Monday, December 31, 2012

Spam

I just want to say that I hope you people appreciate how much spam I've had to wade through since I got rid of captchas so you could comment more easily.

I just deleted an ad for "ejaculation trainer reviews." Not even just an ejaculation trainer, but reviews for ejaculation trainers. Because there are apparently more than one of these horrible things (whatever they are--don't want to know), and people need to see multiple reviews to make an informed decision of which ejaculation trainer is best for them.

So yes, you're welcome.

Seating Rank Order


Sunday, December 30, 2012

How was your holiday?

One really annoying thing from coming back from a holiday or even a weekend is that everyone asks how your holiday/weekend was. It's another of those pleasantries that I find really ridiculous. Nobody cares how my weekend or holiday was. And now I have to figure out a way to answer that question without being boring.

And god forbid I don't ask someone how their weekend or holiday was. That would be really rude of me.

I propose we all stop asking questions that we don't care to know the answer to. Starting...... now.

Gone too far....

Me: "Do you think my posts sound like 'me'?"

Husband: "I dunno. Maybe a little too whiny."

Me: "Gasp! Are you implying I'm too whiny??"

Husband: "Well you do have a weekly whine. Plus a lot of daily whines too."

Me: "I guess I should be grateful you don't think I'm whiny in real life."

Husband: "I just assume you are whining to yourself all the time."

Me: "Secretly?"

Husband: "Yeah, like in your head."

Me: Well, I'm thinking of whines to put on the blog."

Husband: "But you have so many that sometimes you have a whine that isn't a weekly whine."

Me: "I know. It's out of control."

Husband: "I just think it's really funny how my purposely offensive post for you was the least offensive one."

And then he insisted that I write a whine about HIMYM and how it's so annoying that he still hasn't met the mother. Because seriously.

Types of Primary Care Patients


Saturday, December 29, 2012

Weekly Whine: Pager walkaways

You know what really grinds my gears? When someone pages you and then walks away from the phone.

It annoys me to no end when I try to promptly return a page, only to be met with endless ringing on the other line. When you page someone, you have to give them a grace period to answer the page. We can argue how long that grace period should be, but at least sixty seconds.

Yesterday I was waiting all afternoon to get a callback from a surgeon's office on my pager. When I finally got the page, at like 4:30, I quickly ran to a phone to return the page. The person who paged me was on the phone. I hung up and called back, this time getting a message that they had left for the day.

Friday, December 28, 2012

Presents

I have to be honest, I am not into presents.

I don't buy any presents. I don't receive any presents. I don't send any cards or Christmas letters or any of that.

Last year, I brought a plate of brownies to work for the holiday, but I subsequently realized that there are so many treats around now, when people bring in one more, the staff makes little vomiting gestures. So I figure I'll bring it after the holiday, when people might actually enjoy it.

When I was younger, like a teenager, I used to buy presents for my friends. But at some point, I became vehemently anti-present. And this is why:

I feel like presents, except those given to small children, are rarely appreciated. It's usually something you don't even want.

Furthermore, presents make other people feel left out. Every time I considered buying a present for someone I worked with, I realized that I'd have to give it to them in secret to keep everyone else I work with from being offended. Plus they wouldn't have gotten me something, so that would be awkward.

We got a Christmas card this year from the staff in our building. There are like eight of them. I said to my husband, "Are we supposed to give them all something?" I didn't even know who half the names were. But if I got something for one or two of them that we deal with, I'm sure the others would be insulted and, like, we'd have no heat this winter or something unexpected like that.

Same problem with daycare. There are probably like five or six float teachers that take care of my kids, plus their usual teachers, plus the directors. I knew that whatever I did, I'd probably leave someone out and make them feel slighted. Finally, I brought in three separate plates of cookies for each floor.

Describe Your Headache


Thursday, December 27, 2012

H/H

Is there any particular reason we always report the hemoglobin and hematocrit, consider they're almost always equivalent tests? What do we gain by listing both or calling it h/h or any of that?

Heart Conditions


Wednesday, December 26, 2012

Trendy Names

I am totally judgmental about how parents name their kids. Naming your child is a great privilege and sets the tone for their entire life. Maybe some parents freak out under this awesome responsibility, I don't know. But man, there are some terrible names out there.

