On Saturday, Rita and I decided to try our luck with the bus to Verona, as it's only about a 20-30 minute drive from Brognoligo. We drove back to San Bonifacio, found out where the bus stop was, stepped into the Tabacchi to buy our biglietti, and killed time in a cafe with the "due cappuccini" I mentioned yesterday. It took about an hour to get into Verona with all the various stops the bus made, and once there, we actually rode the bus for a bit too long. Since Rita had never taken the bus before, we went right past the stop for Piazza Bra and the large Arena (roman ampitheatre), and in fact on through to the bus depot on the other side of the city. So we had a fair walk to come back into the city, passing through both it's medieval and roman city walls. We strolled up Via Manzetti, well known for shops like Gucci and Louis Vuitton, Cartier and Diesel, most of them hideously expensive, all with high Italian fashion displays in their windows. We turned down a side street to visit Giuletta's house...about the only thing that is true of Romeo & Giuletta (Shakespeare had never been to Italy when he wrote the play), is that the families of Capulet and Montague did in fact exist. Ironically enough, Giuletta's house is a set-up, much like that of 221 Baker St here in London. (I have a picture of "the balcony" and there is a statue of her in the courtyard which people stood in line to have their pictures taken with, all from girl of about 8 to man of 72 cupping one hand around her breast and giving the thumbs up or smiling cheekily.) Romeo's house, on the other hand, which probably did belong to the Montague family, has a small plaque to mark it, and there aren't any crowds-- Rita didn't realize it existed until I read it from a walking tour of Verona. I guess the plain truth just doesn't draw the crowds the way a house built to the specifications of Shakespeare's imagination does. Anyway, we found our way to the market of Piazza Erba, where I joyfully discovered a vendor selling panzerotti (like calzone, but smaller and better, with a different sort of dough). Before the afternoon was through we'd also seen the memoralized Scaligieri graves (the ruling family of Verona, the way of the Medicis in Florence), an old Roman theatre (smaller than the Arena), and the Castelvecchio (old castle), built by the Scaligieri family. We bought some deliciously gooey amaretti for the bus ride home, and made our way back to the bus stop only to find the next bus didn't run on Saturdays, and it would be an hour until we could catch a bus. Not that this should have been surprising, given that things in Italy, and in Greece for that matter, just seem to happen in slow motion.
We arrived back in Brognoligo eventually, where the plan was to join Rita's family for pizza. In Italy, everyone orders their own pizza, it's sort of a personal thin-crust pizza, probably a good 12 inches in diameter, and it's the best pizza in the world. Somehow just different, somehow just so much better. To the delight of Rita's family, I put my good appetite to use and polished off my whole prosciutto e funghi pizza, and said yes to some of Pippo's homemade salami. I think he was disappointed when I stopped after three slices, but I was full to bursting, no matter how delicious it was. And of course we had apperitifs, vino di tavolo, prosecco, sweet fizzy wine, limoncello, and grappa, all homemade. Not too much grappa, because the homemade stuff is not to be trifled with, usually at least 80 proof. Italians usually put a little bit in their coffee.
Wednesday, May 31, 2006
Yet another new Skype "friend"
"I'm calling you from Bulgaria. Please call me...any time you want. Preferably in the evening. Thank you." That's the latest message on my Skype voicemail from Alexi Alexov. Random!!
More on Italy to follow a bit later on this evening.
More on Italy to follow a bit later on this evening.
Tuesday, May 30, 2006
Arrivo
I almost dread starting this post, as I have so much to say, I don't know where to start, and I'm sure I'll rattle on long past when I should end. I've decided not to write the first paragraph in Italian, though I'm sure that would be a good challenge for me - however, my grammar might end up being shockingly awful to Jenn, so I will refrain. Allora, ragazzi...
I will try to intersperse this with pictures, which will probably mean I'll have to republish these entries a couple of times since the pics have to be posted separately, so bear with me. There are several themes here...food (naturally), wine (of course), my rediscovery of conversational Italian idiosyncrasies, my adventures with small town Italian life, and our misadventures with Italian public transit.
I caught my flight to Verona Catullo airport on Thursday afternoon with no complications, and arrived to a very warm, still very light out Italian evening around 8:30pm. Rita (Jenn's mother) and Rita's cousin Pippo (short for Filippo) were waiting for me. We drove first along the autostrada and then turned off into smaller towns that lead to Rita's small town of Brognoligo, and I dreamily watched the hillsides terraced with vines and olive trees and old old building and churches slide by. And I particularly like in the town of Monteforte where we have to drive right up in front of the church, and pass where there is barely enough room over cobblestoned street between the church and what serves as town hall/tourism office/enoteca and probably more. I happily made myself at home in Rita and Morris' restored old farmhouse, picture to follow, and we decided to make our way to the train station the following morning. Meanwhile, Rita got out some cheese and crusty Italian bread, as well as a bottle of Pippo's homemade vino dolce (which is a bit frizzante), and I obligingly made my way through most of it myself, for as soon as we discovered it was sweet, Rita didn't really want to have more than a small glass. And guess what, no hangover.
