Monday, December 10, 2018

Cleaning dilemma

I was wondering if I could get advice on this....

We recently moved into a house where laundry has become a huge pain in the neck.  Our W/D is in the basement and our bedrooms are on the second floor, and since I injured myself twice trying to carry laundry upstairs, I've decided I'm not going to do that anymore.  Part of having money is being able to pay people to do stuff you don't want to do.

So we have a cleaning woman to whom I pay $150/session, and she has agreed to do the laundry.  But she feels our dryer takes too long, so last time I came home from an exhausting day at work to find dry clothes in the dryer, wet clothes in the washer, and ANOTHER load of wet clothes in a basket.  I literally started to cry because I had a headache and I couldn't deal with three loads of laundry right then.

I don't know what to do.  I feel like there must be a solution to this problem, but I haven't found it.  I don't know if I'm expecting too much from our cleaning woman either.  But I know I don't want to come home on her cleaning days to a shitload of wet clothes I then have to deal with.

Wednesday, November 28, 2018

Do I eat healthy?

I've been looking at my diet lately and trying to figure out if I eat healthy or not-so-healthy.  And I'm honestly not sure.

So one of my favorite things to eat is vegetables.  Good start, right?  I buy about 3-4 bags of frozen veggies every week. (I heard freezing them maintains the nutrients.)  That said, I don't steam them or anything like that.  I will put them in the frying pan with a little olive oil, some butter (maybe a tablespoon), and cook until delicious.  I top it with a sprinkling of sea salt, and that's dinner.

What's the verdict?  Healthy?  Unhealthy?

Thursday, November 15, 2018

Guest post: Adorable

A senior doctor came home and told his physician wife about the adorable first year medical student who came to clinic that day. Quiet, in her little white coat, she listened attentively and ‘actually’ spoke up at the end of the discussion and made a valuable observation.

His doctor- wife was none too pleased. “Adorable? How could you even say that? At least don’t repeat it to anyone else.”

I already did,” he admitted sheepishly. “But it was to a woman faculty member, and I prefaced it by saying, “this might be inappropriate, but…”

It reminded her of her childhood when the mean girls would say ‘no offense, but…’ then follow with a totally offensive comment. She secretly hoped those girls googled her now. Anyway.

She pointed out how the desire to apologize meant you should keep your mouth shut. She then trotted out all the reasons why he should never do it again.

It is demeaning. Would he have referred to a male student that way? Yes, he replied. Even if they were 6’3” and ‘built’ (he is 5’9”). Yes, he replied. I doubt it, she responded sagely.

It implies naïveté. Babies are adorable, puppies are adorable. Both being tabla Rosa, unformed, certainly not learned. Which leads to:

It is disrespectful. Prior to arriving in his clinic, she had devoted at least 6 years of AP classes, SAT prep, pSATs, SATs, a pre-Med curriculum, extracurriculars, MCAT prep, MCATs, interviews. That’s not ‘adorable’, it’s impressive. Very impressive for a woman or man (another pet peeve, calling med students and residents ‘kids’, but that’s for another time).

Finally, she is not sure the student would want to be graded on a rotation by someone who thought she was adorable.

Tuesday, November 13, 2018

Stuffing emergency!

Two posts two days in a row??  What's going on!

But I need help!

Thanksgiving is next week.  And I'm not gonna lie, one of my favorite things is Stovetop Stuffing.  I will eat it all year round.  Usually I buy it in the canister and eat it over the course of a month or so.

Recently, I moved to a new town, and they don't have the canister at the grocery stores.  So I got the box, which is also fine usually.  Except when I made it, it tasted awful.  It tasted like mushy bread with no seasoning.

That was the chicken flavored stuffing, so I then bought a box of savory herb stuffing, thinking that might taste better.  It was not.

Now it said it was savory herb, but here is a sampling of stuffing from the box.  See if you can spot the ONE herb. It's harder than finding Waldo. It basically just tastes like flavorless chunks of bread.

What is going on here???  Why is all the stovetop stuffing I buy awful????!!!!!

Monday, November 12, 2018

Don't stop reading

I was reading some old blog entries I'd written here ages ago.  It shocked me how brazenly I criticized my co-residents and attendings.  I was fearless and/or stupid.

