Rants from the Crib

An Ob/Gyn gone mad

Archive for the tag “humor”

My Husband, The Food Terrorist

My husband has, er, a strong opinion about the correct consumption of food.  It overwhelms any sense of shame he might have (he hasn’t).  He has embarrassed me so many times in so many food venues.  And his food rules are many and complex.

He once demanded to see a manager in a McDonald’s.

On a date, in a 5 star restaurant in Atlanta, he waved over the maître d’ to inform him that the baked potatoes had been sitting under the warmer for far too long and they were unacceptably dry.  I wanted to crawl under the table and yet… I married him.

Every time we go to Ruth’s Chris, he sends his steak back to be put back on the grill and done right, and he lectures the wait staff on the nuances of steak preparation.  He informs them that he wants no pepper on the steak rub, and he doesn’t want it to come with sizzling butter on the plate.  What possible food  would NOT be improved by the presence of sizzling butter?

I am Harry. He is Sally.

He always demands his dressing on the side, because “they put too much on”.  He requests no croutons.  And when the croutons come anyway, he piles them reproachfully on the side of his plate.

We were out to eat with my parents, and my mom leaned over and whispered, “Why does he DO that?”  She was referring to his highly odd practice of ordering a salad with chicken, and carefully removing the chicken and placing it on a separate plate.  I had already asked him. “Why in the hell would you order a salad with chicken, and then take it off?”  He looked at me as if I were dimwitted.  “The hot chicken wilts the lettuce.”  Seriously?

We have yet to buy food through a drive-through.  He refuses to drive his food home, because it will be “too cold to eat”. Alternately, he also refuses to get Blizzards in the drive-through, because they will be too MELTED when we get home.  He can’t eat melted ice cream.  I’m not sure what he think happens when it gets into his stomach.

When we were first married, he was obsessed with expiration dates on food.  He read everything in the pantry, and no matter what it was, he refused to eat it if it was one day past the expiration date.  The first time I brought him home to meet my parents, he informed my mom that the can she had just opened was past its due date.  My mother, who buys food and stocks her fridge and pantry as if she were preparing for Armageddon, clipping coupons and buying in massive bulk, looked at him like he had cabbages growing out of his ears.  Actually, she looked at him like she wanted to whack him with a spatula.  I know that look.

He has always been obsessed with sodium.  His dad was probably the last human being who was ever placed on a low sodium diet.  He scrutinizes everything he picks up in the supermarket and scowls.  “I can’t believe how much SODIUM they put in this!  It’s like the silent epidemic!”  I have told him innumerable times that no one really worries about sodium any more.  But I’m only a doctor, so what do I know?

Then there’s the fat thing.  To say that he eschews fat would indeed be putting it mildly.  He peels and scrapes and carves every bit of his meat which seems to be remotely white in color.  Even a very lean pork chop – he carefully minces off scarcely visible edges of fat and piles them on his plate, testament to his lack of confidence in the buyer’s ability to purchase a decent piece of meat.  He won’t eat a bite until the surgery is adequately performed.  I’m not sure what he would do if he ever accidentally put a morsel of fat into his mouth.  It would probably immediately induce vomiting.

And, there are the popsicles.  He consumes sugar-free popsicles, packs at a time.  He likes to bring them to TV time, so that the dialogue sounds like CRUNCH CRUNCH CRUNCH rip, shred, rip, shred (him opening more popsicles).  He used to do the crunching and the rip-shredding in bed too, until I made him stop.  He leaves the wrappers everywhere, despite having a garbage can within arm’s reach.

He’s convinced that he has mercury poisoning, so he now rejects the “sulfur-forming” foods:  cruciate vegetables, eggs, basically everything that is good for you.  And he has another Bee in His Bonnet – after consulting multiple forums on mercury toxicity (but not a doctor), he now takes a chelating regimen of literally dozens of vitamins a day, to exorcise the evil toxin from his body.  I don’t want to know how much they cost, but unfortunately I have a pretty good idea. We even have vitamin packages arriving from South Africa.  He looks like an HIV patient – he has timers set on his phone, for these miracle workers must be taken at precise times.  I don’t know what will happen if he messes up a dose, but I am sure it is dire.  We have timers going off every four hours throughout the night.

Also, he refuses anything he had to eat in childhood.  His family was fairly poor, and he had to live with his grandparents a while.  They did a lot of living off the land; they had a garden and fished and hunted.  So to this day, he will eat NOTHING that they had in abundance when he was a kid.  No okra.  No spinach.  Only iceberg lettuce.  And no freshwater fish, because they caught and ate them.  They taste “too fishy”.  I have no idea what the heck else a fish is supposed to taste like.  He only eats top-of the-food-chain ocean fish, although he now rejects them as well because they contain mercury.

He goes on Atkins a lot, mainly when his 32’s get too tight.  He refuses to buy up a size in the face of his increasing age.  You would think, given his food obsessions, that he would eat a healthy diet.  Oh, no.  I think he would eat Mexican food every day if he could.  He eats like a pig:  ice cream, Blizzards, tangy Sweet Tarts, popcorn, until the 32’s get tight, then he slams on the brakes and eats only lunch meat and cheese.  Cooking for my family is impossible.  If you combine the fat-eschewing with the loathing of most domestic vegetables and fish and the fear of sodium, mercury and sulfur, and the no-carbs rule – big fun at meals in OUR house!

Just a little food OCD.  I will not, however, mention the fact that I eat six cartons of yogurt a day.  There’s NOTHING weird about that!  Nope.  Good times.

Hah Bumbug!

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The Beadstork family is a bit eccentric. I will seamlessly offer proof in the form of a list of our Christmas Day activities:

1. My husband did actual billable computer work. On Christmas. He works EVERY DAY. And he fixed my Mom’s computer.

2. My father consumed an entire pound of homemade fudge between the hours of 9 AM and 7 PM.

3. My daughter’s favorite gift was a bow and arrow – a toy, but much better made and high tech. She spent the entire day shooting the suction cup arrow down the hall into the front door. By bedtime she had a blister.

4. We ran the dishwasher 3 times.

5. I gave my husband a sterling silver chain maille choker that I made, worth hundreds of dollars. He gave me a library book that he made my daughter wrap.

6. We spent a good part of midday creating multicolored polymer high bounce balls with a chemical reaction that occurred in our kitchen.

7. My father read me poetry out of his poetry book that he published.

8. We had an exhaustive conversation about social status and personal responsibility. Somehow it turned into a discussion about how longbows and crossbows had rendered body armor obsolete.

9. My mom Facebook messaged me from her computer upstairs to my phone downstairs : “So where are you spending Christmas this year? Ohio? North Dakota?” From downstairs I messaged back: “Um… at your house?”

10. An enormous Wile E Coyote wearing a Santa hat sat in one of the living room chairs the whole weekend.

11. My mom gave me this AWESOME “Happy Light” designed to treat seasonal depression that I can also use to make my jewelry. Bonus: she says she got it free with the purchase of a lightbulb that cost a fraction of the free lamp!

12. We drank 3 pitchers of Crystal Light lemonade.

13. My father spent the day reading my “gift” book from the library. He’s a quarter of the way through already.

14. My seventy-something mom showed us videos on her smartphone.

15. My husband spent the evening reading a book on beginning meditation. New obsession!

16. Mom turned the sound off for every TV commercial during The Grinch.

17. My daughter and my mom made the annual “granddaughter-grandmother” cheese ball from scratch – a tradition now spanning 4 generations.

18. There were exotic chickens roaming through our yard. The peacocks were off duty today.

19. We temporarily lost the cat.

20. We found a picture of my friend’s dad on Facebook that had a mysterious glow between his legs, and three generations giggled about “Christmas balls”

21. I tantalized my daughter with tales of a tongue twister that results in horrible obscenities if said incorrectly.

22. We schemed to take up money to buy the neighbor a new muffler, since the poor man clearly can’t afford one.

23. My dad would have eaten all the mint brownies, so mom had to hide them.

24. We discussed the pros and cons of collecting copays up front in a doctor’s office.

25. I taught my daughter about super-nummerary nipples. She asked me if I have an extra boob, and when I said no, she said “Aww… I wanted a special mom!”. I told her that I am way too special already without one.

26. We discussed the importance of protecting book spines and dust covers.

27. I ranted about super-conservatives who equate using the word X-mas with satanism because ” you’re taking the Christ out of Christmas “. I worship Satan because I don’t write the word out longhand on every box I put back in the attic? Honestly, I told my husband, it’s not like we’re replacing the word Christ with a SKULL or anything, at which point my husband said, ” Bwa ha ha! Merry Skullmas!”, which became an instant family classic.

