Thursday, October 25, 2012

high-maintenance

I remember watching When Harry Met Sally and being horrified at one scene. Absolutely horrified.

No, not that scene. This one.



I decided that I was not going to be high-maintenance. Ever.

Or at least not on a regular basis.

But now I am! And I hate it.

This is the way I have to order at our favorite Mexican restaurant: "I would like the Juarez Combo but I want the chicken taco to be in a soft corn tortilla, I want the cheese enchilada to be a chicken enchilada with no sauce, I want the tostada to not have any meat sauce or cheese and the beans to have no cheese on them."

The only thing on my plate that is not changed is the rice.

Needless to say, we are pretty memorable to the waitstaff which is why we try to get our usual waiter (honestly, if our usual waiter isn't there, I get fajitas because the only thing to change then is the tortillas).

Lest you think I only inconvenience others, I have to confess that I also have had to go shampoo free.

No, I do wash my hair but it is with either castille soap or homemade shampoo (made with castille soap). I would much rather that my hair smell of vanilla or flowers but I get tea tree oil or peppermint. sigh.

For the past several years (10 or more) I have had to use dandruff shampoo in the winter because my scalp would get dry and itchy. In the summer I could use whichever one I liked without a problem, but each winter it was back to dandruff shampoos.

A little over a year ago, my scalp problems got much worse. Last winter I tried every medicated shampoo I could find and I still had raw spots on my scalp.

Raw spots from scratching.

I have colored my hair since I was 13 (only about 2 years total since that I have been my "natural" color). Coloring my hair was horribly painful but it did seem to help my scalp be less itchy.

Seriously, the horrible chemicals in hair color solution would improve my scalp.

Last January, I realized that part of it is gluten-related. I am not sure if going to Burger King and having a burger and onion rings would cause my scalp to break out - mostly because I don't want to deal with all the other side effects to just test it out. Each time I spend about a week eating out of kitchens that are not gluten-free, my scalp breaks out. It did seem to heal faster with the castille soap, so I kept using it.

Even though it stinks.

To add to the fun, I learned that with hard water, castille soap can cause a build up that makes the hair look oily.

The same day it is washed.

The treatment for that is simple, just a vinegar rinse.

So tea-tree oil castille soap (which stinks) followed by vinegar (which also stinks).

My wet hair does not smell lovely. Or floral. Or appealing.

While I do use apple cider vinegar, which does smell better than distilled white vinegar, it still stinks.

This week I decided to see if I could use normal shampoo (because I wanted to see if I might could do pretty smelling hair.

The first time went well, no problems. My hair felt wonderful.

So I tried it again. Everything seemed fine until about 3 hours after washing my hair when I realized my scalp felt somewhat painful. I couldn't figure out why but it just kept getting more and more painful as I thought about it. Then I remembered the shampoo. By the time I got to the shower, I couldn't wait for the water to get hot.

Luckily, washing off the remaining shampoo seemed to mostly do the job.

Mostly.

It is still a little tender.

So now I can make Sally Albright look low-maintenance.

Great.

Sunday, October 21, 2012

4-H Wildlife

We had our first wildlife contest last Wednesday and so have been busy preparing for that. Junior didn't want to do the contest (and I don't blame him) but Daisy did. She scored well considering it was her first year (unless you count all that 3 years ago) and it is a hard contest.

So you can get an idea of what was involved, there are 4 parts of the contest: plant ID and preferences; habitat management; hunter safety; and techniques. In plant ID they have 59 or 60 plants to be able to recognize and tell if it is the prefered plant of waterfowl, deer, squirrel, dove, quail and turkey (some plants can have almost all of them and some have none of them). To give you an idea of how hard this is, here is the plant list:

As if that wasn't enough, the hunter safety part is the general hunter safety that would be part of the hunter safety course but also any new thing in the Texas Parks and Wildlife Outdoor Annual.

 In the Habitat Management portion they are shown an area and given a story with this area and asked if the area is capable of supporting turkey or deer etc. They are also asked what should be done to make that area capable of supporting the chosen animal. The difficulty with this part is the "experts" giving the contest don't always agree so you have to hope that you think about it the same way as the one judging your answers.

And the techniques are quite possibly the worst part. They can put any animal that has lived in the wild in Texas and ask a question about it such as what type of skull is this, is this animal native to Texas, is this bird wing from a mature or juvenile bird. They also have to be able to age a deer by its jawbone.

She has another contest over this in a couple weeks so we have more studying to do.

Saturday, October 13, 2012

Autism

Autism has been on my mind quite a bit lately. Did you know that the current statistics are 1 in 88 kids are on the autism spectrum? Boys are the hardest hit with it being 1 in 54 compared to 1 in 252 girls. This represents a 78% increase in autism over the previous 5 years and a 1000% increase over the last 40 years. And those are just the ones getting autism-related services.

 A study in South Korea by Autism Speaks found as many as 2/3 of the kids who had autism were not diagnosed or receiving autism-related services which leads to the statistic of 1 in 38.

So with all that, you have a good chance of knowing someone on the autism spectrum if you know very many children at all.

And Rainman is not typical of most people with autism. In fact, of the 4 people with autism that I know have autism, none are very much like Rainman. As far as that goes, those 4 all have very different stories and symptoms. You would not group them together; one is female the other 3 are male; one is 30+, another is 15, and the other 2 are in elementary school or preschool; one was normal and then regressed, 2 others either had it at birth or before they were old enough to regress (I am not sure about the 4th).

