You know what ammolite is, right?

It's the fossilized shell of a squidesque beastie that lived in the late Cretaceous (IIRC) period and which died out with the dinosaurs. The shells of those guys were apparently made of something very much like the stuff that makes pearls, but the fossilizing of their shells makes them all opalescent and gorgeous and rainbow-glittery.

Imagine the darkest, reddest amber you can, and then shoot green and yellow through it. That's ammolite. It's amazing. It's also found only in a very few places, from Utah to Saskatchewan, and around my neck.

Yes, friends and neighbors, this is mine. (Dry-washes hands, cackles.) It's a craptastic picture, but I was shooting and shooing a cat away at the same time.

Der Alter Jo and I were looking at this piece at a street fair, and I walked away.

Then I doubled back, with DAJ giggling with glee, and handed over my bank card. I knew that if I didn't get it, I would think about it forever, just like I do with a necklace I passed over in Alberta lo these many years ago.

In other news, things at the new NCCU are. . . . .well. Exciting? Thrilling? Slap-yo-mama-type fun? Sure: let's just call it that and leave it alone. I'll tell you: if it's not a stroke that takes out one entire side of your body, or a brain problem that leaves you face-blind (I passed over "prosopagnosia" and then typed "face-bling," which is what I've got around my neck, yo), or a previously-undescribed demyelinating disorder, we ain't got it. It's been one of those weeks where residents and nurses high-five one another over lab results, in other words.

Best moment of the week, and possibly of my entire life ever, came when one of my coworkers, who teaches jazz and ballet on the side, spun around in her chair to answer an intern's question. The thing was, she had her left ankle behind her head at the time, as she was trying to stretch out a cramp in her glutes. I had just put an empty accordian folder on my head as a hat and was humming to myself, and one of the midlevels was playing Bejeweled on her phone. It was Anything Can Happen Day in the NCCU.

I really think that shows like "Scrubs" and "House" are/were great for hospital staff. People get used to seeing craziness on TV, and it doesn't bother them nearly as much when they encounter it in real life. Unless, like that intern, they're just looking for the nearest vending machine.

What to do on your day off.

Wake up to a cat licking your knuckles. Roll out of bed, stopping mid-roll to rub the doggy belleh presented to you. Start the coffeemaker, then pee.

Check your messages. Notice that your trainer has cancelled your training session for the day. Hope that she doesn't have the violent stomach ailment that's been going around.

Leave the house an hour after waking up, having spent more time than is necessary in the shower with mounds of scented soapsuds and lots of implements. Make your way to Target.

Find that everything you need--boring stuff, like dish soap and lotion--is on sale. Grab a bag of work socks as an impulse buy. Think of how nice it'll be to have a dozen pairs of the same socks.

On the way home, decide to visit the strange little nursery on the edge of town. (NB: One of my few unbreakable life rules is never to shop at a nursery that doesn't have resident cats.)

Roll on into that nursery and greet the Domestic Orange Jumbo who patrols the perimeter. Meander slowly down the rows of trees (Japanese maples are big this year) and hardy annuals until you get to the greenhouse. Push aside the plastic sheeting that covers the door, walk into the greenhouse, and take a deep breath of warm, humid, growing-things-scented air.

Take a few more deep breaths.

Dodging craneflies, examine the offerings. Consider buying four-inch pots of catmint. Discard this idea when you remember how prolific and invasive catmint is. Sniff hard when you bend down to look at the Carolina jessamine and Asian jasmine in teeny pots. Admire the Meyer lemons and wish you could remember to bring such a thing inside when it gets cold.

Walk out of the greenhouse and enjoy the change from warm and humid to cool and slightly muggy.

Walk to the next greenhouse. Stop along the way to pet an argumentative calico cat and a black-and-white cat with long whiskers. Realize that the combination of greenhouse and relative outside humidity has made your hair go native in a big, bushy way.

Enter the second greenhouse. Breathe deeply. Realize that this one is mostly roses, but don't go back out, even though you don't want roses. Stroll the aisles of rose plants, reading every card and smelling every bloom. About halfway through, pick up the calico cat who's followed you in and carry her so she'll stop complaining.

Leave the second greenhouse. Stop to commiserate with the nursery's owner, who thanks you for paying attention to the bitchy calico (now curled up with her head on your shoulder). Discuss the drought, the invasiveness of artemisia, how Home Depot has ruined foundation plantings, and whether you can divide buddelia by whacking at it with a shovel.

On the way home, stop to pick up tacos from the taco truck.

Eat your tacos. Update your blog. Take a nap.

My head, let me show you it.

We had a patient recently who had something I've never seen before (for that matter, neither had the physician). He'd infarcted his corpus callosum.

Now: If you're not a brains person, this won't mean jack to you. It's a very big deal, though, for a couple of reasons: first, the corpus callosum has a huge blood supply coming from (if memory serves) three different arteries. Second, infarcting (cutting off the blood supply) it means that you end up with something called split-brain syndrome.

