Weekly Whine: Spam

Lately I have had a problem with emails being inappropriately labeled as spam.

I sent an email to my boss's assistant about the call schedule. Despite the fact that I have exchanged hundreds of emails with her over the years, the email went to her spam folder. Why?

And then more recently, an email I sent to my husband went to his spam folder. It goes without saying that I have sent him more than a few emails over the years, and I wasn't trying to sell him some illegal Viagra. (Or was I?)

On my end, all the emails for my daycare suddenly started going to the spam folder after having previously having been delivered to the correct place.

Best of all, an email from my mother somehow went into my spam folder. Granted, sometimes she sends me an excessive number of emails, but I'm not sure why Gmail suddenly decided that particular email was spam.

Gmail, what's up with your spam filter?

pee pee soaked heckhole

I was just thinking about the squallor I used to live in when I was a kid. My parents were divorced and my mom always felt like she didn't have any money, so she spent money very sparingly. I always joke about it, because it's not like we were poor and starving or anything, but it was just sort of funny that our apartment was always such a mess.

Like for example, we had the same ratty couch from before I was born up until I was about 14 years old. I don't know what the average lifespan of a couch is, but I know for a fact that I peed on this couch as a baby, plus the backrest was so worn down that the springs were protruding a little bit through the fabric.

Or the chair situation. We had about three chairs in our whole apartment, which might not have been so bad if two of those chairs weren't broken. They had this mesh that was supposed to serve as the seat, but they were so old that the mesh had worn out and there were just holes where the seats should have been. This might have been a good time to buy some new chairs for $10 each or whatever, but instead my mom just put a cushion over the hole and acted like it was fixed.

We had two bookcases that came directly from the garbage room.

Our TV stand was held together with duck tape.

All of the handles had fallen off the dresser with my clothes in it. I kept one of the broken handles on top of the dresser and I'd have to latch it into the holes where the handle had been in order to get my clothes out in the morning.

Our refrigerator was set weird so that it needed to be defrosted like every week. If we didn't defrost it, large icicles would start to form in the freezer.

I think the most amusing thing was the paint situation. Because we hadn't had the place painted in a long time and our last paint job was shitty, there were large areas on the ceiling and wall where the paint was chipping away. Sometimes I'd stare at the ceiling and find shapes in the chipped-away paint (like with clouds). Sometimes a piece of paint would fall on me from the ceiling. Finally, my mom realized this was getting out of hand and she got someone to plaster over the holes in the ceiling. But for some reason I don't understand, the person who plastered the ceiling used pink plaster. So now our ceiling and walls were covered with large pink spots. And it was like that for YEARS.

These same principles applied to the food I ate and the clothes I wore. This is why I have absolutely no concepts about name brands and no appreciate for nice, expensive things. And even though most of my current furniture is from Target, you can see what a huge improvement it is over the way I used to live.

Pee-wee

I was always a huge fan of the Cosby Show when I was a kid. It was a wholesome enough show that I was allowed to watch it, but it was actually really funny. It's sort of sad that reruns can't be shown because of… Well, you know.

I don't know how to feel about television shows being pulled off the air because we find out that the guy involved in it was actually a bad guy. I mean, if it's a good show, why shouldn't people be allowed to watch it? I suppose it also depends how bad a guy we're talking about.

My husband and I were recently talking about what happened to the actor who played Pee-wee Herman. For those of you who are painfully young and don't remember it, he was caught in a porn theater doing the kind of private thing that people sometimes do when watching porn movies. And because of that, his very clever TV show Pee-wee's Playhouse was pulled off the air.

I always thought that was sort of unfair. Yet at the same time, the actor did a pretty dumb thing. He took a chance, he got caught, and he paid the price.

My husband argues that he was probably desperate, because what woman would want to sleep with Pee-wee Herman? Frankly, I think there are probably plenty of women out there who would've happily slept with a rich celebrity, even if that celebrity was the guy who played Pee-wee Herman.

Dr. Orthochick: Stupid is as stupid does

Scene: Outpatient trauma clinic, me seeing patient who had knee surgery, has history of brain issue

Patient who has had 9 brain surgeries for congenital defect: Is it ok if I ride my bicycle now?

Me: You can ride a stationary bicycle but I want you to wait another few weeks before riding an outdoor bike because i don't want you to fall and put all your weight on your knee

Patient who has had 9 brain surgeries for congenital defect: I can't wait to get back on my bicycle

Me: You always wear a helmet when you ride your bicycle, right?

Patient who has had 9 brain surgeries for congenital defect: No...why?

::sigh::

Fun with Pharmacy

I haven't done "fun with pharmacy" in a while, but this is one I had to do. The order was:

Zoloft 50 mg PO qAM

Guess what time the pharmacy scheduled the medication for.