28. I got an email notifying me that I made Delta Diamond Medallion. It’s good to be the queen!

29. We argued over whether or not Will Wheaton was in Stand By Me (he was – ha!)

30. Mom read aloud an entire article about 18 little known facts about the movie A Christmas Story.

31. My daughter’s second favorite gift was a huge hardback set of the Lemony Snicket books. She lugged the box up and down the stairs all day.

32. My husband picked all the nuts out of his fudge.

33. I ate my husband’s ice cream, which made him avow eternal wrath.

34. My mom’s tuner croaked Christmas Eve, necessitating that we stream free Amazon Prime Christmas playlists off my phone via a little bullet speaker. We listened to Straight No Chaser nine hundred times.

35. I spent, like, a whole lot of time searching for sterling silver letters I bought to make a gift bracelet. I SWEAR I brought them. I KNOW I brought them.

36. I gave my dad a beaded bald eagle I made to add to his beaded bird collection – he has four now. I stayed up late Christmas Eve because I HAD to finish it.

37. My husband took four or five fists full of vitamins every few hours because he is attempting to purge mercury from his body.

38. Mom and I went through ALL of my daughter’s school pictures, only to discover that she has three sets that I don’t. What?

39. I caught my sweater on some blinds and knocked over a window-worth of Christmas decorations.

40. We discussed how the arrival of the Spanish conquistadors changed the Mayan social caste system.

41. Also, my husband texted me AS ME on my own phone demanding hot Christmas sex.

42. I ate something other than yogurt today.

43. My daughter made a Lego set containing police alligators with red and blue lights, moving tails and (SCORE) mouths that really open.

44. My husband gifted me an awesome fossil ammonite pendant from his trip to Slovenia.

45. I don’t think anyone ever got dressed.

Last flight home to the North Pole!  A Merry Christmas to all, and to all a good night!

The Cynic’s Stages Of Pregnancy

1)  Thinking About Having a Baby:  has no effect on whether or not you will actually have one.  The universe will pregger you pretty much as it chooses,  (or not) any time that it chooses.  A general rule of thumb:  your chances of conceiving a pregnancy are inversely proportionate to how much you want to be pregnant.

2)  Conceiving a Pregnancy:  Did you really think I was going to give you instructions here?  I will say, standing on your head may be helpful.  If you need to have conception explained to you, call your mom.  And then enjoy watching her freak out.  Especially if you are older than forty.  The internet is jam full of very interesting videos (OK, porn) which will offer you limitless ideas for different approaches to conception.  Or gonorrhea.  You’re more likely to get gonorrhea.  Fact:  pregnancy IS a sexually transmitted disease.

3)  Finding Out:  First, you have to deal with the baffling intricacies of the pregnancy test.  Most people choose to pee on an average of at least 6 sticks before they accept the verdict.  The home pregnancy tests available over the counter are exactly as accurate as the much more expensive Doctor Ones.  I’d do them at home unless you are having problems.  You may get the dreaded “kinda pregnant” result with the little faint pale fuzzy line.  Just repeat in a week.  If still fuzzy, call your doc to get sorted out.

4)  The Response:  divides more or less into three camps, although they may intersect somewhat.  You will either be Team Ohhhhh Noooo, or you will be Team Yessssss, with Team Ambivalent hovering in between.

5) Telling Everyone:  may be as follows: The OMG So Excited Twitter FB LinkedIn Email Text Phone Call Billboard strategy, also affectionately known as The Drama Approach, b) telling your partner, your family and your close friends, also known as the Moderate Approach or c) telling only your partner until you hit 12 weeks and your risk of miscarriage is pretty much gone – which is a very smart approach.  Up to 1 in 3 early pregnancies may end in miscarriage – if something happens, do you really want to face the painful questions and watch your friends fumble to think of the right thing to say?  This is the Cautious Approach, and as an OB, I must say I recommend it.
6) Early Pregnancy: you will look like you are getting fat and letting yourself go instead of looking pregnant. It is possible that you may barf up your toenails your entire first trimester. Maybe longer. Your boobs will hurt really bad and you will want to assassinate your partner for merely dragging the bed sheet across your chest. Your refrigerator and your trash will smell so bad you will vomit, because your sense of smell becomes so acute.
7) Your OB: by now, you’ve probably found one. Your first visit will be interminable, you will be asked all sorts of embarrassing questions, and they will remove approximately half of your blood from your body for labs. The ultrasound is really cool, though.
8) Second trimester: you will actually start to show, and get a baby bump, thank goodness. Your raging hormones will chill out a little. You may actually feel almost normal. I will warn you, the “glow of pregnancy” is actually grease.
This is when strangers will start to touch your belly and ask questions. Because the national pastime is scaring pregnant women to death, they will give you wrong and scary advice, tell you horrible stories, and you will call your OB in tears multiple times. One major plus: you get to feel the baby moving. Sometimes your partner can’t feel it yet and gets really jealous. Another bonus: you get to find out the sex of the baby. Or you may argue vigorously with your partner about whether you are going to find out the sex of the baby.
9) Planning For Delivery: you will be terrified of the impending delivery until you are so uncomfortable near your due date that you no longer care – you just want that baby OUT. If you are gung-ho, you will most likely have read at least 8 books about pregnancy and delivery, all of which made you more terrified than you already were. If you are really intrepid, you may have created a birth plan, or you may have gotten a doula or a midwife to attend your delivery. This is all OK with us, but OBs have a cynical expression:  “Birth plan + doula = C-section.”. This is not because we want you to have one; we want you to be happy with your birth, but it seems that the universe always conspires to make those who really want a natural birth need a C-section, which sucks for us and for you.
10) Delivery: I won’t delve into this much because everyone’s experience is different. This is a good time to give yourself a pep talk about control. As in, you don’t have any. We happily try to accommodate you, but what we need to do in labor is completely dictated by the baby’s well-being and by what your body does, and you can’t control either. This will help you to accept that you will have no control over most of your parenting either, because kids are little people and they often have other ideas about how any given day may proceed. Also, during your delivery, your partner may or may not pass out.
11) Bringing baby home: a properly installed car seat is a must. Then there is that moment where you pull up your driveway with a whole new person and you look at each other and think, ” Holy crap, what did we just do?!? “. And so it begins…