By the way, none of them are "dumb" or "slow" or whatever derogatory term you think of. Their brains are wired differently and so they don't receive signals the way that we (neuro-typicals) do. We have satellite TV, and with a storm it can be very difficult to get a good enough signal to watch a show. The dialogue may not come through, the picture can be very pixelated and it can be impossible to understand what is going on in the show. I suspect that living with autism could be somewhat comparable, except not only is the input messed up but also being able to express thoughts or what ever is as difficult (or more difficult) than understanding the input.

Anyway,

The earlier the parent (or someone else) notices the signs the better because early treatment is a huge deal. The earlier the treatment, the better the outcome will be.

According to autismspeaks.org the red flags for a child needing evaluation are:

  • No big smiles or other warm, joyful expressions by six months or thereafter
  • No back-and-forth sharing of sounds, smiles or other facial expressions by nine months
  • No babbling by 12 months
  • No back-and-forth gestures such as pointing, showing, reaching or waving by 12 months
  • No words by 16 months
  • No meaningful, two-word phrases (not including imitating or repeating) by 24 months
  • Any loss of speech, babbling or social skills at any age

Please, if you know a child who has these red flags go to http://www.autismspeaks.org/what-autism/learn-signs to learn more.

Statistics come from http://www.autismspeaks.org/science/science-news/autism-prevalence-rises-1-88

Sunday, October 7, 2012

Friends



My mom always said that if you want to find out who your real friends are, either move or have twins. There aren't too many who will help you out through. I would add one to that, go gluten free.

Potlucks or even events where everyone signs up to bring something are hard on my kids. I usually try to sign up for a salad and a dessert so that my kids get a complete meal. They still only get to eat what mom brought while everyone else has their plate piled high with a variety of foods. It's hard. 

It is much easier on me because if I see something I really want, I just plan on making it later that week or the next. I do feel a little awkward just because it looks like I am a food snob since I only eat what I brought. It probably builds character or something like that. Luckily I am not as self-conscious as I was in high school or junior high.

 But back to my point.

We have some amazing friends who have gone out of their way to be sure that my kids (and I) have had something safe to eat at several events lately. I know that this hasn't been easy for them because they aren't gluten-free and it can be so difficult to know what is safe and what isn't.  Especially since gluten hides in unexpected places. Like in Chili Cheese Fritos or all Blue Bell chocolate ice creams.

We are members of a homeschool co-op, a group of homeschool moms and kids where the moms all teach 1 or 2 subjects giving the kids a chance to learn something that we (individually) wouldn't be willing or able to teach. For instance one of my son's classes is music but not music appreciation like I thought. No, they are learning to play the recorder. There is absolutely no way I would teach that class, whether it was just my child or a group of kids.

But I digress.

We always start off the year with a party, this year with the theme of the Olympics. There was pizza, cake, nachos, fruit, hot dogs and other treats - the only naturally gluten-free thing on the menu was fruit. The nachos could have been made gluten-free but I kept forgetting to call the mom in charge of nachos. Plus, I hate putting others out and Junior is the only one who likes nachos and I can easily do those at home. With the menu in mind, I brought my kids their own gluten-free pizza and made cupcakes. The mom planning the event was going to make candy sushi (with rice krispies) and while I offered to make it for my kids, she also made some gluten-free candy sushi for my kids. They also had goody bags with candy and she double checked which ones were gluten-free and made sure my kids got goody bags with candy they could eat. I don't know if Betty realizes how much that meant to my kids and I.

 Then at our September 4-H club meeting, two friends made sure that all the snacks were gluten-free. Heather brought these mini cheesecakes (and that is her blog) and Robin brought an amazing bean dip (and she doesn't have a blog so I can't link to it). That was the first meeting in 2 years that they could eat the snacks like the other kids. Heather and Robin have since made snacks for other potluck like things that were gluten-free so my kids would be included.

Heather also teaches an election class at our co-op and to make it fun for the kids, they are doing candy elections (complete with slogans and all that).  They are getting to sample candy each class so they can be more informed of the options and Heather always makes sure that some of them are gluten-free for my daughter to sample.

Most recently, Robin's son had a birthday and she brought cupcakes for our wildlife group to celebrate her son's birthday. My heart sank because I didn't know in advance and so couldn't make some for my kids. I should have known better than that because she also baked some special for my kids that were gluten-free.

Friends like that bring tears to my eyes.

Friday, October 5, 2012

4-H Egg Workshop

This year I agreed to be the leader of our club Food and Nutrition project with 4-H.
While we are supposed to supply the kids with learning experiences, it has been a learning experience for me.

Our first meeting we went over unusual kitchen tools and gadgets because I know some of the moms didn't know what some of the more unusual and handy (or not) kitchen tools are. Like a potato ricer which I love when I use it, although often I just grab the potato masher. Or a mezzaluna which I thought would be wonderful and I really prefer using a knife. Or my ginger grater that I display and like to use.

Our second meeting I let my husband handle. S worked in a restaurant for several years, starting as a dishwasher and working his way up to assistant manager. It was a smaller chain but kind of like an IHOP. Kind of. So when S mentioned the possibility of doing an egg workshop to teach the kids how to make several kinds of eggs, I thought it was a great idea.

Before the meeting we prepped omelet toppings: ham, sausage, tomatoes, sauteed mushrooms, sauteed onions, sauteed bell pepper and some cheese. We got there early so the water could start boiling. And as the kids came in, they were each given a plastic freezer bag and a sharpie to write their name on the bag.

