Christmastime and Tortoise Shells

At work today I got to have the dubious honor of handing out some of the Christmas bonuses to the staff. It was monetary and not cheap like a subscription for the Jelly of the Month club so I was received fairly well. To help with the festive occasion, I donned a very large, very tacky Santa hat. It truly is amazing the feeling that one has when handing out presents. This is what the season is all about-that warm sensation in your gut that is just a fantastic feeling. Oh wait, that's the Eggnog....
Becky is in full party mode. We have the First (and possibly last) Ugly Christmas Sweater Party this weekend. Over 100 people are expected and for the life of me I am not sure how in the hell happened. I didn't think I knew 100 people, let alone invite them to my sanctum sanctorum so they can silently judge me and my house (like I do when I go to parties). Just kidding, but this is the most people we have every had in the house at one time and certainly enough alcohol to soothe the most chapped of Holiday moods. Can't say I am not nervous but it will be good to branch out from my introverted self and suck down a few brews with over 100 of my closest friends.
The kids are on their way to Henderson for the weekend with my folks. Thank God for Mom and Dad stepping up to the plate to help out. Couldn't imagine doing this party with three wee ones around. The pooch is headed to the Spa (aka Vet) for the weekend where she will be far away from our guests' crotches and the the allure of the onion dip. That dog just doesn't have any social graces, bless her little heart....
What I have discovered about planning a party with my wife is that the party takes on a life of it's own. I thought "hey, put out some chips, beer on ice...we got a party". Apparently that is not the way it is done. There are "considerations" to be had, varying from who mixes well with whom, the amount and quality of beverages, the food and the prep/presentation of the food and so forth. This thing went from a small soiree to a major undertaking. Don't get me wrong, I am not complaining. I am just amazed with the amount of planning that goes into this. It will be a success-for the simple reason that my wife IS in charge of it. She thrives on this shit. Me? Not so much. The more planning/elaborate the party, the more tortoise like my personality becomes and I shut down. Not sure why, but it does. Oh well, time to break out the Holiday Tortoise shell and prepare for what appears to be a kick ass party. Cheers!

Abby and the Sign

Today was an interesting day. It started with a call from Becky laughing hysterically because Abby had taken a "triple dog dare" from Jack and stuck her naked tongue on a very cold sign. Flailing, crying, bleeding and absolute hilarity ensued because everyone knows how the story goes. Tongue warm, sticky...cold metal, poignant...ouch...A Christmas Story revisited. Either way, Abby is ok, Jack feels bad that he had her do it- lessons learned.
Another full day kept me busy...Good Lord, if the paperwork doesn't end I may shoot someone. I start to get hives just thinking about it. I think it is one of the biggest reasons for my Carpel Tunnel Syndrome. Oh well. Daddy has to bring home the bacon for his little chitlins...
My tar baby patient showed up in the ER with a broken hip. I have put Humpty Dumpty back together so many damned times I just don't know how much more tape and glue he can withstand....
We are supposed to get ice/snow/sleet tonight so not sure whether the kiddos will have school. I love seeing the excitement in their eyes from the possibility that they may be able to play hooky tomorrow. So cute.
Prepping for our "Ugly Christmas Sweater Party" this weekend. Man, this thing has ballooned to over 100 people. I didn't think I knew 100 people...Should be fun as we have spent an ass load on booze and redneck food. Hope the old house can take it...
Well, that is it for today. Boring I know, but deal with it.

Writing and Blogging

December 14th, 2010

This is the first entry in several months. Some of my lack of activity has been because of a nagging carpel tunnel syndrome in my left hand that has plagued me for darn near 10 months now. It truly is a pisser when every time you want to use your dominant hand it falls asleep on you. Wake up!! I got shit to do!! Anyway, most of the reason that I don't blog more is because I think I have the rules down all wrong. I feel like I have to produce an insightful piece each time I do an entry and I can tell you, that ain't gonna happen. I suck at writing. Okay, I said it. I suck at the written word. Always have, always will. I just don't seem to have the ability to expound upon things in a flowery way (another way of saying "bullshitting"). My worst grades in school were in English. I still remember my 7th grade teacher giving me my worst grade I have ever received just because I couldn't diagram a sentence. Really? Does anyone really remember how to diagram a sentence?? Part of the reason I am a doctor is because I didn't want to write papers in medical school. All the tests were multiple choice. No 10 page paper about why I thought the patient had a bleeding disorder or why I felt the need to write for one antibiotic instead of another. Anyway, the whole point is that I have been intimidated by writing for as long as I can remember. I have felt that I needed to put something worthwhile down on the blog for it to be enjoyable to others. But I realized today that if I worry about my verb tense or grammar then I will never write anything. Also, I need to write for me and only me. As therapy...to get all of the crazy shit out of my head and onto something solid that I can deal with and analyze. If I worry that what I write won't make sense then I will never write. What I really want to do is to have a record of my thoughts for that particular day- no holds barred. Like a literary snapshot of what was occurring that day, this will be a time capsule for the future. Who knows, maybe the more I write, the better I will become....nahhhhh. Won't happen.

