what is happening now is this

GALLEYS!




So, the galleys. While it's fun to see what the book is going to look like actually laid out on the page (the layout nerd in me takes particular pleasure in the fonts and the spacing), I also have this weird feeling when reading through that like I'm watching a monster movie through slitted fingers. Because I know that if I find a section that feels clunky or a paragraph that reads awkwardly, I've for the most part moved beyond the point where big changes can be made. Want to rewrite Chapter Nine? That ship has sailed. So I'm just kind of holding my breath and hoping that, aside from the errant typographical error or stray hyphen, nothing that's in this version of the book is going to be too humiliating. You know, because my name is on the cover.

I've had to think a little more about self-promotion, and it's led me to realize how horribly uncomfortable it makes me to talk about myself. I know, I know, I just wrote a 319-page first-person non-fiction personal narrative, I should be pretty good at talking about myself, but I'm not. That's writing. Writing is solitary. Self-promotion involves other people. Tooting my horn in front of other people.

I am not one for tooting.

In general, I have no big problem with public speaking. I have given speeches in front of audiences. I was in student government in high school and college. I have presented at Grand Rounds; Power Point slides, laser pointer and all. But the difference between that and what I will probably have to do for book promotion is that before, the public speaking I had to do was not about me. It was about graduating high school or about the college resident advisor system or pulmonary hypertension. Talking about myself makes me feel like an egomaniac. I could just try to stick to talking about the book, but unfortunately, the book is also sort of about me. So like it or not, I'm going to have to talk about myself. And not only does that make me feel like an egomaniac, it makes me worried that other people are going to think that I'm an egomaniac.

I never really liked being the center of attention. It's not that I'm shy per se, I just get embarrassed in situations where I might be perceived as self-aggrandizing. Even on my wedding day, I wondered if I could skip the part where I walked down the aisle and everyone had to stand up and look. It just seemed so self-indulgent and beside the point, somehow, like, can't we just skip to the party, which is the real fun part anyway? I don't like to be fawned over. I don't like situations that invite fawning.

When I was in medical school, one of my medical school teachers (the late great Steve Z. Miller) said of our transition from second to third-year medical students that there had to be an essential change in how we viewed ourselves as part of the picture. Until that point, he told us, we all strove to be awarded "Best Actor." We studied hard to get the best grades, we worked day and night to make ourselves better, smarter, more prepared to be good doctors. But once we stepped on the wards the July of our third year of medical school, that would all be in the past. It would not be about ourselves anymore. From now on, the patient was the important thing, the focus, the center of the picture. And from now on, we would strive to be not the star, but "Best Supporting Actor." I've been living that truism for the past nine years. It's not about you. It's not about ego. It's not about whether you had a bad day or if you think the surgeon you're working with is a shithead or if you have to get out of work early to pick up your kid from school. When you step up to the patient's bedside, it's not about you anymore. Best Supporting Actor. It's a good and noble thing to be.

Anyway, this awkwardness I feel about attention is something that I'm going to have to get over, because like it or not, I'm going to be doing some book promotion, and part of me does kind of want to do it. I want people to read this book. I want them to like it. I just wish it wasn't so embarrassing for me to say so.

because I'm right, that's why



Ever since the dawn of time, I have had a problem with how Joe slices his bagels. See, quick poll: what would you say is the safest way to slice a bagel? Probably to lay the bagel down flat and move the knife horizontally through it while stabilizing it from the top with the flat of your palm, right? Or if you have a sturdy enough bagel, maybe prop it up on its side and slice straight down towards the cutting board. Or else get one of those crazy bagel cutters that Sky Mall keeps telling you to buy.




What's the wrong way to slice a bagel? I HAVE OPINIONS. One wrong way, one dangerous way, in my opinion, is the way Joe does it, which is to hold the bagel in his hand, with his fingers wrapped around each side like a taco shell, while sawing the knife directly into his palm.





My argument is that regardless, he should probably be more careful with how he wields a knife. But especially as a plastic surgeon, whose very livelihood is dependent on the precise control of his hands, he should damn well be wearing chain mail if he's even thinking about sawing a blade directly into his palm, or better yet, slice the bagel like a safe human being. Joe, on the other hand seems to think that intention is the key to causality and that bagel knife misfire is outside of the range of possible outcomes, because what is he, and idiot? I counter that, idiots or not, most people who cut themselves probably did not intend to do so, and that bagel-related lacerations are probably the scourge of the ER and likely one of the most common kitchen injuries. To which he responded--what is that thing that kids do, where they put their fingers in their ears and start singing loudly so that they don't have to hear you? That.

Anyway, feel free to weigh in on this debate, which while it has been raging in our household for years, though it has unfortunately had zero effect on how Joe chooses to slice his bagels. Maybe a little tour of the ER on a Sunday morning would have more impact. Or a quick tour of his disability insurance premium rates.

wherein we fed saltines to a bear




Since it was a long weekend that gave us a little breathing room from the non-stop game of catch-up that comprises our usual weekend schedule, I decided that we should take a little family day trip, so long as it was neither too far, too expensive, nor too red-neck-y. So we decided to go to the Yellow River Game Ranch, which bills itself "Like a zoo...but BETTER." (This claim on its roadside billboard is, inexplicably, backed up by a giant picture of a squirrel, which, animal it may be, speaks to me far less of zoo and far more of vermin.)




