ChaiTeaLatte

COLD, COLD, COLD OUTSIDE

It's so cold the little Starbucks in the corner of the Clinical Center had the door to the outside frozen shut and we had to come in the door through one of the lobbies. I had the usual. Chaitealatte, with soy. Posted in the corner of one of the plate glass windows is a large black poster to which black and white photographs have been fixed. One of the baristas is a photographer and quite an artist. He has beautiful scenes of his travels, tastefully displayed and labeled, for sale. He sold a few during Christmastime. I'm thinking of buying a print myself. The baristas are such sweet things. Brrrrrrristas, I should say.

Sorry. Couldn't resist.

YOU ASK, I ANSWER. CAUSE I AM JUST THAT KINDA PERSON....

Pathology is divided, as a medical discipline, into anatomic pathology and clinical pathology. Pathologists are the 'doctor's doctor.' They run the clinical labs in the hospital - microbiology, blood bank, chemistry, hematopathology (analyzing blood smears, bone marrow biopsies, etc). This is known as clinical pathology. Anatomic pathology includes surgical pathology (analyzing all those biopsy specimens and specimens removed at surgery), neuropathology (brain and muscle biopsies and the like) and autopsy pathology (including forensics).

Not everyone qualifies, or boards in both anatomic and clinical pathology, but most do as it is the best way to assure a job in private practice, and thus not be confined to academia, unless that is your choice. It used to take five years after med school to qualify in AP/CP, but now it takes four. We have seen the number and quality of candidates increase by dropping this year. The year was dropped for a variety of reasons. One is that it was initially intended to have the pathology resident do a year of internship (medicine, pediatrics, ob-gyn) before starting pathology. This was a suggestion, not a requirement, so it didn't usually happen. People usually took the extra year studying pathology.

Now, we have four years of study after med school, followed by a fellowship for most (hospitals want that extra board or expertise) in a specialty area. Yes, there are even more specialized areas than those I mentioned above. I am AP/CP boarded and trained and I have a fellowship and board in dermatopathology. Wow. I get tired just typing this.

When I was in medical school, the conventional wisdon was that we would need more general practitioners, not specialists and there would be no jobs for pathologists. Unless there would be lots (conventional wisdom also noted the increased average age of a pathologist - darn near retirement). The last idea has generally been more true. Exploding technology, patient and doctor expectation, and the aging of the pathology work force and general population has meant the jobs are there. For now, at least.

QUIET

here in my office today. I am just now ready to set off into the snowy night. I have my thick, chunky black boots on which I wore all day instead of changing into shoes that would match my brown suit. The clinics were closed, but our department was open (well, so were the ORs and someone had to cover them). Today was frustrating, because I didn't sign out as many cases as I wanted. Basically, I wanted to finish everything from last week so I could concentrate on a fellowship application I am working on. I want to finish the application by Wednesday. Sigh. Why can I never finish things on schedule? Technically, it's not due until early February, but I have an interview next Monday for the fellowship and want them to have everything before that.

So, I have now just typed a bunch of stuff on my blog (for what purpose I am not entirely clear) and I am ready to go. My eyes are bleary, I am sleepy, and I think, that after dinner, I will go to bed early. It is very cosy in my little 'nest' up above B______ Street.

CAN IT HAVE BEEN LIKE THIS? IT'S SHOCKING TO REMEMBER

"We have waited for more than 340 years for our constitutional and God-given rights. The nations of Asia and Africa are moving with jetlike speed toward gaining political independence, but we stiff creep at horse-and-buggy pace toward gaining a cup of coffee at a lunch counter..."

Martin Luther King, Jr.
Letter from Birmingham jail

GUARDIAN SHORT SHORT STORIES

Lisa first told me about them. I thought I would give it a shot, except that I didn't count the number of words. Too much trouble for the girl who didn't even know this thing had spell check.

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Krishna lived in a small house attatched to the back of the post office. It was the postmaster's house and she was the postmaster's daughter.

BUT, YOU ARE AN ANIMAL

Link: I was reading this review of Raging Bull by Roger Ebert and became intrigued by the comparison to Othello, mainly because I had just seen both this film and a modern language version of Othello on PBS. The scene where Jake LaMotta hits his head against a wall in prison screaming "I am not an animal," made me think: but that's exactly what you are. You are pure rage, the present, unreflective, in pain because you can only sense in the periphery of your soul all that you lack. I sympathized with Vickie's character more than Jake's (why shouldn't I identify with the female more?) I liked her implacability in the face of his violence, the fact that she didn't cower. She pouted. I thought that brave.

And I hated Othello. Hated him (spoiler ahead for anyone who doesn't know the story, which included me for the first thirty odd years of my life). Interesting how transposing the play to the present changes your reaction to it. In the end, what justified any of his jealousy and madness? He was manipulated into thinking his wife was having an affair with another man. And then, because of this, he smothers her. I hated him as he held the pillow to her face and she struggled and pleaded. I don't want to empathize with this pathology. That's how if felt to watch the play without actors in tights. I loathed Othello. There is a scene in this version of the play where the actor talks about being black in English society, about how his ancestors once worked the land on sugar plantations in the Caribbean. I wonder if this was included to make the character more sympathetic to modern audiences? Were there intimations of this in Shakespeare's version? I can't remember.

The violence done to women in the name of masculine insecurity may make a brilliant character study, but in the end it's the character that I respond to, not the pyrotechnics of the study. Well, that's not entirely true. Raging Bull is brilliant. One of those movies that actually lives up to the hype.

BRUNCH AT AN ATTIC IN THE SOUTH END

Well, an attic apartment anyway. If you looked out of the picture window over the couch you could see the roofs and attics of houses across the street: green and brown and red. We had a lovely brunch - lots of potatoe pancakes with sour cream and applesauce, smoked salmon, and quiche. The tables were covered with flowered and faded cloth. "They look very French," one of the other guests said, and we all agreed. Yes, they did look French. And then we talked about trips abroad, to France and Spain and Italy and Portugal. I told them about the Taj Mahal and my trip to India. "The thing about the Taj Mahal is that it is so much larger in person than you think from looking at pictures. There are really no other buildings around for comparison when you face it directly, and somehow, you never think to compare it to the size of the people standing next to it. I was very surprised by it's height, and also, the inlay of flowers on the walls."

(And yes, yes, story coming. I do plan to keep my resolutions this year!)

Update: Umm, apparently it's spelled potato (pancakes). Dan Quayle and I are the only people who don't know that. Sheesh. And did I spell apparently right? Why doesn't this thing have spell check!!!

Even more fabulous updates: ANNA in comments say this thing does have spell check. It's this kind of attention to detail that makes me special, no? What? No, for real? Oh. Ok, then.

RESOLUTIONS

Never kept a New Year's resolution in my life. That, I think, says something about me. Anyway, there's always a first time for everything so what I would like to do with this blog for this year is post a bunch of stories I have been working on, some related to medicine and some not. Let's see how this works out.