To summarize a couple of things, I more than made use of my time in a gastronomic sense, with many of my personal favorites, including gnocchi, homemade risotto, tender beef with a gravy-like accompaniment made only in the Verona region called peara, homemade salami, fresh, hot panini, fresh bread, Italian pizza with homemade oglio picante, gelato, amaretti, and cherries picked from the side of the road. I was unfortunately one weekend ahead of the Brognoligo cherry festival which is happening this coming weekend (I saw everything being set up in the small town center as I left). I had homemade grappa, homemade limoncino, homemade vino di tavolo, homemade prosecco, homemade vino dolce. I bought jewelry and sandals, 6 boxes of panne (traditionally used in cream-bases sauces in Italy), bags of amaretti to bring to my coworkers, and 10 bottles of locally made wine to bring back. I even drank the requisite cappuccino. While waiting for the bus to Verona on Saturday, Rita asked me if I wanted a cappuccino "or something" and I said yes, as I'm always able to find something else to drink, but Rita temporarily forgot I don't drink coffee and immediately ordered "due cappuccini". I dumped two packets of sugar substitute into mine, and managed to somewhat enjoy it. I had to, for when in Italy...
I will try to intersperse this with pictures, which will probably mean I'll have to republish these entries a couple of times since the pics have to be posted separately, so bear with me. There are several themes here...food (naturally), wine (of course), my rediscovery of conversational Italian idiosyncrasies, my adventures with small town Italian life, and our misadventures with Italian public transit.
I caught my flight to Verona Catullo airport on Thursday afternoon with no complications, and arrived to a very warm, still very light out Italian evening around 8:30pm. Rita (Jenn's mother) and Rita's cousin Pippo (short for Filippo) were waiting for me. We drove first along the autostrada and then turned off into smaller towns that lead to Rita's small town of Brognoligo, and I dreamily watched the hillsides terraced with vines and olive trees and old old building and churches slide by. And I particularly like in the town of Monteforte where we have to drive right up in front of the church, and pass where there is barely enough room over cobblestoned street between the church and what serves as town hall/tourism office/enoteca and probably more. I happily made myself at home in Rita and Morris' restored old farmhouse, picture to follow, and we decided to make our way to the train station the following morning. Meanwhile, Rita got out some cheese and crusty Italian bread, as well as a bottle of Pippo's homemade vino dolce (which is a bit frizzante), and I obligingly made my way through most of it myself, for as soon as we discovered it was sweet, Rita didn't really want to have more than a small glass. And guess what, no hangover.
To summarize a couple of things, I more than made use of my time in a gastronomic sense, with many of my personal favorites, including gnocchi, homemade risotto, tender beef with a gravy-like accompaniment made only in the Verona region called peara, homemade salami, fresh, hot panini, fresh bread, Italian pizza with homemade oglio picante, gelato, amaretti, and cherries picked from the side of the road. I was unfortunately one weekend ahead of the Brognoligo cherry festival which is happening this coming weekend (I saw everything being set up in the small town center as I left). I had homemade grappa, homemade limoncino, homemade vino di tavolo, homemade prosecco, homemade vino dolce. I bought jewelry and sandals, 6 boxes of panne (traditionally used in cream-bases sauces in Italy), bags of amaretti to bring to my coworkers, and 10 bottles of locally made wine to bring back. I even drank the requisite cappuccino. While waiting for the bus to Verona on Saturday, Rita asked me if I wanted a cappuccino "or something" and I said yes, as I'm always able to find something else to drink, but Rita temporarily forgot I don't drink coffee and immediately ordered "due cappuccini". I dumped two packets of sugar substitute into mine, and managed to somewhat enjoy it. I had to, for when in Italy...
The Florys farmhouse. The half you see starting on the left hand side of the picture belongs to an older woman named Teresa. When you ask how she is, she always says something like, Oh, not so good, I don't feel well, I feel bad, etc. So it was very funny when on my third day there she said something to the effect of, better than yesterday.
Venezia
On Friday, Rita and I set out for the train station in San Bonafacio, and arrived in time to find out the train for Venezia would be arriving soon. The guy selling the biglietti basically lied and told us it was the intercity, so we paid more money to take the direct train. As it turned out, it was il treno regionale, so we stopped at every little station along the way, and it took us two hours to get to Venezia. However, when we got there, I was so excited, I couldn't believe I was finally in Venice with the sun shining! (When we lived in Italy, my family went during the winter, when I went back to Italy two years ago with my friend Pete, we were there for Carnivale at the end of February, but it was gray and raining the whole time.) And then...oh for shame, and then I had to stop and buy a memory card at three times what it should cost, because when I went to erase old pictures on the train to make room for the new, I realized I'd brought my camera without a memory card in it- DOH! Some highlights in Venice included the Ponte Rialto (which a lot of people think is the Bridge of Sighs), the Ponte Sospiri (which actually is the Bridge of Sighs, so romanticized by Lord Byron because it connected the Palazzo Ducale to the prison, and prisoners who were to be executed or serve a life term would heave great sighs or take their last breaths of freedom as they crossed this bridge), Basilica di San Marco, and the traffic on the canals.
I had two servings of gelato in my favorite flavor, pistacchio (pronounced peestakkio in Italian with a hard c), and took a picture so as not to forget the sight of gloriously mounded, creamy, melt in your mouth, oh so much better than ice cream, small bowl or cone of heaven.
And I was reaquainted with one of my favorite Italian phrases..."sempre dritto." At the end of our day, as Rita and I tried to find our way through the maze of small, windy Venetian streets back to the train station, we got lost. We stopped several times to ask for help, and the inevitable answer was a right and then a left (or a left and then a right) and from there on "sempre dritto" although you need to imagine the first syllable of the first word drawn out in what you might almost call an Italian drawl. Seeeeeeemmmmmmpre dritto. Meaning, always straight. If you ask an Italian anywhere for directions, his answer will always include at some point, and often more than once, that you have to go sempre dritto. I even remember hearing about this in our crash Italian course before my family moved there for two years. The funny part being, you can't sempre dritto in Venezia. There are no cars, so the streets are tiny and twisty, and intersect and interconnect in impossible ways. You could only sempre dritto if you were a crow. But eventually, we did find the train station. And discovered it was three hours until the train we needed, and once we were finally on that train, Rita had my heart stopped for a minute as we pulled out from the station, the conductor made an announcement, and Rita told me we'd gotten onto the wrong train. I didn't see how that was possible, and it turned out we were on the right one. But traveling with Jenn's mom, as I was just beginning to discover, is always an adventure.
