A Unconditional Guarantee

There are few absolutes in medicine. But there are some. Like if you get on the bad side of the nurses, they WILL make your life miserable. And if someone in the medical profession, or an immediate family member, is admitted to the hospital, something major will go wrong.

And another unconditional absolute is this: Folks that have more than three drug allergies or that own more than three cats, certainly have been, or should be, assigned a diagnosis from the most recent edition of the DSM (catalog of mental illnesses).

Additionally, if they need surgery in Roanoke, Virginia, I WILL most certainly be their anesthesiologist.

Just today I had one who wouldn't allow the nurse to start an IV on him. Nor would he get into bed or even don a hospital gown. So I had to sneak up behind him and shoot him in the ass, through clothes and all, with a big syringe full of ketamine. Not one of my more graceful moments as an anesthesiologist.

He growled and hissed and I almost lost an eye. But I got the job done. Now, I didn't get paid, because he was uninsured. But there is one more crazy man from southwest Virginia with teeth that shine when he bares them.

The Problem with Mall Santas

All three of my children despise mall Santas. We have $35 photos of all of them as little ones, struggling valiantly to escape their clutches, mouths wide open in blood curdling screams, snot and tears smeared across their red-purple faces.

And as they've gotten bigger, they aren't any more willing to pay these Santas a visit. And, you know, I really don't blame them. They smell bad, like a combination of the urine of other terrified children and sweat that forms from sitting in those suits under the glare of camera flashes all day. They are often in pissy moods, as I would be if I had to do that for eight hours straight. And they know that these figures are imposters, or rather "Santa's helpers" as we call them, because really, they're in EVERY mall. And truly, I'm happy that my three inherently feel uncomfortable sitting on a strange man's lap. They should!!

So we don't force the issue in our house. Now, they tolerate the Santa Claus at the annual Chrismas brunch at the Club...from a distance. But we do not require the mall trip, the wait in line and the forced smile.

I guess my photo albums will be less complete. That's o.k. But the real tragedy is that I'll never acquire a collection of supremely awesome photos like the ones above.

Tiny Baby Girl Twins

I am so excited about this weekend. Ashley and I are going to Raleigh to spend time with Allison, Matt, Jackie and our new babies, Stella and Scarlett.

They came home from the hospital yesterday and everyone is doing so well! Allison seems really happy. The breastfeeding is going well. And everyone is managing on one and a half hour stretches of sleep at this point. I am contantly amazed at the power of endogenous catecholamines and how they enable our bodies to rise to pretty much whatever task needs to be done.

It's amazing the rush of feelings that her experiences are bringing back. Concrete rememberances of time with our tiny newborns seem to exist in a distant fog at the back of my mind. I was so sleep deprived and hormone-crazy. But I do remember specifically holding their tiny hineys in the crook between my thumb and first finger.

Seems funny to remember that! I guess I was amazed.

The Profofol Shortage

Thanks to contamination by endotoxin or particulate matter, or Michael Jackson's overuse, or whatever, we are in the midst of an international shortage of the one anesthetic induction agent we use most. Propofol.

Most of us are doing mask inductions. The old folks we anesthetize are pros at this and are just thankful its not ether they're breathing. And we're substituting intravenous induction drugs that are clearly not as good when patients can't go to sleep with a mask. Patients are suffering more nausea and hemodynamic instablity. Luckily, we can deal with these side effects. But things are messier in the OR these days. It feels sort of like trying to write with your left hand.

Dear Propofol Manufacturers,

Please hurry!

Sincerely,

Anesthesiologists of the World