Stretched

Dinosaurs in the American Museum of Natural History

“I want to change doctors.”

Reviewing her chart before entering the room I could see that she had been asking for this for months. The medical assistant had warned me that she was going to bring it up again.

“Why?”

“Well, I never get to see her when I need to. She’s always out or I have to see the nurse practitioner because she’s too busy. Besides, you were the one recommended to me by several coworkers but you weren’t taking new patients.” She stared at me, accusation in her voice. 

“Well, the reason I stopped taking new patients is because the ones that I did have could not get in to see me when they needed it.”

Some days I have open slots that don’t fill. It makes me antsy but I try to remind myself that not overloading the schedule ensures that people can get in if they need to. I want to be able to see them, have a relationship with them, even if it hurts my bottom line. THAT gives me joy.

“….But you should also know that I have kids. Sometimes they get sick. Or I get sick. Or some other emergency pops up…”

“Well, she doesn’t have kids. At least not that I know of.”

In truth she is undergoing a fertility work up, hoping to have kids but it was not my place to tell a patient this without her permission. A woman should have the right to have a child if she wants one, shouldn’t she, even if it inconveniences others.

I agree to take her on as a patient. The very next day:

“Uh, mom?”

“Yes?”

“I just puked.”

The smell of vomit began to waft through the car. I cracked a window.

“Block my open slots until I can get to the clinic and see what is going on.”

“You don’t HAVE any open slots.”

As my daughter retches again into the plastic sack I know I don’t have a choice. They will all have to be rescheduled. There is no one else that can watch her.

“He’s going to have surgery. I’ll need to be out for at least a week….” 

It makes me nauseated to think about it, rescheduling that many people, but it just cannot be helped. 

He needs me.

No doubt someone, somewhere is asking to change doctors. Knowing that bothers me on some level but being a mom also brings me joy. My kids deserve a mom who can be present for them. It strikes me that this sort of issue is unique to female physicians. It is partly why we make less money. It is partly why we don’t hold as many leadership positions as our male counterparts. 

I choose my kids. 

I choose my family.

Meanwhile, I am sitting in a hospital room with my laptop, trying to do as much as I possibly can from here.

That doesn’t make me better. Or worse. Just different. 

Or maybe the just same. 

Thursday Thoughts From the Throne

Thomas Fuller quote over NYC bridge

If you will recall my corny post from last month, Twindaddy of Mental Defecation correctly deduced that I had written that post while sitting on the toilet. Truth be told, I do a lot of blogging from the potty. Clearing the bowels tends to clear the mind. In the comments Twindaddy graciously offered to allow me to use “Thoughts from the Throne” which was a recurring feature on a previous blog. I love alliteration. Alliteration is sexy. 

So I am going to try to make this a recurring feature. It may not be every week, but from time to time you may see this title and I wanted you all to know where it came from. 

Also, you should know the above image was created using Pixlr. Desley Jane at Musings of a Frequent Flying Scientist did a post on this recently. I have found that it is addictive…. 

Blow

Sailboat in the Hudson Bay

“How much time are you spending on social media?” 

“Well, I stopped completely until about a week ago. I’m easing back into it.”

“Really? You stopped it all? Completely?” I tried to keep the suspicion out of my voice.

“Yeah. For about six months.”

“Why?”

“I didn’t like how it made me feel.” There was real, actual eye contact, no phone in sight. 

“Now that you are back at it, what do you think? Does it make you feel good?”

“No.”

“So what do you think you are going to do?”

“We’ll see.” She shrugged. “Maybe I’ll pull the plug again.”

That, folks, is a kid who is going to be all right…

Infertility 

Ellis Island hospital

Graciously bestowing 
You spilled your precious seed
Upon my barren ground
Ignorant and unknowing
An unfulfilled wanton need
Your attempt at marking 
A territory unfound
Traversing the open sea

The ownership unclaimed
My body left untamed
Believing you were deceived
I’m naked beneath the gown
Empty loss echoes down 
Long abandoned corridors
Infertility finally decreed
By the sterile orators 

Devoid of progeny 
The solemn sodomy
Repeats itself again
Another painful bleed
An unwelcome visitor
Testifing silently
Before the Inquisitor
Sounding the final amen

A viscous self loathing
Clogs the rusted plumbing
Magnified through your eyes
Value is forever drowned
Held down by a flood of lies
I’m merely something to breed
A conduit for birthing
Your immortality 

Proximity

Pizza shop in New York City

“I need to do a six month physician supervised weight loss program before I can get the gastric sleeve covered by my insurance.” She wasn’t even that heavy to start off with, her BMI was 32. She wasn’t diabetic and did not have high blood pressure. 

“You are going to be married to a fistful of vitamin supplements for the rest of your life.”

“I don’t care. I am tired of being fat, of having people judge me.” I understood. People can be so cruel. “My friends have all had it done and they look great,” she said hopefully. “But I can’t loose too much weight right now or I won’t qualify anymore…”

We both knew she had no intention of really trying. 

Sure enough she demonstrated a nice weight gain at each visit and steadfastly refused to count her calories or exercise or do anything except to say, “I’m cutting back, Doc. Really I am. I don’t know why I keep gaining this weight!” 

