When you were born...

From Patagonia Ele...

When you were born...



Starting on December 21, I was on call every other day through the 25th, which means I was at home from about Noon until 5am the following morning on the 22nd, 24th, and 26th. I had it all worked out: work straight until the 28th and then I would have five days off, followed by 7 more days of vacation. During these 12 days I was hoping would bring the fourth child of ours. If her respect of my schedule is any indication, Pati will be a most compliant and obliging daughter. There was a crossover date where I had coverage at the hospital, but was expected to be there. Kristi started having contractions starting somewhere around 7pm on the 26th, a day where I got off around noon from a 30-hour shift of being on call at the hospital. I was able to nap some from 11 or so until about 3am when the groaning next to me became a bit more intense and closer together.



The plan was to take the three kids next door to our wonderful neighbor's place (Dana and Nancy Ewing) as soon as we needed to, but we had some backup just in case. On around 6:00 on the morning of the 27th I realized that I needed to get in gear and make sure the kids were breakfasted, clothed, pottied and had a change of clothing in preparation for a quick trip next door to the neighbor's place. Somewhere after the oatmeal was ready (yes, I can cook when I have to, but the trick is to make it edible but not too close to savory that you are asked upon to perform the culinary art during non-emergent states) and the bags were nearly packed our lovely midwife Heather Judson decided to see how things were progressing. Feel, rather, is more like it, I guess. Anyhow, I didn't hear any words of the conversation that was going on in the "exam" room except for the word "COMPLETE."



Now, maybe to the lay person that doesn't mean anything, but I suppose it would be like telling a cook that their oatmeal was either about to boil over or had run out of water. In the next few minutes the children were up, dressed, hastily fed, and packaged and delivered next door after a call to the neighbor at 7am. Fortunately for us, our midwife is no lay person either, and the word "COMPLETE" meant that in the time I had packaged and delivered the bewildered children next door, our bedroom had been transformed into a birthing suite, and before long we were full into it, with pushing, a bag of water that broke and showed us the GI tract was working in the new one as there was some meconium staining in the fluid (this can indicate fetal distress and is a problem if the little tot inhales some with the first breath of cool, fresh air). She was pretty efficient after that and before more than 10 minutes had passed, maybe only 5 since the water broke, a crowning head was clearly visible. One push after that we were trying to find the orifices to suction before the rest of the monster was delivered (the baby, of course is the one I mean is being delivered, although I know it is mutual deliverance). It was difficult to suction because she was facing behind mommy, so suctioning was a bit like attempting to find a hole with a screw on the end of a bit on the back side of an ottoman that you are seated in front of. In no way is my lovely wife similar to an ottoman, but that seems the best description I could think up.



Anyhow, there she was and next thing I know we were sitting there wrapping the little sausage in a blanket and working the clamps on a cord after a minute or two. Pati was discovered to be a Pati and not a Mark, or James, or John, or whatever we would have named her if she was a boy at this point, and was noticed to be incredibly quiet, blue, and nealy inactive except for large blinking eyes. We finally rubbed her down and got a little hoarse cry out of her before we clamped and cut the cord. Then we worked on getting Pati pinked up and suctioned out and dried off and wrapped up while waiting for the twin to be born (the placenta that is). This took a bit of time, and I was a bit too close because this placenta was sort of it's own plug, holding back about a quart of blood and fluid that came out all at once and hit me right in the leg and foot. That being over, we had an issue with mom bleeding for about 45 or more minutes after the placenta was delivered, which involved massaging the fundus, giving some shepherd's purse (some herbal thingy), metherjin (that is how you pronounce it anyway), and pitocin that was intermixed with prayer of course.



The bleeding stopped, the baby nursed, we all felt a bit better and then got a nap or two before our first night together as 6. Pati seemed to be quite pleasant, and has continued to seem so. I don't know if this will continue, but we are sure grateful for her quiet voice and calm demeanor. Takes most everything either asleep or quietly gazing into the still winter air as if she is waiting for spring to come before she really wakes up and becomes who she is going to be.



Heather, the aforementioned midwife and long-time family friend, was escorted by 4 of us this morning to the airport, so it is just dad and the three older kids doing their best to stay out of mom's hair and keep everyone fed, in clean clothes, and the house in good walking order (paths clearly marked). I have no idea how my wife does it. I think I would go insane after a week or two dealing with this crew. Not that they are bad kids at all, just that so much is going on and nobody really is that much of a help, yet. I was able to get some help organizing the lincoln logs and such today, and I can warm up a mean frozen pizza and make some pretty sweet hot chocolate. Really, the older kids and I went to the towpath this afternoon while mom and baby and Anne were napping. We made it a good four miles before the girl had to go potty, and it was right next to a latrine, so I consider it a pretty good day, in all. I still am figuring out how I am going to go to the store and get some necessities. Duct tape seems like it would sure come in handy if it weren't for those bothersome CSD people and their spies. I guess it will be discrete pinches in sensitive locations for now.



Well, this was meant to be both a blog entry for you all, as well as an accounting for Patagonia when she gets older and asks about what her birth was like. Actually, it will be for me because by then I will most likely have some form of dementia or memory loss or something, and will need a crutch like this to help me out.



Thanks for the prayers and for not making fun of Pati's name. We figured she could always go by Pati or Elena or Elen or something if she really doesn't like it. If you don't like it, well that's just too bad.



David

Pictures of December

From December 2006

You don't hear from me (Kristi) much because every time I sit down to write a new posting I get distracted with trying to put a picture in it. I usually just give up after I have used up my 30 minutes of kids nap time trying to get a picture to configure and post it on the site (it must be done before anything can be written). I thought that I must be very inept since I know others who fill their blogs with multiple pictures and it never seems to give them a problem. I feel a bit better to know that the pictures give David trouble too, in fact, posting pictures gives trouble to most everyone who uses beta blogger instead of just plain blogger. Unfortunately we didn't know that there was difference between the two and to change from one to the other now would be a royal pain - so I guess I will keep trying to post pictures with minimal success, althuogh I do hear that beta blogger is working on fixing the problem since no one is happy about it!. [I added the above picture after the fact, DC]

If I could have put pictures in I would have put in Kaytra Copper and Sarah Coder playing with my kids. They came out to Ohio for a week and made cookies and bread and freezer meals, took care of my children, cleaned bathrooms, mopped floors, folded laundry, wrapped Christmas presents, and took about 500 pictures on our digital camera. We sure miss them. They were also here for 3 of the days this month that David worked 30 hour shifts and were great company for me.

