Vanguard: A Miscellany

Ciao

Sorry. Things have been crazy. And well the posts have suffered. It's the job. Both of them, but the primary one primarily. Patients seem only to have become more demanding. But the second job...well we're in negotiations to open a second location. Then there's my family--significant (though happily non-life-threatening) medical issues. And of course there's me and the dating debacles and my realization that I am ok remaining single. It's been a pretty tough couple of months. So the blog has suffered.

So I'm saying goodbye.

For now. Cause I'm going away to Bali bitches and I'll be back with pics and hopefully a story or two since my straights have already decided that we're going to a gay bar on our first night.

Laters!

Really?

Please file in the "what you talking about Willis" file.  Really?

Week In Review '08.34

If I were to title this post with anything other than the typical "Week In Review", it would be "Darkest Before the Dawn", at least if I were feeling optimistic.  Let's review, shall we.

8/16 - Because of a scheduling fuck up, I had to be at Job #2 at 9:00.  Actually, two of me were supposed to be there at 9:00 because I was scheduled with a client at that time and I was also scheduled to be participating in a training session with someone who is without question THE shit in this field.  After one other surprise client, I was finally able to rush home, get in a forty minute run with just enough time to get ready for the evening.

Razor Burn and Unicorn picked me up within 5 minutes of getting ready, heading out to Century City to meet up with Fishering's friends for dinner.  And oh my God!  After living in L.A. all these years, I can't believe how I've never heard or tried the tuna burgers at Gulfstream...heaven.  

We ended the evening with Tropic Thunder.  Overall, a little disappointing, slow at parts, but the parts that were funny were side-splittingly so.  I so want to see Satan's Alley!

8/17 - I thought that Sunday was going to be relatively calm.  Not so.  I wasted hours at Niketown trying to exchange my Nike Amp--the watch that also doubles as a remote for my iPod nano.  Turns out I left the receipt at home.  After returning for the second time, I also find out that not only does my Nike Amp not synch with my iPod nano, but none of the Nike Amps in the store were able to do so.  "We've been having problems with these which is why we're discontinuing the line, I think."  That's what the salesman told me.  Waste of hours!

On a good note, I did have a decent game of volleyball.

8/18 - The work day was tough.  Seems to be getting more so as the days and weeks and months go by.  It was sweet relief to be able to turn off my brain, do no thinking and just do what I was told by my trainer afterwards.

8/19 - I got to work at 8:30.  I had to work through lunch; aparently to some having foot pain for two weeks was an emergency that needed to be dealt with that day.  It wasn't that important during the thirteen days preceding during which she could have called to make an appointment.  It was only an emergency that day...or else!  So I worked through lunch.  Oh, and I didn't leave the office until 8 pm.  

It gave me just enough time to get in a five mile run before eating a late dinner then immediately going to bed.

8/20 - Again, no lunch for me.  Nope, we had a mandatory meeting.  But I got through the day using Wednesday night volleyball as the proverbial carrot at the end of the stick.  And honestly it was a little light in the middle of a pretty dim week.  I played two hours of two man beach volleyball to the extent that I could barely move my legs.  It was awesome.  

And then, I had to go back to work.  Yup another night on call.

8/21 - In general, if I'm on call on a Wednesday, I will try to keep Thursday as a true half day.  Unfortunately, I did have a client scheduled at Job #2 after finishing my regular morning clinic.  Work there got dragged out at the last minute, and though the reason for it was a good thing (the potential acquisition of a second location), I didn't finish work until about 7:00.

And still I made it to O-Bar.  If there was a week I needed it, this was the week.

8/22 - I just wanted to get through the week, and I did.  It was over, right?  I just wanted to go out for a run, watch some Olympics then go to bed.  And so I did.  I ran.  I ran six miles, and happy to get home.  Only as I reached into the newly purchased shoe wallet, I realized the my key had fallen out during my run.  A visit from a locksmith, $150, and a deadbolt that needs replacing later, I think maybe I should have blown off the run.

I'm just glad the week is over.

What If?

Seriously.

And seriously, how do you embed youtube files on fucking Typepad anymore?

