26 January 2009

Pile on

You know how things seem to come in groups? Three cardiac arrest calls, a week of bad news, nothing seems to happen in isolation. I used to feel like a big part of that was perception, once you're down everything just seems worse. Last week cured me of that feeling. No matter how hard I tried to keep a positive attitude, a fix it and move on mentality, the hits kept coming. The following began last Tuesday...

Bathtub liner was feeling "squishy" for a week or two, decides to "pop" off the floor of the tub a night when it was below zero outside, breaking the caulk along the walls, leaving the tub not water-tight. Having only one bathroom, we continue using it, trying to minimize the amount of water behind the liner, while trying to determine the best solution. K leans toward the whole tub/shower remodel, I lean towards gluing the damn thing back down (fingers in my ears, "lalalalalalala - I can't hear you, so there is no problem"). I call the company that installed the liner in the hopes it is still under warranty, of course it is not - they know exactly how long their glue lasts.

Bathtub decides on it's own that it would like to be replaced. Water between the liner and the old tub builds up and begins leaking into the basement. Prior mold and rot to the wood in this area of the house (presumably from when the tub leaked leading to the liner installation) make this require an immediate fix.

K reports desktop computer not working right, nothing shows up on the monitor when you turn it on. "Lalalalalala - you're just doing something wrong, computer is fine." As we have other machines in the house, this one is temporarily ignorable. K has projects due for class which are started on the broken machine, but has enough time to finish elsewhere.

A search of local home improvement stores leads to the finding that they only carry white bathtubs in-stock and we don't really find tile we're happy with. Any sort of off-white tub (which would match or at least not clash with the toilet and sink) is "special order", requires a couple hundred extra bucks and a 7-10 day wait. A search of specialty bath places locates a "Linen"-colored tub, available the next day, for about the same "special order" price. We locate a tile place which claims to have everything in-stock in project quantities and are able to select tile and leave with backerboard, mortar, grout. Credit card heating up.

Removal of old liner, tub and tile commences. Liner is well-secured in many places with a rubbery epoxy which simply stretches as you pull it away from the wall, anyone doing this would be well advised to have a Rotozip or something similar with a plastic cutting bit, as that seemed to work well to get manageable pieces which could be pried off the walls. Old tub turns out to be robin egg blue, blech, and cast iron. If you don't know, cast iron is VERY, VERY heavy. This tub is upstairs in our split-level. The Internet recommends smashing a cast iron tub into smaller, easier to carry pieces for removal. 8 smashes with a heavy maul have lead to chipping the porcelain coating, but no breakage. K is not going to give in to a tub and continues smashing, finally we get a chunk to break and then the demolition takes off.

Demolition debris is loaded into the back of our pickup for recycling/disposal the next morning. We get down to the last piece of cast iron tub, it is about 1/4 of the tub and is the piece with the drain and overflow, weighs at least 100 lbs and is very awkward to carry, even with two of us. Up and over the side rail of the pickup, rounded side down. As soon as we let go, the unmistakable sound of glass breaking. Tub went through the back window of the pickup. Only broke one part of the three-part sliding rear window, but whole thing has to be replaced. NH is very cold this time of year, open windows are not workable. Credit card placed in snow bank to prevent melting plastic.

Carpentry repair goes reasonably well, new plumbing install goes reasonably well and it is time to set the new tub. Tub does not fit. Remove and/or break holes in drywall. Tub does not fit. Opening is 60", tub is 60". Can't slide it in from the side because of forced hot water heating pipe. Can't tip it in, gets stuck on studs. Begin shaving studs on interior wall. This old house has 2"x3" interior stud walls, so not too much available here to shave, other option is to remove that wall entirely and re-build after tub install. Wall is in MY closet and would require removing nearly every piece of clothing I own. Eventually get enough gap to tip in tub from shaving studs. Tub is level the direction of the support stringer. Tub is not level from side to side. Remove tub. Install some additional plywood on outside edge. Reinstall tub. Hear chorus of angelic singing as tub fits and is level. Check head for bumps or concussions, find none, clean eyes, tub still appears to be in place and level.

So here we sit, tub in, backerboard up for tile, waiting for mortar to dry. Tonight's adventure is rolling on the waterproofing membrane, then waiting again for dry time. Tomorrow is to lay out the tile pattern and all the necessary level reference lines and start to tile. K works tomorrow and I work tomorrow night, so limited work will be finished. Fingers crossed to finish tile Wednesday, wait for drying. K might be able to grout on Thursday, I'm out for a school interview. Maybe by Saturday, I can shower at home again.

19 January 2009

Repeat business

Walking into the hair salon this weekend, my stylist commented to another, "Look, I am so good she doesn't even look like she needs a haircut!" She was joking of course, but that brought us to a conversation about never actually wanting to be that good because it would kill the bread-and-butter of repeat business. If hair didn't grow, there wouldn't be a steady line of customers every 4-8 weeks looking to have her make their hair look exactly the same as last time.

In itself, repeat business on the ambulance is not notable. Some folks are seriously ill and we see them often enough to know a bit about them. Others have a variety of reasons for calling that have little or nothing to do with their medical conditions. We have a large set of "frequent flyers" who should earn free trips for the amount of business they give us, if only they paid for trips in the first place. I was recently on-duty for 3 calls to the same address in less than 48 hours.

The original call was in the late morning for an overdose/unconscious person. We arrived to find a sobbing woman who pointed us to a bedroom. On the bed was a man laying on his back, snoring loudly. Not "snoring respirations" (a somewhat bad sign where a person is not keeping his airway open and possibly not getting enough air). Just snores. I walked in and shouted his name, to which he immediately awoke. After a long series of questions to both the patient and the woman, it turns out he "overdosed" on his sleeping medication and "passed out" the night before and her mom told her to call the ambulance. Stupidity discovered, we leave the happy couple with the police and move on.

