This might be the most horrible thing I've posted (and I know I've put up some bad stuff)- sorry.

So I'm working on my research project, and every article I find seems to lead to a few others... and I kept seeing references to 'noma', which I had never heard of. So I looked it up- apparently it's a horrible infection that usually infects malnourished children- mostly in Africa. Starts as a little ulcer in the mouth, and apparently over the course of A FEW DAYS it eats their whole face off and they die. 100,000 cases per year, and 70-90% fatal. And those that don't die are horribly disfigured and can't talk, eat, drink etc. Imagine not having a functioning mouth. The 'good' thing about it, I guess, is that it's high on the list of operations-plastics-guys-go-abroad-and-do-for-free-to-make-themselves-feel-like-good-people ;) which is how I kept reading about 'noma surgery'.

Has anyone ever heard of this before? I certainly hadn't. I guess I'm naive to think we hear about most of the horrible diseases out there.

But anyway, so then it led to this lovely quote.
Not much turns my stomach, but this one gets me. Reminds me of female genital mutilation.
I will spare you the pictures.

During the past forty years a concerning cultural belief has been observed in a parts of central eastern Africa. Parents are told that their infant's unerupted baby teeth are "worms" which cause sickness and diarrhoea. Babies as young as six days old and small children are having their baby teeth deliberately removed from under their gums. The soft white tooth buds are mistaken for the fever causing parasite worms, commonly found in diarrhoea. It is normally administered by village healers for a fee but also by parents, community elders, priests and even midwives with a variety of tools including knives, sharpened bicycle spokes, hot pokers and fingernails. Known locally by names such as "elbino" and "nylon teeth", this has become known in academic circles as Infant Oral Mutilation (I.O.M.). The practice always leads to pain and suffering, often resulting in disfigurement due to the damage to gums and permanent teeth beneath, and occasionally leads to death through the onset of infections like septicaemia, tetanus and noma. In the last ten years, this practice has been observed in high levels across a much wider swathe of Africa, including Uganda, Sudan, Tanzania, Kenya and Somalia. While it is possible that this practice has previously been "missed" in these other regions, it is widely believed to be rapidly growing as a custom, spread between communities and tribes displaced and fleeing from civil war and conflict.

Jesus. Poor babies.

My dad just sent me an article from the NYT style section a week or so ago. Unfortunately it's not free on the NYT website. But it's about this designer:



This is his "woofer" series: (he says "tweeters" are next)




And here are some cool lamps:

Ok peeps.
I like to think I'm this great humble selfless person.
But it's been brought to my attention that maybe I am really a totally crazy selfish attention-seeking drama queen.

I guess I kind of know that I am.

But I don't want to be.

So I'm going to try to stop.

Sorry!!
(and thanks for putting up with my nonsense.)

First- spam comments?! WTF. Sorry you have to deal with this shit, Paul.

Ok, but on to my crazy story. I finally got some answers, so I can spill the beans. Maybe you all won't be as stunned as I am, but I am still a little taken aback.

So...
A week or so before Christmas, I got a message on Myspace. It said "hi, my name is G. I'm a surgeon, relocating to WNY. How do you like the area?" So I checked out his page. Seemed legit... And he's not just any old doc, but a pediatric neurosurgeon. And, the icing on the cake- he's hotter than hot. So I wrote back, he wrote back, etc. He asked if I used AIM. I gave him my info, and after that we started chatting. And for the next two or three weeks, we 'talked' pretty much daily, for at least an hour or so- one time for FIVE hours. I learned a lot about him. He was charming and interesting. He was in the Navy (a SEAL, no less), but then left the navy for med school. Married his girlfriend from med school. After med school, residency, fellowship, etc, he and his wife were working in Pittsburgh. And then one day, about 2 years ago, his wife was killed in a car accident. And he just had to get away, and so he rejoined the Navy. Is now serving in Iraq. But his 6mo tour of duty was almost up. He said a recruiter in Buffalo got in touch with him, because Children's is looking to expand the peds neurosurg faculty. So he accepted the job, and was gearing up to move to buffalo.

