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The quick brown fox jumps over the lazy 21-year-old white male with a history of lymphoma, now with abdominal pain and CT scan showing mesenteric adenopathy. God, it’s too early, I can’t focus on the monitor and Bob and Tom in the morning, KKRQ, Cedar Rapids, all the hits of the 60’s, 70’s and 80’s. Windy, cold and cloudy with blowing snow and a traveler’s advisory. Winter storm warning in effect and a foot of snow in the forecast. Maybe she won’t leave; she hates to drive in the snow. Where she comes from you have to watch out for cobras on the highway, not ice. C’mon and take a free ride, yeah, yeah, yeah, yeah.

What would you do If I sang out of tune? Would you stand up and walk out on me? What the hell does she want from me, anyway? Her doctor says it’s the lack of sunlight that makes her so depressed. So why do I have to take the blame? Description: The patient was placed in the supine position. General endotracheal anesthesia was administered. The patient’s abdomen was shaved, prepped and draped in the usual sterile fashion. Who told this guy he could sing? A 15-cm transverse incision was made just below the umbilicus. The large and small bowels were removed from the abdominal cavity and placed in a moist Endo-bag. Approximately one foot proximal to the small bowel resection margin, a large mass of tumor was uncovered, which had previously gone unnoticed. I thought we’d be happier in America. Guess I was wrong.

Maybe I should go to the cafeteria and get a cup of coffee. Maybe some breakfast. Maybe I should’ve stayed home, talked with her about our problems, but God we need the overtime. One of our problems is that I’m never at home, another problem is that we never have enough money. Catch 22 cm of small bowel was resected. Have to remember to type 1999 instead of 1998. I see all good people turn their heads each day so satisfied I’m on my way.

Good morning, Surgery Word Processing. No, she’s not here. Nobody’s here but me. Sorry, I can’t pull the records for you, most of the system’s shut down, the techies are using the holiday to install upgrades. Call back tomorrow. Big Wheel keep on turning, Proud Mary keep on burnin’. Rollin’. Rollin’. Rollin’ on the gallbladder, which was elevated off its bed in the liver using careful electrocautery and sent to Pathology as a specimen. Approximately 50 cc of turbid, brown foul-smelling pus was suctioned from the abdominal cavity. Love stinks. Love hurts. Love is like a rose, like a flame, like a virgin.

Dr. Metcalf, Dr. Al-Jurf, Dr. Corson, Dr. Wu, Dr. Hsu, Sioux City Hsu. Dr. Hook and the Medicine Show. On regular days, when the whole crew is in the office, I have to turn off the radio and wear both earphones, and then it seems as if their words materialize in the very center of my head, just like thought. I don’t have any idea what any of the physicians actually look like, I probably pass them in the halls all the time without recognizing them. But I’ve invented faces for them in my head: Dr. Corson is grey and dour, the product of a Dickensian British public school. Dr. Schneider is tall and athletic, a young Jimmy Stewart, the kind of guy who’d be fun to go out and have a few beers with. Dr. Urdaneta sounds just like Ricky Ricardo; I imagine that he escaped from Cuba on an inner tube raft. Dr. Ranson sounds like she’s sixteen years old; she whispers in my ear and her voice is sweet and hesitant and vulnerable. She can give me an erection just by describing a ruptured spleen.

Enter user ID and password. System data is confidential. Violations of confidentiality may lead to dismissal from your job and/or penalties under State law. Steve: There’s bean dip and chips in the fridge. Please don’t eat over the keyboard. Happy New Year! Pam. I get by with a little help from my friends.

A transverse incision was made between the umbilicus and the xiphoid process. This was deepened down through the subcutaneous tissues and linea alba, come together, right now, under me.

Indications: The patient is a 26-year-old male with a life-long history of eating difficulties following lye ingestion as a child and subsequent colonic interposition. The only thing a gambler needs is a suitcase and a trunk. She could go, and good riddance, but I know she’ll take the kids with her. That would kill me. When I came upon the child of God, he was walkin’ along the road and I asked him tell me where was he goin’ and this he told me: we’ve got to get ourselves back to the Garden.

The fibers of the external oblique aponeurosis were divided obliquely with electrocautery. The peritoneum was entered with Mayo scissors, taking care to isolate the peritoneum from the bowel. Sing us a song you’re the piano man, what’s she want from me, anyway? I give her all my pay, I do all the housework. “I was not born to be a maid,” she says. Evidently, she was born to sit on the sofa and watch COPS. It confirms her belief that America is a violent, dangerous place. Once the peritoneum was entered, the appendix and cecum were delivered into the wound. I work myself to death so she can buy a machine to ionize the air in the house, but she won’t sweep the floors. Dust bunnies the size of the large and small bowel were run from the ileocecal valve to the mesenteric base and she’s buying a stairway to Heaven.

