Reading The Signs


I spent the day yesterday playing with my kids. We made the BIGGEST pile of leaves I have ever, ever seen and literally swam in it. Why do people pay money to have someone get rid of their leaves and then pay to go to the gym? This upper arm, ab, and leg/butt workout was way fun and soooo much cheaper…

Then, I made sourdough cinnamon rolls and sourdough bread and hummus encrusted chicken and ninja bread cookies (like gingerbread men but in the shape of ninjas… they were pretty awesome).

I have been missing this…

To be honest, my job is a huge demand on my time, but so is blogging. Yes, blogging. You all know this. You do it, too. I read a ton of YOUR blogs. I answer everyone’s comments (I like to have the last word, so sue me). I write a post 6-7 days a week because I am obsessed over the blog traffic numbers. And what do I have to show for it? 

Not a whole helluva lot.

Well… except for making some really great friends (I love you guys!), honing my writing skills, and having plenty of stuff to put in that imaginary book for my kids some day.

It occurred to me today, though, that I have been missing looking my kids in the eye. My phone is always with me. My blog is at my fingertips. I am OCD. And ADD. And who the hell knows what else? So my eyes are constantly drifting down to the screen. Get a second to breathe? Check the phone: Oh, someone made a new comment… let’s respond. 

“Just a second, honey…”

If I make it seem like I have everything together, let me assure you, I do not. It is a delicate balancing act to keep it all from toppling down at any given moment.

My kids are still of the age where they like me most of the time and I intend to make use of this, creating memories enough to use as cement later when they realize I am not really that cool mom. 

Adolescence is coming….

Therefore, there will be changes here. I am not going to give up blogging, but I intend to slow down the pace a bit. How much? Dunno. I will let you know after New Years.

I realize it is a huge a time commitment to read this blog every time I post and to those of you that do, I thank you. You make this whole thing worthwhile. To those of you that don’t, I don’t blame you. 

Merry Christmas! See you in 2016….




The fetid odor hung heavily in the air, prevented from dissipating by the closed space of the exam room.

“So help me, if he farts one more time, I am going to stab him with a serrated steak knife,” she growled.

Anger radiated off of her.

“For years I worked while he was retired.” Her voice rose higher. “Every day I got up early and drove to work. Did he ever help around the house? No. He was disabled. Back pain. ‘I hurt too much!’ he would whine. Instead he watched goddamn Westerns all day while eating vast quantities of peanuts and cheese balls. I hated him every single day.”

She paused, took a breath, and then continued.

“When it was finally time for me to retire I was really looking forward to being a woman of leisure. Maybe traveling. Maybe just sleeping in. Heck, maybe even helping out with babysitting the grandkids. Instead, he has a frickin’ stroke and here I am babysitting HIM!”

She pointed over at the man in the wheelchair. His vacant eyes were staring off into a far corner. A bit of drool dangled from his stubbled chin.

At that point she broke down sobbing.

“I should have divorced him years ago. When will I have MY happiness?!?!! Now everyone says, ‘What a saint you are for taking care of him!’ Bah! I just want him to die already. But I cannot SAY that. Not to anyone. To them I am a such saint. If they only knew….”

Another Post


This morning I saw three patients, ran to my kids’ school Christmas program for an hour and a half, then ran back to the clinic and saw more patients. 

At the time this gets posted I will be having lunch with the office staff for our Christmas party: exchanging gag gifts and eating some terribly unhealthy, yet super tasty, fast food salads. You see, salad is a ranch dressing delivery system in the South (United States)…. And being a doctor’s office, we like to at least pretend we are healthy, even at Christmas.

I got off topic. Sorry.

To be honest, I felt terribly guilty about taking time off for my kids’ school program. I wrestled with it for a couple of weeks when I learned of the change in time (it was supposed to have been last night). This time of year the clinic is crazy busy and those slots were already booked weeks in advance. I HATE making patients reschedule…

Sometimes I *think* I am a better person than I really am, though. I told myself it was all about the patients. That IS true to a large extent….

AND YET, while I love and adore my kids, probably to a fault, I realized last night that I would NOT feel as guilty playing hookie to go see Star Wars *if* I had tickets for today. I am not saying that I would have no guilt. Just less guilt. I don’t have tickets but if I DID I would probably even have ditched the school program for it. You can judge me if you want, but those school programs are beatings and, well, Han Solo is still awfully darn sexy.



Each year I get stuff sent from specialists who want to say “thank you” for sending patients (and oh by the way please send some more). 

Are you curious? Wondering what gets sent? 

So far this year:

A neurosurgeon, as he does every year, sent a stack of personalized note pads of assorted sizes (actually kind of handy). 

An orthopedic surgeon sent a lemon  bundt cake. I used to get half a cow or a smoked turkey but I did not refer to him that much this year…

A hand specialist that I don’t refer to anymore sent a huge gift basket of cheap crackers and processed cheese food and dried meats. Blech.

One bottle of wine. I threw away the card without paying attention to who sent it. Thank you, whoever you are!

A rheumatologist that I don’t ever refer to sent one of those tower boxes of candy and caramel popcorn. 

A large group of GI specialists sent an expensive pecan pie (makes me want to donate it to a patient that will be seeing them shortly so they can hook up with the pie again on its way out).

There is a giant tin of assorted popcorn flavors from a sleep specialist, for late night snacking.

Another giant bin of flavored popcorn from an ENT.

