Our First Trip to Columbia – Updated

We left Wednesday night after work to drive to Columbia, Missouri where the University of Missouri’s College of Veterinary Medicine is located. While it is a six hour drive, it is a relatively easy one given that most of the road is four lane. The hardest part of the drive is between Little Rock and Harrison, which is, if you are not familiar with it, a small town on the Arkansas/Missouri border – that portion takes about 2 hours (1/3 of the total time) but is only about 1/4 of the total mileage. In fact, the experience of driving through Missouri on non-interstate highways has convinced me that the roads of Arkansas are inadequate.

We stayed in a Holiday Inn near the University. It was adequate. Zoie liked the king size bed that we allowed her to share with us, but Jennifer and I found it uncomfortable. Sadie barked at many passers by in the hall, a fact that I’m certain endeared us to our single serving neighbors in the hotel.

On Thursday morning, I awoke around 8 and took the dogs out to take care of their business, the details of which are not important, and then had some breakfast at the hotel’s surprisingly decent continental buffet. I took some food back to the room with me for Jennifer. Since Zoie was, in preparation for possible sedation that day, not allowed to have any breakfast or water, the presence of food in our room maddened both Zoie and Sadie. I like to think that Sadie had refused to eat in solidarity, but in fact she had no choice in the matter – even if feeding her would not have been cruel to Zoie, it would have been nearly impossible given our small quarters.

After Jennifer and I showered, we loaded up and headed to the vet school. It’s an experience that I wish on no person with an animal companion. Still, if it is necessary, I’m glad that places like the University of Missouri exist. The doctors and students truly care about the health and well being of the animals, and of the people bringing their animals there for care.

Sarah, the fourth year vet student assigned to Zoie, greeted us with a smile and an extended hand. She led us to an exam room where she explained the process at the vet school. Basically, a student is assigned to each case and, to the extent that student stays on the rotation, will remain with the animal throughout hospitalization if that is necessary. However, she said that Zoie would likely be treated by several different doctors. She said that, since the hospital is a teaching hospital, the rationale is to expose the doctors to different diseases and animals thereby widening the knowledge of the doctors and improving care overall. She assured us, however, that continuity of and proper care are, despite the hospital’s dual mission, the first priority. One attending doctor supervises each case handled by the various residents in each specialty. In other words, one attending doctor, with whom we may never speak, is supervising Zoie’s treatment which will be administered by several oncology residents. I was glad to hear Sarah’s faith in the hospital’s approach. In truth, however, I was familiar with it already and it was actually one of the reasons we chose to take Zoie there. The bottom line is that they have a team of oncologists that work on every case. In all instances, I’ve found that many heads are best for solving difficult problems.

After her spiel, Sarah took a medical history of Zoie and did a quick physical exam. Zoie can be temperamental, but she liked Sarah. It could be that Sarah kissed Zoie on the nose when she was listening to Zoie’s lungs, but more likely I think it was Sarah’s overall demeanor which is kind. After she finished the exam, she went to speak with the resident assigned to Zoie for the day. While Sarah was gone for about an hour, Jennifer, Zoie, Sadie, and I waited. Waiting always sucks, but especially when health is involved. An hour seemed like three. Periodically, Sadie threw herself onto the tile floor in apparent exasperation with the whole process.

When Sarah returned, an oncology resident, Dr. Kimberly Statham, accompanied her. Dr. Statham talked in detail about the type of cancer Zoie has, and the suggested approach to developing a treatment plan. She said that they would like to sedate Zoie, take a CT of the area where the tumor was removed, take a chest X-ray, and do a full blood screening. The CT, she said, would show if all of the tumor was removed and provide the basis for radiation if that was the suggested approach. The chest X-ray and blood work would, to the extent possible, determine if the cancer has already metastasized. Already knowing the type of cancer, Dr. Statham said that nothing is certain until the results of the CT are reviewed, but that radiation would likely be recommended for Zoie’s.