I gave my kids The Best Names Ever. Obviously. But seriously, I'm pretty happy with them. One is a name that's persistently ranked around 80-100 in the top 100 names for the last half a century, meaning it's a well known name but one that isn't super common. The other is a very classic, timeless name that's common, but will likely never be dated. Of course, there are lots of great names out there, and most parents don't seem to screw it up.

What I don't approve of:

1) Giving your kid a non-name. Like naming them after a fruit, an article of clothing, a dishwashing detergent, or a feminine hygiene product. That's just wrong.

2) Trendy names.

I'm sure I'll take flak for #2 since by definition a lot of you have probably given your kids trendy names. I've said this before, but I just feel like the trendy names of today are going to be the old-fashioned names of tomorrow.

For example, would you name your kid Melvin? Probably not. But in 80 years, Mason is going to sound to the people of the 2090's exactly like Melvin does to us now. You are essentially naming your child Melvin. Think about it.

Furthermore, I've noticed another disturbing trend. It seems like a lot of recent popular boys names have evolved into girls names. For example, Jordan seems to have made a transition, and I'm noticing more and more little girls named Aiden and Riley (but spelled Rylee). How long before we start to have girl Masons out there?

So, essentially, when you name your child a trendy boys name, you may as well just name him Kelly or Ashley (both initially boys names!).

Stages of Needing to Pee


Tuesday, December 25, 2012

Weakly Whine: Being Skinny*

Recently one of my loyal commenters joked that I should write about how "Being Skinny Rocks". Except everyone already knows (or thinks they know) how being a skinny woman "rocks"-- basically, you get more attention from men. So instead I'm going to tell you why being skinny can really suck. Don't believe me? Read on...

1) I mentioned this in previous posts, but other people (especially heavier people) are constantly remarking on my eating habits. Half of them imply that I must be secretly anorexic. The other half see me eat some oreos or donuts after a lunch at McDonald's and assume I must be secretly bulimic! Sorry, but you're wrong on both counts. I eat a reasonable portion size, and sometimes I enjoy a small treat after my meal. There's no big secret here; I've found that if you practice some basic self-control it is easy to eat a satisfying meal while maintaining a very healthy BMI. Even if the wild accusations of others are just jealousy, it can really get to you
(Don't get me wrong-- there are obviously some people who struggle with obesity whose problems are not some simple moralistic "lack of willpower". For example, some of my bed-ridden patients who simply cannot get around like us able-bodied folks.)

2) Claims that my being skinny will somehow scar my kids-- it is totally inappropriate for someone to bring your kids into an argument like that. I'm proud to be a skinny mother of two. As a mother, it's important to set a good example for my kids, and as a doctor, I strive to set a good example for my patients. You could definitely argue the opposite point, actually. Overweight or obese parents set a terrible example for a young child, teaching them that an unhealthy weight is "normal". It's also unfair to the children who will (statistically) lose those parents early to heart disease or stroke.

3) The attention from men ain't all it's cracked up to be-- I don't want to blow this out of proportion, because I'm NOT trying to accuse any guys I know of sexually harassing me or creating a hostile environment. Mostly, I've just noticed that a lot of men tend to be a lot friendlier and more helpful to me and the other women around who are a healthy body weight. And I suppose that's just how men are. But frankly, I'm happily married and have two beautiful children. I'm not keeping my slim figure for their benefit, and I'm past the point in my life where I need to constantly be flirting with men. And look, I get that this attention is not fair to the heavier women. But it's not my FAULT either. The animosity displayed to me by those other women is what really creates a hostile environment for me. (It goes without saying that whatever great advantage they think I'm getting from this attention is all in their head; being skinny didn't get me Christmas off to spend with my kids!)

4) Finding clothes that fit-- I live in the United States, where the average clothing store mostly caters to the size of the average American. 'nuff said.

Skinny readers, feel free to add to my list in the comments.



*This satirical post was actually written by Mr. McFizz, who is on vacation now and clearly has too much time on his hands. He isn't skinny, but actually lost 40 pounds recently which I think is pretty great for him (his health at least... I'm totally into overweight guys). He said I would never post this, but clearly he doesn't know me very well. But I may take it down quickly if a firestorm results.

Tips for Step 1


Monday, December 24, 2012

Why Working Holidays Rocks

Aside from the annoyance of having to deal with childcare issues, I really like working on holiday weeks. It's like the funnest time to be working because:

1) There is so much food and treats everywhere. Yum.

2) Everyone is in a cheerful mood.

3) No traffic.

4) No trouble parking.

