promise.

“What was the problem?” I asked curiously.

“It’s about LIFE IN ALASKA!”

And it was. It hadn’t been shelved with true crime, but my friend the patron had automatically assumed that if it was by McGinnis and had a title with words like “EXTREMES” in it, it had to be good.

I apologized profusely and suggested to the library director that we put a warning label on the outside of the book: “NOTICE: CONTENT OF THIS BOOK IS NOT LURID, GRAPHIC, OR UPSETTING.”

That was me, always looking out for our patrons.

 

Posted in Jay | Tagged | Leave a comment

Yay! I’m Doing Expense Reports

Expenses!

I hate doing expense reports.

Posted in Jay | Tagged | Leave a comment