A card from an opthomologost saying that he made a donation to a charity in my name (I might be blind but I don’t see how much of a donation listed anywhere on the card.)

A big box of Swiss chocolates from a bariatric surgeon. Drumming up business in more ways than one, apparently.

More chocolates from an OB/Gyn. Because, you know, periods…

There is still over a week left before Christmas. No telling what else is gonna show up. The people that I refer to the most, though, never send a single thing and I’m actually quite glad for that. 

What are some of the odd things you have gotten from people during the holidays?

Growing Pains


My daughter has been letting her hair grow long. She wants to look like Rapunzel, she says. It is almost down to her waist… golden and gorgeous. 

I am quite jealous. 

And, secretly, rather proud. 

However, there is this certain part of a certain Disney version of Rapunzel where her hair gets cut and it changes from golden blonde to brown…

My daughter had to try it out at school yesterday. 

Now there is a very big chunk of hair missing from the right side of her head. Very big.

I cannot be mad. Hair does grow back, after all. Secretly, I am proud of how ballsy was to chop her hair off and I am proud of her curiosity. Truthfully, I feel bad for her now that she knows her hair is not magical. HOWEVER, her school program is on Friday and Santa is visiting tomorrow and there will not be time to get that hair “fixed” beforehand. It is going to require a professional and I just cannot rationalize canceling patients for my daughter’s vanity and my own bitter pride.

So if you happen to see her before Saturday…. yes, I know. Just pretend it isn’t there…



“I am always sad this time of year. I miss my son.” Her voice wavered a bit as she tried to speak around the lump forming in her throat. 

“I am sorry,” I said quietly, grabbing the box of tissues for her.

“He’s been gone for four years now and I still cannot shake this sadness at the holidays.” Tears formed and overflowed. She dabbed at them. I already know that she is in counseling, that she does not want to discuss meds, that she is not a danger to herself.

“I am not sure you will ever get over it, you know. Not completely.” She nodded understanding.

My heart aches for her. A pain that threatens to swallow me up if I let it. 

I stand.

Part of me wants to stay. I want to talk to her about her son. What was he like? What does she miss about him the most? But I can’t. My other three rooms are full and I am running 20 minutes behind. 

My mind races ahead to what lies in the next exam room…

So instead I give her hand a squeeze and when that just does not feel adequate, I give her a good, strong hug. 

“Rosie will be in shortly to take you to the lab for the blood draw. I’ll see you back again in three months.”

And I walk away…



I don’t know if it is true that I diagnose more bad things in December than other months but sometimes it feels that way. Maybe it is because people have finally met their deductables for the year and want to get all of that testing done that I recommended earlier.

Or maybe it is simply because we all feel the sadness of a bad prognosis more acutely during the holidays.

You Are NOT The Little People

cambodia2 086Dear office staff:

Over all everyone is doing a great job. A GREAT job. But sometimes things slip through the cracks, errors are made. We ID them. We call attention to them. We work to prevent them in the future. You don’t want to wait until someone dies or gets hurt to say “Ooops! Sorry!”

Everything you do or do not do is critically important.

So long as you are doing your best work, we won’t have any problems. Honest mistakes, OK. Learn from it and move on. Do better next time. But if you are deliberately trying to shirk a duty or punt to someone else? That is an issue. There will be consequences.

It is not lost on me that many of you think I am too picky. But I ask you, who do YOU want taking care of your family? Someone paying attention to the details? Or someone who does not give a flying rip about anything?

It is not someone else’s problem. It is OUR problem. We are a team. What is at stake? Someone else’s life. Someone else’s LIFE, people. 

You don’t understand the bigger picture. You don’t know what a particular medication’s side effect profile is or what a patient’s complex medical issues mean. That is fine. No one expects you to. You DO, however, have to trust that what I and the other doctors are asking you to do is reasonable and necessary. If you do not understand, then we expect you to ask. Don’t ignore. Ask.

Sometimes people are mean and ugly. That does not mean we stop caring for them as we would anyone else. They still deserve respect and attention… because they are human beings and because we do not know what is going on in their lives. We are on the front lines of pain and suffering. So many of our patients come from backgrounds where everything they have they had to fight and struggle for. They are not used to being heard. Can they trust you to take care of them? They don’t know! Not yet. But they will, right?

You are NOT the little people.



Poured Out

 interior of old passanger train car 

“Why can’t you fix him?” She demanded. “Why can’t you make him stop?” Her voice rose as we talked in the hallway.

“Have you removed the alcohol from the house?” I knew the answer but I still asked to make the point.

“No! My husband would never let me do that.” Her eyes flitted to the closed door then back to me. “He just needs to stop drinking.”

“He cannot. He cannot make a rational choice about alcohol. Not at this point.”

Over three years I had watched this young man deteriorate from a healthy, if somewhat anxious human being into the wheelchair confined jaundiced lump that sat trembling in my exam room.

“He’s dying.”

She recoiled in shock. Disbelief crossed her face.

“He is 23 years old and he is dying. You want to save him? Get him into a treatment facility. At the very least, get rid of the alcohol at the house like I have been telling you to do for months. He is your SON. But even with that, it may still be too late.”

“The doctors at the hospital said the same thing but I don’t believe you. I don’t believe any of you!”

All I could do was shrug.

I watched that tiny woman wheel the giant form of her son out the door. They never came back.

Six months later he was dead.