How To Survive A Trip To Your Gyn

This post may seem somewhat redundant, and rather lengthy.  I am putting this out there because every day a search term such as “do you need to shave your legs to go to your gynecologist?” is the predominant search that brings people to my blog.  Obviously people are desperate for information.
And you men.  I see you about to click out of here.  Not so fast!  A truly wise man will absorb the wisdom here so he can a) sympathize with a woman when she is about go through this frightful experience and b) look like a totally cool guy who pays attention to women’s issues, which may get you laid.
So.  How to survive a visit to your Gyn in a few easy steps:
1)  Decide to make an appointment.  This may seem obvious, because we women can come up with two hundred thousand excuses not to go.  You need to go.  Go.  We may catch something early that will save your life!
2)  Make an appointment.  Do not overlook this important step, friends.  Making an appointment is NOT “just popping by because you were getting groceries up the street.”. Dropping in will make your Gyn grumpy.  And you don’t want a grumpy pants poking a speculum at you!
3)  Show UP for the appointment.  Otherwise you totally wasted steps 1 and 2, and you will be put in the Gynie Book of Shame.  (Just kidding.  We don’t have that book.  But if we did, you would TOTALLY be in it.)
4)  Don’t sweat the small stuff.  Literally.  We don’t care if you shave your legs.  We won’t even NOTICE that you didn’t shave your legs.  Unless you apologize for not shaving, in which case we will feel obligated to look.  It’s not your legs we’re looking at, ladies.  Also, don’t fret that it’s been a long day and “you’re not that fresh down there.”. This is a concept invented by the feminine hygiene products corporations.  And they sold you on it, didn’t they??  Unless you smell like a Tibetan Yak after a goat milk bath, which would be exceedingly rare, we don’t notice that either.  Last, don’t attempt to scrub away any “odor” with toilet paper.  It rolls up into little balls that get all tangled up in your pubic hair, and we have to figure how to work around them without embarrassing you by telling you they are there.
5)  We don’t care what you’re wearing.  With ONE exception.  If you are wearing leather shoes or boots without socks, your feet STINK.  Trust me.  And that smell can render an exam room unusable for a few hours.  PLEASE wear socks (plus, you can wear them for your exam so your feet don’t get cold – we’re not looking at your feet either) with any footwear, and try to avoid that pair of stinky Sperry’s you’ve been wearing all last year.
6)  We want you to tell us anything that might affect your female health.  If you’re a lesbian, speak up.  There are some health issues and screenings that are different, believe it or not.  You being gay is just a piece of information we need.  We are discreet.  We are NOT going to out you.  We will not put up a billboard.  I PROMISE.
7)  Please feel free to tell us about any of your sexual practices and habits that you think might be “unusual”.  Trust me.  They’re not unusual.  Unless you’re having sex with llamas, in which case, we need to talk.  We need to know because there is knowledge that you need regarding certain things that we do.  We aren’t fishing for information so we can tell funny stories.  Again, I promise.
8)  When it’s time to get undressed, the nurse will tell you exactly what you need to do.  If you’re confused, please ask.  Many doctors will leave your clothes on until we chat, because we know it’s a little disarming to meet someone when you’re stark naked.  We may have you immediately undress when you arrive if we know you, because it saves time.  But if you prefer to leave your clothes on until the actual exam, then ask the nurse.
9)  You are totally not expected to dress up for us.  After all, it’s not your clothes we’re looking at.  We don’t care if you’re wearing your best underwear.  We aren’t even going to see it.  Clothes that have at least been washed in the past week would be nice though.
10) We can’t do a very good breast exam if you leave your bra on.
11) Equipment:  if you’re just having your yearly, and not having specific problems, we don’t need much.  The main object of terror is the speculum.  Your friends may describe it as “the duck” or “the clamp.”. It is not a duck.  It kinda looks like a duck’s beak, I guess.  But there will be no quacking of any kind.  Now, about the clamp thing.  It is NOT a clamp.  It is the opposite of a clamp.  We just use it to hold your vagina open enough so we can see your cervix up there.  If you are clamped by a speculum, we are doing something wrong.
12) Other equipment:  if we are doing a pap, all we should need is a tiny brush and a jar to swirl the brush in.  On occasion, a q-tip may be used.  None of these are scary.  There is no cutting or pinching or whatever Gothic fear you may have about what we are doing up there.  We just sweep (in a circular motion) with the little brush.
13) Special equipment.  If you are having a particular problem, we may need some different equipment.  A lot of the time, the nurse will have these terrifying-looking implements laid out on a tray.  Do not look at them and panic.  Most of the time, we aren’t going to use all of them.  They are just there in case.  If you want to know what one is for, ask.  Some patients prefer to know NOTHING about what is going to be done.  If so, just say so.  I will stop the discussion about the Kevorkian biopsy forceps immediately, and I will distract you by talking to you about your cat, or your kid getting expelled from school, or any other topic you care to introduce.  If you are too terrified to talk, I will talk.  I will talk your ear off.  Many times my patients say, ” aren’t you going to use that q-tip?”, to which I will reply, “I already did.  While we were talking.” Gynies learn to be very good talkers, because a distracted patient is a more relaxed patient.  On occasion, I have a patient laughing so hard that I tease them that they are about to cause my speculum to fly out in my lap.  Which has actually happened on a couple of occasions.  Which was very funny.
14) You can bring someone in with you if they help you to relax.  Just be warned, I am going to assume that if you don’t mind being naked in front of them, you don’t mind me discussing things in front of them.  If that is not true, please let me know when I walk into the room.
15) I love to teach people about their bodies.  Unless you’ve been to medical school, there are TONS of things I can tell you about which will be really cool to know.  I’ll start with one now: the female parts on the OUTSIDE of you, the parts anyone could see if they just looked down there are called the vulva.  Not the vagina.  The vagina is the part on the inside.  That’s the part that we have to put something in there to see.  That’s where the tampons go.  Vulva = outside.  If it itches, or has bumps on it, it’s probably your vulva.  Because you can see and feel that part.  Vagina = inside.  You’d have to stick something up in there to feel it.  Now you will look really really smart when you next talk to your Gynie, and she will be very impressed.
16) Your Gynie should notify you of your test results somehow, by mail, or a lot of offices are going to email or web sites.  The old “no news is good news” system does not let you know if your test might have been overlooked or lost.
17) Some of the rules of testing have been changed.  You may be told that you don’t need a pap every year.  Don’t worry.  Be happy.  Same deal with mammograms.
18) More bleeding is usually more worrisome than less bleeding.  At worst, less bleeding might mean pregnancy or menopause.  Increased bleeding can be any number of things, some of them not benign.
19) We like to quiz you on which you hate worse, your gynecologist or your dentist.  People seem to be divided on this.
20) Please pay us.  I know people think we are rich, but we are paying the nurses, the receptionist, the coders, the billers, the phone people, the transcriptionist, the schedulers, the ultrasonographers…  You get it.  And we’re paying their health insurance, their 401k, our staggeringly horrifying malpractice, and on, and on…
21) Don’t panic!  We want to make this easy for you.  Also, if the receptionist was mean to you, or you had to wait 5 hours, please tell us (nicely) – we need to know.
22) Please no drama.  No fights in the lobby about whether the guy with you is the father of your baby, or yelling on the phone to your old man because he’s in jail, fistfights – we’ve seen it all.  And calling security is such a bummer.
23) We keep your information secret.  Not just because it’s the right thing to do, it’s the law.  We get fined around $10,000 if we give out any information.  A corollary to this:  we give you a form when you come in where you list the people we can give your results to.  If the person is not on the list, whether they be your husband, your sister, your teenaged kid (we are only allowed to give out a minimum amount of information, even though they are minors.  Otherwise kids would be too scared to ask for birth control, or tests for diseases, or pregnancy tests), we can’t tell you anything.  Not even that the person is a patient here.  We’re not being jerks.  If they sign that Mom can get all results, then we’ll tell you.
24) You’ll feel so much better when you’re on your way out the door!  Granted, you will have the icky gel stuff leaking out of you for the rest of the day, but your health is totally worth it.  I trust we’ll see you soon!

Take Your Vitamins

Most of you are familiar, I believe, with the concept of vitamins. They are compounds that are essential (or at least damn useful) to the physical well-being and development of the organism taking them. Many of us take vitamins. Some take them religiously. They have been seen as possible cure-alls for almost everything. My husband superstitiously takes magadoses of Vitamin C whenever he feels like he is getting sick, which I think is a crock, but it probably won’t hurt him. The problem is, when I feel like I might be getting sick, he tries to foist them upon me too, and he becomes indignant when I refuse to take them. My dad, in the past, has dabbled with mega-doses of various vitamins and minerals. Usually when you take hyperdoses of vitamins, your body takes out what it needs, and dumps the rest into the toilet, wasting your investment

I will stand on my Doctor Soapbox for a moment, and remind my gentle readers that it is actually dangerous to take excessive doses of the ADEK vitamins (a mnemnotic for vitamins A, D, E, and K), which are the fat soluble vitamins, and they can actually hurt you in excess. It has been discovered that Vitamin E, taken in dosages higher than recommended, can cause heart problems.

Among other things, excessive vitamin A can cause birth defects in a fetus who is conceived when Mom is on megadoses. The acne medicine Accutane is actually a form of extremely high-dose Vitamin A, and they medically recommend abortion if you become pregnant while taking it – it often results in babies born without brains, which, needless to say, is an extremely undesirable outcome. Physicians are required not to prescribe Accutane for a female of childbearing age unless it is verified that she is on a reliable form of birth control. Accutane has been linked to suicide in some users. I don’t like Accutane. It is nasty stuff.

Then there are “medical vitamins”. These are not actually vitamins, but are very useful medications. Anything we medical types jokingly call “Vitamin” is usually a drug that gives immediate results, typically for a patient who is anxious, in need of immediate intervention, or a pain in the ass.

Vitamin K is a good one. There is an anesthetic drug out there called ketamine. Some of you may know of it. It was initially used as a veterinary anesthetic, because when they tested it on humans, it caused pretty intense hallucinations. It is seeing more widespread use now in people. My specialty uses it frequently to boost pain control in an awake patient who is having some discomfort during her c-section with a poorly functioning epidural. This results in the patient saying some pretty darn amusing things. I was actually given it during my c-section, because I had a hot spot in my epidural and was in a lot of pain. I watched the anesthesiologist squeeze something into my IV really fast and then I was out. When I awoke a few minutes later, the pain was gone, but all I could see were blue brains. Fortunately, I am not easily rattled and pretty much realized they had just dosed me with ketamine. The blue brains turned into blue triangles, and then I realized it was just the blue surgical drape that was placed over me. I couldn’t remember what I was doing for a minute. “Oh,” I thought, “I’m having a baby. Is it a normal delivery? No. It’s a c-section. What’s a c-section?” We also use it to quickly sedate uncooperative patients who need to undergo anesthesia. We hit them with something called a ketamine dart, usually in a sneak attack on the shoulder. Most typically this is used for patients who are unable to understand or cooperate, or who may be outright combative. I have a fairly large group of patients in a state facility who need annual pelvic and breast exams, but they may be violent or scared and unable to be awake for them. They are brought in, given a ketamine dart, and then their IV is placed after they are asleep. In one particularly funny episode, we were sedating a large and dangerous mentally handicapped female patient who struck fear and respect into everyone she came into contact with. She is missing one eye, and legend has it that she is so mean, she removed it herself. At any rate, she bites, spits, and hits anyone who comes near her, and she packs a mean wallop. Our anesthesiologist danced around her like a prizefighter, trying to sneak up on the side of the missing eye to administer the ketamine dart. She caught sight of him anyway, and administered a massive blow before he could duck away. She was finally successfully sedated, but not without a lot of expletives from the nurses and the anesthesiologist. Ketamine is also a street drug, prized for both its general anesthetic and its hallucinatory properties. On the street it is known as Special K.

