Wednesday, August 29, 2012

On Julia Child and the Duchess of Catastrophe


I certainly didn’t grow up wanting to become a doctor. Although my dad was a physician and my mom was a psychiatric nurse, medicine and nursing weren’t exactly what I had in mind. I had lots of interests: drawing, painting, sculpting, cooking, writing poems and short stories, and reading philosophy--not exactly profitable aspirations, but enriching nonetheless. Frankly, I never really envisioned myself “becoming” much of anything. In high school, I cultivated an obsession with classical French cooking, and cooked my way through “From Julia Child’s Kitchen.” From her explicitly written instructions and detailed step-by-step drawings, I learned proper technique. Whether it was chopping an onion, boning a chicken, beating egg yolks and sugar until they formed “the ribbon”, or baking baguettes, I felt like a chef, imagining myself working alongside my breathy, 6'2" idol. What I loved most about Julia was her attitude toward culinary mishaps: they happened to everyone, even her, but there was always a fix. “Oh dear! I’ve just cracked my bûche de Noël while attempting to roulade. Let’s see...I’ll just spackle over it with a little buttercream, and plop a meringue mushroom on top to hide the defect. There! No one will ever know the difference.”
There’s a humorous old adage that quite accurately describes the practice of anesthesia as “hours of boredom, punctuated by moments of sheer terror.” Cartoons often depict anesthesiologists as oafish, unintelligent doctors, who sit on our asses behind the surgical drape, reading the newspaper or chatting on our cell phones whilst lazily reaching up--without so much as looking--to silence an alarm or adjust the dial on our anesthetic vaporizer. In my seven years as an operating room physician, I’ve somehow managed to miss out on that kind of (in)action. Somewhere along the line, I inherited the proverbial black cloud, prompting my self-deprecating nickname, “The Duchess of Catastrophe.”
On a completely involuntary level, my experience as an anesthesiologist has involved a disproportionate amount of terror with grossly insufficient levels of boredom, to the point where my residents and anesthetists purposely traded shifts so as not to be on call with me. OK, I admit, that’s probably stretching the truth a bit,  but you get my drift, right? Apparently, I’m a magnet for disaster. The worst part of it all is that I absolutely detest crisis and drama, especially in the operating room. I’ve given this a fair amount of consideration over the years, and have concluded that there is some crazy universal law in effect, operating under the principle of “what doesn’t kill us makes us stronger.” Yes, as unfortunate as it may seem at times, I’m definitely the right person for this all-too-often hair-raising, but mostly gratifying job. Give me your failed code blue airways, your super-morbidly obese dialysis patients in need of IV* access, your bleeding parturient whose congenital heart disease is in need of an updated repair, and your septic 95 year old with a perforated diverticulum. Hey, you can even throw in a ruptured aortic aneurysm for good measure: the fainter the glimmer of life, the brighter I’ll keep the home fire burning. Maybe being an expert at what I do isn’t such a curse after all.
Being a good anesthesiologist is a lot like being a good cook--both science and art in part--seasoned by knowledge and experience, steeped heavily in versatility and intuition, and liberally peppered with a healthy dose of anticipation, preparation, humility, and humor. I’ll put it to you this way: had an anesthesiologist been available somewhere amidst all the king’s horses and men, Humpty Dumpty would’ve been put back together again. I wonder if my love of cooking is what drove me to shift gears during my internship from surgery to anesthesia. Anyone can dice an onion, peel a carrot, or truss a chicken. However, making delicious and sustaining soup from these few simple ingredients mandates more than just knife skills--it demands innovation, ingenuity, and vision. Bon appetit
(and to my surgeon friends, whom I couldn't do without, you know I love and respect you! It's all in good fun...XOXO)
*IV: intravenous



Christmas 2008...me & my homemade saucisse de Toulouse, made especially for our holiday cassoulet. Julia Child would definitely approve!
My battered old original copy of "From Julia Child's Kitchen", beneath which lies a signed copy given by Paul & Julia to their friends as a Christmas gift, which in turn was given to me and Spartacus as a wedding gift by our dear friends, Allen and Bryan.




