The nun's belly was so smooth and utterly unmarred. No scars, no bruises, nothing but a modest expanse of alabaster skin. I put my hands on her belly, gently at first, lightly scanning the lovely skin to get a sense of it before probing more deeply. I started over on the left side, the unaffected side. I pushed in with my fingertips, causing a slight wince. Releasing the pressure caused more than a wince. I asked her where it hurt and she indicated her right side. I moved my hands to the painful side. Before I even applied pressure, I could feel warmth and fullness. It wasn't apparent to my eyes, but my hands could tell something was wrong. I pushed in very gently, causing pain. When I released my pressure this time, the nun blanched and gasped. I told her what I thought -- that her appendix was infected. She refuted me -- it couldn't be -- she had Ash Wednesday services the next day, and she was flying to Seattle the following Monday. She simply was too busy to be sick.

But she looked sick. This lovely nun normally had a sparkly, shiny aura. She always smiled. She smiled this day too, but it wasn't a glowing smile. She was grey.

I agreed not to send her immediately to the hospital. She agreed to let me draw blood and arrange a CT of her abdomen for the next morning. (This was late in the day. I could get the CT early the next morning, prior to her Ash Wednesday services.) I was worried. I made her promise to go right to the ER should her pain worsen, or her fever go up. She agreed.

The next morning we got a fax from the imaging department. The nun had appendicitis. The hard thing was finding her. I called her home, the church, her emergency number. All I got was recordings. I left messages, but was not happy about it. I was considering calling the police to go find her, but first asked my doctor what he would do.

One of his talents is knowing everyone. He knew who the nun's best friend was. He called her and told her what was going on. The friend knew where she was. Within 15 minutes she had called me back and we made arrangements for her to go right to the hospital.

Her appendix was removed in short order, and she was home in time to make her flight to Seattle.

And I will never forget her lovely smooth belly. It was the prettiest belly I have ever seen. I think I am in love.

I woke up with an Amazon in my bed this morning. A parrot. My son's. Actually, I think the parrot is mine now. The son is planning to move away soon, and he asked if he could leave Veda with me. I am happy to keep the bird -- Veda and I have bonded. It took a long time, but it happened. Veda is so beautiful, and he talks too. He screams my younger son's name frequently, or sits and mutters all kinds of things, or puts together words to form new meanings. I think he is intelligent. He likes to kiss me. Birds kiss by nibbling at or touching their tongues to your lips. After a recent session of bird-kissing, I found my lips to be burning fiercely. I nearly freaked out, wondering what kind of bird-enzyme I'd been poisoned with. Then it came to me -- parrot food has dried hot peppers in it. Parrots love hot peppers. Apparently, Veda had been nibbling one before nibbling at my lips... and the burning faded away after a short time...

Ah, life in small-town Georgia. It has been a rather quiet afternoon, and I noticed that traffic had backed up outside our door. Turns out there was a parade. The high school's homecoming or something... Anyway, since I had no patients, I joined the others on the sidewalk and watched the parade. It lasted all of 4 minutes. :) But I recognized virtually everyone in it, as well as the police officers directing traffic... Made it fun. Then back to the office to finish up my day. I have it so good. I really like this stuff.

I am amazed. I saw a patient this morning whom I had last seen about a year ago. He then weighed about 400 pounds and had all the problems that go with that kind of weight: diabetes, hypertension, arthritis. He couldn't walk and got around on an extra-large electric wheelchair. I remember he asked me how he could lose weight. (asked ME, a person carrying around about 80 extra pounds myself.

We discussed many options. He was not eligible for diet pills because of his hypertension. His insurance wouldn't cover a gastric bypass. Trying to follow a diabetic diet had failed for him because it left him terribly hungry. The portions were just too small.

I suggested he try the Atkins diet. It was the only thing that I could think of that was possible for him. It wouldn't make his blood sugars go up, and hell, it might just work. He needed desperately to do something.

So I see him today, and I gaped. He was WALKING. With a cane, to be sure, but it was the first time I ever saw him not in a wheelchair. He gave the biggest grin, and got on our scales. He hadn't been able to weigh on normal scales in years. (When we had to get a weight to qualify him for an extra large wheelchair, we had to send him down to the box factory nearby and use the industrial scales.)

He weighs 298 pounds. I am so jealous. If I had started and stuck with a diet when HE did, I would now be a normal weight.

But I am inspired. For someone that large to lose that much, and to be so much healthier...

And I am so happy for him. It was pure joy to see him WALKING and so happy. He has worked hard and stuck to his diet, and deserves his rewards.

Another pet peeve -- the word "whatever". I cringe when I hear it, it is so overused, cliched and juvenile. It amazes me how many grown people will use this word as if it still had the freshness it possessed in 1972. Used as a sarcastic dismissal, it is enough to convince me totally that the person using it thus is totally lacking in intellect and wit. I think anyone who uses "whatever" in that manner should be made to pay a heavy fine to the grammar police.

My Bug-eyed dog died last Friday. I am very sad, and miss her desperately. It was baffling, so I had an autopsy done, and she had a congenital weakness in her diaphragm, which suddenly and spontaneously ruptured. She wasn't even 6 months old yet.

On the other hand, my old dog Sadie doesn't miss Bug at all.

Everyone is tragic today. Real tragedy. A woman I have been treating for a panic disorder, who has been doing really well, came in looking utterly frazzled. It has been 2 months since I've seen her. She laughed in an almost demented sort of way and said she's only had one panic attack since I last saw her. It started three days ago when her son and brother (honest to god) were lost at sea. Then yesterday they were found. It was incredible, people lost at sea are rarely found at all, much less ALIVE. So she had a well-justified panic attack and is still getting over it. I think two months with only one panic attack is great. I think I, who have rarely in my life panicked, would have had a panic attack if my son and brother were lost at sea.

Then there was a woman who came in for a bus driver physical. She was muttering "I know I am going to fail, I know I am going to fail." I asked her what was going on, because I rarely fail anyone on a bus driver physical. (In fact, I have only failed ONE person -- she was blind! Her vision was 20/200 in both eyes -- and boy was she mad at me! "I've NEVER been in an accident!" she wailed. All I could think was that I wouldn't want her driving MY kids around, no WAY could I pass her! The acid test: would I let my kid ride with someone?) Anyway, this poor woman was a wreck because her son had just been diagnosed with bone cancer in his left leg. I think that entitles a person to be a nervous wreck. I did her physical, and she was ok, even had good vision. Then we talked a lot about her son. I hope he's going to be okay too.

My next patient was a wreck too. She had just buried her son two days previously. Her job wanted her back at work, but she just didn't feel ready. Besides, she was bitter because her job hadn't sent flowers, no card, nor had they attended the funeral. Her son had died in prison. She felt sure that they thought somehow that the fact he had been in prison for 15 years somehow negated the effect his death had on her. But of course it didn't.

Anyway, what can you do? I gave her a note for 2 weeks off work, and we talked a long time. My great grandmother once said that losing a child was the worst pain that you can suffer, and I believe her.

I am exhausted. My children love to come to work with me -- they think all we do is have fun. And we do have a lot of fun here. We like each other, we like our patients, and the atmosphere is generally friendly and easy-going. But some days are hard. I can't wait to go home and sleep.