The "BETTER" part of the equation is that you could feed most of the animals, and pet a selected non-carnivorous subset. It was pretty fun. The animals ranged from the standard petting zoo menagerie (goats, chickens, rabbits) to some more exotic though still essentially commonplace animals (there were deer wandering all over the paths sticking their faces into unattended stroller bags in search of food) as well as some animals that I did not really expect. There were bears, for instance, in cages, but which you could feed via a long, sloped pipe through which you could thrust peanuts and other delectables. (There was a bear parked at the base of the pipe basically with his mouth on it, like Barney Gumble.) Also there were a variety of wild big cats, like cougars (don't start) and bobcats and such, though those we were instructed not to feed for obvious reasons, and whose small enclosures and listless lolling were more depressing than awe-inspiring. They did not, however, have a cage containing the world's most dangerous game. (They had this exhibit at the Bronx Zoo when I was a kid, consisting of a mirror with bars over it. Because MAN is the world's most dangerous animal, don't you know. Hoo! EDITORIALIZING!)




Even though there was a certain grimness to the whole thing, as there always is to non-government funded zoos, the animals looked for the most part healthy and, with the exception of the man-eaters, most had a lot of space to move around and whatnot. And the kids had a good time, though there was a fair amount of walking for those who deigned to walk, so some of us were kind of tired by the end.




(Above: Mack, still entertained by the bunnies. Cal, meanwhile, totally over it.)




Anyway, despite appearance to the contrary, a good time was had by all. And now, back to work.

(Full picture set here.)

you should probably take your metformin before reading this

Look, I'm not saying that my kids are perfect. They're not. But when it comes to the two of them getting along, they are almost perfect. I assumed that Mack would grow up idolizing Cal, because isn't that what younger brothers do? You know, like Happy and Biff in "Death of a Salesman," only less pugnacious. But what has surprised me is that, as an older brother, Cal is even more in love and delighted with Mack than Joe and I are. Exhibit A: In a pile of Cal's school paperwork that came home this weekend was this, which I can only describe as a love letter.

I think for a kid who just turned five his handwriting is pretty decent and his spelling is at least close to phonetic (or at least phonetic relative to how he thinks words are pronounced) but here, let me provide a translation:

September 3 2010

Hi Mack I love you

I want to have a great time

I want to have a camp out some day

You are fun to play with Mack

I love you love Mack (string of hearts)

Do you????

Mack's favorite things

(Drawing of some kind of wheeled vehicle, an airplane, a ball, and a house)

I swear, this kid just kills me sometimes.

idiopathic

We got a call from one of Cal's teachers this morning that he had a rash on his face and they were wondering if someone could come in to take a look at him. Luckily, I was on call last night and therefore was in a position to get out from work early today, so I headed in to school around 11:00am. It was as I suspected; that is to say, essentially benign. See, last year around this time of year, Cal had a period that lasted a few weeks where he would periodically get these urticarial rashes (I believe "hives" would be the closest corresponding colloquialism) on different parts of his body. His face, his chest, his torso, his limbs. We presumed they were allergic in nature and tried restricting this and that food product and this or that detergent or product, but since nothing new was being introduced and there seemed to be very little rhyme or reason to when the hives would appear (I had a few days where I was convinced that it was either heat urticaria or that he was allergic to his own sweat, though none of these theories panned out under more rigorous clinical tests: i.e. ice packs, warming pads, forced exercise, what have you) and since there seemed to be no untoward sequelae aside from some itching, we just chalked it up to idiopathic urticaria and eventually it went away.

Yesterday he had some hives on his legs before bedtime. I put some steroid cream on them and told him to quit scratching them, for God's sake. And this morning he had some hives on his face, though they had almost completely subsided by the time I arrived. He has eaten no new foods, no new lotions, we have not changed detergents, even his clothes are old. He has no wheezing, no swelling, nothing else but this urticarial rash which comes and goes. I expect this cycle will last for a few weeks like last time, and then go into hibernation again like last time. One of our friends (who happens to be a pediatric immunologist--see, sometimes having gone to medical school is useful, at least you always have someone to call) is also completely nonplussed, which is reassuring. Last year we gave him Benadryl every time he got the rash, but it hardly seemed to make any difference and anyway, I hated sending him to school with the prospect that he might fall asleep halfway through circle time, so I just stopped doing it and it was fine. So I guess we'll stick with the "less is more" approach for now.

Once I arrived at school and ascertained that Cal did not have some sort of purpuric fever nor was his airway swelling shut, I pointed him back towards the rest of his class and told him that I'd pick him up in a couple of hours, at the end of the school day. He scampered off, as did I. Then, on my way home to put Mack down for his nap, I got McDonald's for lunch and now I have post-McDonald's regret. It seemed like such a good idea at the time, though.