My State of Mind, In a Nutshell
The holidays are around the corner, and yesterday I read the word "Hope" on a holiday display as "Hep C."Hoo boy.

Silence. Listen.
Noo and I had to put our cat to sleep ten days ago, a very bad day indeed. I was starting a week at Nordstrom and had to drive back and forth from work to home three times that day, and it's hard to drive on rural highways when you're crying.I've been quiet on the blog because I've been listening to myself. I realized that I've been putting solutions together for years which look good on paper but truly suck in practice. Flashing my middle finger at Gimbels and working at Nordstrom (a good job, btw, but...) seemed so reasonable at the time, but I hate being away from my home for a week at a time, and I hated missing my cat's final moments because I was on my way from 60 miles nort

Everyone Has Her Limit
No, I haven't disappeared off the face of the earth. Since my last post, I've been holding down the jobs at Macy's and Nordstrom and one of my cats got sick. She was diagnosed with diabetes and kidney failure, and now--in addition to being an effective nocturnalist and itinerant rural hospitalist--I am also learning how to give her subcutaneous fluids (twice a day), insulin (twice a day), and vitamin B12 supplements. She's got diabetic polyneuropathy so she can't really walk around, which means I'm changing a lot of linen and investing in waterproof crib liners to keep the house habitable.I've coped effectively with the upheaval in my professional life, Noo's melanoma diagno

Comparison Shopping for Rural Hospitalists
Recently a reader asked me why I left rural practice, and I took this as a sign that my recent job-hopping has made me seem like one of them fancy-pants, highfalutin' cityfolk doctors who make such a stir on TV. At one time, I too believed a country doc stayed in one town for thirty years, delivering babies and burying octogenarians, until you finally drop dead in the office one day after seeing a clinic full of patients. Modern doctors seem to move from job to job, role to role, throughout their careers, as mobile as information technology supervisors, customer service representatives and hedge-fund managers, regardless of the demographic they s