5) Generally tends to be easier, quieter days, at least where I work.

6) Excuse for any relative who complains that I'm not visiting: "Oh, sorry, I have to work!"

How long will you live?


Sunday, December 23, 2012

How to cut a surgical knot


Holiday Repeats

Well, it's Christmas week, which means everyone is either away on holiday or pissed off that they're not away on holiday or pissed off that they have to see their stupid family. In summary, everyone is either away or pissed off.

So I decided that I'm going to spend this holiday period reposting some of my favorite cartoons from the history of this blog with possible occasional new content.

Enjoy!

(Or else get further pissed off about the lack of new content.)

Saturday, December 22, 2012

Weekly Whine: Defriending

In the modern world, it seems like de-friending people on Facebook, Twitter, or whatever is really common. People will agonize over why so and so dropped them as a friend. Did I do something wrong? Were the ten billion photos of my newborn child one too many?

Probably, yes.

I'm on Facebook, but I've never dropped anyone as a friend. Partially because I don't know how. But also, I'm pretty sure that on any social media site, I can block things I don't want to read. In all honesty, there were a few people on my friends list who went a little overboard with the babies updates and I just couldn't take it anymore and so removed them from my feed. It was easy and they never knew!

I say we end this random "defriending" of people. It's fine if you defriend someone who's a stalker or doing something really reprehensible, but if you have to think about it, I say don't defriend. Why hurt someone's feelings?

Friday, December 21, 2012

Code Blue is not funny!

Yesterday I heard something that I had never heard before: the person announcing the code blue overhead started laughing.

I was in the bathroom when I heard the familiar beeping overhead and a woman announcing: "Code blue on 3 center, room 318."

A brief pause, then: "Whoops!" The announcer started giggling and said, "I mean, room 380. Code blue on 3 center, room 380. Hee hee."

Whoops!

Thursday, December 20, 2012

Defensive

In the ER, as an intern:

Me: "How much alcohol do you drink?

Patient: "I drink beer at night."

Me: "How many beers?"

Patient: "You know, a couple."

Me: "Well, how many? Like 2 or 3? 3 or 4?"

Patient: "Um, I'm not sure..."

Me: "If you had to take a guess though... how many beers a night?"

Patient: "Maybe 5 or 6."

Me: "Okay. Have you ever wanted to cut down?"

Patient: "You know, these questions are a violation of privacy."

Me: "Excuse me?"

Patient: "I mean, you're asking me 2 or 3, 3 or 4 beers... I feel like this is rehashing prohibition."

Me: "Prohibition?"

Patient: "Well, I guess you don't know much about American history. Prohibition was... look, I don't mean to lecture you. It just feels like... you know, there are some questions that are private that you're not supposed to ask."

Me: "I don't want you to feel like I'm singling you out. I have to ask everyone about their alcohol use. It's on the form and I have to fill something in. I don't want you to feel like I'm attacking you."

Pt: "No, I'm sorry... I just... I feel like some things ought to be private, you know?"

Me: "Yes, of course."

I wrote on his history: Patient became very defensive when asked about alcohol use.

Wednesday, December 19, 2012

Moms are always right

What is it about becoming a mother than means that suddenly you know everything about everything, and you are always right?

Because somehow this seems to be a magical process that happens to many women. They squeeze a baby out of their body and suddenly they become an expert on many things that they weren't an expert on just months previously. (And as I understand it, if the baby is squeezed specifically out of your vagina, that adds even more expertise.)

About a year ago, I wrote a post on Mothers in Medicine how at times, I am just a giant ball of stress, notably during the process of picking my kids up and getting them home. I wrote:

"I don't like stress. Stress stresses me out. While I adore my kids more than anything, it would be so nice to be able to take one shower without someone busting in on me and asking when I'll be done. It would be nice to spend a whole day in bed getting to do whatever I want to do. Something like that feels selfish, even decadent, to me now."

The responses, in general, were pretty supportive. But naturally, moms know best. So I got a couple that weren't quite as supportive with some "helpful advice." Such as, "Can't you use a bit of discipline? It sounds like she's spoiled."

Actually, I think my daughter being upset because every single day for the last two years, I've had a snack for her on the way home and this time I've failed to provide one is a pretty reasonable response for a small child. But thanks for that helpful advice, mama.

But my absolute favorite was this one: "Just an FYI, the baby shouldn't be wearing a coat at all in the car seat. You can't get it tight enough with the coat on."

