Tuesday, April 29, 2008

Drink the whiskey, play the tango, dance the foxtrot

My office continues to offer crazy benefits, the latest being a truly spectacular boost in our fitness options. My last gym membership lapsed after last year's unpleasantness and my apartment's gym was designed by a bunch of guys from Spart, so yesterday I hied me over to the spendiest of the downtown gyms and flung myself at the sales manager to plead for a tour.

So let's see, what've we got here? Right, multiple racks of treadmills, yes yes, very nice. Lots of bikes with TVs and programmable rides, those are good too. Yoga and spinning studios with HD sets that allow you to punch up your choice of classes when a live teacher is not available, ooh, plush. A sign-up board to manage crowding on the cardio machines, yeah, I'll be coming back to see how well that works at peak times. Hey, there's one of those current-generating pools so that you can pretend you're a salmon heading toward a hot date in the Eagle River, neat. Steam and sauna rooms, bless. Aaand, the piece de resistance, a tanning booth.

Wait, a tanning booth? A tanning booth. You are seriously...no, come on, stop screwing with me. You've got a redacted TANNING BOOTH? A tanning booth, IN your house of healthy goodness, where trans fats are barred from the cafe and subcutaneous fat from the members. All I can say is, if that thing doesn't dispense malt liquor and unfiltered off-market Russian cigarettes, I am going to be very disappointed.

Monday, April 28, 2008

Earn your spurs

Although he wouldn't have been my pick to play Aragorn in the Lord of the Rings movies, ain't no denyin' that Viggo Mortensen is a horseman through and through, that rare modern actor who can ride well. It was just a tiny bit distracting that he was the only rider in the Rohirrim scenes whose horse was collected into a classical frame. There have been plenty of equine glitches in modern movies, like the final scene of "Hidalgo" (itself a terribly cheesy flick) in which the title pony is released to join his wild brethren and takes off after them, showing his...ach, damn, showing his neatly shod heels, the moral equivalent of showing Queen Elizabeth I with braces, but you can't fault Mortensen's work in the saddle.

The fact that he is in a position to grant wishes for his fellow fanatics behind the scenes is really just icing on the cake.

Friday, April 25, 2008

Con su flor en la boca and my 10 blade in his trachea

Gala Theater's "Blood Wedding" was such a fun trip back to halcyon days of minoring in la bella lengua. You absolutely cannot accuse Federico of ever having been too subtle, what with Leonardo riding his great big sweating horse hither and yon in search of stolen moments with La Novia, while the chilly Luna keens about how she wishes she were able to warm her hands in the hot blood of a human heart, and Gala didn't try to minimize any of the fantasy in the interests of realism. The flamenco trio who performed in the first half almost overshadowed the rest of the production—bring back the guitarist! more stamping!—but were balanced out by a great arrangement of the woodcutters' song in the second act, where three peripheral characters sing a lament to the moon, asking her to leave some shadows where the lovers can hide. She doesn't. It ends badly.

Continuing the cantata in the key of goooooore, this week's mini-med course was on non-cardiac thoracic surgery. I've always heard that surgeons are the fighter pilots of the medical world, all ego and strut and absolutely bugger-all in terms of personal skills, and mostly I haven't been able to argue. This week's presenter clearly loved, oh but I mean LOVED, her job, but she was also weirdly charismatic (and gorgeous and raising twins on her own and a fine arts grad and able to do plumbing work on her 1865 house during her residency and oh God I've wasted my life). She explained how open-chest surgery became possible with the development of the ventilator, then she kind of took a sharp left turn and from then on we were all sitting in stunned silence as she ran us through at least five different major operations, including tracheal reductions, bronchial lobectomies, arterial reconstructions, esophageal reconstructions, and tumor excisions, complete with CT scans (which she made comprehensible, a neat trick), graphic photos, a couple of videos. I especially liked one video—an esophageal operation, maybe—where she could clearly be heard snapping, "I don't care, I don't care." She looked a bit embarrassed and said, "I only care about important things when I'm doing surgery." Other memorable lines included, "The aorta is tough, like kevlar. The pulmonary artery, though, it's like American cheese. Rips if you look at it," and of course, "Wow, I wish I could go on Letterman for this one. I can sever a trachea at the neck, extract it from below, and reach up to wave at you through the hiatal space." Surgeon humor.