I will leave the rest for tomorrow, as there is so much to write about, but for now, here are a few more pictures from Venezia. Ciao tutti!
I had two servings of gelato in my favorite flavor, pistacchio (pronounced peestakkio in Italian with a hard c), and took a picture so as not to forget the sight of gloriously mounded, creamy, melt in your mouth, oh so much better than ice cream, small bowl or cone of heaven.
And I was reaquainted with one of my favorite Italian phrases..."sempre dritto." At the end of our day, as Rita and I tried to find our way through the maze of small, windy Venetian streets back to the train station, we got lost. We stopped several times to ask for help, and the inevitable answer was a right and then a left (or a left and then a right) and from there on "sempre dritto" although you need to imagine the first syllable of the first word drawn out in what you might almost call an Italian drawl. Seeeeeeemmmmmmpre dritto. Meaning, always straight. If you ask an Italian anywhere for directions, his answer will always include at some point, and often more than once, that you have to go sempre dritto. I even remember hearing about this in our crash Italian course before my family moved there for two years. The funny part being, you can't sempre dritto in Venezia. There are no cars, so the streets are tiny and twisty, and intersect and interconnect in impossible ways. You could only sempre dritto if you were a crow. But eventually, we did find the train station. And discovered it was three hours until the train we needed, and once we were finally on that train, Rita had my heart stopped for a minute as we pulled out from the station, the conductor made an announcement, and Rita told me we'd gotten onto the wrong train. I didn't see how that was possible, and it turned out we were on the right one. But traveling with Jenn's mom, as I was just beginning to discover, is always an adventure.
I will leave the rest for tomorrow, as there is so much to write about, but for now, here are a few more pictures from Venezia. Ciao tutti!
Oh yeah, I did drop a ton of money on training for an OT assessment tool back in November!
Had a little blast from the not too far away past when I arrived back in Harrow Road...only about 15 minutes ago in fact. By the time I got off my flight around 10:40pm, got through passport control, collected my luggage, caught the Gatwick Express train from the airport to Victoria station, caught the Underground from there to Stratford, and caught the 257 bus (boy did I feel lucky as I thought it had already stopped running for the night- it drops me off two blocks from my house), it was already going on 1am.
Anyway, I have lots to tell about my long weekend, but that will have to wait for when I'm capable of coherent thought...for right now, a mini celebration, in that (da-da-da!) I am now a calibrated AMPS administrator! Had an email waiting for me, and I just had to share the news. I'll start in with stories and pictures tomorrow after work. Ciao ciao.
Anyway, I have lots to tell about my long weekend, but that will have to wait for when I'm capable of coherent thought...for right now, a mini celebration, in that (da-da-da!) I am now a calibrated AMPS administrator! Had an email waiting for me, and I just had to share the news. I'll start in with stories and pictures tomorrow after work. Ciao ciao.
Wednesday, May 24, 2006
Brognoligo, here I come!
I spent a good hour earlier this evening making homemade chocolate chip cookies, Dad-style, y-ummmm! Tomorrow we are celebrating the birthday of one of my co-workers, Annette, and I will bring some to Rita as well.
Tomorrow is the day! I return to Italy. This time it's only been two years since I've been back, so I count that as an improvement over 11 years!! I literally cannot wait, I am so excited! I can't believe it's finally here. Jenn's dad will be away on business in China, but her mom and her mom's cousin Pippo will be at the airport tomorrow night at 8:30pm to pick me up! I am going to eat my heart out...
So there won't be any updates again until Monday, although if I am really tired, it may not be until Tuesday. But I promise I will have pics, and stories. And lots of lots of Italian wine :)
In the meantime, I wish all of you a glorious Memorial Day Weekend...I wish I could BBQ with you all, I hope you have better weather than we have been having, and for those of you in Vermont..."Helloooooo, the lake!" I'll be with you in a month! Make me a list of chores that don't end up getting done this weekend! All my love, Allison.
Tomorrow is the day! I return to Italy. This time it's only been two years since I've been back, so I count that as an improvement over 11 years!! I literally cannot wait, I am so excited! I can't believe it's finally here. Jenn's dad will be away on business in China, but her mom and her mom's cousin Pippo will be at the airport tomorrow night at 8:30pm to pick me up! I am going to eat my heart out...
So there won't be any updates again until Monday, although if I am really tired, it may not be until Tuesday. But I promise I will have pics, and stories. And lots of lots of Italian wine :)
In the meantime, I wish all of you a glorious Memorial Day Weekend...I wish I could BBQ with you all, I hope you have better weather than we have been having, and for those of you in Vermont..."Helloooooo, the lake!" I'll be with you in a month! Make me a list of chores that don't end up getting done this weekend! All my love, Allison.
Tuesday, May 23, 2006
Typical
I got an email from my manager today regarding my National Insurance number. The one she helped me apply for on my very first day of work, meaning Feb 22. It is now 3 months later, and they have sent back a letter saying, due to a change in legislation, the application I had filled out is not valid, can I please fill in the new form they have sent and then send it back. Honestly, I can't see that the new form has changed at all, but what do I know?
