Thursday, September 18, 2014

Fuck it All Honest Finals Version Full Screen





This is kinda how I'm feeling about my job this week.

Monday, September 8, 2014

NEJM articles and musings on changes

Interesting article in this week's NEJM regarding the ethics of testing of procedures. A lot of what we do in OB/GYN is procedures - surgeries, office procedures. And a fair amount of what folks do is based on shoddy science and cool tools (I'm looking at you, DaVinci).

But science is linked to asking the how and why questions. And we change practices if we can be shown (some people may need to be beaten about the head with the evidence). Episiotomy rates have plummeted - I was a resident when these studies were coming out and most attendings drastically decreased that procedure fairly quickly. Early term inductions as well - my first practice they wanted to deliver everyone by 38ish weeks. Vaginal mesh is now rare...thank goodness. Digging it out of the vagina is a hot, unpleasant mess. I'm happy to say I was an early disadopter of the various meshes.

Sterilization methods may be revolutionized as well if some of the newest data from Canada holds up, but it'll be another decade before we can see a reduction in ovarian cancer because of changing the method of tubal ligation. Plus, some new data from Essure is showing long-term, it's not as effective as we need it to be.

Guess I'll always have something new to learn.

Wednesday, September 3, 2014

Really?

Today was a facepalm kinda day. Sorta like this:



You know, FOBs talking about how THEY plan on breastfeeding, telling me "I didn't shave the kitty", or getting knocked up by a guy who has multiple girlfriends tends to make me do that.

Like I told a coworker, "I got whacked with the crazy and stupid stick today."

Sigh.

Thursday, August 28, 2014

Tired

Of people assuming I'm stupid because I'm female.

Of teens who show up 30+ weeks pregnant.

Of my house being a flipping disaster.

Of administrative bullshit. I may have told a VP of the hospital that he was a roadblock to progress.

Of always being asked to pick up extra.

Of my stupid ortho injuries. Yes, plural.

Of pushing with first time moms at O'dark o'clock.

gah. Thanks god for a long weekend.

Wednesday, August 6, 2014

Venting

Why the HELL do people think a degree from fucking Dr. Google trumps my experience and education?

I went to med school for 4 long years. I then did a residency for another 4 incredibly long and painful years. I have been out of residency for 8 years. I know shit. I know OB. I've done thousands of deliveries. I can tell you what is likely to happen if we do things your way. Doing things my way leads to a HIGHER chance of a vaginal delivery!

SO FUCKING LISTEN TO ME when I make a recommendation at 8 am. And then you won't have to be telling me at midnight "You were right." DAMN STRAIGHT.

Thursday, July 31, 2014

Lucky

Have had several days recently where every patient was NICE.

All toddlers were cute and so proud of "their" baby.

New patients almost completely (and correctly) worked up by the referring physician.

Surgeries that go exactly textbook.

I just jinxed myself.

Thursday, July 24, 2014

Best. Call. Ever.

Wake up at 3:22 am to the sound of a dog howling. Get her calmed down.

4:00, decide sleep was no longer an option. Boot up computer to goof off. Hear a wet farting sound behind me to see a dog having a diarrheal episode. Throw her outside, where she has more and then wipes her butt on the grass. Turn around to realize that I've locked myself out of the house. Get into the garage, banging leg against lawnmower. Find the lightswitch so I can find the #$%&^%^^*$##$@$$%&^% key.

Let myself back into the house and let the dog back in. Gather supplies to clean up living room. Enter living room to find our dipshit lab trying to EAT the mess. Start yelling and wake the husband up (again). I'm dry heaving as I'm cleaning up the mess. He takes over. I go into kitchen to find coffee.

At 7 am, decide that dozing sounds like a great idea...The newest dog jumps into bed. Fine. Until she pees on the bedspread. FML.

By this time, I've decided that I'm just going to sleep on OB from now on.