How to tell your patient's pneumonia has resolved

Weekly Whine: Bad Dentists

Not that there aren't tons of bad physicians out there who do awful things, but I feel like somehow bad dentists are a special, unique brand of awful.

For most of my life, I used my family dentist, who was an old friend of my father's and I trusted him completely. When I was in my last year of med school I needed a routine dental appointment and just picked a random dentist in the area that took my insurance.

Huge mistake.

The guy was a recent grad, and he did that annoying thing where he spent the whole time asking me questions while his fingers were in my mouth and I couldn't answer. Then he insulted me for having gone to med school and talked about how much he partied in dental school. Then he spent the rest of the time trying to convince me that if I didn't have my wisdom teeth out now, they would become infected and get a huge abscess while I was in residency. I told him my trusted family dentist said they were fine and they weren't causing me any discomfort, but he told me that they were definitely going to get infected.

On the way out, he asked me if I wanted to make an appointment for him to take them out. I said no thank you.

Sadly, I did not learn my lesson. The next year, I made an appointment with a random dentist again. He talked me into a root planing somehow. I didn't know what it was and thought it was just like a cleaning. I asked him if he'd need to numb me up and he said no, which was a blatant lie. I told him I had a dinner I was going to that evening and he said I'd be fine. I was not fine. I had to cancel all my plans for the night. I felt like I had been lied to and assaulted by him. Also, he told me I needed to have my wisdom teeth out.

From then on, I have always asked for recommendations from a friend before going to a dentist. And never had another problem (and nobody else thought my wisdom teeth were a problem). Except....

When my daughter was almost 4, I took her to a dentist for the first time. I got a recommendation for a good dental practice, but somehow there were two pediatric dentists a block away from each other and I got mixed up and took her to the wrong one. She did have a cavity and the dentist wanted to put her under sedation to fix it. I was like no way. I took her to the guy down the street and he fixed it without sedation, and she was perfectly well behaved.

Paula Deen in the elevator

When I was in a public elevator yesterday with two Caucasian women, I overheard the following conversation:

Woman #1: "Can you believe what's going on with Paula Deen?"

Woman #2: "I know! I feel so horrible!"

Woman #1: "Right! I mean, who hasn't used the N-word in their life?"

Woman #2: "Exactly! It's awful how they're shaming her for this!"

I felt a little embarrassed to be listening to this conversation, partially because I realized that they were only saying it in my presence because I'm white so I *wink wink* get it.

My thoughts were:

I have never used that word or any kind of racial slur. Not only that, I've never even been in a situation where I've wanted to use a racial slur but decided against it. I've never had a conversation with a person who used that word. Is it really so common?

I care less that Deen used a word and much more that she mistreated minority workers, which it seems may be the case.

But I kept my mouth shut. My husband told me I should have said something, but honestly, I think it's hella obnoxious to interrupt a conversation to give my piece. Isn't it? I mean, what would have been the point? It's not like I was going to convince them of anything.

You suck, Payless!

I used to buy all my shoes at Payless. And when I had a child, I bought all her shoes at Payless. Then in the last year or so, I noticed that every single pair of shoes I bought there had the same problem. I'll let you guess from the photo what it is:

These are shoes purchased less than a month ago if you can believe that. I bought a pair of shoes for a dollar at a consignment sale that held up better than that. There was a hole I could stick my finger through.

Ordinarily, I'd just buy new shoes, but considering this had been happening faster and faster each time, I decided to go to Payless and complain and maybe even see if they'd replace the shoes. I mean, the shoes were $7 but it was the principle of the thing.

I spoke to the manager and explained the situation. She said it was my kids' fault because they drag their feet. I find it hard to believe that both my kids simultaneously developed a foot-dragging problem in the last year. But she did agree to replace them this one time. Which was sort of nice, considering I didn't have a receipt.

Unfortunately, they didn't have those shoes so I had to pick out a new pair that was more expensive. Like $14. I agreed to pay the difference. Except for some reason, the cashier said the shoes that we already had were now reduced to $3 (!) so that was all the credit they could give me since I had no receipt. I asked to speak with the manager again, but alas, she was "on the phone."

I was like, "Seriously? You're a multi-million dollar company and you're squabbling over $4??" I mean, they were probably making like $10 profit on the new shoes I was buying.

I ended up buying the shoes mostly because she really needed shoes, and the new ones were pink and sparkly and I couldn't deprive her. But I will NEVER shop at Payless again. Partially because the pettiness of making me fight over $4. Partially because they blamed my kids when it's really their crappy shoes at fault. But mostly because their shoes really suck now.