Like I said, we were talking a LOT. And I can't say I had FEELINGS for him, but he really seemed like a great guy. We joked a lot and bitched about work... He had a great sense of humor, and it was nice to talk to someone who knew medicine inside and out, and I found the Navy stuff fascinating. I really looked forward to seeing his name listed as online in my buddy list. The last time I heard from him, he was talking about using a big black marker to count down the six days he had left in Iraq. Then a few days in Germany for debriefing, then a Lufthansa flight to NYC, then to Buffalo. Some paperwork etc, and then he told me he had patients to see at children's starting the 23rd or so.

The last time we talked, he added me to his myspace 'friends'. Then the next morning, we chatted for a sec. he said he had just gotten back from the gym, and needed to shower, but would be back later. That was fine, b/c I had stuff to do too. I also noticed at that time that he had deleted me, and ALL his friends, from his myspace list. Hmm, odd, but I didn't think much of it. And then he never came back online. Whatever, he's busy, didn't think much of it. Well, that was 3 weeks ago. I haven't heard a word from him since. And he hasn't signed back in to myspace. According to the timeframe he gave me, he should be in Buffalo by now, and should have started work. I figured maybe he was one of the soldiers that had to stay longer in Iraq. I was a little sad to not hear from him at all, but I was trying my best to not be some obsessed stalker psycho girl- I mean I've never even MET the guy!

But after a while, I started to wonder. I googled him. NOTHING. And I thought that was a little odd. I mean everyone comes up in google. And you'd think a hotshot neurosurgeon would definitely come up. So I checked out the website for the neurosurgery program he said he trained at. It has a list of graduates. His name is NOT on that list. At least, not the name he told me. I finally went so far as to call children's, and ask if there's a new guy coming. They didn't know what I was talking about.

I know, I know, at this point I had crossed the line to psycho behavior, but now it was a mystery, and I wanted answers. I kept hoping there was some innocent explanation. Maybe he was delayed in Iraq. Maybe the internet service at the base was down. Maybe his days as a Navy SEAL made him paranoid about putting his info on the web, so he gave a fake name. And as much as I wanted it to be something innocent like that, I had a hunch that something wasn't right.

I emailed my friends in neuro to ask if they'd heard anything about a new guy. But I didn't get a response. Then I sent a girl on myspace a message. She was his only friend on there for most of the time I was talking to him. And, oddly enough, she is a friend-of-a-friend. For real. My friend out in AZ worked with her- she was his med student. I mentioned that to him one day, like 'hey, small world... that girl N was my friend's med student!" And he responded "oh yeah, she's a nice girl. She did a rotation at bethesda when I was there and we worked together."

So I sent her a message... Didn't allude to any of my suspicions. I played it naive, and just said 'hey... you don't know me, but I think you know this guy G, and he said he's moving to town but I haven't heard anything from him in a while... Just wondering if you have... I hope he's ok."

Well last night she wrote me back.

She said "I'm sorry I can't help you. This freaks me out a little bit. I don't know him. I never worked at Bethesda. He told me the same story, except that he's moving to LA, not Buffalo." [she's an anesthesiology resident in LA.]

HOLY SHIT!

So now I don't know what to think...

I mean obviously he's a fraud. But... why?? and why me??
And- how? I mean, he was CONVINCING. And I know I'm pretty trusting and gullible and naive... but your random guy can't talk in detail about neurosurgery for five hours straight without slipping up... At least I couldn't! And it was CHAT, not email. No time to fact-check and do research on the side.

I'm just kind of astounded.
He never asked me for anything... it's not like he was trying to swindle me for my credit card info or anything...

And if he's not really moving to buffalo, it's not like he was trying to seduce me.

I just don't get it.

And now I wonder how much was true, if any. Is he even a doctor? Is he really in Iraq? How many girls across the country is he feeding this story to? And, why did he stop? Did someone figure him out? Who is he?

And finally, I'm sad about the whole thing. I feel let down.
I mean, I was really excited about this guy. I was trying my best to not get ahead of myself, emotionally. But we had such good 'talks'. And he's literally Dr. McDreamy. A HOT neurosurgeon...

And now I feel like an idiot. Like some stupid sucker who fell for a con artist's tricks.

I guess I should have known it was too good to be true.
Things like that don't happen to me.

But I was hoping that just maybe, just once, I'd get lucky.

Sigh...

whoever you are, G, you got me good. I just wish I knew why.

