Needles

Today I went to see the new doctor, who's also a medical acupuncturist. (He told me that in fact, the insurance companies are pulling him off primary-care panels and listing him as a specialist, which means that I should list his nurse-practitioner as my primary-care person.) I like him a lot. He took notes and checked my records on a laptop, but made plenty of eye contact. When I told him why I wanted acupuncture -- for sinus and gastric issues, two of the conditions for which the World Health Organization recommends acupuncture -- he promptly asked for the history on both. When he found out that I'm not taking an acid blocker because I'm nervous about osteoporosis, he said, "The risk of not taking the pills is greater than the risk of taking them," and then he told me that not all of them interfere with calcium absorbtion at the same level. He said that Zantac is pretty benign that way, especially if I also take both calcium and Vitamin D -- which I already do -- so I'm back on that as of this evening.

After he took my medical history, he asked me what I do for a living, and then what I do for fun. As he was positioning the needles for the acupuncture, he said, "So, do you feel as if you've been able to do what you've wanted with your life?"

Nobody's ever asked me that broad a question: not psychologists, let alone any kind of internist. I was very impressed. This guy seems to have a firm grasp on both Western and Eastern medicine, is comfortable using both, and also pays attention to the Whole Person. My only quibble is that his voice is so soft that I often can't hear him, but I'll just have to ask him to speak up. (He works out of a medical spa, which has a very cushy waiting room with aromatherapy and soothing music and deep, fluffy chairs: it feels like the lobby of a high-end hotel. That's different from my usual experience, too, as was the fact that he came out to get me himself and conducted the entire visit without a nurse.)

The acupuncture was fine. He's very deft at needle insertion and was very solicitous about whether I was comfortable, putting a pillow under my knees and covering my feet with a blanket because they were a bit chilly. I'm going back for another acupuncture session in three weeks. I don't notice any effects from it yet, but I think it takes a while.

So that went well, I think. I also found the office much more easily on this second visit!

On a less happy note, this evening I facilitated a Literature & Medicine session at the VA and learned from some fellow knitters there that my favorite yarn shop is closing. This is really terrible news, and I hadn't even known about it. Evidently everything's half price, so I'm going to go over there tomorrow morning and load up on whatever's left (I still have part of a gift certificate my sister gave me for my birthday, but I'm sure I'll go over that).

Deja VA

Tonight was our monthly Literature & Medicine discussion group at the VA. I've been to the VA a bunch of times since Dad died, and it's never bothered me. But tonight I got sideswiped by vivid memories of riding with him in those elevators, of pushing his wheelchair along those hallways. A passing cart of meal trays triggered memories of feeding him the pureed food he hated. The smell of the hospital brought back in a rush the many hours, some surprisingly happy, I'd spent there with him.

Needless to say, I was teary-eyed by the time I got to the conference room where the Lit&Med group meets. Someone gave me a hug, which helped, and once we got into the discussion I was fine.

A friend of mine who's a therapist told me that she thinks the second year after a death is harder than the first. I hope not! I've been rereading The Year of Magical Thinking, Joan Didion's memoir of the year after her husband's death; I'm teaching it in my grad seminar next week. She talks about "the vortex," riptides of memory sweeping her from seemingly innocuous associations to hauntingly painful ones. Reading about her vortices may have primed me for mine. Also, in honor of April Fool's Day, it snowed off and on all day here, and I've been chilly since this morning, which may have made me more emotionally vulnerable.

Or it might just have happened anyway.

The VA discussion was lively and fascinating, as usual. Afterwards, I rushed to Maundy Thursday services at church and got there in time to have my feet washed. This year I found the stripping of the altar especially stark and powerful, well suited to my mood.

We won't be having our usual noon-3 Good Friday service this year. Not many people ever come, and the clergy are tired. So instead we're doing a joint evening service with the Lutheran congregation across the street. I'm curious to see how that turns out. I loved our traditional Good Friday service, but I hope the later time will encourage more people to show up.

Another Week, Another Blog Post

Remember when I used to post once a day, or sometimes even more than that? Yeah, so do I. I remember those days fondly, but don't know if I'll be getting back to them anytime soon. I'm just too busy in through here.

