Rants from the Crib

An Ob/Gyn gone mad

Archive for the month “July, 2012”

How To Be Sybil: On Being an Ob/Gyn

I don’t think people realize the heart-stopping shifts in mood that this profession requires.  In a standard day:

A woman is sobbing in Room 1.  She has just found out she has miscarried again.  You feel terrible.  You try to comfort her.  There is no way to comfort her.  You are fighting back tears when you leave the room.  Sometimes you don’t fight them.

A woman is exultant in Room 2.  She has just found out she is having a boy.  She already has 3 girls.  You slap hands with the husband, and hug the patient.  He is already madly texting to tell everyone he knows that he finally has his boy!  You feel so happy for them.

The woman in Room 3 is sullen.  She is having another boy.  Her third one.  She is actually angry at us for telling her she is having a boy.  She does not want to believe it.  She has already yelled at the ultrasound tech and slammed the door.  You attempt to persuade her not to be angry.  She yells at you.

The next woman in Room 1 is quiet.  She finally admits that she has caught her husband cheating on her with a woman who is known to use drugs.  She is scared that she has caught something bad.  She is crying because her marriage is over.  How do you comfort her?  You can’t.  You sure can feel bad for her though.  And you feel deep anger.  This woman didn’t deserve this.  This irresponsible man has put her at risk for diseases, some of which are not curable.  Some of which are fatal.

Back to Room 2.  The new patient in there is radiant.  She is here for her pre-wedding physical, and to get on birth control.  She goes on and on about the wedding, how nervous she is and how excited, and where she will spend her honeymoon.  You have carried the bitter cynicism in from Room 1 and wonder how long it will take the guy to cheat on her.  You instruct her on how to use the birth control pills.  You muster up some excitement for her.

The woman in Room 3 is a pregnant drug abuser.  She spends all her visits complaining of pain and trying to wheedle Lortab out of you.  She has tested positive for THC, barbiturates, opiates and cocaine during the pregnancy.  You feel intense anger and disgust.  You want to throw her out of the office.  You don’t understand how she can do this to a baby at all.  You want to yell at her that you are on to her little game and you know she is a drug addict and to STOP ASKING FOR FREAKING DRUGS.

Back to Room 1.  In there is a teenager whose mom has caught her having sex.  She has been dragged in for birth control and STD testing.  You can tell the girl is lying when she answers questions in front of the mom, but the mom refuses to leave the room.  She will control this or else.  You wish you had a chance to talk to the girl alone.  You feel like you could help her better if you knew what was really going on.

Back to Room 2.  A stunned teenager has just had a positive pregnancy test.  Her mom is in the waiting room and does not know.  There is going to be a huge scene in a minute when she finds out.

The pregnant girl in Room 3 is screaming hysterical curse words into her cell phone.  She is yelling at her boyfriend about being a stupid sonofabitch who is going to jail.  Her baby’s daddy will be in jail.  She doesn’t bother to get off the phone when you go into the room.  You feel angry at being disrespected, and angry that the other patients can hear that language.  You also feel angry that she has a nicer cell phone than you do.

Back to Room 1.  The elderly woman in there has not been to see you in two and a half years.  Her husband has had a stroke and has dementia and she is spending all her waking hours trying to keep him from wandering away from home or setting the house on fire.  She could barely find a caretaker for him long enough to come in for her appointment.  And she is afraid to drive alone in town.  She is grieving the loss of her husband even though he is still alive, and grieving the loss of her autonomy since she is shackled to caring for him.  The ironic thing is, once he passes away she won’t know what to do with herself.

Room 2 is a woman with multiple physical complaints.  She seems perfectly healthy and her use of office time complaining about every little thing is really annoying.  You wonder what is really going on that she is so unhappy.  She won’t let you out of the room.

Room 3:  a giggling teen here for her yearly exam.  She has her best friend with her who is giggling too.  They are ANNOYING.

Room 1:  A pregnant woman complaining because she is uncomfortable.  Really?  Pregnant much?

Room 2:  A young couple upset because their fertility treatments aren’t working and they are desperate for a baby.

Room 3:  get the general idea?  By the end of the day my emotions have spun so many 180/360 degree turns that my brain hurts.  Do all Ob/Gyns get bothered by this?  I think they must.  If we aren’t psychotic when we start this profession, we will be when we finish.

