Tuesday, December 7, 2010

Crazy trip

My last two weeks have been a little out of the ordinary.

We flew in for a wonderful Thanksgiving. That day turned out to be the most relaxing day of the whole trip.

Then I worked the whole weekend in the ER. It was moderately busy, but no one was seriously ill. I only shipped one lady out and admitted three, so that was probably below average.

I love working there. It's the exact opposite of the ivory tower medicine I practice every day, and I miss the general medicine stuff more than most of my colleagues. The fact that anything may roll in to the ER is unnerving, no doubt, but at the same time it's refreshing. It's increasingly obvious to me that my dream job would be that of a community hematologist, with an amount of general internal medicine thrown in. Hematology is such a specialized field that one almost has to work in a large center to see exclusively hematology, and I'm not sure that appeals to me. Some do combined hematology and oncology, which I won't be able to do unless I get trained in oncology, too.

We flew to Florida and Disney World. We were there two years ago and the kids loved it. I arrived two years ago, convinced I would hate it. I expected a fake, tacky plastic world full of fat people waiting in lines. And, of course, that's what Disney World is. Still, I ended up having a great time and looked forward to coming back. The second time wasn't as good as the first, but it was still a very good time. We visited EPCOT, Magic Kingdom and Animal Kingdom, and they all had their own charm. After the first day, the whole family glided smoothly through the parks with a shared purpose of having fun.

My son, Andreas, sees me as a fun guy who shows up every few months. He had a good time in Disney World, and he opened up a little bit to me on a few occasions. We will live away from him for another year, but at least there is an end to it. He is generally doing better in school than I have feared, but he has behavioral problems. I do wonder if he has a bit of ADD, and his teachers have voiced concerns about that, too. I need to get back in his life.

Suddenly, one night, I had to leave for my convention. We had gotten into a mode of riding Disney shuttles, racing to pools, and playing loud games in our condo. And from one moment to the next, I had to leave. Natali was crying and Andreas went into quiet beyond-reach mode. The taxi came quicker than I expected, and I had to leave a house full of wailing chaos.

So there I was, at the hematology convention, wearing a suit and talking about lymphomas with other hematologists, knowing the Girl and the kids were just a few miles away.

I want to describe Orlando. Partly because Orlando is a horrible place that deserves mention, but partly because I realize that my fellow Danish convention-goers think of Orlando as America. What a terrible place to live! Everything seems so unsustainable and fake. There are beautiful sidewalks that meander through flower beds and palm trees. They end suddenly, at arbitrary spots and are clearly built for people to look at through car windows. It's not possible to walk anywhere; I had to break several laws to find my way on foot to the convention center.

The grass is unnaturally green, and if one runs on it, it feels fake. It's watered several times a day, making it thicker than grass should be. If one runs on it, it's apparent that there is no normal soil underneath. It grows on some kind of rubber mesh. The grass is made to be admired from a car.

Orlando has a strip, akin to the Las Vegas strip, of hotels and restaurants. Universal Studios and Seaworld lie at opposite ends of this strip. Everything is manicured beautifully, and a trolley reminiscent of Europe or San Francisco will take you up and down the strip. But when one looks behind that row of glitzy hotels, there is nothing. Just abandoned lots and fences and, beyond them, an unhealthy-looking swamp.

And the people. The convention-goers all praise the service level here. I am struck by how unfair it all is. It's hard not to notice how everyone in a menial job is black or Hispanic. Every white person appears wealthy, thin and aloof. Every Hispanic, and I mean every adult person to the man or woman, is obese. There are restaurants so exquisite they import the entire waiting staff from Italy, while the people who actually live here eat mostly fast food.

Okay, so I have been away from my routines for two stressful weeks, and it shows in the above post. But I stand by the general sentiment. I hate Orlando.


SteveQ said...

I've never been to Orlando, but then again, I've never been to a Wal-Mart either. I expect they're not dissimilar... fat people standing in line to spend money on cheap crap they don't need.

I HAVE been to an ER. I expect it's better to work in one than to come in on a gurney.

I've been coming to the realization that Americans' first thoughts of what Denmark must be like are rather dark and sullen - more Kierkegaard than Tivoli Gardens. Odd...

SteveQ said...

Time to ask a hematologist:

I was reviewing some old notes and saw that adults have two forms of hemoglobin, 98% having 2 beta chains, the other 2% having two deltas. Is anything known about why there are two forms? Do they have different oxygen binding affinities? Does the ratio of the two forms vary between populations? What I really wonder is: does altitude training or EPO alter the ratio of the two?

SteveQ said...

Never mind. Eddison, G.G. et al, J. Clin. Invest. 43(12):2323-2331 (1964) suggests there's no functional difference between HbA and HbA2.