Weekly Whine: McDonald's Shaming

I am seriously sick of all the shaming that goes on around eating at McDonald's. If you don't like McDonald's and don't think they taste good, then don't eat there. But don't act like you're better than everyone else because you don't eat there or other fast food restaurants.

Someone recently made a comment on this blog that they could tell I was stressed out because I take my kids to McDonald's a lot. First of all, I don't know how a complete stranger who mostly just reads blog entries that I largely wrote before I even had kids knows how often i take my children to a particular restaurant. I probably take them there once or twice a week on average. I try to limit the number of times I take them there, not because I think they are so unhealthy, but because it's a pain in the neck to wait for the drive through and it's more expensive than making something at home. Plus then when we go to McDonald's, it's a special treat that everyone gets excited about.

Is McDonald unhealthy for children? Seriously, I don't think so. Maybe McDonald's is more healthy than some gourmet cook making special organic meals for her child every day or something. But I am willing to bet that the average woman does not give her children food that is healthier than McDonald's.

Most children love the following foods: chicken nuggets, fish sticks, pizza, etc. my kids demand chicken nuggets almost daily. I looked up the nutritional value of the "healthy" frozen chicken nuggets that I buy at the grocery store. And guess what? They have the exact same number of calories and fat as the nuggets at McDonald's. So if I get them a side of apple slices and a yogurt with the nuggets, am I really subjecting my children to something so horrible? And I think the little burger they get there is probably healthier than most red meat dishes I might make for the kids.

Probably the main reason I limit McDonald's is because the stuff that I get there is much worse than the stuff that I make for myself at home. And the temptation to get myself something is too strong if I do the drive-by.

I just think there's too much McDonald's judging going on when it comes to children. In small children, I don't think McDonald's is contributing to obesity. At least not based on the caloric and fat content of their food for kids.

Yummy lunch

Some patient on our unit had an epic bowel movement yesterday. It was one of those poops where the smell permeated the entire hallway and traveled down several adjacent hallways.

The smell even went into the back room where I usually do my charting. I heated up my lunch, with the intention of closing the door to the room and opening up a window, so that I could eat without the smell of feces in my face. Before I could do that, somebody in the room with me crinkled up their nose and said to me, "Your lunch smells awful!"

I don't know, maybe I sometimes bring weird stuff for lunch. But I'm pretty sure I've never brought feces.

Contribute!

A while ago, I informed the readers of this blog that I was building an anthology of humorous medical stories of 1000 words or more. Some of you were kind enough to have contributed stories. Well, it turns out we have enough to go ahead with the anthology, thanks especially to the generous contributions of Dr. Grumpy. Here is the cover:



I am still collecting story submissions, so if you have anything appropriate, email it to me at Fizzziatrist@gmail.com. Remember, all profits in the book will be donated to Red Cross.

Dr. Orthochick: Neverending

Circulating nurse: Schools are closed again tomorrow [because of snow]
Me: Wow, I really do not miss being in school
Dr. Orthoking Jr: Why's that?
Me: First off, I don't have to do homework.
Dr. Orthoking Jr: Yeah Orthochick, you don't have homework.
Me: Well--
Dr. Orthoking Jr: What did you do last night?
Me: I did some reading on proximal hamstring injuries, then I wrote out my operative plan for this case and the next case, then I reviewed my article for journal club and worked on my presentation for Tuesday on minimally invasive sacroiliac joint fusion.

Damn.

It never ends around here.

Scribble

I was just doing a CME activity and the lecturer had the most unintentionally hilarious slides that I had ever seen. He had clearly drawn on some of the slides, but it all just looked like freehand scribbles. Basically, it look like something my preschooler would have done, except maybe not quite as good.

Here is a sample of a slide, just so you don't think I am exaggerating:



What do those scribbles signify, exactly?

Weekly Whine: Charity

A few days ago, I was at Barnes & Noble. I don't go to bookstores much anymore, but my mother was visiting and she wanted to buy some books for the kids, so we went.

We bought a few books, and while my mother was paying, the cashier mentioned a book drive for the poor that Barnes & Noble is doing. "Oh, that's great," I said. "So I can bring in books to donate?"

Apparently not. Apparently, you actually have to buy the book from Barnes & Noble, then the book is passed on to an underprivileged child.

I have seen supermarkets do similar things. They have a bunch of items that you can buy from them, then the items are donated to charity. Except I don't understand how this is not the store exploiting poor people to make money. Because I would've been buying the Barnes & Noble book at full price. Then they just pass the book on to charity. I could just as easily donate an old book to charity myself.

What were you doing when your pager went off?