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On Circumcisions

During my residency, I was trained to do circumcisions.  Circumcisions are a barbaric practice in which perfectly good skin is removed from a helpless infant who is too young to consent.  We feel perfectly good about this, but I am sure there are other civilizations who are criticizing or who will criticize us for our mutilation of our children.  Now, here is my question:  if Ob/Gyns spend their whole training on learning female anatomy, how is it that we are expected to do surgery on MALES?  Very important surgery, as any man will tell you.  We did the circs when I lived in Atlanta.  We do them here in Alabama.  Why do the pediatricians not do these?  Why do the urologists not do these?  The urologists do circs on older children and adults; why can they not do the newborns?  Is it that they just can’t be bothered?  Ask any Ob/Gyn and they’ll tell you that circs are among their most hated procedures.  The whole thing is just disturbing.  First there is the ridiculousness of the preop “Time Out”.  On adults, this makes sense.  You verify the patient’s identity by asking them.  You then ask them if they know what procedure they are having done and the name of the doctor that is doing it.  A typical Time Out for an infant circumcison might go like this:  “What is your name?”  Baby:  “waaah”.  What procedure are you having done today?  Baby:  “waaah”.  Who is your doctor today?”  Baby:  waaah.  Great time out guys, I feel so reassured that the baby is OK with this.  The baby’s arms and legs are strapped down tightly to something called a “circ board.”  The babies hate that as much as anything, and they start to yowl and cry as soon as they are strapped down.  They are numbed with a cream or with a needle into the foreskin, which really must hurt.  Then they are painted with cold iodine prep, and the cold shocks them and makes them cry again.  Then the foreskin is grasped with two mosquito forceps at the upper outer corners, and another mosquito forcep is spread open repeatedly under the foreskin to break down any adhesions between it and the penis.  This is not a hit with the baby.  The third forcep is then clamped up the middle anterior third of the foreskin to create a pinched bloodless area where a scissor cut will be made.  Again, not a hit with the baby.  The foreskin is then peeled back, something one of my colleagues refers to as “skinning the grape”.  A metal bell with a handle is then selected to be the correct size to just cover and protect the penis.  This is placed on the head of the penis and the foreskin is pulled back up over it.  A safety pin is used to perforate and hold the two edges of skin together around the bell.  Essentially, the baby gets his first body piercing.  Then the bell is locked into a mechanism that cranks a plate tightly in a circle around the foreskin, with the penis protected underneath.  A knife is then used to cut off the newly isolated foreskin.  The gadget is then removed and the foreskin arranged and wrapped with vaseline gauze to prevent sticking.  May I just say that the infants are not pleased with this arrangement.  They are given sugar water to suck on during the procedure because apparently studies were done that show that the baby’s pain response is blunted by the pleasure of sucking on the sweet stuff.  I’m not convinced.  How did they find out that the baby’s pain response is blunted?  Did they ask the baby?  Because I think the baby would say differently.  The babies don’t pee for several hours afterward, we think because they fear the burning afterwards.  We may be overly reading in to this.  Anyway, the whole procedure is a bit disconcerting for everyone involved.  I know the studies show decreased penile cancer and decreased transmission of sexually transmitted diseases, but I bet some day another culture will be looking at us and wondering what the heck we thought we were doing.

Bachelorette Party

Yesterday I was invited to a friend’s bachelorette party.  It must be said, I am 44 years old and she is 42; this will be her second marriage.  Her first one was pretty bad.  The first time around I was the maid of honor and there was no bachelorette party per se.  The party will be in New Orleans and I am VERY EXCITED.  I lived in NOLA in residency and this will be a chance to see New Orleans since Katrina and see some old friends.  I told my mother that I am going to New Orleans for Labor Day for my old friend’s party.  “Why New Orleans?” she wanted to know.  I don’t know, Mom, why not?  “They live by Mobile, why can’t they go there?”  I don’t know, Mom, ummm, let me think, because New Orleans is A LOT MORE FUN?  “Well, this is a second marriage and she has children; should she really even have a bachelorette party?  She’s not a bachelorette.”  You’re right, Mom.  She made a bad decision and married a crazy abusive man, and she needs to pay for that by NEVER EVER HAVING ANY MORE FUN FOR AS LONG AS SHE LIVES.  Needless to say, I left that conversation angry.  As one of my friends put it, “Our moms are OLD SCHOOL.”  Well, there are some things to be said for old school, I guess.  I do think it’s a good idea to be married before the babies arrive.  If you have the babies first, though, I really won’t judge you.  As long as you do the best you can.  I’ve decided that there’s Old School, and then there’s Old School with Consequences.  My mom dishes out the latter.  Old school is a set of ethical, moral and etiquette rules.  Old School with Consequences means, if you break the rules, you should suffer.  For the rest of your life.  And wear a scarlet letter, if it can at all be arranged.