Vitamin A is Ativan, which is a drug in the same class as valium and it works great on addled little old ladies who are in the hospital and causing a fuss. Typically the anxious patients are placed on this medication, or others in its class, as outpatients, to calm nervousness and the bad habit of calling the office daily with imaginary problems.

Vitamin H is Haldol, which is less commonly used, but extremely useful in the case of a violent or psychotic patient as it is a rapid acting antipsychotic and has an almost immediate sedating effect. We will frequently call for “a butt full of Haldol” for an out-of-control patient, because they aren’t going to cooperate with any pills given them, and pills wouldn’t act fast enough anyway. The key is to, well, corral them enough to pin them down and administer the aforementioned Haldol Butt Shot.

Vitamin V, or Versed, is also an antianxiety drug that is extremely potent. It is used for situations where a patient needs to remain conscious but sedated for a procedure, and combined with a good pain med, it keeps them calm and comfortable. Vitamin V is used routinely in the OR holding area, where the patients waiting for their surgery are almost certainly anxious, whether they seem so or not. Versed also has a powerful amnestic effect – that is to say, once you are given it, you will almost certainly not remember what transpires in the next few hours. This is handy, because the patients will not remember the ride back to the cold OR, the positioning on the table or preliminary and potentially frightening discussions about instruments or other such. Best of all, should a patient have an extremely rare consciousness experience under general anesthetia, which I understand is terrifying, they will probably not remember it. Having been given Versed myself, I can testify that the stuff is AWESOME.

Watching a patient being given Versed is a wonderful thing to see. At the bedside, in preop holding, your patient is trying to hold it together but it is obvious that they are tense and aprehensive. After your preop chat, where you address any final questions or concerns, it is nice to be able to then say to the patient, “Anesthesia is going to be coming in a couple of minutes, and they will be giving you the equivalent of at least 3 margueritas in your IV. Once you get that stuff, you will be grinning and telling me that you’re so psyched, you’re having surgery!” They look at you skeptically, and you hang around because it is so merciful and fun to see that stuff kick in. When anesthesia arrives with the syringe of Versed, you tell the patient, “Here come your margueritas!” They will eye their arm apprehensively and watch as the needle pushes the medicine into the IV. Then, about 30 seconds later, you can see them visibly relax, and almost sink into the bed. A lot of times they will look at you out of stoned eyes and slur, “Thish shtuff is AWESOME! I’m having Shurgery! YAY!” Gives me a kick every time! And a lot of times, they will tell you some REALLY funny things. One patient, after her Vitamin V, became convinced that the handsome CRNA was a doctor whom she needed to seduce and make her sugar daddy immediately. She pinched his ass repeatedly, making him yelp and jump every time he tried to check her vital signs. She kept offering him fascinating sexual favors, some of which are only available online, and he was so embarassed that he turned bright red, which was hysterical because he is normally an obnoxious and non-embarassable person.

My husband has a very funny history with Versed. After we married, for the first several years, he seemed to need a surgery almost every year, usually in November. For his first ever surgery, I accompanied him to the holding area because I am a doctor and I can. I also had some concerns. My husband, in his right mind, is a blabbermouth who cannot keep a secret even if he really means to, and has very little internal filter regarding whether something might be inappropriate to say. He has mortified me on numerous occasions. Rarely, I have seen him drunk, and am surprised he has not been arrested (or at least had the shit beat out of him) for some of the things he says. He loves women and doesn’t have any problems with discrimination against women, near as I can tell, but what he thinks is subtle sexual innuendo, out of his mouth, can be freaking AWFUL. No filter. Then he brightly looks around and says, “Oopsie! Was that my out loud voice?” I maintain that it is his out loud OINK.

At any rate, I had concerns about his behavior under the influence of Versed. It was entirely possible that he would began to disseminate details of our intimate personal lives, or the last awesome video he saw on YouTube, all of which would render me humiliated and my colleagues confused as to what kind of person would marry someone this awful. So I was there to police him, at least until he was wheeled back to the OR. Well, Vitamin V knocked him on his ass. I somehow kept him on track until they wheeled him back, but I am still worried about what he may have said on arrival to the operating room. The problem is, it may have been embarassing enough that my colleagues would not report it to me. I will never know.

After the surgery, my husband waxed lyrical about the amazing stuff they gave him on the way back to the OR. “I never understood how anybody could crave or be addicted to drugs, but I could sure see wanting more of THAT stuff!” He did remark, however, that he found it extremely disarming that he could remember nothing after the injection was given. That could be disturbing for a bona fide control freak, which he most certainly is. At any rate, despite that, he found the stuff quite enjoyable.

A year later, we were back in the holding area, getting ready for another surgery. My husband had told me that he was psyched, because he was looking forward to the Vitamin V, but that this time, he was DETERMINED not to forget events that followed its administration. I told him that was probably not possible. He insisted that his superior intellect would absolutely make memory of the event possible. I found this immensely reassuring, because, distracted by the work of recalling all events with his “superior intellect”, he would be unlikely to say anything inappropriate, because he would be focused on remembering everything around him. I also found this extremely amusing, because a fiendish plot was forming in my mind.

Prior to the administration of the Versed in the holding area, I pulled the CRNA, who is a friend of mine, aside. I explained to him the whole dislike of forgetfulness and loss of control thing, and about my husband’s determination to use his “superior intellect” to beat the amnesia. My friend, who is my friend because he catches onto things very quickly, smiled a sneaky Grinch-like smile at me. “I’m doubling the dose.” he told me. This did not concern me as it would not harm him – he was about to be put all the way to sleep. It would, however, be wicked funny as hell.

Sure enough, my friend loaded up enough Versed to drop a rhino and pushed it through my husband’s IV. He was WHACKED. I watched him ride back to the OR, pointing at objects on the way back to the operating room and slurring, “I’ll remember you DOOR and I’ll remember you WINNOW and I’ll remember you LADY and I’ll remember you DESK…”. Awesomesauce. Never laughed so damn hard in my whole life.

After the surgery, I asked him how his memory was. He was indignant, because somehow, the drug had overcome his superior intellect. He couldn’t understand it. Of course, at that point, the final stop in my plot arrived – I told him I had arranged to have him DOSED and he couldn’t have remembered his name if someone had asked for it at that point. He was downright incensed. And then he laughed. And laughed. Because he loves a good joke, even if it is on him.

So as a medical person, I must say, it is essential to remember your vitamins! And not just the ones that come in expensive bottles at the GNC…

Medical Coding Made Easy

Many of you may wonder, how is medical billing done?  How are your unique ailments translated into standardized format, to be recognized as payable by the insurance company?  Or, more likely, NOT recognized as payable to the insurance company.

The first coding category is ICD-10 code.  Translated into English, this category encompasses Shit That Is Wrong With You.  For example, gonorrhea is 098.0, which encompasses the following conditions and more:  acute gonorrhea, gonorrhea of the vagina, gonorrhea penis, gonococcal urethritis and acute Bartholin’s gland gonorrhea.  However, something slightly different (and you may be provided hours of entertainment trying to visualize how this was transmitted), gonococcal infection of eye is 098.4.  There are codes for every possible disease, illness, deformity, even one for High Risk Sexual Behavior.  I have this one memorized.  The digits in front of the decimal point usually delineate the main category of the disease, whereas the 2 digits after the decimal point delineate more specific details.  That fifth digit (the second one after the decimal point) is added only where extreme differentiation is required, say as in 607.83 (edema of penis) and 607.84 (impotence of organic origin).  In my opinion, many codes for Shit That Is Wrong With You have been excluded.  It would be very useful, for example, to have an ICD-10 code for Skank Ass Ho.  This would immediately trigger payment by insurance for things such as testing for STDs, multiple pregnancies, and chain smoking.  You could add a fourth digit, after the decimal point for Skank Ass Ho Who Lives In A Trailer Park, and a fifth digit to delineate Skank Ass Ho Who Lived In A Trailer Park But Got Thrown Out On Her Ass For Screwing The Guy In The Trailer Next Door.  See how useful this would be?  Also there could be one for Neurotic Middle Aged Woman, which would cover any number of ills, which I will not go into here for fear of being lynched.  Another highly useful code would be for PITA (which physicians all know stands for Pain In The Ass).  That code should cover all sorts of tests that the patient demands for ailments that he doesn’t really have, and allow higher billing, because the visit will be interminable because of all the whining and complaining.  The ICD-10 codes are changed almost annually, to numbers that are frequently completely different, by the Powers That Be,which are most likely owned by Big Insurance Companies.  The changing of the codes occurs in hopes that some hapless doctor will accidentally use last year’s code, which is now obsolete, and then they can weasel out of paying. 