Sunday, August 26, 2012

The Novel Perpetuity of It All

     Since I'm usually the first one awake around our house in the mornings, it's customary for me to let our German short-haired pointers, Simon and Lilly, out for a pee while I fix myself a latte. Mechanized and automatic, it's a ritual that requires nominal effort and minimal thought, one of life's little routines. Every morning, these silly brown dogs charge gleefully through the door into the courtyard and the sultry Atlanta dawn--expectant, stumbling over their huge front paws, their hind legs spinning ridiculously behind them, like chariot wheels furiously hoping to meet with traction somewhere atop the waxed concrete--as if it's the first time they've ever seen or smelled outside, clearly enchanted by the novel perpetuity of it all.
     Summer is winding down; I can feel it. The palpably cooler morning air that's now skimming the hairs on my bare arms is mingled with a familiar uncertainty, distant memories of future past segueing into reflections on future present...what's happening? I'm an infant, clumsily feeding myself Cheerios, arms and legs akimbo in my high chair, no different in nature than my dogs. Uninhibited and sublimely sloppy, I hold my fork indelicately in a closed fist, my elbows planted firmly on the tabletop as I lick my knife and chew with my mouth wide open. Here, there is no Sunday-evening-spent-dreading-Monday morning, no anticipation or expectation, no worries or regrets. Restless, my hunger satisfied, I flail my arms wildly, signaling to my mother: "I want DOWN!!!"  Before she can reach me, I've already wriggled my way out of confinement, deftly sliding from beneath the cereal-littered tray into the sanctuary of my own kitchen--indulgent yet determined, elegantly unrefined, still blissfully indifferent to convention.