The one picture that we almost took but didn't was of Jan, early this last Sunday morning. She had gotten up before anyone else because she needed to use the bathroom. While sitting on the toilet, in the dark with no one to talk to she noticed that there was no toilet paper on the roll. The most natural thing to do was to take off the rod that usually holds toilet paper, take it apart and pretend that it was jewelry. When she finally hollered for me to come and help her one of the ends of the toilet paper roll was good and stuck on her pinky. Of course, David had left several hours earlier and would not be home until the next afternoon. I tried greasing it up with several things, then cutting with tin snips and wire cutters. Nothing worked. It was off to the emergency room. I was so grateful that I didn't have to haul the other two kids out of bed and take them with us too. Kaytra and Sarah stayed with them while Jan and I headed to Akron Children's Hospital. The doctors and nurses down there couldn't figure out how to get it off either. They finally called up a big brawny janitor from maitenance to bring a large pair of tin/wire cutters. About an hour and fifteen minutes after she first put it on it finally came off. Her finger was swollen, cut and gray but she could feel it. (And they gave her a pretty white bear for being so good...she was so pleased with it that I worried a little about a repeat performance.)

It has been snowing for most of this week and it is beautiful outside. We have a few pictures of kids with red cheeks making snowangels. Anne Pilar is so bundled that she can hardly walk, looking like a cross between a boy and a girl in Alec's hand-me-down blue snowsuit and a powder pink hat. Pretty cold, but we make it out a couple of times a day to pull the sled around and try to make snowballs. The first day Jan rolled snowballs around for twenty minutes trying to make a snowman. She kept saying "I think it is getting bigger Mom!" But it wasn't and she finally gave up. I guess wet Oregon snow is just better for snowpeople. David even made it out to pull kids around the house in the sled a few times before he had to go to bed. (His overall schelule this month is pretty awful and he goes alot of nights with no sleep at all..I guess that it will make having a newborn look easy!)

The house is half decorated for Christmas - we hope to make it out to get a tree next week (along with some new PLASTIC toilet paper holders). We don't have pictures of doing advent, but it would be fun to post a few since it really is the best time of day. It is most fun when David gets to be home for it. The kids are relearning some of Luke 2 and are starting to be able to sing the real words to "O Come O Come Emmanuel" (which is good since David and I can't help getting the giggles when they are singing along earnestly, but don't really know the tune or the words.).

I started this month fretting about the upcoming birth, about David's schedule, about lack of childcare options during the birth. Several people have mentioned that they are praying for for all of that. This week I have had peace about God's control over all of those things. I am interested to see how He works it all out...and I can't help wishing that it were over!

Maybe our next post will have real pictures - of a new baby!

Hope you all have a good December.
Kristi for the Carnes

Neurosurgeon Thanksgiving

Giving Thanks is such a good thing. Anything that gets your focus off of yourself is a good thing, and I am hard pressed to think of anything to thank myself for. Being in the line of work that I am gives me much more to be thankful for than most, I think. During my month of Neurosurgery I have been able to meet many grateful and many devastated people.

Two weeks ago a woman in her mid 50's came in to us because we operate on the brain and she had a problem where the remedy matched our job description. It sure is nice to not need an advertising budget as all of your work comes to you. She had been complaining of worsening headaches and some mood changes. She went into the emergency department at her local hospital, fortunately for her because everyone who follows her example gets a CT of their head, and they immediately sent her to us.

I examined her and noticed she had a very flat affect. This is doctor speak for lack of emotion or expression. Her husband added that she had lost nearly all motivation for doing much of anything over the past bit, and was concerned her scan was related. The nurse and I looked at the scan and decided she needed surgery. She got an MRI because the surgeons need the MRI to better show the limits of the tumor that had entirely replaced her Right Frontal lobe... In essence she had a golf ball sized tumor in the front of her brain that was squeezing the living daylights out of it. Fortunately for her, there is not too much that goes on there that will let you know something is wrong. There is no motor or sensation control there, or even speech or anything, so you won't have much more than headaches and problems thinking and feeling (sort of like a functional lobotomy, really)emotion.

When we opened up her scalp and drilled out a wallet-sized chunk of skull so we could access the tumor we were impressed again with the size of the lesion. It was a dark grey mushy mass of tissue inside the ivory white brain tissue, and it took us quite some time to dissect it carefully away from the healthy normal brain tissue, especially since these tumors are so vascular (which means they bleed whenever you touch them). We did finally get her tumor out and filled up the hole with saline so her brain wouldn't collapse back into the hole. We carefully sewed back the layers covering the brain and then I got to screw the flap of skull back on and we closed her scalp.

To my amazement she was only a little nauseated when she woke up. Then when I saw her in the ICU the next morning, she actually smiled! Wow, she hadn't done that for some time. By the third day after her operation she was joking, planning out her holiday preparations and was trying to make up for lost time in the energy department. I am not sure if her husband will be thanking us or not since she lost her energy gradually so he could get used to it, but now she had it all back over the space of 3 days, which has to be quite the shock.

Makes me especially grateful for what I have and how blessed I am. Also makes me feel very safe and secure to know that I have a personal relationship with God, and that He is so steadfast and dependable. Living is so unpredictable in itself, with seemingly random tragedy and elation waiting for each of us around the corner. I sure do not depend on my body for satisfaction or function tomorrow. I can either be cynical and sour about not being able to know that I too won't end up under the lights with my brain exposed, or else I can just accept that uncertainty and take solace in the odds and put my confidence and trust and life in the hands of the Creator and see what it is He would like my body to be doing during the time it is here.

Another guy we took some brain tumor from won't be so blessed. He is pretty devastated and upset given the fact that his tumors, unlike the lady above, are not primary brain tumors but they are metastases from lung cancer that has not yet been located. He has a 10 or less percent 5-year survival and he is very much into his body. He did smoke for years and years until he had a heart attack. He then started working out with the same enthusiasm he used to smoke with, ate all natural stuff and paid close attention to his body. What he gets from that is metastatic brain cancer that will buy him radiation and chemotherapy and a very low chance of making it more than 2 or 3 years from now. Unfortunately he worshiped his body, so he is devastated about it.

I have been thinking about him some lately, and hope I get to see him again sometime as the time he spent in the hospital was very busy for us... I never got a chance to talk with him about God more than just passing one-line comments to ascertain his openness to the subject, which seemed to indicate he was as he has no family and only a few friends around here. I will keep praying he will come to know God in a way that allows him to place his life in His hands (as if it is not already, you know?).

Well, that is what I have been dealing with the past week or so, along with many other patients as well. My stretch of being on call has come to a close so I get to enjoy Thanksgiving at home with the family and even get this weekend off, except I have to go in tomorrow because we are opening up a few more brains and spines.

We hope you all have a good Thanksgiving and have ability to be thankful for the blessings you have undeservedly been given.