The second category is the E Codes, which in English mean Bad Shit That Can Happen To You, basically from an external force.  These are numerous and extremely specific, such as Slipped On Deck Of Yacht While Walking In Swim Fins.  I believe this one actually exists, although I seldom have cause to use it.  The ones I use are usually tragic, things like Spousal Abuse, or Rape, Alleged.  You gotta love it.  Even medicine is biased against the sexual assault of women.  There is no Rape.  There is only Rape, Alleged.  I am totally surprised that they don’t have an E Code for:  Rape, But The Bitch Totally Had It Coming.  They have numerals that differentiate between Jumped and Was Pushed.  I shit you not.  There are some E Codes that would be extremely useful but do NOT exist, such as Had His Ass Kicked In A Bar Parking Lot After Talking Smack To Some Gangsta Guy.  Now THAT would be useful.

Then there are CPT codes, which translated into English are Shit That The Doctor Does To You, which covers most surgeries, treatments, and other medical interventions, or a badly needed bitch slapping.  We use these to cover Normal Spontaneous Vaginal Delivery, Primary Cesarean Section, Total Abdominal Hysterectomy, and Oopherectomy (removal of the ovaries), just to name a VERY few.  The insurance companies like to “bundle” these codes, which is to ensure that we are paid as little as possible.  For example, you are paid so much for just a Total Abdominal Hysterectomy.  If you remove the ovaries at the same time, these two codes are bundled, because they are frequently done together.  If you had removed only the ovaries, you would have been paid for that, but for both together, you just get paid the one reimbursement, usually the lower of the two costs.  They bundle some rather unlikely things, to make sure that we don’t get too big for our britches and do “unrelated” stuff.  Also, let’s say you do two procedures, with two different surgeons.  The specialist OB/Gyn does a hysterectomy, and a sub-specialist Urogynecologist does a bladder lift procedure, during the same surgical episode.  Typically only the sub-specialist is reimbursed, for both procedures, because they are considered capable of doing both, and sub-specialist outranks specialist.  I consider this outrageous, because it deters physicians from seeking specialized care for their patients, because if we bring in a sub-specialist, we don’t get paid for anything.  Thus, patients may be subjected to two different procedures at two different times, so that reimbursement will be given to both parties.  Now tell me how that optimizes patient care?

There is another coding system, for psychiatrists, which I believe is now DSM-4.  They change that up a lot, just like the CPT codes.  New diseases are added and removed with each revision.  For example, Female Hysteria was finally fortunately removed .  See?  We are making progress.  Psychiatrists code things on Axes (plural for Axis), in which one axis might be physical (like psychosis induced by lack of sleep), or biochemically induced bipolar disorder.  Another axis might be external, such as psychosis triggered by drug ingestion.  My friend, with a PhD in psychiatry insists that they should add a whole other axis, “The Axis of Evil.”  She also states they should be better reimbursed if it is invoked.

So let’s see how all this works.  A patient presents to the ER, bashed up and ranting and raving.  ICD-10 codes might be Acute Alcohol Intoxication, Chronic Alcoholism, Oppositional Defiant Disorder, Nausea and Vomiting and Opioid Addiction, Other.  E-codes might be assigned for Had His Ass Kicked In The Parking Lot Of A Bar After Antagonizing Some Dude Named Vinnie and Blunt Force Trauma To The Head, .  CPT codes for Shit The Doctor Did might include codes for Gastroesophageal Lavage (stomach pumping), four-point leather restraints, skin suturing, CT scan of the Head, and Adminstration Of A Rapid Paralytic Agent To Settle The Guy Down And Shut Him The Hell Up.  See how neatly that works?

I hope that this quick guide has helped you to a deeper understanding of the inner workings of the world of medicine.  If it does, I’ll send you a bill.  ICD-10:  Eyestrain, and Complete Incomprehension of Medical Procedures, E-Code:  Spending Too Much Time Reading Blog Posts, and CPT code:  Administration of basic information needed to comprehend the complexities of the medical world.  That’ll be $1,349.53, of which your insurance will cover $135.  Any further questions will cost you extra.

French For Dummies

My mom was a French teacher, so guess what language I got to take in school?  Yep.  French.  I must say, no one even inquired whether I would like to take a different one, as was so often the case.  Mom used a lot of French and English words interchangeably, so a lot of our little family jokes are multilingual.  She minored in Spanish, but apparently this did not rate, except that we always referred to hands as “manos”.

I got pretty much immersed in French.  I knew a lot more words than I thought I did, even as a kid.  My folks referred to each other as “Homme” (Man), and “Femme” (Woman), except to be cute, they shortened their pet names to Um and Fum.  Since French for girl is “Fille”, I got called Fee, and was photographed in front of every US Fee area sign across the United States.  Ha ha.

Mom referred to most body parts by their French names, so when I was a kid, a “bouche” was of course a mouth, and “pieds” were of course feet.  Didn’t everybody know that?

Mom was a Helicopter Parent long before it was cool (was it ever?) and had me doing all sorts of fun projects, like doing French language tapes while washing the dishes, which annoyed the piss out of me.  I used to roll my eyes and rattle the dishes while chanting zombie-like enchanting phrases such as “Bonjour, Sylvie!  Ou est le bibliotheque?”  (Because a library is the first thing we look for when we arrive in France.)

By the time I got to high school, I had taken years of French.  Looking back on it, it was pretty amazing.  I remember in one French lit class, we read Camus and “Le Compte de Monte Cristo” in the original.  In my boarding school, we were given assignments to translate Edie Piaf songs into English for fun.  One day, it was pretty outside, so we had the classroom windows open.  Our teacher required us to speak only French in class.  A wasp flew in the window, landed on the soft part of my thumb, and stung the crap out of me.  I jumped out of my seat and yelled “SHIT!!”  Madame eyed me with irritation, sighed, and said, “Non.  MERDE.”  Je regrette, Madame, je regrette..

I admit, we did have fun.  Mom and I went to Europe together at least two or three times, once on an art museum tour, since we took an Art History class from the same teacher at Alabama, just about a decade apart.  (We were, of course, superlative students.)  We hit the Louvre, and Les Tuileries, and Monet’s home, with the real water lilies.  We used our French every chance we got.  Mom had lived in France for a time when she was in college, as part of an exchange program, so between the two of us, we could whip up a pretty good conversation.

I did discover that native French speakers are not necessarily ecstatic about dabblers in their language.  When trying to buy a t-shirt in Paris, the sales girl hautily informed me to “Speak English.  It will be easier.”  Bitch.

We derived great amusement from travel guide books.  You can learn some truly useful phrases in them!  One that can still make Mom and me howl after all these years:  “Il y’a des moustiques au plafond!  Veuillez les vaporiser.”, which translated literally into English means, “There are some mosquitoes on the ceiling.  Please come vaporize them.”  Awesome.

While I was in medical school, dating the Emotional Terrorist, his sweet sister lived in Montreal with her super jock boyfriend, who was an extreme skier who had grown up there, among other places.  We would go up to see them every winter, to ski Mont Tremblant.  Quebec, of course, has attempted to secede from Canada over the use of the French language, among other things.  The Quebecerais are pretty insistent about the correct use of French, especially outside the tourist area of Montreal.  The Emotional Terrorist, who had no language ability or knowledge (except for the ability to hurt my feelings, in which he was both fluent and multilinguall) wanted to insist on using “French” at all times, despite the fact that he didn’t know any.  (He tried to pull the same bullshit in Chile, with Spanish, years later when he was visiting me there, with equally unimpressive results.)  He crawled over the seat at the drive-through window at McDonalds and attempted to order his Egg McMuffin in French.  Our host clapped his hand over ET’s mouth and hissed, “Don’t DO that!  They will SPIT IN OUR FOOD.”

Years later, when I lived in New Orleans, I was friends with a “mixed” family – a French speaking Cajun woman had married a native Parisian, so their kids spoke fluent French, in two completely distinct dialects.  When the daughter, my “birthday twin”, got married, she married an Irish man, in full tartan and kilt, and his best man was a Scotsman. What an amazing, wildass party!  A bunch of drunk cajuns, Parisians, Scots and Irish?  In New Orleans?  And no, they don’t wear anything under those kilts!  I was lucky to speak French well enough to speak it at the wedding and for some peculiar reason, one of my Mom’s childhood gifts to me were an entire collection of French folk songs, which by happy coincidence turned out to be French drinking songs. Who knew?  Not my mom, that’s for sure.  Somehow I got us started and we all started slurring, “Sur Le Pont D.Avignon”and “J’En Bourrez, Oui Oui Oui, J’En Bourrez, Non Non Non, J’En Bourrez, Si Le Vin Est Bon….”