I didn't care if they discovered those posts.  In fact, I hoped they would.  Because then they would see what a jackass they were for complaining to the female resident who had to take time off to have surgical repair for her fourth degree tear during childbirth that "you just had a vacation!" (Vacation = maternity leave)

But now I care.  I wouldn't insult people from my current job or even my last job.  It's a small field, and I respect those people too much.

And I don't want to just talk about my family.  This is not a Mommy Blog.  I don't want to be the author of a Mommy Blog. 

So the only thing left to write about is how my cat writes emojis in her litterbox:

(Honestly, I always felt like my cat isn't that playful, but this litterbox winky face proves me wrong.)

Fortunately, I recently made an online friend who is a female physician who expressed interest in writing some guest posts.  And she's at the end of her career, so she does not give a shit who she insults.  That must be nice.

So stay tuned.  I should have a post from her this week.  Or failing that, more cat poop emojis.

Wednesday, October 17, 2018


In the next twenty-four hours, I will be arrested for first-degree murder.

I don’t know how this could be happening. I’m not the kind of person who goes to jail for murder. I’m not. I’ve never even gotten a speeding ticket. Hell, I’ve never even jaywalked before. I’m the most law-abiding citizen who ever was.

“They have a pretty solid case against you, Abby.”

My lawyer, Robert Frisch, does not sugar coat things. I’ve only known him a short time, but I already know he’s not about handholding and gumdrops and lollipops. He has spent the last twenty minutes enumerating all the police department’s evidence against me. And when I hear it all laid out for me like that, it sounds bad. If I were some neutral third party listening to everything Frisch was saying, I’d be thinking to myself, That woman is definitely guilty. Lock her up—throw away the key.

The whole time I was listening to Frisch, my heart was thumping wildly in my chest. It actually made it a bit hard to hear him for stretches of time. To my right, my husband Sam is slumped in his chair, a glassy look in his eyes. Sam was the one who hired Frisch. He’s your best chance, Abby, he told me.

So if he can’t help me, that means I have no chance.

“It’s all circumstantial evidence,” I say, even though I’m not certain that’s the case or even exactly what circumstantial evidence is. But I know one thing: “I didn’t do it.”

Frisch lets out an extended sigh and folds his arms across his chest. “You have to understand that if this goes to court, you’re going to be convicted.”

If this goes to court?”

“I’d recommend a plea bargain,” he says. “When they arrest you—”

I imagine the police showing up at my door, snapping metal cuffs on my wrists. Reading me my rights. You have the right to remain silent. Is that something they really say in real life? I don’t want to find out.

If they arrest me,” I correct him.

Frisch gives me a look like I’m out of my mind. He’s been a criminal attorney for nearly thirty years. One of the best. You can tell how successful he is by the leather sofa pushed up against the wall and the mahogany desk where he’s got a photo of himself shaking the hand of Barack Obama. I’ve got money, but the length of a full trial might bleed us dry.

“Second degree murder is fifteen years to life,” Frisch says. “Whereas for Murder One, you could get life without possibility of parole. If you plea down to Murder Two—”

Monday, October 8, 2018

middle aged

From a discharge summary:

"Patient is a 37-year-old middle-aged man..."

I was horrified to read that!  37 is NOT middle-aged!

Although then I told this to my husband and he argued that 37 very well might be the middle of your life.  And it's almost definitely the middle of your productive life.

But I also feel like for someone with a career that requires education, the 40s should be the peak of your career.  And as someone who is nearing that point, it's a lot of pressure.  Maybe it would be better to be middle-aged now...

Friday, September 28, 2018

Starting over

So I recently moved and have had to go through the process of meeting all new people again.

It’s so hard!

I am constantly approaching new parents at the playground and introducing myself, but I still feel like I am begging when I try to make a play date. It’s especially hard for me because I am not naturally outgoing.

Has anyone gone through this process recently? It’s really depressing to have to start over again.

Monday, September 17, 2018

What a shame

I was recently advocating for a young patient who had been hit by a car to get more time in rehab.  I was talking to the insurance company, and the second I got on the line, it was really clear they didn't want to hear anything I had to say.  (Honestly, does it EVER work to advocate on the phone?  Because whenever I talk to anyone, they already know everything in the notes, and they've already decided on a hard no.  And repeating my arguments just ends up with a heated discussion.)