When I met my husband, my mother threw a fit.  He had been married before; he was a “divorcee”.  I know that divorcee is incorrect, it should be divorce with an accent aigu, but I can’t find this on this keyboard, so.  At any rate she had a Bad Name for what he was and she used it against him.  “Why don’t you call the FIRST Mrs. B,” she said.  “Find out what REALLY went on.”  I explained to Mother through gritted teeth that I already knew what “went on,” his wife did not want children and he did and he was very sad about the divorce but he really wanted a chance to have children.  She felt there was something sinister and deeper going on.  She Googled him.  She found another person by the same name who had been up to some no good and called me triumphantly to tell me she had caught him at something bad.  Wrong.  In rapid succession she found everything wrong with him she possibly could.  He was too short.  His feet were too small.  He was too bald.  He looked like a lawn gnome.  A LAWN GNOME????  This was my Emily-Post-and-Miss-Manners-reading-mother, and I could not believe these things were coming out of her mouth.  This added considerable stress to my prenuptial days, as you can well imagine.  The only thing that helped this was that my husband was actually amused by the things that my mother was saying.  He cackled over the “lawn gnome” remark.  And he did something even more amazing.  He refused to be intimidated by my intimidating mother and had a meeting with her and asked that she stop the sniping because it was upsetting me and that she might not be included in the wedding plans if she didn’t stop.  Wow.  What a concept.  My dad said he should have done that years ago, but he wanted her to be happy and spoiled her.  So she is basically allowed to roll along, judging and handing down her idea of punishments for infractions real or imagined.  So I think it’s great that my friend is having a bachelorette party and I already have my tickets.  And I married my husband and he is a good husband and father so HA, there never was anything sinister going on.  So, I am OK with Old School, but forget this thing called Old School with Consequences.

Living with a Teenaged Seven Year Old

You know, things used to be simpler.  All us old folks say so.  I remember being a kid, and it wasn’t that complicated.  I didn’t know much about the world around me.  I remember vaguely being terrified by the oil shortage in the early seventies.  I didn’t know much music.  We didn’t have a TV.  And I certainly don’t EVER remember being a drama queen like my seven year old is.  It’s something they absorb through their Happy Meals or something (we didn’t have those either). 

My daughter creates the most incredible drama everywhere she goes.  She is a sweet, bright kid, but Lordy, the least little thing will get her going.  The other day, for the first time, she told me I was ruining her life.  She put her head in her arms and her little shoulders shook with sobs.  My infraction?  I told her she couldn’t take her Nintendo DS on a field trip where they were going SWIMMING.  First of all, a Nintendo DS is a rather expensive piece of equipment, for a child.  My husband has already categorically forbidden her to bring it to school or summer camp ever.  Which begs the question:  why did she ask my permission to do something she has already been told she will never do?  She knows she gets in trouble asking the other parent in hopes of getting a different answer.  Second of all, really?  Swimming?  And electronics?  And how on earth does that constitute a life ruining event.  Really, analysis is not helpful.  The situation defies logic. 

She broke down in the car the other day because I refused to change the song we were listening to.  “But it’s not FAIR!  It should be a song we BOTH agree on.  Otherwise it’s not FAIR.”  (Sob, sob).  She broke down again a couple minutes later when I refused to take her to Moe’s for dinner, on the grounds that her father was waiting to eat with us at home.  Ridiculous of me not to take her out to dinner and completely ignore my husband and his need for dinner.  What an awful person.  With deep gasping breaths, she wailed, “I just want to choose.  One.  Thing.  I can’t choose anything.  Not the music.  Not the place for dinner.  Not.  One.  Thing.”  (Sob, sob). 

She had a come apart when I would not let her bring an enormous stuffed animal to day camp.  The thing is bigger than she is.  She would/could not understand why that made absolutely no sense at all.  More weeping and wailing and gnashing of teeth.

And don’t get me started about dinner.  Dinner is a hotbed of emotion, rife with boohooing (infernal) and drama.  She NEVER likes what we’re eating.  Even if she liked it yesterday.  When her father tells her she will eat it or sit at the table until she does, the sobbing begins.  She doesn’t want to sit at the table while others are still eating.  If she is done, she just doesn’t understand why she is expected to remain until the family is finished.  Her protestations often land her in time out.  So there she sits on the couch in the sitting room, right across from the dining room, sniffling and wailing.  Or treating us with stony silence.  Which I much prefer. 