I used to love to torment my friend Fred with phone calls, after I had moved away from NOLA.  I was pretty good with accents, and I would ring him up and say, “Bonjour, Fre-e-e-d,” in this really sticky sweet accent, and I always had him convinced it was his ex-girlfriend, calling from Paris.  He’d start jabbering away, and I’d hold up the receiver and laugh and laugh, and he’d know I’d got him again.

The ridiculous irony was, of course, that I had always wanted to learn Spanish.  Beautiful as French is, in the US, it’s not all that useful. Some Cajuns (mostly the older ones) do still speak French, but the dialect is so extreme that it hardly sounds like French at all.  You can use it in Quebec, but at your own risk, since they may spit on your McMuffin.  Some regions of Africa are French-speaking, but if you’re stranded there, you may have worse problems than not speaking French.  You can use it on some Caribbean islands, but frankly, they pretty much speak anything involving money.  You can, of course, speak French in France, but again, native speakers of French are somewhat less welcoming of inexpert attempts than, say, their Spanish speaking counterparts.

Which leads us to Spanish.  Which is spoken here and in myriads of other places, all the time.  So when I started med school, and  noticed that a LOT of my patients spoke it, it was time to learn Spanish, which is a whole ‘nother blog, for another time.  But if I ever want to order “fries with that” in, say, a ski lodge on Mt Tremblant, I can at least be fairly confident that they won’t expectorate in my food.

Why Is It…

I have been accused by many of being a cynic.  I can’t imagine why this is.  My question for you is:  Is it cynicism if it’s true?  I have heard cynics described as “failed romantics”, and if that is the case, I guess I am a cynic.  I tried to deny it during a visit to my shrink, and he reminded me of a statement I made on one of my worst days.  When asked if the glass were half full or half empty, I replied that someone had stolen my damn glass.  Now that I would refer to as bitterness, but who am I to argue?

My cynicism, if it exists, began in junior high, but was firmly seeded when I started medical school.  The summer before I went to med school, several people told me that I needed to read Samuel Shem’s “The House of God”, which everyone agreed “told it like it is” and I would know what to expect when I started that July.  Let me say that it is an excellent book, but you should not read it prior to starting medical school.   It will set the stage for bitterness beyond repair, because all of the things in that book ARE true, and they are a horrible sad reality.  My husband has questioned the source of my somewhat bitter outlook, and among those sources are that book.  I have urged him to read it, so that he may better understand, but he has not read it yet.  He will probably not, unless I maybe read it to him.  He is very busy, and mostly reads technical journals.

I have made many observations, which I insist are realism and not cynicism.  Maybe you will agree with me, or maybe you won’t.  I suspect these random thoughts may ring some very familiar bells, which likely cannot be unrung.

Why is it that when you are terribly late, that you will hit every light on the way to your destination, but if you are early and hoping to delay your arrival, all your lights will be green and there is smooth sailing?  This also happens when you really need a stop light to quickly check a text, which may be crucial to your outings that day.  My husband would claim (I sometimes refer to him as Mr. Spock) that these occurrences are mere coincidence, and that our mind only registers the outcomes that we (bitterly) expect.  I don’t know.

Why is it that my husband always calls me when I am running between airplane terminals, on the toilet, sleeping, or otherwise engaged in an activity that makes it virtually impossible to answer the phone with any convenience at all? He indignantly denies this, and tells me if I don’t stop complaining, he won’t call me at all.  It would be churlish and counterproductive to suggest that this is a desirable suggestion.  It certainly would not make for good marriage relations.

This may not be a problem for most of you, but why is it that when you have been up all night delivering a baby, and desperately need to go home and shower and rest, that just as you walk triumphantly out of the delivery room, there is another woman sitting there in a wheelchair who has just come up in labor?  This seems unnaturally cruel.  It is a lot more unlikely to happen if you are well rested.  It is most likely to happen at 4 in the morning.  Studies actually bear this out.  Human cortisol cycles dictate that more deaths and births occur around 4 in the morning than at any other time.  The baby I delivered this morning came at 4:17 AM.  I rest my case.  When I got the delivery done, there was another woman being admitted in labor.  Really?  Uncool, universe, uncool.

Why is it that when you are in a rush to pick your daughter up from school, she will be covered in paint, in the middle of a project, and her backpack completely unpacked?  If you have plenty of time, she is packed, homework done, and ready to go home.

Why is it that the hotel WiFi always cuts out when I am actively doing something, like Skyping with my family?  It never does it while I am asleep.  Then I get accused of deliberately cutting off the connection.

Why is it that when I am finally getting some sleep, (and of course have not put up the Do Not Disturb sign at the hotel, because I think that there is no possible way that housekeeping will come around that early) that they come banging at my fricking door at 8:45 in the morning?  However, when I am at work at the hospital, and hoping that they will have come already, when I return at noon, they still haven’t come and start banging at my door wanting to know if I want service?  Why is it then, after they have already come and gone (and tried to weasel out of various services because I am sitting there, and they can ask me if I “really need my bed made”) that just after I have gotten rid of them and locked up the door, the head of housekeeping will show up, bang on the door yet again, just to ask if I have gotten my room cleaned.  Why is it that no matter how loud I yell, “COMING” in a tiny hotel room, that they NEVER hear me, even though I yell it twice, they still jam their keys in and pull at the door?  It’s one room.  I have a loud voice.  Have they all been deafened by their vacuum cleaners?

Why is it that there is always massive, dense frost that must be scraped if I am in a hurry or running late, but the windows are always pristine if I have plenty of time?

Why does the damn hospital always call when I am in the shower?

Why is it that they only show the episodes of Law and Order, NCIS and SVU that I have never seen RIGHT when my husband calls and wants to Skype.  Why does he blather on until the whole show is over?  Why can’t he ever call in the middle of the multitude of episodes that I could recite verbatim and am sick to death of?

Why is it that the patients that wake you up in the middle of the night are always the ones that you don’t know, that belong to another doctor or hospital, that have no prenatal care, and who are unbelievable pains in the butt? 

Why is it that after many days of clear skin, on the one day you will see someone whose opinion of your appearance matters to you, will you wake up with an enormous zit?  Why is it always the one that has roots in your damn tonsils, the kind that you can’t hide no matter what, and the kind that takes days (if not weeks) to clear up?

Why is it that if you are late for your plane, the parking lot will always be super full and you will have to park 8 miles away and run? Why, when you are early, will it be totally empty and you have your choice of spots?

Why is it that when you are about to miss your flight connection, your gate will be 6 concourses away, always in the Minneapolis-St. Paul airport, where you have to run most of the way and the tram will take you about 5 inches.  When you are early, your gate will be directly next to the one where you have disembarked.

Why is it that if you decide to go home because a patient’s labor may be awhile, that they will either develop conditions that necessitate multiple phone calls and the need to go back in to the hospital, or they will dump the baby out in the bed before you can get there, but if you decide to wait at the hospital, everything will go smoothly and will take forever, while you are trapped there with nothing to do?

Why is it that in winter, the beautiful sunny days are always horribly cold, and the ones at a temperature where you might actually want to venture out, are always gray, depressing, and raining.  Actually, there is a known reason for this, having to do with weather patterns.  I disapprove.

Why is it that when your call ends at 7 AM, you will get called in for an emergency delivery at 6 AM, which will necessitate you working over your call time, especially on the day that you have to be returning to the airport?  Why is your call replacement always late getting into town?

Why does Walmart never have enough fricking lines open, even during times that are known to be busy? 

Why is it that yogurt, toothpaste, coffee, and other staining items always splorp out on your work or travel clothes, but never on your t-shirt and yoga pants, even if you are being very careful?

Why, when you drop something small, expensive and important, will it always take a bounce that defies the laws of physics, and land in the one place that you believe it was physically impossible for it to go?  Why, if it is unimportant or messy, will it always land right in front of you, or splat on your clothes?

Why is it that the piece of luggage you drop always contains your computer?

Why, within months of the time that my GI doctor told me that I should not drink coffee, were not 1, not 2, but 3 Starbucks erected in my previously Starbucks-less town? 

Why do you always miss the flight when you are headed somewhere of tantamount importance or great desire, but never when you are going somewhere where you couldn’t give a shit if you get there?

Why are the totally cutest clothes and shoes marked down to a totally awesome price only available in someone else’s size?