Accordingly, she also explained how radiation would be administered (basically, 20 doses, 5 per week, for 4 weeks – many small doses over time serve to kill all of the cancer cells in the various stages of development) and the possible side effects (some of which, depending on each individual, can be pretty bad). Ironically, she made the topics fun to discuss. For instance, she explained that radiation is only administered Monday through Friday because the cancer doesn’t grow on the weekends. I just laughed and Jennifer, always quick to retort, said, “How convenient for you guys.” Dr. Statham laughed at Jennifer’s response. I personally appreciated the humor. I suppose she has to be careful in choosing her audience, though.

After she finished talking with us and answering our questions, she took Zoie for the CT and told us to come back about 4:30 unless they called earlier. She told us where to find the local theaters, the mall, and the local coffee shops and restaurants. We left and put Sadie in her crate in the back of Jennifer’s car. That, in itself, felt wrong. I never before recall loading Sadie into the car without Zoie.

We drove off. And waited.

***Update***

We went to Chili’s for some lunch. Sadie stayed in the car (we left it running with the air conditioner on). After we ate, we stopped by Wal-Mart. While Jennifer went in to buy a couple of travel bowls for the dogs, I walked Sadie around a large, undeveloped, grassy outlot near the front of the parking lot. When Jennifer returned, Sadie ate and drank leisurely.

After the three of us had eaten, we loaded up and drove around Columbia to get our bearings. I obviously don’t know it well, but it appears to be a typical college town. It’s definitely pretty.

Around 2:00, Sarah called me. She said that Zoie came through the CT fine and was in recovery. She said that we could come back about 4:15, talk about the CT, and then Zoie would be discharged.

Anxious, we showed up at the small animal clinic around 3:45. We waited some more. While we waited, we met a cute, grayish cairn terrier named Angus, a woman from nearby St. Louis whose pug was being treated for kidney failure, an internal medicine resident who gave Sadie a cookie, and a 20 year old cat whose owner didn’t offer a name. Sadie got a lot of attention all day and so, by the time Sarah took us to the exam room around 4:10, she was worn out, flopped on the floor, and almost immediately fell asleep.

Sarah came back around 4:20 with Dr. Statham who had taken the time to type detailed discharge instructions including her recommended treatment approach. The bottom line is that the tumor was extensive. Even after the removal of most it by our local vet, it still has microscopic tendrils that have attached to three ribs and to the underside of her shoulder blade. Unfortunately, she said that, without radiation, it will grow back (really, it has already started) and will likely be large, debilitating, and inoperable. While Jennifer and I are both loath to subject Zoie to radiation treatment, there is no choice.

As Sarah prepared to walk us to discharge, Dr. Statham, who had already told us that we probably wouldn’t see her again, went to get Zoie who was still in recovery. Before she did, she bent down close to Sadie and playfully told her, “I never want to see you back here again. You don’t want to come see the oncologist do you?” Sadie licked Dr. Statham’s nose in response. Dr. Statham said, “I love her spunk.”

At the discharge desk, Sarah said that, after Monday when Jennifer is dropping Zoie off for the beginning of her radiation treatment, we unfortunately probably won’t see her again either. She apparently has to start a new rotation next month in another specialty. I asked her if she knows what her plans are following graduation. She said that she isn’t sure where she will practice, but told me about a couple of options she is considering.

As I said, the hospital’s approach to treatment is one of the reasons we chose to take Zoie there and I stand by that, but I like Sarah and Dr. Statham. I’m glad that our initial visit was with them. They made the beginning of a difficult process a little easier.

As I was writing a check for the day’s treatments, I felt a nudge on the back of my leg. I turned around to see Dr. Statham holding a leash attached to Zoie. Blissfully ignorant, she was looking up at me, wagging her tail, and smiling. I stopped writing, bent down, and kissed her head. Dr. Statham said, “She acts like she wasn’t sedated at all. She virtually pulled me down the hall.” I laughed and told her that I’ve been there.

