I dream about one who is a ballerina spending the day on her toes and the night touching me.  I wish I could meet her to see if we click and to see if we are truly connected at the soul as I believe.  It is sad to think that, at this late date, I may have found and lost the dancer who has twirled her way into my life for these many years.  It is a shame and a tragedy that it may never happen even though we are only a few miles apart.  Considering her life the last few months and my inability to help due to distance, I can see why she has shut her heart to me.  I can only wait and hope and listen for the phone. 

Unlike many, I enjoy medical meetings not for the content usually but the opportunity to network and see old friends.  I have been going to the SOMA meeting (see www.somaonline.org) for about five years.  This is the organization for the physicians and medics that support the special ops community in the civilian as well as military world (FBI Hostage Rescue, SWAT teams, Army SF, Navy SEALS, etc.).  I always return feeling as though I have been in the company of heroes.  Which, on reflection, I have.  I feel privileged to have been in their company.  What they do and under the conditions that they do it are astounding and far far more severe and demanding than most can even imagine.  Think of being at 9-10,000 feet and having to tend to a comrade's wounds while being shot at and trying to get him down to a level where the helicopters can pick him up.  More than even Frederick Forsythe can write.  We've seen the pictures of the pilots abilities to get into tight spots in Afghanistan but nothing compares with the view from ground level as they come in.  I salute them, the medics, pilots, operators, and troops.  Thank you.

I return to a home that is preoccupied with my brother who is on death's door.  He is too young and too naive to die.  He has not seen or experienced life; that was stolen from him by MS.  Now he has come to the end of the road.  We have never been close.  He's too far right and evangelical.  But blood is thicker than ideologies.  Particularly at the end.  I lost my dad on Memorial Day and now this.  Too hard and too much to deal with.  I am beat.  More later.  Perhaps sleep, even though rare and fitful, may help.  Enough of these musings and to bed. 

I'm not a happy camper.  In fact, I am very sad and don't really know how I am going to resolve this.  I have neglected a good friend, who incidentally put me on to livejournal, and have not called or made contact.  It has been simply due to my not taking the time or trouble to do so.  Once you start putting these things off, it seems as though they get a life of their own and stand in the doorway and don't allow you to do the right thing.  She is a wonderful woman, smart (above all - very very smart which makes her inordinately sexy), physically one of most attractive women I have ever seen even though I know her only via pictures, and a wiseass which gives her an immediate ten in my olympic scoring sheet.  Well, I'll send her this and hopefully she will forgive.  I'm an ADD physician and traveling continually; seems that time passes and I don't see it.  I don't see much as I'm preoccupied with medicine, research, patients, and family. 

Much time has passed.  I have lost the cell phone and lost her number.  She is my soulmate and my other half.  I will find her number and call.  It is a something I have needed and wanted to do.  I guess because I love her more than anyone I have ever loved.  How weird is that?  I have never seen her, held her , talked to her.  but a strong connection is there.  In fact, there is such a strong connection that it cannot be denied.  Hmmmm.  This should be resolved. 

It has been a long time since I have posted here.  Much as gone on.  I have lectured on bioterrorism, lectured on cancer treatments in Turkey and the UK, been snowed on in Chicago, rained on in Seattle, and dumped on in Port Angeles, WA, Dallas, and elsewhere.  Does this seem like a rant?  I guess it probably is.  Went to a huge medical meeting in Chicago - god, they know nothing.  Most physicians have their head up their ass when it comes to biological warfare and considering the new report from the commission on WMD that briefed Bieden, we are toast.  Don't kid yourself:  your smallpox vaccination is useless since it older than 10 years, there is no stockpile of vaccinations or cipro for anthrax.  Is this a scandal?  You bet.  Call your representative to Congress and the Senate.  Make them listen or our society is doomed to the trash heap of history - sooner than you think.  The commission says we will be attacked by a bioweapon in the next five years.  You do the math.

Unfortunately, there are far too many of us who have put our heart and soul into medicine only to be abused by drug demanding patients, greedy insurance companies, and moronic referring physicians.  The latter is probably the cause of burnout of the physicians who are not primary care, i.e. radiologists, interventional radiologists, pathologists, anesthesiologists, neurosurgeons, etc.  We have been taught to have confidence in our decisions or the patients will not have confidence in us.  What ever happened to being honest with the patient?  That confidence spills over into the dealings with other specialties mentioned above.  Don't have the temerity to suggest that a diagnosis or therapy is ill-conceived unless you are willing to have the referrals from that source dry up (a huge $$ loss in private practice and a bad rap in university). 

This conflict between the specialties, particularly that insurance reimbursements are falling leads to specialties poaching on others.  For instance, vascular surgery now does procedures that were only done by interventional radiologists only a few years ago.  All this with maybe a weekend course to provide them training.  And, needless to say, do it poorly.  And, patients don't know that they are being experimented upon to get the experience so that in, say, 50 or more, they might have the experience of the interventional radiolgists.  But they tell the patients that "you were lucky I did it because it could not have been done otherwise" or "you're lucky because we had to open you up and no one could have prevented that."  Crap.  When a physician tells you that you're lucky that he did the procedure, he is lying and trying to cover up his deficiencies.  I wonder if 60 minutes ever reads these.  They should because it is a scandal.  Enough of this for now. 

I'm new here.  One of the few places I'm new.  A friend told me of this space and thought I would enjoy her writings and get my creativity jump-started.  So I'm going to use this space for musings.  Some interesting, some funny, some philosophical, and some you'll never believe it really happened. 

I've spent far too much time in the hospital rather than involved in life.  Let me re-phrase: too much time doctoring and too little living.  It is a solitary existence.  The civilians don't have a clue.  We, the anointed, in our white coats, invest our souls in the care of our patients.  If we make a mistake, or some complication occurs, the self-doubts and the self-recriminations and the whatifs all come out of the woodwork.  It is hard to always be perfect.  So we practice defensive driving, anticipating what could go wrong and not think about the ultimate destination, only the journey. 

I'm too tired to continue with this line of thought but will pick it up later.