David

Give the surgeon a break

Well, I have had some interesting cases this past week, and thought I would share them with you all.
I have been on the Neurosurgery service this past week. This means that I deal a bit more with the sad cases. I guess it is something like oncology or neurology where there are devastating conditions, many times the prognosis is bleak, and people don't do so well. This all makes for patients who don't give you much backtalk, families who are upset, and attending neurosurgeons who are impatient, have a good sense of humur, and fly off the handle at the most "trivial" details. I say "trivial" because to me it doesn't seem all that important whether or not the patient has this or that done or medication taken. After working on their service for the past week I realize they deal with such intense situations and stressful situations that they need a place to vent or they will go nuts. Better they vent when not in the middle of someone's brain or spinal cord surgery, in my opinion.
One interesting thing I have learned about surgery and surgeons in particular is that they get a bad rap for being mean, harsh, unkind, insensitive, etc... I realize this is true very often, but hardly ever unprovoked, and hardly ever is it personal. In surgery, each patient can potentially die at any time. You live each moment of each day doing all you can to try to anticipate problems, complications, errors, and mistakes so the patient has the best chance of making it out of the hospital at least as well as they came in as. Against you there is a tremendous amount of opposition. First, you have the patient himself. Now, patients vary with the way they come in. The trauma patients are nearly always intoxicated out of their minds, foul smelling as if they are all having a competition to see who can make the most of us pass out or at least wrinkle our noses the most, and in great humor as we attempt to care for them by jabbing their arms with needles, poking and proding the extend of all injuries, and inserting large tubes in small orifices under the guise of "this is necessary for your care." Now, this is all true, the necessary part of course, but usually these patients work so hard as law abiding citizens during normal business hours, that they need to blow off steam and go to church around 2:30 am, which is when they are innocently walking home minding their business or driving to church when some idiot is driving through a green light.
Oh, sarcasm and being calloused is one of the requirements to pass the surgery boards, I am told. Anyway, I say all of this to give you the backdrop for the very rare trauma patient who is one of the rest of us. Usually these are either victims of the other trauma patients who are intoxicated and operating motor vehicles, or else they come in during normal business hours. Just yesterday, I was post call, which means I was up all night dealing with the drunken idiots who were out running into parking lot lamp-posts after a few drinks to calm their nerves. I was preparing to go home and was just holding the pager for the intern who was on call as he was in the operating room and I wasn't. Of course, as soon as I attempted to leave a trauma was called in. Now, traumas at 10:30 am on a nice sunny warm day make me think differently then the ones on cold nights after payday.
Anyhow, I was covering my partner on this trauma yesterday morning and the guy was nice. He didn't smell like a dumpster behind the liquor store, and had not a single tattoo on his body. Unfortunately for him he had fallen victim to bloody gravity. Fell from a scaffold and was paralized from the nipples down, also started loosing feeling and strength in his hands and arms as we were examining him. He never swore at us as we were poking and proding and inserting... probably because he was paralized. I have this theory, and it seems validated over and over. The nicest people get the most devastating diseases and injuries. The drunks total their vehicles, ride their motorcycles drunk at 1am and come out with scrapes and bruises and a few free meals. The honest law-abiding citizens who really do go to church end up falling off the stepstool helping the blind widow get some powdered milk off the shelf. They usually end up either paralized from the eyebrows down, or a vegetable on a ventilator from bleeding in their brain... Or they have no injury at all, but when they had the pan-man-scan to look for internal injuries they find the honest citizen has metastatic cancer all over and only has a few more weeks to live.
The other case that came in yesterday was a nice lady of 69 who was having trouble walking and had passed out a few times. She had a CT to look for bleeding and they found a mass in the lower part of her brain. I was working this evening with the neurosurgeon on her brain and we got to see the tumor and took it out to find it could be some form or lymphoma. Well, she was pretty upset when she found out we wanted to remove it because we thought it was a tumor. Thing was she had a son who died at age 42 after 7 years fighting off a brain tumor. Seems like I have it pretty good for being such a nice guy... Well, at least I thought I was, but since I haven't had any really bad disease or tragic injury I figured maybe I was meaner than I thought. Maybe it will be in my favor that I have ordered enemas on all of the medical patients just before I go on vacation. Not really, but it makes one wonder if karma wouldn't bother you so much if you used bigger needles than necessary, no lubricant for catheters, and three fingers for rectal exams.
To get back to the enemies of the surgeon. First, there are the patients who try to die without telling anyone or letting you know but are constantly disguised and hidden among the patients who are constantly crying wolf and feigning all sorts of serious diseases and complications. Next, the nursing staff calls you for anything and everything besides the important things, forgets to check the pulse and blood pressure of the only patients who really need it checked, and don't record the urine output of the patients who develop kidney failure because they need more fluid that you had ordered but they forgot to administer because the patient has been without an IV for some time now but they forgot to call you so they could start a new one, or they tried one but you were busy with all of the tylenol and benadryl orders for people who can't sleep. Finally, there are the families who figure you have nothing better to do than keep them informed on any change in their loved one's condition, and want an explanation. This wouldn't be any problem except that you have 28 people on your list to see and take care of, the operating room is calling you for the next case, the three nursing units are calling you for orders, the ICU needs transfer orders for one patient and central lines changed in two others, your chief resident needs you to check with the radiologist on some scans and you haven't had breakfast or lunch and need to use the little boy's room before surgery before you have an accident. If you just knew which patient that has shortness of breath had the clot in their lung, medicine wouldn't be so difficult.
I am starting to understand why many surgeons get so worked up about things. I have learned that you can't trust anyone, assume anything, and always keep your bladder as empty as possible. One other thing. Most surgeons can blow up in your face if you mess up like Mt. St. Helens. Most surgeons completely forget the matter and are your pal 5 min later. So far I have been chewed out about 7 or 8 times, but I never felt like the surgeon was unconcerned for my education and have always felt like they truly want me to be a great doctor and surgeon. Funny how if you get that feeling from someone you will take just about any tirade or attack and feel bad but not humiliated. I keep coming back to the fact that I am only responsible to God for my actions and responses. That sure helps.

Well, I have to run along to bed since I am on call tomorrow and have to be there early since I am rounding with the Chair of surgery on a bunch of patients I have never met so it will take me a bit.

David

November 06

Sleep is Good

My grandmother suggested I tell you all about what my daily life is like, so I thought about many options available to me and I selected the "day in the life" approach. I have to start off by telling you that my children and wife are occasionally able to share a free on call weekend meal with me in the hospital, and so if you were to ask them what I do I am sure their answer would include "Doctor, surgeon, sick people, hot dogs, cutting on people, grape fanta, giving people medicine so they feel better, and french fries." The hot dogs might actually be higher up on their list, you are welcome to call and ask them yourself and I am sure they could tell you.

