Three hours of inpatient child psychotherapy, an hour of outpatient therapy, ward rounds, an administrative lunch meeting, a seminar on consultation/liaison work, an hour of supervision, a meeting with the pediatric endocrinologist about the abnormal thyroid levels in one of my kids on the ward, and finishing all of my progress notes for the week before 7:30 so I can meet my girlfriend, Marilyn, in time to make the guitar concert at 8:00.
Once again I had pulled off what seemed like an amazing balancing act of competing demands, so Marilyn and I could have some enjoyment on a Friday evening. All this on just five hours of sleep since I had been awakened suddenly at 5 a.m. with a sharp and persistent pain just below my left scapula (shoulder blade). Ah, there was Marilyn at 7:45 with a couple of burritos we could inhale on the way to the concert. Not bad, I thought to myself, just 15 minutes behind schedule. We got to the concert just as it was beginning, and I figured I would start unwinding from the week as I got into the concert. The piano duet preceding the jazz guitarist was a pleasant surprise, and I could feel myself begin to relax from the stresses of the week, except that the pain I had experienced early in the morning was becoming noticeable again. By the time the jazz guitarist got rolling I found my attention divided between his music and my body's perplexing scapular pain.
My mind vaguely connected the fact that I had in fact had this pain earlier in the week (though higher in the shoulder), while jogging after work. It had gone away as soon as I had stopped jogging and I figured it was just mild phrenic nerve stretching caused by really expanding my lungs and diaphram as I was running hard.
By the second guitar piece I was really working hard to stay with the music. Instead, my mind was beginning to actively assess my