Second call to the same address the following evening for overdose/unconscious person. Again, on his back, in bed, snoring. Again, wakes to verbal stimulus, but this time is substantially sluggish. We check his prescription bottles and one of them is a couple dozen pills lighter than yesterday. Off to the hospital where the fine doctors and nurses monitor him as he snoozes the medications away.

Next day, another call to the same address, same problem. Unusual for me to be working this many days in a row, but a shift swap leaves me in the station for too many days. This time, the call isn't for my truck, but I update the responding crew on the prior days events. Catching up with them at the hospital, I discover that this time there was a disagreement in the house with no overdose involved and the patient is now at the other hospital in town being evaluated for some other random complaint unrelated to any recent or potential overdose.

If we were ever good enough in medicine to prevent this sort of repeat business, the ambulances might have very little business at all.

14 January 2009

Buying time

Time is money and not just in an abstract way. During the medical school admission process, if you want more time to think and decide, it costs you money. Holding my spot in the MD program until the end of the admission season cost me a $50 deposit. Holding a spot in the DO program for 30 more days cost me a $500 deposit. If I want more time after that, it will be another $1500 (this part is refundable until June).

Why am I interested in buying time instead of just making up my mind? Well, right around the time I was hitting the decision point, I got an invitation to interview at my top choice school. I know that doesn't eliminate the possibility of ending up at another institution and needing to make the choice, especially since it is likely I won't hear back from the top choice by the time the next deposit is due, but it took a lot of the pressure off and my preference between the two has actually swung back the other direction.

Funny enough, purchasing this education is approximately as expensive as buying a house but is way more stressful to me. I don't actually mind ending up in a house that isn't perfect, good enough is usually the only thing in our price range and we have some skills to help make a place more suitable for our needs. This flexibility is assisted by knowing that we aren't going to stay for the next 50 years, maybe just 4-6 years. It is also assisted by being able to get at least some of my money back (maybe more) when I leave. If medical school felt more like a short-term investment that I could recoup my costs in 4-6 years, I would probably just make a choice and move on. But realistically, education is a mortgage I'm going to have to pay in full and it is difficult to estimate when I might be able to see a cash return on my investment. When is my bank account going to return to current levels? When is there going to be enough money to support an increased lifestyle? How do I know whether spending extra $$ now will result in a bigger or faster return on my investment? We have a financial planner to help with these kinds of questions for our overall and retirement planning, I guess I just need one for medical school too.

05 January 2009

What happens in Vegas

...ends up here. Well, parts of it anyway. K and I have seen Neil Diamond in concert, watched Anthony Cools perform hypnosis and listened to lounge acts. Family gathered to renew connections and catch up with everyone as they gradually cultivate their own lives away from the center. We've gambled at slots, video poker and craps, winning a little, losing a little and watching time go by. We've wandered up and down the strip, through the casinos, marveling at the excess and the sheer volume of money wasted day after day, hour on top of hour. I've remembered how fantastic it is to live in a state with smoke-free bars and restaurants as today my lungs decided every additional breath of smoke was going to result in a wracking cough. All in all, a decent vacation, but I'm looking forward to home, relaxing with no expectations, petting the hound and not smelling like an ashtray.

01 January 2009


Heading out to Sin City today, lounging in an airport for multiple wasted hours of my life. Sitting here in view of the geniuses employed by TSA reminds me of a story I haven't told about being stuck in Chicago during the New Hampshire Ice Storm of 2008. (Sorry for the capitalization, I've seen too many year end summary shows where everything is Made Extremely Important By Capital Letters.) After being told I wasn't going to get home that night, I waited on hold for quite a while and finally got re-booked on the first flight out the next morning.

Arriving back at the airport, I found out I could not check myself in because I no longer had an electronic ticket and got lectured by the agent about "When you change your ticket..." Somehow, she was not especially sympathetic to the fact that I did not want to change my ticket, I wanted to be home. Upon arriving at the security check-point, I'm told that I have to go through extra security screening because "You bought a last minute ticket." Again, no sympathy for the fact that I had nothing to do with the ticket change, just a lecture about not having to go through the alien anal probe if I bought my ticket in advance.

I was personally escorted through a maze of walls and doors where my ID and boarding pass were handed to the next agent. I guess they were afraid I might make a break for it and everyone knows that if a wannabe cop is holding your driver's license, you're as good as locked up. After taking all my carry-on baggage away, I get my shoes and coat off when the guy tells me I have to put my shoes back on then step into the booth which resembles a combination of a telephone booth and an MRI machine and looks about that comfortable. "Stand on the foot prints. Do not move until the doors open." This is when I learn that I should've probably gone to a spray tan booth before traveling because I'd probably be a lot less startled when I'm suddenly hit from 360 degrees by sharp puffs of air. Yes, I got sniffed for explosives because I'm a danger due to my late ticket and I probably convinced them I wasn't a terrorist just by jumping about 3 feet when the air hit me. Finally, the doors open and I'm led off to an individual screening area where I have to take off my shoes, all my bags are individually swabbed for explosives, and I'm checked with the wand. Fun, fun, fun.

After all that, I have to think that it seemed like a relatively silly display of inconvenience more than making me feel secure. If I wanted to do something to a flight, I wouldn't buy a last minute ticket. I would be the world's most OCD terrorist, they could probably find me just by looking to see who checked on the flight 657 times in the 12 hours before take-off and look for the woman checking all her pockets for anything she forgot to pack to head to Heaven, Nirvana, or wherever terrorists think they're going.