Sour Graped

How do you break up with someone?  Well not break up technically, it's not as though we were really dating.  It hadn't been that long.

We met online, and even then I had my doubts.  He contacted me, and I responded with a glib note that was flirty but not too over the top.  And then I waited.  And waited.  And waited.  Three days after my response, he wanted to get together for coffee.

And so we did.  And again, the doubts were there.  I loved that he was actually my age.  But an actor?  Another one?  The "real" kind who ekes out a living working as a waiter in a Jewish deli?  At the age of 38?  It's cute when you're thirty maybe.  Kinda sad at 38.  And he was a bit more effeminate than I was used to dating.  

That was my first impression.  But the date went on from 7:30 to 10:00, meeting surprisingly some of my friends in the interim, and impressively gracious in doing so.  He asked me to walk him back to his car where he asked if we could go out again before giving me a goodnight kiss.

How do I tell him I'm not interested?  Well, that night, honestly I was interested, and we made plans to talk later in the week.

I called him several days later: "I want to take you to Les Mis at the Hollywood Bowl.  It's playing this Friday."  And that Friday, I had everything all set up.  The performance would be a perfect second date; he had done tons of musical theater in the past.  And I picked up some take out from The Cheesecake Factory.  I thought to call to make sure there weren't any dietary restrictions, but I figured it wasn't necessary.  On our first date, when he got hungry, we went to a fast food place on the corner of Santa Monica and Robertson where he ordered a greasy burger with fries.  

But as engaging and present as he was on our first date, he was exactly the opposite for our second.  Maybe he had just had a tough shift at the deli or maybe I had a tough day at the office.  I don't know.  But on the walk to the Bowl, he let me know that he had sort of outgrown musical theater about a decade ago.  And the food I brought?  Well, he doesn't really drink.  He also doesn't eat refined sugars, white foods such as white rice and pastas.  And the cheesecake?  Forget about it.

We ended the date much like the first, except I reluctantly allowed him to walk me back to my car, not that I didn't appreciate the gesture, but I was feeling very self-conscious about my car.  But he walked me back.  We kissed a few times, and then I drove off.

So how do you break up with someone?  How do you tell him you're not interested?

You don't call.  You don't text.  You don't email.  And it's fine because he does the same...until five days later.  And the text comes in: "I guess I'll work on the assumption that the magic is dead :)  Best of luck to you."

And several hours later, the voicemail comes in: "Oh my God.  I'm so sorry.  I usually have better manners than that.  I apologize for not getting back to you sooner.  And I do think you're a good guy, no I think you're a great guy...but yeah, you're right.  I didn't feel much of a connection with you that night.  So best of luck to you too...Van."

Fuck! 

Week In Review '08.33

8/9 - I woke up late because of the previous night's date.  Can't do that again; showed up fifteen minutes late for my first client.  The day was kind of shitty, anyway.  Between being exhausted and having to deal with another Saturday work day and on top of all that feeling a little weird about how the date went, it was just kind of a shitty day.  So I went home, figuring on staying home for some me time.  Strangely, I got a second wind and decided to go out on a run, and after six miles I cleared the cobwebs out of my head and took Razor Burn and Unicorn up on the offer to go grab sushi at Katsu-ya.  Turns out that it was just what I needed--a mellow evening with good company.

8/10 - I think the problem I have with Sundays is that because it is the only day I truly have off, I try to pack it with as much stuff as possible.  I started out taking my mom and dad out for brunch at Caffe Primo.  As difficult as it is for me to say, there is actually a place in Glendale that is OK to hang out in--The Americana.  It's the Grove's twin brother, only fatter and less attractive.

We finished at noon, giving me plenty of time to get home, change, and pack for the beach with Dutch.  I had sort of given up on Sunday volleyball, so we were just going to lie out at Will Rogers beach, a.k.a. Ginger Rogers, the stretch of sand in Santa Monica where all the good little gays go to catch some sun and run around in skimpy skimpies.  Funny how often I'm at the beach but rarely going down to the water until Sunday.  It turned out really great.  I ran into a couple of friends.  I even met some cute guys--one a lawyer and another a thirty something year old retired stock broker/kite surfer who gave me a quick lesson on flying kites.  I even got in a game of volleyball.  So I had a great afternoon (even though I think Dutch was a little bored).