The biggest surprise for me personally was that I could watch the slides at all. Blood and lymph and exposed innards, no thanks, usually, but she had the gift of showing all the squishy bits as structures. I was fascinated by the engineering of certain neat surgical tricks, like how to remove a giant tumor during a laparoscopic operation: You detach it from the surrounding structures, put it in a ziplocky bag inside the body cavity, then snip the mass into bits, seal the bag, and ooze the whole thing out like a sausage. How sneaky! How clever! How I hope I never need that myself! And oh sweet God that teratoma is going to eat my dreams. She wrapped up with a look at the seriously dire fall in the number of cardiothoracic fellows; it's one of the few specialties that's experiencing negative growth, and part of the problem is the hours and the difficulty of training people in such potentially serious areas. She's working with the med students to use her ingenious plaster/bovine/banana-prophylactic models to introduce basic surgeries, but since they won't be fully grown surgeons for 10 (!) more years, there are going to be some very lean years. We may've come out of the class starry-eyed and thinking that surgery looks like, OMG, super fun, but I doubt anyone really wants me trying to figure out how to use a rib spreader.

Thursday, April 24, 2008

Get off my lawn!

One of my coworkers has done gone insane decided to do the National Triathlon, in collaboration with the Leukemia and Lymphoma Society's Team in Training. Which means that she's going to swim in the actual Potomac River. Freely and of her own volition, she's going in that water, and she doesn't even get to keep the money. Talk about going above and beyond.

I'm impressed by her resolve and I have a dog or two in the fight to cure blood cancers, so I'm asking people to visit her page and consider adding a few dollars to the jar. Help Tiffanie fight the good fight!

Wednesday, April 23, 2008

"Don't buy this gum, it tastes like rubber"

More to come on last night's mini-med lecture, which was fantastic and fun and strangely sexy in a "wow I want to be a pilot because I just saw 'Top Gun'" sort of way, but I want to mention the absolute zenith, which was a series of photos of the practice version of an aortic valve replacement our presenter had MacGyver'd up out of a plaster cast, a cow's pulmonary artery, and a banana-flavored condom.

Tuesday, April 22, 2008

En breve: vade retro, Satanas

The miniature cupcakes from Sticky Fingers that my office has set out may be vegan and low-fat and save puppies and turn birdsong into pure nonpolluting solar energy for all I know, but they are still full of sugar and I have no power to resist their siren song. Make them go awaaaaaaaaaay.

Friday, April 18, 2008

Bullet-form update

Summarizing:
  • Dressage: Laura remains huge and slow, the heavily shedding glacier of our class. I am a little faster with the whip this time and she gives me better energy, but the bending exercises remain a challenge. I leave limping, hip a-grumble and legs a-sore. "She reminds me of something," says Pat. "Or someone." "A big old lady in house slippers?" "HA. Yes." Even mares of a certain age need yoga, though, and dressage-bound she will stay.
  • Western: Chock with dread, I nonetheless return, making a last-ditch attempt to be a good student. Molly, my partner for the day, still refuses to turn right, shoving her head out and bolting toward Sterling whenever I cue for a bend. We try bending her at the walk, at the jog, facing this way, facing that. No joy. She wants to be with him, he is her one true love. We try having her follow him through a figure-eight pattern around two barrels; she will follow him around barrels, but then she figures out that she'd rather cut across and stand by his side to face the world. He is disdainful but doesn't threaten her the way he does other geldings or higher-status mares. Eventually we teach her a cloverleaf pattern, and I stop before each barrel, gather in the inside rein, and don't move her until I've got her pointing her nose inward. This, to my surprise and delight, works. She can turn right! It's hard to tell which of us is more shocked.
  • Western, the switchening: Sterling's mom and I switch mounts for a few minutes so that I can ride a horse who doesn't have problems turning. Instead I get a horse who eels from side to side with my breathing, as hyperresponsive as a glider in an updraft. I ask for the trot, and he wobbles off, not at all sure why his mom isn't running the show. His trot jolts me out of the saddle with every step, and he responds to my jiggling by moving into a floating canter I could happily ride for days. "Slow him down! Circle him!" calls Mk II. I don't want to, but I do. I'm grinning like an idiot. I ask Sterling's mom how she manages to sit that jog. She rolls her eyes, shakes her head. "Oh, it's only taken me four years to learn how. You've just got to sit and sit and sit." Fun in Western again. I had given up.