Time away
Looking at my calendar this morning, I was very pleased to discover two things...for one, now that I've written in weekend trips to Cornwall and to visit Rob and Nicole in Guildford, my weekends in June are now fully booked. And for the other, I have already been granted the time off for my two weeks in the States in July, and in the near future, I plan to turn in a request for two more weeks in August for a vacation with Maja (most likely in Turkey). Which means that is basically a month (4 weeks total) I'm not spending working at this current rotation! Woohoo!! Although I have to say, given that I love OT, it makes me sad to be so desperate for time away from it. Hopefully that will change with whatever rotation I have next.
Meanwhile, an update on those two patients the physio and I wanted to send to inpatient rehab, or Intermediate Care. Via the head nurse, both consultants have "caved" for lack of a better word, and the referrals were sent off this morning. Now we have to wait until the assessments are carried out this week, to see if they are accepted for Intermediate Care.
Meanwhile, an update on those two patients the physio and I wanted to send to inpatient rehab, or Intermediate Care. Via the head nurse, both consultants have "caved" for lack of a better word, and the referrals were sent off this morning. Now we have to wait until the assessments are carried out this week, to see if they are accepted for Intermediate Care.
Monday, May 22, 2006
Escargots
First and foremost...Happy Birthday Tressa! And I believe she has just taken her last exam today. Congrats, kiddo, you survived! Next stop, graduation. In all seriousness, Tressa is a real life hero to me, and I'm glad she's in this world with me. Be nice if we could have conversations more than about once a month via long distance phone calls, but by the time I return from my grand British adventure, Tress will be back in Africa. Le Sigh.
It has been raining here quite a lot, as well as high winds, since the middle of last week I think. England is finally living up to its climate reputation. On my walk to work I cross underneath a roundabout (traffic configuration, they have them in Mass, only they're called rotaries), where pedestrians such as myself and bikers, and horse riders can safely avoid the traffic. England has a rather large, indigenous population of snails. Unfortunately for the snails, who like to come out and for whatever reason, cross the footpaths, in the rain, people seem to like to smash them. I've been rather saddened this morning and last week by the needless violence of it all....and invariably have found myself rooting on the rare snail still alive, barely moving across the footpath. I will it along, to move as fast as it possibly can, can't it see the carnage surrounding it, go snail go!
It has been raining here quite a lot, as well as high winds, since the middle of last week I think. England is finally living up to its climate reputation. On my walk to work I cross underneath a roundabout (traffic configuration, they have them in Mass, only they're called rotaries), where pedestrians such as myself and bikers, and horse riders can safely avoid the traffic. England has a rather large, indigenous population of snails. Unfortunately for the snails, who like to come out and for whatever reason, cross the footpaths, in the rain, people seem to like to smash them. I've been rather saddened this morning and last week by the needless violence of it all....and invariably have found myself rooting on the rare snail still alive, barely moving across the footpath. I will it along, to move as fast as it possibly can, can't it see the carnage surrounding it, go snail go!
Sunday, May 21, 2006
The beer stein
Last night was an interesting night...I started out way over near Wimbledon (over an hour on public transport) at the Oktoberfest pub. They were having what they called Mayfest, billed as a pre-Oktoberfest event. For 10 pounds, you got entrance to the pub, a free glass beer stein (see below), and your first drink free. I swear, you had a workout just lifting the silly thing which is very heavy on its own, and especially when full of beer or cider or whatever. I was out with Nicole, Dave, and a couple of Dave's friends, and we had a good time. But after a while, I got tired of the so-called Oompa Loompa band playing the only three German drinking songs they knew, as well as Take Me Home Country Roads and When the Saints Come Marching In over and over and over. And I got tired of the drunk guys using cutting through the crowd as an excuse to put their hands all over me. So along about 10pm, I left and headed for Liverpool Street, which is only a couple of stops from my stop on the central tube line. I'd had a text from Nicole Levesque that she and her boyfriend Rob and several of Rob's friends were at a bar/club in that general area. They let me check my beer stein at the door and Rob's friends were very very nice. The music was good, and suddenly I didn't feel so tired anymore. I forgot to keep track of the time, since the tube shuts down at 12:30am, but luckily everyone was planning to take cabs, and were happy to drop me off on the way. But first, we went up the road to a bakery that had bagels...it was the one-year anniversary for two of Rob's friends who are a couple, and they wanted to do exactly what they had done at the end of the night this time a year ago. They had bought bagels with salt beef and mustard that clears your nostrils the same way wasabi will do. So we all went and bought them- salt beef tastes very much like corned beef. I also tried something called Eccles Cake, which I'm told is Welsh-- it was sugary pastry filled with a sweet raisin filling, very tasty! The girl behind the counter took one look at my stein, looked back at me, and shook her head in disbelief.
Thursday, May 18, 2006
"Ici, on parle football!"
French because we watched an Arsenal game that took place in Paris last night, and I have just made plans to go to Paris! For those of you who are familiar with Arsenal football (soccer) club, I watched the European Cup final last night between Barcelona and Arsenal. It was heartbreaking, as Arsenal played most of the game one man short. They lost the goalie to a red card early on in the first half, after a slide tackle that was quite obviously intended to take out the man rather than retrieve the ball. I did comment at the time that I'd never seen a ref take away the advantage before (Barcelona scored, only to have the goal disallowed by the ref who had blown his whistle on the goalie and Barcelona then missed the free kick)...however, it did not end up being much a blow to Barcelona who went on to score two goals in the second half. Arsenal played their hearts out, but pretty much were run all over the field with only a substitute goalie and 9 men playing.
