Christmas Tree

We had a swell weekend. We had a visit from friends from MN. To top it up, the weather turned out to be pretty nice this weekend, unlike the last several days. We took advantage of the warmer day and went out to the nearby lake/dog park.

As always, whenever we get together there's always a bit too much food. And yes, that's a SECOND turkey you see (the first one being Thanksgiving Day). Except this time, it was a 22-pounder. The dang thing took me 5 1/2 hours to roast, and by that time my guests were gnawing on my legs out of hunger.

Yup, it was a busy but extremely fun weekend. Thanks for visiting, guys!

Happy Thanksgiving

As usual, our maniacal chef (mua) got to play with his trusty flavor injector again.A lot of basting, herbs, and 4 hours later, waa-laa:
One juicy 16 lb turkey.
Really though, the secret to a juicy turkey is brining. Roasting the turkey for so long tends to dry the breastmeat out. So, my secret is to dip the bird in brine overnight. What I use are:

• 1 cup salt
• Half cup brown sugar
• Minced cloves, aniseeds, allspice
• Also what I do is to inject the bird with flavoring (I use a concoction of soysauce and orange juice), and then make about a dozen slits in the meat and stuff in cloves of garlic.
• Lastly, cover the top part of the bird with foil- prevents burning.

Works every time.
Also tried out this new recipe for pumpkin pie, with a twist. Besides pumpkin filling, I also added a cup of apple butter. Pretty damn good, even if I may so so myself.
The dogs seemed to agree.

Hope you all had a good Thanksgiving, folks!

Idle Christmas Thoughts

I can't believe it- they've been playing Christmas songs on the radio for the last 2 weeks. The holiday lights and deco are up. Admittedly, if you've followed my blogging trends over the years you know I get nostalgic and perhaps a bit homesick this time of year. Not that I regret the path I took; I think I'm very fortunate and I am blissfully happy. But one is allowed to ponder, no?

• I think about my highschool buddies with whom I'm still very close emotionally, though I wished we got to see each other more. I wish going out would be as simple as a call and a drive to the mamak stalls. Then again, with kids and work and all, even those who remain in Malaysia don't get to hang out the way we used to.
• I miss my family. Though we never really celebrated Christmas, we do put the tree up. And the last couple of Christmases they were around. Not this year though.
• I miss the snowless, hot and humid Christmases back home. With the fake (cotton wool) snow and the very fake Santa. I suppose it's inevitable in Asia; you're not going to find a white man with a big belly and a facefull of white beard to play the role. It's always going to be some Indian or Chinese guy. Not sure which is funnier. But yes, I do miss Malaysia's attempt at trying to be Chrismassy.
• I miss my buddies from our years in Rochester; I miss simpler times when all we cared about were 1) What crazy cases we saw oncall and 2) Which buffet to hit now that we were postcall, pissed and hungry.
• I am happily married, but I have to say Christmas makes me ponder about lost loves too. Girls who came and went, and a lot of what ifs. Most of all I wonder about my first love, Elaine, for whom I developed a huge crush when she performed in that Christmas dance when I was 11. Whose family migrated to New Zealand that following Christmas. Wham's 'Last Christmas' and 'Hark, the Herald Angels Sing' tend to remind me of that.
• I miss hearing my dad sing along to the Christmas songs over the radio. Sinatra, Como, Elvis and a host of others. For some reason though, 'The Little Drummer Boy' seems to stick in my head the most.

Thinking about it all, I realize that what I'm missing most isn't just family and friends, but also memories we've shared, those special moments in the past that have forever left their mark in one's psyche. Moments that will never return, and for that reason, is probably even more special. Bygone times that seemed so much simpler; no jobs, no worries about mortgage or life insurance or bills, no wives or kids; just hanging out and fostering friendships, having simple, thoughtless fun. Having said all that, it's part of growing up (or old, however you look at it). I now have my own family, and it's exciting too thinking about how we begin to pave our own paths, and make our own family's (yes, MY family) traditions and memories (like what we've done for the 2nd year, heading out to the local Tree Lighting ceremony and how we discovered puppies don't like fireworks, but that'll have to be another blog entry).

34 more days to Christmas, folks. What's on your mind?

A Tale of Two Losses

I lost two 'patients' in the last 3 days. What a difference it was between them, and no less tragic was either.
I'll call the first Karen, a patient with poorly controlled diabetes, a1c 12.2%, a 20 year old who also found out last month she was pregnant. This was unplanned, and though I hate to judge, I could not help myself. She still chain smoked, and still refused to check her glucoses nor was she compliant with her insulin despite my advise, despite glucoses running clear into the 400's. When she found out this week that she miscarried, she expressed relief. Now, perhaps she was putting up a façade or trying to act cool, but she actually told me, "That's good news than, I can stop my insulin and go back to pills". Now, I've seen patients more upset about losing a football game, than the level of emotion this woman showed. Perhaps it was true, the baby meant nothing to her.

On the other hand, Lisa was a patient who came a long way. I saw her during her admission for ketoacidosis and new diagnosis of type 1 diabetes. After the initial shock, they took control and learnt all they possibly could about diabetes and insulin. They were also about my age, and in many ways they reminded me of Kristin and I. I have gotten to know her and her husband well; their dreams and their fears. A couple of visits ago, she had dropped her a1c to 6.2% and was doing well, and seeked my blessings for them to try to conceive, which I gave. When Lisa called me 4 weeks ago to share the good news, I was excited and supremely happy for them. She called me today crying, sharing that they had just miscarried. I have to say I felt genuine sorrow for them; my eyes actually welled up. I made it clear to her; there was nothing she could have done differently, she tried, and I knew she did. This was one of those things. After all, miscarriage occurs in at least 25% of clinically apparent pregnancies.