Sunday, August 19, 2012

From Sacred to Sacrosanct

    I started blogging on Monday, November 28, 2011, going public with my first post at precisely 10:02 a.m. EST. I'd just finished taking my final 24 hour in-house call at the medical center where I'd worked for a little over a year, and aside from being exhausted, I was distraught beyond belief, teetering on the verge of irretrievable disillusionment with this whole "medicine" gig. Being a doctor had really started to suck. I came home, bleary-eyed, mildly confused about what day it was, and stinking to high heaven, like every good anesthesiologist does after being up and running all night between labor and delivery, the operating room (OR), and the intensive care unit (ICU). Let me pause here to explain the "stink." A little more complicated than garden-variety body odor, our stink is intricately layered, accumulated in waves over the duration of the call period. An on-call anesthesiologist's corporeal bouquet is directly proportional to one's cumulative time spent inside the hospital, as well as the usual stress-inducing suspects: lack of sufficient manpower to start scheduled cases; complex patients, including the mostly-dead ones who always seem to present to the OR at 3 a.m.; a$$hole surgeons and administrators; simultaneous obstetric and OR emergencies; inappropriate consults for central IV line placement from lazy hospitalists or emergency room docs; and last but not least, the presence of a full moon, which intensifies one's funkified aroma by several orders of magnitude.
     Showers are sacred to me. In medical school and residency, I learned to appreciate the sanctity of a quick shower and a fresh change of underwear. Regardless of how little sleep I was running on, the ritual of stepping under warm, pulsing water to rinse away that insidiously acquired, eutectic film of blood, sweat, and tears never failed to invigorate both my body and my perspective, rendering me relatively amnestic for the recent past's most unpleasant events. Standing in the shower on this particular morning, however, I was caught up in a nightmarish memory loop, reliving the events of the past month over and over again.
October ?: On call. Busy afternoon. General surgeon posts non-emergent, add on case: 2 year old with thigh abscess, high-normal white count, no fever, not toxic-looking. This kid ate a chicken biscuit less than 4 hours ago. Need to delay case by at least 2 hours to avoid aspiration risk from full stomach upon induction of general anesthesia, unless surgeon wishes to declare this an emergency, supported with written documentation. Surgeon declined this option, as well as doing case later in evening, opting instead to re-post case on OR schedule for tomorrow morning.
October 17th: Electronic anesthesia record goes "live", soon to be followed by other areas of the hospital. Been there, done that at Emory two years ago. No big whoop.
October 25th: Penned a comic-relief Facebook post about the hospital's newly implemented electronic medical record system, which was really stressing all of us out: 
"Going live with the Cerner electronic anesthesia record has made me dwell on such pleasant thoughts: rainbows, crusty scabs, happy clown faces, putrefied old urine, unicorns, toothless wrinkled old ladies who dip snuff, cherry sno-cones, and a skinny jackal's dirtbutton." Heh heh!
Received lots of amusing responses from co-workers and colleagues alike, including one which (seriously) suggested I should consider writing a children's book! LOL!!!!!!!!!
October 28-30th: Celebrated 2nd wedding anniversary in Chattanooga; first weekend away together since Brad's stepmom died last August. 
October 31st: Back at work; crazy night on call. Exhausted.
November 1st: Post-call day off. Colleague (Eddie) who is leaving our practice and has already moved back to Louisiana, arrived today to stay with us for a couple weeks while he finishes working his 90 days' notice. Made crispy-creamy sauteed flageolet beans and cabbage for dinner; enjoyed good Cabernet and excellent conversation with Eddie and "the hubs."
November 2nd: Assigned to labor and delivery, GI suite, and other "odds and ends." Crazy busy day; lots of epidurals and C-sections. Incoming phone call from boss around 10:30 a.m. as I'm heading to a C-section; unable to chat...will call him back. Home around 2:30 p.m. Brad has just quit his sucky, home-based IT job with AT&T, after encouragement from me. I make plenty of $; we'll be fine; IT jobs are plentiful. Finally call boss back at 3:30...
Him: "Uh, you're going to have to leave the practice." 
Me: "What?! Are you kidding? Why?" 
Him: "The administration didn't like your Facebook post, and a surgeon has complained you're too 'rigid'. You've got to go." 
Me: "Just like that, huh? And I have no say in the matter at all?" 
Him: "Just like that. There's nothing I can do."
     It really went down, just like that. I spent the next few days in a state of shock and near-suicidal depression, unable to get my head around this outrageously absurd set of circumstances. Brad and I had gone through so much trouble to move from Atlanta to Rome, and now we were both out of a job. Funny how the administration had overlooked an earlier barrage of Facebook posts from operating room personnel one stormy summer day when we lost power, and both the hospital's generator and backup generators failed, leaving patients under the knife, as well as their surgeons and anesthesia providers, in a deafeningly silent darkness. Holy HIPAA violation, Batman!!!* My benign post regarding that silly piece of software certainly seemed to pale in comparison. I was never offered an audience with the hospital's administration, nor was I provided with information on exactly which surgeon had registered the complaint, although I suspect it was the one from the scenario described above. It was all so conspicuously one-sided, and worst of all, I had absolutely no recourse. Like the poor bastards in "Deliverance", I was sodomized by rampant small-mindedness, so to speak. Hard as I'd tried, I never really fit in there. I was disposable. I resigned, agreeing to work the next 90 days with the exception of taking any more call. Bad things tend to happen on call, and I wasn't going to risk losing any more of my humility or my medical license for the "privilege" of continuing to work under a hostile administration. 
     My final, post-call shower wasn't just sacred, it was sacrosanct. Every blessed rivulet of water converging across my body anointed me with radiant visions of a new-old me: passionate, creative, spontaneous, vibrant, carefree, happy. As I toweled myself dry, a wild idea erupted: "I'm going to start writing a blog today." Laptop in hand, I crawled into bed, wrote my first post, and then spent a good hour-and-a-half, struggling over what to call it. I was so tired, I think I was actually hallucinating. In a fleeting moment of beatific clarity, I was overcome with an intense awareness; I could feel my father, who was also a physician, sitting right next to me on the bed. It was as if I'd been channeling him, and he came to me. Just like that, Channeling Hippocrates, the single best thing I've ever done for myself, was born. And with it, so was I.

*HIPAA: Health Insurance Portability and Accountability Act of 1996. In the above context, HIPAA refers to the protection of sensitive patient data.
   