I have now puchased tickets to go back to Paris for the first time in...hmm, lord knows how many years. Probably since we were living in Italy. My friend Jo and I will be taking the Eurostar (yay!) and may try to check out some of the Da Vinci code irregularities. We will definitely take in the Louvre. This will happen the weekend of June 24, which means the week of June 26, I will only be working 1 day! (Will take the Monday off, and then will be on a training course Wed-Fri). And then I'm gone for two weeks, back to the States! Midge has been laughing at me for the way I've been arranging my travel plans to break up what has turned out to be a very slow-paced rotation. Speaking of Midge, though we tried, we won't get to meet up, as she didn't get her visa delivered until Tuesday, and has various family plans until she leaves. It's a shame, but then again, we've had some great phone calls last week and this one.
I have now puchased tickets to go back to Paris for the first time in...hmm, lord knows how many years. Probably since we were living in Italy. My friend Jo and I will be taking the Eurostar (yay!) and may try to check out some of the Da Vinci code irregularities. We will definitely take in the Louvre. This will happen the weekend of June 24, which means the week of June 26, I will only be working 1 day! (Will take the Monday off, and then will be on a training course Wed-Fri). And then I'm gone for two weeks, back to the States! Midge has been laughing at me for the way I've been arranging my travel plans to break up what has turned out to be a very slow-paced rotation. Speaking of Midge, though we tried, we won't get to meet up, as she didn't get her visa delivered until Tuesday, and has various family plans until she leaves. It's a shame, but then again, we've had some great phone calls last week and this one.
Wednesday, May 17, 2006
It's a dog's life
Being in dog country can be rather funny. I hope no one gets offended by this comment, as I'm certainly not the first to make it...I believe I've read this in various magazines, heard other people say it, etc. And especially with regard to the dog owners I see every day on my walks to or from the hospital, it amuses me to no end in its veracity. Some dog owners seem to choose their pets based on physical resemblance to themselves. There's a lady with shoulder length hair, dyed a reddish color, and rather dry and shaggy in looks. She has a ginger and white collie I always see her walking. Then there's a man who is very tall but with small, sort of scrunched facial features, and I don't know the name of the breed of his two little dogs, but they definitely have scrunched facial features. I could go on with examples, but you get my point. I wonder, does this tie in with the theory that we choose our romantic partners based on physical similarities? (I have often read that couples who could be mistaken for brother and sister are, generally speaking, the most compatible couples.) Do we naturally gravitate toward people and things that remind us of, well, us?
Tuesday, May 16, 2006
Just call me "the all-knowing, all-seeing Trash Heap!"
From Fraggle Rock?! Anyone? Anyone? Beuller...Beuller...
Sorry Midge, you've already heard this one...
I had a case conference meeting early this morning, with a consultant (doctor) who I have enjoyed "working with" since my arrival. I say "working with" because I only ever see him in case conference-- almost all of the patients at the day hospital are seen by SHO's (Senior House Officers - basically residents), and the cases are then reviewed by the consultants once a week. Or perhaps a bit more often if the SHO's consult with the consultant before case conference comes up. Anywho, the physio and I brought a case up this morning for a lady who had been declining functionally, with a previous medical history of stroke. She has shown some improvement in two weeks with two physio appointments, but the physios are only part time at the day hospital. They cannot see patients on a daily basis, and are able to only take on so many to be seen once a week for 4-6 weeks. This lady, it was felt by myself and the physio, had much to gain if she were willing to participate in a 6-week inpatient rehab program, which she did say she'd be happy to do.
The consultant's first retort was, well, why can't you see her more frequently here? Evidently in the past, the day hospital did function in a rehab sort of sense, and there was enough therapy staffing for patients to be seen on a daily basis. The trouble is, now there's not, and the consultant couldn't seem to wrap his head around the fact that the physios are struggling to keep up with patients for balance class and new referrals. In theory, it's ok that we aren't able to offer rehab through the day hospital because there are other hospital services to whom we can refer where they can get rehab. He gave up on arguing about what services the physios should be providing at the day hospital, and next wanted to know why we wanted to "bin" this poor lady by putting her in Intermediate Care (inpatient rehab), what has she done to deserve it. When you bin something over here, you're putting it in the garbage can. I cannot even begin to explain how offended I was that he was calling inpatient rehab services a bin. I have had most of my OT work experience in such a bin, I have helped many a patient regain functional independence in such a bin, and as with any medical agenda, if the patient didn't want to go to rehab and did themselves consider it to be a bin, they always have the right to refuse. If inpatient rehab is garbage, then I will happily self-profess myself to be a garbage-man. Er, woman.
Being a professional, I did not make a sweeping exit as I yelled back at the consultant "Bin this!!!" with accompanying obscene gesture.
Our only recourse is to refer this lady to a more short term therapy in the home, and tell that therapist we had wanted rehab for her, and hopefully that therapist will then make the rehab referral after their two-week time frame for working with the patient expires.
"The Trash Heap has spoken! Nyeah!"
Sorry Midge, you've already heard this one...
I had a case conference meeting early this morning, with a consultant (doctor) who I have enjoyed "working with" since my arrival. I say "working with" because I only ever see him in case conference-- almost all of the patients at the day hospital are seen by SHO's (Senior House Officers - basically residents), and the cases are then reviewed by the consultants once a week. Or perhaps a bit more often if the SHO's consult with the consultant before case conference comes up. Anywho, the physio and I brought a case up this morning for a lady who had been declining functionally, with a previous medical history of stroke. She has shown some improvement in two weeks with two physio appointments, but the physios are only part time at the day hospital. They cannot see patients on a daily basis, and are able to only take on so many to be seen once a week for 4-6 weeks. This lady, it was felt by myself and the physio, had much to gain if she were willing to participate in a 6-week inpatient rehab program, which she did say she'd be happy to do.