CLEARLY, when you're stressed to the breaking point, the answer is to take all your kids' coats off in the freezing snow before buckling them in. That is something that obviously every mother does and it's not totally insane at all. Great, helpful advice that I was obviously just asking for. Thanks, mama.

Recently, a woman was publicly criticizing me online for my response to that particular comment to that post. She wrote:

"...She wrote about how difficult it was to buckle her daughter into the carseat because the daughter’s winter coat was so huge. Someone pointed out that it’s unsafe to buckle a carseat over a jacket and she’d solve her problem and keep her daughter safe by taking the jacket off.

She went ballistic.

I then posted a comment about how the carseat info was correct and I was shocked she responded with such vitriol. My comment was deleted."


First, for the record, I'm not a moderator for Mothers in Medicine, so I can't delete comments there and I'm innocent of that offense (it likely had links in it that got it filtered as spam). Second, I didn't write about "how difficult it was to buckle [my] daughter into the carseat because the daughter’s winter coat was so huge." I wrote about how my life is stressful. But certain mothers felt that they knew best and just had to weigh in, no matter how obnoxious it made them sound. No, I wasn't nice in my response. But I just freaking warned everyone in my post that I was really stressed out. If someone puts up a sign saying there are lions behind this door, you probably shouldn't open the door and tell the lions they're buckling their kids in wrong.

When I pointed out to this women how her comment made me feel, her response was, "I understand having a rotten day. But, please don't let your rotten day put your children in danger."

Because clearly, it's not about being right. It's that she was just sooooo worried about my poor little kids. People who give unwanted advice to other parents are really just compassionate souls worried about the poor kids.

Not that it's anyone's business, but my daughter has a compressible jacket that's "carseat safe." I told her this and she kindly retracted her comments and announced to the website where she'd been bashing me, "She assures me that her children are safe in special car seat safe jackets."

And everyone was so relieved. Because now Fizzy's kids are safe. Which is what everyone was just terrified about. Shit, they probably couldn't even sleep at night. It wasn't about being right at all. Or else nobody commented or cared.

I'm a mom so that means I apparently know everything. So here's some really wise advice:

Do not give other mothers unwanted advice about their kids just because you think you know better than they do. Ever. That's right, ever. They are doing a good job raising their kids. Your advice isn't going to do anything except raise their blood pressure.

Tuesday, December 18, 2012

Monday, December 17, 2012

Why Being a Doctor Rocks

I've written before about the downside of medicine, the limitations, why medicine is a crappy career for a mom, etc. I'm sort of getting the feeling y'all think I'm quite a Debbie Downer, and maybe I deserve that. I guess I just feel like so many people desperately want to go to med school and think of being a doctor as this amazing thing, so I'm just trying to keep it real (yo). I'm trying to honestly present the other side, because I don't think it's something people see a lot. People have thanked me for my honesty and told me that it's refreshing.

That said, there are a lot of great things about being a doctor. I mean, DUH. Still, I feel it needs to be said on this blog. So I'm going to slip from character and write a really positive post about some things I genuinely love about medicine:

1) There are few greater feelings in the world than when a patient profusely thanks you for helping them and changing their life. It happens more than you think.

2) The intellectual challenge of medicine is really fun, such as interpreting a tricky EMG (my fav) or trying to figure out the best way to treat a patient.

3) Being sick is really rough, and I love trying to be the compassionate person who treats my patients the way I hope to be treated in that situation.

4) I do get respect, sometimes more than I feel I deserve!

5) My kids are proud of me. My daughter thinks what I do is so neat. I got to give the doctor talk to her class one day and all the kids wrote me a thank you card.

6) I get to spend much of my day walking around and not crammed behind a desk.

7) This might not be true of everyone, but I love working with my hands, and medicine gives me tons of opportunities to do so.

8) The pay... well, it's pretty great. There, I said it.

9) Lots of job security in this economy.

10) A lot of physician jobs do give you the flexibility to work part-time. And because the compensation is so good, you can afford to work part-time.

11) There are so many options within medicine: you can be a teacher, you can do research, you can work with patients, you can be an administrator... or all of the above.

12) The privilege to get to do and see things that most people never get to do or see. I mean, I've seen an open heart surgery, dissected a dead body, counseled patients at the end of their life, administered life support, and I'm just a rehab doc. Seriously, how amazing is that?