They each made a plastic (ziplock) bag omelet with their choice of add-ins. The adults were amazed at how well it worked and several loved the potential. All you do is write your name on a freezer ziplock type bag, put in your choice of omelet ingredients (onion, mushroom, cheese, etc) and then 2 or 3 well beaten eggs and drop the baggie in boiling water until it is done. He kept the water at a light boil and they took 5-10 minutes to cook. They aren't restaurant pretty omelets but for large groups, it is an excellent way to cook them.

He also taught them how to flip an egg in the pan. Well, the first step to learning how to do it. He had them flip toast in a pan because that way they could learn the motion needed to do it. He would coach them through it and some of them got pretty good at it. The benefit of doing it with toast is that toast is cheap and if it falls on the floor, it doesn't make much of a mess (some crumbs on the floor is all). When they get extremely good at it, they can try flipping eggs in the pan and start trying to toss dried beans in the pan. The dried beans will act like diced onions or sliced mushrooms but like the toast will be easy to clean up.


The workshop was a hit with the kids. After he had said what all he had to say, he became a short-order cook and made different types of eggs as people would ask for them. The mothers got beautiful omelets and the kids would request a type of eggs and he would cook it. One boy ate 14 eggs; another boy - who doesn't even like eggs - ate 3 omelets.

S cooked over 72 eggs! And after our club meeting he cooked eggs for he and I for supper. We had some beautiful omelet toppings left over.

Thursday, October 4, 2012

Oops

Since it has been almost a year since I last posted, I am pretty sure that it will surprise you when this pops up in your feed.

All I can really say is "oops." Honestly, I haven't felt like blogging because . . . I don't know exactly why. Part of it is that the stuff that was most on my mind wasn't mine to share. Partly that I still had stuff to work through. And then there is the guilt.

 I felt guilty for not blogging and then there was the question of what to blog about. When it has been months and months, there is almost a feeling of "what I write should be important, major, significant etc." Since I don't really do significant, major, important etc, it is a little hard to live up to.

Since it has been so long, you get a bullet list to kind-of catch you up. (Lucky you!!!)
  • Daisy turned 13 in July which I didn't quite need therapy for, although I thought about it.  Luckily I am blessed with a wonderful 13 year old who does things like cook dinner when her mama has a headache.

  • Daisy decided to do 4-H Wildlife again after 2 years off. In case you are wondering, that is long enough to forget almost every thing we learned. And some of what we do remember is no longer on the contest. So far we are doing pretty good, I can ID about 40 of the 60 plants, trees, and grasses that they have to learn. Why do I have to know it? I'm not really sure other than so I can pop quiz them. I suspect Daisy knows more than she thinks she does because she was able to tell me some of the identifying characteristics (bark color and texture and some other things that I don't remember anymore) of a black cherry. The only way I could identify a black cherry would be if I were told "this is either a black cherry or a grass." I might could figure it out then. Maybe. 

  • In a related note I have had chiggers for the first time since I was 15, and that was over 20 years ago. I also found a tick which would have had me calling a therapist but they typically don't accept new patients at midnight. Like a good homeschool mom/4-H mom, I googled it and found out that it was the Lone Star Tick and that they do not carry lyme disease. We now spray down with bug spray.

  • Junior got his black belt in Tae Quon Do which was a great reward for his perseverance. We were incredibly proud of him. I was also thrilled to have Tuesday, Thursday and Friday evenings free.

  • I no longer have Tuesday and Thursday evenings free. 

  • Tuesday is known by my family as "nightmare day." Daisy has piano at 3 and Junior has guitar at 3. About 1 mile away from each other. Both of their lessons end at 3:30. Also one mile apart. Then we swing through Sonic because it is Happy Hour and get to Wildlife at 4 which lasts until 6pm. At 6 we go to Robotics and are done with that at 8pm. If we are lucky, I managed to put something in the crockpot so that we can eat dinner when we get home.

  • We are still gluten-free so if I don't put dinner in the crockpot, there is only 2 fast food places to get food, Five Guys or Chic-Fil-A. 

  • I love both Five Guys and Chic-Fil-A but I can get really tired of them quickly.

  • We learned what Junior's reaction to gluten ingestion can be. He gets irritable. For about a week. It is kind-of like PMS irritable where you don't realize that you are making everyone walk on egg shells because you think that you are being completely rational. It was a long week. I think he still doesn't realize how cranky he was.

  • I have some others but they are long enough to be posts on their own so . . . 
The End

Wednesday, November 9, 2011

Hello again

Well I took an unintended hiatus for a bunch of little reasons, most really inconsequential but some of them worth a blogging break. I have written posts in my head that never quite made it past my fingers and I have been where I couldn't even think about doing any posts.

Part of it is that God and I have been dealing with some issues that I think are now mostly resolved. I think.

Then there was also gearing up for Food and Nutrition contest with both kids competing for real. (The posts on that are here and here).

I have been cooking more again and enjoying it. I did a wonderful roast chicken tonight that looked so good my husband asked where I got it. He was surprised that I roasted it so well the first time I tried it.

I am also trying to figure out what exactly to do with these blogs. Part of me says to combine them, since some things (like the contest posts) I would like to have here even though they seem to fit more with the cooking. The other part says to keep it separate because I don't know how many of you would be interested in gluten-free cooking or why I measure with a scale now or whatever. I would love to hear your thoughts on the matter.

I think I should be posting more now that I have worked through some things with God (I may share more on that latter, just not ready to right now).

Tuesday, November 1, 2011

book review - Lethal Remedy

It is time for a FIRST Wild Card Tour book review! If you wish to join the FIRST blog alliance, just click the button. We are a group of reviewers who tour Christian books. A Wild Card post includes a brief bio of the author and a full chapter from each book toured. The reason it is called a FIRST Wild Card Tour is that you never know if the book will be fiction, non~fiction, for young, or for old...or for somewhere in between! Enjoy your free peek into the book!