In this case, it was especially frustrating because the patient was, as I said, fairly young and really could have benefited from the extra time.  I said to the reviewer, "It's really a shame he can't get more time because if he had another week, he could get home independently."

The response of the reviewer: "Well, it was a shame he got hit by a car."

Me: "..."

I mean, what do you SAY to something like that?  Sometimes I want to say to them that I hope they have a better insurance than the company they work for.

Saturday, September 8, 2018

You suck, Shutterfly

When you've got kids, the tendency is to want to take a million photos of them.  And this can quickly get out of hand.

So since my younger daughter was born, I've been diligently making a hardcover photo book on Shutterfly every six months, so I have the photos organized.  And the photobooks are so small, so far they only take up a quarter of a shelf in my bookcase.

Lately, I've been noticing Shutterfly gives you more and more options when you make a photo album.  Like you have the option to have pages that lay flat or a special cover or whatever.  But this time, there was a new option that sort of pissed me off:

Basically, they are giving you the option to remove their crappy logo from the book and it costs TEN DOLLARS.  To remove a tiny logo.  I like how they mention that without their logo, the book has a "clean, sophisticated look."  

Monday, August 27, 2018

Paint job

Lately, I feel like every time I deal with people, I hate all of humanity.

We recently moved out of an apartment where we had lived for eight years.  During that time, we never got a paint job.  So I assumed any damage to the paint on the wall would be something we wouldn't be responsible for, given places need to be painted more frequently than that.

So I was really surprised when we got a bill for $140 for painting the apartment from the giant company that owns our complex.

When I called, they complained that there were stickers on the wall that were "difficult to remove" and had to be sanded off.  I find it really hard to believe that a child's sticker required more than soap and water, but whatever.  I didn't even think of it.  Then they complained there was some crayon on the wall, so the whole place had to be repainted.  I said that in eight years, weren't we entitled to ONE free paint job?  They said no, that they expected the walls to be in the condition they were when we entered eight years ago, except for "minor touch ups." 

Also, we paid to have the apartment professionally cleaned when we left, but I forgot to tell her to clean the fridge.  So we got a bill for $130 for cleaning of the fridge and oven.  Except the oven is self-cleaning.  So it's $130 to clean a fridge apparently.  I should get a job cleaning refrigerators.

Then they told us like they were being so nice to us that we didn't have to pay for them to replace the carpet, which wasn't even new when we moved in.

I mean, it's not a huge amount of money but it's the principle of the thing.  We lived there eight years.  I feel like we're entitled to one paint job, for god's sake. 

Tuesday, August 14, 2018

IT help

Yesterday, I spent a whopping THREE HOURS on the phone with IT.  I wanted to cry by the end of it.

The only silver lining is I actually really like the IT guys.  They are centered in Alabama, and they all have these absolutely adorable Southern accents.  Really sexy, actually.  I want to comment on it to them, like, "I love your accent," but I suspect it will be taken the wrong way.  I probably sound like I have an accent to them.  I recently got told for the first time that I had a New York accent, which seems odd considering I haven't lived in New York for over a decade so how could I be getting a New York accent?

Anyway, I was joking with one of them about how hot it had been lately, and he was laughing at me and saying I didn't know what hot meant.  Then he told me about how the whole state got shut down over half an inch of snow in January.  I said that around here in January, that's just Monday.

That said, three hours on the computer helpline is beyond painful.

Wednesday, August 8, 2018

Too late

My kids have been going to the same summer day camp for about six years, which has also been their afterschool program.  It's a great program, and for the most part I've been happy with it, although they will not be attending next year because we're moving.

Anyway, on one of the last days of camp on which only my youngest was attending, they were going on a field trip, which they do maybe 3-4 times a week.  It was an 8:30 a.m. cutoff (which is usually 30 minutes before the leave time), and this is generally earlier than we would arrive most days.  So I got my daughter going early, and even with some bad luck with traffic, I got to the camp with the clock in my car reading 8:30. 

Except when I got into the camp, the trip director Lucy said, "Oh, I'm so sorry, it's 8:32, and the cutoff was 8:30 so we can't take her."

I was absolutely shocked.  First of all, my watch said 8:30.  Second of all, the bus for the trip hadn't even arrived, the lunches were still in an open cooler in the classroom, and nobody has made any move to leave.  When I pointed this out, she said, "Yeah, but I've already done the buddy list.  So there's nothing I can do."