13) The stories. I love a great story, and I love getting to know new patients and hear their stories. I feel like I could practically write a book about every single patient I meet. They're all fascinating in their own way. Especially in my field.

Just because I try to present the other side of a field that sometimes gets over-glorified, that absolutely doesn't mean I don't think being a doctor can be a rewarding career.

Tomorrow: Why having lots of money rocks.

Sunday, December 16, 2012

Don't take it seriously

Somehow I feel like this needs to be said:

The only things that truly matter to me are the health and welfare of my family, especially in scary times like these.

I write Weekly Whine posts to entertain you guys, as a distraction from the real world and real problems. Some people enjoy them, some not so much. But don't for even a second think that any of the issues I write about are ones that I feel vehemently about. Please believe me, I am not devoting any brain space to worrying about 3-D movies or kids with hyphenated last names. The things I truly worry about are not things I would ever write about on a public cartoon blog.

I'm not bothered by serving sizes any more than Jerry Seinfeld is bothered by the little black box on the plane.* Those posts are meant to be lighthearted and entertaining. But if it truly angers you so much to read the Weekly Whines, maybe you should avoid them for the sake of your own sanity. No hard feelings.


*Seriously, why don't they make the whole plane out of the little black box??

Ask a patient recently put on Elavil

Me: "Is the Motrin you're taking helping your back pain at all?"

Pt: "I guess so. But I don't like it because lately it makes me too sleepy at night."

Me: "I've never heard of Motrin doing that. That might be from the Elavil you recently started."

Pt: "The Motrin also makes my mouth really dry and cottony."

Me: "That's probably from the Elavil too."

Several minutes later, attending comes into room:

Attending: "So is the Motrin helping you?"

Pt: "It helps, but it makes me tired and it dries out my mouth."

Saturday, December 15, 2012

Weekly Whine: I love my job!

If you don't want to piss me off, don't say to me, "I love my job!"

Maybe it's just that I know too many people in medicine, but it seems like only people in medicine seem to say this. Notably, I remember on one OB call in med school, the intern was running around like a crazy person all night delivering babies, definitely getting zero sleep, and at one point she said completely earnestly and to my complete befuddlement, "I love my job!"

(My private response: "Is that why you act like a bitch all the time?")

Most people don't really love their jobs. That's why it's called a job. You might like it. You might love some aspects of a job. But I feel like "love" is an emotion that should be reserved for people, not a place where you are obligated to go 5+ days a week.

There were times in the past when I said I loved my residency. But I didn't really. I mostly felt peer-pressured by all those job-loving liars out there. Plus it was so much less awful than my internship, it didn't feel like a total lie to say I loved it. Comparatively, I loved it because I didn't hate it with every fiber of my being.

So yes, I suspect a lot of the time when people say they love their jobs (or med school or residency), it's disingenuous. Either they're trying to convince themselves or they're trying to feel superior to other people who hate their jobs. But even if that's not the case, it's still an obnoxious thing to say, considering most people don't love their jobs. It would be like saying how much you love being a mother in a room full of infertile women. Or me blogging about how much I love being skinny, which I know would really piss off one or two of you in particular.

And if you still insist that you love your job... well, maybe you and your job should get a room.

Friday, December 14, 2012

Physiatrist vs. Psychiatrist

Psychiatrist: "Somehow patients always manage to get their Viagra. Their blood pressure meds, whatever... but they always take the Viagra."

My attending: "That makes sense."

Psychiatrist: "Viagra is really big in the gay male community, you know. It increases libido. Although I really don't think they need it. I mean, they're already having so much sex."

Attending: "Uh..."

Psychiatrist: "Even if you think you have a lot of sex, you can't even conceive of how much gay men have sex. You have no idea."

Atttending: "..."

Psychiatrist: "I had one patient who would go to these bathhouses and he told me he'd have sex like 12 or 13 times in one night!"

Me: "With different people?"

Psychiatrist: "Yeah!"

Me: "Wow."

Psychiatrist: "I don't know what it is about me. It seems like patients just ALWAYS want to share their sexual history with me. I don't think most doctors have this problem."

Attending: "Well, you're a psychiatrist and I'm in rehab. Patients just want to tell me about their speech problems or their knee pain."

Psychiatrist: "The only way I get to hear about knee pain is if it happened during sex."

Thursday, December 13, 2012

Swayback

Me: "So you're here for back pain?"

Patient: "I don't really have any back pain. I'd like a back brace."

Me: "Uh, why?" Because back braces are cool?