And she tells on herself all the time.  Bless her heart, she just does not know how to be devious.  She’ll be forbidden to watch another movie that day, and later she’ll announce that she watched one with the sitter.  Then she is amazed when she gets into trouble.  I’ll buy her an outfit, and remind her that her father gets upset when he hears we bought something because the other kids at school have it.  Her first cheerful announcement the minute we hit the door?  “Mommy bought me some Puma shorts because I wanted them because everyone else has them.”  Then we are both in trouble.  Hello?

Clothing is a whole other can of worms.  The child wants to wear dresses everywhere, all the time.  Out to play.  To a picnic.  Rollerskating.  School.  Softball.  Every time she is refused a dress, there is a major drama scene.  And shoes.  Lordy.  And SOCKS.  Something happens with her socks that causes her to have a come apart.  If the toes are not aligned perfectly, she has to take the socks off over and over again and put them back on again until the toes feel right.  This morning, the tags in her bathing suit were bugging her.  She was wearing her new shorts, and for some reason her shirt HAD to be tucked in, and that caused her bathing suit tags to rub her back.  ON AND ON she went about it, muttering and sniffling and whimpering, and squirming, and tugging and pulling.  But she refused to untuck her shirt.  That could not be done, because it was almost as long as the shorts and she wanted everyone to be able to see the new shorts.

And the dancing.  That provocative, hip swaying dancing.  And the singing.  And the songs that she learns.  She came home the other day singing, “I’m sexy and I know it!”  Rumor has it, a kindergartner was actually booted out of school for singing that song.  And Lady Gaga.  Which is entirely my fault.  I adore Lady Gaga.  I think she is a very talented artist and songwriter, and she packages herself brilliantly.  So we listen to Lady Gaga in the car.  And A learns all those songs.  Now there are some songs we skip over.  I don’t want her learning/singing them.  Because Lord knows, she will.

So the drama – I just don’t know.  Like I said, she’s actually a real good, bright kid, and all this makes her sound like a real brat.  The whining really gets to me.  Can I tell her she’s ruining my life?

The Rats in the Walls

When I was a resident in New Orleans, we lived in this cool old double shotgun 2 story house uptown.  We were the only renters on St. Joseph.  All of the other houses were owned, and we were HORRIBLE neighbors.  One half of the house was, basically, occupied by an off-campus branch of a Loyola frat house.  The other half, my half, was occupied by a bunch of diverse and intrepid Ultimate Frisbee players.  I did not really play frisbee.  I had a boyfriend who LIVED Ultimate, and who badly wanted me to play but I sucked, and I did not play.  Our side was occupied by a mixed racial couple, an ice climber, a PhD student in Mayan studies, and me, an Ob/Gyn resident.  Our house looked like hell.  The lawn was full of weeds.  The gates were sagging.  The paint was peeling.  We had loud parties, often overflowing into both sides of the house, and people camping in the front and back yards at Mardi Gras time.  We were, in short, complete nightmare neighbors.  We sat on the front porch swings all night, even on week nights, smoking cigarettes and drinking beer and wine until 2 or 3 in the morning.  And another thing.  There were RATS in the WALLS. 

We were no more pleased about the rats than the neighbors would have been, had they known.  In reality, they probably had rats too.  New Orleans is famed for its rats, evil, beady eyed giant things who originally arrived in ships and disembarked on the wharfs.  You could sit on the porch at night and watch the rats run along the power lines from house to house, and kitchen to kitchen.  But we had SPECIAL rats.  Because our landlady didn’t give a crap about the house, and we certainly didn’t give a crap about the house, an exterminator was out of the question.  None of us were anywhere near able to afford one.  And the kitchens were a disaster all the time, with crumbs and dirty dishes and beer bottles and all the sorts of things that rats really love.  I was on a diet.  I had just discovered the Atkins diet from a 70-something year-old infertility specialist and had bought several bags of sugar-free candy.  A word about the candy.  One quickly learns, when dieting on sugar-free candy, not to eat too much, because the stuff gives you GAS and DIARRHEA.  Well, one night the rats found the sugar-free candy.  I’m surprised they would even eat it, but that’s a rat for you.  The scene in the morning was hysterical.  There were a few hard droppings leading up to the candy bowl.  LEAVING the candy bowl, which was full of chewed wreckage, the droppings got looser and looser as the rats got further and further from the bowl.  That stuff had made them dog sick.  We had to keep all uncanned or unbottled food in the refrigerator, or they would get into it.

