Christmas videos

And another rant

THINK BEFORE YOU CALL ME IN THE MIDDLE OF THE NIGHT.

No, really.

Think.

Is this an emergency? Can it wait until the morning.

Because I'm telling you, at midnight, I just don't give a fuck about the consistency of your stool.

Various rants

1. My sister is a fucking idiot. I'm going home this weekend for Christmas and I may end up in jail due to the need for my hands to be around her neck.
2. My mother is ill, going downhill now. She's killing me with the phone calls "BTW, I'm short of breath." "BTW, I've lost 20 pounds in a month." "BTW, I can't walk to the bathroom because it's too far." WHAT. THE. FUCK?!?!?!?!?!?!?!?!?!?!?!? This leads back to point #1. My dumbass sister is willfully blind. She needs to be smacked with a clue-by-four. I volunteer to do this.
3. My fucking arm is killing me. I could barely make it through a case on Monday. I'm heading BACKWARDS in terms of function. I see ortho later this week. He worked me in because I called and said "I'm a hot mess." And that was a direct quote.
4. My partners are killing me right now. Can't say why, but we're all fucking insane. Me, because of my family. One partner is just going nuts. Another partner is in a similar situation as I am regarding parental units. I feel sorry for the office manager. Babysitting us has got to be fun.

Thank god my hubby is still mostly sane.

Call and its consequences

So my last weekend call blew. Pages galore, hubby sleeping on the couch so he wouldn't wake up, getting called in at the ass crack of dawn for a delivery, not remembering conversations with the nurses regarding a triage.

That's the life of an OB.

It sucks. Hard.

Many OBs decide fuck it and stop doing OB. Can't say I blame them. Younger generation is looking at the olds and thinking "WTF?" Laborist movement is gaining momentum. I have to admit, shift work sounds soooooooo tempting.

Overheard in the OR today...

"Do you wanna hold my Babcock upright"

My partner and I were cracking each other up with words like that during our case together today.

Thanksgiving.

Is still my favorite holiday. Hopefully yours will be filled with reasons to be thankful.

Overheard in waiting room

People are the same everywhere. I was in the waiting room during my mom's case. I was planning on doing some work, writing up a lecture. Instead, I listened to this for over 30 minutes (I was texting a friend during this time, I have time stamps on this!). It was more entertaining than going to the CDC website to get some stats.

Slightly disheveled lady is on the courtesy phone in the waiting room. She talks loud. I'm sitting about 10 feet away, so my laptop can be plugged into the wall.

First phone call: You KNOW he fucking took my percocet! That SOB. Long, drawn out conversation about living situation.

Second phone call: Sounds like it's to another friend. The SOB also took her cell phone.

Third phone call: Sounds like it's to some local apartment complex, trying to deal with getting an apartment.

Fourth phone call: To the orthopod's office for more percocet.

Fifth phone call (we're going on 25+ minutes at this point): To a friend bitching that the goddamned doctor doesn't understand pain.

Sixth phone call: Trying to get a ride to somewhere.

Except for location, this could be my patient. Easily.

Two steps forward...

And one step back.

My mother must have more lives than a cat. She had major surgery again last week. Still in the hospital but doing well. Her surgeon looked younger than me. Now THAT'S depressing. She's trying to guilt me about Thanksgiving but I'm on call that weekend. And like anyone would trade that. sigh.

Got back into the OR for the first time in almost 6 months recently. Muscle memory is an amazing thing. It was really nice - the staff when they saw me ran to me and gave me lots of  hugs. It's nice to know that coworkers like you. But physically, I'm paying for it. I'm looking at my surgery schedule for next month and beginning to think I may have pushed it a smidge. Crap. Not going to tell our office's scheduler because she acts like a mother hen to us docs. She tells us what we will do when we've done things to ourselves.

At least I see pain management next week for another round of procedures.

Please donate.

My extended family has relatives still living in the Philippines. Please, the devastation there is awful.

Pretty please

After my last weekend call, I'm officially banned from L&D per nursing staff :

"You just walk onto the floor and shit happens!"

"You ARE the full-fucking-moon!"

"STOP IT!!!!!!!"

"Shit magnet."

"Black cloud"

Crossing fingers that my partners agree to take me off call.  ;) Somehow, I doubt it.

Boys are silly

My son was staring at his fist this morning. "My brain is this big...no wait. My heart!"

