I could delete this if it works, but I should probably leave it up just ’cause. There aren’t any other pics in my photostream yet, but that will change soon.

Ok, onto the next post…

(Update: Ugh…how do I get the text NOT to float on the right? Small potatoes for now…how do I get the pic to specifically link to the “Large” version on Flickr? Perhaps that’s a blogging software limitation. I’ll try it by hand. And why am I typing “out loud” for testing purposes? Probably to show that even though I may not post every week day, I still think about it. )

Sid Schwab posted an entry the other day about EM blogs (I’m including nurses in what I write here) and their penchant for not only being right-of-center politically, but “vitriolic.” I want to say off the bat that I’m not here to defend his remarks point-by-point, but what he said about his post not being directed at any one blogger in particular and specifically that it was written months ago is absolutely true. In fact, he shared the draft with me in November of last year. The draft then is very close to the post of the other day, down to the same witty ending. In that sense, what is written really is representative of how he feels, not some knee-jerk rant.

But why did he share the draft in the first place? Because I said that I was going to post about that very topic because I had come to many of the same conclusions independently. I’m unapologetically liberal on most issues, but I keep an open mind and try not to let the occasional offhand remark about “lefties” keep me away from an otherwise informative or entertaining blog. Unfortunately, there are some sites that I just can’t read because of in-your-face right-wing screed brought up with no provocation, or commentary that is so ill-informed, it begs the question if the poster has MPD to also be a healthcare provider with [assumedly] a necessary component of humility and compassion. When I took stock of the sites that fit that category as I was trimming my newsreader’s feeds, I came to an inescapable conclusion: almost all of them were EM blogs.

EM has been corrupted by being made into the PCP of the disenfranchised and uneducated, as well as the pressure valve for inpatient floor inefficiency as admitted patients crowd the ED, further straining things. I get it. I was a volunteer at Ben Taub Hospital in Houston for over a year, primarily acting as an unofficial Spanish translator. Ben Taub is a model of your classic, inner-city urban hospital. Analogies would be Parkland in Dallas or King in LA. Houston, being the 4th largest city in the US and given its demographic, the ER population was primarily Black and Latino, both seemingly unable to speak decent English. I’m not going to pretend that my experience means a damn by comparison, but I wanted to make clear that I’m not talking out of my ass here.

I give the benefit of the doubt to any blogger of any kind when ranting that this the blowing off of steam is not representative of the patient care, that the “dumbass welfare mother” did not get treated at 30% of the care as the “private insurance patient.” But when blowing off steam or generalizing various patient populations is a near-daily occurrence (so much so in one example of a nurse blogger that ™ed the phrase “Medicaid Mentality,” as if it took much mental muscle to come up with it), ultimately I see it as a sad state of the person that wrote it. Just as it’s the height of stupidity to tell a cop, “My tax dollars pay your salary…” it’s just as stupid and self-important to say, “My tax dollars paid for that Mexican’s CT scan.” You don’t make enough to make a difference in anybody’s hospital bill as you aren’t that important. Abuses will occur in any system, and to the best of the ability of those responsible, it should be reported and dealt with. But the cost of tracking down every thug who has some drug money stashed away who might just be on Medicaid is ridiculous (watch your tax dollars go away even faster with the new Medicaid Police Enforcement Unit!). The fact that they come into your ER wearing far more jewelry than you’ve deemed appropriate for your label of what their economic/Medicaid status should be is irrelevant at best, pompously arrogant at worst.

On the subject of labels, “liberal” is used as a mild pejorative by those on the right, with “pinko,” “tree hugger,” “moonbat,” “terrorist sympathizer,” and many other colorful words to use for stronger effect. What words are used to describe those on the right? “Conservative” is simply a proper term (except this administration is anything but; real conservatives despise the “neocons” just as much as we do). “Fascist,” perhaps, but there’s a lot in between. You see, therein lies a big difference: there isn’t nearly the same screedy list to choose from because collectively, we try not to be that way. Everyone is guilty of generalizing to a degree as a necessary evil, but profane name-calling and deriding those who are “too stupid to go to their PCP/OBGYN” is not a staple of most any medical blogs outside of the EM ones. For the blogs that are offenders here, the tone of “I’m better than you” (you = patient/family, boss, administration, co-workers) is unmistakeable.