You never know when I might play a wild card on you!


Today's Wild Card author is:


and the book:

Abingdon Press (October 2011)
***Special thanks to Julie Dowd (Abingdon Press) for sending me a review copy.***

ABOUT THE AUTHOR:


Richard L. Mabry, MD, is a retired physician and medical school professor who achieved worldwide recognition as a clinician, writer, and teacher before turning his talents to non-medical writing after his retirement. He is the author of The Prescription for Trouble Series, one non-fiction book, and his inspirational piesces have appeared in numerous periodicals. He and his wife, Kay, live in North Texas.


Visit the author's website.

SHORT BOOK DESCRIPTION:

An epidemic of a highly resistant bacteria, Staphylococcus luciferus, has ignited, and Dr. Sara Miles' patient is on the threshold of death. Only an experimental antibiotic developed and administered by Sara's ex-husband, Dr. Jack Ingersoll can save the girl's life.

Dr. John Ramsey is seeking to put his life together after the death of his wife by joining the medical school faculty. But his decision could prove to be costly, even fatal.
Potentially lethal late effects from the experimental drug send Sara and her colleague, Dr. Rip Pearson, on a hunt for hidden critical data that will let them reverse the changes before it’s too late. What is the missing puzzle piece? And who is hiding it?




Product Details:

List Price: $13.99
Paperback: 288 pages
Publisher: Abingdon Press (October 2011)
Language: English
ISBN-10: 1426735448
ISBN-13: 978-1426735448

AND NOW...THE FIRST CHAPTER:

No one knew the man’s name. White male, probably in his late seventies, found unresponsive in an alley about two o’clock in the morning and brought to the emergency room. Just another homeless derelict, another John Doe.

“Pneumonia, late stages,” the intern said. He yawned. “Happens all the time. Drank himself into a stupor, vomited, aspirated. Probably been lying in that alley for more than a day. Doesn’t look like he’ll make it.”

“Labs cooking? Got a sputum culture going?”

“Yeah, but it’ll take a day or two to get the results of the culture. The smear looks like Staph. Guess I’ll give him—”

“Wait. I’ve got access to an experimental drug that might help. Let me start him on that.”

The intern shrugged. It was two in the morning. He’d been on duty for more than twenty-four hours straight—why’d Johnson’s wife have to go into labor today?—and he was bushed. The bum probably didn’t have a snowball’s chance of surviving anyway. Why not? “You’ll be responsible?”

“I’ll take it from here. Even do the paperwork.”

“Deal,” the intern said, and ambled off to see the next patient.

Three hours later, John Doe lay on a gurney in a corner of the ER. An IV ran into one arm, a blood pressure cuff encircled the other. Spittle dripped from his open mouth and dotted his unshaven chin. His eyes were open and staring.

“Acute anaphylaxis, death within minutes. Interesting.” He scratched his chin. “Guess I need to make some adjustments in the compound.” He picked up the almost-blank chart. “I’ll say I gave him ampicillin and sulbactam. That should cover it.”

* * *

The woman’s look pierced Dr. Sara Miles’ heart. “Do you know what’s wrong with Chelsea?”

Chelsea Ferguson lay still and pale as a mannequin in the hospital bed. An IV carried precious fluids and medications into a vein in her arm. A plastic tube delivered a constant supply of oxygen to her nostrils. Above the girl’s head, monitors beeped and flashed. And over it all wafted the faint antiseptic smell of the ICU.

Chelsea’s mother sat quietly at the bedside, but her hands were never still: arranging and rearranging her daughter’s cover, twisting the hem of her plain brown skirt, shredding a tissue. Sara decided that the gray strands in Mrs. Ferguson’s long brunette hair were a recent addition, along with the lines etched in her face.

Sara put her hand on the teenager’s head and smoothed the matted brown curls. The girl’s hot flesh underscored the urgency of the situation. Since Chelsea’s admission to University Hospital three days ago, her fever hadn’t responded to any of the treatments Sara ordered. If anything, the girl was worse.

“Let’s slip out into the hall,” Sara said. She tiptoed from the bedside and waited outside the room while Mrs. Ferguson kissed her sleeping daughter and shuffled through the door.

Sara pointed. “Let’s go into the family room for a minute.”

“Will she be—?”

“The nurses will check on her, and they’ll call me if anything changes.” Sara led the way into the room and eased the door closed. This family room resembled so many others Sara had been in over the years: small, dim, and quiet. Six wooden chairs with lightly upholstered seats and backs were arranged along three of the walls. Illumination came from a lamp in the corner. A Bible, several devotional magazines, and a box of tissues stood within reach on a coffee table.

This was a room where families received bad news: the biopsy was positive, the treatment hadn’t worked, the doctors weren’t able to save their loved one. The cloying scent of flowers in a vase on an end table reminded Sara of a funeral home, and she shivered as memories came unbidden. She shoved her emotions aside and gestured Mrs. Ferguson to a seat. “Would you like something? Water? Coffee? A soft drink?”

The woman shook her head. “No. Just tell me what’s going on with my daughter. Do you know what’s wrong with her? Can you save her?” Her sob turned into a soft hiccup. “Is she going to die?”

Sara swallowed hard. “Chelsea has what we call sepsis. You might have heard it referred to as blood poisoning. It happens when bacteria get into the body and enter the bloodstream. In Chelsea’s case, this probably began when she had her wisdom teeth extracted.”