Why is it that you always have some weird muscular spasm and ram your freshly manicured toenail smack into the underside of the drying table when you are getting up to leave from your pedicure?

Why does your car wait to go off waranty before it totally falls apart?  Why does this happen one day after it expires?

Why is it that the drier always beeps when you are in the middle of dinner, or a shower, and it is always the load that must be hung up immediately?  It is never towels.

Why is it only the glass ornaments that fall off the tree?

Why do you always have to poop right after your shower?

Why is it that you always get horribly sick on vacation, and not when you could totally use a break from work?  Why does your kid only get sick when you are about to leave on vacation?

Why is it that packages that must be signed for only come when you are not home?  Why does the mailman come at 2 PM when it doesn’t matter, and at 9:30 AM when you are struggling to get bills out on time?

Why does your phone lock up while you are trying to pull up your boarding pass to get on a plane?

Why is your plane seatmate always the last to board?

Why is it something different that sets off the TSA metal detector every time, when you always pack the exact same things in the exact same way?

Why is the person ahead of you in line at the grocery store always trying to pay in Euros, or trying to use their debit card to bring down the entire US banking system as we know it?  Why must their items always be price checked?  Why do they have 80 coupons?  Why is their credit card always denied?  Why is it that the line you pick is always the one that comes to a smack halt, when all the other ones are moving smoothly?

Why do travel opportunites, parties and visits with friends only come available when you have already made other, unbreakable commitments?

Why do your coat, backpack straps, purse straps and other items always get hung up on doors and handles so intensely that you must back up and untangle them?  Would this ever happen if you needed this to to save you from falling off a cliff?  Hell no.

How can an enormous ice scraper disappear out of a rental car that only you use, that you always keep locked, and that is so big that if it fell out, you would totally hear and feel it falling on the ground?  Why does this only happen on the day that the most ice forms all over your windows?

Why is it always someone else that wins the damn lottery?

Why is there always a crisis when you desperately need to be doing something else?

Why, if a cabinet door is opened for a minute, will you smash your head into the corner of it so hard that your ears ring and there is a bloody flap on your scalp?

Why does one earring always come out and get thrown away with the scrub cap?

Why, when you have to do a delivery so fast that you don’t have time to change out of your street clothes, or put on your tall hipwader boots, does the amniotic fluid explode all over you, the blood sprays all over and out of the cord, and the placenta flies out with a plop and a splat on to your feet, but when you have on your protective gear, the delivery is unbelievably tidy, and nothing gets on anything?

Why do you always get a paper cut right before you have to cover your hands with alcohol solution to do surgery?  Owwww.

I could go on.  Really.  Endlessly.  This is but a random smattering of my questions for the universe.  My husband would state that all of these occurences are random, and have nothing to do with the circumstances at hand, but I just don’t agree.  Somebody stole my damn glass.

 

 

 

 

 

Things That Men Say

Let me preface this for those who do not know my by saying that I am an OB/Gyn – a doctor that takes care of women, doing, you know, women stuff like baby birthing, hysterectomies, icky periods… yeah, that stuff. Because I care for women for a living, I get to spend a lot of time with their men, frequently under bizarre circumstances like childbirth, or a really icky pubic rash. Shhhh… I’ll tell you a secret. OB/Gyns have a saying: “All women are different, but all husbands look alike.” Their men are a constant source of amazement, embarassment, stereotypical behavior, sweetness, and hilarity, planned or not.

I made a previous post about things that patients say that amuse me. This one’s just for the guys! Here’s to you and thanks for all the laughs (and muffled sobs)!

1. When you do her hysterectomy, can you get the mean out of her too, doc?

2. Hey doc, while you’re sewin’ that up, can you throw in a couple extra stitches, just for me?

3. You mean that thing’s an extra nipple? Babe, you’re a FREAK!!!

4. Only YOU would ask the doctor for something like that, Princess.

5. I thought she’d go back to normal after the baby came out.

6. We both dug around and looked for it, doc. Just can’t figure out where the damn thing went!

7. Are you gonna stick that duck thing in ‘er?

8. I’m leavin’ the room. I don’t wanna see this.

9. Oh, my God, what’s THAT?

10. What’s that brown stripe in the middle of her belly for?

11. Hey, if you’re gonna do that to her, you oughta at least buy her dinner first!

12. I dunno, doc. She got off your scale and just started cryin’.

13. What do you mean, she got pregnant in April? I wasn’t here in April!

14. What’s THIS for?

15. Is it OK if we keep the litter box in the kitchen?

16. Don’t worry, doc. I ain’t gonna pass out. It’s just like guttin’ a deer, right?

17. If it’s a girl can you put it back?

18. If it’s a boy, you only got one dick you gotta worry about. If it’s a girl, you’ve gotta worry about ’em ALL!

19. She caught that somewhere else.

20. I AM payin’ attention, hon. You just keep pushin’!

21. I’m just gonna sit over here.

22. I feel a little…. THUNK!

23. There ain’t another un in there, is it?

24. You swear it ain’t twins?

25. Does that hurt, babe? That looks like it hurts! What do you mean, shut up??

26. OW! You’re gonna rip my fingers off!

27. What do you mean, this is all my fault? You was there too!

28. My wife is hurtin’! Fix that Goddamn epidural thing, NOW!

29. She done broke her water all over my truck upholstery!

30. What do I do? What do I do?

31. Damn, Babe! You’re big as a frickin’ HOUSE!

32. Is she gonna be OK?

33. I am NOT drunk!

34. Can’t you just grab its ears and pull?

35. Why’s his head all pointy? Is that gonna go away?

36. What do you mean, you don’t want my mom in here?

37. Some things a man just shouldn’t have to see.

38. What do you mean, she can’t just have it now?

39. Can you just spay her?

40. Damn, I can’t even look at her but she gets knocked up with another one!

41. What do you mean, we can’t have sex til the baby comes?

42. Seriously, what do you mean, we can’t have sex until the baby comes?

43. How long do we have to wait to have sex?

44. Tie her tubes? Cut ’em the hell out, set fire to ’em and STOMP ’em!

45. Semen analysis? Hell no, doc, I know it ain’t ME! Ain’t nothin’ wrong with ME!

46. How soon can you do a paternity test?

47. Where’d the red hair come from?

48. She said it was a alien probe! That’s funny Babe! Ain’t that funny?

49. I can’t wear one ‘a them things! Like taking a shower with a raincoat on!

50. It can’t just get lost up in there, can it?

51. Damn, looks like you’re stickin’ your whole HAND up in there!

52. Oh my God! I shouldn’t’a looked down there! Oh, CRAP!

53. What’s that stuff comin’ out of her now?

54. That is just so GROSS!

55. Gawd, doc! How’m I gonna compete with THAT thing?

56. She told me she couldn’t get pregnant.

57. Can you give her somethin’ to make her wanna, well, you know… ?

58. Why’s she squallin’ like that?

59. Damn, her boobs got BIG!

60. Her nipples look like dinner plates!

61. Her boobs are bigger than my kid’s HEAD!

62. That thing makes her look like she’s on a milkin’ machine! OW, Babe!

63. I can’t pick him up. I don’t know how to hold his head.

64. COOL! He blew poop out his diaper right up his back! THAT’S my boy!

65. What do you mean, I get to have the next one?

66. I swear I didn’t think that thing’d get stuck up there.

67. Oh my God! Why’s that woman next door SCREAMIN’?

68. Did you really have to go into labor right in the middle of the Iron Bowl?

69. Do some jumping jacks, Babe. We need to have that thing this year – we need the deduction.

70. Can’t tell if she’s walkin’ or rollin’.

71. Why does she still look pregnant?

72. She can’t have the baby Thursday. I can’t get off work then.

73. She cain’t have the baby on Halloween – he might be a WITCH!

74. What the hell’s a onesie?

75. If her mom don’t leave I’m gonna go nuts.

76. No, you can’t buy all new shoes if your feet spread.

77. How come you need your toenails painted? You can’t even SEE ’em!

78. Stirrups? You mean like on a horse?

79. Why’s she so grouchy when she’s on the rag?

80. Oh my God! That needle is huge!

81. Don’t worry. I’ll make her take her pills.

82. Damn, girl! Your Tweety Bird tattoo’s done turned into Big Bird!

83. Is she gonna have to take that piercing out?

84. Looks like he’s a little alien tryin’ to crawl out your belly.

85. What’s that cut for her c-section gonna look like?

86. She doesn’t want an epidural. You don’t want an epidural, hon. We want an all natural birth.

87. Just breathe, hon. You’re not breathing the way we practiced. What do you mean, shut the hell up?

88. What the hell do you want me to do??

89. Why are all the magazines in here for women?

90. She’s a MILF in training.

91. I forgot the camera.

92. This wasn’t in the birth plan.

93. You’re not the doctor we’ve been seeing.

94. How can you stand looking at this stuff all day? Why’d you decide to do this?

95. Don’t you feel weird looking at women’s crotches all day?

96. Will she still be a woman if she has a hysterectomy?

97. Will she still be mean when her periods go away?

98. You gotta do something, doc. She’s rippin’ the covers off and freezin’ my ass off every night.

99. I told her I was coming in with her to make sure she addresses this issue.

100.Thank God I’m a man. That’s all I’m gonna say.