Indications: The patient is a 64-year-old male, 14-year-old female, 29-year-old paraplegic male with a history of alcohol abuse status post gunshot wound to the right temporal lobe in 1974. The patient is a long, cool woman in a black dress. The patient is a 34-year-old dissatisfied mother of two married to an underemployed, undemonstrative 41-year-old cyborg, the organic link between the digital Dictaphone system and the computer records-keeping system, hard-wired for eight hours per shift by my fingertips, eyes, ears and one foot, channeling Latin that’s all Greek to me, the ghost in the machine. Death, dismemberment and disease, in one ear and out the fingertips, day after day after day. The patient was discharged to home, to the care of his family, against medical advice. The patient is deceased.

Indications: The patient is a ramblin’ man, born in the back seat of a Grehound bus rollin’ down highway 41.

Procedure: Excision of myofascial necrosis involving left shoulder, right abdomen and right posterior thigh and buttocks. I’m not dumb but I can’t understand why she walks like a woman but talks like a man. If a case of the clap becomes epidemic, is it then considered a case of applause? More continuous classics right after the news, KKRQ, Cedar Rapids. The abdominal wall was examined and shown to have a thick black eschar that had essentially auto-amputated from the free egg nog in the cafeteria. There was undermining of the peripheral tissues with non-viable fat around the perimeter of this eschar. Electrocautery was used to resect a margin of what the hell is this stuff? If there was ever any food in the fridge I could bring my own lunch. Oh yeah, life goes on, long after the thrill of livin’ is gone.

In the news: The Euro heralds a new era for Europe, the Arc de Triomphe reopens to tourism, the American embasy in Tel Aviv was closed after receiving bomb threats, the U.S. reduces its Persian Gulf forces, and today is J.D. Salinger’s 80^th birthday. The three major themes in Salinger’s work are: young girls, old letters and cigarettes. Last year a woman published a memoir claiming she had an affair with Salinger when she was just 18 and he was 53. A few years ago he went to court to stop publication of some of his old, nasty, letters to Oona Chaplin. If he dies of lung cancer, the circle will be complete. Guess that’s why they call it the blues.

1998 in review: Vigra, Monicagate, John Glenn returned to space and Mark McGwire broke Hank Aaron’s record. Peace was achieved in Northern Ireland but not in the Middle East, terrorists bombed the American embassies in Kenya and Tanzania. It was the deadliest hurricane season in two centuries. Eating a bowl of high-fiber cereal each morning may reduce the risk of breast cancer. If a baboon’s red ass doesn’t put a smile on your face, check your pulse. C’mon people now, smile on your brother, everybody get together, try to love one another, right now.

The University of Iowa meteorological center reports ten inches of snow on the ground with more coming. This is already the biggest blizzard in twenty years. The gargoyles outside my window, carved from Iowa limestone by Italian free masons in 1911, perched sixty feet over the courtyard where I take my illegal cigarette breaks, are all wearing tall white hats of snow. The Cedar Rapids Gazette and Iowa City Press Citizen are expecting delays in delivery of today’s newspaper and ask their readers to be patient. Indications: The patient is a 3-year-old male who was hit by a car oh shit no I can’t do one of these right now.

Complications: Intraoperative death. Christ, skip out of this dictation now, throw it back in the pool and let somebody else type it tomorrow, he’s just Andy’s age, his birthday was only a month ago, and I wonder, who’ll stop the rain.

Indications: The patient is a 41-year-old African American female who has had two episodes of right upper quadrant abdominal pain over the past two weeks, in addition to a history of occasional postprandial right upper quadrant tenderness, oh yeah, a nice, safe gallbladder. Female, fat and forty. Here’s to you, Mrs. Robinson.

The patient was placed in the supine position. General endotracheal anesthesia was administered. The patient’s abdomen was shaved, prepped and draped in the 1999 Bridal and Wedding Show, beginning January 4 at the Iowa Memorial Union, brought to you by the good folks at Ewers’ Men’s Wear and Heart to Heart Florists.

Forecast of six more inches of snow before nightfall, high for the day 15 degrees, -10 with the wind chill. The free skating lessons at the Coral Ridge Rink are canceled for the day. The Sycamore Mall is closed for the day. The Free Lunch Program at the Mennonite Church is canceled for the day. I wonder if she’ll be there when I get home. If she doesn’t leave she’ll spend the day on the sofa being sad and angry. The breakfast dishes will still be on the dining table when I get home. I wonder if I’ll follow her back to Thailand if she goes. I’ll follow the kids, that’s for sure. Be sure and catch the Bob and Tom Show Monday through Friday at 6 AM on KKRQ, have mercy baby on a poor girl like me, all we are is dust in the wind.

The areas of proposed liposuction were treated with ultrasonic waves for ten minutes at 30 watts. I’ve seen fire and I’ve seen rain. The lateral thighs on either side were liposuctioned with approximately 350 mL of bloody fat removed from the patient’s left thigh and approximately 450 mL of bloody fat removed from the patient’s right thigh. Approximately 20 mL of the recovered fat was centrifuged to remove the blood and loaded into a Veress needle. Approximately 3 mL of fat was injected below the vermillion border of the patient’s upper lip. Approximately 5 mL of fat was injected under the vermillion border of the patient’s lower lip. Well I don’t know, but I been told, a big-ass woman aint got no soul.

