Thursday, September 24, 2009

Stimulus Plan

We, the Mooses of the North, are a one-family stimulus plan. Nevermind the spending we've done in the last 18 months; the real money is in home buying. Of course there is a lot of money that changes hands in the actual transaction of buying/selling a house. It is certainly not a simple transaction of money flowing from us to the seller, oh no, a portion of it gets siphoned off to real estate agents, title companies, and banks. I'm not complaining much - our agent definitely earned her commission, and I'm guessing that the seller's agent did hers. The title company is, more or less, part necessary evil and part scam, as are some of the bank's origination fees. (Really, did I honestly have to pay someone $25 to look at the FEMA flood zone map and certify our house didn't need flood insurance. The maps are public record and available on the internet - I looked it up myself in all of three minutes!) So the apparatus of the real estate industry got some much-needed business from our transaction.

What I consider our real stimulus to the economy would be all the improvements we are making right off the bat before moving. There's a few hundred bucks to rent a truck and hire some guys to do an awful lot of heavy lifting to transport our many stored possessions from A to B. We hired a guy to come in and repair the plaster on the 2nd floor. There was extensive cracking in basically all of the walls, so it took him over a week to patch and skim-coat it. Then there was another week or so of him priming and painting. At $20/gallon for no-VOC paint, the square footage adds up fast. In the last two days we had some guys who were clearly hard up for business come in, tear out the carpet in Brynna's room, and refinish the hardwood floors beneath it and on the rest of the 2nd floor. We have an energy audit scheduled in about two weeks, after which we'll add some badly-needed insulation to the roof before winter. We hope to tear down a half-wall that separates the living and dining room, which would then pave the way for the flooring guys to rip out the living room carpet and put in hardwood to match the dining room's. The front porch has some posts in need or repair or replacement. The porch decking has old and chipping paint; we'd like to replace them with lumber made from recycled plastic. The many, many incandescents ought to be replaced with CFLs. We'd like to plant some bulbs this fall and prepare a garden for next spring. The foundation brickwork needs to be re-pointed. The list, and the costs, go on and on.

These are, of course, just the joys of home ownership. We went into this with open eyes. We expect that these improvements will increase the value of the house. But more to the point they will increase our enjoyment of the house. All in all, we're pumping a lot of dollars into the home improvement industry. The craftsmen and workers tied to it get some business, consumer spending moves forward, energy waste will be curtailed. Certainly we could save a bundle by doing some of this work ourselves. I've refinished hardwood floors before, could do the carpentry work, learn the basics of plastering. But, because we have zero time these days, we need to pay others to do this work if we want to actually live in our new home in the next six months. So, stimulus package it is!

Thursday, September 17, 2009

African Football

Just because I'm an engineer and well versed in all kinds of high technology doesn't mean I don't appreciate a piece of low-tech brilliance when I see it. As a matter of fact, my constant exposure to technology means that I sometimes tend to overthink things. I laud people who are able to do amazing and eminently practical things with the basic materials on hand. If anything, the world needs a lot more simple, transparent, low-tech solutions to problems. Here's another:

Wednesday, September 16, 2009

Signing Up A Storm

Work no better today...apparently I put policies over people, need to get in touch with my humanity, and do not care about my patients' needs. (Translation: I maintained that a patient would indeed be leaving against medical advice since we are not yet sure that the very serious infection is gone.) Thank goodness for my very supportive senior residents and attending. And the lovely comments I've received from you, dear readers.

I did have a good, though looong, outpatient clinic in the afternoon. I really love having my very own patients. We can start working on something at one visit, and then I can see them again to follow up next month! This kind of continuity, and the ability to work on something incrementally, is why I am doing primary care, and it is thrilling. I'm also learning to slip in preventive care at every opportunity. Here to discuss back about a flu shot? Perhaps a colonoscopy? Maybe a lipid screen along with your headache medicine?

Brynna is also thrilling. She is learning things so quickly! Her repertoire of signs is expanding by the day. She does rather conflate "more," "help," and "again," but in her world, those are often interchangeable in any given situation. She now does "please," which is very sweet. She has also just learned "sleep," and since she has a bit of a cold, actually used it to ask for both of her naps at daycare today! She has also developed a sign for "dog." She pats herself on the chest, which is a version of the patting-the-thigh sign that Miss A and we have been using for dogs. She does it when she sees Jasper, but also when she sees other dogs and when she sees pictures of dogs. This evening we were also working on "cat," which uses the fingers to sketch out whiskers on the cheeks. We were turning the pages of a book back and forth between dog pictures and cat pictures, and practicing the different signs. It's so amazing to watch her figure these things out!