Travel. Really.

Since I have been traveling for work almost a year now, I feel I am in a position to offer some insightful travel tips and hints.  With any luck, these will not frighten you away from ever traveling again.

1.  Sweaters with festive metallic threads will light up a metal detector like a Christmas tree.  You will be groped and cavity searched.  Happy holidays.

2.  Atkins bars show up as liquids in the scanner.  They will open your carry on and paw through it.  They may or may not grudgingly admit that Atkins bars are not liquids.  They will not apologize for accusing you unjustly of smuggling liquids, nor will they apologize for pawing through your bras once again.

3.  Sometimes it is quicker to go pick up your rental car first than to go wait for your luggage.

4.  Sometimes it is not and they will whisk your bags away to Unclaimed Luggage when all you did was stop to pee and buy a coffee before heading to the luggage carousel.

5.  Ice scrapers mysteriously disappear from cars, especially when they are laden with ice and you are late.

6.  Do not torment yourself by repeatedly checking the weather before you leave on your trip.  Sometimes it will actually be better and sometimes it will be worse.  The only constant is that it will change a million times over that 10 days.  Get a quick impression.  Will it be crappy?  Will it be hotter than hell?  Will it be cold as f*ck?  Pack accordingly and then never look again.  Unless you really want to.  Or if it looks like the sky is falling.  Get a weather app for your phone and you can torment yourself hourly.

7.  You will always be seated next to a screaming baby.  Some people like to pay to fly their screaming babies first class, so don’t think you will get out of it that way.

8.  Everyone in first class will be swilling alcohol.  Especially the innocent looking little old ladies, who will get hammered and begin to swear like sailors.  A flight attendant friend of mine told me that all that drinking is because in first class the alcohol is “free”.  They will drink no matter what.  Even on a Tuesday morning at 8:30 AM.  Especially on Tuesday morning at 8:30 AM.  Especially if they are going to work that day.  Because it’s always 5:00 somewhere.

9.  No master how slick a traveler you think you are, you will always manage to do something that is wrong, clumsy, and awkward.  Get over yourself.  You’re not that slick.

10 You will always get lost in the Minneapolis St Paul airport.  The architect was drunk.  The people who made the signs were drunkerer.

11. You will hate the Denver airport.  It will hate you back.

12. The Houston airport always smells like tacos.

13.  You will always drop the bag your computer is in.

14. They do not allow you to bring food or drinks into the Delta Sky Club, even though the food and drinks they provide in there are free.  Go figure.  Yeah.  Think about that again.  Than, go figure, because I can’t.  But you can always sneak them in.  I do.

15. While waiting to catch your plane, you will be sitting next to a fat loud business man who is on his cell phone at top volume, thinking he is the Wolf of Wall Street, and looking and sounding like a fool.

16. The computer charge ports will be occupied by bored texting teenagers who have piled their bags into the adjacent seat, which you will have to ask them to move so you can charge your computer.

17. Sometimes your Kindle will spontaneously burst into flames while you are on an airplane.  No.  Really.

18. You may become trapped in an airport bathroom once all your luggage is dragged in after you.  Something will always fall on the floor.  The toilet will flush while you are on it.  The doors open inwards, so good luck getting out of there.

19. You will suddenly need to poop as soon as you get on the plane.

20. The soap in the bathroom dispensers always look thick and fluffy, but it is watered down and it is never enough.

21. The water in the sink will cut off on you 700 times as you try to wash your hands.

22. You will look at the weirdos at the gate and think, “Thank goodness, I won’t have to deal with them because I am in first class.”  They will be sitting next to you in first class.

23. The crossword in your Sky magazine will always be partially worked, in ink.

24. They may or may not detect a weird chemical while doing a random swoop of your carry on. They will not tell you what it is, or if it is dangerous.  They will then remove everything from your carry on, even your undies.  They will glare at you, and wish they could cart you off to Gitmo.

25. You will eventually be in a situation where you will have to receive a full pat down.  They have an entire hour long speech that they are required to give you first.  You cannot stop them from giving it by telling then not to worry about it and just get it over with.  They will give you the full speech anyway, even if you are late.  Especially if you are late.

26. The luggage is loaded on to the plane by large angry mountain gorillas, because they are cheaper to pay than people.  This is all the explanation you will need to understand the appearance of your luggage when you get it back.  IF you get it back.

27. Your ride to the airport will either be early or late.  Either way, it will be the most inconvenient outcome possible.

28. You will sit in the wrong row of seats on the plane many times.  At least I do.  I like to think of myself as Aisle Impaired.  The most common phrase I hear while traveling is, “Excuse me, ma’am, I think you’re sitting in our seat”.  I don’t understand how in the hell I keep doing that.

29. Just as you begin to happily think that the seat next to you will be vacant, your seatmate will be the last person who gets on the plane.

30. It may or may not be true that if the person next to you is so obese that they require a seatbelt extender, that the whole plane will tip over sideways in flight.

31. Your rental car’s last occupant was always at least 8 feet tall. All seats, belts and mirrors will be adjusted accordingly.

32. Every single rental car has its gas cap in a different damn place.

33. Your next door neighbor in the hotel will be a sex fiend screamer who likes to bang the headboard against the wall, a family with multiple small children with a father who likes to tickle and wrestle with them so that they scream and giggle while he hoots and hollers, or a drunken cowboy who indefatiguably loves to hurl all available furniture against the wall.

34. Virtually all hotels now are strictly nonsmoking, but someone on your hall will be smoking anyway.

35. Woe betide you if you are in your room when they come to clean it.  They will ask you if you want each individual service, in an effort to wear you out and shame you into telling them they can skip vacuuming today.  It is not considered acceptable to say, “Just do your damn job!”, even if you really want to, because next time they will spit in your coffee pot.

36. There will always be some elderly person checking in for a week long stay at the desk if you run down there with a quick request.  They will question the desk person about each item to be initialed, and argue about whether or not they need to sign it. They will have forgotten what kind of car they drive, and they will have to go outside and look.

37. If you leave canned soda in the trunk of your rental car in a cold climate, it will violently explode and leave Cokesicles hanging from the underside of your trunk lid.  If you are lucky, it will be diet.  Don’t ask me how I know this.

38. Walmarts are like weird warps in the space-time continuum.  Once you enter one, you could be anywhere.  You can walk into one in Ohio, and when you walk out you may be in Alabama.  Strange but true.

39. Airplane bathrooms are scary biohazards.  One day they will discover that Ebola got started there.  Never forget to close the seat before flushing, or that weird blue water might get on you.  And then you will have Ebola.

40. You will forget about the drink you bought to drink on the plane until you get off the plane.

41. There will always be some chick on the plane who will glare at you for no apparent reason.

42. If there is one person on the plane with peanut allergies, they will not serve anything containing peanuts.  This is probably prudent on their part, but I am using this paragraph as a platform to segway into the fact that I think that it is totally weird that I knew no one ever who was allergic to peanuts when I was a kid, and now everybody is.  Same deal with gluten.  Will they one day no longer serve wheat on planes either?  Because if so, please remind me to bring my own snacks.

43. There will always be a kid behind you kicking your seat.  Their parents never notice, probably because it keeps the kids occupied.

44. Having children does NOT make you tolerant of other people’s children.  Does not.  Does not.  Actually, it’s usually the crappy parents I’m intolerant of.

45. Someone on the plane is always wearing shorts and flip flops on a flight to North Dakota in winter.  It is amusing to ponder how anyone could really be that stupid.

46. Money does not guarantee taste.  And no, a fuzzy chartreuse sweat suit that says Juicy Couture across the ass worn with a multicolor Louis Vuitton bag with blaring primary colored logos all over it and gold sequined Uggs do not make you look rich and classy.  They just make you look like Walt Disney threw up on you.

47. Someone always has luggage that is so nice that you want to bop them over the head and run away with it.  Do not give in to this impulse.

48. Who was the settler who arrived in North Dakota in the dead of winter, surveyed the 8 feet of snow surrounding them, stuck their nose out in the -19° weather and said, “This place is AWESOME.  I think I’ll stay”?

49. Your phone battery always runs down much faster than you think it will.

50. Accept the fact that something bizzaro is probably going to happen to you.  Today.  Revel in it.  If nothing else, it will make an awesome blog post.

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