The afternoon zoo’s 1999 Death Pool includes Jack Klugman, Joe DiMaggio, Bob Hope, Strom Thurman, one of MacKauley Culkin’s siblings, Don Knotts and Phyllis Diller. My marriage will beat them all to the grave. The colonoscope was advanced without difficulty through a very long and tortuous colon to the cecum. Biopsy showed tubulovillous adenoma with high grade dysplasia. Gimme the beat, boys, and free my soul, I wanna get lost in your rock n’ roll and drift away. The patient tolerated the procedure well and without complications.

She’s my best friend’s girl but she used to be mine. Surgery was indicated to obtain margins-free specimens. Surgery was indicated for resection of the persistent lesion on the forehead. Surgery was indicated to save the marriage, to punish the husband, to give the wife some room. Surgery was indicated for curative resection and to prevent metastatic disease, carcinomatosis and death.

The patient was awakened and extubated without difficulty. His wounds were dressed and he was taken to Carpet Tree’s biggest floor covering sale in Eastern Iowa all year! Update the look of your kitchen or bathroom with new vinyl or ceramic tile. Save up to 50% on an 8-year-old male with a history of significant gastroesophageal reflux and no payments until April, 1999! The underlying properitoneal fat was grasped and elevated and the periteonal cavity was entered. Watch out, you might get what you’re after.

Five o’clock news, same as the noon news. Five o’clock colorectal anastomosis same as the noon colorectal anastomosis. Wonder what I’ll make for dinner. Wonder if I’ll be eating alone tonight. If I am eating alone, I sure as Hell won’t be eating rice. I’ve had enough rice to last me a goddamn lifetime. Wonder if she turned the heat off in the house before she left, be just like her, leave me alone in a cold house with frozen pipes. Wonder, wonder, who wrote the book of love. The Brooklyn Daily Eagle, on New Year’s Eve in 1899, predicted the rise of Germany and Japan, that horseless carriages would leave the streets quiet and clean, electric lights would rid the streets of crime, and Brooklyn would lose its baseball team. I predict that she won’t come back, that my kids will grow up not knowing me, calling some other guy Dad. I predict that I won’t get to read the kids “Goodnight Moon” tonight. I predict that I’ll never have love in my life again. I predict that my car won’t make it to spring. I read the news today, oh boy, about a lucky man who made the grade, and though the news was rather sad, well I just had to laugh. Multiple adhesions were lysed and the sigmoid colon was mobilized. The ureters were identified bilaterally and preserved.

Happy hour at Mahoney’s every Thursday with 25-cent draws from eight until midnight. We haven’t been out together since she was pregnant with Andy. Come back home to the best food in town at Hamburg Inn. We haven’t had a decent conversation in the transverse colon, which was involved with many adhesions which made its mobilization difficult. The mesentery was thick with hard, inflamed lymph nodes. C’mon baby, light my fire, try to set the night on fire.

With the breast tissue stretched moderately, a 38-mm cookie cutter was used to incise through the epidermis surrounding the nipple-areolar complex. All breast tissue above the pedicle was elevated to the level of the second rib. The skin, fat and glandular tissue were resected using cautery. Fifteen inches on the ground and it’s still coming down. Five degrees above zero at sunset, with another thirty degrees of wind chill. The Cedar Rapids police department warns that any vehicle left on the streets after midnight will be towed to make way for snowplows. Getcher motor runnin’, head out on the highway. Maybe she won’t go. This kind of weather terrifies her. Just one more thing about sleepy, pastoral Iowa that terrifies her.

One more and I’m done, one more report and I get to go home. “Get” to go home. Home to what? Home to the anastomosis was carefully inspected and additional stitches were placed as necessary in the outer layer. The end of the first day of 1999, maybe the end of the last day of my marriage, Interstate 80 is closed between Des Moines and Omaha, the Highway Patrol is asking that nobody travel unless absolutely necessary. Maybe getting away from me is necessary. General endotracheal anesthesia was administered. General endotracheal anesthesia was administered. General endotracheal anesthesia was administered. I have become, comfortably numb.

The large and small bowel were replaced into the abdomen easily and seen to be in their proper anatomical positions. The abdomen was irrigated and the fascia closed with interrupted simple stitches of #2 Novofil. The subcutaneous tissues were irrigated and the skin was closed with staples. The wound was covered with sterile 4 x 4 mesh gauze followed by silk tape. The patient tolerated the procedure well and there were no complications. The sponge, needle and lap counts were correct. The patient was extubated in the OR and taken to the PACU in good condition. The Eastern Iowa Airport is closed. It was clear this operation was palliative and not curative. Wal Mart has sold out of snow blowers, but it’s still rock n’ roll to me.

© Steve Rosse. All rights reserved by the author.

The author can be contacted at: shavethemonkeys@gmail.com

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