We went back and forth on this for much longer than it could possibly have taken her to add one child to the buddy list.  (Presumably less than two minutes, since the cutoff was 8:30 and she was done with the buddy list by 8:32.)  I mean, it's not like a rocket was taking off and the doors were slamming shut at 8:30.  It would have been so easy for her to let this happen.  In fact, on another occasion three years earlier, I got the cutoff wrong and was late by FIFTEEN minutes, and even though they yelled at me and had already put the lunches on the bus, they still let my kid stay.  If they had turned me away that day, they would have been justified because I was really late, but they didn't.  So there was no reason for me to believe that being late by something between not at all and two minutes would result in rejection.  I'd seen plenty of parents stroll in at the deadline.  In five years, they were NEVER strict about this.

At some point, I was almost in tears, begging her to let my kid stay because I genuinely didn't know what I was going to do.  And my daughter was crying because she thought she wouldn't be able to go on the trip.  I'd known Lucy for about six years--she was new as trip director, but she taught my kids dance several years ago.  She was a new mom, so I thought she'd be sympathetic.  But no.

Finally, I saw the owner of the daycare, who I also knew pretty well.  I flagged her down and told her I was two minutes late, could my kid go on the trip.  She said, "Of course!  We always do a five-minute window!"  I had a feeling she'd say this, but I didn't want to go over Lucy's head.  But I had no choice, and Lucy had to eat it.

So my daughter got to go on the trip, I got to go to work, so technically, I WON.  But I was fuming all day.  I felt like Lucy had an opportunity to very easily be decent to me and she chose not to for no reason other than... I have no idea what.

Thursday, July 26, 2018

Little help?

Inspired by a recent burst of sales of my book Brain Damage, I decided to write something new. 

My newest book is a departure from my others in that the protagonist is not a doctor.  It's my first book that is a straight-up women's thriller.  The title is The Surrogate Mother.

The last time I published, I asked for help with beta reading and got some pretty good opinions. (It's already gone through four people.) So I'm asking for help once again!  Anybody interested in reading a thriller written by yours truly and offering a constructive opinion???

You must.....

--Actually want to do it.  Please don't do it out of obligation or because you feel sorry for me.

--Have read and enjoyed at least one of my other books.  The one beta reader I got last time who hadn't read anything by me got halfway through and quit.

--Be able to read it in under one week.  And after reading it, be able to email me your opinions in a coherent way.  And not vanish instantly when I ask a follow-up question.  (If these things hadn't happened to me repeatedly, I wouldn't say them.)

--Enjoy thrillers.

Here is the prologue, so you can see what you're getting into:

I have been informed that in the next twenty-four hours, I will be arrested for first-degree murder.

I don’t know how this could be happening.  First-degree murder.  I mean, that’s crazy.  I’m not the kind of person who goes to jail for murder.  I’m not.  I’ve never even gotten a speeding ticket.  Hell, I’ve never even jaywalked before.  I’m the most law-abiding citizen who ever was.

Wednesday, July 25, 2018

Row row row your boat

We rented a rowboat a few days ago to row around a local lake.  Apparently, it was a popular idea because there were a ton of other people around in rented boats.  And I noticed something all the boats had in common:

In any boat where there was a man in the boat, the man was the one rowing.

This was true without exception.  The only boats where a woman was rowing were the all-female boats.  And then it occurred to me that I've been in these boats a lot of times, but I'm not sure I've ever rowed one.  

So I guess I'm the problem, not the solution?

Thursday, July 12, 2018


My mother: "How long do you cook spaghetti after the water comes to a boil?"

Me: [baffled that my 70-year-old mother doesn't know how to make spaghetti]

Mom: "Well, I never make spaghetti!"

If it were someone else, I would worry they were getting demented, but it's actually the kind of question my mother asks me not infrequently.  Like she's never sure how to calculate the tip in restaurants.  And she didn't know what a pinata was.

I finally told her to look at the box, which said 10 minutes, but she insisted that wasn't usually that long.  Although I don't understand how it can "usually" not be that long if she "never" cooks spaghetti.  I asked and she said:

"I cooked it once a long time ago."

I can just see my kids writing stuff like this about me someday.  They already gave me a hard time for not knowing which produce qualifies as fruits.  (How could a zucchini be a fruit????)