There are very polarizing issues in health care, such as is healthcare seen fundamentally as a right or a privilege? How much should the economics of medicine be market based vs. government regulated? There are no easy answers to these questions, yet too many simply state their simplistic opinion and accept no other. I don’t care if someone’s on the wrong side on an issue from my POV, but a well-stated argument–however ill-informed I think it to be–deserves respect. Too many right-wing bloggers don’t even bother…not they they owe me or anyone else an explanation, but at the same time some of these are the same that jump on others’ sites sniping their tired rhetoric there as well.

When I saw the comments to Sid’s post both on his site and others, it struck me how some didn’t even read it properly; the answer to their question was right in front of them had they simply turned off their prepackaged assumptions. Worse still, some clearly read it by quoting and commenting and STILL overlooked the obvious. It occured to me at that point that Sid’s post acted sort of like a political Rorschach test–in reading it, one would see what one wants, perhaps a reflection of oneself.

Lastly, a modest request to the right-wing EM bloggers that can’t help but make commentary on sociopolitical issues of their less fortunate patients: when there is a positive story (and there are, don’t lie), share it and don’t ruin it with a caustic comment about this or that. Write about a surprisingly positive encounter for what it is. It’s not right to have a situation where your assumptions were turned upside down, proved dead wrong, only to mentally chalk it up as an anomaly. No one here is so naive as to think that there isn’t a definite pattern among certain patient populations, but the exceptions are far more interesting than the rule. Share them.

(Update 6/26/08: The SCOTUS just ruled the DC handgun ban unconstitutional. Believe it or not, I agree with the majority and Scalia’s written opinion that any complete ban that prevents law-abiding citizens from protecting their home is against the spirit of the 2nd amendment. I’m from Texas, after all. Just another example of how none of us are 100% anything politically)

Bags:
As I wrote on Twitter the other day, I have a serious thing for bags. I am, in fact, completely indistinguishable from a woman shopping for purses with the level of scrutiny that I investigate pockets, seams, zippers and compartments. However, the presence of my Y chromosome does mean that I must depart somewhat from my inner female in that looks and it matching anything else I have are nearly irrelevant. I don’t care if the bag looks like a freak accident that escaped the Coach genetic testing labs–I care about function,form, and feel, ONLY and in that order.

So my brother was here last week, and I saw a bag he had that I don’t recall his having this last Christmas. I asked what it was, and he said “Weren’t you the one that told me about this?” Disgustedly, I gave a look like, “You fool! Do you think I’d forget something like this?!?” as I pawed The Precious.

Here is the object of my desire. It’s different from my brother’s, but our gear needs are different. Yes I know the orange isn’t the most aesthetically pleasing color, but just look at that removable DSLR camera bag attachment. Yes, I know the whole “snake” theme is a bit odd, but that’s some sexy stuff. YeSSSSS!

Obviously, I’m not getting this anytime soon, but my current eBags laptop backback is not doing too well (in fact, it’s nearly unrecognizable from the online pictures). It’s also surprisingly heavy all by itself–something I found recently as I emptied it to have it be managed by Claudia when I was last in the hospital. “Honey, I need this because, like, you know, the next time I might be in the the hospital–what? yes, I know the doctor said all would be fine, but you never know…ok!–I’m just saying, the next time, if I have this, it won’t be as heavy for you when you have to manage it,” just isn’t very convincing. I’ll work on it.

Social Networking:
In my previous life, I was a senior-level IT person/consultant. It should come as no surprise, then, that when faced with a “SIGN UP NOW” email from a relative, friend, or annoying co-worker–it matters not–in order to see their pictures or whatever online with some proprietary service, I normally would hit “delete” without a second thought (and might even be annoyed that thanks to them, they at least have my email address). Why on earth would I want to give away my information to a business that I have nothing to do with who, upon trying to make ends meet, will be like so many others and whore their user data to the highest bidder, maybe even sinking so low as to start putting up yarn ads. (If you got that reference, you’ve read this all the way through and I thank you from the bottom of my ad-less heart)

Maybe it’s the sweltering Texas summer heat, maybe it’s having some burnable time on my hands, but I seem to be trying out new services sites like it’s going out of style. Normally meticulously recorded in SplashID on my Blackberry (encrypted of course), I have yet to keep up with all the usernames/sites I’m registering. It’s like I have Daddy’s credit card and going on a registration/shopping spree and don’t care about amounts or receipts, wadding them up and throwing them on the floor as I search the next target. There’s a ton of redundancy and overlap in these things, and I think I’ve reached the limit of what I’m willing to try. I think with each useful service, there is a “best of breed” product; that’s the one I’ll sign up with.