Made me giggle.

Call

Is the bane of my existence. I hate call. I hate my phone. I hate my ringtone, which was the loudest one I could find (I'm a sound sleeper). I hate stupid questions (and yes, they most definitely exist). I will not drive back to the office at 4:45 on a Friday to do your prior auth. Sorry. Oh, GAWD, Jennifer Crazypatient paged again. Did you not get the memo that this is an emergency line? No, I can't schedule your next appointment - docs don't have access to the scheduling system. Call during office hours. Someone in the office called you and you're returning the call? Sorry, I have no clue why she called you - call back during office hours.

I don't mind going in for deliveries - but I prefer them during reasonable hours. I'm happy (sorta) to talk to the ER docs about what to do. I don't mind rounding on weekends - things are usually calm and I chat up the nurses. Frequently I bribe them with a dozen donuts.

But my phone. must. die.

*sigh*

Direct patient quote: My mom had breast cancer in her right boob. Or left boob. Something like that.

I think I need to refer to Grumpy...

More on physicality of our job

In my previous hospital, I would occasionally have a nurse practioner student shadow me. Many of them were RNs who worked at this hospital and arranged their rotations with assorted docs there. I was popular for the OB/GYN portion.

Anyhow, one week one of them saw my surgery day - multiple laparoscopies, a vag hyst. Next day, she witnessed a vacuum assisted delivery. Also that week was a section on a very large woman. Now, people think of surgery as this delicate, precise thing. And many times it is. But shoving a port in during a scope takes some muscle. Sucking out a baby takes muscle. And entering the abdomen in a section is neither delicate nor easy. Basically, you and the assist put your hands in and pull AS HARD AS YOU CAN outward.

Vicki came up to me after all of this and said she understood why I didn't exercise - I was working out at work!

Tired

It's 4 am and I'm up. Not because of call, but because of pain. And I'm tired of it. I've been diagnosed with a condition that looks like it'll be chronic, which sucks. It's also exquisitely painful. I've been having good days and bad days (yesterday was a bad one). I hate narcotics, but I'm grateful they exist because some days, it's the only way to dull the pain to get some sleep. I have, by myself, covered our FAMILY'S deductible. I am grateful I have insurance.

I have voluntarily cut back on things like elective surgeries. I can't do it. I'd never make it through a case. I've been still taking call, but it's not easy. I can take my APAP and NSAIDs on call, but I won't take "the good stuff" if I'm on call. I pray babies just slide out, because operative deliveries are not a good thing. I'm having a hard time being nice because I hurt. If this continues, I may need to consider going out for a bit on disability.

I am compliant as all get out. PT/OT. Imaging. Appointments.

Magical, powerful

OVARIES!!!!!

By golly, every thing that is wrong with a woman is the OVARY'S fault. Got weight gain? It's your hormones. Low libido? Hormones. Irritable? Again, hormones. Can't sleep? Out-of-whack hormones.

Abdominal pain? Ovaries. Definitely.

Here is a message to every single ER doc in the USA.:

IT'S NOT ALWAYS THE OVARY'S FAULT! STOP SENDING ME PATIENTS THAT HAVE 2.35724 MINUTES OF PAIN 5 DAYS AGO, WITH THE DIAGNOSIS OF FEMALE ABDOMINAL PAIN AND/OR OVARIAN CYST.

And my fellow 40-somethings. You're tired, gaining weight, have no sex drive because something gave. It's called taking care of yourself. You're running around, kids in various activities, work outside the home, clean the home and wonder why you're going to hell?

Obviously it's your hormonal milieu.

Fuck you ABOG and ACOG

I paid $695 for the pleasure of recertifying my board status. It's called Maintenance of Certification, and for OB-Gyns, we have to read a shitload of articles and then answer questions on each one. And we get to do chart review of our charts to ensure that we're doing things according to standards (this part I actually think is a good idea). And THEN we get to read some horseshit article on communication and answer more questions.

But do they give us the articles for free? Oh FUCK NO!!!!!! They want to charge ~$30 per article times 15 articles. Other, enterprising hucksters will sell you hard copies for only $200 for all of them. (hey, they only need 3-4 of us to buy from them to make a profit!) I'm starting to get those postcards in the mail.

Times like this I'm glad hubby works at a university - I use his account to access the library and get the articles for free.