Wednesday, April 16, 2008

Ayurveda to rumble?

Last night's mini-med lecture was the one I was most unsure about, because while cellular processes and chemical reactions are fun and games, is complementary and alternative medicine really science? Despite my yoga-doin', massage-gittin', biofeedback-slightly-creditin' ways, stuff like reiki and homeopathy still gets the full eyebrow of dubiousness.

But the woman who presented the lecture is used to getting a similar look from med students throughout a full semester, so she was undaunted. After covering the history of the NCCAM (shriek about your tax dollars if you wish, but Americans spend about $27 billion on CAM each year; a little investigation into whether any of it actually works wouldn't hurt), she ran through short descriptions of a bunch of different modalities, including homeopathy, naturopathy, traditional Chinese medicine, acupuncture distinct from TCM, the forms of yoga that aren't asanas, ayurveda, and traditional Greek "take two humors and call me in the morning" medicine. The proselytizing I was half expecting never materialized; she simply described each discipline and a bit of its history, then moved on, apologizing occasionally that condensing a semester's worth of material into two hours meant giving some questions short shrift. In the last 10 minutes, she presented some of her preliminary statistical results on using homeopathic saw palmetto to treat prostate cancer and on mind-body treatments for stress among med students, both tentatively positive.

I'm not convinced that understanding what throws the yellow bile upon the black is likely to provide major medical breakthroughs, or that homeopathy is anything but the placebo effect in expensive action. Still, encouraging a focus on prevention, on treating people rather than symptoms, and on making it easier for everyone to take an active role in managing their health could stand to be integrated into the medical culture. The world would be a happier place if more of us got massages covered by insurance.

Monday, April 14, 2008

Checking kites


Kite pics! Photographic evidence to the contrary, I don't wear my stripey Hot Topic-esque gloves all the time, just when it's chilly and I'll need manual dexterity but can't rationalize wearing my riding gloves, or when I'm being very juvenile. Both applicable here.

I spent a quiet weekend, after a long cafe dinner with friends on Friday, napping and cleaning and mulling over what to do about the situation with Teacherwoman Mk II. It seems increasingly likely that I'll end up dropping her class, which will mean having gone from three hours of saddle work a week to one, unless I find another local barn that suits me. The odds of finding another Western class are slim, but more English work, even jumping, would still let me keep the appropriate leg tone and flexibility. Riding is supposed to be fun, and for the last month or so I've had dressage classes that were fantastic, followed the next night by Western classes that have left me wretched with frustration. That's not to say that dressage has been easy and that everything I've tried has worked, but each time I've come out thinking, "Okay, so that worked and this didn't. Next time we can work on this and make sure not to lose that." (God knows what the horses have been thinking, although for Cappi it's probably some variant on, "Sup-sup-suppertiiiiiime!") In Western, though, I feel like I've regressed; all I can think about when I leave is how many things we couldn't do right. Last week was a low point and is forcing me to reevaluate what I'm getting out of the classes versus what I want. Mk II knows how to ride, and many students really enjoy her classes, but she and I may be too similar in all the wrong ways—we're both acerbic, analytical, impatient, sharper-tongued than we mean to be—to work well together as student and teacher.

But lest I leave on a note of repining: The Dupont Circle Farmers Market gave me something of a boost. Not only were there Stayman apples (hey, if Eve fell for them what hope do the rest of us have), there was a bluegrass quartet singing something oddly familiar. "And if fate/ Should break my stride/ Then I give you my Vincent/ To ride." Why do I know that song oh my GOD I know that song! A girl could feel special.

Sunday, April 13, 2008

You may well say gee, young man

I may need to buy a gun. Phased plasma rifle in the forty-watt range? Yeah, this one's ideal for home defense.

The more I read on Hello Kitty Hell, the more freaked-out I get. Really? REALLY? You've got to be joking. And so on. Makes Beeblebears look positively normal.

Saturday, April 12, 2008

Ain't love the sweetest thing

"Love is without envy or jealousy." AS IF.

Friday, April 11, 2008

Bitter experience?