Dr. Orthochick: Respect

On Friday I was walking from Point A to a rather remote Point B and I ran into one of the peds ICU docs so we walked together. (side note: I have no idea how I know the peds ICU docs because I try to stay out of that place, but for whatever reason, I've always been the type of person who knows everyone. This happened to me in med school too)

Me: Hey, is everything OK? You seem sort of...bummed.
PICU Doc: I pronounced a kiddo this morning.
Me: Oh wow. I'm sorry.
PICU Doc: His father is probably going to go to jail.

I'll spare you the details, but it was probably one of the most sickening child abuse cases I've ever heard. (And if you're in ortho, you see child abuse. And domestic violence. And elder abuse. I don't talk about it much, but I see a fair amount of it.) Not to get too graphic, but the six month old baby had multiple skull fractures and had been shaken so hard that the gray matter of the brain couldn't be differentiated from the white matter of the brain. And that was just the injuries he had to his head.*** I wound up talking down the PICU doc for a while which was a little strange since I don't really know him, but he kind of seemed like he wanted to talk.

I've also been to some really sad places lately. The other day I was doing something in the ER and one of the general trauma docs (Dr. MarineBerg) asked if I could help him for a little while because he didn't have a resident and a Tier 1 trauma was coming in. So I followed him into Trauma Room B, gowned and gloved up...and the medics brought in a dead 13 year old. Gunshot wound to the chest. Dr. MarineBerg pronounced, I left the room.

The reason I bring all this up is because I was involved in a (different) upsetting case the other week where a 20 year old guy tried to kill himself by jumping out of a building. He broke his neck, his back, both legs, both feet, one arm, and lacerated his liver and his lung. One of his ankle fractures was open so we had to go to the OR to wash it out and do what's known as "damage control orthopaedics." (DCO for short) He was hemodynamically stable, intubated, and appropriately packaged by about 22:00 so we headed up to the OR then.

I really try to not get holier than thou, but I was disgusted by the behavior of most of the OR staff. The anesthesiologist said repeatedly he wished the kid had succeeded in killing himself so we wouldn't have to operate on him now, the circulating nurse said it pissed him off that our tax dollars would likely go toward the guy's medical bills, the scrub nurse said we should just finish the job and kill him in the OR, and my attending said he couldn't understand why we were bothering to save him since he was a suicide.

I'm sorry, I'm better than that. I was raised better than to make comments about how people should kill themselves and I"m not even going to make a comment about finishing the job as a joke. That's disgusting. I know it's late at night, but that's the sacrifice you make when you go into medicine. Sometimes problems don't happen between 9 and 5. Yes, it's inconvenient, but here's someone who really, really, really needs help. Let's do this. No, it's not what i was planning on doing with my Saturday night, but it's my job and I will do it to the best of my abilities. So I wanted to tell everyone to please refrain from making comments like that, but I didn't want to come off as holier than thou. So I didn't, but I wish I had.

I am very sensitive and I worry that since this stuff upsets me to the level it does, maybe I'm not cut out for trauma. But if the peds intensive care doc can still get upset when kids die and be a damn good doctor, then it's OK for me to get upset when people get hurt.

And quite frankly, I wouldn't want it any other way.

***If it is any consolation to anyone, all of his organs were harvested. Heart, lungs, kidneys, intestines, pancreas...everything. I think there were three transplant teams working at the time.

Fist Bump

When I started my residency, I was one of only four girls in the entire program. The hospital where I was rotating most of my first year had only male residents.

There were two male residents Nick and Rick in the program who I often ate lunch with and they were constantly fist bumping each other. I honestly can't give you an example of a fist bumping situation. It probably involved mentioning some girls booty.

I started to become intensely jealous of the fist bumping. As a woman, I felt really excluded from it. I used to talk to my husband about it, and whine about the fact that I never got a fist bump. granted, there were other guys who ate lunch with us who didn't get fist bumped either. Mostly, Rick and Nick would just fist bump each other.

Anyway, one day I said something (can't remember what, possibly involving some girls booty) and to my delight, Rick held out his fist to me. I happily bumped it. I was so proud.

Fast forward to nearly a decade later. I did something at work recently that my boss really liked. Instead of complimenting me, he held out his fist and I bumped it. I was only slightly more happy than when I get a raise.

I don't know what it is about having my fist bumped. I just really like it.

Weekly Whine: Tailgating

Last night, I was driving home on this twisty dark road. The road was so twisty, there is actually a sign on it that said "this road has dangerous turns". In addition to that, it was raining. Great driving weather.