The worst part about them though is that they were in the WALLS.  And they stomped.  I have never heard any living thing, save maybe an angry husband, that STOMPED like these damn rats.  And they crunched.  I’m not sure what they were crunching in the walls, food, or probably the insulation off our ancient wiring system.  They probably thrived on copper.  At night they would come in the walls and VISIT.  You’d be lying there in your bed and you would hear stomp stomp stompstompstompSTOMP.  Stop.  Right across from the pillow on the bed.  Silence.  That thing would just be sitting there, listening to you breathe.  Plotting God knows what.  If you got your nerve up, you would yell and bang on the wall to get rid of them.  You would quickly discover, however, that this actually attracted more rats.  Stomp stomp stomp stompstompstompSTOMP.  Stop.  Crunch crunch crunch.  Right in front of your pillow.  It was HORRIFYING.  Especially if you were in the house alone.  It was like being in some kind of horror movie:  The Rats in the Walls.  We never got rid of them.  We eventually all moved out, and they got rid of us.

Things Patients Do

Things patients do, with a capital Things.  It is unreal how many completely inappropriate things can be done in a small exam room.  Where to start?  Shoes.  Patients wear leather shoes without socks and their feet STINK.  Any gynecologist will tell you, it’s not the crotch smells that get you, it’s the FEET.  Also, patients put their shoes right on the little step at the bottom of the exam table.  Well, that’s great, people, but I can’t open my bottom drawer and get to my pap brushes because your shoes are sitting there.  Why would that be a good place for shoes?  Clothes are also placed on the floor, despite having a large seat cushion to put them on and hangers on the back of the door.  Would you put your clothes and underwear on a dirty old floor in a doctor’s office?  People in doctor’s offices have GERMS.  In particular, shoes and purses are placed directly between my seat and my lamp.  Just how do I pull the lamp up to the table to use it, people, if you have all your clothes tangled up in my wheels and blocking the lamp on the floor?  Another area of poor parking involves BABIES.  People bring their babies, which I understand, because they are new, and they want to show them off, and they may not have a sitter, but why put the infant carrier on the floor EXACTLY where my chair needs to go, at the bottom of the table?  Then you wind up having to move a purse, or a sleeping baby, and the patient is giving you irritated looks, despite the fact that their stuff is on the floor right where you NEED to be.  Then there is the issue of bringing entire FAMILIES.  A woman will come in for her checkup after having a baby, and she will bring her infant, the older sibling, the boyfriend, and maybe the mother-in-law.  Then the baby will be screaming, the toddler will be babbling and dragging the baby carrier toward the garbage can, the boyfriend will be on the phone and the MIL will be saying, “What about THIS?  And THIS?”  Meanwhile, the patient, instead of being appropriately ashamed of having brought this monstrous collection of human beings, will be trying to discuss her ENTIRE LIFE HISTORY with you, over the screaming baby, the yelling toddler, the distracted boyfriend making drug deals on the phone, and the MIL trying to get your attention to try to discuss what SHE thinks is more important, like, when can the patient have sex with her son?  Then there are the telephone people.  People are supposed to have their cell phones turned off when they come in.  Well, they don’t.  I come in and the patient is yacking on the phone.  Instead of apologetically turning it off, they keep on blathering.  On several occasions I have told the patient, “I’ll come back when you’re ready,” and they’ve STILL kept on talking.  So I leave the room, and go see another patient.  Then, even weirder, are the ones who talk on their phones THROUGH their exams.  In Atlanta, I was examining a stockbroker, who, during her pap smear was yelling, “Sell!  For God’s sake, sell!”  She still had on the top part of her power suit, which was even more disconcerting.  Then there are the stealers.  The worst offenders are often the boyfriends.  I once had one steal the toilet paper key from the bathroom.  His girlfriend made him give it back.  I catch them squeezing their zits in the mirror, stealing the q-tips, and looking for needles.  One of our patients stole the nurse’s cell phone.  Then there are diapers.  This should perhaps be organized under babies.  A ripe poopy diaper can ruin an exam room for the better part of the day.  So do old tampons.  Then the patients refuse to follow instructions.  My nurse tells them to put the blue thing on open in the front, they put it on backwards.  My nurse tells them to spread the white thing over their laps, they sit on it.  The worst part is, I reiterate these instructions before I leave the room to have them undress.  So they’ve heard it twice.  Then there is the big old sign that says PLEASE DO NOT CLOSE THE DOOR WHEN YOU LEAVE.  This is to prevent mystery patients.  If we see a closed door, we think there’s a patient there.  We can waste an hour on an empty room if we don’t figure it out.  I think most folks can read.  So why do they close the freakin’ door?  Not all of these things are big things mind you, but they sure add up over the course of a day.  So use a little common sense, people, please?  Make our days a little easier.