Patient: "For my swayback."

Me: "What's swayback?"

Patient: [incredulous] "You don't know what swayback is??"

Me: "No..."

Patient: "It's a well known condition!"

Me: "Uh."

Patient: "Here, look!" [shows me totally normal-appearing back]

Me: "Uh. How long have you had it?"

Patient: "I was born with it, of course! I can't believe you don't know what swayback is."

Me: "Do you mean scoliosis?"

Patient: "No, but I also have scoliosis."


Later:

Me: "The patient said she has... swayback."

Attending: "What's swayback?"

Me: "Oh my god, that's what I said!"

Attending: [googles "swayback"]

Apparently, swayback is excessive lumbar lordosis. It's also a rock band with the feel-good hit of the summer.

Wednesday, December 12, 2012

Perfect Christmas Gift

OMG, Christmas is right around the corner! And you haven't bought any presents yet! What are you going to dooooooo??????

Never fear, you can always buy your loved ones a copy of A Cartoon Guide:



You know how it's totally annoying I never post cartoons anymore? Doesn't that piss you off? Well, now you can get all those cartoons I never post in one handy book!

Buy it from Amazon or Lulu just in time for Christmas! And if you get two-day shipping, you can still make it for the last day of Hanukkah, in lieu of yet another dreidel! Yay!

Why we cut back

About a year and a half ago, there was an op-ed piece of the New York Times called Don't Quit This Day Job by Dr. Karen Sibert about how women in medicine have an obligation to work full time, and an obligation to take on the same workload that men generally take on. I've been thinking about this lately, and why mothers increasingly do not make that decision. I'd like to present an entirely plausible scenario to you:

Mary is a physician and a mother of two children, ages 2 and 4. Her husband is also a physician, and she learns in September that he will have to be on call for the upcoming Christmas. The daycare that her children uses will be closed on Christmas and Mary has no family in the area. The babysitter she usually uses will be out of town. So she requests to her boss that she have Christmas off this year, hoping to get priority given her predicament, even though several other people have also requested it off. She receives one or all of the following replies:

“If you work in the medical field you should realize that you will be working holidays and it's presumptive to assume people without kids should work holidays just because it's hard to find child care.”

“Your inability to find childcare does not mean I should be forced to take second pick at holidays.”

“Well, kids are expensive and stressful. Didn't you know that before you had them? I don't feel bad AT ALL for doctors who have kids during training and then discover that childcare is expensive and inconvenient.”

“If you can't pull your weight and do your fair share due to your situation, then you need to leave.”

“You chose to have children. Parents who both work in professions that work on holidays chose to do so.”

“Not wanting to leave [your kids] with a stranger is not an acceptable reason for someone to cover you.”

“If you want holidays off get a new job and stop bitching.”

“But bottom line is that reproduction and child rearing is, at the core, a choice we make as human adults. I never once said that it's easy or painless to have an abortion or give a child up for adoption, only that those are choices available to women who are not ready to deal with child rearing and the stress/hardship/etc that it entails.”

“If someone decides to have kids then they need to bear the brunt of what ensues and not expect other single or childless colleagues to sacrifice just because.”

“Sorry, Mom, you cannot have your cake and eat it too.”

“If you want to make the big bucks you have to do what it takes to prove to the employer that you are worth those big bucks.”

“You may see your time with your kids as a priority, don't expect others to do the same.”

“You may see that as selfish, but my 'me time' takes priority over other people's kids.”

“A good Christian is one who deals with their own problems like childcare without complaint or burden to others. They are your children, dear. Not mine.”

“You chose to have kids. You chose a profession that requires you to work holidays. Get a backbone and deal with the consequences of your choices and stop trying to make the rest of us who made good life choices or are happy with them suffer for your decisions.”

“If you feel your very young children need to be watched that carefully, why work at all?”

“One of the major responsibilities of being a parent is having adequate childcare, which includes backup and backup for your backup. “

“The fact of the matter is that the decision to have kids is a personal one. Once you make that decision don't expect everyone to plan their lives around yours. People who are really concerned about having holidays off become teachers or find office government jobs. “

If these comments sound familiar, it's because they all appeared when I suggested on this blog that someone in Mary's predicament have priority.

And maybe all of you are right. Maybe she shouldn't have priority. But if anyone is wondering why women cut back on medicine and even leave the field after having kids, now you have a taste of what we face. Can you really blame us? And just to hammer the point home, here are a few other comments that will give you a flavor of what we mothers in medicine go through:

“At times childcare falls through, and I'm forced to rely on the goodwill of others.”