Call

I'm on call today. My partner left me with only delivered patients, no one laboring. I'm discussing tonight's dinner plans with DH, pointing out that there are plenty of leftovers and we should finish them up before they go bad. This also has the advantage of him nuking dinner and not COOKING dinner, which is better for everyone.

"You got anyone laboring?"

"No. But give me a few hours, I can fix that."

Lucky

I've been feeling kinda sorry for myself lately, about some things that have happened and I haven't posted about it. But every now and then this job can reach out and slap you hard.

There are many kinds of patients. Some are truly wonderful people and you love to see them on the day's schedule. Many are a blank - you see them rarely and they seem pleasant enough. Others are, to be honest, a pain in the ass. Some are mean, some are noncompliant, some are argumentative, some are a lovely mix of all of that.

Being on call, I get to round on all hospital patients. My partner warned me about hers. Wildly noncompliant, and a medical train wreck. Great. Just what I wanted to start off my weekend. I get to the floor and swoop through the healthy multips who all delivered the night before and are doing great with no questions. I save problem child for last. I look through the computer and see her labs. I'm getting ready to go in and have the "Talk with Jesus" talk, as one of my attendings in residency would put it. AKA "Grow the fuck up and take some responsibility for yourself".

I get to problem child's room and she's improved. I start in on my "You got to take better care of yourself" speech when I notice that she's crying. 30 minutes later, after a long talk and a lot of hugs, I leave her room. I can't fix her problem...her social situation is a disaster at best. I'm recounting this to her nurse - I can treat her medically, but I can't help the web of bad choices and poor support that surrounds her.

I'm so lucky in that respect. Even though statistically, I should have been her, I'm not. The difference is even though we started out dirt-poor when my dad left, my mom made good choices. She went back to school with 2 toddlers in tow. Her mother babysat us frequently so that my mom could do that. Welfare (called ADC back in the day) was short-term (government cheese tastes like shit, let me tell you). My mother emphasized to her daughters that we needed to be able to care for ourselves - education was valued. I didn't have a baby as a teen (Mom would have killed me!). Many of my high school classmates did. I had family support to get through school. I married a nice guy who respects me and likes me.

Lots of little things. But each choice individually may not matter. But the net sum does.

Headsmack

I really should never cover call for anyone else ever again.

I felt like this:

Damned doctors!

They are the worst fucking patients. Worse than nurses. And that's saying something because nurses are lousy patients.

So my partner injured her hand while biking. Her dominant hand. Surgery is scheduled soon. The idiot won't take time off of work, even though we've all told her "We got this." She has canceled her OR time for the next month. She's gimping through office, obviously hurting.

*backslap*

For the last 15 years

This was what we had sung 15 years ago at our wedding. It's as true today as it was back then. I love you sweetie.

Honored

When someone you know outside of the doctor-patient relationship chooses you.

Being at the delivery of another child from the same couple.

It's part of what makes this job nice - knowing that having place their trust in you again.

Charting

Was reading a chart and saw this:


"Cannot tell patient if a glass of wine and 1/2 of a Xanax will definitely harm fetus."

Sucky

The nicest people ALWAYS have the worst disease, the widest cancer metastases, or the most distorted anatomy.

I think I'm going to turn into the world's bitch. I'll live forever.

Re-entry

To normal life soon.

:(

How not to start a vacation

Book a complicated itinerary that involves people flying into a hub airport from all around the country so that we could all be on the final leg of the journey together.

My mother's flight to the hub was delayed so she missed the leaving flight that we were on board. Every other family member made the last leg.

After takeoff, notice that we aren't flying very high and BTW, we're flying in circles. Pilot comes on the intercom and announces some "engine trouble" and we need to land back at the hub. But the plane is too heavy to land, so he's burning fuel by flying in circles.

FML.

Try to spin this as an adventure as to not freak out my worry-wort daughter. Boy is out cold, let him sleep until time to land.

We land and find my mother, who is booked stand-by on the next flight to our destination. No, they won't put her back onto our flight since she missed it. We are stuck in the airport waiting for a plane. No, they have no idea how long this will take.

Woot! She gets a confirmed seat on the new flight. And takes off, leaving the rest of us still stuck in the hub.

Woot! They found a plane for us. It's only been a few hours. Candy Crush and Angry Birds are getting old.

