Archive for July, 2009
Posted by Alex
Jumbled anatomy lab box: sticks, knots
Ivory polished by years of touch
Fingered, fitted, laid in rows, decades
from the proper rest of graves.
Carpal, tarsal, incus, stapes,
Ilium, ischium, rib.
Conjure-names for destiny,
Spells with a terrible grace.
Grandma said her friend didn’t have a single mean bone,
So for years I thought of one small bone, a spiky knot
Of meanness caught in certain people, maybe in the throat,
Making rattled ugliness whenever they talked.
Never Lower Tillie’s Pants
Grandma Could Come Home
Navicular, lunate, triquetrium, pisiform
Scaphoid, capitate, cuboid, hamate.
Grandma got to be the scaphoid;
necessary bone, essential
for the proper use of hands:
knit, stir, spank, hug.
Wire-strung, castanet Mr. Bones
in the comer dressed for Halloween
Groucho glasses and cigar
Say the secret woid, Mr. Bones.
The ankle bone’s connected to the knee bone
Fibula, tibia, femoral condyle
Dry bones have no remorse -
Always the last stone along the path.
Sinew-strung blocks, rag-tag scraps,
flesh a banner too-long flown
tattered by the years hanging from a staff.
Bones grow stronger under strain.
Until the day they snap and life rains down,
sculptured beauty splinters into pain.
Meanness is a given, soaks to the bone
but beauty doesn’t stop at the skin.
CATHARINE CLARK-SAYLES
Mill Valley, California
Posted by Alex
HAIRY CELL LEUKEMIA (HCL) is a chronic В-cell lym-phoproliferative disorder that accounts for approximately 2% of all leukemias. The typical clinical picture consists of a man with a median age of between 50 and 55 years with splenomegaly, a varying degree of pancytopenia without lymphadenopathy, and characteristic hairy cells in peripheral blood and bone marrow. Bone lesions, having an incidence of 3%, are an uncommon complication of HCL. We present a patient who developed a pathologic fracture 22 years after his initial diagnosis. We also provide a review of the literature on this rare complication of HCL.
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Posted by Alex
ACUTE ONSET OF HEMIPLEGIA is a common presentation of cerebrovascular accident. Rapid reversal of this focal neurologic deficit may occur with transient ischemic attacks. However, hypoglycemia has been reported only rarely as a cause of reversible motor deficits. We now report the first case of a patient with alternating right and left dense hemiplegia related to episodes of hypoglycemia.
Report of a Case
A 69-year-old African American male with a medical history of hypertension, congestive heart failure, chronic renal insufficiency, anemia, and myocardial infarction in 1988, was diagnosed as having type II diabetes mellitus. One week prior to admission, he was started on glyburide 5 mg orally once a day. There was no prior history of cerebrovascular insufficiency, migraine headache, or seizure disorder. His family history was noncontributory.
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Posted by Alex
If you had flown in like a bat
and banged around,
all search and disappointment,
I might have fled the room,
afraid of your confusion.
But you moved in slowly,
unconcerned and steady,
so heavy with your age
that I walked out to meet you
impatient and unafraid.
ROXANNE LANIER
Greenbrae, California
Posted by Alex
Phillip Kennedy woke up later than usual on Monday, January 27, 1997. He had a headache and fever, and he planned to stay home from work. I awoke at 5:45 AM, tired after a weekend on call. As I dressed in the dark winter dawn, I looked forward to coming home early. But, Phillip Kennedy was to die that day, and I was destined to share in his death.
Phillip was 54 years old with diet-controlled diabetes and alcoholism in recovery. I had cared for him in my internal medicine practice for seven years. Phillip usually saw me three times a year for routine visits and his annual physical. He was a gregarious, affable man with red hair and a ruddy complexion. Our interactions were friendly, natural, affectionate, and at times, playful.
canadian pharmacy
Phillip came to see me for his annual physical on Wednesday, January 22. He felt good and had no specific complaints. Phillip told me that, over Christmas, he had married June, the woman he had been living with for the past 12 years. June was 20 years his junior. Phillip said that there were parties surrounding the wedding and that he had started to drink again. He said that he was just celebrating with friends, not drinking excessively. Everything was under control.
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