A Deadhead Is Not A Cool Thing

My writing life would not be complete without a mention of my husband’s horrid new obsession with gardening.  Last year we completely relandscaped our lawn, which seemed like a good idea at the time, but which horribly backfired.  Our old lawn had seedy looking bushes around it and the flower beds were growing up with centipede grass.  We had the whole thing redone, including new sod with a new kind of grass that would do better in the blazing heat, to the tune of about thirteen thousand dollars.  Ugh.  The problem is, the old lawn, although not worthy of a Better Homes and Gardens mention, was functional and not completely unattractive.  The NEW lawn is pretty gorgeous, and we have gotten a lot of compliments, but my husband is now OBSESSED with keeping it beautiful.  I really wish we had just stuck with the old one.  I was perfectly happy ignoring it.  Now we have to keep things DONE.  We have to go out on the damn porch with a hose and water the front bushes because “the leaves get limp if they are not watered daily.”  Well, I don’t know what freaking kind of bushes those are, but I’d like a word with a landscaper that plants bushes that have to be watered by hand every day.  I think my husband might be full of it.  Also, weeds must be routinely pulled.  Man, those things pop up and get big fast.  Must be all the watering.  But worst of all are the damn flowers.  I have one word for you.  DEADHEADING.  This is a word that I never before encountered out of context with Jerry Garcia.  The theory is:  cutting the spent blooms and seed pods reduce the plant’s energy expense and redirect it into the making of new blooms and leaves.  This may or not be so.  I do know this:  my husband has expanded this thinking even farther.  The roses have developed some kind of Dreaded Rose Fungus that must be routinely sprayed.  Now, we don’t just cut the spent blooms, we cut ALL the blooms, the theory being that the energy can be directed by the plant into healing those yellow lacey leaves into healthy new green leaves.  NOT WORKING!  Also, the buds must be spared, so I find myself handpicking blooms out from between new buds by hand.  All this under temperatures in Alabama in the summer time, which a couple of weeks ago were above 100 degrees.  He had me outside in this heat IN THE MIDDLE OF THE DAY FOR A WHOLE WEEKEND deadheading roses.  We also deadhead lilies.  The seed pods and dead flower stalks must be cut off, like, weekly.  The stems must be cut ALL THE WAY AT THE BOTTOM and not in the middle or near the top.  I am not sure who made up this rule but I am pretty sure it was my husband.  All of the cut stalks, lilies, and roses must also be picked up and put in a bag.  Apparently some bozo told my husband that leaving the cut leaves and blooms under the bushes makes the fungus problem worse.  So if we didn’t impale ourselves on the damn thorns the first time around while we were cutting them, we impale ourselves on the thorns while picking the wretched things up.  Also there are Japanese beetles on our roses, which are apparently lethal to plants, so we have to spray beetle-killer all over our bushes, which we then have to root around in whilst we do our deadheading.  I realize that this attitude makes me the Worst Wife Ever, as I grow quite surly when sent outside for yet another round of gardening in a convection oven.  But somehow I am convinced that all this was made up to torture me, and the damn things wouldn’t look any different if we JUST LEFT THEM ALONE!

A’s Birthday

This weekend was my daughter’s birthday, and the machinations required to pull off a good party are amazing to me.  Of course, the folks made a trip to  see their favorite (only) granddaughter turn seven.  Grandmama came laden with presents.  My husband and I had bought a few of our own.  My main gift was three whole cards worth of earrings, because A got her ears pierced as an early gift.  I was amazed by that, because my husband had been adamantly against ear piercing from the get-go.  He actually made A do a survey at school to see how many of the other first grade girls had pierced ears.  He finally agreed to pierce them for her birthday, which is in July.  On Memorial Day, I guess he got a wild hair and said “Let’s just go get A’s ears pierced!” so that became an early birthday gift.  Her six weeks of healing were up so she could change out her earrings for her birthday.  Oddly, I bought three cards of earrings at Claire’s (doesn’t every little girl in America get their ears pierced at Claire’s?) and they promptly disappeared.  I was certain I had hidden them in their usual hiding place, the bathtub in the bathroom in my walk-in closet.  Gone.  I even went through A’s things to see if she had found and appropriated them.  Nope.  Not there.  Weirdest thing EVER.  I still haven’t found them.  I had to go back to Claire’s and get her a new set.  I also bought her a Barbie Vet dog in a pink carrier, which she had begged for when I got it for one of her friends a few months before.  I discovered to my chagrin that when she opened it, the damn thing talks.  It sneezes and you have to blow its nose.  It makes a smacking noise when you give it a bone.  This is all done with magnets – you just wave one of the accessories at its nose or mouth and the magnet senses it is there.  Then the dog makes the appropriate noise.  Magnets appear to be a hot new way to make kid’s toys work.  She got another set of little tacky plastic toys called Zoobles.  These things fold into little balls that won’t open up unless they contact metal.  They seem to contain little magnets that hold them closed.  When they touch metal, their eyes, ears, horns, fins, whatever pop out.  It’s rather diabolical.  DH got her a travel easel, which is pretty cool.  It’s got a chalkboard, a pad of paper, crayons, chalk, pens, a dry erase marker and a dry erase board all inside a little travel kit.  So that’s actually kind of neat.  Grandmama got her a ridiculous number of twirly dresses, which A is addicted to.  The dress must fly out when she twirls around.  She also got Jessica Simpson (!) dress shoes and a twirly skirt with a top. 