Hmm, so I can't seem to leave comments on posts that don't already have comments, using firefox or IE.

So, since I don't feel like working, I'll post.

My comment to imk-

Yeah, how COULD that boyfriend-husband of yours let you get "so far gone"?! Parking tickets! You lawbreaker you!

Speaking of non-existent husbands, I was on the phone with my bank once, about my student loans or something, and the guy was nice and almost flirty, sympathizing about loans, and he said something like 'well, don't worry... someday when you marry that rich doctor it will all be ok.' And maybe I shouldn't have said anything, but I couldn't help it, and I said 'actually... umm... i am a doctor' And the poor guy was so embarrassed. So when my credit card expired and the new one came in the mail, I noticed that it says "Dr. Jenks MD" Not just Dr, or MD, but BOTH. They must have put big red flags all over my account. hehe. It's embarrassing though, b/c people think I'm that asshole that requested to have Dr emblazoned all over my card. Twice.

I am off to kick a patient out of the hospital. I get a surprising amount of satisfaction out of it. I am sick of people who think the hospital is a hotel. I mean it's one thing if you're sick and need to be in the hospital. But this guy has been ready to go since Friday. We tried to send him home friday, but he said he 'wasn't ready' and begged to stay through the weekend. We said ok. Monday- "no way I'm still in pain you can't kick me out". FINE, one more day. Tues "well I know I said I'll go, but I had a little bit of a bloody nose. I have to stay one more day. I PROMISE I'll go tomorrow." This morning "no I can't go b/c my son's car broke down and he can't pick me up." "well, we can arrange transportation for you." "Nope, I won't leave with anyone but my son."

Ugh. So much of this is a stupid political game. This guy has no medical reason to be in the hospital, and every day he is here costs taxpayers money. But you can't make patients feel like you're kicking them out. They have to feel like it's their idea to go home, or they get upset. And there are several games you can play. One is the "well the food is better at home and your bed is more comfortable and you don't have to wear a gown and have your ass hanging out all the time and have people walk in on you peeing". Next is "well I'm not going to kick you out, I'm just afraid you might get pneumonia or something if you stick around too long! Hospitals are for sick people! You're all better!" If that doesn't work, sometimes the 'well, I'm not going to kick you out- *I* love you and as far as I'm concerned you can stay forever, but you just need to know that your insurance might make you pay for the extra days'. That usually works. (But you can't play the insurance card with veterans.) When they say 'i don't care, i'll pay for it', a last resort is to stop all pain medicine, give them a low-fat, bland diet, and order daily suppositories and twice-a-day blood draws. That will often remind them how nice their own house is. But once in a while they just persist, and threaten to call the "patient advocate" and tell on us, saying the big mean doctors aren't being nice. And since we are so lawyer-phobic, we give in.

Seriously, I've had patients stay in the hospital an extra WEEK b/c "my girlfriend has to work and can't pick me up." Um, I hate to say this but your carlessness is not my problem. (But even though it's not our problem, we have social workers etc who can get them all set up with taxi vouchers, even ambulance rides home.) I always want to just write 'discharge patient to home'. That's is a 'doctor's order'. The nurses theoretically HAVE to carry it out, and I think the patient has 23hr to leave after that's written in the chart. But often they won't. So you think the patient will have left, since technically he had to, and then you come in the next day only to find he's still here. I've never understood how this works.

But apparently I am a mean inconsiderate bitch b/c I don't want my tax money to pay for this guy to spend an extra unneeded week at Spa VA.

But so today enough is enough and we called the nursing administrator, who for once, is on our side. She said 'he has to go, I don't care. We need the bed, and he has no reason to be here. Send him home.' So we just document that carefully, and write out all the things we will do for the patient to not make him feel abandoned (home visits by nurses and physical therapy, pain meds, follow-up appointments, etc etc), and then kick his ass out of here.

Also, I might feel differently about it if the guy was not a mean, nasty little old man. If he was NICE, I might be a little nicer back.

Wow, that was a really long, boring, work story!
haha.
Sorry 'bout that...

I promise it will be more interesting when I get some answers about my international man of mystery.

-J

Ok, so I know I always talk about my life being full of crazy drama. Which it is, to an extent, but yes, I also exaggerate.

But this time (right when I need to be studying and can not afford to be distracted) I have some real life international mystery/deception going on.