Tuesday, July 10, 2018

The Mosquito Bite

I don't know what it is, but it feels like as I've gotten older, mosquito bites have been getting itchier.

Last week, I got a mosquito bite on my elbow.  It immediately started driving me totally insane.  I read somewhere that toothpaste helps with the itchiness, so I smeared that all over it, which everyone in my household informed me was "really weird."  Then I used witch hazel pads to ease the itch.  I was bad enough that it was waking me up at night.

My husband: "Why don't you just use calamine lotion?"

Me: "We don't have any in the house."

Actually though, it turned out we had TWO bottles of it, which I've been using religiously ever since.  It's a lot less messy than toothpaste.  I also tried liquid bandaid, which burned so much, I had to wash it off immediately.

I have to say, I think the elbow must be one of the worst places to get a mosquito bite.  After the penis, I suppose.

Thursday, June 28, 2018

New stuff

I don't know why, but I have a lot of trouble buying new stuff.

I don't mean stuff that I need necessarily.  But new versions of items I already own.  For example, I only recently got rid of a jacket I've had since college.  I've been wearing the same shoes for two years (although I have replaced the insoles).  I do have new clothes, but only because my mom loves buying me clothes.

When we moved to this area with all our old furniture gone, we bought an apartment-full of stuff at this college store nearly a decade ago, which we assumed we'd replace over the years.  We still have almost all of it.  Ditto with all my pots and pans and dishes, aside from my one big frying pan.

I don't know why I'm so adverse to buying new stuff.  I guess I always just feel like why should I replace a perfectly good [insert name of object]?  I don't really enjoy shopping for new things.  Honestly, it sort of stresses me out.  I only replaced my awful laptop because it wouldn't run a program I needed for work.

But you'll be happy to know I do replace my toothbrush on a regular basis.

Monday, June 11, 2018


I feel massive, crushing guilt about not posting here more frequently.  Well, not really.  But I do feel a little bad about it. 

The problem is, the less you post, the less you post.  No, that's not a typo.  Basically, if you're only posting every couple of weeks, you start to feel like every post you make has to be incredibly profound.  It's not enough to make a post about a Cheeto you found that looks like a guy masturbating.  And since my life is not that profound, I don't know what to post.

Also, I'd post more if the blogger app didn't suck so bad.  Just sayin'.

The big drama in my life these days is I bought a new car.  It's a Subaru Forester--my first SUV.  I'm horrified I did this... the best thing about my kids getting older was I didn't need to have a bigger car, but somehow this car happened. I love/hate it.  I love the way it drives and the visibility is great.  I hate everything else about it. 

The thing I hate most this week is I realized I had the option of getting a trunk that opens automatically, but because the salesman didn't tell me this was an option (because he probably wanted to unload a car nobody wanted), I didn't get it.  So now I have a trunk that's impossible to close for short little me.  I called the car dealership and cursed them out, but it's not like it's some big revelation that car salesmen are skeezy. 

Question of the day: if I live in a place where snow comes out of the sky on a regular basis during the winter months, do I need special tires?

Monday, May 21, 2018


I don't want to overgeneralize, but when it comes to patients, all old women love me.

Partially because I really try to relate to them.  I ask them about their kids and their grandkids.  Again, I don't want to overgeneralize, but all old women love to talk about their grandkids.  Although I do pretty well with the ones who don't have grandkids too.  Like, we talk about bridge.  I think deep down, I'm actually a 70-year-old woman.

The only problem is that once I get them talking, it's hard to stop.  I find it very easy to do a directed history on a chatty patient, but I feel bad interrupting someone in the middle of a story about their grandchild.  But if I let them, each of these patients would go on for hours and I'd get home sometime after midnight.

Any advice on how to cut these conversations short after a respectable amount of time?

Thursday, May 10, 2018

Vitamin D

Vitamin D seems to be the new big thing.  I've had multiple friends tell me they were feeling tired, then they were diagnosed with Vitamin D deficiency and started feeling better after taking supplements.  We check Vit D levels all the time on patients.  I myself have been a believer in the Vit D hype, and even take supplements myself.

But now this review has come out, stating that "Routine vitamin D supplementation does not prolong life, decrease the incidence of cancer or cardiovascular disease, or decrease fracture rates... Randomized controlled trials of vitamin D supplementation in the treatment of depression, fatigue, osteoarthritis, and chronic pain show no benefit, even in persons with low levels at baseline."