Except now where the hell do I get my kids shoes?

Higher standards

I've noticed that I hold doctors to somewhat higher standards when it comes to health-related or safety issues.

For example, when I smell cigarette smoke on a doctor coming back from their break, I get pretty irritated at them. I mean, they SEE the horrible effects of smoking. How could they make that choice? Ditto when I found out about a doctor at the hospital who went biking without a helmet.

A while ago, I made a post about how I got worried whenever my daughter had vaccines, so I am sympathetic to vaccination fear. A family practitioner commented on the post that she had the same worries and for that reason, spread out vaccines in her own kids and patients, and even skipped vaccines that weren't totally "necessary." I confess, I wasn't very nice to her, but I was livid. How could a doctor behave that way?

I think if a doctor ever told me she was giving birth at home, I'd probably flip my shit.

We probably shouldn't put doctors on a pedestal like that. I mean, they (we) are only human. I make lots of stupid health choices, like I eat fast food sometimes and I don't exercise (although to be fair, I've seen a disproportionate number of serious sports injuries in my field). But I don't know... I just expect more from doctors, including myself.

Maybe that's unfair though.

Dr. Orthochick: Helpful Advice

Me: Hi, I'm Dr. Orthochick, I'm a resident working with Dr. Calm. I noticed you were here last month. How have things been going since the last time you were here? Did something happen in between your last visit and now?

Patient: Where did you go to med school at?

Me: Uh, I just graduated from UCLA in June

Patient: Well, my son was just accepted into a DO program. But he's not sure if he should pursue a DO degree or if he should go to an MD school. My daughter is in her second year of med school at Virginia in their DO program there and she said...blah blah blah...

Me: Uh, are you having any pain in your hands or other joints? Are you having trouble opening a jar?

Patient: No, I'm just here to find out what my son should do for medical school.

Call me crazy, but that seems like a waste of a co-pay. In addition to being a waste of my time. I told her that a DO degree is pretty much the same thing as an MD, it's harder for them to match into dermatology but then again it's almost impossible for anyone to match into dermatology, so that's not saying much. If you want to be a dermatologist then choose parents who are on the faculty of dermatology at a program.

Also, I wasn't sure how to present that one to Dr. Calm. "Ms. Smith is a 58 year old lady who we see for rheumatoid arthritis, she's doing well on Enbrel and she wants to know if her son should go to DO school?" Actually, that's pretty much what I said. Dr. Calm was equally confused. He did not have any words of wisdom for her.

Salary

A couple of weeks ago, we had fun telling how much debt we were in.

Now here's another question I bet everyone is interested to hear the answer to:

What's your salary? (and in what field?) Obviously, feel free to answer anonymously.

I have to ask, because a colleague of mine recently got offered a physician job at 90K and I was like whoa.

Reader

What is everyone using to replace google reader?

I'll probably use feedly. But then again, I only read like 6 blogs. Maybe I don't need a reader.

Weekly Whine: It's called compassion

Sometimes I post about topics that don't affect me currently or directly but I've noticed the effects they have on others. For example, when I talked about how crazy hard it is to pay nanny taxes or how people with small kids should get extra flexibility in choosing which holidays to have off.

No matter how many times I reiterated that I DO NOT and will never have a nanny, or that my work gives me ALL major holidays off automatically, people keep insisting that I'm being selfish and entitled.

I mean, I am pro-choice but I have never and probably will never have an abortion. I am pro gay marriage even though I don' t want to marry another woman personally. People are capable of caring about issues that don't affect them directly.

You can call me "wrong" if you want. But I'm not selfish for making a post to help people who are not me.

Bad Translation

A pet peeve I have about bad translation is when a family member describes a patient's pain without asking the patient first. The worst example is when I asked the patient to point with one finger to where her pain was. Instead of asking his wife, the husband just reached out and pointed to a location on her back with one finger.

I don't think I know my husband well enough that I could pinpoint his pain with one finger. Then again, we haven't been married for 40 years like this couple probably was. So... yeah, that's something to look forward to.

In any case, this is why family members should not be the translator.

Retirement age

A lot of men feel like women don't put in their "dues" because of maternity leave. Plus a lot of women in this country are forced to go without pay on maternity leave, which can be a financial hardship.

Here's an idea stemming from yesterday's post:

The life expectancy for women is 81 years in the US. The life expectancy for men is 76. We've got five years on them. If a woman takes a maternity leave, why can't the government subsidize that leave but then push back the age at which she can get retirement benefits? We get heart disease later and are healthier later in life, so why not?

