Thursday, November 27, 2008

A Letter to whiny patients

Dear PIA,

No, I do not want you to have a miscarriage. However, since you are now in your third trimester, that would be difficult. No, I am NOT going to write an off-work note for you because the factory is "too cold." Put on another layer, dammit, and quit trying to get out of work.

No, your boss asking you to lift 10 pounds is not unreasonable. Here's a copy of the ACOG guidelines for working in pregnancy. YOU ARE NOT DISABLED!!! Quit trying to be a drain on society and go to work.

Yes, you should live in a place with water, electricity, and heat. At your last appointment (2 months ago, since you've missed multiple ones), we gave you the phone numbers of agencies around here that can help. You have not done a thing to help yourself. I'm sorry you're being evicted tomorrow, but I did give you the number of the local women's shelter last time. I can't help those who won't help themselves. And it isn't the caseworker's fault your documentation isn't in order. Grow up and show some responsibility for your own actions.

Oh, and those ciggies in your pocket can pay for the bus ride here. Don't tell me you don't have money to pay for that when you smoke a couple of packs per day.

FYI, if the L&D nurses fight over who will be "lucky" enough to have you as a patient, that is not a good sign. Stop being a whiny twit. You are not the first, nor the last woman to give birth.

Your OB

Saturday, November 22, 2008


5 pound dermoids are cool...the link is obviously not mine, but it was cool. My path report showed that it included mature brain, thyroid, adipose tissues.

2 ectopics in 1 week are plenty.

delivering twins is amazing.

people say the strangest things when under the influence of anesthesia.

I seriously dislike vaginal hysterectomies.

Actually, I HATE M-F vaginal hysterectomies. I do 'em because the recovery time is shorter for the patient, but I do loathe them.

I need to clean - I'm hosting Thanksgiving. :(

Woo-Hoo, it's now 7 AM and I am off-call for the first time in 2+ months!

Monday, November 17, 2008

Another One Bites the Dust

Another OB in town announced his retirement. Our hospital can (based on deliveries and population of service area) support 10 OB-Gyns. With this retirement, we'll be down to 4. Just 4. When I arrived 3 years ago, I was the 7th doc. We're dropping like flies here!

Rural areas are drowning. I'm on track to do 350 deliveries in 2009. A busy practice in the city would do 150-175. There are always more patients, more people who need help. Those of us who remain are hustling fast and hard. And there is no relief in sight...I am booked months out for new patients, for surgeries, for anything! Good luck getting a pap smear booked!

We're a small and close-knit department. We all have the haggard look in our eyes, the perpetual fatigue in our bones. Other docs look at us with pity, knowing that you can almost always see an OB's car in the doc's parking lot. I know what call rooms get cell reception and what ones don't. I'm interviewing for someone to join me, but it's a tough sell. Rural, work hard, call Q2, interesting patient population. Sounds like a great life, eh?

Of course, if I had been smart, I would have done a cushier specialty. But I wouldn't love my work if I had...

Monday, November 3, 2008


Just do it. I did today...waited over an hour.

And dammit all, this is the first election where technically I'm old enough to run for POTUS.


Sunday, November 2, 2008

Having fun

Ahh, Halloween. When kids can have fun and Mom can steal her favorite candy from the pumpkin. ;)

I'm particularly fond of Reese's.

Saturday, November 1, 2008

Funny as hell

Long...about ten and a half minutes. But well worth it.


Well, this summer has been eventful. I left my old private practice and opened up a solo practice as a hospital employee. Part of the contract involves supervising Gyn portion of the free clinic here in town.

I'm having so much fun! Working my tail off, lots of people to be seen. A lot of pathology, uteruses weighing over a kilo, a 5 pound dermoid, seeing OB patients for the first time a week before the EDC (scan done early in the ER, so dates are good). It's a lot like residency, but a lot more fun. Even in rural areas, we have the crack inductions of labor. ;)

And to top it off, another Gyn in town in leaving. I heard from a friend who works in his office...he is writing a letter to give to the hospital. That just means more work for those who remain, which is dwindling fast.

Primary care is in trouble. OB-Gyn is not far behind. The number of new graduates going into either is falling. And you wonder why it can take months to get into a's because we're overwhelmed with the amount of work that needs to be done. And I can only see so many patients per hour and work only so many hours per week.