Interesting.  I have to admit, it gives me pause.  Is all the Vit D hype over nothing?  Is this like when I used to take zinc when I thought I was getting sick?

Monday, April 30, 2018


Maybe it's just my imagination, but lately, I feel like I've been noticing a lot of people saying "supposably."  And I'm talking about college-educated people who should supposably know better.

Supposably--not a word.

And neither is "irregardless."

But I'd probably sound like a jerk if I said that.

Monday, April 23, 2018

Being responsible

It feels like the people I know who don't work in medicine don't seem to understand the responsibilities people in medicine have toward their jobs.

I was ill with a fever a few weeks ago, and I was having a bit of post-viral malaise (still am).  I wasn't feeling fabulous, but I wasn't actively sick or anything.  Just dragging a bit since the fever, although improving.  I was supposed to work at the hospital over the weekend, and multiple people told me I should blow it off.  Adults.  Who have had or currently hold jobs.

One person further suggested I should take several months off.

It's exhausting to explain this to people.  Including my husband.  Do people in other fields really don't get that you can't just take off work without warning just because you're a little tired?

Monday, April 16, 2018

Our neighbors

I don’t know what to do about my neighbors.

I live in an apartment building, so I’ve never actually met them. I’m not even sure if it’s my upstairs neighbors or my side neighbors. But lately, they’ve been bothering me a little.

The guy who lives there shouts curses a lot. That part doesn’t bother me. Usually I notice it because I’ll be getting dressed in the bathroom and I’ll hear him screaming curses.  It’s a little unsettling, but also somewhat amusing.

However, on two occasions, his shouting woke me up. Last night, it woke me up at 1:30 in the morning. On another occasion, I think he might have been having a fight with his wife at six in the morning. I heard him screaming, “What the fuck do you want from me???” over and over at what sounded like the top of his lungs, and then a woman giving a muffled response.

I’m not sure what to do about this.  It’s not in a place where the kids can really hear it, so I’m not bothered if he yells curses during the day, but I’d rather not be woken up by shouting. But I’m not even sure where the guy lives, and he seems like a possibly unstable person I don’t want to antagonize. We’re only going to be living here for a few more months. What do you think I should do?

Sigh.  Just when the baby moved out...

Monday, April 2, 2018

Customer service

I feel like as a doctor, part of my job is customer service.  Because when I see inpatients, a lot of the time when I ask at the end of seeing them if there's anything else I can do for them, they have a complaint about their call button taking too long to be answered, the food being bad, their roommate being too loud, etc.

I try to handle the complaints best I can.  I never ignore them.  I say something like, "I'm so sorry that happened.  Let me see what I can do to fix it."  Then I tell them my plan, which involves anything from talking to the nursing supervisor about nursing issues or to the unit coordinator to get them a room change.  I can't personally fix the problem, but at least I try to show I'm taking it seriously and addressing it.

It's made me a lot less tolerant of bad customer service.

Recently, I got an email at 6PM from our leasing office, saying that tomorrow (a holiday when kids were off from school), they were doing repairs and our water would be shut off intermittently "after 8AM."  I was horrified.  We didn't even have a day's notice of this!  I was going to be home with the kids all day and how can you do anything at home when you don't know if you're going to have water to clean it up?

I called the office, and the woman I spoke to was almost rude.  She assured me they were in no way obligated to inform us in advance of such a thing.  When I asked for a better estimate of when the repairs were being done, she huffed, "I gave you an estimate already!  It's going to be after 8AM."  I was like, "But that's the WHOLE DAY."

Finally, after talking for several minutes, I pleaded with her to at least talk to the repairmen in the morning to see about getting a better estimate on the time, and she very grudgingly agreed.

How hard would it have been to apologize to me for this unexpected inconvenience?  How hard would it have been to offer to check with the repairmen instead of forcing me to beg her to do it?

I think Customer Service 101 is not acting like the complaint is the fault of the customer.

Wednesday, March 14, 2018

Do you smoke?

Me: "Do you smoke cigarettes?"

Patient: "No."

Me: "Did you ever smoke in the past?"

Patient: "Yeah, I quit a week ago when I was admitted to the hospital.  Before that, I smoked a pack a day."

