Saturday, November 26, 2011

Passed on Black Friday

My mother is of yesterday morning at about 2:30.
We were able to keep her without pain at the last.
Cattle under a tree in Central Louisiana.

Winter in Louisiana can be a source of solace and renewal.
Flights of geese overhead, honking as they travel, the pop and boom of hunter's rifles and shotguns in the near distance punctuate the air.

I am filling bird feeders, planting house plants, hanging family photographs and readying the house with a fir Christmas wreath on the front door.  Colorful Christmas lights will play a role in the memorial I am planning for next weekend for my mother here at her home.

The great state of Louisiana
I am gathering myself to move forward by first addressing my personal and immediate landscape.  Readying myself and my mother's home to greet her family and friends.

Wednesday, November 23, 2011

Father Paul saved the day, twice!

Gumbo on the fly
Today I cooked a chicken, duck and sausage gumbo.  Had to make three rouxs for it because I burned the first one.

Nearly set the house on fire, smoke was everywhere, when I was saved by my mother's parish priest calling for me in the living room (he had come in the kitchen door) while I was in my mother's room tending to her.  I threw the roux off the kitchen stoop into the bushes, put the skillet down on the steps and started over.

Father Paul likes crazy hats.

A proper roux in the making.

Father Paul, after alerting me to the near fire, in his subdued, calm, even-paced manner came back to talk with my mother when I interrupted him to ask, "How do you feel about spiders?"  He unflappingly replied that he did not particularly like them but said that he did not share my grand aversion to them.  I said, "Great, then you are the man for the job!"  And he scooped up the giant spider (two inches across--no lie!) that I had previously blasted with Raid on the bathroom floor.

(I also made a berry cobbler and a pork roast.  Both excellent.)

Father Paul later came back in the kitchen to observe my therapeutic cooking and we swapped gumbo know-how. Father Paul is from Pakistan and is not a completely active participant in South Louisiana cooking.  But he has learned to make chicken gumbo for himself and we compared notes on our favorite roux making techniques.

Black bellied whistling duck
I put a black bellied whistling duck, that my uncle shot in the field yesterday, in my gumbo today.

Gumbo in the water
They are a pretty duck often found in Mexico that actually recycles wood duck's nests in the early summer time in Louisiana swamps and marshes.  My Uncle Beanie says they fly slow and are rather stupid (though I think they are pretty).  He got two with one shot yesterday! I guess that is evidence of flying slow and being stupid.

And I am in the waiting pool for Yale's Physician Associate program. Boola Boola!  Go Bulldogs!

Monday, November 21, 2011

Winter at Effie

Satsumas ripen in late fall and winter in Louisiana

My mother's Satsuma tree, outside her kitchen door, is heavily laden with ripe fruit.  They are sweet and seedless.  I brought in a bowl for the table as a centerpiece for the dining table.

Louisiana Satsumas

I learned today what the extra five pounds on my hips is for.
They are for days like today, when I can't remember if I ate or not and I had to give my mother a shot.

I cooked today to relieve stress.  I made red beans and rice, tomato stew with okra and bacon (the best), and pimiento cheese.  I didn't eat all that;  I just cooked it.  Very therapeutic.

I plan to make a blackberry (dew berry, actually) cobbler today. Don't know yet if I will eat it.

After I cook, I will work on some more PA school supplemental applications.

Red beans and rice with Tabasco

Friday, November 18, 2011

I'm on my way to Avoyelles Parish

I am headed to Alexandria, LA tomorrow (have a one way ticket) to be with my mother as she heads into her last time with us.
Effie, Louisiana in central Louisiana
This will be a difficult time certainly (especially since my father is an invalid and not able to participate).

However, I am looking forward to helping my mother with her "bucket list," which she is currently on page two of listing her things to do.

I am also anticipating many visits and calls from family and friends who want to see her and share their love for her.  This will be good.

Avoyelles Parish Louisiana
My mother has always been an Avoyelles Parish girl,   steeped in the rich, French culture of Louisiana's past.  She grew up along the Red River in Vick, Louisiana and after enduring thirty plus years of hard winters in NYC and other parts of the Northeast, she happily retired to her family home in Effie, Louisiana where she resides now.

So I am exiting life in Buffalo, for the moment, and entering life with her in Avoyelles.  Not sure exactly what is in front of us, but I will engage it to the best of my ability.

Wednesday, November 16, 2011

Impending loss

Preparing for my mother's death, has evoked thoughts about who she was as a young person and who she has become and how she arrived there.