We took off around 5:00 to grab dinner and margaritas at Marix, finishing off the night with a beer at Here.

8/11 - Not much.  Work, then session with my trainer.

8/12 - Once a week, I get two half days.  This was that week.  And Tuesday was the first half day.  So how did I spend it?  Not good.  I went to the Barney's Warehouse sale.  I really should know better, but c'mon!  Shoes!  And I'm Filipino.  And there's shoes!

Afterwards, I drove down to the beach and ran from Santa Monica to Venice and back.  6.5 miles.  Yup, getting kind of into running.  Besides, I only have about two weeks to not be the fat one on vacation.

And then back to the same thing that's been keeping me awake longer than I should--several days' worth of the Olympics on TiVo.  I honestly tried not to get too into the games knowing the time suck it would result in.  No such luck.  Between swimming, volleyball, beach volleyball, track and field (and the one day of men's synchronized platform diving because I was trying to figure out which of twink was a top and which was a bottom), I've been getting very little sleep.  By the way, I'm glad that the swimmer's are enjoying the benefits of the new suits, but I kinda miss the speedos.

8/13 - I actually had a decent day at volleyball.  I think it had to do with studying the techniques and strategy of the Olympic volleyball games.

8/14 - Half day number two.  After my clinic day, I drove about twenty miles to see my trainer, finishing around 3:00, then driving about thirty miles back to job number two to give a lecture at 7:00, then swinging back around to get to WeHo for Thursday night O-Bar to meet for friends' surprise wedding shower.

8/15 - After work, I did another 6.5 mile beach run.  A friend from Arizona came by for a visit.  More Olympics.  And then much needed sleep.

Addict

I don't have an addictive personality...or so I thought.

I hate running...or so I thought.

Turns out I was wrong on both counts...at least after I got my iPod nano and Nike plus shoes.  It is so fucking cool!  Here's the deal, for under $30 I bought a sensor that fits into a compartment in the special Nike shoe.  The sensor connects wirelessly to my iPod which allows it to record data such as miles, duration, pace and calories burned.  And while I run, a voice (either male or female, depending on which you choose and I clearly chose male) tells me how many miles I've run or how many minutes I've run and how many I have left.  After the run and synching to my computer, the information is automatically dumped into a Nike website that keeps track of my runs, and I'm able to compare distances and miles and paces of previous runs.  

For example, since getting my equipment on August 2, I've logged in 28.75 miles.  I've run 4.27 hours.  The farthest I've run in 6.55 miles at one time.  It's really cool and instead of feeling like I'm just clocking in hours, because of the pace measurements, there is automatic incentive to try to improve.  I'm not just running by myself anymore; I'm actually racing myself.  

Besides that, there are all these unexpected features like Mary Decker-Slaney congratulating me (or rather her recorded voice) for running an 8.5 minute mile, my fastest so far.  Or Lance Armstrong giving me supportive words for running my longest run so far, 6.55 miles.  OK some might think it's cheesy; I think it's cool.

So yes, I have a new addiction.  And just in time cause I am so over men.

Week In Review '08.32

8/2 - The week started off well, still on my high from the date the night before. I practically skipped into Job #2 on Saturday morning. I didn't even wait the requisite three days (let along two days), to call and leave a message, telling him how much I enjoyed meeting him and how much I looked forward to hanging out with him again.  And surprisingly, it was well received.  At least that's what it seemed on the message he left on my voicemail: "Thanks for your phone call!  It's good to hear from you!."  Yes, there were exclamation points.  And knowing my schedule was busy, we made plans to make definite plans midweek.

8/3 - I planned for an active day.  I went out and did a thirty minute run, then headed to the beach for some volleyball.  Oh, I was looking forward to it.  Psyched, even.  Until I got down there.  Here's the thing, since my several month break, the dynamics of the group have changed such that the people I really enjoyed playing with have left, leaving only people that, well, make it less fun.  So I turned around, went home, telling myself to look forward to the Wednesday night volleyball group.