Arrive at final destination 4 hours later than planned. My mother is sitting in the terminal, reading her trashy magazines.

And that is how NOT to start a vacation.

Monday mornings

Suck.

I hate my stupid alarm clock.

I want my weekend back!

Happiness

Is a repeat C-section where there is minimal scarring, a healthy screaming baby boy who pees on the doctor, and no other problems so that I get to scrub out about 20 minutes after making the incision.

Follow the money.

First, I am an employed doc. On salary. Have been my entire career. I'm 7 years out from residency, 11 from med school and I have about 3 more years of paying off my loans (which will be ~20 years ahead of schedule, since I consolidated them). Financially, I could NOT enter private practice out of training. I needed to support my family and I needed the financial security of a paycheck, not the uneasiness of running my own practice.

But I care about my AR, my write-offs, my billings. Why? Because I understand that I need to make bank in order for my employer to continue my services, for my staff to get paid. And I am covering my expenses, which makes the hospital happy and keeps the practice in business.

But there is a lot of shit in the air, to be blunt. The RVUs suck. The AMA and older leadership should be ashamed at how we've allowed coding and documentation to wag the dog. It has killed the most important part of medicine, the family doc/internist. They have gotten the shaft completely.

It also has, in some ways, hurt patients. Let me give you an example from my field. Hysterectomy. Fairly common surgical procedure for us, our practice does several every week. Abdominal hysterectomy is still the most common way of doing this in the US, although that is shifting. Vaginal hysterectomies are relatively rare in the US, although studies show it is the method with the lowest complication rate and the cheapest.

Why?

Vag hysts are difficult to do compared to other forms. They are a pain in the ass for the surgeon (and, I suppose, the patient too). But...they are also reimbursed at a lower rate. One of my partners and I were going over reimbursements of surgeries from various companies. Vag hysts are consistently paid about $150-200 less than abdominal or laparoscopic hysts. So even though I struggle more, I get paid less. I can see how some docs say "Fuck it".

Just one example in one field. ACOG and AAGL are all up in arms about increasing the rates of minimally invasive surgery. You know, PAYING us more for the medical care you want to encourage and less for the others may get you further than the hand wringing currently going on.

And yes, office visits that require, you know, actual thought need to be much better reimbursed.

Dear uteri:

I can guarantee I will win any contest. I will remove you if your owner schedules a hysterectomy. It's better for her though, if I don't have to struggle vaginally.

That baby WILL come out, even if I have to cheat using a vacuum or a scalpel. And I will.

So please, just go easy on me? Everyone's happier that way.

Thanks!

For those shocked last night by HBO...

Very NSFW.

My name should be Grace.

Late afternoon. Patient is scheduled for follow-up, and having reviewed her test results, I thought surgery should be the plan.

I knock, open the door and promptly turn my right foot, twisting my ankle and ending up on the floor. "I think you need surgery!"

My M.A. was cracking up. Fortunately, this amused the patient as well.

Choices

Medicine is full of them - some are easy, like starting a family. Some are harder - do I choose medicine versus surgery for this problem?

Some are heartbreakingly awful. Any choice leads to a bad outcome. Allowing your seriously ill teen to enter hospice. Organ donation. Every clinical field can give examples, they're just more common in some like geriatrics and palliative medicine.

We don't have many, but the ones we have are big ones. And we just have to remember not to judge, for we have been lucky enough to live our lives not to have to make those decisions.   Yet.

Academic versus Hicksville medicine

So I went to that conference recently. And a big name (a BIG name) in the field was talking about surgical safety. He mentioned that every time, one should introduce yourself to the others in the OR, because you probably wouldn't know everyone in the room.

I started laughing out loud. I pointed out that I knew the names of every single OR tech and nurse at our hospital (there's only 20 or so). Not only do we in smaller towns know that, we frequently know the kids' names and other small talk stuff.

Tertiary docs. HA!

Happy Birthday

To the guy I love.

Immaturity is to cherished

So I went to a gyn surgery conference this week. And at one of the lectures on prolapse surgery, the lecturer stated "You want to leave the OR with a good vagina."

I can't help it, I started giggling. Yes, I know, it's childish. But it was pretty damn funny.

You can thank Fizzy for this

So her post today brought back memories from med school:

Rectal gangrene. A patient had been discharged from the hospital about 2 weeks early after having an AP resection. He had gone home and sat in chair, pretty much without moving. Why would he need to - he had a foley and colostomy. Came back in with gangrene of the buttocks.

