Random News and Views 1/30/10

Today I used a snowblower.  It was a life changing experience.  We really didn't get enough snow to use it but I did all the same.  Wow.  It made short order of the driveway and kept me from busting my back (that's  right- I can say that now that I am an old man of 38).  If you ever get a chance to use one, I highly recommend it....

The snow we did receive today was great for my dog.  She has been going ape shit in the house and now she is a pooped pup.  It is a good thing....However for a dog that may have the worst nose on the planet she still was able to sniff out the snow covered dog turds.  Apparently she enjoys a frozen snack while playing...

The girls went to a birthday party today.  They were supposed to dress as fairies.  Hmm.  I didn't have themes for my parties growing up...Just cake and presents and if I was lucky a trip to Skateway USA.  Oh well.  Not sure I would have liked having to dress like a fairy, especially if I had to go rollerskating too....

My son had a birthday party with the family last night.  We asked him what he would like to eat on his very special day and he said "Raman Noodles".  Nice.  That kinda left the rest of the family out in the cold but it WAS his birthday.  The kicker was he wanted a cookie cake.  Who thought of this sorry excuse for a cake?  Birthdays are supposed to have cake.  Period.  You don't have Birthday Pie, or Birthday Flan, or Birthday Cookies for that matter.  I do make an exception for ice cream cake because it is soooo tasty as well as for cupcakes (these are just miniature cakes anyway).  As nasty as the cookie cake is, it has practically disappeared already....

I love my girls, but they really can be aggravating at times.  Abby was throwing a fit before she left because who knows why...all I know is that she got this scowl on her face and was stomping her feet out the door.  We had to use the "if there is one more fit, you don't get to go to the party" line (even though we wouldn't have enforced it at all.  Please. Two hours of free babysitting...SWEET!).  Oh well, I am just used to Jack who is so easy going and never decompensates....Here is a picture of the girls when they are acting sweet...

Ugh.  They are so cute I can't stay mad at them for long.  This parenting thing is getting old real quick...

In case you were interested...

When I told my father that I was going to pursue a medical degree, I was a freshman in college.  It was just enough time between this revelation and summer vacation for my father to try to talk me out of it.  Before going on, I must reveal that my father is a General Practitioner and has been in private practice  for 50 years.  He has been my role model in my professional development and a colleague with whom I seek advice.  However, upon hearing that I wanted to be a physician, he wanted to make sure I had the intestinal fortitude to persevere in the rigors of medical training. So he did something that changed my life forever.  He arranged for me to work as a Nurse's Aide (NA) at my hometown hospital.  If you are not aware of the hierarchy on the wards from a nursing perspective, then let me enlighten you.  Top tier: RN's.  They are in charge of dispensing medicines, making decisions regarding when or if to call the physician and generally being in charge.  Then come the LPN's.  They also are in charge of dispensing meds and caring for the patient, generally doing everything a nurse does but getting significantly less pay for it.  If you want to know who the LPN is on the floor, look for the person with a chip on their shoulder.  If I did everything the RN did but got paid about half of what they received, I think my panties would be in a wad as well.  Then came the NA's.  That was me.  The NA had the distinct pleasure and responsibility of bathing, shaving, changing (both diapers and bed linens), disimpacting (that's right.  Disimpacting.  I don't think I have to tell you what that is because we all know that there really is only one cavity within the body that gets so backed up that manual evacuation is the only answer), enemizing (is this a verb?) and overall gopher and scut monkey.  Before I could begin, there was a training orientation that was required.  I had to learn the aforementioned hierarchy, learn to check vital signs (blood pressure, pulse, respirations), and generally have it drilled into my head that it is a privilege to care for the sick-I was literally an extension of the team and I must care for the patients as I would care for my own family members.  Well I can tell you that I took this VERY seriously.  I was going to be a DOCTOR by God!  This was what I was called to do.  Why did my Dad try to talk me out of it?  Of course I could handle this.  Please.  I was going to be the reincarnation of Marcus Welby or even better, Trapper John, MD.  So the day finally came to hit the wards.  I put on my uniform with pride (white shirt, pants, and shoes) and strut into the hospital.  I report to the Head Nurse and she tells me to go help a group of NA's and RN's that were having problems cleaning a mildly combative lady with dementia.  I stroll down the hallway and begin to hear moaning, squealing, and crying.  I then hear what I assume to be a nurse telling someone to "Be still!  We're almost done!"   I was appalled.  I must go and help this damsel in distress.  A white knight riding in to save her the humiliation being wrought upon her by the vile nursing staff.  I enter the room and there were 6 nurses/staff around a bed that contained a very tiny, frail, and wrinkly octagenerian.  One of the nurses yells to me, "Get over here and hold her hands down.  Watch out.  She is a mean old hag!"  I assume my position at her side and pick up her hand and slowly start to rub it.  I say in the most soothing voice that I can muster- "It's ok, ma'am.  I am here to help you.  Just relax.  Please.  Calm down.  Shhh...."  Her body seemed to relax, her eyes focused on me and became as big as saucers, welling with tears.  She then said "Oh, Oh, Oh. Please help me.  Please free my hands..."  I told her that I couldn't do that but that it was all for her own good.  She then said, in a not so nice tone of voice-"Oooo, I hope they pull your pecker off!"  BAM.  WHAM.  POW.  I was deflated. As the other medical staff just cackled and said "Welcome to the floor, boy!", I took a very valuable step in my development as a healthcare professional.  Never, never, EVER take yourself too seriously or have too high of regard for yourself.  There will always be a person there ready to knock you down a notch.  It became immediately clear to me why my father had wanted me to do this job.  If I could wipe butts, give enemas, change dirty beds and bathe paralyzed patients and still want to go into medicine, then there was no doubt that I could be a doctor.  He knew I could do the school work.  What he didn't know was did I have the drive and compassion to care for others, even when it was not the glamorous job of being a doctor.  I went on to work that summer and loved it so much I worked the following summer on the 11pm-7am shift.  I learned some great lessons those two summers but also experienced some crazy things as well-stories that I will remember forever.  For those that know me well, THIS is where a large part of my perverse sense of humor took root and blossomed.  In case you were interested....