I don't get that.  If a doctor asks you if you're a smoker and you only quit a few days ago, you are still a smoker.  Why do people do that?

Friday, March 2, 2018

Women in medicine

Yesterday, a female resident went in to see a patient.  A bit later, she returned with her male attending.

Patient (to the attending): "You're so lucky you get to bring your wife to work with you!"

Attending: [horrified] "She's not my wife!"

Patient: [winks] "Even better..."

Monday, February 19, 2018

Survey on your experience...

I recently bought some expensive tickets for a show through a ticketmaster-type website.  After the purchase, it said my e-tickets would be delivered to me in twenty minutes.

Three hours later, I still hadn't gotten the e-tickets.  So I sent an email to customer service.

The next morning, I still hadn't gotten tickets or a response, so I called customer service.  The rep I spoke to basically acted like I was being impatient.  She was like, "Well, you bought your tickets at 7PM on a Friday night... what did you expect?"

"I expected the tickets in twenty minutes if that's what your site said would happen."

"Yes, but it was after business hours."

"Right, but the email didn't say I would get them the next business day.  It said I'd get them in twenty minutes so it's obviously automated."

"Yes, but nobody is working on a Friday night."

"Your site says the tickets are supposed to arrive in twenty minutes. If that's not going to be the case, the site shouldn't say that."

We went back and forth like that a bit, and she was basically blaming me for being impatient.  But the show was in a few days and it was clear something had gone wrong.  Finally, she basically put in an email to.... someone. 

"And when should I expect a reply?" I asked. "Like, at what point do I need to call again?"

"I don't know," she said, sounding very exasperated.  "Look, you'll get your tickets before the show!"

I finally gave up on her.  A few hours later, I got an email from customer service, saying my ticket purchase somehow hadn't been uploaded to the system, and they fixed it, and my tickets arrived five minutes later.

In any case, after my call with that woman, I got an email asking to rate my interaction with her.  I essentially never fill these things out, but i was so steamed, I did fill it out, and mentioned how unhelpful she had been and that she blamed me for being impatient when there was actually a glitch in the system.

It just got me thinking about surveys in general.  Sadly, I'm the sort of person who only fills them out when I have only an especially great or awful experience.  That's the inherent flaw in things like Press-Ganey.  Unless everyone is required to fill them out, how can you really get an accurate assessment of care?

Monday, February 5, 2018

Weirdest winter ever

Usually by this point in the season, I've been sick at least four or five times.  Having a cold is sort of my thing.  And this winter has been really bad for everyone around me getting sick.

Yet weirdly, I haven't had one cold all season.  I have had some sinus issues, but no actual colds.

It's honestly almost a little frightening. This hasn't happened since I've had kids. I'm wondering if my body is revving up for some monsto-virus that will result in my death.

Or have I now just acquired every upper respiratory virus circulating in a 30-mile radius and have become immune?

The only other thing I can think of is that I started taking multivitamins this summer.  Could that be why I'm not getting sick??

Thursday, January 25, 2018

An education on late term abortions

I was recently talking to a friend of mine named Joe who works in health care and is an intelligent, well-educated person.  The subject of abortion came up and Joe told me he was pro-choice, but...

Joe: "I just don't think women should be allowed to have abortions at 37 or 38 weeks pregnant.  That's just wrong."

I think I gasped audibly and said, "Oh no!"  I didn't understand how a smart guy in healthcare could believe women were having abortions two weeks before delivery.  Or putting it another way, that there are doctors out there who are effectively willing to murder full term fetuses.

Donald Trump said it during a debate though.  And while people did point out that this ridiculous, I always felt like a big enough deal wasn't made out of this.  Our presidential candidate believed women are allowed to have abortions at full term.  How can we brush that off?

I calmly tried to explain to Joe why this logic made no sense, and he quickly said, "I don't want to talk about it anymore."  And.... that was the end of the discussion.

Now I am someone who sympathizes with people who are genuinely pro-life.  I have female friends who believe life starts at conception, and can talk intelligently on the subject. I am willing to listen to anyone who does not just want to ban abortion as a way to punish women for having sex. But the issue of late term abortion is one that I think is confusing to a lot of people, and I genuinely believe that very few of the politicians, especially the ones trying to ban abortion after 20 weeks, really understand anything about it.