“How many babies go to daycare and end up with a febrile illness within 3 weeks of starting? Practically all.”

“My sister has three kids and hasn't had a Thanksgiving with her family in 20 years.”

“Then I had a kid. So I moved to a field where I do not have to work any holidays or weekends unless I want to.”

“When I had to work in a remote hospital thirty minutes away, I arranged for my childcare to spend the night and went there to stay in a hotel so I could make the 8 am frozen sections."

“Our state would expect an emergency worker to respond, including physicians. our employer, and state, expects you to have appropriate emergency coverage for children in the event of a disaster.”

Just food for thought.

Tuesday, December 11, 2012

Highly Recommended

Thank you for the book recommendations from the other day. When there's not one specific genre that you really love, that makes it much harder to find books to read. As fun as it is to be engrossed in a book I really love, it's equally frustrating to try to read book after book that I just can't connect with. I have to say though, I'm a little baffled by some of the recommendations to read books that were specifically what I said I didn't like to read.

All this reminds me of something...

When I was in grade school, I was also a really avid reader. I read much more then than I do now, because I had actual free time. I can't really remember what I used to read, but I liked some of the girlier mysteries (Mary Higgins Clark) as well as medical mysteries (Robin Cook) and a little bit of Stephen King and that sort of stuff thrown in.

We had to keep a journal of every book we read with a little summary of the book. My teacher Mrs. Hanson collected my journal, and after she saw my reading list, she made a recommendation to me:

"You should read Jeffrey Archer," she said. "Try A Matter of Honor. You'll love it."

And since I was a huge teacher's pet, I immediately rushed to Barnes and Noble to purchase A Matter of Honor.

You guys, I hated it. I found it unbelievably boring. It had all this political intrigue and foreign affairs and stuff that I was totally, utterly uninterested in.

I was pissed off, in a ten year old kind of way. Why did Mrs. Hanson recommend this horrible book to me? Obviously, she didn't really understand what I liked. The book was just something she liked, and without any regard for my own taste, she recommended it to me. I expected better from my teacher.

This is why when I ask people for a recommendation, I always try to make it clear what kind of books I like. Because one person telling me they personally liked a book doesn't really help. I mean, I could go on Amazon and find strangers who like just about any book. I prefer it when someone says, "Well, if you liked Twenties Girl, you would just love...."

Sunday, December 9, 2012

Reading Suggestions

I posted about this on Facebook, but I am searching for new books to read.

You can look at my reading list to see what sorts of books I'm interested in.

Basically, I like books that are easy to read and interesting. Things I don't like:

1) Pure fantasy.. I can handle the Hunger Games, but nothing too out there

2) Overly flowery or complex language

3) Non-fiction

Depressing Sundays

I figured this was an appropriate Sunday post...

When I was in residency, I would get two emails every Sunday night:

One was a reminder email to go online and log my duty hours.

One was an email from the chief resident with a list of all the cross-coverage for the week.

It was just about the most depressing thing to get these two emails every Sunday night. It always signified the end of the weekend, and reminded me of all the crap I had to do that week. (And the cross coverage schedule was often a depressing nightmare.)

If only I filled out my duty hours on Friday night, I could have avoided one of these emails. But somehow I never ever did in the entire three years.

Saturday, December 8, 2012

Weekly Whine: PMNR

It bothers me to no end that people constantly call PM&R "PMNR".

I mean, it's not like Linens 'N Things. Or Toys R Us.

I get that people in other fields have no idea what PM&R is, so it doesn't surprise me that they don't know what it's called. But what really bothers me is when someone is applying to PM&R, and they still think it's called PMNR. It sort of shows you didn't research the field very well.

For example, I got an email from a reader of this blog, telling me that he was interested in going into "PMNR" so that he could become a "pyschiatrist", and he wanted advice. My advice was, first and foremost, learn what the field is called.

That might sound a little mean, but my program director told me that when he got an inquiry from a resident or med student interested in "PMNR", it was already like two strikes against them.

Friday, December 7, 2012

Pay Attention!

Note to patients: when your doctor comes into the room, it's time to PUT DOWN THE KNITTING.

Seriously, this woman I saw in clinic last week would not stop knitting the whole time I was interviewing her. It was really distracting.

