Our house

A photo tour of our daily life:

I have been asked to provide pictures of where we live. Our street is a pot-holed, shady lane. You often have to make the choice between hitting a pothole or a pedestrian when driving, so its best to go slow. We live across the street from a Korean church (see picture below. I don't really know what religion), so on Sundays, there's always little kids racing around in the parking lot.

Our across-the-street neighbor has two great danes and a construction company named after them. The house is adorable.

Our house is a 1000 square foot little bungalow on almost 1/2 acre with a huge pine tree in the backyard. We rent it for $950/mo, and our landlady loves dogs and fixes problems immediately. Our neighbors are friendly. We are biking distance to our favorite local supermarket and less than a mile to UofO.

The inside is cute, and we spend 99% of our time in front of the pellet stove. Brina spends her time scrounging leftovers.

And here's some pics of the time we aren't in front of the pellet stove. :)

love you all!

Complications

Picture is of two Mexican dogs that pulled through and have great homes. They remind me why I do what I do.

I have just finished a book called Complications: A Surgeon's Notes on an Imperfect Science, by Atul Gawande. He says, "It is because intuition sometimes succeeds that we don't know what to do with it. Such successes are not quite the result of logical thinking. But they are not the results of mere luck, either." I call it the 'Gestalt' of medicine (I stole that from the Gestalt of bird watching, but I think the concept can be applied to nearly any field. It has to do with listening to your gut.)

Gestalt: a structure, configuration, or pattern of physical, biological, or psychological phenomena so integrated as to constitute a functional unit with properties not derivable by summation of its parts. What this really means is: when you see a square, you recognize it as a square. You don't have to compute mentally the four lines that comprise the square before proclaiming it as a square. People want doctors and veterinarians to be masters of Gestaltism. See sick animal and proclaim, "pancreatitis!" without any further ado.

But, medicine is not cut-and-dry. For example, a cat had come in to see me for ADR (Ain't doin' right). The cat was somewhat feral and would tolerate only a superficial exam before coming at me, teeth-bared and claws slashing. My superficial exam revealed only moderate ear infections, possibly ear mites, and nothing else. We had a choice to make.

Were this my cat, I would treat with antibiotics and ear meds for a few days and see if the symptoms resolved. I would be knowingly taking a chance that the cat would get worse or even die due to the lack of a complete exam. I offered the owner two options: 1. we anesthetize the cat for a full workup or 2. we try the medications. The owner said, "You're the doctor. You know best."

In vet school, as in med school, we are taught "Primum non nocere," which means "First, do no harm." I knew with the sub-optimal anesthesia we'd be forced to use on this whirling dirvish, a certain amount of harm would be unavoidable. I suspected, in my gut, that this cat was having a few "off" days and would rally if his ears were treated. I decided to listen to that impulse. I squared my shoulders and told the owner I'd recommend trial treatment for no longer than two days; if at that point the cat was still feeling puny, we'd anesthetize and continue diagnostics. We did so, and the cat, on the last call-back, was doing great. Thank goodness.

The owner's assumption that I should be able to decide the course of action because I am the "doctor" is essentially a human paradigm: the doctor knows best. However, human patients can be examined; feral cats cannot. When I, with my DVM, peer at a growling ADR feline through Have-A-Heart trap cage bars, I do not see any more of the pathology than the owner does. I see a pissed-off cat with sharp bacteria-laden canines and the potential to do some serious damage to me and my staff (think hospitalization and IV antibiotics and large WC claims). Due to my lack of xray vision, I often put the onus back on the owner to decide the risk vs. the benefit. Should we risk the anesthesia in order to take samples, examine, and treat? Or should we decrease stress (and therefore avoid depressing immune function) by sending the pet home with a barage of empirical treatments?

This is the Gestalt of veterinary medicine, the sum of all the clinical signs and tests and findings. When is the risk worth the benefit? When do you push a client towards spending money on diagnostics and when do you support them in their choice to try the less-expensive Option B? When do you say definitively, "This dog needs $2000 worth of emergency surgery!" vs. waiting it out to see if the situation improves?