This is an incredible article by an OB/GYN about late term abortions.  Here are the highlights:

1) Late term abortions make up about 1% of all abortions, so banning them does not really reduce abortion rates much.

2) 80% of late term abortions are for serious birth defects, many of which are incompatible with life.  Should politicians really get to decide if women have to spend four months with a baby with no brain in her uterus?  Why is that even a political issue???

3) Most of the remaining 20% are for serious maternal health reasons.

4) After 24 weeks, abortion is NEVER performed.  Delivery is always attempted.

Essentially, these politicians want to keep women with the most heartbreaking situations (tragic birth defects, life-threatening conditions) from getting medical treatment.  I can't figure out any way to justify it other than ignorance about late-term abortions.

Tuesday, January 23, 2018

Watch phone

You guys always give great advice when I ask for it, so I’ve got an important question:

My 11-year-old has already destroyed one laptop by dropping it on the floor.  I want her to have a phone but she’s assured me she’ll probably lose or break any phone I get her.  So I’ve been considering getting her one of those watch phones for kids that has a GPS, can call a few select numbers, and text a little.  They seem to run $30-70 on Amazon.

Does anyone have any experience with these phones? Recommendations? Advice? If it makes a difference, we have AT&T.

Tuesday, January 16, 2018

Physician suicide

I was talking to a medical student recently who said he didn't want to do a residency in NYC because "everyone there kills themselves."  I think that's a little dramatic, although I do recall several years ago there was a rash of suicides in residents.

I just read an excellent article on physician suicide.  What's sad is that if a physician really was feeling suicidal, I guarantee there's no way they could seek counseling quickly that wouldn't jeopardize their career and confidentiality--the only effective way would be to threaten suicide, which would take them to the ER and give them a record of suicidal behavior.... a fate many proud physicians would consider worse than death.

I'm going to take a step further and say mental health treatment in this country is really bad.  This is not a jab at mental health professionals, who are probably fine individually.... just saying there aren't enough of them. The system is bad. If someone is feeling depressed or suicidal, they can call their local behavioral health center and maybe get an appointment in a month or two.  Hopefully they're alive by then.

I had a few really down periods during my medical training, so I can speak to all this from experience.  There were no mental health services available.  At one point, when I was having a really hard time, I called some student health hotline, and the person told me that this wasn't the purpose of the line. I asked where I could go, and they said such a service didn't exist at the school. They talked to me a little, but it was clear that they were just doing it to be a good human being, and not because it was their job or something they were trained in. 

So.... I guess the takeaway is don't get depressed because if you do, you're shit out of luck.

Monday, January 8, 2018

Guest post: Weight loss surgery

Tuesday I sat through another hard sell for weight loss surgery. I'm so done.

I'm weary of doctors who won't hear my "no" and plow ahead extolling the virtues of procedures I have already investigated and decided are not for me. I would be at high risk of suicide if I allowed myself to be bullied into this. (That is not true for most people but would be for me.)

Today I felt calm enough to respond via email. To be sure, I responded plenty in the moment but everything I said was ignored or argued with and the doctor just kept going. My husband was present and he was shocked--as a fat man himself his doctors bring things up and then drop it if he says no. I talked with him about how hard it is to turn around and look for another doctor because I don't even know how THAT doctor will handle the sensitive issue of weight. If there's one thing I'd wish of doctors is that they come to appreciate how we've already survived a lifetime's worth of assaults on our self esteem based on our weight. Unless they've been there I don't know how easy that is to understand--but I wish they'd try.

I sent the following to Doctor M:

Subject heading was "Boundaries."

I understand that all doctors will discuss weight with their fat patients. I expect that it will be brought up. What I did not expect was the hard sell on weight loss surgery after I repeatedly indicated that I was not remotely interested in it and had firmly decided it was not for me for many reasons. You continued for something like 20 minutes AFTER I indicated that. But what is dangerous to my well being and survival was that you did so after learning I had spent months being verbally abused and was dealing with the resulting depression. Fortunately I've had years of therapy and could deal with the hurt, shock and distress I felt after having my boundaries violated.

It also concerns me that you'd dismiss the value of walking simply in relation to weight loss.

WEIGHT LOSS IS NOT A GOAL OF MINE. A Health at Every Size strategy of movement and eating healthy food IS. Obesity research has demonstrated that 95% of us regain. This is a feature not a bug.

Can you respect boundaries?