I was mad, mad that this happened. And while I can't say that anyone deserves this, I was mad because I knew very well that Karen could have changed the outcomes had she been more responsible. And I was mad that on the other hand, though someone tries their darndest, these things can still happen. And no two patients were ever more different.

Nonetheless, I still lost two patients. And for one would-be mother, she lost a child. For another, she had a burden lifted off her shoulders.

For that, we shall mourn together.

Dear Santa...

Holy cow. Not that I'm unhappy with our Lexus IS or anything; conversely, it does what the Boxster can't- a quiet, comfortable ride for the family, and handles much better in the snow. But geez, watching this video just makes one lust for this like nothing else.

Question is, would anyone spend US$350,000 on not a Ferrari, but a Lexus???

The Lexus LFA is the Japanese answer to the Italian and German supercar makers. 6 years in the making, so much so that many thought the car would never ever be developed, this car costs more than a Ferrari 599, makes 560, hits 60 mph in 3.7 seconds and tops out just over 200 mph! Just listen to the engine; it sounds more like a Formula 1 race car than a luxury supercar.

Oh Santa, what would I have to do to get one of these this Christmas?

There's really nothing quite like:

Having your patient spray you with his pee on a Friday morning.

Actually it wasn't that bad. Poor Mr. A had to potty during his visit with me. He was a disabled man on a motorized scooter, and usually needed help to go. Because I was the only man in the clinic, he sheepishly asked if I could help him, instead of getting the nurse.

I agreed, before he cautioned me that he has a tendency to spray (Uh oh...).

Well, he did. All over my hands as I held the urinal (he couldn't get up close enough to the toilet). He pretty embarassed by it, though we both had a good laugh when I reassured him that urine is sterile.

I had this interesting experience yesterday. I saw a patient in consultation for thyroid cancer. He had received initial care at my alma mater, and then heard there was a WFMC-trained endocrinologist here (closer to his home). He was excited to find out I was Malaysian Chinese (so he said in his emails to the clinic making the appointment).

And so I saw him yesterday, a dearly older gentleman who reminded me of Albert Einstein. Even had the same crazed hairstyle. This Caucasian man in his 60s. But I didn't expect what came next.

He stood up to shake my hand. And started jabbering in some foreign language excitedly. And then it hit me that he was speaking in Mandarin (and it sounded fluent too).

Sheepishly, I had to tell him I didn't speak Mandarin, which prompted him to switch to saying 'Hello' in pretty damn good Cantonese.

Apparently, Mr. K was well-travelled, and spent considerable time in Asia, including Malaysia. At the end of our visit, after I had outlined the treatment plan for his thyroid cancer, and discussed the prep for radioactive remnant ablation, he proceeded to write 'Thank You' in Chinese on the whiteboard (well, so he says. Could have been F*ck you for all I know).
It was amusing, and admittedly a bit embarassing; my ancestors from China were probably turning in their graves, disavowing any relations to me.

Paintball

Question: When is it legal to shoot your wife?

Answer: At paintball!! We spent the weekend visiting Kristin's best friend 5 hours away. And joined them for a paintball session. Something her friend has been hosting in conjunction with her birthday for the last 3 years, as a fundraiser for toys for kids.

It was our first time playing paintball. It was quite an adrenaline rush, actually. And great fun; we now have several welts and bruises to show for it.

(and no, I did not shoot my wife)(not that I wasn't tempted, but I was too fearful for the safety of my gonads had I shot her)

Of Remembering Names

Any of your out there have the same problem as I do?

I shared this story with Kristin the other day. I was filling the Lexus up with gas in a nearby gas station. It was 6.45 am, and I was on the way to work. It was also pretty damn cold, for October. I was hungry (always too lazy to have breakfast, and I always curse myself 30 mins later) and sleepy.

"Dr. Magus!" I heard a yell (he had mispronounced my name).

A patient happened to be driving by, and recognized me. He excitedly looped around and drove into the gas station. He asked how I was, and proceeded to tell me how things have been for him since I last saw Mr. H. After a minute, he eyed me suspiciously, probably realizing that I haven't yet called him by name. He probably realized that I hadn't the foggiest idea what his name was.

I'm ashamed to say that was certainly the case. And though I do think of my patients as people not as diseases, when you see so many and you're as demented as I am, it's impossible to remember the name. The thing is, you do tend to associate faced with diseases. And while it took me days to figure out his name, I knew who he was right then. Mr. H with the hypopituitarism from neurosarcoid. I had not seen him in 6 months, but I had a clear picture in my head of his medical history, and what dose of steroids I had him on.

And so I asked him how he was doing, and when he last saw his neurologist, and how things were doing from that standpoint. I asked him when they next wanted to do his MRI. I asked him how his visit with his dermatologist went. He beamed, and excitedly gave me his updates while I waited for the tank to fill. I guess I had redeemed myself and he realized I do remember him. He shook my hand before we parted ways, and promised to keep me updated. And somehow, I wasn't hungry or cold or sleepy anymore the rest of that morning.

But it does remind me of the other time I ran into another patient in the store. Hadn't the foggiest idea what her name was. But I remembered her case, her diabetes. And I joked with her about not telling my nurses I had 2 frozen pizzas in my cart.

I think many of us are guilty of that though. We do think of patients as individuals, but perhaps to ease our recollection, we always begin our presentations with "This is a 50 year old man with Addison's" or "This is a 28 year old woman with hyperthyroidism...". Naturally we tend to remember medical details better than names. Nonetheless, I really should try to do a better job with remembering my patients my name though.

Anyone has any good remedies for poor memory?