I can’t believe the dentist didn’t put her on a prophylactic antibiotic before the procedure. Sara brushed those thoughts aside. That wasn’t important now. The important thing was saving the girl’s life. Sara marshaled her thoughts. “We took samples of Chelsea’s blood at the time of her admission, and while we waited for the results of the blood cultures I started treatment with a potent mixture of antibiotics. As you can see, that hasn’t helped.”

“Why?”

Sara wished the woman wouldn’t be so reasonable, so placid. She wished Mrs. Ferguson would scream and cry. If the roles were reversed, she’d do just that. “While we wait for the results of blood cultures, we make a guess at the best antibiotics to use. Most of the time, our initial guess is right. This time, it was wrong—badly wrong.”

“But now you know what’s causing the infection?” It was a question, not a statement.

“Yes, we know.” And it’s not good news.

Hope tinged Mrs. Ferguson’s voice. “You can fix this, can’t you?”

I wish I could. “The bacteria causing Chelsea’s sepsis is one that . . .” Sara paused and started again. “Have you heard of Mersa?”

“Mersa? No. What’s that?”

“It’s actually MRSA, but doctors usually pronounce it that way. That’s sort of a medical shorthand for methicillin-resistant Staphylococcus aureus, a bacteria that’s resistant to most of our common antibiotics.”

Mrs. Ferguson frowned. “You said most. Do you have something that will work?”

“Yes, we do. Matter of fact, when Chelsea was admitted I started her on two strong antibiotics, a combination that’s generally effective against MRSA. But she hasn’t responded, because this isn’t MRSA. It’s worse than MRSA.” She started to add “Much worse,” but the words died in her throat.

Sara paused and waited for Mrs. Ferguson to ask the next question. Instead, the woman crumpled the tissue she held and dabbed at the corner of her eyes, eyes in which hope seemed to die as Sara watched.

“This is what we call a ‘super-bug,’” Sara continued. “It used to be rare, but we’re seeing more and more infections with it. Right now, none of the commercially available antibiotics are effective. These bacteria are resistant to everything we can throw at them.”

Mrs. Ferguson’s voice was so quiet Sara almost missed the words. “What do you call it?”

“It’s a long name, and it’s not important that you know it.” Matter of fact, we don’t use the proper name most of the time. We just call it “The Killer.”

“So that’s it?”

“No, there’s a doctor at our medical center doing trials on an experimental drug that might work for Chelsea.” No need to mention that Jack is . . . No, let it go.

“Can you get some of this? Give it to Chelsea?”

“I can’t, but the man who can is an infectious disease specialist on the faculty here at the medical center. Actually, he helped develop it. Notice I said ‘experimental,’ which means there may be side effects. But if you want me—”

“Do it!” For the first time in days, Sara saw a spark of life in Mrs. Ferguson’s eyes, heard hope in her voice. “Call him! Now! Please!”

“You realize that this drug isn’t fully tested yet. It may not work. Or the drug may cause problems.” There, she’d said it twice in different words. She’d done her duty.

“I don’t care. My little girl is dying. I’ll sign the releases. Anything you need. If this is our only chance, please, let’s take it.”

Lord, I hope I haven’t made a mistake. “I’ll make the call.”

“I’m going back to be with my baby,” Mrs. Ferguson said. She stood and squared her shoulders. “While you call, I’ll pray.”

* * *

“Mr. Wolfe, you can come in now.” The secretary opened the doors to Dr. Patel’s office as though she were St. Peter ushering a supplicant through the Pearly Gates.

Bob Wolfe bit back the retort he wanted to utter. It’s Doctor Wolfe. Doctor of Pharmacology. I worked six years to earn that Pharm D, not to mention two years of research fellowship. How about some respect? But this wasn’t the time to fight that battle.

He straightened his tie, checked that there were no stains on his fresh white lab coat, and walked into the office of the head of Jandra Pharmaceuticals as though he had been summoned to receive a medal. Never let them see you sweat.

Dr. David Patel rose from behind his desk and beamed, gesturing toward the visitor’s chair opposite. “Bob, come in. Sit down. I appreciate your coming.”

Not much choice, was there? Wolfe studied his boss across the expanse of uncluttered mahogany that separated them. Pharmaceutical companies seemed to be made up of two groups: the geeks and the glad-handers. Patel typified the former group. PhD from Cal Tech, brilliant research mind, but the social skills of a tortoise. Patel had been snatched from the relative obscurity of a research lab at Berkeley by the Board of Directors of Jandra Pharmaceuticals, given the title of President and CEO, and charged with breathing life into the struggling company. How Patel planned to do that remained a mystery to Wolfe and his co-workers.

Patel leaned forward and punched a button on a console that looked like it could launch a space probe. “Cindy, please ask Mr. Lindberg to join us.”

Steve Lindberg ran the sales team from an office across the hall. Lindberg could memorize salient scientific material and regurgitate it with the best of them, but Wolfe would bet the man’s understanding of most of Jandra’s products and those of its major competitors was a mile wide and an inch deep. On the other hand, Lindberg had his own area of expertise: remembering names, paying for food and drinks, arranging golf games at exclusive clubs. No doubt about it, Lindberg was a classic glad-hander, which was why he had ascended to his current position, heading the marketing team at Jandra.

Wolfe hid a smile. Interesting. The President of the company and the Director of Marketing. This could be big. The door behind Wolfe opened. He deliberately kept his eyes front. Be cool. Let this play out.

“Hey, Bob. It’s good to see you.” Wolfe turned just in time to avoid the full force of a hand landing on his shoulder. Even the glancing blow made him wince. Lindberg dragged a chair to the side of Patel’s desk, positioning himself halfway between the two men. Clever. Not taking sides, but clearly separating himself from the underling.