I am just picking a regular day, not an on call day since the on call day is not something I usually like to re-visit. Typically, I wake up around 5:20 and am out the door to drive it to the hospital around 5:35. I arrive and print off my patient lists from the computer so I know who it it I need to see that morning. I then check on the laboratory values of the patients I am going to see, and then any recent radiographic tests as well, and if the patient has a chest x-ray already back by 6am I will look at that real quick as well. I try to start "rounding" on my patients by 6:10, which involves seeing anyone who just had surgery or is new on our service before the others who are either ready to go home soon or are "rocks," and will likely be there for some time to come.

I usually start with gravity rounds, where I start on the highest floor first and work my way down to the lower floors. This is only the case if I don't have patients in the ICU or other "units" to see, and then they are seen first because they are more urgent. Going to the patient room, I take the chart from the pull-down and quickly look at any new orders (tells me what is really going on), overnight vital signs (this includes pulse, blood pressure, oxygen saturation of the blood, respiratory rate, urine output, intake and other output if the patient has drains or tubes or is vomiting or eliminating). Armed with this information, I look at the other doctor's notes if they are decipherable, and then charge into the patient's room where I spend usually less than 2-3 minutes asking incredibly pointed questions that are never to be repeated outside of the correct context. The conversation goes something like this, "Hi Mrs. Smith, sorry to wake you up again, any troubles overnight? Were you able to walk around at all yesterday? Are you eating anything, any nausea? Passing and gas or stool? How well is your pain controlled? Is there anything you need? Okay, I will see you later on, send you home, or explain the plan, etc..."
I then quickly scribble out a note that includes how long since they have been in the hospital, or how far out from their surgery or trauma they are, any other major issues being treated for and then pending tests or evaluation or upcoming studies or surgeries and other plans, or even when I think they will go home or back to the nursing care center, or whatever. I sandwich this information around a very detailed exam where I mention they were breathing, had a pulse, and their belly exam or wound inspection and status, and the character of any fluids draining out of anywhere.
This is repeated on the 7-15 patients I see every morning until around 7 or so we usually have some sort of educational meeting, where we also meet with the other members of the team and discuss all of the patients with each other and then go from there to the Operating Room where we first meet the patients if we haven't already, or else go straight to the OR suite and announce our presence to the scrub team and pull our gloves and gown so they have all of that. As we are scrubbing in with the attending, we fill him in on all of their patients and see what they want to do for each one and what the plan will be. After the cases we some times will physically "round" with the attending physician or we will go do other duties that may include but not be limited to pulling out drains, draining an abscess, pulling our or placing a chest tube, ordering special studies or reviewing studies with the radiologist and attending, seeing any new patients that have come to our service and getting them checked in to the hospital, and if we are lucky catching a quick lunch.
If we are on call, we get paged at any time for questions up on the floors, new traumas that have come in, or other questions that are inappropriately asked of us. If there is time remaining after the cases in the afternoon, we will quickly go over the list of patients with our team of residents (oh, each team has at least a chief or senior resident and an intern.... often a mid-level resident as well, and then 3-6 attending physicians, whose patients we are responsible for)and then make sure everything is tied down for the next day and tell the on call staff about anything that needs to be taken care of, results that the attending needs to be called about, drains or lines that need to be removed, changed, or placed. Hopefully it is only 5pm and we can go home, at the most it is 7pm by the time we get out and sometimes it is 4.
On call, means we do all of that and then at 5pm we are responsible for all of the surgical patients, any new surgical patient that comes into the ER, or that is already in the hospital but has become a surgical patient. This is typically very busy and means answering pages from all over the hospital for most of the night. Things seems to calm down normally around 11:30pm, which is typically the calm just before the shooting or drunken trauma comes in. You would be amazed by how many innocent people are shot by folks, especially when they always say they were just minding their own business (at 3am). Just a lot of crazy people out there, you know.
The on-call day ends at 7am, when you get to ditch the pager to the next on call resident. Hopefully you have been able to round on some patients before 7, but at times this is very difficult, especially if any traumas come in after 4am. In order to go home after being on call, you must have rounded on your patients, checked out with your team, possibly helped with 1-3 surgeries and then checked out again. We are required to be out of the hospital for 8 hours following being in the hospital for 30 hours continuously, but we never have to come back in before 6 the next morning, which is nice, since at times we may be on call again. Typically, I get four week-end days off a month, which is when I get to help Kristi out a little bit and hopefully sleep in some too.

That is about it... I think I will have to discuss some interesting cases and interactions if I get a chance next time I comment about work.

Yesterday, the weather was so perfect, and I was stalled in my research so I took the day off after the 7am education meeting and we went to the Cleveland Zoo, raked leaves in the afternoon, and played with the children. Tomorrow I start the neurosurgery service, so that will be interesting for me. I will be the only resident on the service, which will be no fun, but fun because I get to do whatever case I want to in the operating room, as there will be no competition. Just means I will have more paperwork and dictating to do... Oh, I forgot to mention that in the course of a normal day we are required to keep up with our dictations and paperwork, try to go to office hours, read topics for upcoming educational conferences, etc...