When I turned out of the daycare onto this road, there was an SUV pulling out of the daycare behind me. Despite how dark, twisting, and rainy it was, this car stayed really close to me. It was so close, that its headlights were completely of obscuring my rearview mirror and even obscuring my windshield slightly. I really wanted the car to somehow pass me, but it seemed to be following me at every turn. Finally, when we got to a light, it quickly skidded ahead of me and went through a red light in order to pass me.

I really don't understand tailgating. I can't say I've never done it because somehow it's hard not to when do you want to get someplace fast and the car ahead of you is too slow, but it really just doesn't make any sense. This car being right behind me and blinding me was making me go slower, not faster. I don't think I've ever been tailgated by a car and it's made me go faster. In fact, I usually slow down because I figure if they slam into me, at least we'll all be going slower. I really doubt anyone speeds up when they're being tailgated.

In the case of that other car, they were doing something incredibly dangerous with their children in the car. They were tailgating on a slippery twisty road and then went through a red light. Is there anywhere you really need to get to that quickly to make it worth risking your life?

The most frequent tailgating I get is on this road near my house. I always slow down there because about 25% of the time, there is a cop car lying in wait. I'm holding my breath for the moment that the car behind me gets pulled over for tailgating me.

Books vs. Movies

I love to read. I feel like there is nothing like being midway through a really great book. My husband, on the other hand, hates to read. I don't think I've ever seen him pick up a book in the entire time I've known him.

It doesn't bother me that we don't have that in common. To be honest, even if he loved to read, he probably wouldn't be into the same kinds of books as me. My taste in movies is fairly gender-neutral, but my taste in books is very girly.

Anyway, his assertion is that people make too big a deal out of reading, like it's some higher activity. But is it really any better to read a book than it is to watch a movie? Is there a greater cultural value in reading the book gone with the wind than there is in watching the movie, both of which are considered classics? or to pick something with less literary value, the Harry Potter books versus the Harry Potter movies?

Truthfully, even though I like to read a lot, I sort of agree with him. I don't read because of any sort of cultural value. I read because I like it. I'm not sure if it's any more highbrow then watching a movie. It's just more portable and often more fun for me.

El Flu

Where I work, the flu shot is mandatory.

It doesn't mean we get fired if we don't get it or that they hold us down while jabbing at our left arm like my dad did to me when I was 16 and didn't want a flu shot. What it does mean is that if you don't get a flu shot, then during the entire flu season, you are required to wear a mask in patient care areas.

In addition to the mask, you also have to wear a badge that explains why you aren't wearing the mask. The badge says "I'm wearing a mask because I care about your health." That doesn't sound so bad, except underneath that statement is a picture of the cartoon pig wearing a mask.

Personally, I am in favor of mandatory flu shots for everybody who is capable of getting it. I have heard a lot of the reasons people don't get flu shots and I think most of those reasons are dumb, in all honesty. Most of the reasons are something along the lines of, "I never got a flu shot and I have never gotten the flu before so why should I get a flu shot?" Or, "I got the flu shot once and got sick right after, so I will never get a flu shot again."

That said, if someone has a really good reason for not getting a flu shot, like a history of Guillain-Barre, then I'm not sure it's fair to restrict them like that. I mean, wearing a mask for four months straight really sucks.

Dr. Orthochick: Feelings

Morning Rounds, me seeing 60 y/o lady after her elective spine surgery

Me: How are you?
Patient: Terrible! starts crying
Me: What's wrong?
Patient: My boyfriend broke up with me! He said he couldn't handle me being in the hospital! We've been dating since February and everything was going so well!
Me: I'm very sorry to hear that...
Patient: Can you give me an anti-depressant?

Feelings are overrated.

Code Dentures

I got possibly one of the most annoying pages ever yesterday. It was a nurse calling to inform me that an elderly female patient had stolen her elderly female roommates dentures.

And where was this lady keeping the dentures? In her mouth, obviously.

The denture thief was demented and apparently would not let anyone take the dentures back. So what exactly was I supposed to do? Knock her out so we could take the dentures?

To be honest, I'm pretty sure the roommate didn't want them back at that point.

Weekly Whine: Waste

I'm embarrassed to tell you how much of my day is spent in documentation. There are some moments during every day when I feel more like a secretary than a physician. But it's important to do, not just to communicate information and to cover my ass but also for the sake of reimbursement. In order to bill for my time, I have to document a certain way.

There are times when I get pissed off about the fact that I have to do all this documentation. Don't insurance companies trust me? I'm very honest. Then I hear a story like this:

A cardiologist told me that back in the "old days", he used to bill for reading arterial blood gases. Every time a patient on his service had an ABG, he would "read it" and then bill some ridiculous "reading" fee. He apparently made a ton of money doing this.

I have heard dozens of similar stories about the crazy things people used to bill for in the "old days."

Older generations of doctors: you ruined it for the rest of us.