The preparation for the party was a whole other ordeal.  The cake had to be ordered the week before.  We got it from Publix, of course, because Publix has the best buttercream icing.  A wanted chocolate, which I knew someone would hate/be allergic to.  Then, very weirdly, she decided that she wanted Strawberry Shortcake on her cake.  She does not have one single Strawberry Shortcake toy.  She has no movies.  She has no anything.  Why on earth did she want Strawberry Shortcake?  Anyway, that’s what she wanted.  So that’s what we got.  When we called about the cake the morning of the party, they freaked me out because they couldn’t find it.  Eventually they found it; they had not been able to figure out where it was because it was on “the other side,” whatever the heck that means.  Is that some kind of fourth-dimensional portal in the bakery at Publix?  Then we had to pick up napkins, plates, forks, blah blah blah.  I had previously put together party favors for the kids (the dollar section at Target rocks for these things), with little stretchy koosh balls with eyes, sunglasses (left over from her party two years ago), glow sticks (left over from her party last year, little plastic rings and a couple of miniature chocolates with which I utterly ruined my diet by eating the leftovers.  I concealed the wrappers in the garbage can of the bathroom of my walk-in closet, where I hide a lot of things.  Of course, there was a riot over the party favors.  I had bought assorted colors, and the girls all wound up wanting pink or purple.  Silly me.

The party itself was wildly fun.  Not.  I wanted to have a water slide party in our backyard, which we had done twice before and which was really really fun.  A wanted her party at the Skate Castle, which we discouraged because last year, no one brought their kids because they’re too little to know how to skate.  So we made the party at the bouncy place at the mall.  Ugh.  Just that partial phrase “bouncy place at the mall” makes me nauseous.  I hate malls.  And I think that seven is too old for bouncy places.  And as parties go, this idea has absolutely no originality or personality at all.  Even A was unthrilled.  The problem is, in a small town, there just aren’t all that many choices.  A co-worker and I agreed that it sucks when the kids start having a mind of their own, because then we have to work with them instead of doing exactly what we want.  A water slide party would have been MUCH better.

So, we had the party at the bouncy place.  I invited 16 little girls, seven showed up.  Not much of a showing.  I guess my daughter will never be one of those that has the enormous birthday parties.  They all showed up with pink presents and proceeded to have a fabulous time on the bouncies.  Until suddenly, one of the little girls was looking for her mommy, because her front tooth was KNOCKED OUT.  “It ain’t a party until someone’s tooth gets knocked out,” I said.  My husband tweeted that.  The parents were sitting around kind of bored, until there was a midair head butting collision, which brought another spate of mommy-seeking.  So the injuries kept it exciting.  The kids were suddenly starving and began to demand food, so we went to the party room for cake.  The room REEKED of lysol or some other cleaning agent.  It smelled like a hospital in there.  The smell was so overpowering we could hardly taste the cake.  Then A started to act like a brat and say that only certain friends could sit next to her, etcetera.  So grandmama had a quick talk with her.  Of course, one little girl didn’t like chocolate and wanted more than one piece so she could eat the icing off them.  When time came to open presents, the kids all piled up in a giant inflatable throne.  A opened her gifts and they were sooo girly and pink!  She got two Barbies, a nightgown, some girly Legos (the Lego people finally realized that their market for females was totally untapped, and they began to make Lego Friends, with little cafes and houses and little convertibles with little girl figures with interchangeable hair), some bean bag animals to paint, and numerous other pointless, pink, disposeable items which will make my house look like a landfill.  We took home the middle of the cake, which had no icing, and I got a really cute picture of my dad sitting on the giant inflatable throne.  A wore some new earrings and the party was a success.