Various updates and bits o' news:

* I'm still fiddling and writing every day. I've now invested in a fancy Kun shoulder rest rather than my previous foam pad; the Kun's improved both my posture and my tone, although the second still has a long way to go. The sound's no longer muffled by the foam against the bottom of the instrument, though, so I'm getting more resonance. I also bought an inexpensive backpack case for the fiddle so traveling will be easier. I'm already wishing I'd spent a bit more, since this case has already developed zipper problems, but they won't endanger the instrument -- they're on the outside pouch -- so I'll use this one as long as I can.

* Harley's still letting me brush his teeth, but a few mornings ago he smelled alarmingly of urine, so on Monday we're taking him to the vet for his followup bloodwork and urinalysis. I haven't noticed the odor since then, so I hope it was just temporary.

* The book contracts came this week, and it turns out that I'll get half the advance on signing. I thought I wouldn't see any money until I delivered the manuscript, so this is good news. With that money, plus what we saved from my summer teaching gig, we're going to attempt to: 1) go to Honolulu for Spring Break, 2) get the ductwork redone in our house so we actually get some benefits from our furnace and AC, and 3) go on an Alaska cruise in May. This is both ambitious and decadent, but we're going to do our best anyway. It's been a tough year, and we're both acutely aware of having to have fun while we can.

* Monday would have been Gary's father's birthday; I'm going to try to call his mom that day. Today I got a sweet, wistful card from Fran, who often dreams about Dad and was writing to thank us for everything we did for her while she was here. I called -- I've been meaning to write her and hadn't, so I felt guilty -- and it turns out she's doing well: she has friends, is spending Thanksgiivng with family, and generally sounds more chipper than I've heard her for ages.

* Speaking of my father, the other day I got a call from the RN at his assisted-living facility. "I remember you told me after your Dad died that you'd found a place that would take partly used medications. Can you remind me where that was? I have a lot of stuff I want to donate." So I told her. I also told her that the phone call made me feel really good; Dad would thoroughly approve of medications going to the homeless-outreach clinic rather than being wasted, and her phone call made me feel as if something positive came from his death.

* Speaking of medicine, I learned this week that the Literature & Medicine program at our local VA is a go. I'm facilitating it, so I'm very happy and excited.

More news in . . . oh, in a week or so, if I run true to form. And there will be a homily tomorrow!

Yet Another Time Sink

A few days ago, I got yet another invitation to join Facebook. Gary caved in a while ago, but I've stayed away, because I was afraid that if I got sucked in, I'd spend hours there and would get even less done than I get done anyway. In fact, although I'm very fond of various dear friends who've invited me there, I was feeling rather self-righteous about the fact that I wasn't on Facebook. I felt that way before blogging before I started, too.

No, I still haven't joined Facebook. But I have become much more active, perhaps disastrously so, on Ravelry. I signed up months ago, looked at a few patterns and joined two or three groups, and never went back. But in my quest for new and better sock patterns, I revisited the place last week, and since have spent hours downloading free patterns, browsing groups (I now belong to nine, a modest number in Ravelryland), and, yes, getting great sock advice.

My latest project -- as if I need another thing to do! -- is to start a Ravelry group for fiberfolk interested in any aspect of Medical Humanities, especially Narative Medicine or Literature & Medicine. And if this sounds insanely specialized, you haven't browsed Ravelry groups. There's one for people who clean house while listening to their iPods (I swear I'm not making this up). There's one for clumsy people, which I should join but haven't yet. There are zillions devoted to various aspects of charity knitting, and there are a lot of medical groups: for doctors, nurses, patients, physician spouses, med students, medical transcriptionists, and pharmacists, among others.

But to start a group, I need to be able to invite three people. So I've put up notices on various boards asking if anyone else would be interested. So far I've only gotten one response -- although it's early days yet -- so I may not be able to carry through. Which, really, would be just fine, given my time constraints! But if you're on Ravelry and interested in MedHum, give me a shout, okay?

The good news is that last night and today, I got a lot of work done for my freshman comp course this fall, which will be about, you guessed it, Narrative Medicine.

Fun with Gums!

Turns out I need three periodontal procedures; two can be done at the same time, but the third will have to wait until the other two have healed and until my insurance has rolled over. Two involve grafting new gum tissue onto places where it's missing, and one involves snipping gum tissue away from places where pockets between the gum and the tooth have allowed bacteria to collect, resulting in bone loss.