Tuesday, August 14, 2012

A Divine Pastiche of Chaos

     Convoluted and unsettling, my pre-dawn dream was a divine pastiche of chaos: vaguely iridescent, interminably ephemeral, carnally wholesome. Spartacus and I had clandestinely organized a flash mob nighttime circus-carnival, an altogether macabre yet wildly successful undertaking which we staged inside our own urban loft, its 14 foot ceilings, 2500 square feet of wide open space, and sturdy concrete floors easily accommodating the continual incoming parade of wild animals, beasts of burden, angels, sprites, succuba, and the general public. Aside from the presence of a brickwork labyrinth, necessary for accessing the front door, the configuration and dimensions of the dream architecture accurately replicated our current living space.
     I hurriedly wove my way through dank, stale, maze-like corridors, defiantly illuminated only by the moon and stars, who chose to completely ignore the ambient incandescence of the downtown cityscape. I was both master and amateur of ceremonies, an apt yet discordant conundrum. Throngs of people were milling about, unfamiliar yet singularly recognizable, and I had the overwhelming sense that we were "on to something" of such epic proportions that it was almost shameful, a modus operandi best kept under wraps. Wandering through the confines that were once my living room, dining room, kitchen, and bedroom, I noticed everything and nothing. I was simultaneously overcome by anxiety's release and avant garde prescience, and then, there was the aroma of camphor: I was Spirit, inseparable from my surroundings, rendering all previously perceived divisions between "me and them" nil. I heard my dead father laughing, and I laughed with him, my third eye drowning out the palpable, ever-present disapproval of the ignorant and unenlightened. And then, I awoke.