I read occasionally on the internet (masochistic, I know) about how vets should be like doctors. We should be able to prescribe medications for ailments without running every test in the book. I had an older couple who brought their ancient Labrador in for me to determine what was causing her to vomit. I examined her, described what I thought might be going on, and asked permission to get some radiographs. The elderly owners looked down at me as I sat stroking their dog's head in my lap, and said, not unkindly, "Our old doc used to be able to just look at our animals and know what was wrong. I guess they don't teach you young doctors that in school anymore, eh?" With my heart dropping, I said, "No, that's a specific talent that I still don't have." My boss, bless him, laughed when I told him this story, and told me that after 40 years in practice, he didn't have that talent either.

As I spend time in the field, I have started to develop a certain model of practice that allows me eventually to find the Gestalt of a particular case. Some days, my gut instincts diagnose correctly right-and-left, and I am left euphoric at the end of the day. Veterinary superhero! But, most days, I am confronted repeately with the fact that my best guess is not good enough, and many times, takes me further from the truth. And I have pledged: Primum non nocere. So, dutifully, I use my diagnostics first, running radiographs and blood work, doing ultrasounds and surgery. When all the results point fuzzily in different directions, I call almost spiritually on the Gestalt of veterinary medicine (and the specialists on VIN) to guide me towards the most likely path. Like Atul Gawande says, medicine is an "imperfect science," and I am unfortunately an imperfect veterinarian.

"The thing that still startles me is how fundamentally human an endeavor it is. Usually, when we think about medicine and its remarkable abilities, what comes to mind is the science and all it has given us to fight sickness and misery: the tests, the machines, the drugs, the procedures. And without question, these are at the center of virtually everything medicine achieves. But we rarely see how it all actually works. You have a cough that won't go away - and then? It's not science you call upon but a doctor. A doctor with good days and bad days. A doctor with a weird laugh and a bad haircut. A doctor with three other patients to see and, inevitably, gaps in what he knows and skills he's still trying to learn."

Angry lesbian music

"I'm proud of the fact that I'm worse than I seem." - Ani D.

My wonderful husband, Peter, actually bought us Ani Difranco tickets.

Let me repeat that.

My husband, who never fails to show his utter disgust when I play...in his words..."Angry Lesbian Music," took the initiative and bought the tickets. If he had not done this, I would have awakened sometime mid-May, with a start, out of my general time-line haze, and said, "We should get those Ani Difranco tickets!" And Peter would have softly broken it to me that she had come and gone. Instead of this kind of travesty, Pete just bought them. Two of them.

The show started at 8 pm tonight, but I was late coming home from work, and poor Peter was left to collect our tickets alone at will-call amidst all the Angry Lesbians. I fretted for him a little, I admit, because he's a guy's guy, and an Ani Difranco concert is a guy's guy's version of Hell. Turns out he did okay though. There were a few Angry Lesbians, but I'm often an Angry Straight Lady, and so I think Pete found himself in surprisingly familiar (if not slightly more forgiving) territory.

And Ani absolutely rocked. Seriously. "Men make angry music and it's called rock-and-roll; women include anger in their vocabulary and suddenly they're angry and militant." How true is that? Look at rap, for God's sake. Well, tonight, she talked a little about patriarchy, and she said the word "tampon" once in a song, which made Pete bristle a little, but in general she just seemed passionate, about her music, about the crowd, about the time and place. This type of unbridled enthusiasm really gets a crowd going. That, and the old hits, like Firedoor and Napolean and Shameless.

Pete agreed. He said she was a good guitar player. Kudos from a straight male, right?

My other good friend named Peter, Lexie's dad, once wrote beautifully that "Anger has no place in my private pantheon." (I hope that's a correct quote.) He is a wholly peaceful person so the statement rings honest and true coming from him. I remember thinking, "Why I do feel it has an important place in mine? Why am I so attached to its presence?" I would love to be the kind of person off whom injustices roll like water off a duck's back. And it started to bug me more than it should have (metaphorically, as David Wilcox would say), not just that I felt anger, but that I relished well-written homages to the concept of Anger. Intentionally with a capital A. I tried to adopt Peter G's ideology, but I mourned the loss of my attitude problem. I've always had more than one personality, and my Hippie Lovechild loses to my Angry Lesbian every time.