The periodontist was extraordinarily thorough. First he examined every tooth, calling out arcane descriptions to a scribe. "Fickle buckler on the ninth meziodontal tyrannosaurus!" (Okay, obviously I'm not remembering this precisely, but that's more or less what it all sounded like.) Then, after telling me, "This will be the worst part," he probed every millimeter of gum with a sharp instrument. It actually hardly hurt at all, which means he's good at what he does. Then he pondered his notes and drew up a treatment plan, and then he showed me diagrams and charts and explained in exhaustive and dizzying detail -- making notes in handwriting even worse than mine -- the treatment options for each situation. Then he had the scribe hold a magnifying mirror in front of my face, had me open my mouth, and showed me the three places that absolutely must be fixed now, as opposed to many others where the gum integrity's somewhat compromised but where he doesn't expect it to get any worse.

(Having my gums poked with the sharp instrument wasn't the worst part of the exam: looking at my magnified face in a mercilessly brightly lit mirror was the worst part of the exam. Ah, the perils of middle age!)

There's a two-week healing period and I'm leaving town June 10, so we've scheduled the first two procedures for May 18, if I'm not on jury duty. Right now, everything in my life is contingent on whether I'll be on jury duty starting Monday, or possibly the following Monday.

If I'm not on jury duty next week, I'll teach one final class, attend one departmental meeting, and go to two doctor's appointments (including the one with my PCP about allergy/arthritis/asthma issues). If I'm not on jury duty the following week, I'll have the periodontal procedures, and if I'm on jury duty long enough to have to reschedule the periodontal appointment, but not for the entire week, I'll be having lunch with one of my priests. If I'm not on jury duty and do have the periodontal procedures, I may or may not be up to lunch, depending on how my mouth feels.

It's all very complicated. I need a flow chart to keep track of my life these days.

My sister had gum grafts some years ago and says they were hideous. My doctor said that the pain level depends on whether the putty he puts over the donor sites stays on or not: if it does, you don't feel anything, but if it comes off, you're very sore (and it can't be replaced).

When I told my sister how thorough he'd been, she snarled, "He probably knows my guy. My guy teaches the damn stuff."

"So does mine. Did you like yours?"

"His job was to inflict pain. How could I like him?"

Of course, I doubt that would be his description of his job. I'd asked my Gum Doc if he likes his job, and he says he loves it, and I said I was glad to hear that, because I'd always heard that dentists were miserable and had high rates of suicide. He said, "That used to be true, but not anymore. We've gotten a lot better at giving shots and handling pain, so people don't hate us anymore." My sister's Gum Doc was back in the dark ages, I guess. I hope his patients are happier now!

Meanwhile, the good news is that we're going to start a new Literature & Medicine discussion group, this one as part of a new program at VA hospitals, next year, and I'll be facilitating it. Yippee! I love Lit & Med, and I feel like I have a connection to the VA through Dad. I met the VA folks over lunch today, and they were all very nice and seemed enthusiastic, so I'm really looking forward to it.

Also, I express-mailed a Mother's Day card to Mom today. I'd already sent her a small gift, which she received today and seems to like. I'm terrible about mailing cards on time, though, and one of the things I regret about Dad's time in Reno is how holidays went by the wayside. He was in the hospital on Thanksgiving, and Gary and I were out of town on Christmas, because my father-in-law's funeral had been just a few days before. We meant to have a belated Christmas celebration with Dad and Fran when we got back, but it never happened. Dad said he didn't mind, but I minded. I've always loved Christmas.

So, anyway, I'm doing whatever I can to observe holidays on time with Mom, so I won't have those regrets with her when the time comes. The postal clerk who waited on me understood completely, even though $17.50 postage for a greeting card seems a bit extreme. "This is my first Mother's Day without my mother," she said, and we shared stories about our parents. I told her about Dad, and she told me about her Mom, who died very suddenly, in apparently perfect health and on vacation, at the age of 76. We agreed that there are much worse ways to go, and that we both think about our dead parents every day.

Thanks, Doc!

I talked to Dad last night, and he sounded better. This morning I left a message with his primary-care doctor at the VA about getting him in to see someone about his depression. The PCP called me back around noon, and when I explained what was going on, he said he'd work on a referral.

Ten minutes later, a VA psychologist called me, and shortly thereafter, she'd set up two appointments for Dad for tomorrow: he's seeing a psychiatrist at 3:00, and her after that. This isn't the usual order, but it's what was open for tomorrow.

Nice to see that government bureaucracy can move quickly on occasion! Dad and I are both very grateful that he has such a proactive primary-care doc. The PCP had evidently walked into the psychologist's office to explain the situation, rather than relying on phone or e-mail. Thank you, doctor!