Other signs she knows..."all done" and "milk" have been around for months. "Eat" for awhile, too. There's also "up" and "down," "book," "change" (a diaper), and she is working on "share" and "thank you." She points at things (often signs "help" and then points, or "please" and then points). She also understands "dance," "sit down," and "stand up" though she doesn't make those herself yet. And she connects signs, like "please-more." Miss A has even seen her do "please-more-eat."

Because she communicates so well with signs, she hasn't had to work too hard in the talking arena. We certainly talk to her all the time, including while we sign, and she babbles a fair amount and is starting to do much more imitation. Today she said "boo" when she was showing me a book, and last night we were quacking together as we played with her rubber ducky. We know that she understands tons of spoken words. So I don't have any worries about her talking—it will come in time! In the meantime, the signing helps prevent frustration. Though sometimes she waves her arms around, clearly trying to convey some message, and we have no idea what she is trying to tell us!

We'll try to get some video of her signing soon, since it's pretty cool to watch!

Tuesday, September 15, 2009

Five More Days

I am tired. Luckily, I have only five more days on this rotation. I am doing the dreaded "terminal call," covering the service overnight Friday and all day Sunday before handing it off to the new interns and senior residents coming in on Monday. This last week theoretically should have been easier, because I have the past five weeks of experience behind me! Instead, it has been really tough so far. I have been taking care of five patients who arrived over the weekend. This isn't a huge number, actually, but they have been quite complicated.

The most straightforward one had a blood transfusion, not that simple, after all! Of the other four patients, one is an alcoholic (which contributed to the problems being treated during this hospitalization), one used to be a drug addict (which led to the organ failure being addressed during hospitalization), one is addicted to food and cigarettes (leading to very, very bad heart and lung disease that will probably kill this patient who is not much older than me), and one is using a variety of illegal drugs, making our treatment decisions about a bloodstream infection extra complicated. All four also have significant mental illness.

This set of patients make me incredibly sad and incredibly frustrated, in about equal measure. Two also have very demanding families who make me want to run the other way. Normally, I really like explaining what is wrong with a patient and what sorts of things we are trying to do to fix it. But these families are completely irrational—not uneducated, which would be OK, but utterly irrational! I can explain until I am blue in the face, and then we go back and start all over again at the beginning, as if we'd never talked before at all. One family member, in total denial, fought tooth and nail against us doing a very necessary procedure yesterday—then today, after the procedure was done and the patient was feeling better, was all upset that we didn't figure out that this "commonsense thing" was necessary sooner, and get it done quicker. Because, after all, the surgeon who did the procedure knew what was wrong! And fixed it really fast! (Um, yes, because we called him and told him the situation and asked him to do exactly that.) Aaargh!

So. That's my work life these days. But in five days, I will get back a bit more of a home life. I will be able to take B to daycare, and pick her up, and spend a couple more hours a day with her. (Perhaps she will then go back to nursing once a night, rather than the two to three times a night that she's built back up to over the last few weeks.) Alex and I may be able to start exercising again. Jasper will get longer walks. And we'll be able to pack up and move into our new house! So, as the much-anticipated New Hampshire fall gets into gear, there is some hope for sanity on the horizon. Please send patient, kind, tolerant vibes my way for the next few days, though. I want desperately to be able to heal my patients—or at least to treat them gently and well during a time of need—but I also have to learn how to leave work behind me at the end of the day.

Monday, September 14, 2009

And I'm Passing It On!

In a lovely addendum to last night's post...

Brynna walked up to where I was sitting on the couch today, pointed at one of her board books, and made the sign for "book," which is the first time I've seen her do that, though I realized over the weekend that she recognized the spoken word "book." She was asking me to read to her! I picked up the book—it was Sandra Boynton's Barnyard Dance—and we read it together, with Brynna turning the pages (she's been doing that part for awhile), and me saying the words. She was very intrigued by "stamp your feet" and "clap your hands" and kept bending over to stamp my feet for me.

Then we did Brown Bear Brown Bear, What Do You See?