Getting the ol' Screwgie again this year....

Over the weekend, I picked up the latest Louisville Magazine and I was treated to the annual "Doctors Issue". This is the issue where all the doctors in town get to vote on their favorite (read 'most referrals') brethren. The categories usually include all the subspecialties as well as primary care. Most of the time it seems to be just like high school, with the popular east end docs getting the votes while the lowly downtown docs get snubbed (correction: Dr. McClellan gets snubbed-but no...I am not bitter about it). This issue was different. It had the top surgeons in town with rankings of everything from boob jobs to toe nail removal. Need butt implants? We have you covered. Nose job? Here too. Even a category for emergency appendectomy. Really?? I don't know about you but I have never had a patient in the throws of an acute appendicitis say "Who is going to be doing my surgery? Were they listed in the most recent Louisville Magazine? No? Well, I think I will wait it out instead...".

I tell you what you won't find. You won't find rankings about the little things, the things that really matter. So here is a partial list that I would like the magazine to consider for next year's publication:

1)MD who is most on time-we all have crap we need to do and the last thing you want is to spend 4 hours in the doctor's office just to have them see you for 3 minutes then charge you an arm and a leg.

2)MD who will actually listen to what your complaint is-many times patients have their list of problems to cover and the doctors have theirs. I can't tell you how many times a patient will tell me that they mentioned something to the subspecialist only to have them receive a blank stare followed by a completely unrelated series of questions dealing with medications, how their hemorrhoids are doing, anything but the answer to their question. Irritating to say the least...

3)MD most likely to examine you-believe it or not (I didn't when I heard it from some of my patients), when you go and see a doctor....they are actually supposed to examine you! As a doctor that examines patients, it is my lowly opinion that some sort of touching should occur (not bad touches, just healthy touches). My wife gets mad at me when she has an ailment of some sort and the first thing I do is touch it. "Why are you always touching and squeezing on me? It's just a mole!" It is called examining and I believe that something CAN be gleaned from using all of the 5 senses...

4)MD with the most patience with your parents-for all of my friends that are now caring for their elderly parents, you know exactly what I mean. For those that don't understand, you probably still have someone caring for you...

5)MD who is best at filling out forms from insurance companies-good gravy, I am getting so good at doing this I should pimp myself out. Still hate it though...

6)MD with the best office staff-needless to say, having a good office staff is one of the true keys to a successful office practice. Some offices are good, others are horrendous.

This is only a partial list. I am sure there are quite a few more categories that are worthy of notice but I can't think of anymore at this time. I am sure I will think of more, that is, unless I am in the Louisville Magazine next year for being a "Top Doc" in which case I will think this blog entry is frivolous and nothing but a bunch of "sour grapes" by an overlooked, frustrated by "the man getting him down", under appreciated internist from the hood (aka downtown Louisville). Thanks for your time and don't forget to vote next year!

Excuses, Excuses

I love my patients. I really do. I empathize with what they have to put up with in regard to their chronic medical disease. Their pain and suffering, both mental and physical, can take there toll over time. I love that they come to me and ask my medical opinion regarding their treatment and prognosis. However the thing that I especially love is when they think that their doctor takes everything they say at face value. It is amazing that people will lie right to my face about why they haven't done what I have asked them to do when last I saw them. Here is a smattering of the excuses followed by the true interpretation. We will start out with some easy ones, then gradually get to the more ridiculous....Ready? Here we go...

1)Me: Why haven't you taken your blood pressure since I last saw you?
PT: I haven't been anywhere that I can have it done.
Me: You haven't been to the pharmacy? Grocery store? You can even come here to our lab...
PT: Well, I don't get out much...
INTERPRETATION: I don't want to get my blood pressure checked. It may be high, then you will put me on medicine.