Wolfe studied the two men and, not for the first time, marveled at the contrast in their appearance. Patel was swarthy, slim, and sleek, with jet-black hair and coal-black eyes. His blue shirt had a white collar on which was centered the unfashionably large knot of an unfashionably wide gold-and-black tie. Wolfe wondered whether the man was five years behind or one ahead of fashion trends. He spoke with a trace of a British accent, and Wolfe seemed to recall that Patel had received part of his education at Oxford. Maybe he wore an “old school” tie, without regard to current fashion. If so, it would be typical of Patel.

Lindberg was middle-aged but already running to fat—or, more accurately, flab. His florid complexion gave testimony to too many helpings of rare roast beef accompanied by glasses of single malt Scotch, undoubtedly shared with top-drawer doctors and paid for on the Janus expense account. Lindberg’s eyes were the color of burnished steel, and showed a glimmer of naked ambition that the smile pasted on his face couldn’t disguise. His thinning blond hair was combed carefully to cover early male pattern baldness. The sleeves of his white dress shirt were rolled halfway to his elbows. His tie was at half-mast and slightly askew.

Patel, the geek. Lindberg, the glad-hander. Different in so many ways. But both men shared one characteristic. Wolfe knew from experience that each man would sell his mother if it might benefit the company, or more specifically, their position in it. The two of them together could mean something very good or very bad for Bob Wolfe. He eased forward in his chair and kicked his senses into high gear.

Patel leaned back and tented his fingers. “Bob, I’m sure you’re wondering what this is about. Well, I wanted to congratulate you on the success of EpAm848. I’ve been looking over the preliminary information, especially the reports from Dr. Ingersoll at Southwestern Medical Center. Very impressive.”

“Well, it’s sort of Ingersoll’s baby. He stumbled onto it when he was doing some research here during his infectious disease fellowship at UC Berkeley. I think he wants it to succeed as much as we do.”

“I doubt that.” Patel leaned forward with both hands on the desk. “Jandra is on the verge of bankruptcy. I want that drug on the market ASAP!”

“But we’re not ready. We need more data,” Wolfe said.

“Here’s the good news,” Patel said. “The FDA is worried about The Killer bacteria outbreak. I’ve pulled a few strings, called in a bunch of favors, and I can assure you we can get this application fast-tracked.”

“How?” Wolfe said. “We’re still doing Phase II trials. What about Phase III? Assuming everything goes well, it’s going to be another year, maybe two, before we can do a rollout of EpAm848.”

“Not to worry,” Patel said. “Our inside man at the FDA assures me he can help us massage the data. We can get by with the Phase II trials we’ve already completed. And he’ll arrange things so we can use those plus some of our European studies to fulfill the Phase III requirements.”

Lindberg winked at Wolfe. “We may have to be creative in the way we handle our data. You and I need to get our heads together and see how many corners we can cut before the application is ready.”

Wolfe shook his head. “You say this drug will save us from bankruptcy. I don’t see that. I mean, yes, it looks like we may be in for a full-blown epidemic of Staph luciferus, but we won’t sell enough—“

Lindberg silenced him with an upraised hand. “Exposure, Bob. Exposure. If we get this drug on the market, if we’re the first with a cure, our name recognition will skyrocket. Doctors and patients will pay attention to our other drugs: blood pressure, cholesterol, diabetes. Our market share will go through the roof in all of them.”

Wolfe could see the salesman in Lindberg take over as he leaned closer, as though to drive home his point by proximity. “We’re preparing a direct-to-consumer push on all those drugs, ready to launch at the same time we release Jandramycin.”

The name didn’t click with Wolfe for a moment. “I . . . Well, I’ll certainly do what I can.”

“Do more than that,” Lindberg said. “Jandra Pharmaceuticals is hurting. We’re staking everything on Jandramycin.”

That was the second time Wolfe had heard the term. “What—“

“Stop referring to the drug by its generic name,” Patel added. “From now on, the compound is Jandramycin. When people hear the name Jandra Pharmaceuticals, we want them to think of us as the people who developed the antibiotic that saved the world from the worst epidemic since the black plague.”

Lindberg eased from his chair and gave Wolfe another slap on the shoulder. “This is your project now. It’s on your shoulders. The company’s got a lot riding on this.”

And so do I. “But what if a problem turns up?”

Patel rose and drew himself up to his full five feet eight inches. His obsidian eyes seemed to burn right through Wolfe. “We’re depending on you to make sure that doesn’t happen. Are we clear on that?”

* * *

Sara leaned over the sink and splashed water on her face. The paper towels in the women’s rest room of the clinic were rough, but maybe that would put some color in the face that stared back at her from the mirror. Her brown eyes were red-rimmed from another sleepless night. Raven hair was pulled into a ponytail because she could never find time or energy for a haircut or a perm. Get it together, Sara. She took a deep breath and headed for the doctor’s dictation room, where she slumped into a chair.

“Something wrong, Dr. Miles?”

Sara turned to see Gloria, the clinic’s head nurse. “No, just taking a few deep breaths before I have to make a call I’m dreading.”

Gloria slid into the chair next to Sara. The controlled chaos of the internal medicine clinic hummed around them. The buzz of conversations and ringing of phones served as effectively as white noise to mask her next words. “Is it one of your hospital patients? Got some bad news to deliver?”

“Sort of. It’s Chelsea Ferguson.”

“The teenage girl? Is she worse?”

“Yes. The cultures grew Staph luciferus.”