Watching your kid fall in love with books—priceless.

Sunday, September 13, 2009

I Think I Have A Problem...

Hi, my name is Hilary, and I'm a book-a-holic!

Went to the library this afternoon to see if they had the new Star Wars book. They didn't, damn those city budget cuts. So then I thought I'd just wander around for a few minutes.

And then this stack came home with me:

That's two Janet Evanoviches (thanks, Steph!), two Alexander McCall-Smiths, a not-new but as yet unread Star Wars book, and several recent Bicycling magazines.

And yes, I am still on the Medicine service. One more week! Then I'll have time to read all of these lovelies. But I did already finish one Janet Evanovich.

Also saw today the good news in the newspaper that Philippa Gregory and Diana Gabaldon are both coming out with new books.

I may, in the future, take up reading serious books again...but not during my intern year!

Thursday, September 10, 2009

Smart Car, Urban Legends, Viral Email, and Critical Thinking

I received an email from a colleague the other day, with the subject line "...Want a Smart Car?..." Accompanied by two images:

The juxtaposition of the Smart Car with the Brooklyn Bridge and the subject line "Want a Smart Car?" made me think at first that this was a gag. "Hey, want to buy a Smart? How 'bout this bridge I can sell you, too?"

The second image purported to be a Smart car smashed between two dump trucks in a recent accident in Jefferson Parish, LA. It also had the added commentary: A Snow Flake in Hades has a better chance than this guy did. I Think I'll Pass on the UN-Smart Car.

This particular email is apparently a recent development, but has already hit blogs and message forums, leading to self-riteousness from all sides that borders on obscene, and certainly unseemly.

The fact that this was obviously a chain email, destined to rebound in the infinite echo chamber of the intarwebs, combined with the utter smugness of the commentary, and the fact that I am an engineer who professes to some critical faculties, led me to investigate this just a bit more. Join me as we deconstruct this a bit...

As I usually do with such fantastic stories, I checked it against  The image and the event are corroborated, but the vehicle is actually a Ford Escape hybrid - a mid-sized SUV - not a Smart.  Checking images of an Escape shows that the wheels, at least, are the same as those in the crushed car.  They fit better, anyway, than do thewheels of a Smart.  Accoridng to snopes, the vehicle was apparently not centered between the trucks, so the driver's side was not as badly smashed in the impact, and the driver survived without grave injury.

I've seen crash-test videos of Smart cars (check youtube). They tend to show that the frame is an exceptionally rigid cage that can survive many impacts without buckling.  However, being extra rigid and a tiny car, it means that there are no crumple zones to absorb the impact. The car tends to rebound off whatever it hit (or hit it), so the occupants end up getting tossed around at high accelerations in an exceptionally rigid cage.  I'd rather not predict the results.

I wonder if the driver in the above accident would have fared better or worse had he been on a motorcycle.  Better by not being crushed in a twisted can of metal, and possibly tossed away from the impact; worse by not being in a can to absorb the impact for him, and being ejected from the impact.  I doubt the smug writer of the original email would have been so quick to denigrate someone, a person of true leather-clad grit, who while cruisin' around on his Hog, just happened to have the dumb luck of being pancaked between two American-steel dump trucks doing the manly work of reconstructing the gulf coast.

I guess in the case of a rock and a hard place, and outweighed by perhaps 20:1, things just don't look good for anyone.  For what it's worth, here's the Mythbuster's take on an ordinary car being smashed (off-center) between two 50 mph semis.  It didn't do so well, either; nothing would except, perhaps, an M1-A1 Abrams.

Anyway, getting back to the story. I've never really thought that highly of Smart cars. Debunking this chain email hasn't changed my view on them, either. The moral of the story, for any that haven't yet realized it, isn't about car endorsements: don't forward chain emails without first doing a little poking around. is a great place to start - they've seen it all, and usually have done a lot of the legwork. The above information I found in all of about five minutes of curious Googling. Thinking on this and many other forwarded emails I've seen, I've realized that the more the email is trying to make someone appear stupid, the more skeptical one ought to be of it.

Wednesday, September 9, 2009

Recent Weekend Fun, #2

10 days ago, I had the whole weekend off, and we went to Connecticut to stay with my parents. Brynna got lots of quality time with her grandparents, and Alex and I got to sleep in!