Have a great week
Dr. Meat

October 2006

Lessons in Physics

Most of us eventually "discover" the truth that we don't really have the ability to know everything about anything. There are some things we learn through experience. Some things we learn from the experiences of others. Then there is everything else that we really don't know the first thing about, and try to just make it through life without having our ignorance come up and bite us, or at least not while others are watching.
Although experience is a pretty good teacher, it's utility is not only in making one less ignorant. Confidence is what experience is really good at. Now, this is good and bad in that a little bit of knowledge is good in helping you mentally get going and helps you try new things and learn more because you think you know how to cover yourself if you get into trouble. Experience and the confidence it brings also can get you into trouble by allowing you to think you can do things or go places you really can't and shouldn't and just got away with it one or two times before is the only reason you think you can safely do it again.
This is all in reference to life, of course. Specifically, I am thinking of my lovely children, the lovely weather, and my current occupation. Just because I dug through the garbage once and nothing came of it doesn't mean I won't get it if I venture in there again. Just because it is October doesn't mean it won't snow and be nasty outside. Just because I know how to start an IV doesn't mean I can get away with starting a central line or just because I can put a scalpel on a handle doesn't mean I know the difference between nerve and tendon.
That being said, this past few weeks have been pretty good... I guess. The weather predictably unpredictable, the children have been growing up and learning new things with us, and we are getting closer to our first spring in Ohio. For the past 10 days I have been on call nearly every other or every third day, which makes for little time for much else. I am finally done and now I get to join a team at the hospital that is short a person, so I get to keep on rounding every morning, which is good for me I am sure.
Apple season is here, and Kristi took the kids to Amish country with Mrs. Sobie, a former ATI mom who is very knowledgeable about these things. So, we have lots of apples. We are still raking leaves, and watching some snow fall once and a while. Anne is getting a little bit better with her eczema, and that makes us pretty happy (now we have all 4 eye teeth coming in) for the most part. We had a wonderful time on Saturday at the mansion of the guy who was co-founder of Goodyear Tire. The children are learning more and more about animals and letters and numbers and phonics. Anne is walking like a champ, and that has helped her frustration level, which in turn helps ours. Jan and Alec now have I John 1 memorized and enjoy reciting it for those members of the treats for verses club.
We are still working on social graces, keeping our voices down in public, second and other ballet positions, recognizing the warning signs of a BM when Anne is in the tub with us, keeping the doors closed and only necessary lights on in the house, gravity, inertia, and responding to authority.
I have been able to get to know some of the other residents a bit better after being on call with some who I have not really worked with that much, which has been good. I was on call Sunday and over a patient with appendicitis that I was lining up to go to the OR one of the Emergency Residents says, "Hey, you sure missed a good sermon at church today." I, with experience, have learned a few social graces so I by-passed the "who in the heck are you" and replied, "Yeah, my wife emailed me and said Steve did a very good job explaining the Word and the place it should have in our lives."
Feel a bit more ingrained here since I have started running into nurses and residents and just this morning I chatted with a family doc at the hospital who goes to the Church we have been attending. Sure are nice people, and what impresses me is they seem genuinely interested in growing spiritually and being challenged and knowing what God says and how it should change the way they live. The kids are very much learning and growing, and talk about the Bible stories they learn each week. That is good too.
Well, that will do it. I have some "research" to attend to and must get back at it. Also, I need to get some exercise. This week we have Andy Smith coming by on his way back to Bible College from DC, we are having dinner with the Pastor's family, and multiple other appointments and engagements.
Feel free to drop us a line any time. Next month I think I have Neurosurgery, but I may be bumped back to Cardiovascular/Thoracic service as there is a shortage of intern over there.

David

A Carne by any other name....

This week and next week have their share of 30 hour shifts for David. While he is gone and kids are in bed I am spending time sifting through piles of names. (This pregnancy has required time spent with my feet above my heart and there honestly are not alot of productive things that can be done with your feet piled on pillows or propped against the back of the couch. Looking for names is something that works here.) This used to be something that my friends and I did for fun - as 13 and 14 years olds we all had lists of names that we absolutely, positively loved. I guess that I lost my list.
Seriously...David and I have a hard time picking out names for the new people in our family. Not exactly sure of why, but something to do with how important it is, how frequently it will be used, how it will have much to do with the impressions others have of him/her when they first meet, etc.
So many names that I just "like" don't go with Carne. Some of them just don't go with the names of the siblings. Some of the names I like were David's neighbors while he was growing up and he hated them. Some of them I just like on paper, I don't like the actual sound of them.

Alec thinks that we should name whatever it is "Spanky Alfalfa". We aren't asking him anymore.
Jan is agreeable to most any name that I suggest, but would really like to name it (whatever it is) "Sasha". Don't ask me why. Why can't I be as opinionated as that?

I am wishing that I would have told that ultrasound tech that I would like to know if the baby is a boy or a girl, just so it would be narrowed down a bit. If anyone was wondering there are about 3x as many girls names as there are boys names. Well - we have two months plus to figure it out so it isn't panic time yet.

One of my favorite verses is in Isaiah - asking Israel if a mother can forget her nursing child - and then says that even she may forget but He will not forget them. He has their name written on the palm of His hand. I like to think of my name being written on God's hand. I like to think that whatever my next child's name is, God has it written on His hand.

I learned something new about Ohio this week. They celebrate a holiday called Sweetest Day. October 21. It is like Valentine's Day for the second time around or something like that. Advertisements everywhere - even a Sweetest Day section for cards at Target. This may be a day that has a honored and illustrious history but I can't help wondering if it is just a ploy to get people in Ohio to spend more on cards, chocolate and flowers at a time of year when Hallmark type stores just don't get alot of business. I probably shouldn't be so cynical - maybe by the time we leave here I will celebrate it as though it is a real holiday...but I doubt it.

Looking forward to tomorrow - Starting tomorrow David gets to come home in the evenings for three days straight. Tomorrow will be my Sweetest Day.

Fall is fall so you fall

Well, I suppose I should write something since I have this blog now and I am on a month of research. That means that I get much more time to be at home than normal, which is good because I wasn't expecting to have a month like this until I retired or got fired or something. I am actually working on some research, so it is all legit. Just that if there is a nice day and I have gotten to a place in my work where I can put it up, I am not encouraged to stay, so today I packed it up around 1 or so and we went hiking and played outside and went to a pumpkin patch so the kids could get frustrated in the hay maze and cry about not wanting to go through the tunnels in the hay fort. The weather couldn't be any more lovely here today, and I was debating with my research "supervisor" at about 12:50pm today if I could in good conscience take the rest of the day off and then she said there was talk of the "S" word coming to town on Thursday night or Friday morning. The next thing she heard was the door to office closing behind me.

This past few weeks have been pretty busy. We took the kids to the Columbus Zoo on Saturday, which was incredibly fun and action packed. They have a very nice zoo there, only thing is it's 2 hours away, and we have to pay half price, which is not all that much, but when you are used to going to the Zoo for "free" it is hard to swallow. Not that hard, I suppose. I am now becoming a great fan of the Gibbon species, they are gobs of fun and really entertaining. Nothing like having kids, for sure.

We have been learning lots about leaves here as well. I went out last night and "mulched" the leaves and then mowed them up so they all fit in only one trash bag.... only to get home today and see more leaves on the lawn than last night. I suppose it is like taking a bath or something, feel like you should but you will just stink again anyway so feels like a waste.

Also in the past few weeks, I ran in a 5-person marathon relay team with my fellow residents against a team of our attendings. They even brought in some "ringers" from other non-surgery departments to compete with us, but I think they should have saved the expense because we have a heavy-duty team here. We started off with Paul, a second-year guy here who is built like me and plays lots of soccer and lacrosse, then had a body-builder type who is a fellow intern but can run alright, and then Jill, the third intern this year with me who ran track in highschool and ran about 7 min/mile for over 6 miles. I think by the time I got the handoff we were already 20 minutes ahead of them. They treated us and our wives out afterward to a "clam bake." Now I haven't been to many clam bakes, but this was not what I expected. I started to wonder and had even dusted off my hip waders when the chair of surgery announced one morning in resident conference, "Oh, for that clam bake, the country club requires sport coats." I didn't think clams were that up and up, but that is why I am still a resident, I suppose.