Saturday, August 11, 2012

Selective Memory, Intentional Disinformation

     Yesterday started out just like any other work day...well almost. My alarm went off at 0530, jarring me from a deep sleep. Immediately ascending from the yin-yangy cool warmth of my comfortable bed where Spartacus lay sleeping, I brewed myself a caffe latte, and sat down for a brief moment at my computer to check my email, Facebook, BlogCatalog, and finally, my online banking service. Noticing that the direct deposit monthly income from the house I'm renting out hadn't yet cleared my checking account, I logged onto my rental management company's site to further assess the situation. I haven't been super happy with my role as a landlord; I really just want to get rid of my old house. Although I'm receiving monthly income and the house isn't sitting idle, I'm still losing money. Aside from not breaking even on my mortgage payment, I'm paying $100/month for yard service and $75/month for pest control at that property, as well as maintaining a rather expensive home warranty. In my opinion, the tenants living there are enjoying a pretty sweet deal. What frustrates me beyond belief is the fact that these tenants don't seem willing to take on any minor responsibilities, such as ensuring that the air conditioner filter gets changed every couple of months, nor does Excalibre, the rental management company who receives a respectable 7% commission from me, monitor or initiate this type of maintenance. It leaves me wondering exactly WTF are they doing for me that I couldn't do myself?
     Three weeks ago, I'd emailed the property manager to inquire about whether the tenants have been changing the A/C filters. Filters cost $8-10, and replacing them is a simple task. As hot as this summer has been, common sense dictates that regardless of whether one rents or owns, one does what's necessary to prevent a catastrophic interruption in air-conditioning here in the deep South. The problem I run into, trying to understand how these folks operate, lies in using myself as an example. Prior to moving back to Atlanta last spring, Spartacus and I were also renters, and because we both realize that nothing comes for free, we took it upon ourselves to perform routine maintenance chores, such as changing HVAC filters, vacuuming the refrigerator coils, and removing the calcium deposits which routinely clogged up our faucets. For us, these tasks were part of good stewardship: we treated our rental as if it were our own. Anyway, in response to my email regarding the filters, I immediately received a message informing me that the tenants were now complaining about "overflowing gutters with stuff growing out of them", and that there was also a hole in the brickwork at the side of the house they wanted fixed. This really infuriated me. It was as if being asked to do something to ensure their own comfort while living in MY house imposed upon them somehow. If you ask me, that's the definition of entitlement. Why did these idiots allow the gutters to reach the point of overflowing in the first place, when all they had to do was notify the property manager that they needed some attention? I thought I was paying Excalibre to stay on top of this kind of thing. Overflowing gutters lead to roof leaks...doesn't everybody know that?
     The property manager got a couple of estimates for gutter cleaning and the brickwork repair, which totaled around $300. Since Spartacus also uses Excalibre on his leased property, I asked him whether I'd be billed directly for these repairs, to which he replied verbatim, "No, it will come out of the tenants' deposit that was initially withheld." This explanation made perfect sense to me, so I thought nothing more about it. Yesterday morning, when I was reviewing my profits and losses on Excalibre's website, I noticed that the amount they were paying me this month was $300 less than last month. "This must be some sort of clerical error!" I thought. I finished my coffee while emailing the property manager to inquire why the repairs weren't being deducted from what I thought were reserve funds on my account. Since I was running late for work, I showered in haste and slapped on some make up. As I was getting dressed in our room, Spartacus opened his eyes, which I interpreted as an indicator that he was awake. I told him about the Excalibre situation, seeking confirmation that the information he'd previously given me about the reserve funds was indeed correct. He blinked a few times, hesitating before dropping the bomb:  "No, any work that's done is deducted from your monthly rental income." BOOM! This prompted a ridiculous "he said, she said" argument from which we still haven't quite recovered. I mean, where else would I have gotten the reserve fund idea? Ah, selective memory...ain't it grand?!
     Fuming as I made the 35-minute eastward trek to work, especially after having received a text message from Spartacus, accusing me of being inconsiderate for awakening him with my urgent question, I was deluded by an ironic sense of security with which I reassured myself, "Welp! This day certainly can't get any worse." I arrived just as our first colonscopy patient was having her IV (intravenous line) started. After interviewing and examining her, I checked out 15 vials of propofol, now infamously known to the general public as "the Michael Jackson drug," and mentally prepared myself for a pleasant morning of GI (gastrointestinal) anesthesia. "It's going to be a good day!" I thought, glancing at the schedule while drawing up a few starting syringes of propofol and lidocaine. Indeed, it did look like an easy, breezy day. Aside from the fact that all the patients in my room were age 57 or under, and presumably healthy, the GI docs and the nursing staff at this facility are great fun to work with. I don't mind traveling the 20-plus miles out of Atlanta to work with these folks; the camaraderie makes it all worthwhile.
