Our clinic has been unbelievably busy, thanks in part to the H1N1 scare. We have set up a fully-staffed flu clinic just to keep on the demand for the seasonal flu vaccine. The new H1N1 vaccine is supposed to be here in about 2-3 weeks, assuming we get our allotment. At first, we heard that two H1N1 vaccines will be required, but now the word is "just one". Our multiple-provider clinic can see about 400 patients in any given day, and we expect the demand to be high.

In practice devoted to pediatrics and adolescents, the high-season is usually Thanksgiving to the end of February, but this year is different. Our schedules are completely booked and everyone is working to capacity. If and when the H1N1 hits big-time, I hope that we will be able to accelerate this already-busy pace. All of us are dog-tired. Of course, I have even more of a reason to be dog tired. At the moment, with the new puppies, I have eight dogs; about five too many.

Our dogs have the newborn baby schedule. They stay up late; wake in the middle of the night ready to eat, poop, and play, and then get up early in the morning to repeat the process. It was nice when they were able to be contained in a plastic swimming pool "whelping box", but now they have taken over the house. Since I work 12-hour shifts, it is starting to wear on this old man. I worked to 9 PM last night. I stayed late to suture a 21-month-old who split her lip and to deal with a shocked teenager who I discovered was pregnant. She came in for something else, of course. This was just the icing on the medical cake. When they have sex and don't use birth control, I am constantly at awe that they are surprised when I tell them they are pregnant. How long did they think they could play sperm roulette?

My grandson is in a year-round school, so he is off this week, staying with us. I tried to take him to see a movie this afternoon, but I fell asleep in the theater. Since we were the only two people in the theater, it wasn't an issue. Apparently, I did not snore, or at least my grandson didn't hear it over all of the shooting and explosions in GI Joe. GI Joe was the only movie in our theater that was not rated R. He liked it. I will reserve a vote until it comes out in DVD and I can see it again for the first time.

My wife and I bought a huge, metal gazebo when we were in Mexico a year ago. We had it dismantled, tied it to the top of the truck, and drove it home about a thousand miles. When my turn came at the border crossing, the customs agent asked me if I bought anything in Mexico that I was bringing home. I had this huge, jumble of metal tied to the truck, sticking out in all directions, perhaps standing four feet taller than the roof. I looked at him and said, "No, why do you ask?" He smiled and wondered why I didn't get it painted first. In retrospect, he was right. We had our oldest son finally weld it back together this weekend. It's going to take another two weekends to paint it.

It rained a bit in Northern California last week, just enough to cause a few hundred lightning fires; no big ones, fortunately. A few weeks ago, about 80 homes and businesses were lost when a wild fire raged through our foothill community. We were able to tour the devastation. Lifetimes of memories went up in minutes. Some families only got out with the clothes on their backs.

In a weakened moment, I agreed to take a medical student in my practice for the next month or so. Usually, students will slow you down, but this one is a bit more experienced, so I am hoping he will be able to help with the deluge.

I took off five days in mid-September to speak at our annual conference in Palm Springs. My topic this year should be fun. I am speaking about bizarre patient encounters. Maybe it's me, but I seem to have some sort of magnet that draws the strange and unusual to my door - the foreign bodies in the nose and ears; the people with a confusing array of symptoms, the hypochondriacs, the drug-seekers, etc. They come to my practice and they stay because I am nice to them. Over the years, I have collected quite a number of them. With the utmost respect to odd human behaviors, I will be talking about them this year. No names, of course. I will be offering suggestions on how to deal with these most-challenging patients.

Someone once said that one out of five people are absolutely crazy. I thought of my four closest friends; and they seemed "okay", so it must be me. Or I am just dog-tired.

A puppy just bit me on the toe. I will probably get rabies.

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Labels: dogs, medical practice