I was good and was able to assist my resident in the debridings. I also was able to (barely) help with the frequent dressing changes in his room. I honestly think I honored that rotation because of this.


*shudder*

For those who think all we care about is our golf game.

First, I don't play golf.

Second, was talking to one of my partners. We've both had awful cases recently, involving death or serious morbidity. And she said "You were trying to do everything to ensure a vaginal delivery instead of cutting her before 5 pm. Don't you wish that sometimes we just did what we're always being accused of doing by the lunatics? But we don't, we try to do what is best for the patient."

FUCK YOU NCB crowd.

A new one

Pregnant gal was working out in the fields when her protruding belly touched the electrical fence.

Are you fucking kidding me?

Things of beauty

There's a scene in the movie Aladdin (so shoot me, I've got young kids), where the hero and Jasmine are in trouble on a roof ledge. He turns to her and asks "Do you trust me?" She slips her hand into his and they escape.

That is what we ask our patients every single day. Do you trust me? Then take a leap of faith and ________. Allow me to cut you open. Allow me to schedule an induction. Let me order this test.

We do this daily. Hopefully, we are worthy of this trust.

At the dinner table...

I had mumbled something about my whackaloon patient being due the week that we are taking a family vacation. I also mentioned that she would probably want me to deliver her the day I got back from the vacation at which point the boychild hums "Dum dum DUM" in a creepy melody.

My kids have met this particular nutcase because I keep running into her around town. ARGH!!!

Why I should be in charge of sex ed at my house.

So we found this amusing website. The kids & I have been having fun looking though the various ways other dogs are very bad. Bathroom trash, specifically feminine hygiene products are frequently featured.

My son : What's a tampon?

My husband : Something that catches girl cooties.

Boychild : Oh.

WHY?!?!?!?!?!?

No, just no.

Small amusements

Background: I am white. One of my partners is African-American.

I have a patient who needs delivered this weekend and I'm not on call - my partner is. So I'm talking to her today about induction & she asks me about things. One question was "What does she look like."


"Nothing like me." Said with a straight face.


Thing is, being lost in middle america, people are incredibly racist around here. But when they meet my partner, everyone loves her. Moving this area slowly into the 20th century...

That kind of day

I did literally facepalm while talking to a patient this morning...and the day didn't get any better.

Tired

Of ortho crap. I am an ortho's wet dream, a klutzy hot mess.

Last summer, I tore my rotator cuff. Rehabbed the shoulder, it's mostly OK except when I have difficult vaginal deliveries. The next 2 days I can totally feel it in my shoulder.

Last summer, I looked in the mirror and didn't like what I saw. My head still has this image of me as a hot teen, with the BMI of 18.3 (yes, that really was my BMI). I now have a BMI of 33.3. So I joined the local Y and started an exercise class.

6 months in, my fat pants are loose, although I had GAINED 5 pounds. And then I go and injure my foot. I'm 2 months out from my injury, doing PT (DAMN I hate physical therapy! They are EVIL!). I limp now, although it's getting better.

Between multiple Xrays, an MRI, and doc appointments, this is the most expensive exercise class I've ever taken.

I just want to walk normally. please?

My wish

Is that any other phone call I take this weekend will not make my jaw drop.

It's a WTF? type of weekend.

I don't know

If olive oil is a good anal lubricant.

#holyshitdidshejustaskmethatquestion?

Okay.......

We check pregnant patients' urine. Every. Single. Visit.

Well, some of our more stellar examples of better living through chemistry club (we have the president and the treasurer right now on our patient list) are paranoid about our intentions. I really just care about the protein and the glucose. But they are convinced we run drug screens every time we check their pee. (just as an aside, that would be too much work! plus, it's not CLIA-approved)

So yesterday, Ms. President of the Better Living Through Chemistry Club brought in her SON'S pee for us to test. It was still cold from being in her fridge!

Really?

WTF?!?!?!?!

My duaghter takes riding lessons. She lives for horses - most of her t-shirts have horses and/or statements relating to horses on them. Her room has horse posters up all over. I think she would be happy if I gave her horse perfume (although the rest of us might turn up our noses...).

So anyhow, today is lesson day for her. And I dutifully took her there and sat in my car and read a book.  She then reappears at the car and asks "Can you hear a baby's heartbeat?"