A doctor goes to the doctor...

I went to the doctor today.  I must say I did not like the experience.  The anxiousness, the uncertainty, the paperwork, the WAIT.  Are you kidding me?  Good lord.  I show up 30 minutes in advance (because I was not going to be THAT guy who showed up right at or a few minutes late for his appointment) like a good little boy.  Filled out the reams of paperwork, paid my copay and then waited.  And waited.  And waited.  This time gave me the chance to fester and smolder with angst and fear about what may transpire if I ever make it back to the sanctum sanctorum. One hour after showing up, I was taken back to the exam room but first I was shown to the "Scale of Truth".  This inquisition-esque monstrosity should be relabeled the "Scale of Shame" as the MA (medical assistant) had to keep clicking the balance farther and farther to the right.  Suddenly the cinnamon roll I had for breakfast felt like an anvil in my stomach (maybe this is where the extra 8 pounds came from?).  I have to make the obligatory comment to cover up my nervousness-something like "I think your scale is wrong" or "I was ten pounds lighter when I weighed myself naked this morning".  My patients' always seem to utter these excuses so I felt that maybe I had to as well.  The MA did not find this humorous at all.  I was then placed in an isolated room with nothing to read.  There was not even an old copy of "Country Living" from 2004 that I thought was standard issue in doctors' offices.  The same MA then returned and proceeded to take my medical history and ask me about my medications.  One never feels as old as the medical history that is given but I think I aged 10 years at that moment.  Wow.  That sucked.  Luckily the appointment went well and I was on my way.  This foray into the "Other Side" gave me a lot of perspective into how a significant number of my patients must feel despite the fact that I try to put them at ease.  I get them back on time, I have up to date magazines for them to read, I see them quickly and spend a lot of time with them.  So what can I do to ease the burden of coming to the doctor?  Aside from offering free coffee and cocktails, terry cloth robes and mood lighting, I think I do a pretty good job.  It may be that this is just the "nature of the beast"- I am in a profession that makes people uncomfortable. They feel out of their element, anxious and without control.  What I can do for them I do- a smile on my face, an unassuming attitude and my full attention when I am with them.  After spending a little time being the patient, I realize that MY patients probably don't care how much I know as long as they know how much I care.  I was hypersensitive in that office today and I let everything affect me as if I were about to get a rectal exam by Andre the Giant.  Why should I think that my patients are any different?  A calming attitude and polite demeanor will most likely help my patients more than any prescription I can give them.  Unless the patient has herpes...in which case the prescription will definitely help them more.