And what it is with the lack of vowels in these names? Flickr. Stumblr. Feedlr. Tumblr. Mastrbatr. I gotta pull back before some 21-year-old CIO in the Bay Area tweets to his other entrepreneur buddies and with all their collective information figures out the exact position of all the constellations at the time of my birth. On their iPhones.

(Medical stuff–personal and news/commentary–coming in a jiffy, I promise!)

I may yet continue as a Mexican medical student at another school, so I haven’t given up the domain yet, but it’s time for some serious housecleaning around here. If your blog is not on my sidebar and we’ve commented/emailed in the past, let me know–it’s just on oversight on my part. OK, time for me to start scrubbin’!

So, given the above, I’m sorry to admit to my peeps that even though I’d like to, I almost certainly won’t get to read all of your posts. If your magnum opus was much before last week or so, chances are I won’t see it unless you tell me.

As for me, well, I’m doing better in some ways and worse in others, all to be shared soon. I know, you’ve heard that before, but this time, I’m motivated by something coming up in my ongoing personal medical drama in a couple of weeks for which I’d like the site to be current. That aside, I genuinely am motivated to write again for its own sake. I think I had to step away for a bit (part voluntary, part forced) to appreciate what I have here, namely, the friends and associations I’ve made online and the support I’ve received publicly and privately.

Lastly, after having been egged on somewhat by Dr. A. and Vijay, I am trying to get over myself to start audio and/or video blogging. I’m 100% ready to go, except every time I record something, and especially for video, I see it, I shy away and trash it instead of posting it. So why the conflict? Well, put simply, “blogging” in this way is SOOOOO much easier. A long post that is edited, re-edited, etc. can be simply dictated/filmed naturally. Sometimes typing is a chore, and I can’t seem to shut off the “edit” filter with the written word; since we’re not talking Hollywood special effects here, I just don’t feel the need to over-edit for A/V media. So if this seems even remotely interesting to you, please leave me a comment telling me what you think so I can stop second-guessing myself and put it out there once and for all. If tomatoes get thrown my way, I’ll just make a marinara.

P.S. You can also follow me on Twitter (when it’s up–don’t get me started on that…), since of course it’s far easier to update goings-on there.

Dr. Schwab shows a natural attraction
To verse in utmost compaction.
 He’s written a book
 So go take a look
At our Limerick Laureate in action!

This is the first time I participate, so I’m especially honored to be included in such a creative edition!

I will be back shortly.

For now, here’s a small list of some general comments to catch you up, in no special order (some of which will be expanded on later):

• I got some email wondering if my “Hiatus” post indicated I was going to seek psychiatric care or the like. Funny that, because I did actually call around to see what was available. Unfortunately, there isn’t anything available for “crisis counseling” on an outpatient basis for people who need short-term, more focused help but are functional otherwise. Therapists and psychiatrists are backlogged for weeks or months, so “emergencies” here are handled by inpatient programs akin to the state ward where you get to use crayons and clay for art therapy and ice cream snacks are used as rewards for good behavior. Um, no thanks.
• Instead of mental health care, I got treated to some hard-core health care: 2 hospitalizations with a sum total of 15 days inpatient stay involving multiple scopes, surgery and blood transfusions–oh my! (definitely much more on this later) I’m still on pain meds as I heal, so pardon the grammer and mispellingses for now.
• Shortly after I arrived in TX, I treated myself to a Blackberry Curve 8320 now that I was stateside and my cell contract had long expired, ripe for cheap equipment renewal. No more living in the Mexican data desert! (Actually GDL is totally wired for 3G–it’s just that there, the “3″ means you have to pay 3x as much!) Having mobile email and browser is schweeeeeet.
• In just the span of a couple of months, my daughter seems to have grown up so much, yet she’ll barely be two next month. It’s awesome seeing her slowly develop every day into her own person. It’s also clear to me that all the trauma we’ve gone through seems totally lost on her–as it should be–as I watch her happy as can be with the simplest of things. I’d go through 100x more just to make sure it stays that way.
• I still haven’t decided what do call my new domain (since Mexico Medical Student is obviously not applicable anymore). I am tending to pick a generic title that has nothing to do with medical school, just because I want to be prepared for anything, and more to the point, keep using it after medical school. I want to be happy with something long-term and not have yet another migration later.
• It’s nice to have TiVo actually doing what it’s supposed to do now that it can actually use US programming data. I watch so little TV anyway, but what I do watch, I’m fiercely addicted to. Right now that means Top Chef and Battlestar Galactica, both new seasons recently started. In Mexico, I used to always download and watch episodes in large chunks after-the-fact; now it’s almost torture waiting week by week like everyone else for what’s next.