I'm rereading The Citadel of the Autarch (which Wikipedia contends was once misprinted as The Castle of the Otter) and savoring, as always, the illusion that I will someday understand exactly what is going on in the story. In the meantime, I enjoy Severian's company. Damn but Gene Wolfe can write.
Since the time I had ridden Vodalus's charger out of Saltus, I had supposed in my innocence that all mounts might be divided into two sorts: the highbred and swift, and the cold-blooded and slow. The better, I thought, ran with the graceful ease, almost, of a coursing cat; the worse moved so tardily that it hardly mattered how they did it. It used to be a maxim of one of Thecla's tutors that all two-valued systems are false, and I discovered on that ride a new respect for him. My benefactor's mount belonged to that third class (which I have since discovered is fairly extensive) comprising those animals that outrace the birds but seem to run with legs of iron upon a road of stone. Men have numberless advantages over women and for that reason are rightly charged to protect them, yet there is one great one women may boast over men: No woman has ever had her organs of generation crushed between her own pelvis and the bony spine of one of these galloping brutes. That happened to me twenty or thirty times before we reined up, and when I slid over the crupper at last and leaped aside to dodge a kick, I was in no very good mood.

Wednesday, April 9, 2008

In the taste confounds the appetite

Last night's class was presented by another first-time mini-med speaker. Unlike last week's presenter, however, this one stuck pretty well to the order of slides as distributed in the class packet (thank you, sir) and had left himself enough time to get through all the material and still have a decent Q&A. He also seemed more at ease, connecting with the audience and answering questions without being brusque. If his manner during the class is indicative of his interactions with patients, his practice must do well.

God knows it's probably growing, because he's an endocrinologist specializing in diabetes, the topic of last night's lecture and an, er, expanding field in its own right. The doc covered the clinical and therapeutic differences between Type 1 and Type 2 diabetes (the first involving complete and apparently spontaneous failure of the insulin-producing beta cells; the second, once known as adult-onset diabetes, involving a slower progression from insulin resistance to complete beta-cell failure, and strongly statistically correlated with weight gain), the definitions of prediabetes versus full diabetes, how the disease rates have changed over time, what therapies are available, and how regimens have been adapted to cope with shifting disease patterns. He emphasized that most of the increase in Type 2 is lifestyle driven, and although I was a smidge disappointed that he didn't mention our borked-up food distribution system, which IMO is responsible for many of our dysfunctional eating patterns, he did advocate much wider access to gyms and nutritional counseling. Questions from the audience included whether Lipitor is associated with weight gain, because everyone in the questioner's family who has taken it has also put on pounds (response: sorry, this is a case where correlation != causality); why some physicians worry that insulin is associated with cardiovascular disease (response: incorrect data were presented by a high-profile physician, and although the numbers have since been refuted, not everybody got the news); and why fatty fat fatties don't just stop being so fat (from, of course, That One Guy, who needs to shut up so hard; formal response: it takes a lot of work and commitment that many of us find difficult to maintain).

My only quibble, come to think, is that the presenter was so pleasant and positive that the scale of the problem may not have come through. Unless our health care system, food network, and overall cultural attitude toward exercise change drastically, the number of people with diabetes is going to continue to rise. Pharma companies can make stupid money off treating diabetes—it is largely a disease of wealthy societies, after all, although genetic predisposition plays a significant role—so while we may see increased funding for medicating diabetes, coordinating efforts for preventing the disease from ever developing are tricky. It's a lot easier to fund a drug than it is to make a city's layout safe and accessible for bicyclists and pedestrians and to make fresh food more affordable and appealing than preservative-laden packaged stuff.

It was a cool spring night when we stepped out of class, so I walked the two miles back to Dupont rather than waiting for a bus. Truncal obesity begone! Integrating exercise into daily life, yay! Today my hip registers a protest at all that strolling in nonsupportive shoes. Damn, it's always something.

Tuesday, April 8, 2008

Certainties

Death, taxes,...and Eurovision. There is no escape from the power of this fully armed and operational festival of continental WTF. Ayyyyy!

Also, Neil Gaiman is twelve.