Zoie

If having a soul means being able to feel love and loyalty and gratitude, then animals are better off than a lot of humans. –James Herriot

I love Herriot’s books. He has a lot of very wise things to say about animals, and humanity.

We’re leaving tomorrow night for the University of Missouri. Zoie’s appointment with the oncology department is on 9/27 at 10:30. If you are the praying type, say one for Zoie on Thursday morning.

Funky Coffee

One day last week, I had an early meeting. On my way to it, I stopped by the coffee station on our floor and grabbed a cup. I normally don’t drink it because it’s just not very good coffee. On that particular morning, though, I had only had one cup at home so I thought a little additional caffeine was in order for an early, probably boring meeting. So I decided to tolerate it.

I pulled out one of the Styrofoam cups beside the pot, filled it up and, just a few seconds late, quickly walked to our conference room, and then sat in a room already filled with meeting attendees. I absent mindedly sat the cup down on the table in front of me. As I pulled my hand away, however, I felt something slightly sticky on my palm. It was not a sensation that I had expected and it made me think that something was amiss. Curious, I turned my palm toward my face and investigated.

I found a booger. No other way to describe it. It wasn’t big, but it was slightly green and unmistakable. Worst part: I know it wasn’t mine. I hadn’t blown my nose or otherwise been involved with any of my own mucous all morning.

I almost gagged. I wanted to scrub my hands. I can easily excuse myself from most meetings, but not the one I was in at the time. I wasn’t sure what to do with it. Then I thought that, no matter what I did, I was on the moral high ground because someone devoid of manners had left snot on the community coffee pot or on one of the coffee cups for me to encounter. With that in mind, I wiped it under the conference room table, suffered in silence until the meeting was over, and immediately went to the restroom and washed my hands.

No more coffee from our coffee station for me.

No Sacred Place

At least once a week while I’m in the restroom at work, a member of the housekeeping staff knocks on the restroom door. Always two rapid knocks in succession, followed by a cheery announcement, “Housekeeping!” Unsure how to respond, I always panic. I’m not sure why. It would be very simple to just say, “Occupied.” Instead, I think, “What should I say? Hello. I’m in here. Go away. Leave me be for God’s sake.” After mentally rummaging through the litany of possible responses, I usually just manage a weak, “Yes?”

I never get a response, just the muffled sound of the door closing from its slightly open position.

Shameful

Cost of the war in Iraq (so far) according to the National Priorities Project: Over $450 Billion – That’s with a B; 450 followed by 9 zeros. See the calculator here.

Cost of the proposed increase in the State Children’s Health Insurance Program that W is threatening to veto: $35 Billion. Short article here.

Priorities, Georgey. Priorities.

The Great Feats of Arkansas’ Legislature

There are many things I love about my state. Sometimes I wonder, though, if they are outweighed by the stupid things that happen here. The latest thing that has made me question the collective intelligence of those in our state is the marriage law that the state legislature recently passed.

For those of you residing outside Arkansas, here’s the deal:

In its most recent session, the Arkansas legislature passed a law that was intended to modernize the antiquated minimum marriage age (i.e., with parental consent, 16 year old girls and 17 year old boys were permitted to marry). The legislature intended to set the minimum age at 18 unless the person applying for a marriage license is pregnant and has parental consent. Unfortunately, the bill that was passed by the legislature included an ill-placed “not” in front of the word pregnant, thereby permitting anyone under 18 to marry so long as a parent consents.

Genius huh?

All of that is bad enough. Mistakes happen. I guess (I’d get fired for such a blatant error).

But the lawyers of this (right now) banana republic cannot leave well enough alone. It seems that the mother of a 17 year old girl who was, in accordance with the stated intent of the legislature, denied a marriage license in Northwest Arkansas is suing to enforce the improperly drafted law. Whatever, if you want to marry your daughter off at 17, I think it’s stupid but it’s your business I suppose. The person I hold in contempt is Tim Hutchinson (junior, not the former U.S. senator) for taking the bleeding case. In my opinion, he took it for the publicity. I’m guessing that he is looking out for number one and is hopeful that the publicity will further his political career.