Get the picture? Alright, let's move on...Here is the EXERCISING/WEIGHT LOSS edition:

2)Me: Are you exercising?
PT: Yes. But probably not as much as I should...
Me: How much?
PT: I do a lot of walking at work.
Me: That doesn't count.
PT: Well, it IS a long distance to the copy machine...
INTERPRETATION: I am way too lazy to do any exercise, and I don't want to do any exercise. I like my TV and Cheetos more. Can we change the subject?

3)Me: Any luck with losing weight?
PT: No. My wife is just too good of a cook.
Me: Well, it is about portion control...
PT: I just eat what my wife puts in front of me. If I don't eat it, she will be pissed at me.
INTERPRETATION: I don't want to push my fat ass away from the table, close my pie hole and show some restraint.

4)Me: Any luck losing weight?
PT: No, and I don't eat that much (says the 300# woman). I have yogurt for breakfast, a Fiber One bar for lunch (God forbid she get backed up) and a salad for dinner.
Me: How MUCH salad are you eating? (Just kidding, I wouldn't say that...)
INTERPRETATION: I really don't know how to count calories OR I am putting twinkies on my salad for dinner...

5)Me: How are you doing with the Overeaters Anonymous classes?
PT: I have eliminated sugar, wheat and flour and I still can't lose weight. *Stern look in her eyes* What are YOU going to do about my overeating? I don't want a bunch of medicines either. How are YOU going to fix it?
Me: Sew your mouth shut. (of course I didn't say this but I almost lost control of my inner monologue...)
INTERPRETATION: There is a hell of a lot more going on with you than not being able to control your voracious appetite, lady.

All of these conversations have occurred at one point in my 8 years of practice. I have heard it all, but really all I want is the truth. Is that so hard?

Monday!

I gotta say, I am beat. Today was a rough one. Not only was it a Monday, but it was a Monday with a catastrophic blunder. Here I am in clinic, bee-bopping along when I go in to see my 86 year old patient who is accompanied by her daughter. Without thinking, I say "Well hello there! Where is your husband? He decide to stay home today?" Complete silence and a confused look on my visitors' faces. "Daddy died in April. Remember?" Oh Snap! Talk about awkward! I am still tasting my shoe polish after my foot spent the next 30 minutes in my mouth while I apologized profusely for my major gaff. I haven't felt this bad in a loooong time. Instead of moving slowly through my day, methodically reading the chart before entering the room, I feel confident enough to roll in and start what I thought was a lighthearted icebreaker. Wrong! This is Monday you are dealing with! It doesn't fuck around....It is out for blood and if you don't watch it, it will pounce on you and beat you to a useless pulp. Needless to say, Monday had the upper hand the rest of the day, making me watch everything I did, worried another ignorant statement would come flying out of my mouth. Luckily I am home now, where my mistakes are not noticed by my children and if they are, they forgive me with a smile and a pat on the back. Curse you Monday! I have been foiled again by your sneaky, brain draining ways! I will not be so easy to defeat next time, I guarantee!

Confessions of an Addict

Hi, my name is Chris and I am an addict. That's right. The first step in the healing process is admitting you have a problem, right? Well, I do have one. It is a big one too. I find myself thinking about it at least a dozen times an day, longing to be with it and not where I am at the time. I find myself not able to devote any time to myself lest I feel guilty for not spending an ample amount of time on my addiction. I have come to the conclusion that I will probably never excel at anything again. Oh sure, I may dabble in things and may even be good at some point, but the drive to truly master something will never be there. It just takes too much time away. For this I blame my addiction. I purposely put things out of my mind that don't pertain to this ever present fixation. At times, I need to have my wife force me to get away, to remove myself from this invisible bind I have and to surrender completely and focus on only me. It seems so utterly foreign to contemplate and even while writing this I am feeling guilty. For you see, my addiction is my family-my wife and kids. I can't seem to get enough, and when I do, I feel horrible that I desire to get away. I once was able to spend hours upon hours focusing on studies, reading, and even athletics but fortunately I have been cursed with the unwavering desire to be "A Family Man"... Wow. This catharsis has helped soothe some of my internal anxiety regarding my problem, but I am going to need everyones' help to force me to take a little time for myself. All work (in this case, family) and no play makes for a dull boy and I must remember that I am expected to be a well balanced, happy and productive member of society, even as I nurse this extremely dark and private addiction...P.S. when is the next FA (Family-aholics Anonymous) meeting? Will there be childcare provided?