(My mother was diagnosed in January with a cholangeocarcinoma that has proven to be unresponsive to chemotherapy and radioactive micropellets.  She is in hospice care now beyond treatment options and has just been advised to prepare for her last weeks.)
A bed similar to my mother's.

Sitting on my mother's antebellum family heirloom bed in her childhood bedroom, a teenager, visiting my grandmother's house at Christmas time, I guiltily read her diary from high school and LSU years while listening for footsteps in the hallway.  I recall the smell of the leather diary, yellow-brown pages, faded blue fountain pen ink as dry and sweet.  The diary smelled like another time.  A time I never knew but was hungry to understand and picture.

The antique furniture and lace curtains of my mother's childhood room are no longer there because thieves broke into the home several years ago with a truck and emptied the house of rooms full of antique furniture, silver and family heirlooms.

My mother is there now in that very room--now austere, curtainless, no headboard, no ornaments.  She likes it that way--it is her style.  (The robbery never seemed to anger her as it did me.)  Where is the young lady from Effie, Louisiana who attended LSU medical school on a Betty Crocker scholarship? 

How does the quaint vision of my Mom at LSU in the 1950s, wearing heels and dresses at football games, photographed astride her bicycle in The Gumbo (LSU yearbook) as part of LSU's promotion of biking on campus, connect with who she is today?  

I remember a lamp, much like this one but larger, on my mother's bedside table (all lost in robbery)

I am thinking about how as a PA, I may interact with patients and families going through what I am experiencing now and how one connects clinical care with compassionate care and makes those one in the same.

I know that I do not want to be the kind of clinician who does not return phone calls and who delivers bad news abruptly and coldly.

Tuesday, November 15, 2011

Back home in Buffalo with some Yale blue in my veins

My Yale visit was nothing short of amazing!
Yale's motto: Lux et Veritas, light and truth.

Got back to Buffalo at 3am and I am off to teach my 8:30 class now, but here are a few quick photos from the weekend.  And a more detailed post will follow:

Stocking up at the Yale bookstore.

Theodore Dwight Woolsey's statue at Yale where lore has it that you rub the toe of his left boot for good luck.
You will notice that the toe on that boot is rubbed shiny from students touching it before an exam.  Of course, not being one to break with tradition--I rubbed the toe for good luck before my interview!
The Whiffenpoofs singing at Mory's Monday night.

Coming out of my interview

Trumbull Master's house

Yale campus with fall colors.

The Sterling Hall of Medicine -- Medical school library.

A quadrangle on "old campus"

Memorial Hall

Courtyard within the Sterling Memorial Library.

Sterling law building

The Harkness tower.

Sunday, November 13, 2011

I'm on my way, don't know where I'm goin'...thanks Paul Simon

The city that never sleeps
Buffchic grabs a bite in NYC!
Here I am in New Haven, after a great trip down from Buffalo to NYC. Being back in the city after a 25 year absence (little known secret--I grew up in Brooklyn, NY), brought back a flood of memories and a way of life I left behind.

We lucked onto the "pay what you want" evening at the Guggenheim Museum.  Maurizzio Cattelan's installation was fascinating and thought provoking.

Cattelan's installation at the Guggenheim

Cattelan's work suspended from the ceiling at the Guggenheim was at times in-your-face, abrasive, jarring, like a teenager, and at times subtle. 
Taxidermy featured prominently in his work

After an evening in the Guggenheim, some mandatory shoe shopping and dinner on 2nd Ave., I'm thinking if I spend much more time in NYC or live there (again), I will have to strap pillows to my feet.

Even Pope John Paul made an appearance.

View of the "Meteor strikes the Pope" or as Dave calls it "Pope on the rocks"

And after we paid what we wished at the Guggenheim (and also took in the Kandinsky exhibit and his Painting with White Border), we splurged on dinner in NYC.
Dinner in NYC

After all, I AM saving my travel budget for the Yale bookstore!

Paul Simon's "Me and Julio Down by the Schoolyard,"  was one of my favorite audio backdrops to growing  up in NYC.  Humming a few bars and singing along with a memory, "I'm on my way, don't know where I'm goin', but I'm on my way..."

Friday, November 11, 2011

My First WNYPAA Meeting

I attended my first WNYPAA meeting on Wednesday.  Dr. Arvind Gupta from Pennsylvania State College of Medicine spoke about new FDA approved therapy with Dificid and Cubicin for treatment of MRSA and Clostridium difficile, respectively. Brought back memories of working in microbiology and all the MRSA (and a few VRSAs) and C. difficile that we dealt with there.
Beta hemolytic Staph on a blood agar plate

31 Club looking cozy on a snowy evening.
The venue was the 31 club in downtown Buffalo.
Beautiful restaurant and good food!

