Wednesday, February 10, 2016

VA work ethic

A while back, I used to do outpatient clinic at the VA and our clinic receptionist was possibly the worst receptionist I’ve ever seen ever.

I've done a lot of clinics in the last few years and dealt with a lot of nurses and receptionists... and for the most part, they have been pretty good. I mean, some have been great, some have been okay, and some have been not so great. But this woman, let's call her Hilda, was amazingly bad.

I don't know what her job entailed exactly because every time anyone asked her to do something, she replied, “That’s not my job.” Basically, every time I came to her desk, she was either chatting with patients or more likely chatting with a friend on the phone. When a patient arrived, we (the doctors) would call the patient out of the waiting room ourselves and bring them to the examining room. I guess she scheduled patients for regular visits, but she wasn't even allowed to schedule any of the EMGs, Botox, epidural steroid injections, or anything else because she was constantly accidentally overbooking patients. So we (the residents) had to do much of the scheduling.

She definitely didn't clean the examining rooms. When I walked into the examining rooms in the morning, they looked like a hurricane hit. There were dirty gowns strewn around the room, dirty tissue paper on the tables, dirty pillows on the examining tables. When I was 40 weeks pregnant, I had to change dirty pillow cases and put new sheets on the examining table for every patient I saw, because Hilda said “that wasn’t [her] job.” One of the rooms ran out of tissue paper to put on the examining tables and I asked her if she knew where more was, and she didn't. She'd been working there for YEARS and she didn't even know where the paper was for the tables?? I had to ask my attending to change the paper on the table.

Another resident told me a story about Hilda: he was doing consults in another part of the hospital, so he asked Hilda to page him if one of the clinic patients showed up. (We had a high no-show rate.) A patient showed up and Hilda just let the patient sit there for over an hour and didn't bother to page the resident or any doctor to let anyone know the patient was there. She said she “forgot.”

I remember there was one week when Hilda called in sick to clinic, and me and the other resident did the receptionist work. We basically just put a sign-in sheet near her desk and grabbed the charts ourselves. It wasn't any extra work whatsoever.

I have honestly never been in any other situation where the residents had to schedule their own patients, room their own patients, and clean their own rooms after every patient. But I guess it’s the culture of the VA that useless, lazy, or incompetent people can’t get fired. An attending at the VA once said to me that the only way to get fired from a VA job is that you’d have to make babies with a dead patient three times. The first two times you made babies with the dead patient, you’d just get a warning.

Saturday, February 6, 2016

Lesser evil

I haven't written anything political on here in a long time, but I have to say, with the primaries officially underway, I spend a good amount of time with my husband (who I usually agree with politically) arguing over our choice of candidates.

He thinks that Trump becoming president is the worst thing that could happen to this country.

I think that Ted Cruz becoming president is worst thing that could happen to this country.

In reality, the idea of Trump becoming president is incredibly frightening. But on the other hand, Cruz is vocally against all the issues that are personally really important to me: Gay marriage, Planned Parenthood/abortion/birth control, global warming, gun control, Obamacare.  Don't get me wrong, Trump is on the wrong side of all of these issues, but not quite as vehemently.

On the daily show, they compared it to a blood clot versus cancer. I can't remember who was who.  

Thursday, February 4, 2016

Mystery email

This was an email that my mother sent me yesterday:

"Got two leg wrenches. What about the elves?"

It took me a long time and deciphering one typo before I figured out what she was talking about. Any guesses?

Wednesday, February 3, 2016

Med school living

I lived in college dorms for four years but I've never experienced such shitty living conditions as in my med school dorms. I give you an example of messages they have left me on my answering machine:

"Sorry to inform you that your water will be shut off for the entire weekend, from Friday night through Sunday at midnight."

"We will be replacing your carpet tomorrow. Please remove all items from the floor of your room."

"You have failed inspection due to boxes in your kitchen. You will be charged a penalty."

"Workers will be entering your individual rooms every morning this week."

"An exterminator will be coming this week. Please remove all food and other items from the kitchen."

"Due to unforeseen circumstances your water will be shut off until 6 PM today, starting in ten minutes."

Saturday, January 30, 2016

More sitcom recs

My husband and I are once again out of TV shows to watch. We recently finished binge watching most of the episodes of a few really good series:

Master of None
Silicon Valley 
Brooklyn 99
Peep Show
Inside Amy Schumer
Nathan for You

Now we yet again need a 30 minute sitcom to fill in the gap. We want something that's funny and that is no longer than 30 minutes.

Any recommendations?

Here are some other examples of sitcoms that we have both liked:
The Simpsons
King of the hill
The office
30 rock

Sitcoms we have tried watching and not liked:

Bobs Burgers 
Arrested development 

The series should be available on Netflix streaming or Hulu. Also, don't bother recommending the Big Bang theory, how I Met your mother, or modern family. Those are all shows that I like that my husband won't watch.

