Tuesday, October 17, 2017

Proposal

Me: "Do you have any other questions for me?"

Patient: "Yes. Will you marry me?"

Me: [laughs]

Patient: "I'm sorry.  I put you in an awkward position.  You don't want to marry me, but you don't want to upset me by saying no."

Me: "I'm already married."

It would have been a lot more flattering if the patient weren't ninety years old.  And mostly blind. 

Still, it's nice to know I have options!





Tuesday, October 10, 2017

Food boredom

I am officially bored of everything I cook.

Worse, my family is bored of it.  I've started bringing home food for my daughter from the hospital cafeteria because she was so bored of everything I made for her.  You know things are bad when the hospital cafeteria is a treat.

Any easy meal ideas?  I have about 20 minutes to make dinner before I turn into a pumpkin.  (Seriously though, I don't cook anything that takes much longer than 20 minutes.)

Monday, October 2, 2017

Antibiotic overuse

I went to med school in a place where Lyme disease was endemic.  So when I was on my Medicine rotation and one of my co-students complained about feeling tired and achy for a few days, our attending immediately said to him, "Get tested for Lyme disease."

The student was reluctant.  He didn't have a rash.  Our student health plan was crappy with a huge deductible, so he would have had to pay for the test out of pocket.  Also, I pointed out (from a personal Lyme scare) that he could get a false negative this early on.

"Well, if you don't want to get the test," the attending said, "I'll write you a prescription for doxycycline and you can just treat it."

And then we saw another attending, who totally agreed with this.

Even years later, I still find this offensive.  The course of treatment for Lyme is 10-21 days of antibiotics.  Would you really give someone up to THREE WEEKS of antibiotics because they were tired and achy a few days?  I took doxycycline and it made me throw up... not something I'd personally be excited to take for weeks for no reason.  And... hello, antibiotic resistance?

I'd like to believe that the attendings were just overtreating because it was a colleague and not something they recommend to all their patients.

Friday, September 22, 2017

Goodbye, Cyndi Lauper

When I first started practicing, any time a patient would have brain surgery, the surgeon would inevitably shave half their head to do the surgery.

I found this practice ridiculous.  The patient would come out of the surgery looking like Cyndi Lauper at her worst.  I have never witnessed anyone who looked good with half their head shaved. (Including Cyndi.)  I always felt like it then fell to us to deal with the remaining hair.

More recently, the trend has changed.  Instead of shaving the whole head, the surgeon will just shave a teeny area at the incision site.  So instead of rocking Cyndi Lauper, the patient looks pretty normal post-surgery.

From a perspective of compassion for people's vanity, I think this is awesome.  I love it.  It's bad enough you have to have brain surgery without losing all your hair and changing your entire appearance.  So I'm glad about this change.

But from the perspective of the doc who has to monitor these incisions, it's so.  Annoying.  Half the time, I have to do a search for several minutes to find the damn incision.  If it started looking worse, it would be really hard to tell.  And digging staples out that are caked in both dried blood and hair is not a fun task.  Shouldn't we put patient safety above hair?

I'm really torn on it, honestly.

Thursday, September 14, 2017

What day is it?

Me: "What is today's date?"

Patient: "Well, it's the day after yesterday!"

I'm going to have to remember that one for when I'm old and confused.

Thursday, September 7, 2017

The Pediatrician's Dilemma

A friend of mine who is a pediatrician told me the following story.

He has a patient who is a little girl with some chronic medical issues.  The girl's mother had some legitimate issues with the nursing care that the girl was receiving while hospitalized as an inpatient.  Although this was not the pediatrician's fault, the mother apparently laid into him, screaming at him publicly for a good five minutes.

Of course, the girl is still hospitalized and he's the pediatrician on the inpatient service right now.  So now he has this awkward situation with the patient's mom.  He said that if this girl had been one of his clinic patients and he'd been treated that way, he would have requested she find a new doctor.  But since the girl is hospitalized and probably will be for another week or so, he's stuck.

"I just have to suck it up," he told me.

That's a rough situation though.  Even though the mom screamed at him, she didn't fire him so he's still allowed to see her daughter.  Is there really no alternative to treating a person whose family was verbally abusive to you?

Wednesday, August 30, 2017

Back to school

For my soon to be fifth grader, this was the list of supplies she needed for school:

2  binders
4 single subject notebooks (multicolored)
5 folders (different colors to coordinate with notebooks)
Scissors
Colored pencils
Multicolored pens
Notecards
Pencils: 2 boxes
1 package eraser tops
2 Glue sticks
1 box of markers
1 box CRAYOLA crayons
Post-it notes
1 Highlighter
1 Box of tissues
1 canister Clorox/Lysol wipes
1 Roll of paper towel

I got it all at CVS for $60, which felt a little ridiculous.  Why SO MUCH stuff?  Especially since I guarantee after one month, all of these things will be lost in the recesses of her bag.  If I ask her for a single pen from her bag in November, she can't find one.

Also, a roll of paper towels??  She really needs to carry an entire roll of paper towels AND a canister of Lysol?  Seriously?  How dirty do they expect things to be getting over there?  

And this is why I have back problems.  Because I spent my entire childhood lugging around THAT.

Friday, August 25, 2017

WTF abbreviations

These are three more abbreviations I saw in a single discharge summary yesterday that I couldn't figure out without google:

WBXRT

CRAO

PSC

I really do think there should be a list of standard abbreviations that are acceptable and everything else should be spelled out.

Monday, August 21, 2017

Woman docs

It seems like I can't book an appointment with a doctor anymore without being asked if I'm okay with seeing a man.

OK, they didn't ask me when I booked an eye doctor appointment.  But when I recently scheduled an urgent care visit for a stomach bug that was taking a long time to clear up, they asked me.  And the OB/GYN office always asks.

Personally, my first pap was done by a man, and I really liked him.  My second regular ob/gyn was also a man and also great.  Yes, I'm a little more uncomfortable being examined down there by a man, but honestly, it's uncomfortable either way.  It depends on the doctor more than it depends on the gender of the doctor.  It's only a recent thing that there are enough female doctors that patients can even get a choice.

What bothers is me is that when they specifically ask me, it makes me feel like maybe I *should* request a woman.  Why can't they just mention the doctor's name and see if I protest?

Also, has a man *ever* been asked if he was okay with the gender of his doctor?

At work, I have also been put in positions from time to time where I was pressured to see a patient for no other reason than they had "woman problems," when I believed another doctor was better trained to treat their issues.  I'd have no problem with it if the woman had specifically requested a female physician, but that was never the case.  It was always decided that "she'd probably prefer a woman."  Sometimes I feel embarrassed to march in, knowing that I'm only there because of my XX chromosomes.

Thursday, August 10, 2017

Badge reversal

We recently got an influx of new nurses at work, and I'm awful with names, so I've been struggling to keep it all straight.  I pride myself in knowing everyone's names, so I hate it when I have to ask for something from a nurse whose name I don't know.

Anyway, yesterday I was asking a nurse a question during a meeting, and I couldn't remember her name.  I checked her badge, but her badge was flipped over so I couldn't read it.

Then I looked around the room and discovered that with only a couple of exceptions, every single person in the room had their badge flipped over so you couldn't read their name.  (You'd think just by chance, half would be correct.)

There's something about that which really bothers me.  Badges are required at work for a reason.  Whatever that reason is, I'm sure 80% of badges being flipped the wrong way is not in the spirit of the reason.