Freaking lawyers. Sometimes I’m ashamed.

Small Things

As Jennifer and I were walking into a restaurant tonight, a family was walking out. Jennifer was in front of me so she held the door open. The mother walked out first and the father last. Their daughter walked in between them. Because she was young (maybe 4 or 5) and obviously short, I barely noticed her between the adults. That is until I heard her exclaim, “Thank you Jay-zus!” When she said that, Jennifer and I both whipped our heads around to look at her. We saw that, as she emerged from the restaurant, into the outside heat, she was pulling off her father’s jean jacket which was obviously much too big for her.

Having presumably been cold throughout the meal, it made me smile that she was completely joyful to be comfortable again.

A Few Things

I’ve been saving up the following with the intent of writing separate posts about each, but I don’t think I’m going to get around to it. So here they are in brief:

1. Note to Lee Scott: Changing the motto is not going to change the fact that Wal-Mart sucks.

2. Speaking of mottos. Check out the U.S. Lawn Mower Racing Association’s (yes, you read that correctly): “We turn a weekend chore into a competitive sport!” Who knew? But my favorite part is that their website is called Let’s Mow.

3. One more thing for me to be a hypochondriac about: A Japanese study suggests that early risers have a higher risk of developing heart problems. More here.

4. I recently had a hard time throwing away a cooler that I’d had since high school. I was puzzled by my reaction because I’m not normally emotionally attached to objects. Regardless, it clearly needed to be trashed.

5. Every year, Beloit College provides professors with a mindset list to help them identify with incoming freshman. Most of this year’s freshman were born in 1989. That in itself didn’t make me feel too old. At least until I started reading the list. For example, #1 is, “What Berlin wall?” Rest is here.

6. I recently learned a new word that I love because of its specificity: specious.

7. I don’t understand the fight over giving the FDA oversight over nicotine (actually, I think it should be entirely banned – I can at least make an argument that alcohol has health benefits in moderation). Last week, during a downpour, I watched people stand outside in the only smoking area on my company’s campus, sucking on their cigarettes. Tell me that it’s not a drug.

Movies

Shoot ‘Em Up

I like Clive Owen a lot. I also like Monica Bellucci and Paul Giamatti. So I went into this movie with the attitude that there was no way I would dislike it. I’ve often found that such an attitude just results in disappointment. But I think the movie held up fairly well under the circumstances. I hadn’t read anything about the movie before seeing it, but it turns out that it is a spoof of action movies. The joke, though, is in the almost mind numbing overabundance of violence, and the ridiculous acrobatics undertaken by Clive Owen’s character while successfully killing his rivals (a mid-air gunfight after jumping out of a plane, for example, was riotously funny but obviously completely unbelievable – that’s exactly the point of the movie, though). Also, I’m not normally prudish about sexual content in movies, but one scene during which Monica Bellucci’s character, who is a prostitute, breast feeds a middle aged man with an obvious fetish is just plain gross in my opinion. You’ve been warned.

Paris Je T’aime

This homage to Paris is made up of a number of short films (12, if I remember correctly) each set in a different Paris neighborhood. It’s difficult, I think, to maintain the interest of an audience for two hours without one storyline to follow, but the transitional segment directors did an excellent job of maintaining continuity by connecting the shorts with wide angle shots of the city itself. Regardless, I thoroughly enjoyed most of the shorts. There were only a couple during which I considered stepping out of the theater to visit the restroom. Overall, though, I enjoyed being reminded why I and, apparently, many famous directors (Gus Van Sant, Wes Craven, Joel and Ethan Coen, Alfonso Cuaron) and actors (Bob Hoskins, Emily Mortimer, Nick Nolte, Natalie Portman) love Paris.