I'm sure there's a down side I'm not seeing.

Men are never lonely

I had this friend in college named Mike who was a bit of a downer. Like he'd always be the one to point out things like, "College is the best time in our lives. It's all downhill from here."

Anyway, one day he said, sort of out of nowhere, "One great thing about being a man is that I won't be lonely when I get old. It's really easy for elderly men who are single to find women."

And I said, "You realize that's because most of you will be dead, right??"

I guess I was the one who was the downer there. I suppose I can see his point though.

Dr. Orthochick: Farts

Dr. Calm: Did you notice that when I asked [our patient] to lie on her right side she farted?

Me: Yeah...I did notice that, actually.

Dr. Calm: And she didn't even excuse herself! She just kept right on talking! I guess she was hoping we wouldn't notice.

We noticed.

Speaking of which, I find it necessary to confess that one time when I was on my SICU rotation (November of my MS3 year) I farted in a coma patient's room and blamed it on him. I thought I was alone and the dude was all vented and sedated and everything so I didn't think he'd mind and then my resident walked into the room 2 seconds later and asked what the smell was. I said it was probably the patient. I wonder if he believed me. I really hope he did. I mean, I'm not totally sure if coma patients can fart, I'm guessing they can since they can have bowel movements and generally the two go together but I actually have no idea, now that I think about it.

Amateur Lectures

As a resident, I was always forced to go to lectures by one of the candidates interviewing for attending jobs. All the attending candidates gave a lecture and we were always forced to go to prove that the residents aren't as apathetic as we actually were.

Most of the lectures were actually pretty good, I guess because the applicant is trying to put their best face forward. One lecture was an exception.

First of all, the guy was YOUNG. I think he was either currently a fellow or just graduated from fellowship. He mentioned at one point in his lecture that he "hadn't been in practice long" and it was like, Yeah, no kidding. Have you noticed that there's a different style people have when they give lectures based on their level of training:

Attending: This is information I'm TELLING you based on my many years of practice and study.

Resident: This is information I looked up in a few books and articles. Does this sound right to you?

This guy lectured like a resident. I could have given that lecture. He had this inflection in his voice, like he thought someone was going to interrupt him and correct him at any time.

The topic was pretty dry too. Something about coughalators. The only thing keeping me going for the first fifteen minutes was the fact that the guy was fairly cute. But not cute enough for me to sit through an hour of this. He'd have to be, like, Channing Tatum, and I'd have to be, like, 12 years old.

I contemplated paging myself out of the room, but I was worried someone would figure out what I was doing. So instead I pretended like my pager was on vibrate and that it just went off. I jumped slightly and pulled the pager out of my pocket and pressed a few buttons. I then made a big show of holding up the pager and staring at the screen intently as I walked out of the room. I think I was nominated for an Emmy later that year.

Happy Father's Day!

This is the first year we've decided to make the kids entirely responsible for the gifts. I think 6 is old enough, right?

Weekly Whine: First World Problems

If you have absolutely nothing productive to say about a blog post, I think a good comment to make is "This is an example of a first world problem."

Essentially, you are saying that the content of the post is trite and you have nothing to add.

Here's a newsflash: If you are sitting at home reading and commenting on a cartoon blog, you do not have any third world problems. You are not worried about famine or drought or shelter. ALL your problems are first world problems too. If your child is failing all his classes at school: first world problem. If your toilet is flooded and there's literally shit all over your floor: first world problem. Even if you have cancer and are considering chemotherapy: first world problem.

So what you should really write is, "This is an example of a first world problem, much like every single problem in my life."

Guest Cartoon: First Day in the OR

Scrubbing in: 1st day in the OR



Submitted by www.medcomic.com

Diagnosis: Asian (Guest Post)

Jenica, the toy warden, is the mother of three half-Asian daughters

Violet was really cross-eyed when she was born, but that’s not uncommon. I had thought that the problem had corrected itself, but a couple months ago it seemed to come back. She looked slightly cross-eyed to me most of the time. At a check-up, her pediatrician saw the crossing and referred us to a pediatric ophthalmologist.



I was terrified we’d walk out of that appointment with a baby wearing glasses. As adorable as baby glasses are, I really didn’t want to deal with fighting her to keep the glasses on.

Luckily, my fear didn’t become a reality.