Well, that’s pretty much enough to get an idea of what’s going on. Other than the medical stuff that will follow, there’s not been much. I do have to make one very important point to close this post, however. A few friends have asked how school search/applications are going, completely because they cared and wanted to know. On the blog, however, I will not be posting anything about any facet of any applications, status updates, prospects, etc. Medical school application is a rigorous and, frankly, competitive endeavor. There are enough lookie-loos from my school who (for reasons also to be written about) are in the same application pool as I, trying to transfer to other programs. I don’t need to divulge what I’m doing for obvious reasons. If anything is shared, it’s pretty much because something is a done deal well after-the-fact. Since my target is August, that means mum’s the word for a good while. I hope this is easily understood. Thanks.

Which is the point–too much is too unstable to be blogging here about it right now. Either I blog about what’s going on (which part of me would LOVE to do) or I censor myself to the point of losing interest, blogging out of some unspoken forced obligation. The former runs the almost certain consequence of shifting the blog too negative (more than it already has), and I think that’s too high a price to pay. When things calm down (and I thought they would have by about now) and life is more stable, I look forward to writing about many things again, without the seemingly ever-present undertone of doom and gloom.

Speaking of doom and gloom, one of my worst fears has been realized. I promise, that’s what’s not sending me into a non-writing funk, but it’s close.

In the meantime, I have to change the name of this site from mexicomedstudent.com to something else, since it clearly no longer applies. Any suggestions you’d want to leave in the Comments section would be greatly appreciated.

Until later!

The big story on the game is the weather. The 3-day estimate for kickoff was 4 degrees. I just checked online about 45 minutes ago and found this:

That’s for about 1pm local time; kickoff is at 5:42pm, so you can be sure it’ll probably be a bit colder, certainly dipping lower as the game progresses into the night. The temperature situation is serious enough that the Packers issued a press release giving safety/health tips and advice to fans attending the game.

The advice given above doesn’t apply to the comfortable temperatures here in Guadalajara, so my prescription for gametime is the following:

Like antibiotics, you should not stop treatment early, even if you feel better. hehe

My “work” for the Medblog Awards was done back when Medgadget was responsible for collecting nominations and determining finalists, and since the final vote belongs to the public, I’d let things slip a little (and as a judge, my blog, however not worthy of being among them as of late, isn’t eligible anyway) In general, my blogging activities have taken a back seat to the administrative hassles at school, but this should show that I’m still alive and kicking and still not without humor. I feel bad for not promoting this earlier, but better late than never I s’pose.

If you can’t tune in tonight, you can catch the show archive anytime thereafter. Watch Medgadget on Wednesday, January 23rd, to see who the official winners are (and what lucky individual gets that Kindle)!

Prelude:
Thanksgiving is two days away in the USA. This will mark the 3rd Thanksgiving in a row that I am not home to spend with the rest of my family. Perhaps I’m just a little nostalgic for home right now, but I really wanted to incorporate the holiday here in a way besides references to turkey, pie, and football (Go Packers!). Victor Hugo said (translated), “Music expresses that which cannot be put into words and that which cannot remain silent,” and like the last time I hosted, it is to music I turn once again to express myself.

In the Thanksgiving spirit, all of today’s selections will highlight American composers. Since all links here are set to open in new windows (or tabs), you can read articles while leaving this window playing in the background. In all but one shorter case, the selections are about 8 minutes each; I hope you indulge my desire to share. Enjoy!