     We sailed through the first four cases, well ahead of schedule. I've recently been working on perfecting a technique for suppressing the coughing and gagging which occurs in patients having upper endoscopies (EGD, or esophagogastroduodenoscopy, where a flexible camera is passed orally into the esophagus, stomach, and small intestine), and it was working beautifully. Here's what I do. I give a 100 mg bolus of lidocaine, followed by about 40-50 mg of propofol, slowly titrating in enough propofol to keep the patient breathing spontaneously while ensuring a deep level of sedation. No coughing, no gagging, and no apnea is about as close to nirvana as an anesthesiologist can get. Two colonoscopies, an EGD, and a combined EGD-colonoscopy (known as a "double-dip") later, we were ready for our second double-dip of the day. Our fifth patient was a guy in his mid-40s, who was a bit rough around the edges. His appearance was disheveled and unkempt-looking, with greasy long hair and a very large bushy beard, a physical attribute which raises concerns over potential problems in managing a shared airway. Aside from being a smoker, he was healthy. He was quite nervous about his procedure, which isn't all that unusual. The GI doc was seeing another patient in his office between cases, so I wheeled our patient back to the procedure room where it's nice and quiet, thinking a friendly chat about his anesthesia would help allay his anxiety. After placing him on monitors and a little oxygen, all of which are standards of care for propofol sedation, he began asking lots of questions about which anesthetic agents would show up on a drug screen. I reassured him that, unlike other narcotics, propofol wouldn't interfere with his work-related drug screening. One of the beauties of using propofol sedation for GI procedures is that it virtually eliminates the need for benzodiazepines or opioids, providing an unparalleled depth of hypnosis which rapidly disseminates once the anesthetic is terminated, with minimal residual CNS (central nervous system) effects. He wanted to know much anesthesia it takes to "put someone under" for a procedure like the one he was about to have. I told him that it depends upon various factors, such as one's alcohol intake and concurrent illicit drug use, as well as the use of pain medications or any drugs, such as anticonvulsants, which rev up one's liver enzymes. In general, the presence of any of these pharmacologic entities are guaranteed to increase one's anesthetic requirements. I was greatly relieved when he told me he rarely ever drank alcohol, but found it odd that in the same breath, he asked if it would be OK for him to "have a drink" with dinner. BIG red flag, but I gave him the benefit of the doubt. People who lie about their drinking and drug use always declare themselves under anesthesia; it's a simple matter of pharmacokinetics and pharmacodynamics.* Warily, I informed him, "No, you'll be advised not to drink alcohol for 24 hours after your anesthetic." Just then, the GI doc popped into the room; we were ready to get started.
     Although the milligram dosage of propofol required for an EGD-colonoscopy varies among patients, based on their co-morbidities and medications, it is also somewhat dependent upon the proceduralist's technique. From my personal observation and experience, the dose typically ranges between 230-370 mg, which amounts to two vials of propofol. Normally, following 80-100 mg of propofol, a young, relatively healthy person will look heavenward, closing his eyes as he lets out a big yawn, after which he'll begin snoring. I won't bore you with the details of the 20 minutes of sheer terror we endured with our thrashing, combative, self-professed teetotaler, who consumed 1200 mg (six vials) of propofol during his short procedure and was still fighting, except to say that he managed to contaminate our only end-tidal CO2 filter with bloody secretions, rendering it useless for our next three cases. In this scenario, I was victimized by selective memory's evil twin, intentional disinformation. Clearly, I'd been lied to, as nothing in this patient's history added up to 1200 mg of propofol. What people who willfully conceal details about their drinking and drug use don't seem to understand is that when anesthesia is added to the mix, it can kill them. It doesn't just injure them, it ends up affecting everyone else, like the poor recovery room nurse who had to put up with our patient's unsolicited groping, and the subsequent patients whose cases were delayed by 45 minutes as we frantically searched for another CO2 filter, while attempting to sterilize the one that had been needlessly contaminated.
     It's funny how my job as an anesthesiologist whips everyday situations into perspective. Over the years, Spartacus, who is a network engineer, and I have exchanged tales of what happens when things go "south" in our respective professions. In the world of information technology, operator error that produces a big network outage might be grounds for termination, but customers don't die as a result of not being able to swipe their credit cards. On the contrary, my job is a matter of life and death, requiring perhaps an even higher degree of vigilance for user errors. Every patient is a both an innocent and a suspect. Similar to the nature of communication in the aviation industry, my work requires the transmission of information that is accurate and precise. There are very few fudge factors and little to no wiggle room in anesthesia. In considering the events of the last 24 hours, I'm aware that although I don't bring my personal life to work, some aspects of work do come home with me, such as the expectation that statements are backed by knowledge, and hopefully, truth. I suppose you could say I'm intolerant of deception of any kind. From my perspective, hearing "I don't know" is rarely ever a problem; it's "I think I know" that'll burn me every time.