I don’t know why that sort of thing qualifies someone for surgery. A barbaric surgery with lifelong consequences. Sometimes I wonder about the ethics of the surgeons doing these things and why there isn’t better after care for people undergoing the knife. Cut them up and then cut them off seems to be the plan across the board. 

She had her surgery. 

Three years later her weight was back where it started from and then some and she wanted a referral for a surgery revision. 

I wanted to say, “I told you so.” And then I wanted to call her surgeon up and give him a piece of my mind.

But I didn’t….

A few weeks ago I was at one of those giant outdoor malls. There were easily 20-30 restaurants clustered around. Right there in the midst of it all there was a weight loss clinic. 

Having just eaten at the Melting Pot myself I was so stuffed it was hard to breathe. Way too much food to be healthy but then why didn’t I just stop eating? I was too focused on not wasting anything. Getting my money’s worth. I blame my upbringing. I blame past poverty. I blame portion sizes. 

I blame myself.

Where does that come from, anyway?

At first I was offended that this clinic placed itself where it did. Then I realized it was a brilliant marketing strategy. This is what we have become, isn’t it?

Binge. Purge. Binge. Purge.

Binge.

“How’s your daughter?”

He smiled and pulled out his smart phone, flipping through pictures of a grinning, curly haired toddler. They’d had so much trouble having a baby. 

“Oh, she’s beautiful!” 

He nodded, beaming.

“How is your wife?”

His face changed in a instant. He looked stricken. “You knew she had the gastric sleeve done?”

“Yes, I had heard.”

“Well, she developed Korsakoff Syndrome.” Oh. Wow. “She got confused, couldn’t remember things. Couldn’t walk straight.”

Thiamine deficiency.

“When she said she wanted to get the surgery, I didn’t say anything. I just wanted her to be happy. She suffered so much emotional turmoil over her weight. We had no idea something like this could happen, though. If I could go back in time I would tell her she didn’t need to do it. That I loved her just the way she was. Now she is not the same person. She has to carry a book with her to write everything down since she has so much trouble remembering things and she uses a cane to get around.” 

“Mommy, I’m thirsty!”

It was swelteringly hot. I stood in line to get our fifth soda refill of the day in the $15 red amusement park drinking bottle I had purchased earlier that morning.

*Free* refills on Coca-Cola products all day!

I don’t need Coke products. My kids don’t need Coke products. Water would do just fine to keep us hydrated. But STILL…. I paid $15 for that stupid cup since I could not bring anything into the amusement park. I want to get my money’s worth, dang it. A small bottle of water costs $4.50 a pop multiplied by at least five times per person per day… but soda pop in the big red drinking bottle? Yeah. What is anyone going to pick?

So here we are.

Making money by making people fat. Making money to make people skinny again. Making money getting them fat again. Making money to get them skinny again.

And so on.

It does not ever stop.

How do we make it stop?

Worn

Interior, Metropolitan Museum of Art

Every year around this date I especially find myself marveling at love…

Love that is gained and lost, and found again. Love that is unrequited and unrewarded and yet still persists. Love that claws its way through the heart and lodges itself there against all logic and stays regardless of physical presence or absence. Love that endures despite being utterly spent, never quite reaching the point where it simply cannot love anymore. 

Lonely love.

Brilliant love.

Eternal love.

For over twenty years I have loved this love. At times gingerly, even tentatively, and at other times fiercely and with conviction. Is it more valuable for bearing all of the scars and scuff marks, the wear and tear of time and hurt? Is it more precious for simply surviving?

Perhaps….

But then, all love is precious. 

Emergencies 

Sunset reflected in a road puddle
“I want a wart removed this Friday”

“The doctor does not have any openings for a procedure this week. We are short staffed and she is completely booked. We can get you in on Monday if you like.”

“I am going on vacation next week. The doctor always accomodates me! You tell her I want to have this removed on Friday.”

I do try hard to get people in when they need it. But sometimes…

Honestly, it has been a rough week. 

With one of my partners out, our nurse practitioner out, AND it being the week before school starts back for many kids in the area… the clinic has been crazy. Finding time to blog/breathe/pee has been hard to come by.

“Fine! You tell her I am finding another doctor.”

It is like this every year. 

Next week it will be a ghost town around here but for now those emergency wart removals are killing us. 

Past Pains

Ruins of the Ellis Island Hospital

A deafening shriek reverberated again off of the tiled walls and metal tables, the sound of pain and fear made all the more palpable as it echoed around the cold, hard surfaces and magnified until it shook the very core of anyone listening. 

The staff inside that room did not make eye contact with each other over their masks. To acknowledge anyone’s humanity, even their own, would only serve to distract from the task at hand.

*****************************************

This is another shot from inside the ruins of the Ellis Island hospital. Several areas contain art by JR, a French artist. Generally speaking, I prefer my ruins untouched but this image seemed to enhance the spooky feel rather than detract from it.

It is disconcerting to stand in the empty rooms and corridors imagining the hustle and bustle of a busy hospital. There are times you can almost feel the brush of someone passing or hear the echoes of fear and hope whispering off of the crumbling walls. 

I ran into some photos of the hospital taken in areas that I did not get to see when I was there and it makes me want to go back, to somehow have more access. I wonder what that would take? 

Have you ever felt drawn to a place in a way you cannot explain?