Many years ago, I had coffee with a friend at her apartment. My friend lived a block up the street from a high school, and across the alley from a retail/office building. I looked up from my coffee and saw five young men - high school boys - huddled in a circle in the loading dock of the building across the alley. My immediate thought was that it was drug deal underway. (It wasn't a thought of alarm - just an observation.) In the next moment, I saw that it was raining, and I realized that the young men were merely having a conversation out of the rain. But why had I assumed that drugs were involved? Was it because all five of the young men were black? That thought worried me.

I told my friend that I just had a racist thought, and I told her of the thought process I'd had. Before I finished, my friend had already started shaking her head no. "You're not a racist at all," she told me, "Look at the way those boys are dressed." I realized that she was right. It was the thug gangster outfits I was seeing, and not the color of the young men's skins. I honestly do not consider myself a racist. I do tend to have first impressions based on the way a person chooses to dress.

A few weeks ago, a young man came into our clinic for the first time, and I helped set up his new account. That's always a sad and tense event, because it means that the patient had very recently been diagnosed HIV positive. In the process of entering his demographics into my computer, the patient told me that he was homeless. Judging by the nice state of his clothes, I guessed that he had not been homeless for very long. He was accompanied by a man about his age, who was dressed in a stylish suit. The man in the suit made sure that everything was taken care of properly. I assumed that the man in the suit was the patient's case manager.

The patient came in later for his followup appointment. I checked him in. Then I went to lunch. At the elevator, I was stopped by the suit, who had just stepped off the elevator. The suit asked if I remembered him, which I did. The suit was concerned that the patient had made it to his appointment on time, which he had.

The patient came in today for his followup appointment. I checked him in. The patient told me that his boyfriend would be arriving later, asking for him, and would I mind telling the boyfriend that the patient would meet him in the waiting room?

A while later, the suit showed up and asked me if the patient was still there. Then it struck me: The suit was the boyfriend, not the case manager. I couldn't get over what an odd couple they seemed to be. It had nothing to do with their different races. It was the stylish suit and glasses on one, and the t-shirt, jeans, windbreaker, and nightwatchman's cap on the other. What did they have in common? (It did occur to me that it was the same stylish suit I'd seen each time.)

Then, when I saw them reunited after the appointment, in a more relaxed situation than that first appointment, and I saw their body language, and their PDsA, I thought they looked like a perfect couple.

I walked past a coffee shop on my way home. I glanced in the window. There was the suit and the patient, having what looked like a pleasant conversation. It made me happy, for some reason I couldn't quite place.

At a staff meeting this morning, we talked about our clinic's high "no show" rate. With an average of 25% no shows per day, our clinic has one of the higher rates in the hospital. It was generally agreed that the nature of our patient population is a major factor. Then I spoke up. I said that I've observed that there are a few of our patients who take advantage of their ability to been seen on a walk-in basis in order to avoid being tied to a schedule. They will readily accept any date I schedule them for, I continued, then show up when they're in the mood to and say, "I think I've missed my appointment - is there any way I can be seen today?" One of the doctors told me I was absolutely correct in that observation.

Being a primary care clinic, in a public hospital, we are prevented from refusing care to anyone - no matter how bad their no show rate is. The doctor had an interesting proposal, however: What if we refused to schedule appointments for certain patients, and allowed them to be seen on a walk-in basis only?

A geocacher named fauxSteve sent us an email today. He said he'd been thinking about the problem "White Noise" has been having with its adhesion. (He was the Second To Find, and found it because it had fallen onto the ground.) He suggested a solution that made a lot of sense to me. So, tonight I went out and re-did White Noise with fauxSteve's design. That was very nice of him.

Phillip walked into Broadway Video on Saturday afternoon and walked out with The Adventures of Sharkboy and Lavagirl in 3-D. It wasn't a movie I would have picked out, but - hey - I'm open to a new adventure. This is a silly and imperfect movie, but I watched it with the awareness that I am not the intended audience. I'm not saying that all kids' movies are silly, or that all silly movies are for kids. I just mean that this is a kids-kind of silly movie. It was a lot of fun, and I thought it was a very well made and inventive movie. (I didn't bother watching it in 3-D.) Then I watched the "making of" extra feature - one of the better "making of" features I've ever seen - and learned that the movie was actually written by a six-year-old. So, there you go. Brain storm!

Phillip and I went geocaching yesterday afternoon. I picked out five caches in the Laurelhurst neighborhood. Laurelhurst is a pretty neighborhood, but, although Phillip and I have lived in Seattle for about twenty years, each, neither of us had ever been to Laurelhurst until yesterday. The first cache took us along 45th Street. I've wondered about that street - it seemed to be a major eastbound route - every time I've headed north on Sandpoint Way, past Children's Hospital, on my way to other destinations, but I'd never followed my curiosity and taken the detour to see where it went. Yesterday, we drove along 45th Street. Geocaching has its benefits.

We sought five caches and found four. For the record (not that it really matters), the fifth cache was a "Did Not Find" due to terrain. It was hidden in a wetland that was flooded yesterday. According to the logs, we were following, pretty much, a geocacher named Fish Soup. He was on a University District/Laurelhurst run. Fish Soup also logged a DNF on the same cache that we did, for the same reason, according to his log. I thought it was interesting that he and we were on the same geocaching level - he with 143 finds, and we with 149 finds - until Phillip pointed out to me that Fish Soup has been geocaching only since mid-October. There are a lot of geocachers in our area who put a lot more effort into the game than we do - and a lot who don't put nearly as much effort as we do.

There are about five to seven geocachers in our area who log the vast majority of "First To Finds." They have become known as "The Usual Suspects." I think the term was first used as the title of a geocache in West Seattle. The name has been showing up a lot in cache logs, cache descriptions, and cache titles. They've formed a sort of clique. More and more new caches are showing up by The Usual Suspects that reference the group (i.e. "Fishy Works Near Here"). It shouldn't bother me at all, but it does a little. It spoils the open, friendly, cooperative nature of the game. Phillip and I continue to geocache at our own pace, logging our finds and our DNFs, enjoying the game, knowing that the chance of us logging a "First To Find" is pretty slim.