*pharmacokinetics: what the body does to the drug; pharmacodynamics: what the drug does to the body
   

Sunday, August 5, 2012

Why Me?

     I awoke this morning from a deep and restful sleep, but instead of being greeted by the rich aroma of coffee, my olfactory receptors were rudely assaulted by a pungent splat of dog diarrhea, artfully arranged in a greasy puddle atop the concrete, just a few feet from our front door. Poor Simon! Either he's got a tummy bug or he ate something outside that didn't agree with him. His gastrointestinal distress got cranked up yesterday afternoon, beginning with the passing of a few of his signature silent-but-deadly farts, culminating later in a magnificent, feculent explosion in the courtyard, the magnitude and stench of which could only be described as epic. Spartacus and I went out for dinner and a movie shortly afterward, hoping the worst of Simon's alimentary turmoil had passed. Aside from the rumblings within his gut, Simon was displaying his typical, well-mannered canine behavior, not acting the least bit ill. As I climbed into bed last night, the thought of awakening to a poopy surprise briefly crossed my mind, but was quickly forgotten amidst the televised excitement of Olympic track and field, specifically the women's 100 meter sprint.
     Bleary-eyed, I stumbled out of bed at a quarter to eight, detracted from my much-needed visit to the coffee machine by the reek of sulfurous fumes. A quick survey of my immediate vicinity, which excepting the two bedrooms and bathroom amounts to approximately 2500 square feet of wide-open space, instantaneously revealed the foul effluvium's source, next to which lay a watery pool of vomity-looking chunks. My first thought wasn't "Oh shit!" or even "How am I going to begin cleaning up this terrible mess?!"; it was "Why me?" It's a question I've often asked myself over the years, usually upon peering into the dishwasher to find that someone has co-mingled dirty dishes amongst an obviously freshly washed batch, or when scissors and various tools have mysteriously gone AWOL, to be discovered months or decades later somewhere in the backyard. "Why me? Indeed!" Contemplating the unfairness of it all, I grabbed a giant wad of paper towels, some disinfectant spray, and the Swiffer Wet Jet, and commenced to mopping up the sloppy dysenteric deluge, hermetically sealing the entire fetid mess in a plastic bag which I quickly tossed outside the front door for later disposal into the blue Dipsy Dumpster that's mercifully located at the opposite end of our complex. I couldn't help but wonder if there was anything remotely Olympian about Simon's ill-fated, diarrhea-fueled 8 yard sprint to the front door.
     The floor was now clean enough to lick, but the besmirched ambient air which lingered presented a uniquely separate challenge. A rancid miasma hung heavily over the previously soiled locus of defecation, not unlike Pigpen's ever-present personal cloud of filth, the funkified molecules of which seemed to be multiplying instead of dissipating, rapidly dispersing to other areas of the loft, most distressingly to the safe haven of our kitchen where my hotly anticipated first-coffee-of-the-morning innocently awaited. I infiltrated the concrete with a few blasts of Nature's Miracle Pet Odor and Stain Removal spray, bleakly hoping that this product would somehow live up to its name. It didn't, and I was back to square one. Overcome by toxic fumes, on the verge of hysterical emesis, I turned on the overhead fan, plugging an oscillating fan into the outlet next to the front door in an attempt to break up the putrescence before it started permanently clinging to the upholstery, desperately hunting for my camphor and eucalyptus essential oils while entertaining the novel idea that perhaps air circulation and aromatherapy were the two most practical solutions. The frantic ten-minute search which ensued left me relatively empty-handed, except for a small vial of lavender-sage oil. Suspecting that my still-sleeping son, Nick, was hoarding our cache of more antiseptic-smelling oils in his room, I settled for the flowery-herbal essence, setting the automatic, electric room-mister on full blast. Within moments, our loft smelled like a truffled turd-bomb, enrobed in a delicate outer shell of lavender, sage, and caffe latte. "How awesome is that?!", I thought sarcastically to myself, realizing that I'd just made an unwholesome problem all the more repellent.
     I was in the bathroom, looking for more spray, candles, anything to get rid of the noxious remnants of Simon's accident, when I came across several boxes of restaurant matches that were sitting on top of the toilet tank. "Why didn't I think of this first?!", I exclaimed out loud, lighting match after match at the scene of the crime. I'm happy to report that three extinguished match flames later, the poo smell was gone for good, and olfactive order was restored to our household. I sat down to enjoy what was left of Sunday morning's peace and quiet, contently inhaling the singularly robust fragrance of my coffee, daydreaming about patenting the world's first sulfur-scented deodorizer. Why not me? Spartacus and I have had several amusing conversations about how matches make the best air freshener, which is precisely why we keep them readily available in the bathroom: the sulfur dioxide contained in a match head effectively masks methyl mercaptan, the gaseous compound responsible for the malodors of flatus, feces, bad breath, and asparagus pee. Our mutual experience has clearly demonstrated that even the most offensive flatulence can be neutralized with the single strike of a match. If only cleaning up the actual mess itself had been that easy. As Spartacus elegantly observed upon arising and learning of my early morning ordeal, "There's really no way to neaten up diarrhea, is there?"
{P.S. Despite Simon's troubles, he's eating, drinking, running around outside, and not acting in the least bit ill :-) }
Simon's "Why me?" face

Simon, sleeping off any remaining GI distress, under Lilly's watchful eye