The Shoe Project

A couple of days ago, I ran across a link to the Shoe Project which is a part of the website Twenty One Pictures. As far as I can tell (there isn’t much explanation on the site), each of the themes on Twenty One Pictures is explored through, shockingly, twenty one different photos. Regardless, the Shoe Project shows a picture of each person’s shoes along with a picture of their face. I found it wholly interesting. If you want to check it out, follow this link.

Zoie Update

After speaking to five different oncologists about Zoie’s tumor and what has been done so far, we have decided to take her to the University of Missouri at Columbia for evaluation and recommendation for possible additional treatment. We ultimately decided on the University of Missouri because they have a team of oncologists that consult on every case. They also have an MRI and a CT machine on site, and are able to administer radiation on site if that is recommended. I mention radiation because each of the oncologists I spoke with said that local control is a must with the type of cancer Zoie has, and each of them recommended radiation as the best alternative. We won’t know, however, if that is even possible, or necessary, until after her appointment on September 27.

I have mixed feelings about radiation in general. I spoke to my local vet about it. She said that dogs, like humans, all react differently to the treatment. Some, she said, basically just have a sunburn-like area on their skin and don’t otherwise feel too bad. Some, though, basically feel awful during the entire treatment. If the oncologists recommend radiation, and are fairly certain that it will be successful without terrible side effects, we’ll definitely do it. Still, I can feel the weight of making such a decision for a being that is totally dependent upon and benevolent toward me.

The good news is that, with good local control and provided that treatment occurs before metastasis, the three year survival rate for Zoie’s cancer is 80-90% (cancer survival rates in dogs are measured in three year intervals rather than five with humans). So that gives me hope.

A couple of things I’ve learned:

1. Veterinary oncologists are, in my experience, some of the nicest people I’ve ever been forced to deal with. Each time I called and spoke to a different oncologist at a different vet school, I tried to give them money for a consultation fee. They always adamantly refused. I especially enjoyed speaking to an oncologist at the College of Veterinary Medicine at Mississippi State University and to one at Oklahoma State University. Both of them spent several minutes describing the characteristics of the kind of cancer Zoie has, and how they would recommend treating it depending on what scans show, etc. They both also gave me recommendations about what to do next.

2. With a serious illness, immediately start dealing directly with the specialists. In other words, don’t wait on the regular vet (or physician with people) to make recommendations or referrals. Just learn as much as possible and do it yourself. I regret that I had to learn this first hand and lose some possible days of treatment. That’s not intended to denigrate my local vet. It’s just that she is not an oncologist, and she has many patients. Accordingly, her attention is spread among those whom she can definitely help and not as much attention is given to those whom she may not be able to help. That should probably be a self evident fact, but I didn’t understand it at first.

Counting Crows

For some reason, I’ve recently encountered several people who have maligned the Counting Crows (unfairly, in my opinion). Two of the people happen to be good friends, and I know that they used to like the Crows. So I asked why they grew tired of them. The answer I was given is that they cannot stomach Hard Candy, the Crows latest album because Adam Duritz, the lead singer and chief writer, got too happy. Well, I immediately and viscerally disagreed with that assessment: I pointed out that Duritz, in keeping with his specialty, writes on Hard Candy about rejection, fear of commitment, broken hearts, nostalgia, and even suicide. I make it sound depressing, but it’s not. Duritz has a talent for writing about the things he has experienced, both good and bad, in a way that helps the listener relate his or her own life to Duritz’ experiences.

In fact, Hard Candy includes one of my very favorite songs, “Holiday in Spain”. It’s about the ups and downs of relationships. I won’t include the entire lyrics here, but here are a few lines that amuse me every time I hear them:

She’s my angel
She’s a little better than the one that used to be with me
Cause she liked to scream at me
Man, it’s a miracle that she’s not living up in a tree

Anyway, that is enough apology for the Counting Crows. If you haven’t listened to their music, I recommend starting with August and Everything After, their debut album, and then moving on to Hard Candy, This Desert Life, and finally Recovering the Satellites. I really enjoy several of the songs on Satellite, but Duritz spends a good deal of the album exploring the fame he and the group experienced after the release of August and Everything After. It can be a little off-putting if you aren’t already a fan.