"Yeah, with my doppler, which is at the office."

"Can you come into the stable - we have a pregnant mare."

Evidently, I'm expanding my scope of practice.

Dear Patient,

If when I walk onto the floor, the first reaction out of the nurses and the PCTs and the HUC are "Thank GAWD you're here!", then maybe you need to tone back the bitchy.

Just sayin'.

I looooooooooove the days

When we can get high just from breathing in the office. Because today was a hygienically challenging day, so we spray Febreez in the rooms after the patient leaves.

I think several new cancers were caused today from overuse of it.

Weird

My mother is getting frail. Mentally, she's mostly still with-it, but physically, she's on a downward slope. Modern medicine has added years to her life - the initial presentation of her cancer was a P.E. in 2009 - doubt she would have survived that 100 years ago. She has had radical surgery as well as XRT and chemo - both of which likely have added to her lifespan.

She's finally starting to realize that she likely won't be around much longer. She went to a lawyer recently and we were talking about that today. She mentioned that she wanted to donate her organs and I pointed out that cancer pretty much eliminates you as a donor. I mentioned donating her body to a medical school...she's going to be looking into that.

Not a normal conversation by any way shape or form, that's for sure.

The vagina

Is a place where other doctors are afraid to go. Do a pelvic exam? As if!

But it is our hallmark. Vaginal surgery is what differentiates us gynecologists from other surgeons. We up the degree of difficulty by operating through it. Vaginal surgery violates many surgical dictums - good visualization (nope), easy access (HA!), good lighting (as I knock the OR light with my head yet again). But we do it. Successfully.

Nowadays, we are retreating from it. Adding laparoscopy, or using the robot. And this is not in the patient's nor our society's best interest.

We need to reclaim the vagina for surgery.

:)

So I was rounding on my post-op patient yesterday. I was slightly frazzled, as school had been delayed, so I was dragging my youngest with me.

I'm in jeans with paint stains, a turtleneck, and a sweater (it's cold here in BFE!), with only lip gloss on. And she says "You always look so pretty."

Made my day.  :)

Please

Let me smack my sister with a clue by four? Hard. Upside the head.

My mother was admitted to the hospital on MONDAY with urosepsis...I just got called an hour ago.

Please?

Guess I'm driving home soon. Mom is doing better - I talked to her just now.

There are...

Some things you dread at work. A pap-athon is hated by all of us in the office. Certain annoying patients. Insurance companies and their assinine hoops.

And then, there are some surgeries that you book - knowing that it will be difficult. Could be minimal descensus for a vag hyst, whiny patient with unrealistic expectations (the pain will ALL GO AWAY!!!), the large uterus for a laparoscopic hyst. I had one of those types of cases booked today.

3+ hours into the pain, I looked over at my partner and asked what baked goods she wanted in the office, because I really owed her for agreeing to scrub in with me on this one. My back is killing me, my arms were jello by the end of the case.

9

Doesn't seem possible. We love you, kiddo.

Changing it up

Usually, I use this blog as a vent to bitch about the craziness around me. This post will be different.

Monday, 1/7. Office hours in the morning, surgery in the afternoon. Nice patients in the morning. Absolutely adorable big siblings at appointments to hear "their baby". Nice mix of things - paps, OB, insert IUDs, discuss scheduling surgery.

OR - 4 cases, 3 majors and 1 minor. All cases go well. My vaginal hysterectomy went as smooth as it could. Cute babies from c-section. The worst part was the last case started late due to L&D needing some extra time to figure out staffing (several patients in labor walked in right before we were scheduled to start). And if that was the worst, that is pretty damn good. Besides, I have Angry Birds on my phone - at least I have something to do while waiting.   ;)

It's days like that that totally make up for some of the shit that happens. (don't ask about my last call weekend...).

My hope

So the girl child is whining because school starts back tomorrow. I, being a sympathetic mother, tell her to shut up and stop bitching because I have to work too.

Of course, I'm scheduled for just a c-section and nothing else (long story).

Just a c-section.

I hope to always remember that "just a c-section", something that is routine for me, is something amazing, exhilarating, and scary for those who put their trust in me. Yes, I have done hundreds, maybe even thousands. But to that woman, it is one of only a few.

I hope to always remember. Even at 2 am.