When Aaron Copland burst onto the musical scene in the 1920s, American music would never be the same. While there were several important composers before him–McDowell, Herbert, Sousa–Copland was arguably the first to truly musical codify what it was to be “American,” by drawing from folk songs, cowboy music and other “popular” sources. Everyone knows Rodeo (the last part used in the “Beef: It’s What’s For Dinner” campaign in the States), but there was far more to Copland than catchy tunes. Here is the 2nd movement of his third symphony. The expansive, colorful harmonies and driving rhythms are so distinctly American, one just feels it.

Editor’s Choice:
Sid Schwab at Surgeonsblog has a great piece about people’s need for magical thinking, particularly as it relates to “alternative medicine” and new discoveries. The post builds up steam (both momentum and ire) and finally culminates in a challenge bordering on the ridiculous (the whole point) to those who want to cherry-pick common sense. In a similar vein, Dr. Val comments on an infuriating decision by Medicare to no longer cover expensive, necessary treatments to lymphoma patients while at the same time, government dollars are wasted trying to legitimize the spurious benefits of homeopathy with more research studies. Craziness.

Coming back from the Twilight Zone to the ER (some would say that’s just a few steps away ), the truth always comes out eventually, as Bongi at Other things Amazni shares. It may not come via the patient nor the patient’s family or friends–it may require surveillance cameras to finally shed light on what’s going on. The delay, however, could be deadly.

And on the lighter side, Zac at Agraphia has a story about a particularly reptilian surgeon which had me belly laughing from a similar experience.

Mark O’Connor is of a newer breed of contemporary American composers. O’Connor draws his inspiration from the country and bluegrass aural traditions (handed down through playing, not written) and brings his formal training to transform it into something completely unique. O’Connor’s most famous piece is Appalachia Waltz, and O’Connor has arranged several versions, this one for solo cello. This is a slow, easy waltz, just like sitting on a porch looking at the mountains…

Clinical Perspectives:
Here are two selections about burnout and emotional balance. Keith at Digital Doorway talks about having been all compassioned out. Third-year medical student Nick Gavin at NY Emergency Medicine has a post entitled Traumatic Disconnect where he explores the fact that empathy and connecting with patients don’t come automatically with the white coat.

Straight Talk from the Stanford ER’s Sean Donahue writes a good summary of how an ideal stroke response plays out, from EMS to thrombolytic treatment.

Nancy Brown at Teen Health 411 writes with suggestions on how to ensure an inclusive, positive holiday season for the whole family. With so many families being “go-go-go,” just pausing long enough to communicate openly is probably more than half the solution.

Ever wonder why your psychiatrist doesn’t take your insurance assignment (especially if talk therapy is involved)? Dinah from Shrink Rap explains why.

Terry from Counting Sheep tells a touching story about how a frail, blind nonagenarian had the power to halt activity in a busy OR staging area–in a good way.

Clinical Cases and Images Blog comments on the Perioperative Ischemic Evaluation (POISE) trial and how it might affect perioperative beta-blocker usage.

Some patients just “get to you,” and some do so without you realizing it before they’re gone. About a Nurse talks about one such patient and her struggle to find balance when you can’t even grieve because there’s still work to be done.

In Emergiblog’s first-ever guest blogger post, an anonymous Army nurse writes a letter of thanks to her fellow military nurses who serve our country by helping manage the healthcare of detainees. It’s another world entirely when one is faced with a potential moral dilemma for every medication/intervention, every patient, every day.

Tara Gidus at The Diet Dish shares why she’s especially thankful this year.

How can one talk about American music and not include jazz? Well, 1) Ken Burns already covered that history at length, and 2) I am focusing on classical music. Nevertheless, jazz’ universal appeal influenced many composers from around the world, none more so than American composers. George Gershwin is probably most recognized for this, evidenced most popularly with his Rhapsody in Blue. However, the work I’m featuring is the Piano Concerto in F, an unmistakably American work but rooted in a more traditional form. In spite of feeling a distinct “swing” at times, it’s completely written out and is very strictly timed (as evidenced by the orchestra’s accompaniment–there are no free-form solos as in Rhapsody) Here is about 1/3 into the first movement to the end:

Patient Perspectives:
November is Diabetes Awareness Month. In a special feature, Amy Tenderich at Diabetes Mine interviews musician Elliot Yamin, former American Idol finalist and Type I diabetic, on World Diabetes Day. Stories such as Elliot’s are clearly inspiring for any diabetic feeling imprisoned by their illness. However, this can have an unintended counter-effect, as Kerry Morrone shares at Six Until Me. Just because a person appears healthy doesn’t mean they are disease-free.