Miracles?

So my first patient today tells me that he has experienced a miracle.  A miracle? Please.  However his conviction was almost scary.  He believed God spoke to him and told him to cast out the demons of his illness (in this case, 30 years of dizziness).  He said he prayed and eventually spoke in tongues.  He then looked into the sky and saw 3 hunched over lizard men/beasts in a clear bubble.  They looked at him and shot off at lightning speed away into the sky.  Instantly he was "cured".  Now I have to tell you I have known this man for going on 6 years and NEVER has he volunteered this type of information before.  He was much more animated than he has ever been with me and his excitement was palpable.  I must say that I cannot explain why his dizziness went away, just that it had.  If he had been talking about anything besides the notion of a miracle, I would say that he was a loony.  However, part of me really wanted to believe in his miracle-the idea that there are things that I cannot explain...that there could be some sort of miracle out there for all of us, just waiting to happen.  Part of the reason that I continued to listen to his fascinating story was that his intensity, conviction, and certainty was at a fevered pitch and I was amazed at this.  In this day and age of instant information, Google, and 24 hour news stations, almost any story can be confirmed or debunked in a matter of minutes and it is much harder to "stick to our guns" and be convinced of the unfathomable.  But here he was- as convinced as the day it happened.  From a medical standpoint I cannot explain his sudden burst of health although I have my suspicions.  But that doesn't matter.  To him, it was real and that was all it took to "cast out the demons".  I am not sure that I am capable of this type of faith but I wish that I were.  The problem is that I have to set aside my rational side and just accept what is in front of me and I haven't found a way to do that-save one.   The love that I feel for my children is irrational.  I love them all equally, fully and in different ways.  Before children, I would say that it is impossible- there must be a favorite.  It is human nature to choose the best and disregard the rest.  But that isn't the case.  So as I write this, maybe I have opened my eyes to a miracle that has been in front of me all along-one that I will continue to nourish, love, and cherish each and every day-my children.

Vomiting and Control

My son Jack is sick today.  Barfing.  There is nothing that makes me feel more helpless than when my kids are sick.  It's worse when they are barfing.  Vomiting by definition is an uncontrollable act.  Sneaks up on you and WHAM!  The only other bodily function that I can think of that does that is sneezing.  I don't mind sneezing.  Puking, however, I hate.  Probably because there is no control. Of course, there is the concern that like the Red Death (Poe reference) this bug is going to travel throughout the household, hitting each and every one of us so we go down for the count.  Ich.  Oh well, this is about my son, not me.  I hate that I am always at work when my kids get sick.  I wouldn't do anything but feel powerless at home as opposed to powerless at work.  At least at work, maybe, just maybe I can help some people feel a little less powerless and gain a little more control of their life as well as their illness.

Life happens. So does Death...

I admitted a man to the ICU this evening who for all intents and purposes should be dead right now.  He has large blood clots in his lungs and it hit him without warning.  He told me that he didn't think he was going to live, that this was the end.  He nearly died twice in the ambulance before reaching the hospital to receive treatment.  Odd thing though- It was nothing that the medical establishment did to "save" him. The treatment he received came well AFTER he stabilized.  He did this on his own.  His body recovered.  He just lived. Why?  Not sure.  It just happened.  I have seen younger, healthier people die from this sort of traumatic insult.  Why do some people live and some people die?  I have no clue but I can tell you that we are promised nothing.  Tomorrow it may all be over so please remember this when your day is rotten-the car won't start, you're late for a meeting, or the dog yacks on the oriental rug...We are lucky to be here.  Enjoy it. But clean up the dog yack first.

A new way to communicate....

So I decided to start blogging. Not sure why, just have. Sometimes I feel like I need an outlet to say what is on my mind without having to specifically have context. It may be about my kids, work (certainly if a story occurs from work, no names of patients will be revealed) or about the woman in front of me at Target. I occasionally need a way to decompress and only the beauty of the printed word will do...So, here we go. A new way to communicate...