The Psyching

In honor of Halloween, for a short time, my short story The Psyching (included at the end of "11 out of 10") will be available for free in the Kindle store!



Download a copy now!

Here is the blurb. Obviously, any similarity to The Shining is completely and utterly not not coincidental.

Jack Lawson's job as the psychiatric resident at the Overlook Hospital is perfect for him. As the overnight resident on call at the psychiatric ward, he'll have plenty of time to spend teaching his medical students, Danni and Wendy, and working on his writing. And most importantly, sleeping.

But as the evening wears on, the idyllic psych ward feels ever more boring… and also more sinister. And the only one to notice the strange and terrible forces gathering around the Overlook Hospital is Danni Gerard, a uniquely gifted 24-year-old medical student.

Write a sentence

The Mini Mental State Exam (MMSE) is a test given to elderly patients as an assessment of their memory and cognition. One of the questions on the test asks the patient to write down a sentence of their choosing. I recently performed this test on a patient who is 90 years old, and I think they wrote my absolute favorite sentence in all my years of performing this test:

Photo day

Photo day at school has definitely taken on a new meaning in modern times.

When I was a kid, my parents agonized over how many copies of which picture to get. Or I'm sure they would have, if they were interested in pictures. Anyway, what I'm saying is I'm sure it was important in those days.

Now all I want is one copy so I can make my own damn prints. I'm paying for somebody to take a nice picture of my kid, that's it.

Somehow the packages don't reflect that:



I don't know why anyone would pay so much money for a bunch of prints that they can order on their own for 1/10 of the price. I feel like these companies should just recognize that and basically just email us the one print at whatever cost is reasonable.

Useful measurements

Can anybody tell me why this is a statistic included in the discharge summary for adult patients:



(And more disturbingly, why is it 0%?)

On blogging

I have been blogging for a long time, in one form or another. Since college, actually. There were times in my life when I used to write posts two or three times a day every day. In this blog, I had  2 pages worth of posts scheduled at any given time. There were times when it was almost like an addiction… I tried to quit or at least cut back, but I couldn't.

I don't have that problem anymore.

I recently went to Michelle Au's blog, and realized that it had been dormant for almost 2 years.  It comforted me to recognize that it is a normal and natural thing, after having multiple children, to lose motivation to keep blogging.  Healthy, even.

The problem with this blog is twofold. First, blogging is dying. Most of the blogs I used to follow years ago are gone. Truthfully, I don't really have any desire to read blogs anymore. Second, because this blog is public, I can't write about anything from my personal life or job. So if I can't write about that, the topics I can write about are limited.  And less compelling.

I've lost a lot of readers in the last couple of years.  Also, I try not to respond to subversive comments, because I just don't care enough to have an argument anymore. And partially for that reason, there are less subversive comments. I think it's obvious when a blogger has lost their enthusiasm.  

I want to stick around. There are times when I want to write about something and I'm grateful this blog exists. But I refuse to look at this as an obligation. So I apologize if my posts become more infrequent.

Donations

I just wanted to let everybody know that thanks to your purchases of 11 out of 10, I was able to donate $300 for the month of September to deworm the world initiative!

And I am also donating a portion of the profits from Baby City to the fistula foundation. I was able to give them $750!

Appropriate

Physician colleague: "did a urologist call looking for me?"

Me: "I don't think so. What's the urologist's name?"

Physician: "Dr. Wang."

Me: (bursts out laughing)

Physician: "you're really immature."

ICD 10 WTF?

This is just an example of how ridiculous ICD 10. These are the codes I came up with when I tried to type in pedestrian hit by a car, which is a common occurrence that should be easy to look up:



So it's easier to code for somebody injured on a kayak than being hit by a car?

WTF abbreviations?

I have to say, after number of years of being a doctor, I am familiar with most abbreviations the people use. But I have to say, this exam was completely unintelligible to me:

ICD 10

This week, I have been in ICD 10 hell.

I understand needing a new coding system to address new diseases or whatever. (Actually, I don't entirely understand.)  But so far, it's been a big pain in the butt.

One problem that I see right off is that it seems to expect us to have much greater knowledge than we actually have. If a person had a stroke, you have to know the exact reason why they had the stroke. Ditto with any other medical condition. Because medical knowledge is apparently perfect.  

Also, the diagnoses are ridiculously long.  Take E08.329, which is:

"Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema"

It took reading that three times just to absorb what it actually meant, much less figure out if it applies to my patient. It seems like the goal of this coding system is to make our heads hurt.  If that's the case, it has succeeded big-time.

Useful vaccines

Woman: "my granddaughter is getting vaccinated, but I'm not sure if she should get all the vaccines available."

Me: "She should if the pediatrician recommends it. Which one are you concerned about?"

Woman: "the vaccine for HIV."

Me: "Wow. She should definitely get that one."