Driving Dullsville

Ah, and now for one of my favorite rants.  Driving in this little town we live in.  I think one of the nurses I work with put it best:  “All these new cars in town and not a one of them has a working turn signal.”  Don’t get me started on the turn signals.  Not only do people make left hand turns with no turn signal, they make them out of the FAR RIGHT LANE.  Everyone drives with their headlights on, which in a more forward thinking town might signal caution, but in this case, I think they all just left them on from the night before.  Then there is the GREEN LIGHT BRAKING.  These people ride their brakes through all intersections; I guess they are hoping that the light will turn yellow so they can SLAM on their brakes and have the person behind them run right through their butt.  Then there is the weird truck occurrence.  In ANY other town, you would avoid the lane with the truck in it and get in the other one?  Right?  Not here.  It is a guarantee that that truck driver will get cranked up before these reflexless bozos even notice that the light has changed.  Get behind the truck.  Also there is the Wal Mart phenomenon.  To pass the most smoothly through this part of town, you must get in whatever lane is farthest from Wal Mart, because it is guaranteed that any driver in a near lane will slam on their brakes and decide abruptly that they must stop by at Wal Mart.  MUST stop by Wal Mart.  And the wrecks.  Oh my gosh, this is the wreckin’est town I have ever seen.  Sad, but not a day goes by but that I have a patient whose friend or family member was just killed in a “tragic accident.”  Many of these tragic accidents are caused by alcohol and trucks, but quite a little number of them are caused by NOT LOOKING WHERE YOU ARE GOING and driving straight into someone else’s path.  The Life Flight people are making a good little living in this town.  Then there is the Big Town Fear situation.  Dullsville is actually a tiny little piddly town but many folk who come in to shop or eat out come from REALLY tiny little burgs and are TERRIFIED to drive in The Big City.  They have the white-knuckle grip on the steering wheel and a deer in the headlights look that is unmistakable.  I hear people complaining about how awful the traffic is here (remember, tiny town) and how far it is to drive all the way across town (read, 9 miles), and I remember my life in Atlanta and I snicker.  There are exactly 2 main streets in town.  They intersect each other.  You can reach anything from either one of them.  My hairdresser tried to draw me a MAP to her salon the first time I went there, but the directions were just a simple left turn off one of the main streets.  Why on EARTH would I need a map?  So today’s rant is brought to you by the letter L for Lousy Driving and the letter T for Tiny Town.  If you don’t have your turn signal on, then get out of my way!

Physician Superstition

We docs are a superstitious bunch.  Really.  It’s absorbed with the baby food in med school.  You can never lose the paranoia.  For example:  when you are on call, NEVER say, “It’s really quiet here today.”  The call gods will hear you and will smite you with a ruptured ectopic or an abruption.  This is a fact.  I used to get so angry when my Mom would come to visit me on call and she would say brightly, “Well, it seems like a pretty good day so far!!!”  IMMEDIATELY that pager would go off and I would be pulled away from my home and my visitor for the rest of the day.  We docs much prefer a cowering look at the sky and the statement: “We’re verrrrrry busy here, Lord!”  Also, worrying is important.  When you have a patient with a strong possibility of a bad outcome, you must come up with every possible thing that might go wrong.  If you don’t think of something that could happen, THAT’S the thing that will happen.  So you have to think of them all.  Then you have to WORRY about all the possible things.  Worry constantly.  Worry while on call.  Worry when about to be on call.  Worry in the middle of the night.  And some patients, you can just TELL, have your name written on them.  I had a patient recently with multiple medical problems, with not the least of which is that she weighs over 300 pounds.  And she is not even my patient, technically.  She is my partner’s patient.  As soon as I met her, I just KNEW that her delivery day would wind up on one of my call days.  And sure enough, it did.  Just like I predicted.  There is also the rule of 3s.  All bad things happen in threes.  If you have two ruptured ectopics, a third is on the way.  You can count on it.  Two bad c-sections?  There’ll be another one soon.  This is irrefutably true.  Then there’s the full moon scenario.  We all know that the crazies come out during full moons.  Women also go into labor and come in with their water broken.  This also happens when low pressure systems come through.  The amazing thing is, we physicians believe in all of these things.  And if we are challenged, we actually become angry.  Especially if we are challenged in a way that may bring bad luck.  Amazing that such an educated group of individuals would carry those superstitions around.  Except they’re not superstitions.  They’re all true.  Of course.  We’re very busy here, Lord.

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