The consultant's first retort was, well, why can't you see her more frequently here? Evidently in the past, the day hospital did function in a rehab sort of sense, and there was enough therapy staffing for patients to be seen on a daily basis. The trouble is, now there's not, and the consultant couldn't seem to wrap his head around the fact that the physios are struggling to keep up with patients for balance class and new referrals. In theory, it's ok that we aren't able to offer rehab through the day hospital because there are other hospital services to whom we can refer where they can get rehab. He gave up on arguing about what services the physios should be providing at the day hospital, and next wanted to know why we wanted to "bin" this poor lady by putting her in Intermediate Care (inpatient rehab), what has she done to deserve it. When you bin something over here, you're putting it in the garbage can. I cannot even begin to explain how offended I was that he was calling inpatient rehab services a bin. I have had most of my OT work experience in such a bin, I have helped many a patient regain functional independence in such a bin, and as with any medical agenda, if the patient didn't want to go to rehab and did themselves consider it to be a bin, they always have the right to refuse. If inpatient rehab is garbage, then I will happily self-profess myself to be a garbage-man. Er, woman.
Being a professional, I did not make a sweeping exit as I yelled back at the consultant "Bin this!!!" with accompanying obscene gesture.
Our only recourse is to refer this lady to a more short term therapy in the home, and tell that therapist we had wanted rehab for her, and hopefully that therapist will then make the rehab referral after their two-week time frame for working with the patient expires.
"The Trash Heap has spoken! Nyeah!"
Monday, May 15, 2006
OT rules!
First of all, a big thank you to everyone who checks out my blog, all you regular visitors, as I've now had over 1,000 hits! Secondly, I think I am going to delete my second OT blog, as I tend to write about everything here, including the OT stuff. To that end...
I walked into the day hospital office manager's office, which I do rarely when I need to send off a fax, and happened to see a letter from one of the consultants (doctors) lying on her desk from a woman we recently did a Continuing Care Assessment on...I was intrigued to note that the letter he had dictated to be sent to the woman's GP and social worker was practically word for word what I had written in the medical notes. After having seen the patient who was so demented I had to get all my information from her carer (the patient is already in residential care, they are now petitioning to have her moved to a nursing home), I jumped at the chance to talk to her daughter who showed up in the afternoon. There were several discrepancies in the stories offered by the carer versus the daughter, such as the carer said there is no longer any difference in the behavior exhibited by the patient whether family members are present or not, while the daughter adamantly states the patient definitely still recognizes her and her brother. The daughter also told me she had recently taken her mother home for a two night/1 day visit, during which time the daughter stated her mother seemed to be much more herself, and became more demanding (which the daughter took to be a good sign, given that her mother was a strongly-opinionated, very vocal school teacher previously). The daughter is horribly conflicted, because her mother said to her many times over the years, "I don't ever want to be in a home." And the daughter was inquiring as to whether her mother would basically be bed-bound if she were moved to a nursing home (to which I had to answer, most likely, yes)...it's horrible but the minute people enter an institution their functional skills are pretty much sure to decline. And her mother wanted to know if they moved to a house built for someone who's disabled, arranged 24-hour supervision with various family members, and got carers and all home adaptations, could they care for her at home? To which I was happily able to say yes, you have power of attorney, they cannot place her in a nursing home without your consent, and you should consult the citizen's advice bureau for your mother's and your legal rights. I was the only one to gather this info from the daughter, which I dutifully reported in the medical notes, and as I said, it was repeated virtually word for word in the consultant's findings letter. He finished by stating that this family needs extensive social services input as there are obviously complex social issues at work that need to be resolved before the continuing care process can proceed. How vindicated and purposeful did I feel after seeing that letter!
Below you'll find some more Cinco de Mayo photos that Nicole (Tufts Nicole) shared with me today...
I walked into the day hospital office manager's office, which I do rarely when I need to send off a fax, and happened to see a letter from one of the consultants (doctors) lying on her desk from a woman we recently did a Continuing Care Assessment on...I was intrigued to note that the letter he had dictated to be sent to the woman's GP and social worker was practically word for word what I had written in the medical notes. After having seen the patient who was so demented I had to get all my information from her carer (the patient is already in residential care, they are now petitioning to have her moved to a nursing home), I jumped at the chance to talk to her daughter who showed up in the afternoon. There were several discrepancies in the stories offered by the carer versus the daughter, such as the carer said there is no longer any difference in the behavior exhibited by the patient whether family members are present or not, while the daughter adamantly states the patient definitely still recognizes her and her brother. The daughter also told me she had recently taken her mother home for a two night/1 day visit, during which time the daughter stated her mother seemed to be much more herself, and became more demanding (which the daughter took to be a good sign, given that her mother was a strongly-opinionated, very vocal school teacher previously). The daughter is horribly conflicted, because her mother said to her many times over the years, "I don't ever want to be in a home." And the daughter was inquiring as to whether her mother would basically be bed-bound if she were moved to a nursing home (to which I had to answer, most likely, yes)...it's horrible but the minute people enter an institution their functional skills are pretty much sure to decline. And her mother wanted to know if they moved to a house built for someone who's disabled, arranged 24-hour supervision with various family members, and got carers and all home adaptations, could they care for her at home? To which I was happily able to say yes, you have power of attorney, they cannot place her in a nursing home without your consent, and you should consult the citizen's advice bureau for your mother's and your legal rights. I was the only one to gather this info from the daughter, which I dutifully reported in the medical notes, and as I said, it was repeated virtually word for word in the consultant's findings letter. He finished by stating that this family needs extensive social services input as there are obviously complex social issues at work that need to be resolved before the continuing care process can proceed. How vindicated and purposeful did I feel after seeing that letter!