In The Power of the Flower, Own Your Own Health talks about how physicians who tailor their communications individually to their patients win them over in more ways than one.

In Sickness and in Health, a chronic pain sufferer, has a nice, short post about appreciating the small moments of being pain free.

Of all the many incredible pieces Samuel Barber wrote, his “Adagio” is far and away the most known. The “Adagio” was first penned as the slow movement for his first string quartet, but was arranged by Barber once for string orchestra (which is most played by far), and again for a capella 8-part choir. It is this infrequently performed second arrangement that I present here. The music is set to the words of Agnus Dei:

Agnus Dei, qui tollis peccata mundi, miserere nobis.
Agnus Dei, qui tollis peccata mundi, dona nobis pacem.

Lamb of God, who taketh away the sins of the world, have mercy upon us.
Lamb of God, who taketh away the sins of the world, grant us peace.

The seemingly endless, ever reaching melody passes among all the vocal parts, finally culminating in a climactic chord and sighing quietly to the end. The tonality is never really settled until the final major chord, making one feel that after all of the yearning, peace is found at last.

Healthcare Business and Policy:
The Executive Physician gives his thoughts and concerns on the concept of “cultural competence” as mandated by Washington and New Jersey and offers a more generalized solution.

Regarding hospitals and their attempt to maintain an edge–or at least financial viability–two stories are presented here. ER Murse talks about interhospital turf wars over a trauma level designation. When things get really bad, as HealthBlawg describes, sometimes it may be best to just pull the plug.

David Williams from Health Business Blog interviews the founder of DoubleCheckMD, a free, public web-based medication service that checks interactions and utilizes natural language technology to correlate patients’ symptoms, in their own words, against drug data. I was skeptical given the marketingspeak from the interviewee, but I checked it out before including it here, and it is worth a look.

Toni Brayer at Everything Health laments the whole SCHIP fiasco. I never understood the argument that because certain adults and/or families above a certain income level might be newly eligible (and improperly so, say opponents) if passed, why that would be reason enough to deny coverage (a non-partisan fact) to so many children.

To send this edition off on an uplifting note, here is the finale of Howard Hanson’s, second symphony. Hanson is practically synonymous with the Eastman School of Music in Rochester, NY. He also wrote this symphony at a time when most composers of his day saw romantic, melodic music as an anachronism, preferring instead to embrace the atonality that was emerging from Europe. Hanson, a consummate melodist, unapologetically subtitled this symphony “The Romantic.” While Hanson is not as universally known as Copland, his legacy also lives through all of the Eastman students who have carried some of his spirit with them.

Culture and Media:
Christian at MedJournalWatch presents a absolutely fascinating case study in Africa about body image issues (!?!) and a surprising trend in the perception and desirability of body fat.

Jolie Bookspan at The Fitness Fixer shows how she performed martial arts movement analysis “old school” with high speed film years ago. Later, she returned to this area, except she was the model FOR a computer and even had her moves included in a video game. Cool stuff!

In the spirit of both Thanksgiving and the upcoming holiday season, Paul Levy of Running a Hospital shares his daughter’s essay on Salon.com about fruitcake and family tradition. It’s an extra click from his post, but the Salon article is an excellent read and well worth the extra navigation.

Canadian Medicine talks about how Canada’s health department warned against using a Chinese preparation of caterpillar fungus. Gee, ya think? I wonder how those meetings went. “There’s a fungus among us!”

Postlude:
I hope you enjoyed this edition of Grand Rounds! I hope everyone has a safe and happy Thanksgiving. Regardless what country you’re reading from, I know there’s something to celebrate and be thankful for–after all, you’re alive and reading this, aren’t you?