We had a great time and Kristi and I were able to sample a whole new world. Was also fun to meet the attendings at a more "informal" setting and also to meet their wives was fun.

The kids are enjoying the last few days of summer here, and enjoy riding their bikes a lot. Alec has been showing his skin to the neighbors because the shirts are just too itchy, dad. Anne has really gotten the hang of the walking thing, and is tromping all over the place. Her rash is still pretty bad and is just sort of kept at a dull roar with the steroid cream and other creams and dietary modifications. She has her moments of being pretty miserable and we all feel pretty bad for the little cutie. Kristi is getting near to the end of things with number 4 and we are happy so much is behind us and are praying the Lord will be with her during the next few months and that her body holds up through this pregnancy and delivery. We are very much looking forward to seeing Heather here for the birth, as well as some family just before and then after the birth as well.

Another week of leaf raking, bike riding, and digging out the snow clothes is in store for the Carne family in Akron, OH. God has been very good to us and we are more grateful than we can explain.

David "Pre" Carne

My running teammates are calling me Pre, after the famous runner from that other school in Oregon. That just shows you how little they know about running. I have been wanting to ask them what is so ferocious about a seed, but maybe I will wait until May or June, when the football season is way past us and maybe they won't get too excited.

niagara falls and eczema

That is the best summing up of this September that I can think of. This month David was on the general surgery service for the first time since starting at the hospital. The schedule improved a bit and it was great to see him home for dinner pretty often. We had alot of fun with Grandpa Copper and Uncle Titus when they came out for a week or so (the kids are still going through withdrawals) and for the last couple of days of their visit David and I had a chance to get away for two nights.

This was the first time we have been able to be alone overnight since before Anne was born so we both felt like we were overdue! The kids had a wonderful time, but not as good a time as we did. We went to a bed and breakfast at Niagara-on-the-lake. The weather was beautiful and we enjoyed being out in it together. Niagara falls is impressive, but there are so many people and so many cheesy ways to spend your money within sight of the falls that it was nice to visit the falls and then retreat to Niagara-on-the-lake for some peace and quiet. There really was peace and quiet even though the Boy Scouts of Canada were camped by the hundreds on the green across the street from where we stayed. They were reinacting the War of 1812 complete with costumes and guns that at least made noise although they couldn't have been real. We enjoyed watching them as we walked into town for dinner, glad that we weren't joining their chow line for the "lots of hot dogs still left, guys!"

Dad and Titus gave us a good break and even kept the house clean. Jan informed me that Uncle Titus had taught them to count to ten in Halloween (I figured out later that she meant Japanese). Anne had been working on a nasty rash that was just getting to the edge of troublesome the day David and I left. By the time we got back it was terrible. It has been over a week now and it has cleared up quite a bit with the help of some medication, but she is still uncomfortable.

David is back at work now although the several days that he got to take off were a lifesaver for me. I think that he was able to get pretty rested up and it was just nice for the kids and I to get to see him for a good amount of time. I am grateful that he was around to help with Anne's eczema when it was really bad. We are praying that she will continue to heal and that if we can do anything to help her get better the Lord would show us what that would be. She has an appointment with an allergist on Thursday. She bears it pretty well, I think, but it really is a miserable thing. I wish now that I had taken a picture of her when her rash was bad, just for the record, but I couldn't bear to document it at the time, it made me cry to look at her.

We have been raking leaves and enjoying the blue sky and cooler weather. I think that Ohio falls beat their summers all to pieces. David runs an 8 mile portion of the marathon here on Saturday with some of his fellow residents running the other legs of it as a relay. Jan and Alec are all set to run the kids fun run on the same day while we wait for him to finish. (Alec decided to run this time because there is a goody bag for everyone who finishes.) We have made it down to the towpath a few times for a mix of bike riding/walking/running. We have taken the kids bikes down there several times and they really enjoy the opportunity to ride without worrying about traffic and the end of the driveway. Last night David ran his 7 or 8 miles while we walked and rode bikes. We are looking forward to this weekend because David gets both Saturday and Sunday off (unless "they" change their minds).

That was a little bit of our September. I don't know what October holds, but for me at this point it is all just a count down until this next baby is born. Supposed to happen sometime in the area of Carrie's birthday (December 18) so we have something like 12 weeks left. It always sounds so easy when you count it in weeks! We still don't have names picked out although our kids are never short on ideas about that. Alec is rooting for Spanky or Alfalfa and Jan really likes the name that Cori and Nils picked out for their baby if it is a girl and just doesn't understand why our baby couldn't match theirs. We'll come up with something soon...maybe in October!

Aren't snapping turtles fast, dad?

We had a day off today on Labor Day. Cleveland was having an air show and since we already paid for a year pass to the Zoo, I figured the more we go, the cheaper it gets so I drug the family up to see the animals again. We had lunch in our familiar bench with the elephants and people watched as we all snacked on cucumbers and olives and cheese and pretzels. There seems to be a strong representation of the Amish at the Cleveland Zoo because we have been there three times now and each time there must be at least 30 or so of them there. Either that or they all look the same to me and I just keep seeing them over and over, which is entirely possible. I think the best part of the zoo today was the Cheetah and Tortoise and Monkey area up above. We first came up on the tortoises and my soft spoken children were entertaining the other patrons with their ignorance as to the species presented to them, as well as the qualities of the genera and family. "Are those snapping turtles really fast, dad?" Well, son, those are tortoises.... and no, they are not exactly fast. "Oh, do their babies drink milk?" and so on.

Next was the cheetah pen. We overlooked that one the first time we were there due to the fact that they cheetahs were asleep. They were pretty lively this time, so we discussed the "tigers" and their speed, their relation to other cats, etc... We saw the gorillas, who were lying on their backs chewing on sticks, and so at dinner it was observed that "gorillas chew sticks." Actually, I will give you the entire sentence my son spewed: "Hey dad, these are eyes [holes chewed in a tortilla], and baby elephants drink milk don't they dad? Anne Peewar doesn't like spicy things, Hey Jan, I'm a bald eagle." And so it goes.

Back to the Zoo. We had a great time and left just before anyone wanted to, which is my strategy to get them to be excited about coming back so I can get a walk in and they can be occupied. I am now doing a general surgery and trauma surgery rotation, which is much better schedule-wise compared with my prior rotation of CardioThoracic and Vascular surgery. I have less attendings to cover for, and there are three of us interns on top of two senior residents. This makes the time much more relaxed and I actually have gotten caught up with my dictations and some reading as well. I also was able to operate with the residency program director last Friday, which was good. We took out a groin mass in about 3 min and he had me close for him. Was a good case for me to meet him better and discuss light topics like, why aren't you running in this marathon relay that the residents are running against the attendings?

