Whit’s fur ye’ll no go by ye!

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My first overseas trip was to Scotland about nine years ago. I was there for only seven days.

But it was absolutely magical… I had no idea that somewhere so beautiful lurked behind the mist! That country and its history seeps into your soul and never, ever leaves.

Maybe it was just something they snuck into the haggis?

At any rate, it struck me today what a blessing it is that a country gets to vote for independence. Vote. No bloodshed.

My thoughts and prayers are with Scotland and its people. No matter which way the vote goes this is a historic, awe inspiring moment!

Creeped Out!

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“What the world really needs is more love and less paper work.” – Pearl Bailey

I have been doing research for a future post on Medicare. Mind you, I never gave any sites my email address or my name or any other identifying information. No. I was just surfing the web, doing Google searches. I was not logged in under anything.

Not even two hours later I started getting emails for various Medicare scams!

How the hell does that happen?

How do they know?!??!

(Cue the Twilight Zone theme music…)

I may be getting older but I am a more than a couple of decades away from being eligible for Medicare so it wasn’t like it was some demographic thing suddenly got triggered. Nor was I getting Medicare junk beforehand.

Suffice it to say, I am really creeped out.

Now it makes me wonder if there is a more sinister reason that I have been getting all of that porn crap in my junk filter…

Peacock

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I have already mentioned that I dislike drug reps. Ok, maybe hate is a more appropriate term.

Today a hospice rep brought lunch for my staff. I rarely attend these these things because I generally feel the same about home health and hospice reps as I do about drug reps. (Insert rolled eyes here.) It is somewhat necessary to have them come, however, so we know who can offer what services. These agencies are constantly popping up and then disappearing.

My staff, though, kept showing up at my office door as I was trying to catch up on clinic notes and phone calls saying, “Hey, doc, this guy says he is friends with a lot of your friends! You should go say hi!”

He was name dropping like crazy.

Now, I know good and well that he is not friends with these people. Hell, I am not even “friends” with these people. I know them because I have worked with them but we don’t socialize otherwise. They would never say that we were all friends…

These kinds of people anger me. Strutting peacocks.

What made things even more upsetting was that he felt the rules of my clinic did not apply to him. You can be in the break room from 12-1 to talk to the staff but after that, get the hell out. He was still there at 2PM until my office manager kicked him out.

And under absolutely no circumstances are you allowed to wander the clinic and “pop in on Dr. —-” He seriously thought he would just saunter on over and pop his head into my office while I was on the phone chatting with a patient about their vaginal discharge…

He has been banned.

Just Shoot Me…

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When I saw the article a few months ago about the state of Florida actually making it a criminal act for physicians to ask about guns in the home during an office visit I shrugged it off.

Surely they can’t be serious!

But they were. In fact, the courts upheld the law. Read about it at the NY Times here.

Now, as a kid I shot guns. Lots of them. Automatics. Semiautomatics. 9mm’s. 22 caliber rifles and pistols. My father was preparing us for the apocalypse. Seriously. Someone, somewhere should have told him what he was doing was wrong. No one did.

My brothers and I were given guns for birthdays and Christmases. We were completely unprepared for the responsibility and honestly it is a miracle that no one got killed. We were not living on the wild frontier protecting the homestead from marauders and preventing the livestock from being torn to shreds by wild animals. We were silly kids with no serious sense of responsibility with cavalier attitudes about very dangerous weapons.

I completely respect patient privacy. No one has to answer any question I ask, ever. I also understand a paranoia and mistrust of the establishment to an extent. I grew up with it.

But asking about guns is relevant to healthcare. I don’t ask every patient, generally I stick to my pediatric and depressed patients.

Don’t get me wrong. I don’t believe all guns should be destroyed, that no one should have access to them at all necessarily. It is not my place to decide, really, and certainly it is not my job to police it. What I do believe, however, is that we need to remind parents how serious these things are in the hands of kids and remind them protect those kids if needed.

There was a time I used to get indignant when patients lied to me or withheld information. Then a patient’s medical record, and myself, were subpoenaed during a divorce proceeding. What about physician, patient confidentiality? Can they even do that?!?! Yes. Yes they can. Nothing in writing is ever truly private. I understand the fear. I really do!

