About Face

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My reflection squinted back at me in the magnifying mirror, wanting to make sure what it saw was real. 

Sure enough, those wrinkles were still fading.

I picked up the jar of foul smelling gelatinous goop and slathered it all over my face and neck, trying hard not to breathe it in.

Almost empty.

A bit of vomit caught at the back of my throat and I choked it back. You would think after using it for months now that I would have gotten used to that smell. Still…

A small price to pay for looking youthful again.

I screwed the top back onto the jar, making a mental note to pick up more later this week. There was one more thing I had to do before bedtime.

Pausing at the top of the stairs to pull my bathrobe tighter against the chill, I flicked on the light before descending into the basement. I had hidden them behind the boxes on the third shelf by the washing machine in the far corner. The dust made me sneeze as I shifted the large cardboard boxes to expose the small carved dark one in the back.

There you are!

I ran a hand over the box of mementos, caressing the ridges with my fingers. It was a ritual now. Every evening the same thing, tucking them in for the night before turning in myself. I kissed the lid, then returned everything back to its place.

At first, my need to stalk and kill came as a surprise, a dirty secret that I did not understand. Then I had discovered where the stem cells for my face cream had come from. 

He had grown up now, was locked up in San Quentin, on death row, the most notorious serial killer in recent memory. I could have stopped using the cream once I realized what was happening, I suppose, but it was working so well…

Other women throughout history had done worse in the name of vanity.

Slowly, I made my way back up the stairs, closing the door firmly behind me, turning the lock to keep them safe.

I crawled into bed and turned off the light, snuggling up under the soft, downy warmth of the feather duvet. 

Like heaven…

Thanks to C. S. Boyack for the idea!

The Visitation

 bare tree branches in the forest 
She stood at the bedside, holding his hand. She was wearing tight jeans that cradled her back side just so and a warm, bulky sweater that still showed off her perky breasts.

He could not see her, how good she looked, but he would have appreciated it, I am sure.

The machines beeped and rang and whooshed all around. Everything was moving except for him. He lay so very still, barely breathing.

“Sam, I have to go. I can’t do it. I can’t be the woman who helps you get through all of this.” She sniffed, dabbing at a tear stained cheek with a crumpled up tissue.

I tried not to stare.

Still, I could not take my eyes off of them. It just seemed so wrong. I could have been her, given other circumstances.

She sensed it and looked over, fixing me in her gaze. I coughed uncomfortably, looking down at the patient chart. Quickly, I flipped to the orders section and started scribbling.

“Good-bye.” She gave his limp hand a final squeeze and then was gone.

The doors to ICU eased shut behind her with a soft thump.


He sat up. 

“Pssst!” He whispered at me. “Is she gone?” 

I checked the video monitor to be sure. There she was walking away. No looking back. “Yeah…. She’s gone.”

He smiled.

“Thanks! I owe you…” He untaped the fake IV, unwrapped the gauze turban around his head, and pulled off the hospital gown. Thankfully, he still had on pants underneath.

“That is the last time I help you break up with a girlfriend, Sam. I swear.”

He laughed, then started buttoning up his blue and white striped dress shirt.

A pager went off.

“Yours or mine?” He asked. 

I checked.


He sighed, holding out his hand. I slapped the cold, black thing into his open palm. He finished tying the yellow tie, then shrugged into his brown corduroy sports coat. A quick check of his hair in the reflection off the paper towel holder by the sink and he was off to his next conquest.

“You’re a piece of shit, you know.”

“Yeah, yeah. Merry Christmas,” he called out over his shoulder as his walked past.

Yep. It could have been me…

Absence Makes the Heart Grow Stronger

IMG_3934Today, many physicians are still basking in the post Thanksgiving holiday bliss, enjoying their families and some rest. Plenty are still working, though, staffing the hospitals and clinics, holding the pager so patients with emergencies can still get help.

I am off today and I am so very grateful for those who are working, who make time off for me possible.

So in the spirit of absenteeism I thought I would share a juicy little tidbit…

Did you know that you are less likely to die if you are admitted to a hospital for a heart attack or congestive heart failure when the big national cardiology conferences are being held, when most of the top/senior cardiologists are away?

I had touched on this before, but here is the actual article from JAMA: 

Mortality and Treatment Patterns Among Patients Hospitalized With Acute Cardiovascular Conditions During Dates of National Cardiology Meetings


Patients are less likely to have a heart catheterization during that time. So maybe less intervention? Then there is the possibility that younger doctors are more skillful than their seniors (I like this possibility less the older I get).

It is sobering to consider that there may be other conditions that this holds true for, that as physicians, sometimes we do more with less.


IMG_2396I am thankful for everyone who takes the time to read this blog, for all of the virtual friends who have made my life richer.

I am thankful that my in-laws are fairly nice people since we will be spending the day together.

I am super thankful that I do NOT have to cook a turkey, even if it does mean I have to make a green bean casserole and the cranberry sauce.