I sat with three students from the PA program at Daemen College.  They related their experiences as fourth year students in the five year bachelors/Masters program. Nice kids--I hope to see them again at another meeting.

The stork has arrived with my bundle

Congratulations! It's a New York State License
It's here!
Finally, my brand new New York State Clinical Lab Technologist License just arrived in the mail.

After nearly nine months and much labor, my precious package is finally here.  It took almost as long as a pregnancy and nearly as much hassle, too!  (New York state has a relatively new and cumbersome process for getting your license as a clinical lab technologist--even when you have been in practice for years (or decades!) and licensed and employed in another state.)

Hope I don't have to use this license because I really want to be in PA school next fall.  But if I need her, she's here for me.

If anyone would like to contribute to my little bundle's scholarship fund, please contact me via this blog!

My long awaited New York State CLT license.

Thursday, November 10, 2011

High Anxiety

I am feeling anxious about my upcoming interview at the Yale Physician Associate program.  Just saying "Yale" makes me hyperventilate.  "Yale Medical" brings on a wider array of symptoms.  And verbalizing "I'm interviewing at Yale," outright raises my blood pressure.

Yale University campus
The big day is fast approaching and arrangements must be made.  We are getting ready to drive down to New Haven this weekend (via NYC).
Lady Liberty lights our way.

We changed the oil in the car and splurged on new windshield wiper blades "fit for a Mercedes Benz," says my husband (note: we drive a 14 year old Subaru wagon).
Subaru wagon looking sporty with dust flying!

I have nightmares of the car breaking down somewhere between Buffalo and New Haven, CT.  I WILL get out and walk, if I have to, or rent a car to get there for my interview on Monday!

My husband says he is packed and ready to go--he's got his toothbrush and his change of socks!  I, on the other hand, being the inveterate list maker-- have a list-in-progress as long as my arm of things-to-do, to take, to not forget, to print out and bring, to remember and so on.

NYC shopping, who needs it?
Instead of shopping in NYC, I plan to shop at the Yale bookstore.  Makes sense, right?
This way if I get in, I'm all stocked up.  And if I don't get in, I will have tee shirts, pens, hats and Yale blue paraphernalia to give as Christmas gifts (afterall, you can never shop too early).

So look out kids and Mom, it could be Yale sweatshirts for everyone this year!

Yale Bulldog

Wednesday, November 9, 2011

Will PAs be working at Walmart?

See the internal medicine aisle at Walmart?
It seems that Walmart is casting its net farther into the medical field now as reported today by NPR.
We have become accustomed to the fact that that our Arkansas friends are in the optical and pharmaceutical markets, now look out -- here they come into the world of medicine!

And timing is everything, "Wal-Mart said it would stop offering health insurance benefits to new part-time employees," in late October and now they wish to find a new market strategy for their brand in the delivery of primary healthcare in response to the burgeoning need for such that looms before us in 2014.  Sweet!
Save lives. Shop more.

So is part of our future as PAs possibly working at our local Walmart next to the colas (or Pop as they call it here in Western NY), frito chips, white bread and Oreos?

Granted, Walmart may be able to employ certified professionals to staff their facility, but there are a myriad of other important questions regarding barriers within their system to quality healthcare for a total or whole person.
Ah, perhaps Whole Foods should investigate this venue!

I wonder what the AAPA's position will be on this new venture for Walmart?

Black Friday at Walmart --may have new meaning now.

Tuesday, November 8, 2011


I have lost two dear friends and mentors this fall. 
My heart is broken.

Fencing coach's mask.
Sonny Mercado passed last month.  He was a Maitre d'Armes (Master of Arms) in fencing, and a superb coach and mentor.  I cherish now more than ever the times we had together and the things he taught me about fencing, coaching and life. 
I had an email from him shortly before his death and it still sits in my in box.

And now I learn that my friend Fraser has lost his battle with cancer.  He leaves his wife, Amy, and three young children.  I am beyond sad.  I taught Fraser and two of his children to fence and became a part of their family.  He was one of the most energetic, hard working, over-the-top, get-it-done people I have ever known.  Fraser was a neurosurgeon, husband, father, friend and a fencer.

I can only move forward each day taking pieces of my memories with these friends with me.