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doctors & mechanics
today i woke early, showered, put on presentable normal-people clothes, and went to the hospital with my dad. and then, of course, switched out of the presentable normal-people clothes into scrubs, so that i could come watch his cases.
this morning was two nasal/sinus surgeries, ambulatory, with the ENT surgeon being the old family friend that my dad's sailed with for years and years. for the first one, correcting a deviated septum + turbinatectomy, he used the scope, with the video up on a big monitor; the second one was simpler, and he did that one without the scope. i got very woozy during the first, at the bit where he was removing most of the cartilage plates out of the septum. had to sit down on the floor. the OR nurse was wonderfully sweet, went and got me gingerale and a wheelchair to sit in, and after a few minutes my head cleared again and everything was fine. as before, the strongest impression i left with was "we do this, and it makes things better?!? the human body (and all bodies) are...such amazing complicated mostly-functional systems. wow." also, i'm still pretty sure i don't want to be a surgeon. it's fascinating, but it seems to require a very particular sort of self-confidence, and beyond that, it's very much a craft-skill: cutting, patching, taping, stitching, stapling, yanking, screwing or wiring things together. and so much of the craft-skill seems impossibly crude, compared to the cost of doing things wrong, and compared to the elegance of the body itself. (something new, a further articulation: i don't see myself being incapable of doing surgery, or of doing it well. but i'm pretty sure it's not what i want to be doing most or all of the time.)
i met with both patients before and after the surgery, sat in on the pre-anaesthesia interview and talked with them a little as they come back awake. the second patient was a sweet, delicate old woman, an artist. the surgeries, as always, were pretty gruesome, cartilage and squishy bloody sinus-bits getting pulled out one by one, but both people upon waking smiled, and were already able to breathe more easily, and were feeling woozy but pretty much all good.
from there, my dad stepped in to start the anaesthesia for a patient with a very badly broken ankle, since the scheduled doctor was stuck in traffic. i only got to see the beginning of that one (the prep, opening up the ankle, and the start of the bone-setting) but that was pretty neat -- a crooked fracture and some seriously torn ligaments, and the surgeon was putting in a seven-screw plate.
the afternoon was a colonoscopy on a dignified old-Charleston-family lady, and the placement of a feeding tube into the stomach of a brain-damaged patient. that last was sad, and difficult...there was hassle and trouble with paperwork, difficulty with the equipment in the room and with the procedure, and his situation was not a good one. but it worked out as well as it could, and he'll at least be more comfortable.
the useful conclusion, from this and from my time standing in with my grandfather in the clinic, is that the practice of medicine still fascinates me, and it still feels very much like a good, right direction for me to go. selah.
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...and then i came home and called the mechanic.
the short form is that the oil leaks i've been seeing over the past several months may be partly due to old gaskets, but that the root problem is internal blow-by. the good solution to this problem is to either overhauling the engine or putting in a 'new' rebuilt one. his take was it makes more sense to put in a new engine, because after labor costs at his shop and the machine shop, overhauling the current engine costs more, and a factory-rebuilt engine comes with a 100,000mi/3yr warranty.
my options were, if i planned to keep Matilda, to
a) not do anything, keep putting oil in, and pray i don't get stranded somewhere unfortunate
b) replace the oil pan gasket & rear main oil seal, which would cost a big pile of money and probably just result in an oil leak showing up somewhere else. also praying not to get stranded.
c) rebuild/replace the engine, which costs a really big pile of money, but in theory gives me a shiny new entirely-working reliable engine.
the larger perspective options were:
a) fix Matilda
b) get another new/used car
c) not have a car.