That night I reconnected with a friend of mine Georgia Peach.  I wonder if I've changed in the last year and a half as much as he had.

8/4 - I worked out with my trainer.  Thought it was kind of weird that he didn't ask about my date on Friday.

8/5 - Another pharmaceutical rep dinner at Katsuya, just two reps, Dr. Faux and me.  The really cute female rep was fun.  My rep was boring as shit, but I felt obligated to talk to him.  I'm not going to these things anymore.  Not unless I really like my rep.  I just realized I'm not so big a whore that I'd suffer a painful night of shitty conversation for good sushi.  I didn't feel so bad that I was twenty minutes late because I had to get in at least a twenty minute run before dinner.

Oh I was on call that night too.

8/6 - Despite getting only four or five hours of sleep and working a full day, I suffered through another session with my trainer before going home and crashing.

8/7 - OK, I admit, I pack a lot of shit into my days, but this was crazy even for me.  I worked from 8:30 to 12:30, then had to go to a meeting until 2:00.  Then I drove forty minutes so that I could get one of the few remaining watches at the Nike store at the Grove that can also function as a remote control for my iPod nano when I run.  Yes, I am really, frightening getting into the running thing.  Then, just because it was next door, I poked my head into the Apple store and walked out with yet another stupid impulse buy--the 3G iPhone.  It was 4:00 by then, so I took the 45 minute commute up to Job #2, making a stop at the gym where Smooth works so I could get in a 30 minute run.  And yes I saw Smooth.  And as hot as he ran last week, he ran really cold this week.  What the fuck is up with that boy?

I got to Job #2 by 5:30 and schmoozed my ass off with clients before giving a twenty minute lecture before dashing off home for much needed sleep.

8/8 - I met up with Dutch for a quick drink at Terroni's before my date, the same guy from the previous Friday.  I was excited.  The Hollywood Bowl.  A picnic.  Les Miserables.  Really what could go wrong?

Well that's a whole other story.

Oh, and just for my own purposes, this week I ran 18.70 miles.

Ode to Feet

Oh feet, how I detest thee.  Why art thou the bane of my existence?

For real, anyone who knows me knows that I hate feet, loathe them.  I mean they're great for personal use and everything, but why subject anyone else to them?  And I'm not the only one!  Just to make sure I wasn't all weird or anything, I asked my sister and Dr. Faux, "What do you hate examining the most?"  And without missing a beat each of them individually said feet.  Anytime they do a foot exam, they do just as I do--hold their breaths, breathe through their mouths, and perform the exam through the barrier of latex gloves.  Personally, I would wear a hazmat suit, but I think it would undercut my credibility as a doctor.

Why do I hate them?  Well, when a patient says "I've got this thing with my feet" or "can you check out my feet" I feel a sinking in the pit of my stomach that just gets progressively worse with anticipation as they slowly slip off their shoes and peel down their socks.  It's like a shitty Japanese game show where you know you'll get some kind of funky nastiness as a prize at the end of a slow reveal, you just don't know how bad it will be in the end.

And I just mentally go through the list in my head all the while holding my breath: athlete's foot, toenail fungus, ingrown toenail, plantar warts, calluses, corns, bunions, hammer toes.  And those are the easy ones.  Then there are ulcers, cellulitis, abscesses, wet or dry gangrene, osteomyelitis, and the list goes on and on.

So yesterday, when my last patient of the day--a ninety year old man with multiple, but stable medical problems--came in for a routine follow up and announced "Oh, by the way, my left foot hurts" my heart sank.  I don't mind treating the congestive heart failure or the coronary artery disease or the chronic obtructive pulmonary disease or the end stage kidney disease or the chronic myelogenous leukemia or his dozen other diagnoses, but why the feet?  Why?!?

I held my breath reflexively and said, "Shure, ngould you bhlease ngake off your snhoes ahnd sohcks?" as I slipped on a pair of latex gloves.  Riddled with arthritis it was clear the endeavor would require less time if I removed them myself.  "Lhet me hep you," I said, breathing through my mouth between words.