Our ophthalmologist happens to be of Korean descent, just like my husband. After he examined Violet, he pulled a picture of his own daughter out of a nearby drawer and said Violet AND his daughter have pseudoesotropia, which basically means pseudo-cross-eyed. They look cross-eyed, but they aren’t cross-eyed at all. It’s a common physical trait in Asian kids. It’s my understanding that what happens is the epicanthal fold (what makes an eye look Asian) can obscure the view of the eye and make it appear like it’s crossing when it is not.

I essentially took my child to a specialist to have her diagnosed as Asian.

When I reported the doctor’s findings to my husband, the son of Korean immigrants, he laughed and said “YOU should have known that!” as a joke. Really, he’s the one who should have known this and warned me! But he didn’t. He’s completely oblivious to most of the things I need to know as the white mother of three Asian kids. As a result, white girl me took my daughter to a specialist to get her diagnosed as having Asian eyes. “Why yes, ma’am, your Korean daughter DOES have an epicanthal fold! Good job noticing it!”

What’s sad is this is not the first time I’ve worried about a common Asian trait. When Rose was a baby, I was scared about what appeared to be a vicious bruise on her lower back. It turned out to be a Mongolian spot, which 90% of Asian children have. My husband was oblivious to this too.

And these are the things you never consider when you become the mother of biracial children. You might just take your child to the doctor to have them diagnosed as being a member of that other race. In my defense, pseudoesotropia is apparently one of the leading reasons parents take their infants to ophthalmologists! So, I’m not the only idiot running to the doctor to have their kid diagnosed as Asian.

Am I anal?

I never ever thought of myself as anal. Just the opposite. I am a total slob sometimes and it doesn't bother me one bit.

About a year ago, I bought my daughter one of those organizers for her room with little buckets for legos, dolls, crayons, etc. It stayed organized for about a week. Ever since then, I've lamented the disarray of the organizer, but never fixed it. Finally, last month, I spent hours re-organizing all of Mel's toys, and ever since have been really rigid about making sure everything goes in the right place.

When my mother was visiting recently and I kicked up a fuss when she tried to clean up by tossing toys into the organizer randomly, she commented to Mel, "Your mommy always likes to have things organized, but most people don't care."

Is that true? I don't think so. But I'm a doctor and all docs are at least a little anal, right?

Evidence that I am anal-retentive:

--My kid has an organizer in her room
--I like making lists
--I recently reprinted a bunch of note templates because they were off-center on the page in the first printing. But they were REALLY off-center.
--All my H&Ps have their pieces dictated in the exact same order (HPI, PMH, allergies, meds, ROS, etc), whereas everyone else seems to do them haphazardly. And that bothers me a lot.
--I never ever leave off the date and time
--I am super worried about running out of everything, so as soon as we're low on any item, I immediately put it in my phone to remind me to buy it
--People do often comment that I seem organized

Evidence I am NOT anal-retentive:

--My apartment looks like a hurricane hit
--I let the organizer stay unorganized for like a year
--I let dishes go unwashed for days
--My closet (if you saw it, you'd understand)
--I never change the toilet paper roll
--I sometimes wear wrinkled clothes

So which is it? I have no idea.

Dr. Orthochick: Getting Old

I was in clinic today and I noticed that all old ladies wear sweatpants and sweatshirts with cats or leaves or cats and leaves embroidered on them. All old men wear high-waisted pants hiked all the way up with suspenders. Which leads me to wonder--at what point do you start dressing that way? When am I going to wake up in the morning and go shopping and see a sweatshirt with a kitty caught in a ball of yarn and decide to buy it to match my sweatpants with elastic on the cuffs? Is it going to be before or after I cut my hair short and perm it? By this point I've resigned myself to this eventuality since pretty much every old lady I've had in clinic has the same outfit and the same haircut, but I'd like some advance notice on when exactly it's going to happen to me.

I guess what it really comes down to is, the only patients I see right now are old people in pain. And even the old people without rheumatoid arthritis have osteoarthritis because that's pretty much a fact of aging. So when is this going to happen to me? At what point in my life am I going to stop being able to enjoy things like kickboxing and going out late and eating sugary crap?

I'm kind of scared to get old. Because work has taught me that old people do one of three things:

1. fall

2. worry about falling

3. have constant pain related to previous fall

And really, I don't want to spend my life being afraid to take a shower because I don't want to fall. So I guess I want to know the exact minute I hit "old" so that I can spend every minute before that enjoying my youth. Or, at least, spend some time powerlifting, chewing gum, and being able to drive myself. Because at some point, I'm not going to be able to do any of those things and it really scares me.

Debt

I think regular people truly don't recognize how much debt people get into during medical training.