Here's Brynna banging spoons with M and great-grandfather Dickie:

Getting her first introduction to crayons with Grand:

Practicing coloring, in one of the brief periods of proper use before she started trying to chew on the crayons and we had to take them away:

Playing with magnets, which was a big discovery of the weekend:

We finally had time to take Brynna to meet her pony. Donald is living at a farm about half an hour away, earning his keep and waiting for Brynna to grow up a little bit more. He is 20 years old now, which is amazing to me, as he and I have been partners since he was 2!

Brynna was a little skeptical of the large fuzzy creature but generally game, especially once she saw M and I snuggling up to him. She was a bit more interested in the barn cat than in Donald, though! I am sure this will change with time—it's a good bet she'll be horse-crazy in a few years.

We all got haircuts at Cathy's (B just got a little trim of the bangs), had a wonderful spaghetti dinner with the whole crew, and chased after Brynna as she wandered around making mischief and finding staircases to climb. All in all, a lovely restful weekend.

Tuesday, September 8, 2009

Recent Weekend Fun, #1

We've had several fun weekend events recently, we just haven't had time to post about them!

First was a little more than 2 weeks ago. I was working the Friday overnight then Sunday day shift, which means that I got done at work on Saturday morning. Signout to the day team is supposed to be at 7 AM, but we were running running running all night with admissions and calls on existing patients, and then a sick patient actually died right before signout. Then I needed to stay late and finish lots of paperwork. In the meantime, Alex got Brynna up, covered the inside of her elbows with numbing cream, and brought her to the hospital lab to have her blood drawn to check hemoglobin and lead. He actually managed to accomplish this long before I finished at around 8:30. Much screaming, but success (the results are back, and are fine).

That was the bummer part of the weekend. But then, despite getting zero sleep, things got fun! We had had a longstanding plan to go up to Hanover and meet up with our dear friend Lauren, who had not yet met Brynna and was back at Dartmouth for a wedding. So we zoomed up I-89 and met her at the wonderful Dirt Cowboy Cafe, then took ourselves over to the Top of the Hop so Brynna could roam around. Here are the girls having a grand old time:

After Lauren went off to the wedding, we went out to Wild Hill Farm where we got married to visit John and Peggy and pick some organic blueberries. The visit was delightful and the picking exceptionally fine. Best blueberries EVER! Brynna went in her backpack with me, and I sidled up to the bushes so that she could pick and eat while I picked to keep.

We were, however, sad to find that the Party Tree where we hung lanterns for the wedding had started to rot and had been cut down.

And then we went to see Panache. Brynna slept through it, but I got to groom him and hand-graze him for a little while. He's a happy camper with his lady-love Aly, though he's lost some muscle in his old age. I sure do miss galloping cross country with him, and I bet he does too.

Finally, we stopped at the Hanover Coop, the best supermarket ever. We got our favorite Red Hen bread and I went a little cheese-crazy, picking up some Cabot Clothbound, some sheepsmilk Shepherd's Cheese, some feta, and some caerphilly. All local, all delicious.

I spent all the next week catching up on sleep, but it was totally worth it!

Monday, September 7, 2009

Welcome Home!

It's time to move...again. We've bought a house! Here it is:

We're moving about 5 minutes away, to a lovely quiet street. It's a bit farther from the library and the Capitol, but closer to the food coop and the bookstore. My bike ride to work will be about the same distance, just over different streets. And Alex ends up one exit closer to work.

The main reason we bought this place is that it has a spectacular kitchen. After the closing last week, we went and had a picnic dinner to celebrate. Here's Alex pouring champagne at our new kitchen island:

And another photo of the room that we are surely going to live in the most:

Brynna has already staked out her own spot in the kitchen:

Hey Jasper, what do you think of the backyard?

We think he likes it.

Here's Brynna practicing on the steps with her Aunt Kate:

And, true to form, climbing up her new slide. The family who lived in the house before us left us the swingset:

We're getting some plaster work and some painting done before we move in, and maybe some hardwood refinishing, too. We'll be moving in dribs and drabs over the course of the month. Then we'll be all set to host, so do come visit!

Wednesday, September 2, 2009

Brynna the Climber

Brynna, having mastered the drunken sailor walk and dancing in place, also now enjoys climbing the stairs. And climbing. And climbing. She does climb down sometimes, but mostly likes up. Here's an example.