Wednesday, January 27, 2016

Friday afternoon

Years ago, when I was a medicine intern on the consult service, I got a page from the PA on the vascular service at 4PM on a Friday afternoon, the second I had gotten home because I thought we were done for the day.

The PA said to me, "Gee, sorry to be calling such a late consult, but... we need help with this guy."

The PA explained he was a 75 year old man who was about to go for surgery for revascularization of the leg, but they cancelled it due to pneumonia.

"So do you need help managing his pneumonia?"

"Well, we already consulted pulmonary about that, so they're managing his pneumonia," the PA said. "Also, he's having some blood in his urine."

"So do you want help with the bloody urine?"

"No, urology is already consulting on that." Thoughtfully. "He also has vascular problems in his legs, but we're managing that...."

"So what is your question for US?" I asked. .. that you're calling late on a Friday afternoon for.

"Um.... I guess we just need help managing all his issues..."

"What issues? You already have pulmonary and urology on board, so what are we supposed to do?"

"We just want to make sure there's nothing we're missing."

"But I can't say that to my attending. You have to have a question for us."


"Is there anything specifically that you want us to manage?"


Finally, I tried to help him: "Do you want us to clear him for surgery next week?"

"Oh... uh, okay!"

Of course, it was totally ridiculous. I called my attending and I was like, "I don't really know why they're calling about this guy. All his issues are being managed. They want us to get him ready for surgery, but he's already on a beta blocker. It's kind of a bullshit consult."

My attending said: "Are you already home?"

I admitted that I was. But who would have thought I'd get a consult at 4PM on a Friday? Especially when it's a very non-urgent consult.

The attending was nice to me and admitted that it was a bullshit CYA consult. She said I didn't have to come back to the hospital. Thank you to the attending who didn't make me come back to the hospital at 4PM on a Friday for paperwork.

Wednesday, January 20, 2016

Read it over!

My husband has a history of sleep apnea and has had to use a CPAP for years. Recently, his doctor told him about an oral appliance you could use to replace it. Unfortunately, in order to get the insurance company to pay for it, he had to undergo a total of three sleep studies and other testing.

After the sleep studies qualified him for the device, he got a message from the pulmonologist's office saying that the insurance has denied the claim. When my husband asked for further information or to speak to the doctor, they said that the doctor didn't deal with insurance. End of story.

After a few more pissed off phone calls from my husband, the doctor agreed to write a letter to the insurance company on his behalf. But both of us got sort of irritated that the doctor clearly did the letter on a dictation program and didn't even bother to read it over:

Seriously, is this the way people practice medicine in this day and age?

Monday, January 18, 2016

New Stethoscope

I'm trying to decide if I should buy a new stethoscope.

I bought my Littmann cardio stethoscope during my second year of medical student, over 10 years ago, and I still use it to this day. I replaced the earpieces and the bell cover has fallen off, but it still works.  It just seems sort of… grimy.  Plus it's way heavy to carry around my neck considering how seldomly I actually need to use it (a few times a day, maybe).

Then again, it seems like a waste to buy a whole new stethoscope considering I don't use it very much.

Also, unrelated, The Psyching is free as a short story on smashwords. You can download it in any format.

Wednesday, January 13, 2016

Parking lot surprise

Yesterday when I was coming home from work, I saw something surprising in the hospital parking lot:

A used condom.

OK, I'm not entirely sure that it was used. I can't verify that. But it was out of its package and crumpled up on the sidewalk.

And this wasn't in the back of the parking lot either. It was in the second row of cars, right in the middle. Also, it definitely hadn't been there in the morning, which meant that the condom was abandoned during daylight hours.

All I can say is: wtf???

And you know what the worst part is? This is actually the *second* time I've seen a used condom in that hospital parking lot.

Wednesday, January 6, 2016


When I was in residency, there was one resident who used to always buy Christmas gifts for all the attendings. Of course, we all thought he was a kiss up scumbag for doing it. I mean, who buys Christmas presents for all the attendings besides a kiss up scumbag?

I'd like to believe that the attendings all saw through his behavior, but I'm not so sure. Everybody likes getting presents, right?

As a full-fledged physician, I somehow find myself in a similar dilemma. I have a boss that I really like, but I don't get him a Christmas present because none of his other employees do. I mean, there are a lot of other people at work that I really like and I don't get them Christmas presents. Frankly, I feel like if I got a present for one person, it would go down some horrible road of "well, if I get a present for this person, then I must get a present for this other person" and so forth. And as much as some people enjoy getting presents, it's a much worse feeling to get left out of present giving. So I don't buy presents for anyone at work because I would inevitably manage to leave somebody out and hurt their feelings.

So essentially, if I got a present for my boss, I would only be getting a present for him because he's my boss.

And that would make me a kiss up scumbag, right?