See, the C.C. is the part of your brain that ties everything together. It's a big ropy mass of white matter--the stuff that has the thinking bits of your brain in it--that acts as a communication corridor between the right and left sides of your brain. It allows you, for instance, to be able to recognize a chicken, describe that chicken, name that chicken (sounds like a bad game show title), and talk about what sorts of implements you'd need to take care of said chicken. Besides a knife and fork, I mean.

Occasionally we'll cut the corpus callosum as a last-ditch attempt to stop a really horrible case of epilepsy. That's usually done on children who simply can't stop seizing, no matter what we do pharmacologically, and it's usually done at a very young age, because the ability to overcome that callosotomy, as it's known, decreases as you get older. If it's done too late, or if it happens later in life as the result of a stroke or other injury, you end up with split-brain syndrome.

I'll bring back the chicken and let Wikipedia explain what split-brain syndrome does:

A patient with a split brain, when shown an image in his or her left visual field (the left half of what both eyes take in, see optic tract), will be unable to vocally name what he or she has seen. This is because the speech-control center is in the left side of the brain in most people, and the image from the left visual field is sent only to the right side of the brain (those with the speech control center in the right side will experience similar symptoms when an image is presented in the right visual field). Since communication between the two sides of the brain is inhibited, the patient cannot name what the right side of the brain is seeing. The person can, however, pick up and show recognition of an object (one within the left overall visual field) with their left hand, since that hand is controlled by the right side of the brain.

The same effect occurs for visual pairs and reasoning. For example, a patient with split brain is shown a picture of a chicken and a snowy field in separate visual fields and asked to choose from a list of words the best association with the pictures. The patient would choose a chicken foot to associate with the chicken and a shovel to associate with the snow; however, when asked to reason why the patient chose the shovel, the response would relate to the chicken (e.g. "the shovel is for cleaning out the chicken coop").

Obviously, it's going to be a drag if your C.C. gets all jacked up. It's hard, given the other problems this dude has (like an almost total lack of white matter, thanks to diabetes and hypertension and a bunch of other stuff), to get a really clear read on how it's affecting him and whether or not he even notices. We thought that he had some left-sided neglect (more on that, per Pens's request, in a later post) combined with a major psychiatric overlay (given his history). It wasn't until we saw the MRI, with the corpus callosum lighting up like Christmas, that we realized what, exactly, the problem was. Golly!

(Yes, I actually said "Golly!" upon seeing the guy's MRI. Sometimes I say "Gee whiz!" as well. Ironically, of course. Because I'm hip.)

Now I'm left with a wet, cold chicken who's been in a snowy field and has to be returned to her cozy coop over at Wiki.

Cross your extremities.

I'm waiting for a call back from the insurance peeps. They called earlier regarding my appeal, I called 'em back, got voice mail, and left a message.

Pray, chant, shake your booty, light incense, whatever.

Thanks.

My week, by Jo.

This past week, I was stroke coordinator, advisor to the publications department, advisor to the computer guys who are installing new monitors, preceptor to two nurses, secretary, patient care aide, transporter, housekeeper, fire-putter-outer (figuratively, not literally, thank Frogs), chief inspector of electrical outlets, general dogsbody, and carrier of a full patient load.

I have this weekend off. Except work has called four times as of 0500 this morning to see if I'd like to work extra.

Extra work is not on my schedule. Last night I went to bed just after 5 pip emma, as the sun started to go down. I slept eleven and a half hours and feel almost human.

Things are bad at Sunnydale General: we've got a number of people out with work-related injuries or stress-related problems, our census has ballooned over the last six weeks, and we're all run to nubbins. On top of all of that, I've had such a sore butt over the last two weeks that I've been barely able to walk.

Conversation between me and Der Alter Jo at the Korean barbecue:

Me: My ass hurts.

DAJ: Cross your legs like this: (demonstrates).

Me: (crossing legs like that) scream

DAJ: That's piriformis syndrome.

Conversation with Dr. PMR:

Me: My ass hurts. Friend of mine says it's piriformis syndrome.

DPMR: Cross your legs like this: (demonstrates)

Me: Aw HELL to the no.

DPMR: You work out on an elliptical, right? And you run the stairs here?

Me: Yep.

DPMR: You're a moron. It's piriformis syndrome. Quit running the stairs. And do these stretches. And use a heating pad and NSAIDs.

Me: scream

If there were a Twitter tag for this entire month, it would be #tinyscream.

As the topper, I think one of the docs that I like best is leaving the stroke program. I'm not sure yet, having only heard the most whispered of rumors, but I'm worried.

Kentucky is gorgeous, though, as is Missoula. I could move, right? Right? Even with my sore butt and my worn-to-a-nubbin temper?