For example, the tuition at Case Western Med School last year was $51,450.

Per year!

That's before you buy one book, put a roof over your head, or crack open even one package of ramen.

But that's a swanky private school. Thrifty students go to state schools, like Ohio State, where the tuition is...

$39,159

Yeah.

(Actually, there's a great page on the Ohio State website on how students saved money. My favorite one suggests living off free samples from Walmart. Although I think I had some better ideas.)

How much debt did you acquire during medical training?

Worst Cooks

A little while ago I made a post about how watching cooking shows makes me want to be a chef. But recently I had an experience that made me realize the cooking show I'd be best suited for by far is Worst Cooks in America.

I took a one-night cooking class with a friend of mine. And I realized that I don't know a lot about cooking things from scratch. I got completely stymied when trying to mince garlic. First, I didn't know how big the clove was. Then I apparently chopped it rather than mincing it. I also "looked terrified" when crushing it with the blade of the knife. Also, I didn't know how to chop... well, anything. I had the cooking teacher laughing his ass off.

"You don't cook much, do you?" someone said to me.

Here's the thing though: I cook dinner for my family 5-6 nights/week. I mean, I "cook" in that I use the stove. OK, it's mostly like that show Semi-Homemade or whatever it's called. But it's not takeout and it's hot. If I need minced garlic, I've got a jar of it in the fridge.

For example, this was our family menu for the last several days:

Last night: Sauteed mixed vegetables, seasoned with Teriyaki sauce, added some ramen noodles, a fried egg, frozen shrimp, and beef (coated in flour and sauteed in olive oil).

Night before: Breaded steak (eggs, bread crumbs, saute in olive oil), mushrooms and frozen corn sauteed with a little butter, rice side dish made in microwave (but added frozen broccoli and okra)

Night before that: Made one of those Stouffer's saute meals, but added extra frozen broccoli, zucchini, peas, corn, mushrooms, and some extra noodles to make it enough for all of us

Night before that: Browned beef with sauteed onions, garlic, broccoli, peas, then simmered with jar of tomato sauce and splash of red wine. Mixed with noodles, cooked in oven for 20 minutes. A family favorite.

So like I said, every night I "cook" but nothing from scratch. I open a lot of packages, probably spend more on meals than I could, but really, who cares? A favorite of mine is buying a whole rotisserie chicken and then using that as the protein for rice or noodle dishes. I cheat and get dinner done in about 30 minutes.

But yeah, I don't see myself competing on Masterchef any time soon. (Or if I did fake my way through the first round, I'd surely get tapped on the shoulder by Joe in round two and told, "We've seen enough. You've got to go.")

Weekly Whine: Old Episodes

Right now, I am paying for the following services:

Hulu Plus

Netflix streaming

Cable Plus

Amazon Prime

Yet there's no way to watch the first season of The Big Bang Theory without paying an extra $20 through Amazon. And NO WAY AT ALL to get old episodes of Worst Cooks in America.

Neglect

A hemineglect means that a patient doesn't pay attention or is unable to see half their visual field. Here's a sign that a patient has a left neglect:

Jane: "Hi, Mrs. Smith. Do you remember me?"

Mrs. Smith: "Yes, you're a..." [reads Jane's badge] "Rapist supervisor."

Jane: "NO. I'm an occupational therapist supervisor."

Mrs. Smith: "Oh."

Dr. Orthochick: Where we go when we're gone

I walked into a patient's room this morning for rounds and discovered she was dead.

Well, that's never happened to me before.

(All joking aside, it kind of freaked me out. I walked in and she was a little too quiet and she looked a little too gray and I got close enough to see she wasn't breathing before I backed out of the room. It turned out the nurses knew and they were waiting for her corpse to get moved out of the room but I guess I missed the memo or something.)

That being said, I was glad I at least noticed. One of my old chiefs once told me that he had rounded on a dead guy without realizing it and wrote a note, which doesn't look good in the chart. I mean, yes, the dead usually do not report pain and their vital signs are stable so a note on a dead guy probably looks a lot like an ortho note on a living guy, but it's poor form to not realize the patient's not breathing.

Moar Cartoons, part a million

Yesterday, I got the following comment:

Fizzy! I've been a long time fan of your blog, your cartoons got me hooked and had me emailing all my friends! I don't see as many cartoons anymore, though, as compared to blog posts. Any chance the ratio could be closer to 1:1? Thanks!!