Below you'll find some more Cinco de Mayo photos that Nicole (Tufts Nicole) shared with me today...
Sunday, May 14, 2006
Happy Mother's Day, Mom...
I made an essential error in that I did not buy a card while it was Mother's Day here back in March. And now there are none to be found in the UK. However, I did leave behind a gift before I left, and will be calling home in a bit, so at least I didn't completely screw up!
Time is flying...weekend after next I'm in Italy! Which is the last weekend in May, and Memorial Day Weekend. For those of you in the States, the official start of summer!! I will be thinking of everybody in Vermont, opening up Wissahickon for the summer season, and of all you beach-goers making the first of many trips to the shore this summer. I definitely envy you all!
Happy Mother's Day to Mom, Caitie, Grandma J, Jinny, Jean, Rita, Amanda, and Chris.
Time is flying...weekend after next I'm in Italy! Which is the last weekend in May, and Memorial Day Weekend. For those of you in the States, the official start of summer!! I will be thinking of everybody in Vermont, opening up Wissahickon for the summer season, and of all you beach-goers making the first of many trips to the shore this summer. I definitely envy you all!
Happy Mother's Day to Mom, Caitie, Grandma J, Jinny, Jean, Rita, Amanda, and Chris.
Friday, May 12, 2006
Pear-shaped
It's days like these where I remember why I am an OT, and why I love being an OT, but it's days like these that also burn me up. We had a patient come in for a Continuing Care Assessment...which essentially means, someone is petitioning for the person to be admitted to a nursing home. As in the US, this requires the person's consent if they are mentally competent. So he would need to be informed at some point that his wife and social worker are trying to place him in a nursing home. Actually, he is supposed to be informed that the interdisciplinary assessment process he went through today is one to assess whether he cannot be cared for other than in a nursing home. But he had no idea that he was being assessed for a nursing home! As far as he is aware (because we didn't bluntly say, oh well, we're trying to see if a nursing home would be appropriate for you), there are no plans for him to live anywhere but at home with his wife.
I did my assessment in conjunction with the physios, or at least, the functional part (and yes, this is unusual unfortunately)...and discovered he was able to do sit to stand transfers from his wheelchair independently, and stand independently with a rolling walker! Beyond that, he could move about 5 feet with a slow shuffling gait, a rolling walker, and contact guard assistance. The difference between nursing homes here and those in the States is that a nursing home here is for people who are totally dependent for all care, and once they enter a nursing home, they will pretty much be bed-bound (that's how it's been explained to me).
Meanwhile, this man told us he hasn't walked in about 18 months- ever since he broke his leg. He does have a degenerative neurological disease, but the physios and I definitely see room for functional improvement! He deserves a trial of rehab at least, and as he only has carers twice a week for 30 min (crime), no wonder his wife feels like she can't cope! They don't have the support they need. While I'd like to call up and scream at the social worker, what I will do is discuss the case with his assigned doctor at the day hospital on Monday, and ask to make a referral to inpatient rehab ASAP- meaning Monday. Hopefully they will accept him for rehab (those therapists have to do their own assessment first), and hopefully he will improve with some intensive rehab. Meanwhile, his wife can get some needed respite.
Blast the social workers who always take the easy route, and assume we will rubber stamp people into nursing homes if they're sent to us for continuing care assessments!!
Phrase or word of the week: "Pear-shaped" as in, this poor man's world will go all pear-shaped (upside down) if he realizes someone is trying to place him in a nursing home, and that his wife is aware of the possibility.
I did my assessment in conjunction with the physios, or at least, the functional part (and yes, this is unusual unfortunately)...and discovered he was able to do sit to stand transfers from his wheelchair independently, and stand independently with a rolling walker! Beyond that, he could move about 5 feet with a slow shuffling gait, a rolling walker, and contact guard assistance. The difference between nursing homes here and those in the States is that a nursing home here is for people who are totally dependent for all care, and once they enter a nursing home, they will pretty much be bed-bound (that's how it's been explained to me).
Meanwhile, this man told us he hasn't walked in about 18 months- ever since he broke his leg. He does have a degenerative neurological disease, but the physios and I definitely see room for functional improvement! He deserves a trial of rehab at least, and as he only has carers twice a week for 30 min (crime), no wonder his wife feels like she can't cope! They don't have the support they need. While I'd like to call up and scream at the social worker, what I will do is discuss the case with his assigned doctor at the day hospital on Monday, and ask to make a referral to inpatient rehab ASAP- meaning Monday. Hopefully they will accept him for rehab (those therapists have to do their own assessment first), and hopefully he will improve with some intensive rehab. Meanwhile, his wife can get some needed respite.
Blast the social workers who always take the easy route, and assume we will rubber stamp people into nursing homes if they're sent to us for continuing care assessments!!
Phrase or word of the week: "Pear-shaped" as in, this poor man's world will go all pear-shaped (upside down) if he realizes someone is trying to place him in a nursing home, and that his wife is aware of the possibility.
Thursday, May 11, 2006
Remember Mr. Rogers?
It's a beautiful day in the neighborhood, a beautiful day in the neighborhood, won't you be mine, won't you be mine, won't you be my neighbor.
Not much happenin' today. I had a good supervision meeting with my supervisor, where I was able to show how I'm working to accomplish my objectives and my personal development plan. She told me she's happy with the work I've been doing, and she's impressed with how I've taken on the falls education group as my own. I'm hoping to pick up all the supplies for updating my portfolio this weekend.