...there are no choices that are not painful. but in the end...well, right now, i can (kinda) afford to fix Matilda properly. i was hoping to save that money, but i hadn't yet decided what i'd be saving for, or where i'd put it, or anything. and this roadtrip has been time spent travelling, living, learning, joyous, difficult...but always intensely interesting, always full. and travelling in this particular car has made it so that even the time spent behind the wheel is wide-eyed laughing beautiful life; it lends another dimension, a little more soul. and, dammit, i'm only halfway around! there's miles and miles to go!
more practically, putting in a rebuilt, under-warranty engine would mean she should run well for at least a few more years with minimal maintenance...and if i want to sell her, i'm a hell of a lot more likely to be able to do it when she's got a new engine, as opposed to wonky rings, blow-by, and a multitude of oil leaks.
so, a little unexpectedly, it's still worth it. there was a little question, but not much. my mother put it together before i did, said, "Look, it seems pretty clear that what you really want is to fix this car." and my dad said, "I think you're making the right decision, given the situation. But in the future...don't ever give your car a name." *laugh*
(since i started making the plans for this roadtrip, i've been saying "10,000 miles or as far as the car will take me," and saying that if she died on the road i'd just ditch, ship everything back in boxes, and fly home. but...i failed to consider exactly how attached i am to this vehicle, and more importantly, that driving all over lovely twisty highways and having a ridiculously powerfully good time would make it that much harder to just let Waltzing Matilda go, especially to such a rough and ungraceful end.)
more details, for my own notes and for other car-geeks: what the mechanic said was that the rings that seal the pistons had probably gotten slightly warped, if the car spent a lot of time sitting...which is likely, given that in 18 years it had 38k miles on it. in any case, when the fuel combusts in the chamber, most of the pressure is put into moving the piston, but some of it blows back past the rings. minor blow-by is normal, and the excess pressure is relieved by the PCV valve, but the PCV valve can only handle so much pressure before some of it is shunted back into the engine. thus, the internal pressure of the engine increases enough to force oil out of anywhere it can come out. he measured the blow-by on the engine, and could see it coming out on both sides of the valve. so while the gaskets were clearly 20 yrs old and disintegrating, putting in new gaskets would be only a temporary fix, and he said that he was seeing leaking from the timing cover gasket, which is new.
he didn't speak specifically about the cause of the intermittent front-end vibration, but he did say that the PCV valve was working, and that cleaning the solenoids in the throttle body would very likely fix the over-rev problem i've been seeing for the past couple of years.
and now the day is done. time for sleeping, soon. tomorrow is another full day.
this morning was two nasal/sinus surgeries, ambulatory, with the ENT surgeon being the old family friend that my dad's sailed with for years and years. for the first one, correcting a deviated septum + turbinatectomy, he used the scope, with the video up on a big monitor; the second one was simpler, and he did that one without the scope. i got very woozy during the first, at the bit where he was removing most of the cartilage plates out of the septum. had to sit down on the floor. the OR nurse was wonderfully sweet, went and got me gingerale and a wheelchair to sit in, and after a few minutes my head cleared again and everything was fine. as before, the strongest impression i left with was "we do this, and it makes things better?!? the human body (and all bodies) are...such amazing complicated mostly-functional systems. wow." also, i'm still pretty sure i don't want to be a surgeon. it's fascinating, but it seems to require a very particular sort of self-confidence, and beyond that, it's very much a craft-skill: cutting, patching, taping, stitching, stapling, yanking, screwing or wiring things together. and so much of the craft-skill seems impossibly crude, compared to the cost of doing things wrong, and compared to the elegance of the body itself. (something new, a further articulation: i don't see myself being incapable of doing surgery, or of doing it well. but i'm pretty sure it's not what i want to be doing most or all of the time.)
i met with both patients before and after the surgery, sat in on the pre-anaesthesia interview and talked with them a little as they come back awake. the second patient was a sweet, delicate old woman, an artist. the surgeries, as always, were pretty gruesome, cartilage and squishy bloody sinus-bits getting pulled out one by one, but both people upon waking smiled, and were already able to breathe more easily, and were feeling woozy but pretty much all good.
from there, my dad stepped in to start the anaesthesia for a patient with a very badly broken ankle, since the scheduled doctor was stuck in traffic. i only got to see the beginning of that one (the prep, opening up the ankle, and the start of the bone-setting) but that was pretty neat -- a crooked fracture and some seriously torn ligaments, and the surgeon was putting in a seven-screw plate.
the afternoon was a colonoscopy on a dignified old-Charleston-family lady, and the placement of a feeding tube into the stomach of a brain-damaged patient. that last was sad, and difficult...there was hassle and trouble with paperwork, difficulty with the equipment in the room and with the procedure, and his situation was not a good one. but it worked out as well as it could, and he'll at least be more comfortable.
the useful conclusion, from this and from my time standing in with my grandfather in the clinic, is that the practice of medicine still fascinates me, and it still feels very much like a good, right direction for me to go. selah.