I am totally bewildered and confused at the thought of it all. How/why could/would anyone possibly do this? And why me? It's totally insane.

Hopefully I'm just being nuts and there's a totally logical explanation for it all- but I'm starting to think there isn't.

I wish I were a cool undercover detective or something who had access to all the secret info and could figure out what the hell is going on for real. I feel like I NEED to figure this out- but I'm not sure I ever will. I'm afraid it will just nag me forever.

I'm going to wait til I have the whole story before I tell it, but man...

It's nuts, I say! Nuts!!

-J

Do not get on (e:imk2) 's bad side.

(LMFAO)

"I wish s/he would get gang raped by fucking gorillas and then get fed shit through his/her ears. i wish someone would skin him/her alive and fry his/her slimy skin into a crisp and make him/her eat it. god, god, god, why why why are people like this dumb idiot alive???"

I am having some major motivation problems lately. I have a major test on 1/27, and a research project due 4d later. And because I HAVE to do better on the test this year, I arranged my schedule to have this week off to study. But I am still having trouble getting much done before noon. Since I am technically on vacation, I refuse to set an alarm. But I am still getting up around 8. I'm just not sure where the hours from 8-11 go. So I really should be going now, but I was thinking in the shower and felt like posting, instead. (that's probably where the hours from 8-11 go. ;) )

Yesterday I did some work on my project in the afternoon, then after the office closed went to spot. I love spot. Haven't been in ages. And first I saw (e:joshua), which was a pleasant surprise as I had just been thinking about how I hadn't seen him in ages, so it was nice to catch up. Then I saw a guy that graduated from my program a year or two ago, and he invited me out with 'the boys' tonight. Odd. Then I went across the street for a nice sushi dinner. Good stuff.

But to my point....

So, as some of you may or may not know, I have pretty big boobs. Not freakishly huge, but big enough that my size bras are always hidden away in the stores, and I usually can't wear the cute little sexy, trendy tops. But, I'm not a tiny person, so I think I'm more or less in proportion, and I'm ok with it. Most of the time. But I have been told a few times that I'm TOO big. (Who the hell tells a girl that?!) So there have been times when I've wondered if I'd benefit from a breast reduction. Or even just a lift.

So now I'm doing this research project... I'm studying breast reductions and complication rates, with the hypothesis being that the bigger the reduction (i.e. the more tissue removed), the higher the chance of wound-healing problems. Seems kind of intuitive, but somehow it doesn't seem to have been published before.

So I've been spending this week in a local plastic surgeon's office, going through the charts of all the breast reductions he's done over the last 5 years. I go through each chart and collect data, like height, weight, pre-op measurements, then amount of tissue removed in the OR, and then if they had any problems post-op.

And on the one hand, it's a little reassuring. These women NEEDED surgery. They make me feel downright perky. But after charting measurement after measurement after measurement- it started getting to me.

And when I got home last night, I couldn't help it and I measured myself. And I must say, was relieved to find that I don't think I'd qualify for surgery. And was pleasantly surprised to learn that I'm not even 'saggy' (ptotic) at all. Phew!**

But then it just got me thinking about society and culture and plastic surgery and expectations of women and physical ideals and all that good stuff...

I really enjoy plastic surgery. I think it's fascinating. But it's gotten to the point that if people ask what I want to do, I say "reconstructive surgery" (which is under the umbrella of plastics), because I am sick of people's reactions. If I say reconstruction, they all nod appreciatively like that's a good, noble thing for me to do. But if I say "plastics", there is inevitably a bit of a look-down-the-nose-in-judgment and a snarky comment about the money. (or a request for a boob job.) Sure, the money is great, or rather, will be great, I hope- but that's not my main motivator. I just LIKE what plastic surgeons do. It has its downsides- largely that you have to deal with a lot of crazy, vain women. And then the nasty stuff that no one realizes plastic surgeons do- a lot of wound care for complex ulcers, stinky necrotic bedsores, etc. But I like the cases. I think it's fascinating. And I like the people. I keep finding, over and over, that when I go into the OR with plastic surgeons- it's FUN. People laugh and joke and play music, as opposed to sour dour stressful "what artery is this? what nerve is that a branch of?" in a lot of the other fields. And a plastic surgeon I worked with at Roswell recently broke it down pretty well. He said in general surgery you learn operations. You do each procedure more or less the same way every time. But in plastics you learn techniques. A toolbox. And you have to figure out which ones to use where, and there's a little more problem solving and decision making involved, which I think is awesome. There are other aspects too, but I'll stop there.