It's Thursday, so I've been happily watching House and Grey's Anatomy, and looking forward to tomorrow being Friday!! It should be another beautiful day, with 3/4 of it spent inside, and it will turn colder and rainy, just in time for the weekend...figures.
Anyone seen Mission Impossible III yet? I'm not a fan of Tom Cruise at this point, but I've seen the other two and am thinking I might still enjoy it as a summer blockbuster.
Not much happenin' today. I had a good supervision meeting with my supervisor, where I was able to show how I'm working to accomplish my objectives and my personal development plan. She told me she's happy with the work I've been doing, and she's impressed with how I've taken on the falls education group as my own. I'm hoping to pick up all the supplies for updating my portfolio this weekend.
It's Thursday, so I've been happily watching House and Grey's Anatomy, and looking forward to tomorrow being Friday!! It should be another beautiful day, with 3/4 of it spent inside, and it will turn colder and rainy, just in time for the weekend...figures.
Anyone seen Mission Impossible III yet? I'm not a fan of Tom Cruise at this point, but I've seen the other two and am thinking I might still enjoy it as a summer blockbuster.
Wednesday, May 10, 2006
You're in Blighty, Love!
Highly amusing...I just had a phone call from Midge on my *mobile* who is in the country to get a new work visa for her passport. She's stuck at "home" for the next couple of days while she waits for her passport to be returned with the new visa, so we've tentatively planned to get together next week. Well, tentative in the sense that we don't know what day or what time or where yet, because she has to be at home every day until her passport is returned to her. It was really crazy to hear her voice on the phone, as she reminded me we hadn't spoken since a bunch of us went for JP Licks (ice cream) in Davis Square about a year ago, around graduation time. However, we both have been keeping up with each other via our blogs, and Midge has been very helpful in gently correctly me when I've gotten things unwittingly wrong...such as it's not Thaught Park, it's Thorpe Park. According to Midge, I have really picked up a "British twang" which she thinks may sound so obvious to her since we haven't spoken in a year. Because my friends and family I have spoken to on the phone haven't said anything about it. And I have been conscious of trying not to pick up an accent. But I'm ready and willing to call Midge the expert, and I guess my accent reflects that I'm living in Blighty! We had fun making comparisons- I've been envious of her productivity and opportunities to really work with patients and develop therapeutic rapport, she has on occasion been jealous of my opportunities to plan trips and blog from work because I don't have enough patients to see. I am really looking forward to seeing her next week, it really made my day to hear her voice! Oh, and Midge, turn about is fair play - you do sound a bit more American than I remember ;)
Additionally, I found out today I will be going to a three-day training on Assessment of Perceptual and Cognitive Dysfunction, which makes me very happy. I put my name on a list to be considered for a 6-day Bobath course (the physical aspects of working with stroke patients, it's a specific theory and specific physical interventions), but we won't know for another couple of months who will actually get to go on the course. We were just recently offered a choice among 5-6 other 2-3 day courses, and told if we didn't want to work in rehab or with stroke patients as a career, we might be better off going to one of these courses, as Bobath is quite intensive. I was really interested in the course I mentioned at the beginning of this paragraph but afraid I wouldn't be allowed to do both. So I wrote an email to Barbara, my overall manager and Head OT, explaining that I do intend for my career to be in rehab with a speciality in working stroke patients, and could I possibly attend the Perception and Cognition course, but still be considered for the Bobath, since the two courses cover different aspects of working with stroke patients. And she said, yes, that's fine! So I've killed two birds with one stone...I've gotten permission to attend this course June 28-30 (coincidentally, I have a flight back to the US for two weeks on the night of June 30), and I've made it clear to Barbara that my interests lie in working with stroke patients. Hopefully she'll remember that when it comes time for the next rotation. Finally, I feel like I'm accomplishing something professionally, at least as far as continuing education goes!
I've posted some pictures below from all the various events of this past weekend...
Additionally, I found out today I will be going to a three-day training on Assessment of Perceptual and Cognitive Dysfunction, which makes me very happy. I put my name on a list to be considered for a 6-day Bobath course (the physical aspects of working with stroke patients, it's a specific theory and specific physical interventions), but we won't know for another couple of months who will actually get to go on the course. We were just recently offered a choice among 5-6 other 2-3 day courses, and told if we didn't want to work in rehab or with stroke patients as a career, we might be better off going to one of these courses, as Bobath is quite intensive. I was really interested in the course I mentioned at the beginning of this paragraph but afraid I wouldn't be allowed to do both. So I wrote an email to Barbara, my overall manager and Head OT, explaining that I do intend for my career to be in rehab with a speciality in working stroke patients, and could I possibly attend the Perception and Cognition course, but still be considered for the Bobath, since the two courses cover different aspects of working with stroke patients. And she said, yes, that's fine! So I've killed two birds with one stone...I've gotten permission to attend this course June 28-30 (coincidentally, I have a flight back to the US for two weeks on the night of June 30), and I've made it clear to Barbara that my interests lie in working with stroke patients. Hopefully she'll remember that when it comes time for the next rotation. Finally, I feel like I'm accomplishing something professionally, at least as far as continuing education goes!
I've posted some pictures below from all the various events of this past weekend...
The original painting, which is what you are looking at here, evidently had Magdalene in the robes of an important person...I don't know if any of you are fans of the Da Vinci code, or a student of matriarchal societies of old, but it was interesting to learn the painting that had been done over the top and has now been stripped away left Magdalene out.
Subscribe to:
Posts (Atom)