Gloria whistled silently. “The Killer. That’s bad.”

“The only thing that seems to be working in these cases is that new drug of Jack Ingersoll’s.”

“Oh, I get it. That’s the call you don’t want to make.” Gloria touched Sara lightly on the shoulder. “When will you stop letting what Ingersoll did ruin the rest of your life? I can introduce you to a couple of nice men who go to our church. They’ve both gone through tough divorces—neither was their fault—and they want to move on. It would be good for you—”

Sara shook her head. “Thanks, but I’m not ready to date. I’m not sure if I can ever trust a man again.”

Gloria opened her mouth, but Sara silenced her with an upraised hand. No sense putting this off. She pulled the phone toward her and stabbed in a number.

* * *

Dr. John Ramsey found a spot in the Visitor’s Parking Lot. He exited his car and looked across the driveway at the main campus of Southwestern Medical Center. When he’d graduated, there were two buildings on the campus. Now those two had been swallowed up, incorporated into a complex that totaled about forty buildings on three separate campuses. Right now he only needed to find one: the tall white building directly across the driveway at the end of a flagstone plaza. The imposing glass fa├žade of the medical library reflected sunlight into his eyes as he wove past benches where students sat chatting on cell phones or burrowing into book bags. He paused at the glass front doors of the complex, took a deep breath, and pushed forward.

There was a directory inside for anyone trying to negotiate the warren of inter-connected buildings, but John didn’t need it. He found the elevator he wanted, entered, and punched five. In a moment, he was in the office of the Chairman of Internal Medicine.

“Dr. Schaeffer will be with you in a moment.” The receptionist motioned him toward a seat opposite the magnificent rosewood desk that was the centerpiece of the spacious office, then glided out, closing the door softly behind her.

John eased into the visitor’s chair and looked around him. He’d spent forty years on the volunteer clinical faculty of Southwestern Medical Center’s Department of Internal Medicine. For forty years he’d instructed and mentored medical students and residents, for forty years he’d covered the teaching clinic once a month, and today was the first time he’d been in the department chairman’s office. He swallowed the resentment he felt bubbling up. No, John. You never wanted to be here. You were happy in your own world.

John couldn’t help comparing this room with the cubbyhole he’d called his private office. Now he didn’t even have that. The practice was closed, the equipment and furnishings sold to a young doctor just getting started. John’s files and patient records were in a locked storage facility, rent paid for a year.

He wondered how many of his patients had contacted his nurse to have their records transferred. No matter, she’d handle it. He’d paid her six months’ salary to take care of such things. What would happen after that? He didn’t have the energy to care. Things were different now.

For almost half a century he’d awakened to the aroma of coffee and a kiss from the most wonderful woman in the world. Now getting out of bed in the morning was an effort, shaving and getting dressed were more than he could manage some days. Since Beth died . . . He shook his head, trying to clear the cobwebs that clogged his brain. The knowledge that he’d never again know the happiness of having a woman he loved by his side made him wish he’d died with her. What was the use of going on?

But something happened this morning. He’d awakened with a small spark of determination to do something, anything, to move on. He tried to fight it, to roll over and seek the sleep that eluded him. Instead, he heard the echo of Beth’s words: “You’re too good a physician to retire. People need you.” He remembered that conversation as though it were yesterday. She’d urged, he’d insisted. Let’s retire. I want to get out of the rat race and enjoy time with you. Retirement meant the travel they’d put off, the time to do things together. Only, now there was no more together.

This morning, he’d rolled out of bed determined that today would be different. It would be the start of his rebirth. As he shrugged into a robe, as he’d done each day since her death he looked at the picture on their dresser of him and Beth. She’d been radiant that spring day so many years ago, and he wondered yet again how he’d managed to snag her.

He’d shaved—for the first time in days—with special care, and his image in the mirror made him wonder. When did that slim young man in the picture develop a paunch and acquire an AARP card? When had the thick brown hair been replaced by gray strands that required careful combing to hide a retreating hairline? The eyes were still bright, although they hid behind wire-rimmed trifocals. “You’re too old for this, John,” he muttered. And as though she were in the room, he heard Beth’s words once more. “You’re too good a physician to retire. People need you.”

Fortified with coffee, the sole component of his breakfast nowadays, he’d forced himself to make the call. He asked his question and was gratified and a bit frightened by the positive response. John dressed carefully, choosing his best suit, spending a great deal of time selecting a tie. He’d noticed a gradual shift in doctors’ attire over the past few years. Now many wore jeans and golf shirts under their white coats. But for John Ramsey, putting on a tie before going to the office was tantamount to donning a uniform, one he’d worn proudly for years. And he—

“John, I was surprised when I got your call. To what do I owe the pleasure?” Dr. Donald Schaeffer breezed into the office, the starched tails of his white coat billowing behind him. He offered his hand, then settled in behind his desk.

“Donald, I appreciate your taking the time to see me. I was wondering—”

“Before we start, I want you to know how sorry we all are for your loss. Is there anything I can do?”

Perfect lead-in. See if you can get the words out. “As you know, I closed my office four months ago. Beth and I were going to enjoy retirement. Then . . .”

Schaeffer nodded and tented his fingers under his chin. At least he had the grace not to offer more platitudes. Ramsey had had enough of those.

“I was wondering if you could use me in the department.” There. Not the words he’d rehearsed, but at least he’d tossed the ball into Schaeffer’s court.

“John, are you talking about coming onto the faculty?”

“Maybe something half-time. I could staff resident clinics, teach medical students.”