---------------------
...and then i came home and called the mechanic.
the short form is that the oil leaks i've been seeing over the past several months may be partly due to old gaskets, but that the root problem is internal blow-by. the good solution to this problem is to either overhauling the engine or putting in a 'new' rebuilt one. his take was it makes more sense to put in a new engine, because after labor costs at his shop and the machine shop, overhauling the current engine costs more, and a factory-rebuilt engine comes with a 100,000mi/3yr warranty.
my options were, if i planned to keep Matilda, to
a) not do anything, keep putting oil in, and pray i don't get stranded somewhere unfortunate
b) replace the oil pan gasket & rear main oil seal, which would cost a big pile of money and probably just result in an oil leak showing up somewhere else. also praying not to get stranded.
c) rebuild/replace the engine, which costs a really big pile of money, but in theory gives me a shiny new entirely-working reliable engine.
the larger perspective options were:
a) fix Matilda
b) get another new/used car
c) not have a car.
...there are no choices that are not painful. but in the end...well, right now, i can (kinda) afford to fix Matilda properly. i was hoping to save that money, but i hadn't yet decided what i'd be saving for, or where i'd put it, or anything. and this roadtrip has been time spent travelling, living, learning, joyous, difficult...but always intensely interesting, always full. and travelling in this particular car has made it so that even the time spent behind the wheel is wide-eyed laughing beautiful life; it lends another dimension, a little more soul. and, dammit, i'm only halfway around! there's miles and miles to go!
more practically, putting in a rebuilt, under-warranty engine would mean she should run well for at least a few more years with minimal maintenance...and if i want to sell her, i'm a hell of a lot more likely to be able to do it when she's got a new engine, as opposed to wonky rings, blow-by, and a multitude of oil leaks.
so, a little unexpectedly, it's still worth it. there was a little question, but not much. my mother put it together before i did, said, "Look, it seems pretty clear that what you really want is to fix this car." and my dad said, "I think you're making the right decision, given the situation. But in the future...don't ever give your car a name." *laugh*
(since i started making the plans for this roadtrip, i've been saying "10,000 miles or as far as the car will take me," and saying that if she died on the road i'd just ditch, ship everything back in boxes, and fly home. but...i failed to consider exactly how attached i am to this vehicle, and more importantly, that driving all over lovely twisty highways and having a ridiculously powerfully good time would make it that much harder to just let Waltzing Matilda go, especially to such a rough and ungraceful end.)
more details, for my own notes and for other car-geeks: what the mechanic said was that the rings that seal the pistons had probably gotten slightly warped, if the car spent a lot of time sitting...which is likely, given that in 18 years it had 38k miles on it. in any case, when the fuel combusts in the chamber, most of the pressure is put into moving the piston, but some of it blows back past the rings. minor blow-by is normal, and the excess pressure is relieved by the PCV valve, but the PCV valve can only handle so much pressure before some of it is shunted back into the engine. thus, the internal pressure of the engine increases enough to force oil out of anywhere it can come out. he measured the blow-by on the engine, and could see it coming out on both sides of the valve. so while the gaskets were clearly 20 yrs old and disintegrating, putting in new gaskets would be only a temporary fix, and he said that he was seeing leaking from the timing cover gasket, which is new.
he didn't speak specifically about the cause of the intermittent front-end vibration, but he did say that the PCV valve was working, and that cleaning the solenoids in the throttle body would very likely fix the over-rev problem i've been seeing for the past couple of years.
and now the day is done. time for sleeping, soon. tomorrow is another full day.