Historical Reference

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This is a picture of me with my great grandmother. I loved her.

She died age 93 on my 9th birthday.

Her nickname was “Tiny”. She chewed tobacco but I did not realize it until years later. She kept a spit can under her bed and had this black ring around her mouth that left a nasty aftertaste when she kissed you. Blech.

We thought she was crazy!

She lived in a house that was as ancient as she was and we loved to sneak upstairs when she wasn’t looking. We would raid the shelves of old fashion magazines and books, going through bureau drawers and closets. We found amazing stuff!

She would wander the house in a threadbare house coat that was so thin, you could see her 90 year old nipples showing through. I thought she was beautiful!

She always complemented me on my hair and would ask to brush it. I would sit in her lap as she brushed stroke after stroke after stroke, back when my hair was long enough to reached my waste. She was the first person to make me feel beautiful.

I have pictures of her up on the walls in my clinic. She was extremely poor and one picture features her with her mom, a sister, and a brother. Her brother is wearing a hand me down dress and they are standing outside of their home, a tumbledown one room shack. Her brother died very young from appendicitis. Another picture has her standing solemnly outside a dugout. She even lived for a few years in a tent with her young children.

My grandfather had a scholarship to a local college to study chemistry, but he could not afford the bus fair. He dropped out after two semesters, found a job, and bought her a washing machine with his first paycheck. He was so proud telling me about that, decades later. He never finished college.

I wish I has known her better before dementia set in. I would have loved to know how she managed to keep going in the face of so much adversity.

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Happier with a Hoover!

On the stairway landing in my house I have a series of vintage ads that make me smile. There is Santa proclaiming that he would like an Eversharp-Schick shaver in his stocking and the HotPoint fridge that famously “offers more!”

But my favorite is this one here:

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I love it for several reasons.

FIRST, Hoovers don’t make me happy. In fact, I hate cleaning so much that the only time I will do it is if I am cleaning someone else’s house (then it is a charitable event) or I am high on steroids. This very morning I was looking around the shambles that ought to be my kitchen and sighed. I will never be able to stop working. I have to justify being able to pay someone else to do this for me…

SECOND, if I did happen to clean my own house, I would probably wear high heels and a dress to do it. I would sip a glass of champagne as I twirled the feather duster around the knick-knacks. I am not saying it would be a quality job, but I would look dang good doing it!

THIRD, it reminds me that I don’t have to have someone else telling me what I need to make me happy. I am not someone else’s ad target. I don’t follow their rules. I find my own things to make me happy. That woman in the brown dress? That is who my parents wanted me to be.

Not me.

So save your million dollar advertisement budgets for the mindless masses. It won’t work on me! Unless you are my sister in law, in which case I am totally crazy about Legos and you know what is on my Christmas list…

Hiding Behind The Blank Phone Screen

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Cue the angels singing the Hallelujah Chorus, folks. I am off call! That’s right. An entire week of being at everyone’s beck and call 24/7 OVER! At least for six weeks.

I was sitting at the salon on Saturday with red dye sitting on my roots and eyebrows, looking like an utter clown while returning a call to a pathologist about a markedly abnormal blood count on his slide review. I dread the day when video calls will be the norm because I will not be able to get away with that.

Or with calling patients back about their abdominal pain whilst taking care of my own business in the loo.

You people starting medical school right now…you may have work hours restrictions but by golly you won’t be able to hide behind a blank phone screen by the time you are out of residency. Smirk followed by a winky face.

Obesity and The Subjugation of Women

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No, I am not a bra burning man hater.

I was reading a fantastic post this morning by The Crazy Crone on weight and feminism that made me pause and think. Read her take here.

Since I am on the medical side of things as a physician:

I don’t think the clinical term obesity was intended back in the day to be used as it is today and, at least in my practice, it is not intended to be used as a derogatory term. It is purely clinical. Because it means what it does and weight is such an emotionally charged issue, no matter what term we use, I suspect people would feel the same. There are points where weight HAS to be addressed, such as in the context of severe arthritis or diabetes. The problem is that many physicians have not had weight problems (the selection process for medical school has a bias towards “attractiveness”) and they lack compassion and empathy when addressing the issue with their patients.

Yet there is way more to this issue than just doctors’ responses.

One of the terribly disturbing trends that I see now is that employers are doing much of the shaming. I don’t even have to bring it up.

The big push right now, at least in the US, is for employers to do biometric screenings on employees. I fill out countless forms every year informing employers what my patient’s BMI is as well as their waist circumference, cholesterol, blood sugar, and blood pressure so that they can “earn” a discount on their health insurance.

This bothers me greatly.

On some level, to keep insurance costs down, having a healthy population helps. Yet, I am not sure how shaming someone for a BMI over 25 is going to make them a better employee.

For instance, this week I had an RN from the affiliated hospital tell me that they were pushing everyone to have a certain BMI. They told everyone that they wanted to be the premier healthcare provider in the country and as such, in order for employees to maintain credibility, they have to be “skinny”. She shrugged it off as if it was no big deal but commented she needed to shed a few pounds. Her BMI was 25.5! What is worse is that she was not even using the medical system’s insurance. She was on her husbands and did not have to participate in the biometric screening for insurance purposes. The hospital was driving this independently, doing BMI’s during staff meetings.