I've since realized two things. 1. Women love Ani not because she is angry, but because she is so good at verbalizing (and validating) the feelings that all women have had at one time or another. and 2. There is nothing destructive about verbalizing hidden angst. It's really when the angst is hidden and stealthy that is truly dangerous. (I realize that's not true for large organizations like the Taliban (please imagine Sarcastic Liz at this point). Those of you smart people who are looking to blow holes in my theories, hold your tongues. I just beat you to the punch anyway.)

Here's a quote: "I myself have never been able to find out precisely what feminism is: I only know that people call me a feminist whenever I express sentiments that differentiate me from a doormat, or a prostitute." --Rebecca West, 1913. That's how I feel about this level of anger. I try to hover somewhere healthy between complacency and hostility. But, if I need to get loud and bitchy to keep from being stepped on, so be it.

(Johanna, for the record, I realize you are now getting your hackles up because you think this whole discussion is stupid, and feminism is stupid, and Ani Difranco is stupid, and Vermont sucks. You're so irritated by this that you almost want to start your own anti-blog. I love you anyway.)

Well, I'm off to bed. I have to remove a Pug's eyeball tomorrow and I need my beauty rest.
Love and sweet dreams to everyone.

Support the Nature Conservancy

Saturday market!

Almost two whole months in Oregon, almost two whole years of being married. Time flies!Despite moving to an area with inclement weather, Pete and I have found ourselves outside more, laughing more, walking the dog more, riding bikes more, and God Bless Eugene, they have a farmer's market every Saturday! Last weekend, in the rain, we went to the market and bought Happy Chicken Eggs (The label says: "Happy Chicken Eggs. From Free Ranging Girls."). I stood amidst the daffodils, honey, goat cheese, and endless piles of salad greens and cried. I felt at home. After almost two years in the high desert of Nevada, I felt rehydrated. There are flowers here and everything, attitudes included, is softer. The sign on the grass said, "Please allow the grass time to recuperate." Anyone who knows me knows I love reverence of life and the environment; we are absolutely surrounded by it here. We are also surrounded by 100% certified organic lunatics, which makes things like farmer's markets that much more fun.

Today, we went to the market again, only it was 70 degrees Fahrenheit and sunny. There was a Mexican guy singing mostly Beatles songs with an occasional Sublime hit thrown in. There was a bluegrass band and an old lady singing to the children (all of whom were supplied with various things to bang on for rhythm). Kids were grappling for the samples. Every baked good is filled with marionberries, and we bought a pie ($13.00). We spent WAY too much on line-caught, never-frozen, freshly-canned albacore tuna (2 cans). A tub of goat cheese, a bunch of dried chile peppers, a jar of jalepeno/marionberry jelly, a pound of locally produced italian sausage, and some cilantro and dried fruit rolls later, we found ourselves $90 poorer. There is no more satisfying way to spend money than to hand it over directly to those who made the goods.

The characters at the market are the best part. I watched a hippie with dreads roll in on his single speed bike with his dog in tow, and as he reached the center square, he whispered quietly to his dog, "This is the place, man." The dog was 100 years old, stiff in the joints and long in the tooth, and he for all the world looked like he understood exactly the point. They pushed off, bike and dog both creaking and a little on the slow side. There was a requisite "Let us pray for your soul" booth, as well as about 4000 "Support Obama" booths. There was an old sun-weathered woman with a backpack busting at the seams with tulips. There was a tan man with a mustache and coke-bottle glasses wearing a huge red balloon hat, creating balloon creatures and apparel for a gaggle of swawking children.

You Portsmouth folk: imagine Market Square Day times 10 and recurrent every Saturday at 10 am. That much chaos. People just walking around with big smiles carrying bouquets of flowers and baskets filled with fresh seasonal produce.

Tonight we are off to the Very Little Theatre to see a Tom Stoppard play called "On the Razzle." Does it get any better?

Love to everyone,
Liz