Friday, May 29, 2015

Medical Prankster-ism

Back in the day (if that opening doesn't chase away people in droves I'll be surprised), I would frequently get to my office in this building early.


It was quiet, and gave me time to review files, figure out my day and have a quiet cup of coffee before the day turned frenzied.

A knock on my office door and in came a colleague's nurse, clutching a sheet of paper. She said she was getting a patient ready for the first appointment of the day and had done a pulmonary test, a flow-volume loop for Jeff to read. "I've done it several times, and it always looks like this!" she exclaimed.

Now, normally a FVL looks like this, at least in general terms:


I looked at the report she was holding. It looked like this:


I resisted the impulse to turn the sheet upside down. After a moment I looked up. "Judy" I said, "You've hit the jackpot. Jeff is going to present this at the next ATS conference, I'm betting. You've just diagnosed the one in a million patient." I paused for effect. "This patient's lungs are upside down inside their chest!" Her eyes were wide. "Take this back to Jeff and tell him what you've discovered. He'll probably give you a raise." I handed the report back. She hurried off.

Now, the test is done with a fleisch pneumotach. It looks something like this:


See the two tubes connecting to the port on the bottom? She had no doubt reversed them when she assembled it for the test.

I was just starting rounds when my pager went off (remember pagers?). It was one of those that messages could be sent via text. From Judy, it had only one word, an anatomical reference far south of my pulmonary specialty.


Tuesday, May 26, 2015

Fresh vegs!

There is a paucity of fresh fruit and vegs here, at least what I call fresh. Picked a month ago and stored in an oxygen-free container and shipped several hundred miles does not count. But Saturday was the opening day of the Farmer's Market, which will be open every Saturday until the end of Sept.


Hanging baskets and starter plants from a local nursery


And my favorite, from a farm near Missoula. The Hmong farmers came over in the late 70's, and grow the best vegetables in the state. At this time of year it's mostly greens, rhubarb, young garlic and Morel mushrooms they've garnered from the forests.

Armed with some purple asparagus and morels from the Hmongs


I made asparagus and mushroom cream soup. A first for me, and surprisingly easy.


My buddy the cook down the street agreed, it was one of my better efforts ever.

Tuesday, May 19, 2015

A Repost from a few years ago, St. Helens

35 years ago. There was just an article in the Seattle Times about the uses of the ash dumped into the Toutle river by the eruption, how it's suddenly become of value. So, here 'tis the bit I wrote about it.This was from around 3 years ago. 


One of my dad's favorite destinations for a weekend trip when we happened to be in the northern part of Oregon was Spirit Lake, an hour north of Portland. We'd drive up, rent a cabin owned by the lodge, a boat and spend the weekend fishing for planted trout. My favorite part of the weekend was getting to drive the boat from the stern, using the 5 hp outboard. My dad's favorite part was spending time with Harry Truman, the caretaker (later the owner) of the lodge. Dad had known Harry for several years, perhaps they bonded because of their age and fondness for bourbon and coke. They'd spend the evenings on the porch, trying to out-tell each others stories, I'd sit and listen, learning new words for a 10 year old.


Spirit Lake was fairy tale beautiful, with St Helens rising from the northwest end of the lake. 


The cabins were scattered in the woods behind the lodge. 


Harry was a genuine character, a fixture at the lodge for years, seldom without a bourbon and coke. In the mornings he'd disguise it by pouring out half a bottle of RC cola, and filling it back up with amber liquid. 

Fast forward to 1980.....We were in Portland, I was up at OHSU medical center, my then-only-daughter was in kindergarten. St Helens had been rumbling for several weeks, small seismic events and a growing bulge in the side of the mountain facing Spirit Lake and the lodge. People had been warned, many had moved out of the area. Not Harry. He refused to leave his beloved lake. 

The third weekend of May Kate (then Anne) and I went backpacking in Eastern Oregon, out on the high desert. On Sunday we arose early and started the drive back to Portland. At around 9am we rounded the southern flank of Mt Hood, and could see to the west. Kate was probably asleep, I don't remember, but here's what greeted my eyes. 


My first thought was "Why did they nuke Portland??". A radio station told us that St Helens had blown. The mountain lost 2,000 ft. elevation, and millions of tons of soil and rocks. Many people were killed, including Harry, now buried under hundreds of feet of flow and debris. 



My dad had been dead for 6 years, but I'm sure he'd of thought that Harry made a good choice. 




Saturday, May 16, 2015

The Family Hairline

I noticed as a kid how my dad's hairline was....pointed. The Southmost point was near his forehead, but the demarcation of the hair forest quickly turned to the blade of a knife......


Like this, yes. It runs in the family....

On to my cousin, Kevin....his family branch was on the east coast. He and I were in Oregon in undergrad at the same time....he was a good deal more politically active than I. But, he had the same hairline....the guy on the left, below.

Kevin died rather early, almost 15 years ago.

There has been several minutes where the author above has not touched the keyboard....we find the neighbor across the street, Ann, has come with a Bavarian Creme, from Wheat Montana over towards Bozeman. The author is now reduced to guttural sounds, so we'll leave it at this. 

Wednesday, May 13, 2015

Every town has it's problems

This Alces alces was so tired from it's trip into town (there was a sale at Carl's Fine Foods) that it took a nap on someone's front lawn, and refused to get up and leave.






Personally I would have assumed it needed a large can of PBR before it toddled off for the city limits, and got it a six-pac to take with it.