The typical dichotomy in plastics is that cosmetic pays better, and reconstructive is more rewarding. Most people create their own balance depending on their own priorities.

Yes, cosmetic surgery is sort of fluffy and I don't know how I (will) feel about supporting my children by living off women's insecurities, or men's, I suppose- but at the same time, I think of the poor kid who has had stick out ears or a big honking nose for his/her whole life, and is miserable and the butt of jokes etc etc. If you can fix that for him/her, and improve his/her quality of life that much- is that not a valuable service, even though it is "only cosmetic"?

And the other thing I find interesting is that over the years 'standards' have been developed. I mean what is beauty? Can we define it and spell it out? Well apparently, yes. There are textbooks on the 'ideal' facial features, etc. What angle of the nose, etc, is "attractive", blah blah. Which I think is kind of amazing. That you can break it down in to parts and make a science out of it. And it's not just like one egotistical guy decided what was beautiful and said that's the definition. It's been studied. Kind of neat.

Ok, off to filter through more charts and collect more measurements...

-J

• In case I've made any of you girls out there insecure about your own breasts now, well first of all, I apologize, but here are some rule of thumb "golden rules" if you want to reassure yourself. The main measurement to consider is the sternal notch to nipple distance. Take a tape measure or a piece of string and measure from your sternal notch (that little V at the top of your breastbone) to your nipple, while standing up. A little difference between the two sides is pretty common. And a quick and dirty rule is that an equilateral triangle of 20cm per side from notch to nipple to nipple to notch is "ideal". I doubt too many people meet that. Depending on height/weight, once you start getting closer to 30 reduction MIGHT start to be reasonable. Some of the women whose charts I'm going through were 40+.

And as far as ptosis (sagginess)- put the tape measure under your breasts, right at the inframammary fold (the crease where the breasts come off the chest wall). Nipples 'should' be above that line. Then ptosis is graded based on how far below the line they fall, with the worst (grade III) being when the nipples are on the bottom of the breast, aka snoopy-nose breasts.

Wow, some of these are awesome.

When graphic artists get bored:

Just got this from a wise friend. Perhaps it's pertinent.

"anyway, I read an interesting letter in the book Mudra early songs and poems by Chogyam Trungpa Rinpoche a Tibetan that started Naropa Univ.......there is a letter from a Teacher(Patrul Rinpoche) to his friend, very funny depending on the translation (I think the one in Chogyam's book is the best), the following is a mix of translations, I think the one I have in book form is the BEST....I'll dig it up and send you the whole letter, but I remember one part that went something like....

You've studied hundreds of philosophies Without grasping any of them.
What's the point of further study?
You've studied without remembering
Anything when you needed it.
What's the point of contemplation?
Forget about your "meditation"!
It doesn't seem to be
The Cure for conflicting emotions

a few stanzas on....

Your girlfriend puts on a smiling face
But who knows what she really feels?
For one night of pleasure it's nine months of heartache.
You can spend a month trying to bed her and still not succeed.
It's really not worth all the scandal and gossip, So forget about her.

Giving teachings on meditation texts
Without yourself having
Gained actual experience through practice,
Is like reciting a dance-manual out loud
And thinking that's the same as actually dancing.
People may be listening to you with devotion,
But it just isn't the real thing.

Sooner or later, when your own actions
Contradict the teachings, you'll feel ashamed.

Just mouthing the words,
Giving dharma explanations that sound so eloquent-
Forget about it!

When you don't have a text, you long for it;
Then when you've finally gotten it, you hardly look at it.
Just sleep, eat, piss, shit.
There's nothing else in life that has to be done.

Don't get involved with other things:
They're not the point.

Keep a low profile,
Sleep.

In the triple universe
When you're lower than your company
You should take the low seat.

Should you happen to be the superior one,
Don't get arrogant.

When you're without any worldly or religious obligations,
Don't keep on longing to acquire some!

If you let go of everything-
Everything, everything-
That's the real point!"