May your day be filled with peace, love, and good food even if you are not celebrating Thanksgiving.


IMG_2637My son lost his first tooth at 3:05AM this morning. I know this because he ran in to tell me at that exact moment.

He had discovered at dinner that it was loose and quite honestly, I was hoping for a few days to adjust to this new reality.


3:05 AM.

Less than eight hours from the initial discovery and he now has a gaping hole where a tooth ought to have been. 

I wish he was not in such a hurry to grow up.

This morning I had to leave before he got up. It bothers me that I was not there when he found his first note and gift from the tooth fairy. Clinic, sick patients to see… no choice. I am told he was super excited and that he believes he was sprinkled with pixie dust. I tell myself that he won’t remember if I was there or not, that the magic lies with the tooth fairy, not with me.

Maybe it’s true…. And maybe the tooth fairy really is real.


 tiny orange mushrooms on moss in front of a crystal boulderThose are really tiny mushrooms. Tiny, orange mushrooms growing on bright green moss in front of a white quartz boulder in the middle of a forest.

You want to pluck them up, don’t you?

If you look closely at my eyebrows, they are a bit patchy sometimes. 

Guess why…

It started in medical school and gets worse when I am stressed out; a compulsion I don’t even think about. Pinch a bit of eyebrow, gentle tug, brush against the upper lip to see if I got anything, return focus to unpleasant task at hand (typically the electronic health record). Repeat if necessary.

Some people do this to the point of disfiguring themselves, even to the point of baldness. What I do is very, very mild by comparision. In fact it would probably stop completely if I retired. 

Why the eyebrows, though, I wonder? Why couldn’t my focus be on something useful like armpit hair or the bikini line or the LEGS?!??!? Hell, those pesky chin hairs, even…

So there, now you know one of my secrets.

Do YOU have an any weird habits or fixations?

Golden Oxytocin


I cannot trust
The way I feel.
How much is lust?
How much is real?
How much is you,
Inside my brain?
Guilded reality,
Coursing through 
My bloody veins.
What is attraction?
What is hate?
What is binding
Us to our fate?
Hormone from above,
The goddess of love.
Chemical thoughts
Forever lying,
Forever tying
Microscopic knots.




What makes you happy?

Are you happy? Not just *should* be happy. ARE you happy?

A study was published this week looking at sex and happiness. Turns out, you only need sex once a week to be happy. More sex? Doesn’t make you happier. This held up for men, women, old, young… Everyone across the board. But here is the real kicker: you have to be in a romantic relationship to have the benefit. The length of the relationship did not change the results, so being married for fifty years or dating for six months made no difference in the findings. 

For single people? There was no relationship between sex and happiness. So if you are single, don’t even bother from a happiness standpoint. Which is actually an interesting observation. Perhaps it is not sex we are after so much as the relationship.

Every day at the clinic I find myself talking to someone about sex and libido. There is this myth that has been perpetuated that healthy relationships require sex 3-4 times a week. More is better. I have tried to fight this, preaching that like so many other things in life, quality rather than quantity is the key to sex. Without data to support what I am saying, though, I consistantly get looks of disbelief in return.

But just once a week? 

That surprised even me. 

Is sex a tool for happiness, though? Is that how we should think about it? Is it sex that creates happiness by maintaining intimacy or is that happiness more a symptom of the things in place in a relationship that allow sex to happen at least once a week? 



IMG_4031“Mommy, I love Audrey.” He said this casually, matter-of-factly, as he was scrambling out of the car after school.

“Oh, really? Why do you feel you love her?” I tried to sound casual, too, even though inside I was screaming: LOVE? You LOVE some girl? Look here, there is no possible way she is good enough so just stop right there, mister!

“She is so beautiful. And she is nice to me. AND, I like to kiss her.” He was so serious. 

“You kiss her?” My voice *may* have risen an octave. Aren’t boys supposed to still think girls have cooties? 

“I like when she chases to try to kiss me. I run slow on purpose so she she can get me.” He stopped on the sidewalk and looked up at me, earnestly. “It’s romantic love.” 

And I’ll be danged, he was serious.

My first thought was, What do you, a kid, know about romantic love? Then, I wondered how to describe romantic love to a boy his age which then led me to ask myself, What DO I know about romantic love, anyway?

I was at a loss.

Love is feeling pain and not caring.

You know what my next thought was? The movie The Princess Bride when the man in black says to Princess Buttercup, “Life is pain. Anyone who says otherwise is selling something.”

Romantic love, huh?

“I do not think that word means what you think it means, sweetheart.”

At which point he had a meltdown, screaming at me that he did too know what romantic love was! Truthfully? He probably has a better grasp on it than I do.

I fear my son is going to have his heart broken at a very young age.

How would you explain romantic love to a six year old boy? Tell me about your first love. How old were you? Who was your greatest love? Did you ever tell them they were your greatest love? If not, why not?