I can't be with Dad tomorrow, because I'll be teaching at the med school, but he's arranged for the paratransit van to pick him up and bring him back home, and someone from his assisted-living facility will go with him. Gary and I have to pay for that -- I think it's $20/hour -- but I want Dad to be seen quickly, and this is the only way it will happen.

Meanwhile, we're waiting to see if the weather will permit us to travel to Palo Alto on Thursday. If not, some of the tests Dad would have had there can be done at the VA here, although his echocardiogram has to be done at Stanford. We could drive him down the following week for that, although the long weekend this week would give us more wiggle room.

Today Dad asked when he's going to see me next. Tomorrow I'm busy all day with class prep for Wednesday, teaching a narrative medicine class at the med school in the afternoon, and facilitating the hospital Lit & Med discussion group in the evening. Wednesday I'm busy with teaching, so Dad probably won't see me until Thursday. Although he's been interested in and proud of my medical-school projects in the past, Dad grumbled this time. "Why do you do all this extra work?"

"Because I enjoy it," I told him. (The med-school stuff also gives me service points for my annual review.) The implication, though, was clearly that I should devote every spare moment to him.

Sigh.

A speech therapist is going to visit him tomorrow morning to work on his swallowing; his occupational therapist was there today, and patiently led him through the oxygen drill again. She also reminded him that having people transport him to and from meals raises his bill, which is good motivation to get him walking, or at least using his scooter. I haven't wanted to emphasize that because I don't want him to feel guilty about money (my sister and I have to pay any extra expenses), but I'm glad the therapist mentioned it.

If nothing else, he's getting lots of attention from lots of people. I just pray that it eventually helps him feel better.

Hurrah for Narrative Medicine!

The other day I was flipping through a recent New Yorker and came across a quarter-page ad for the new MS in Narrative Medicine at Columbia. Pretty cool!

In other NM news, I was recently given, as compensation for my work with the Literature & Medicine program, a nice budget for new books. I've had fun unpacking them in my office this past week: physican/patient memoirs, novels and poetry collections about medicine, medical history, texts about medical anthropology. I now have the beginning of a solid medical-humanities library, and I can't wait to read all this stuff!

Medical Goodies

First, this week's Grand Rounds is up. Happy reading!

Second, last night we had our first meeting of the Literature & Medicine discussion group, which I'm facilitating at one of our local hospitals. Those of us on the planning side were nervous about attendance, and indeed only a handful of people showed up (although more have said they want to come next time), but we had a lively and thoughtful discussion, and I think everyone enjoyed it. I certainly did. I can't wait until the October meeting!

And third, yesterday I had acupuncture for the first time.

I liked the acupuncture, which I think helped unclog my sinuses. The preceding diagnostic procedures, however, put my Western skeptic brain into screaming "Warning, Will Robinson!" mode. See, you hold a brass rod that attaches by a wire to a machine with a platform on top; another wire from the other side of the machine is attached to a probe which the clinicians jams into meridian points on your hands and feet to see how well your organ systems are functioning. The machine beeps and whines as a colored bar shoots up on a computer screen to show function level. What made me skeptical is that a) the level seems to vary according to probe pressure and how long it's held there, and b) my very nice nurse practitioner began this procedure by explaining that the actual doctor -- who's an MD as well as having acupuncture certification -- might have to redo some of the readings, because "he's more sensitive than I am and communicates with this machine better."

Um, okay. Some people are better at reading, oh, x-rays than others. Maybe it's like that.

But then, after the initial readings -- which showed that I have an alarmingly "stagnant liver" (which doesn't mean what it would in Western medicine) -- the diagnosis continues with treatment testing. This is done by putting vials of herbs on the machine platform and retaking the readings to see if the high ones are now low. If so, that means this herb will help you.

The APN was having trouble finding herbs that would balance me, so the doctor came in. "How does this work?" I asked him. "How can the machine tell what herbs are in the vials if they're in glass?"

"Electromagnetic fields," he said cheerfully, and proceeded to do a little demo. He'd found a herb that would balance me very nicely, according to the machine. He had me put the tip of my left thumb to the tip of my left forefinger, like an "OK" sign, and tried to pull them apart while I resisted. "Your kidney readings are fine," he said. "If I try to do this while I'm pointing at your kidneys, I can't do it, but if I try to do it while I'm pointing at your liver, which is weak, I can pull your fingers apart easily." This was indeed true, but I suspected either a different grip on his part or the power of suggestion on mine. Then he put the vial of the herbs that will help my stagnant liver in my right hand, and said, "See? Now if I point at your liver, I can't pry your fingers apart anymore."