On the other hand, I take issue with a government entity criminalizing what I do or do not discuss during the course of an office visit. If I sexually assault a patient, hell put me away. Malpractice? Take my license. But at least respect my professional judgement enough to allow me to decide what counseling I need to give my patients.

What is next? A script for me to follow item by item or face jail time? Patients have every right refuse to answer a question or to ask me to not document their answer in the chart, but I should have every right to ask a question if it is relevant.

As always, I learn a ton from you all. I would love to hear your views and perspectives about this…

Disequilibrium

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This morning I read an opinion piece on particle physics “Will the God Particle Destroy Us?” by Meg Urry.

Now, I am not much into particle physics. Hell, I am not much into physics at all except to say that I have become more intimately acquainted with gravity than would like, watching my boobs and other key parts of my body droop. But this article explains it in terms that are easy to understand.

In fact, it seems VERY parallel to biology. We are alive only because all of the different chemical and enzymatic reactions in our cells and bodies are kept in perpetual disequilibrium. As soon as we go to equilibrium, we die. Thus for the universe as well….

Which then got me to thinking about relationships. If we were in complete harmony with each other wouldn’t our relationships eventually cease to exist?

It is the fact that he can infuriate me so much sometimes that keeps me interested. It keeps me in love with him.

Go figure.

Living With Immortality

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“To himself everyone is immortal; he may know that he is going to die, but he can never know that he is dead.” – Samuel Butler

Every day I watch my elderly patients struggle with their loss of independence, the certainty of their own mortality.

Today was terrible. My patient to who is in her 80’s and has travelled the world, looked at me with bewildered, pleading eyes.

Can’t you make this stop?

She was in for a hospital follow-up, her third so far this year. Her last overseas trip was just about nine months ago. She is coming to grips with the fact that travel is over for her. Her world is shrinking.

“Getting old is awful, Doc.”

Yes. Yes it is.

I had another patient tell me once that she had thought she had escaped wrinkles… until she had her cataracts done. “Doc, I cried for days and days when I saw what I really looked like!”

What are the positive things about growing older?

No more periods (but that comes with hot flashes). Grandkids (if you like them). Retirement (if you can afford it).

I would love, love, love to hear about the positive things you have discovered/learned for yourself or heard from others. I need some encouragement as I am getting older, too!

The Perils of Having A Doctor Mom

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My son has been very curious about what exactly a heart attack is since learning that his grandfather died of one right before he was born. The conversation went a bit like this:

“Mommy, how did Grandpa Eddie die?”

Awkward pause while I considered how much detail to share…

“Mommy?”

“Ok. Yes. Well, he had a heart attack.” I decided to leave out the part about it being in the throws of passion with a prostitute.

(Okay, okay…the part about the prostitute is not true. Made you giggle, though, didn’t it?)

“Mommy, what’s a heart attack?”

“Well, dear, you remember the Magic School Bus book that talked about how blood brings oxygen to your body and how we need oxygen for our bodies to live?”

“Yep!”

“So in a heart attack, the heart can’t get enough oxygen to work so it can’t pump blood to deliver oxygen to the rest of the body. Without oxygen, the whole body dies.”

“Ohhhhhh…..” He chewed on this for a bit. “Mommy, can I die from a heart attack?”

“Well, maybe someday but not for a long, long time. That is why I make you eat your veggies. They help keep you healthy.”

“Ok. I will eat my veggies,” he said solemnly.

I was feeling pretty dang good about the stroke of veggie genius when he ate them without fussing the next night. Woohoo!

Well, last night I apparently made a comment in passing about something giving me a heart attack. He was apparently concerned about this and stewed on it all night. He brought it up to his teacher today.

She wrote the note:

“I hope and pray everything is Ok at home! He said his mother had a heart attack last night. Mrs C.”

Tonight we are learning about idioms…

Okay….

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Seen on a bridge in Boston.

Mind you, it was a metal grill, through which you could see to the river moving very fast very far below. The whole thing shook as cars and trucks and busses passed over. Not sure there was any fear free zone!