The Abercrombie and Fitch of healthcare? I don’t know. Is it really about health or is it about the appearance of health?

I am not sure why having a bit of elevated blood pressure or some diabetes affects an employee’s ability to perform their job. Sure, make employees see their PCP and supply a piece of paper that says they have done this every year. Screening is good for early detection and intervention. Why do they have to invade privacy by asking for actual numbers that are not relevant to job function? Why can’t this remain between the patient and their physician?

To carry this further, as pointed out by The Crazy Crone, this undue focus on weight disproportionately negatively affects women. Most of my male patients couldn’t give a rip if their BMI is 25. But my female patients care. They care very deeply.

I don’t want to go so far as to say this is a vast conspiracy to subjugate women. Generally, those instituting these policies genuinely believe they are doing the right thing, but it does give me pause. How much more powerful would we be as women and human beings if we were not so distracted by trying to meet someone else’s often unattainable definition of beautiful or even “healthy”? If we loved ourselves more? If we loved each other more? If we had good self esteem and not self loathing?

Sure, we should be healthy. We should take care of ourselves and our bodies. Extreme obesity does decrease life expectancy and costs more healthcare dollars. Yet studies have shown, repeatedly, that people in the bit overweight category actually live longer than those of “normal” BMI. Check it out.

And that, my friends, is my own two cents worth.

Roses

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“True love is like ghosts, which everyone talks about and few have seen.” – Francois de La Rochefoucauld

One of the cool things about doing what I do is that I get to hear everyone’s secrets. All day, every day, women are spilling their guts to me. So I know I am not alone.

This is why Fifty Shades of Grey is so popular. The fantasy is so much better than the reality for many of us.

Maybe that is actually so for most of us?

As I get older and see my youth slipping away, there are times I am overcome with jealousy. My dreams for reckless, consuming love are lost, replaced by complacency and mutual comfort. Not that it isn’t love. It is. But it is not the fantasy.

How does one find peace?

Nature

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There are hundreds of thousands, if not millions, of people taking photographs of the same places I have been. I can look back at a photo I have taken and think, “Wow! That was great!” But the odds are pretty high that someone else has taken that exact same picture at some point or will in the future.

The exception? Water and sky. Those ripples will never be the same in anyone else’s photograph. The clouds above? They will never look exactly like that again. The rocks, the sand… those will likely be the same. But the lighting as the sun goes down has its own unique beauty exclusive to that single moment in time.

And I captured it. This is mine!

Blind and Toothless

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While typing away on my accursed computer a couple of years ago, all of a sudden I could not see the bottom left of the screen. It was gone. Boom! No black hole. It was simply just not there.

It started to spread. Then, it was replaced by blurring that wound around to the center of my visual field in a sort of spiral with crisscrossing stripes of scintillating grays.

The realization hit me. My retina had clearly detached.

I was going blind!

There are two things that terrify me more than anything else in this world:

Losing my teeth and going blind.

I struggled to maintain composure as I wrapped up the visit with the patient and ran to the phone where I dialed the ophthalmology office down the street. (I send them tons of patients. Surely they will find a way to work me in!) Of course it was 3:45 in the afternoon. Odds were not looking good.

After several holds and line transfers, I was finally told to get my bo-hiney straight on over. By then, my vision was back to normal. I almost said, “Never mind!”

But I didn’t.

I didn’t want this spell to be the warning with the “big one” just waiting to strike the fatal blow to my vision and my livelihood.

My partner agreed to see my last couple of patients.

I sat anxiously in the sub waiting area while my eyes dilated. Try being bored for 45 minutes when you cannot focus on anything smaller than a two by four. Everyone around me was trying to avoid making eye contact with each other, but without the ability to see our smart phones, it was… awkward. There was nothing else to focus on, except the ceiling.

“Well, doc. What we have here is a case of ocular migraine. You are going to be just fine.”

My heart sank. I was a wee bit disappointed, I realized. I wanted it to be real. Real but fixable. An ocular migraine? That seemed like something crazy people complained about.

Wait. Was I crazy?

Maybe.

“How stressed have you been lately?”

I paused, thinking. Stress? I mentally scoffed at the notion of stress. The optho stared at me, waiting.

“No stress.” I smiled sweetly at her.

I sounded convincing because I actually believed it myself.

She shrugged. “Well, it may happen again. Or maybe not.”

On the drive home, with my nifty disposable wraparound sunglasses, I thought about all of this.

First, I know what ocular migraines are. I talk to patients about them. I diagnose them. It struck me how when it is you (or someone close to you) how quickly you loose sense, reason, and perspective. A good reason for the quote from Sir William Osler: “The doctor who treats himself has a fool for a patient.”

Second, and more importantly, I was stressed out. My body recognized it before I did. In the midst of my denial, it decided to send me a message.

You can’t go on like this!

I might not have permanently lost my vision per se, but I was blind to my stress level.

If you ignore it, it doesn’t exist. Right?

Nope. It is still there.

Moral of the story? Give yourself a break. Not to say that I have. Yet. Maybe someday. Oh. And brush your teeth.