The orthopedic shoe slipped off easily.  The sock required more work.  Through the sock, it was clear from the silhouette, he had formed a bunion.  I rolled the thin, dingy sock down to his ankles, then met with resistance.  I had to slip my fingers deeper in between the sock and his leg stretching the material until I got it under his heel.  Even then, I had some difficulty slipping off the garment.  I pulled and pulled and yanked, grabbing the sock from the toe when finally, in one quick snap, the sock came free of the foot.

And that's when I cemented my hate of performing foot exams.  I relive those few seconds in horrific slow motion.  The sock snaps off, followed by a blizzard of skinflakes, each one special and unique, exploding from the sock in an ever growing cloud that fills the room, and in that fraction of a second when I realize what had just transpired, I also realize it is too late for me to do anything, no time for a hazmat suit and no time to stop in mid-inhalation as I choke on the flakes of skin that have hit the back of my throat because I had up until that second been breathing through my mouth which I no longer do because I have now closed my mouth to keep from swallowing more skin flakes and that's when my nose is hit with the full strength of the smell of his feet.

Oh feet, how do I hate thee?  Let me count the ways.

Scapegoat

Medicine in a minefield of potential litigation.  "Cover your ass" was the mantra in training; protection from lawsuits seemingly as important as ensuring the health of those under your care.  Honestly, I get it.  I get that when something goes wrong, assigning blame can misguidedly be comforting.  After all, heart attacks and cancer and death, don't just happen anymore.  People are known to live into their 100s.  Willard Scott proves it every day.  Someone is to blame.

And I see it daily.  Patients who transfer care to me because under the care of this physician or that, their kidneys had failed.  Their cancer had yet to be cured.  The march of time had until now continued unabated.

So when the message came that Susie had to speak to me now, I thought this was it.  I steeled myself for the attack I knew was coming.  She had been so good until now.  She had been strong.  Despite everything that happened over the past year, she had been amazingly strong.  The funny thing about it is that she wasn't even my patient.  

Her father is my patient.  Or rather, was.  In his 80s, his problem list was extensive--hypertension, coronary artery disease, renal failure on the verge of being dialysis dependent, early dementia, and congestive heart failure.  It was always a struggle to keep the congestive heart failure under control, giving him diuretics so he could urinate off fluid that accumulated in his legs and in his lungs, but giving him just enough so he didn't become dehydrated and compromise what little kidney function he had remaining.  It was during one of those episodes several years ago, one of the very first times I had to hospitalize him, that Susie called my office late on a Friday, distraught and in tears.  I assured her I'd do everything I could.  Against my better judgement, I offered my cell number.  In retrospect, I had nothing to worry about; she's never used it.  Not even when her father died three months ago from congestive heart failure.

But everyone has their breaking point.  Her mother had been in to see me recently, also my patient.  She, however, had been relatively healthy, much more healthy than her husband.  Blood pressure was well controlled.  Her rheumatoid arthritis caused little discomfort.  We were working on getting her to quit smoking.  The recent cause for concern was her white blood cell count; it was elevated.  Probably an infection, I thought.  I repeated it after two weeks.  Still elevated, actually more elevated than previously.  Within days, she had several more tests, visited the oncologist, and was admitted to the hospital.

I took a deep breath and dialed the number: "Susie?  It's Dr. V.  I got the message that you called."

"Thanks for getting back so soon."  There was a pause.  A long pause.  And I knew it was coming.  But it was worse than I expected.  She couldn't speak, not through the tears.  "I'm sorry *sob*  I'm sorry to bother you *sob* I just wanted to make sure you knew mom was in the hospital."    

She had been diagnosed with metastatic lung cancer, and Susie was devastated.  Who wouldn't be?  And she had called just to make sure I knew what had transpired that morning and that she wanted to thank me for all I had done for her and her family.

And I thought that this felt worse, much worse, than being assigned blame.  Because nowadays people do live into their hundreds.  And people do survive disease.  And somehow I do believe that there must have been something I missed or something I could have done sooner.  And I understand the need to find who was responsible.