I was trying to keep my face from twitching. (When I described this to Gary, later, he said, "This guy needs to get an act in Vegas.") But a good friend of mine swears by this doctor, so I was trying very hard to give him the benefit of the doubt. "What causes a stagnant liver?" I asked him.

"Internalized anger," he said promptly. This is, of course, a classic cause of depression, and I can't count how many psychiatrists have told me the same thing. And when I talked to the doctor about antidepressants, he was very clear and thoughtful and smart about what they do and what they can't do. In Chinese medicine, a stagnant liver would also cause allergies, so that ties together neatly.

On the other hand, depression and allergies were my two chief complaints on my new-patient paperwork and during my initial interview with the APN, so is he telling me what he already knows I want to hear?

As I say, I did like the acupuncture, and I'm going back in two weeks for more. And this guy's covered by my insurance, which confers a certain legitimacy. In the meantime, I'm taking Chinese herbs, which a) smell yucky, b) aren't covered by my insurance, and are more expensive than my OTC meds, and c) have to be taken in vast quantities (twelve pills a day, in my case). It's too soon to tell if they're doing anything, but I wonder if I can continue with acupuncture but discontinue the herbs. Oh, and he's trying to formulate a homeopathic remedy for my stagnant liver. When he talked about what the liver herbs should do for me, he mentioned relief of symptoms I hadn't told him I had, which was interesting. On the other hand, they're common depression symptoms, so again, maybe that was just a good guess on his part.

The jury will be out for a while on this one. But it's an adventure, that's for sure!

Grand Rounds Meets the Bard!

This week's edition is up, with a Shakespearean theme. Now that's what I call Literature & Medicine!

Elsewhere in medical news, I've made an appointment with a local acupuncturist (who's also an MD, and very highly regarded by a colleague who's one of his patients). I keep hearing that acupuncture helps at least some people with allergies, arthritis and depression, all of which I have, so why not give it a try?

My initial appointment was with an APN, and my friend at work said only the MD places the needles, which would mean I'd need an appointment with him, too. I called to check on this, and the scheduler explained that the APN will spend an hour with me, taking a complete history and doing various tests. Then I'll be led into the acupuncture room and the doctor will come in and place the needles.

Dang! When did I last have that much face time with a provider? Just knowing that someone's going to listen to me that carefully makes me feel good about this place already. (Now that's what I call narrative medicine!) O brave new world, that has such creatures in it!

And, amazingly, this doctor is on my insurance list.

I'll post about it afterwards -- the appointment's in two weeks -- and let you know what I think.

Score One for Narrative Medicine!

I recently got some nice news from my friend Marin Gillis, who's the Director of Medical Ethics and Humanities at our medical school, and who's been a steadfast champion both of narrative medicine and of my work with it. She was the person who asked me to teach a class on narrative medicine as part of the third-year Clinical Reasoning in Medicine course.

Some of the medical students are more than a little skeptical about this, for obvious reasons. They have gobs of hard science to learn, and they aren't getting enough sleep, and many of them are scientists by inclination as well as training. In this setting, narrative medicine, and other work in the humanities, often feels fluffy and extraneous. Although the students have always been polite to me and done the work I asked of them -- often very well -- there's also been some unspoken resistance. I could often sense the "this is bs" current in the room, although no one ever said it aloud. (I should add that this mindset isn't limited to medical students, and is often much stronger in freshman comp classes, where students can be much less polite about it!) But as a med school faculty member told me, "They'll get in five years, you know? When they're in actual practice, something's going to happen in a patient interaction, and they'll look back and say, 'Ooooh! That's why she wanted us to learn this!'"

For at least one student, it didn't take five years.

When I saw Marin last week, she told me that one of the medical students who'd been in the CRIM class told her a story about another student in the class, who'd been very resistant to the material. I'd given them a published case about a fourteen year old boy dying of cancer; I had the students write a letter from one of the people described in the case (the boy, one of his parents, one of his doctors, his beloved neighbor, the beloved neighbor's beloved dog, the girl in his class he wanted to kiss) to someone else on the list of characters. The students paired up and swapped letters; each then wrote a response to the other's letter. So if one student wrote from the boy to his doctor, the second wrote from the doctor to the boy.

