Tuesday, March 18, 2014

Magical

And it's March. Halfway through, actually. It's still mostly cold which is just frankly weird for Austin.  I'm starting to get the hang of things at work, mostly learning my way around the electronic charting system and all the little special stuff. Things like, I finally had a patient that needed labs drawn and I didn't know where the forms were. I wanted to refer another for a sleep study and didn't know who was preferred for that. One of the quirks of this practice (which is actually smart) is that the initial meeting is always a consultation and we haven't entered into a treatment relationship yet. This gives us the option to decide that we don't accept a client. That finally happened to me. Basically, I was out of my league completely - no specifics, but quite severe and chronic illness, many attempts to get help, many medications tried, all to no avail. So a new grad can help you? I asked. The client gave me a nasty laugh -- oh, I'm only here because my parents insisted. Well, that kind of clinched it. There's no therapeutic alliance present, and this is simply doomed. Oh, and I almost forgot...the only drug that's ever worked is something highly abused. Right. Let me whip out that Rx pad, just a min. But interestingly, it still bothered me. This person clearly needs help. And I can't provide it.

My daughter is in New York for Spring Break. It's an interesting feeling to have a child so grown up she can can plan and execute a trip alone to the City. I'm really glad that she's kept in touch with her NYU friends. And she's staying with my fantasy son-in-law, a nice Jewish boy whose dad is a producer/screenwriter in Hollywood. He stayed with us for a week last summer for the Austin experience. Alas, she says they're just friends. She rented a little Soho apartment and then cooked dinner for her friends. Look. Yep, that's Turkish/Lebanese food. Our favorite.


I went to a retirement party for a woman I worked at Exxon with for years. She had the office next door to me for about the last 5 years I was there, when she wasn't traveling the globe. I think she was one of only 3 systems architects for the entire Refining division. Very successful, and single, no kids. It was a lovely party, at Damien's in Houston. Great food, I had scallops. I saw people I had not seen since 2005, when I left to become a nurse. And yes, most of them had not aged well. Exxon does not have a culture that encourages self-care - one of the reasons I left - but some people looked remarkably the same and still others seemed really happy (some of those were retired!). I'm not real big on reunions -- but Suzanne was special to me and I wanted to see her.

And speaking of reunions, I had a great meeting with the office of UT's employee assistance program, and I think I'll be able to partner with them to see their patients that need medication. They are looking for a provider who can see people promptly and collaborate with them, and that is something I'd like. We'd have monthly meetings to go over cases and that would be a little something extra that I'm not getting in private practice. Oh, I have been calling the therapists of some of my patients to compare diagnostic impressions, but those little doses of collaboration are brief. This would be more. I remembered something when I was there, meeting with all the therapists - when I was a freshman Business student at UT in 1980, I got a work-study job at the Counseling Center. And here I am, back again, as a provider. I never could've predicted that. Isn't life surprising? Wonderful. Magical. When a patient looks at me alone in my office, with tears in their eyes, and admits to me their deepest wish, or secret they've never shared....I feel that magic.

L'Wren Scott killed herself. I saw it on the twittersphere last night and just could not believe it. Such a young talented person who seemed to have this charmed existence. A celebrated designer, wealthy (apparently), Mick Jagger's girlfriend by god....how does that add up to miserable? Well, it's certainly an example of how mental illness doesn't discriminate. In my opinion, almost every suicide is in a severe depression. There are a few other instances where people choose that route, but in most cases it's the deep, dark pit. It made me intensely sad. I thought of Alexander McQueen, an even larger talent when he decided to end things. Dani got to see his Met exhibition and she had the glossy book of photographs of his creations....such incredible beauty. And often fragile, not of this world. As he was. And L'Wren.

Yesterday I had a suicidal patient so that pretty much ruined my day. Not that I minded - I never mind doing what's needed in such cases - but there's a great deal of extra work involved. On top of a very busy day. So I was at work until 7:45, long after everyone else had left. Then a comedy of errors began. I wouldn't have believed it, but here's what happened. I had left my phone at home, which was weird but oh well. My office has no place to store my purse securely so I lock it up in the front office. I often leave patients alone on my couch as I run down the hall to consult with my doctor, and it's just foolish to leave valuables sitting there. So, yes, when I finished up alone, so late, I discovered everyone had left, locked up the front and I didn't have my purse. Great. I didn't have my phone, didn't have anyone's number to call. Who memorizes numbers any more? Not me. I finally figured out I could call the answering service for our office and the other NP, who is on call this week, would answer me. I'd ask her to come back and help me. And know what? They F'ing suck. I called them, they refused to give me any information like home phone numbers, guess they thought I was a liar or something, said that they would just pass the message on. I called them back 3 times, got a different person every time who knew nothing. Finally I gave up and called my momma (really) -- and I hear the cleaning people next door. They let me in with their master key. It's 8:30 by now but I can leave. JFC. So many procedures that need to be fixed. Guess things ain't perfect after all. And guess what? The other NP finally texts me back at 11:30 last night. What the hell?


There's this guy at the gym, I call him Tattooed Love Boy, like the Pretenders song, he is older, big and muscular and bald and yes, heavily tattooed. Good looking guy. He is not a newbie, he's not there every morning with us regulars, but several times a week. And he does his dumbbell sets right in front of the rack, effectively blocking me from getting the weights I need while he grunts and sweats. He should know better - such a breach of gym etiquette. But I finally figured something out. He does it when I'm there by the rack, doing my sets. He steps back when it's just guys around, but when one of the women are there, he's all up in our grill. He's doing it on purpose. I guess he thinks it's a way to spark conversation. He must be shy or something. But know what? It just annoys me. I think if he worked up the nerve to say something, I would snap at him: "What the hell is wrong with you?" Somehow, I doubt that's what he's hoping for.