And then this week, I had a patient who was flipping through a magazine the entire time I was talking to her. The best part was when she finally got to the end of the magazine she was flipping through, she picked up a new one and started flipping through that.

I have to ask: is talking to me really that boring??

No, don't tell me.

Thursday, December 6, 2012

Highlighter gone mad

One weird thing about me is that I was never into highlighters in med school. Everyone else was. One day some drug company gave out these pens that had highlighters at the other end, and many of the students were almost salivating.

One day when I was studying with friends during third year, I noticed that the student next to me was highlighting stuff from the peds textbook. I glanced over at the page he was reading and I saw that he had highlighted every single line on the entire page with a single exception. I looked over and read out loud the single sentence that he had not highlighted:

"H. influenzae type b cellulitis is now very rarely seen."

Wednesday, December 5, 2012

Easier than it looks

The new Yahoo CEO Marissa Mayer recently had a baby and got some widespread criticism over her comment: "The thing that surprised me is that the job is really fun…and the baby's been easy. The baby's been way easier than everyone made it out to be. I've been really lucky that way."

This comment pissed people off. Why? Because you are not allowed to say that your baby is easy. There's a little vein in my temple that starts pulsing whenever a woman says that.

I was in a conversation with two other women a little while ago about our kids. One of the other women was exchanging stories with me about mischievous things our kids had done. When we turned to the other woman and asked her about her son, she just shook her head and said, "Oh, no, David is just an angel."

And I was like, really? You can't think of one act of mischief that your three year old child has ever gotten into? Seriously, you've got to have one story in your pocket.

The thing is, I think my kids are pretty good. But there are always going to be times they drive me totally nuts because that's what kids do. That's what they specialize in.

I've noticed that the definition of "an easy baby" varies widely from person to person. My cousin informed me that his eight month old son was a "really easy baby." I later discovered that this really easy baby was still waking up like four times a night. I guess if you have a stay at home wife who does all the work, that counts for you as a really easy baby.

I wonder what Marissa Mayer considers "an easy baby." This is a woman who went back to Yahoo with the umbilical cord still hanging out of her. Her definition of "easy" is probably way, way different from mine. Also, depending on whether you have someone watching your baby all day and helping at night, it seems like most babies would be pretty easy under those circumstances.

In any case, I don't think we should vilify Mayer for saying what she said. After all, she's a brand new mother. She's not privy yet to all the ways we jump on each other.

Tuesday, December 4, 2012

Dr. Wikipedia

I remember during residency, one of our most arrogant attendings was finishing up with a patient himself. When he came out of the room, he handed the resident a huge stack of papers that he had printed from the internet on fibromyalgia.

"I gave a copy of this to the patient," he said. "Put it in the dictation."

"It's from Wikipedia," she said, baffled.

"Yeah, so?" he said. "I love Wikipedia."

Sometimes words fail you.


Sunday, December 2, 2012

Liar Liar

No, this post isn't about that mediocre Jim Carrey movie from 1997. It's about the lies we tell to our kids during the holidays.

My husband and I can't quite agree on the whole Santa thing. Right now, our six year old thinks Santa is probably real. I've been encouraging this. We're even doing the elf on the shelf this year. (Our elf is a girl and she is named Elfa.) I did accidentally terrify my daughter into thinking that the elf was going to trash our home while we slept, but then I convinced her the elf was good and she didn't have to sleep with her bedroom door locked.

My husband is very much not on board with the whole "pretending Santa is real" thing. He feels it's wrong to lie to your kids and they'll eventually find out the truth and think you're a liar. I disagree. I believe I'm just making the holidays more magical for her.

I don't really have a frame of reference on this, because I was never taught to believe in Santa Claus. Also, I was never allowed to trick or treat. (Damn traumatic childhood.)

What do you think? Does pretending Santa is real make the holidays more magical or does it make you a dirty liar?

Saturday, December 1, 2012

Weekly Whine: Serving Size

I'm just wondering how people who make products determine serving size, because I seriously don't understand it.

I feel like anything that's individually wrapped ought to be ONE serving. Like if you buy a muffin, why is a serving size 1/2 muffin. Does anyone buy a muffin for the purpose of eating half a muffin??

And the other day, I was looking at a package of ramen, and one serving was half a package (yet still had like 100% of the day's salt allotment). How is that possible? A package of ramen is like nothing.

Basically, this is all a trick to make people think foods have less calories than they actually do.