Schaeffer was shaking his head before John finished. “That’s what the volunteer clinical faculty does. It’s what you did for . . . how many years? Thirty? Thirty-five?”

“Forty, actually. Well, I’m still a clinical professor in the department, so I guess I have privileges at Parkland Hospital. Can you use me there?”

Schaeffer pulled a yellow legal pad toward him and wrote a couple of words before he pushed it aside. “I’m not sure what I can do for you, if anything. It’s not that easy. You have no idea of the administrative hoops I have to jump through to run this department. Even if I could offer you a job today—and I can’t— I’d have to juggle the budget to support it, post the position for open applications, get half a dozen approvals before finalizing the appointment.” He spread his hands in a gesture of futility.

“So, is that a ‘no’?”

“”That’s an ‘I’ll see what I can do.’ Afraid that’s the best I have to offer.” Schaeffer looked at his watch, shoved his chair back and eased to his feet. “Coming to Grand Rounds?”

Why not? John’s house was an empty museum of bitter memories. His office belonged to someone else. Why not sit in the company of colleagues? “Sure. I’ll walk over with you.”

As the two men moved through the halls of the medical center, John prayed silently that Schaeffer would find a job for him. With all his prayers for Beth during her final illness, prayers that had gone unanswered, he figured that surely God owed him this one.






My Thoughts: I really enjoy Dr Mabry's books and this was was like the others in that it kept me on the edge of my seat. He does an excellent job of having some medicine, in the book but not enough to make a non-medical person get confused. I also enjoy the character development and honestly it is just good storytelling.

I would highly recommned all of Dr. Mabry's books and I am eagerly looking forward to the next one.

Tuesday, September 6, 2011

Book Review - Bonhoeffer


Dietrich Bonhoeffer lived in Germany during some of the most fascinating and horrifying times of its history. Bonhoeffer: Pastor, Martyr, Prophet, Spy by Eric Metaxes tells his story and is an excellent book on many different levels.

In case you didn't know, Dietrich Bonhoeffer was born in 1906, the youngest son of a very intellectual German family. Dietrich decided at a fairly young age to study theology and then later became a pastor and trained pastors. As the Hilter came into power and started to corrupt the German church, Bonhoeffer tried to enable the church to resist and ended up helping form the Confessing Church. Later he would take part in the German resistance and was in on the plot to assassinate Hitler. For his part in the resistance movement he was arrested and then executed for knowing of the assassination plot 2 weeks before US military reached the concentration camp where he was being held.

I understand Hitler's Germany so much more. The German resistance movement is not mentioned in many school history books beyond the sentence or two mentioning the attempt that was foiled by a heavy table. I learned more of the horror that surrounded Hitler's rule although I am sure much more was left out than was actually included. It was sad though to keep reading of friends and family of Bonhoeffer that would die in WWII - nevermind that most of them wouldn't be alive now.

What I read of Bonhoeffer's theology has me wanting to read more, not just Bonhoeffer but also Karl Barth. In my opinion, it is a good book that makes you want to learn more instead of one that leaves you satisfied with limited knowledge.

All in all, I enjoyed this book. It is long (542 pages not including the notes or index) but it is very inspiring and thought provoking. Let me put it this way, my husband was shocked to see me use a highlighter in the book because I don't write in books. I rarely find enough to underline to make it worth defacing the book. I underlined a lot in this book.

One of my favorite quotes is:

First of all I will confess quite simply -- I believe that the Bible alone is the answer to all our questions, and that we only need to ask repeatedly and a little humbly, in order to receive this answer. One cannot simply read the Bible, like other books. One must be prepared really to enquire of it. Only thus will it reveal itself. Only if we expect from it the ultimate answer, shall we receive it. This is because in the Bible God speaks to us. And one cannot simply think about God in one's own strenght, one has to enquire of him. Only if we seek him, will he answer us. Of course it is also possible to read the Bible like any other book, that to say from the point of view of textual criticism. etc; there is nothing to be said against that. Only that that is not the method which will reveal to us the heart of the Bible, but only the surface, just as we do not grasp the words of someone we love by taking them to bits, but simply by receiving them, so that for days they go on lingering in our minds, simply because they are the words of someone we love, and just as these words reveal more and more of the person who said them as we go on, like Mary "pondering them in our heart," so will it be with the words of the Bible.Only if we venture to enter into the words of the Bible, as though in them this God were speaking to us who loves us and does not will to leave us along with our questions, only so shall we learn to rejoice in the Bible. - Dietrich Bonhoeffer

This book was provided for purpose of review by Thomas Nelson but any opinions are mine

Saturday, August 27, 2011

book review - Butterfly Effect & The Boy Who Changed the World

I have to confess that I received these two books long ago but this has been a very hard review to write.

I love the premise of these books, that everything you do matters, that even the smallest insignificant things can have a profound effect.

I loved the first story in The Butterfly Effect about how a action done almost 150 years ago effects us still today.

I love Andy Andrews' writing that is engaging and fun to read.

Honestly though, the story about the wheat and corn turned my stomach. A book making the persons responsible for GMO wheat and corn out to be heroes is just something that I can't support. I try not to get political here but since the 1940s when they first started with the GMO wheat and corn the rates of celiac have multiplied, the rates of autism have soared, allergies are sky-rocketing, among other things. We are tweaking our environment too much and a book that celebrates this is just too much.

I wanted to love these books, and honestly if I could tear out a section of Butterfly effect, I would still love it. If it wasn't a book to inspire and to change lives the politics wouldn't matter. If it wasn't a children's book, the politics wouldn't matter as much. But I can't recommend this book at all because of the GMO issue.