I felt a bit like I was in the old days when I got home from being on call Sunday and my wife says, one of the emergency residents who goes to our church (the one we are checking out) has a piano they need help moving and their moving help fell through and it is going to rain. Reminds me of when my dear sweet mother used to talk on the phone and I would overhear, "yeah, we could come over and move that for you, what time is best?" I am not sure what WE she was referring to as she was just organizing the fun. I assume these folks had never seen me or pictures of me if they were asking for my help when lifting anything over 25 pounds. I suggested that my running shoes and apparel were for outrunning the piano should it obey gravity at any time.

This reminds me of the reason I felt like posting something. Yesterday was the 5-year anniversary of my mother's passing on. Seems impossible to me that is actually reality. I still have a difficult time believing she is not here. It must all be a dream. How is it possible that in the space of 5 years I could have applied to medical school, had my first child, moved to Portland and completed medical school, had two more children, been accepted in to general surgery residency and am now working as a general surgeon resident in Ohio in my first house with new acquaintances and surroundings? How is it possible that all this has happened without my mom here to share it? Seems impossible to me. I have to be honest and admit that my mom seems distant now. I used to feel that I would turn around or when someone answered the phone I would hear her voice, and I guess I still think this will happen. Now, however, I can go a whole day or so when I am really busy on call without thinking about my mom and what she would think about what I am doing or the grand kids she never met, or whatever. It has not really sidetracked me all that much, to tell the truth. I only really am bothered by her absence when things are either really good or really hard... those times you want people to share your experiences with you. Speaking of that, I have new pictures posted http://photos.yahoo.com/reyfrijoles if you want to share them with us. It is the Labor Day 06 album.

Gratefully, I have Kristi here to share with me, as well as my immediate family. I am blessed beyond measure and I honestly have no complaints. I am not okay with my mom not being around these past 5 years, but I am not mad about it anymore and I don't think it really matters anymore. I used to let it bother me and if it affects my attitude that is wrong. I start to think things like, "I wonder what my mom would think or say about this and that," but I now can honestly say to myself that it really doesn't matter to me what she would say or think because she is not here, and even if she were she would say it matters most what God thinks or says about my circumstances. I know He is most interested in my responses to where I am so I am back to needing to not be encumbered by past emotions or thoughts that would weigh down on my actions and attitudes. That whole putting the past behind you so you can focus on the present is key, and not to the exclusion of being unable to learn lessons from the past, but understanding that the past is there as a textbook for use in the present, and is not to be copied over and over.

Well, this is really rambly, and I apologize. I think I will post this thing and hit the sack. Another busy week ahead. Thanks for all of your thoughts and prayers and encouragement. God is good, trustworthy, and supremely desirable.


David

First, know thyself

Even though I am in the business of knowing a lot about others, it has been confirmed to me over and over the importance I should reserve for the opinions of people about themselves.
You may wonder why this is something I waste time to inform you about when I could be telling you about the heat of the sun, the humidity of rain, or the spiciness of chiles. I have thought a lot about this, and last night while I was on call, I had an interesting interaction with one of my patients.
My patient was an elderly woman who had arterial disease in her legs and is waiting for a bypass operation tomorrow. She hadn't been up out of bed, so I offered to take her myself and we toured the unit together at a pace I have never considered in that environment. My laundry list of duties had been nearly cleared by 11:30 last night, so I decided to gamble on the chance that I would be called out for a trauma halfway back from the nurses' station and have to leave her stranded in the hallway next to the soiled utility room. We had a good walk, and she was the reflective type last night so I chatted with her. We discussed life, and death and her grandkids and great-grandkids.
She was widowed about 7 years ago, and she asked me about my family. Somehow the topic of my mom's departure came up and her husband's fight with cancer. She described the amazing fact that her husband had lasted just long enough to see his newborn first greatgrandson, as well as his 75th birthday, which were a week apart. Someone had told her that he would somehow last long enough for them both and she was considering how it was that he actually did.

This had me thinking about another patient I have had that has kept me up the past few nights on call. He is a guy who reminds me of my step-grandfather, who was a hardened old vet with more swearing than legitimate words in his spoken vocabulary. He claimed he had been a part of that company in Vietnam that was reenacted by Tom Hanks in that movie "We Were Soldiers." He had become quite anxious during the course of his admission here and was in jeopardy of losing his other leg to diabetes-related vascular disease. He constantly accuses all of the hospital staff of trying to kill him, kill his last good leg, and a bunch of other stuff I suppose doesn't bear repeating.
He had worked himself up into such a state that he began refusing the treatments that were keeping his leg alive, and his anxiety and paranoia were such that he refused treatments and then blamed the symptoms on the treatments. He finally confirmed my hope that he was going to stress his heart to the point that cardiology would have to take possession of him for more close monitoring, and bless his soul he finally started damaging his heart by being so worked up about everything.
My point is, I keep coming back to that observation that as much as I think I understand human physiology, there is this thing called emotions that also affects physiology in mysterious ways. I remember reading a couple of articles around the time my mother died. These articles discussed the observed affect someone's personality and emotional state has on their ability to overcome terminal diagnoses. They profiled lots of people who were diagnosed with the same kind of cancer and then followed them all to see who died and who didn't. As you may expect, the people who were resigned to whatever was in store for them, wishing not to fight the process did not survive nearly as well as those "nasty old birds" who always fight through everything.
Through this, I have learned two things: what you think about and how you approach things mentally and emotionally does have bearing upon your immune system and physiology, and if everyone in the room is randomly chosen to have a specific diagnosis, the meanest and most undeserving person gets the best prognosis, and the nicest of the group always gets the inoperable 100% fatal with a painful death prognosis.
Take it however you want to, but I think it is about time to stop being so nice and resigning myself to what is perceived to be inevitable. From now on I am going to wear a Livestrong bracelet and think mean, low thoughts for a few minutes every day, just to ensure I am not the nicest person in the room. That is if living here for the longest time possible is the ultimate goal, however, which brings me back to "First, know thyself."

Parting Quote:

Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind. - Dr. Seuss

I would amend it to say "say what you should as a child of God" vs "what you feel."