Yeah, but no. It really can't. Why? Because:

1) Cartoons take time and energy I no longer have

2) I just don't feel inspired anymore

That said, I'd like to open things up:

Do you have a brilliantly hilarious cartoon about medicine? Yes? Well, let me post it for you. With a link back to your blog/whatever. Hell, if you have a brilliant IDEA for a cartoon, I'll accept that too.

Email is fizzziatrist at gmail.com

Dr. Orthochick: Drug Reps

Drug company reps are ridiculously good looking.

They're usually in their late 20s--early 30s and they have great teeth. I dunno what happens to them when they get older than 35 or so but I'm guessing they're put out to pasture or something like that. But damn, they are good looking in a really classic way. Nice shiny hair. Classy trench coats. Expensive watches. They look like the type of people who you could have sex with and then they would make you breakfast in bed the next morning and they would still have great hair and fresh breath.

Anyway, I'm guessing the fact that all drug reps are hot is not a coincidence. I guess they've done studies that show that you're more likely to sit quietly and listen to a presentation given by a good looking person over an ugly one. Just like they've shown that using a pen with a drug logo on it will convince you to give that drug when it is not indicated to people who are violently allergic to it.

The drug reps we had today missed the memo. They were both in their early fifties, I would guess. One of them was even overweight. And seriously, their drug was crap. Had they been hot, I might not have thought so, but I'm pretty sure even they thought this drug was useless.

Drug Rep: So you might be interested in this--it's a combination of naproxen and esomeprazole

Me: Wait, so is this Aleve and Nexium in one pill?

Drug Rep: Yeah. I know normally you just prescribe them separately but, uh, if your patients don't like to take two pills, they can take it as one.

Me: What are the other benefits to this combination?

Drug Rep: I guess it cuts down on the amount of pills people are taking. I know we're not the first people to think of combining an NSAID with a PPI, but this is the first drug that combines these two specific pills.

Me: Oh. Is there a financial benefit?

Drug Rep: It's not yet covered by most insurances.

Me: I see.

Drug Rep: But these two drugs have low incidences of side effects. So, I guess the combination of them also doesn't cause too many side effects.

Drug Rep #2: Our company also makes Symbicort. Would you like to hear about that?

I'm not sure I can think of a real advantage to this pill. I guess if you were flipping out at the thought of taking OMG two pills instead of one then maybe, but since the one has the same drugs and same side effects as the two, wouldn't you go for the cheaper option?

I don't even give Nexium most of the time because it's not covered by most insurances--I give Prilosec because it is and pretty much all proton pump inhibitors are created equally. So I really don't see the point to this new combo drug--it's just combining prescription versions of stuff you can get over the counter and charging an arm and a leg for it. Plus, as the drug rep pointed out, we already have combo drugs that do this. And no one's using them either because they're needlessly expensive. And just needless.

I guess these reps weren't hot enough to convince me that this drug was a necessity for all my osteoarthritis patients. They should have been more like that Moxatag rep back when I was in family med. Moxatag is amoxicillin that you take once a day instead of three times a day. It's not covered by insurance, whereas amoxicillin is available for free at Kroger and for $4 at Wal-mart. Moxatag also wasn't offered in a liquid form, which meant kids and people who can't swallow pills couldn't use it. It had all the side effects of amoxicillin. Clinical trials showed no difference in the number of days people needed to be on moxatag vs. the number of days they were on regular amoxicillin three times a day. But that rep was young and blond and wore nice leather boots with her trench coat, she brought us all Panera (and not only that, she gave us menus and we all ordered our own thing) and man, after listening to her presentation, I can honestly see why we need a version of amoxicillin that costs more and does the exact same thing, but thank G-d saves me the time of having to swallow an additional two pills over the course of a day.

Ipsilateral

I remember during my first year of med school, I spent several minutes searching my anatomy text for where the ipsilateral nerve was. My lab manual mentioned it and I didn't know where it was. Near the femoral nerve maybe?

Can anyone who isn't in medicine tell me where the ipsilateral nerve is?

It's weird how all these words that seemed so foreign to you as a student later become second nature. You don't even realize it until you're having a conversation with someone who isn't in medicine.

Weekly Whine: Recitals

Seriously, dance recitals are like the biggest rip-off ever.

I have been stuck going to two of them for my kid. It's great fun for the kids, and yes, they do look super cute in their little costumes. But here's the tally:

--$50 for said costume

--$15 each for tickets

--minimum of $30 for photos of child in costume

--God only knows how much for DVD of recital

All for the privilege of 3 hours of watching mostly kids you don't know doing clumsy ballet to Disney songs.