Monday, April 7, 2008

You got the thorns, babe

So apparently I have no Elvis in my soul, because this weekend I found another country group to like. The Wrights don't even have the decency to call themselves alt-country, a face-saving genre label that allows the good urban child to pretend that she doesn't sometimes like a little steel guitar. Nope, they're the straight-up thing, although on Saturday they didn't have any backup, just their two guitars and voices, sounding less Opry-commercial and more bluesy, with a fine polish to their vocals. I missed the first part of their set, because c'mon, who shows up on time for the opening act? Oops. Be ye not so foolish. There are lots of love songs out there, but slow slinky call-and-response two-steps about the first year of marriage are thin on the ground.
(Him) You’re like some child always playin’ your games
(Her) And I never knew a man who could be so wrong
(Him) I’m warnin’ you honey if that’s your real name
(Her) You can call me whatever you want when I’m gone
(Both) We’re on the rocks
On the rocks

(Him) I don’t know why I made you my baby
(Her) Who you callin’ baby you made me your wife
(Him) Some best man he didn’t even try to save me
(Her) I can’t believe I gotta spend the rest of my life
(Both) On the rocks
On the rocks

Saturday, April 5, 2008

For this relief much thanks

I spent the last few days progressively getting more and more worked up over a commitment I made to join a friend at a photo shoot, so it was with glee that I read an e-mail from the photographer last night, canceling on account of rain (which has not materialized either, so yay!). Initially, goofing around all "I do want to be America's Next. Top. Model" sounded like a lot of fun, but then for some reason I started getting a little wrapped around the axle about the whole idea. Now officially off the hook (not da hook) about it, I can also luxuriate in the joy that is knowing it is not, in fact, necessary to get up before the sun on a Saturday. Sleep late and drink strong coffee and curse the acrostic! Rock.

The other glee has come from rewatching McCain get heckled at his Memphis speech earlier this week week. You could admire the man's chutzpah for showing up on the anniversary of MLK's death, given that in 1983 he voted against the institution of a federal MLK memorial day, that he backed AZ governor Mecham's 1987 decision to rescind the holiday at the state level, and that he didn't peep when Mecham defended the use of a fairly hateful word for minorities (cites, linked through a common page), but then it's probably not so much nerve as either blissful obliviousness or flat-out pandering. As such, the crowd's response is more polite than he deserves. Let's hope the people in the audience also politely vote his ass to the curb in November.

Wednesday, April 2, 2008

Does what it says on the tin

This morning the dermatologist swapped me a little dermis for two tiny stitches and a warning not to lift heavy objects or twist around too much for the next few days. Hoisting weighty things in a torque-wise manner is probably out, putting paid to the idea of tacking up a horse tonight or tomorrow. I could always ask someone else to do the pregame work, but then there's mounting up and the near-certainty that something would go wrong in a way that called for twisting, so after a little inner struggle I gave up and canceled my lessons for the week. I am grumpy but lack the nerve to face down the RN if I were to bust a suture by, say, wrestling with Okie's right-turn issues. So, apologies: no horse gossip this week. To make up for it, here are a few objects of coveting. Secret Santa presentations cheerfully considered.

Last night's mini-med presentation on NSAIDs was a general disappointment. The presenter was new to the program and hadn't planned the lecture very well, so we spent a lot of time flipping back and forth in the enormous packet of slides and being given tantalizing glimpses of information there wasn't time to address. Some of the presentation was borderline insulting, including the reading aloud of a printed list of NSAIDs on the market, and some was overly technical given the audience. Not quite nul points, because she included some interesting material on why the COX-2 inhibitors were put on the market (and why they're being pulled) and some fascinating data showing that the pain relief from opiate-NSAID combos is inferior to that of some prescription NSAIDs alone, but overall it was a little scattershot and not the best use of two hours. My favorite Q&A moment involved someone demanding to know why the pain-relieving effect of leech bites had not been discussed. Was it because the FDA hasn't approved them for use and the medical institution is biased against alternative therapies? The presenter just looked at her blankly for a second and said, "No, it's because they're not NSAIDs." Hee! (Pedantic NB: Leeches are, in fact, approved for use in U.S. medical facilities, although not specifically as analgesics, and were the first live-critter medical devices approved by the FDA. Maggots were the second. Disgusting medical knowledge, heyah, GETcher disgusting medical knowledge.)

Tuesday, April 1, 2008

Between the covers redux

The things we find in our old e-mail. I had forgotten this. Seeing it again is just.... Oh dear. Oh my. Oh goodness. I mean really.
SFW, except if you drool.

LOLsiblings

Determined Seesterperson is determined.