Grand Rounds leaves Mexico from Puerto Vallarta a few hours away and sails for the Philippines, home of next next week’s host, Prudence, MD. ¡Adios y buen viaje!

I woke up with, uh, let’s be kind and say GI distress. No biggie, yet I hadn’t eaten anything out-of-the-ordinary, food from a different place, etc. Moreover, Claudia had no sx whatsoever, so I wasn’t concerned. By early afternoon, I knew something was amiss because I had been awake probably <1.5h since I woke up. Going back to sleep was such an involuntary response, I don’t even remember going back to bed from my room.

That’s when I noticed I was freezing. Anybody who knows me knows that I have a low tolerance for warm, stuffy environments and usually “run warm,” so for me to be cold when it’s clearly not cold outside was yet another WTF moment. By this time, Claudia knew something was up for sure, seeing me under two layers of covers in the afternoon perpetually asleep and shivering. I took my temperature around that time and it registered 102.5. Holy shit. It’s been years since I’ve had a fever. Even when I’ve had major surgery, my temp didn’t go higher than 101, and that was just during the few days post-op. And I was FREEZING.

Fast forward to late afternoon, and I guess in a daze I put on some warm-ups (which in retrospect wasn’t all that smart) and I’d probably downed >2g of Tylenol by then. Re-take temp: 103.5. Now I have one of those fancy-schmancy arterial IR thermometers we bought for baby, and right about then I was thinking it was a POS–there was no way it was that high. I went to my closet, realized that the room should not be spinning, and fetched my trusty mercury thermometer from my “doctor bag” (which is really a $15 shaving/toiletry bag with handles that looks the part, and which has been gathering dust since the Spring when I last used it in community medicine), and did a real, honest-to-God oral temp. I got the thermometer locally, so it’s Celsius, but it read 39.5–just under what the fancy-ass one read and close enough to know this was for real.

I called a doctor friend, and he just flatly said, “You have an infection.” No shit, Sherlock. Thanks for wasting my first cell minute. “Go and get [GI-localized antibiotic combo only here in Mexico which has neomycin].” I made a joke about my kidneys, but he said it wasn’t an issue for the dose and the few days’ duration of tx. I asked why he suspected a bacterial infection and not a virus. He didn’t have an “evidence-based” rationale, but then again, we were talking on the phone and it’s not like he had any data. Basically, if it was bacterial, at least the medicine he recommended would get something going; if it was viral, I was SOL, but since the abx isn’t really absorbed, no harm no foul. I could live with that. Claudia, a super-trooper with my man-cold, whiny ass, fetched said med from the pharmacy down the street.

I had already switched to ibuprofen for fever reduction, but something changed by night-time as I was feeling hot as hell. It was about damn time something makes sense! Checked temp again: 104.2. Again, I thought, “No way,” and swiped it the other direction (as if the left temporal artery was going to read differently from the right one). 104.3. F*CK! Now I’m in full panic. I didn’t want to go to the local ER because 1) I’m not insured, and 2) I didn’t want to burden Claudia with me AND deal with a toddler who should be asleep while at the hospital. Besides, although I felt like death warmed over, it’s not like I was delirious or anything. I was able to keep down all fluids, was eating fruit, crackers, and other “easy” foods, so there was plenty of reasons not to jump the gun.

Thankfully, before I could start entertaining REALLY crazy things, the fever started coming down. I had already started cooling myself off externally, and I think between that and the ibuprofen, it started making a dent in my core temperature. By midnight, my temp was down to a respectable 101, and–strangely enough–I was sweating bullets like at no time prior. I’ll trade sweating for ER-bound fever anyday, and so the night began to finally wind down.

The next day (which seemed like days later, esp. since my time was so off w/all the sleeping), I felt absolutely craptacular. In spite of a lower fever (which never again went over 100), I seemed to be just as lethargic but now had myalgia as icing on the cake. “I have a geezervirus,” I joked to myself.

So this whole, near-pointless tale of woe is being shared to say that it took until this weekend for me to feel normal. I was WAY behind on work hours, so I’ve been busy catching up with those too. I felt horrible guilty about the timing of my last post and this little mini-absence, but I promise the above is true. There’s quite a bit queued up in drafts from bits of time I felt decent, so I’ll clean those up and get them posted. Thanks again for all those who commented and especially those that delurked.