David

Great Summer

Although I do feel a deep loyalty to the Pacific Northwest, this summer has been a good one. All of the kids are brown from the sunshine (I guess that Jan and Alec are brown, Anne Pilar just seems to be a less bright shade of white). The recreation opportunities, in our yard alone, are almost without number. They swing, swim in our little tiny plastic pool, water slide, do yard work, ride bikes and scooters, play house and matchbox cars - we can even walk to the park or the library if we get tired of our yard.
It is always fun to go in to get the kids out of bed in the morning (I think I meant to say "usually" not "always") because their attitude is something close to "Wow, so much to do. Can't believe that we slept this long!" What a good life.
Some days I do feel a little buried under the weight of fulltime caretaking. David does all he can to lighten my load but he has a heavier load than I do. In an hour or so he will be finishing up his 30 hour shift at the hospital and coming home to four people who will be so happy to see him.
I am finding that I need to go at a slower pace. It is when I have A List and am trying to cross things off that I become frusterated with the limitations of this time in life. My world is pretty small at this point, but I am grateful for a small world. The house, the yard, the grocery store and the library. I am grateful for my children and the good company that they are to me. Jan, although she is just four, lets me see myself and my attitudes in a way that I haven't before. I am consistently amazed by how readily she forgives me when I am impatient or upset. I do think, though, that she wants my job. Alec David is the comedian. He practices. We laugh all day long. We have not quite figured out Anne Pilar yet. She is different almost every day. One thing stays the same. She is a daddy's girl.
I love the kids, but David is still my favorite. I just don't get to see him as often as I would like. I would rather have just a little bit of time with David than alot of time with somebody else, though. Today is a good day because he gets to come home for lunch!

The Table

Waking up this morning, my first thought was "Man, I am sure glad I don't have to go in to work today." Then, my second thought was, "what in the world is she doing up?" My social four and a half year old daughter was either trying to stay under authority, or else feeling the need for adult agreement that she should probably use the restroom since nature was calling. Just wish nature would call later than 3:45am.

The second time I woke up this morning, my first thought was "Man, I am sure glad I don't have to go in to work today." Then, my second thought was, "why in the world should I get up?" Being able to contemplate getting up leaves one for time to reflect, and this is what I did.
Lying there in bed I thought I was most likely the most lucky guy ever. Commonly, I am suprised by this fact. I guess I never grew up having my goal be to say every week or so that I am most likely the luckiest/blessed guy ever. This is truly what I routinely believe, however. At the top of my list is the fact that I know the God of the universe in a personal way, and although unapproachable, He has desired to call me His son. Even thought that is enough for me, I am then blown away by the fact that He has chosen to bless me with the most wonderful friend and companion in my wife Kristi. I honestly don't know what married life is supposed to be like, but if my overhearing of conversation from most everyone I am surrounded by is any indication, there should be major disagreements, issues, frustrations, and heartache. I guess I am not married then, because what I have is better every day and I am only more and more content and grateful for her the more I get to know her. Then, when I do decide to get up out of bed, I am surrounded by three lovely children who call me "daddy," and ask me to help button their pants, feed them food, wipe their bottom, and look at their craft or recent garage sale or library finds.

Speaking of garage sale finds, I am stunned repeatedly when I walk through this amazing place God has given us to live in, the cars he lets us drive, the couches he lets us sit in, and the table he lets us eat at. Kristi and I have remarked several times at how blessed we are, and how hardly anything we have is something we have acquired on our own. Nearly everything we have has been given to us by friends and family. This brought me back to my amazement that I could possibly have anything to complain about. Matter of fact, I don't. Just that I have been and am currently in surroundings with co-workers and colleagues who are experiencing the exact same circumstances as myself, but nearly all they can talk about is how it is rotten, stinks, is horrible, etc..... For example, I have an attending physician I work with who is somewhat abrasive in nature and delivery, sometimes is downright in your face and accusing/challenging. What gets me is that if you sit there and take what he says and say, "okay, I will work on that" he is disarmed and after a few of these meetings realizes that you really want to learn and do your best. From then on he is much more open to teaching and instructing vs. accusing and demanding.
Is there a reason that someone who has been given everything thinks that others owe him something? I can't think of one, except that pride seems to get in the way of personal enrichment. I have found that in my training, most every "mean" attending physician is truly interested in my education. They just want to know if I am before they invest in me.

The funny thing about pride, in my experience, is that it is the enemy of personal growth. I have seen so many golden opportunities lost because the response was "how can I come out of this looking good?" instead of "what can I learn from this?"

Okay, I don't know what a blog is supposed to be for, but since I have been sick and lazed around the house all day, admiring my wife's most recent amazing garage sale deals, I decided that I would just stay home today and do nothing. Lucky you.

The Bargain Finder

While I am fooling around with sick people all day, Kristi has been usefully employed (along with her three able apprentices) as the decorator of our new place here in Ohio. It seems there is much more to the art of garage-saleing than I had appreciated. Here in the great Midwest, they have these new rules and procedures. An estate sale is referred to as a "tag" sale. I think the kids were most likely unfairly disciplined the first time they went and were told not to run around touching things and people and then fleeing with the farewell "You're it." Very misleading.
Also, for all of you ignorant northwestern natives, Thursday is the big day for a sale here. I was hoping I could bring this up with the residency program director here at the hospital and see if I couldn't have Thursday off from now on to go "tagging it" ( I guess you don't use that term unless you want funny looks) but from the empty eyes and raised left eyebrow I took it that I still have to show up on Thursday, tag or no tag.

Anyway, the point of all of this is to tell you that an experienced saler like Kristi is able to find all sorts of bargains. Matter of fact, we have now in our possession a fairly new three piece couch set (all matching), and just this past evening we again tested the capacity of our vehicle with a fairly new Pottery Barn dining room table and chairs. Actually, it is pretty exciting and I promptly got online from the new kitchen table to find out how much we saved off of the current price for this find. Seems like we got if for 94.6% off! Pretty good sale I must admit, and I bow to here skill and ability as well as keeping me in physical shape. Pretty clever woman.

Oh, if you can believe it, there yet a more impressive phenomena here that we didn't have in the northwest. No, not sunshine or humidity or buckeyes or Goodyear blimps.
Garbage Day!
That's right all of you bargain hunters, there is no better deal around here to be had than other people's trash: some of which has become our treasure. It wasn't too long after we arrived here that our neighbors informed us that on trash day people just plop down their unwanted items alongside their trash at the curb. Any one (and many) may cruise around on trash night looking for free stuff. So far, Alec has been the recipient of a new basketball hoop, complete with most of the original hoop.

Well, on that note I will close this flow and get back to seeing how I can cause trouble by getting the kids routy here on a rainy Saturday morning. Oh, I am sure you all know this, but you don't have to sneak around picking through people's trash if you come out here, everyone does it right out in the open. Sometimes it can get pretty rough, so bring some padding and a big stick.

David

Welcome

Greetings family and family friends. We decided to try this blog thing out, so here goes. We will see how well it works to keep us more in touch. Please email us at carnefamily@gmail.com if you have any comments, suggestions, gripes or praises... Just remember your praises should outnumber the criticisms 10:1