Thai and Public Prayer

Last week, I was in Fayetteville and went to dinner with my sister, my niece (sister’s daughter), and my niece’s husband at A Taste of Thai. Jennifer and I frequented the locally owned restaurant when we lived in the area, and I was extremely pleased to have the opportunity to go back.

I started with a Thai iced tea and some summer rolls. I ate and drank with gusto while my sister and I waited for my niece and her husband. When they arrived (around 30 minutes after we did), we all ordered entrees. I ordered chicken in a red pepper sauce with basil (it rocked).

When our entrees arrived, however, my sister asked (apparently rhetorically), “Should we pray?” Before I could say anything, she followed up with, “I’ll pray.” And then she started talking to God without any additional pause.

Catch talked about public prayer not too long ago. I don’t remember the situation he wrote about, but my memory is that he is uncomfortable with public prayer (sorry, Catch, if that’s not exactly correct). Regardless, I am extremely uncomfortable with it (I’m excluding religious services). I am always reminded of Jesus’ teaching about how those who make a display out of praying in public have received their reward in full. I’m not saying that all people who pray in public are insincere; it’s just what I’m reminded of.

I think the real problem I have with it is that I always feel as if the person who is praying is imposing his or her views on those nearby. That bothers me.

Bellamy and Stereotypes

One of the many things that I’ve learned from Jennifer is an appreciation for stand up comedy. I never liked stand up before I met her. Now, I think that, when it’s good (i.e., funny), it is one of the more intellectually stimulating forms of comedy. While there are exceptions (e.g., Carrot Top, Gallagher), most comics rely almost completely on words and the brains of their audience to conjure funny images or situations, and they have a very short period before the audience loses interest. In that situation, I believe that being funny requires great talent.

Because of our appreciation for comics, we watch the television show Last Comic Standing which is currently in its fifth season and is now hosted by Bill Bellamy. My prior exposure to Bellamy was when I saw him, from time to time, on MTV as a VJ or as the host of some random show like the MTV Beach House. But on Last Comic, he starts each show with a short monologue of his own. He’s genuinely funny. I often laugh more during his extremely short set than during some of the longer sets of the contestants.

A couple of his sets, however, have made me really consider stereotypes. Specifically, he has talked about white people (his words, not mine). I won’t try to repeat his sets verbatim because I would get them wrong and, even if I didn’t, there is no way I could recreate his delivery. But during one set, he talked about how white people always wear flip flops, wherever they go, and whatever the situation. I found it funny, really funny in fact.

On last week’s episode, Bellamy again chose white people as his subject. This time, he talked about how, if you want to really piss a white person off, then do something to animals. He said that, when you see a beached whale, it’s always white people out throwing water over the whale and trying to push it back into the water. He ended by discussing how you cannot mess with a white person’s dog. He said they will go to all lengths to protect their dogs. Again, I found his set extremely funny.

But both sets deal in stereotypes, and I’m not sure how I feel about that. In fact, I happen to believe the thing that makes stereotypes funny is that they are sometimes, maybe often, true. The danger, though, is that some people fail to recognize that any particular stereotype may or may not be true for any individual person of a group.

In fact, over the years, I’ve tried very hard to learn not to apply stereotypes to people. Race is among the groups but I’m also referring to gender, religion, sexual preference, economic status, and many other subsets of the general population. Which makes me wonder if I should be laughing at Bellamy’s comedy or not. I know that flip flops and the kinds of people who try to save beached whales are benign subjects. But still.

I may be assigning too much sociological importance to a comic’s monologue…