This one student, evidently, thought the whole exercise was complete and utter hooey. Why were they spending time on this garbage? How was this ever going to be useful?

Two weeks later, he told his friend, something happened at the hospital, and he suddenly understood why it was important. He had the aha moment. "Ooooh! That's why she wanted us to learn this!"

I don't know what happened, although I'd love to know. Marin's trying to get the student to write me a note about it, but apparently he's too embarrassed. (Dear med student: If you're reading this, you don't need to be embarrassed. Believe me, I know the material can seem irrelevant at first! I'm just glad it didn't take you five years to change your mind.)

In any event, this is an invaluable affirmation of the work I've been doing. Marin and other med school faculty have been very positive all along, but the opinions that matter the most are those of the students.

In other medical-humanities news, we'll be starting up the Literature & Medicine program in August, and Marin recently met with the staff of a care facility where there's strong interest in a writing and healing group. So I may be doing that work sooner than I expected. And we also have our first student in a narrative-medicine elective, and she may be able to get me invited to teach a narrative medicine or reflective writing session at the HEART elective in Santa Cruz next April.

I'm excited!

Random Ups and Downs

Today started off very well, with a breakfast meeting about the Literature & Medicine program in Reno. We have a schedule now, and a partial list of people we want to invite. My job by the end of the week is to finalize the syllabus, which will be easier now that my books have arrived from Chicago.

I decided to celebrate by buying a new bookcase for my office at school, to be devoted to Lit&Med books. (I also framed my Certificate of Appointment to the medical school -- the one with everything spelled right -- because it makes me happy.) Gary and I went to my office, measured, went to Office Depot, found something the right size, and went back to my office, where Gary began the long, tedious job of assembly.

In the meantime, I'd learned from the department secretary that my fall grad seminar's been canceled because it didn't get enough students. That's the second time in two years this has happened to me. This time around, I polled the grad students to see which topic they were most interested in, and went with the one that got the most votes, but it still didn't work.

Drat.

Instead, I'll be teaching Women & Literature, which is always a fun course. But I have to get that syllabus into working shape soon, too, so I can order the books.

By the time we got the bookcase assembled and moved into the office, it was 6:00. We went out to eat so Gary wouldn't have to cook after fighting with cryptic assembly instructions. Then we came back home, where I stared mournfully at my third chapter and fiddled with it a bit. In the process, I figured out what comes next (this showing up at the computer really does seem to work!), but I didn't actually write it. I knitted instead, catching and repairing two potentially disastrous dropped stitches in my current project.

I'd hoped to have the third chapter done today, but instead, I'm giving myself until the end of the week. And I'm going to bed early tonight, because I got up at 6:00 for the meeting.

Both of my offices, at home and school, are in utter chaos right now, which isn't helping anything. I need to make time to straighten them up. Gahhhh.

I didn't read today. Mea culpa. I did swim, though.

Back

Well, okay, actually, I've been back since very late Wednesday night -- although my luggage didn't join me until yesterday afternoon -- but I was too busy catching up on other things to blog.

Lee, to answer your question, the Medical Readers Theater went fine, although it was the last event of the Institute, so a lot of people had left already, and those of us who were still there were pretty worn out. I enjoyed it, but I'd like to do it again when I'm feeling more awake!

I came back to pretty horrible smoke conditions in Reno from the Northern CA fires, but the air seems to be clearing a tiny bit. Gary calls Reno in the summer "the biggest little ashtray," and this week, we really fit that description.

No New Yarn Today

My faithful readers will be relieved to learn a) that Gary has graciously forgiven me for my most recent yarn-purchasing indiscretions and b) that I acquired no new yarn today, although I did knit. (And I told the third knitter here about the yarn sale, and the last time I saw her, she was heading off to check it out.)

Not only didn't I buy any yarn, but the two-hour session I moderated went well. I started with a writing exercise that was well-received; I was worried that some of the discussion after that lagged a bit, but the other people in my group said they didn't feel that way when I asked them for feedback.

Tomorrow we'll be doing a Medical Readers' Theater adaptation of Raymond Carver's story "Cathedral," and I'm one of the readers. Our rehearsal this evening went well, although everyone was tired from a day inside with no natural light. After the rehearsal, we went out for dinner to another Italian restaurant, where I once again pigged out, especially on dessert.

Tomorrow the Institute ends around noon; my flight leaves Chicago in the early evening, and with luck -- that is, if I make my Denver connection -- I'll be home by midnight.

It will be a long day. And so to bed!