Monday, March 28, 2011

Elegy

For one of the forgotten ones.

A body was found yesterday morning here in town. I heard this morning who the supposed victim was, police confirmed her identity today according to the online version of our local paper.

I work with the forgotten ones. The ones people gloss over. MR/DD. Drug-addicted. Dirt-poor...and the cycle of poverty continues generation after generation. She was one of these. Her family had been in town for generations...and for generations had been known as "them."

But she did not deserve what the word on the street said happened to her (lets just say I have insider info...one of my last appointments today was her cousin).

Sometimes, looking at the hot blue hair, the poor dentition (a common P.E. finding on my H&Ps for surgery), we have to remember that behind it is a gal...not too different from myself.

There but by the grace of God...

Sunday, March 27, 2011

Things this OB-Gyn hates

In no particular order:

1. HELLP syndrome

2. Stage 4 endometriosis during hysterectomies.

3. Repeat c-sections

4. Abruptions

5. C-sections under general

6. IUFDs.

7. Cancer

8. Floppy, grey babies

9. Shoulder dystocia.

10. Severe post-partum hemorrhage, where you end up in the OR after a vaginal delivery.

11. Severe pelvic adhesions while trying to do a surgery.

I've done all of these in the last couple of weeks. Some more than once. Some patients combined several of these into one craptastic case.

Wednesday, March 23, 2011

Dear OR Gods

Thank you for the awesome day! My favorite assists, interesting cases, ABBA in the background...

I left my first case with a BIG grin on my face and a real sense of accomplishment. This is what surgery at its best is - healing with steel. It wasn't an easy case, but it was a fun one, challenging in the right way. And my patient will feel better than before.

A win for all involved. The two assists (vag hyst) were both saying that is what they love.

Tuesday, March 22, 2011

Dear Patients,

When I ask you in the pre-operative consult if there are any medical problems that I should be aware of, your bleeding disorder is included in that.

Please don't tell me as I am leaving the room "By the way, a doctor tells me I have a bleeding problem."

And then when I ask if you know the name: "No."

And then when I ask if you bleed too much or clot too much "I don't know."

For some reason, as a surgeon, I CARE ABOUT THAT!!!!!!!!!

Fortunately, you knew the name of the blood doctor and I could get a letter from him.

*facepalm*

Yes, this has happened to me recently.

Sunday, March 20, 2011

Spring is HERE!

March madness is on the TV (YEAH BUCKS!). Crocuses are flowering. Daffodils are starting to poke up through the ground. We were able to fire up the grill yesterday for the first time this year. And the boy has (finally) mastered riding a bike without training wheels.

YEAH!!!!!

Friday, March 18, 2011

NO!, part 2

Dear Idiot ER Doctor in smaller hospital next county over:

Yes, I understand that the gal in your ER sees my partner, Dr. Johnson. But you are telling me that she is orthostatic, hypotensive, and blood is pouring out her vagina. I will NOT accept an unstable patient from a 45 minute drive away, so please call Dr. Smith at your hospital. She has GYN privileges at your hospital. And yes, I completely understand that she sees my partner. She could possible DIE in transit. Call Smith.

I needed to repeat that multiple times before he understood no means no.

sigh.

Thursday, March 17, 2011

The OR Gods

Are just as pissed at me as the call gods.

:(

Every few months, I operate on someone with a BMI significantly north of 50. I always hate myself in the middle of the case and the next day when my back is killing me. So WHY do I get temporary amnesia a few months later when another shows up needing something? And I then agree to do the case?

I'm nuts.

Monday, March 14, 2011

Great kid quote

So my boy just lost his front tooth. Now he lisps (which makes me laugh) and it's frustrating him.

"Mom! I can't thay F-wordth!"

*snort*

Sunday, March 13, 2011

Another one

just walked in.

Shoot me now. PLEASE?

Call gods

Are extremely angry at me right now...I'm thinking of offering up my first-born to try to appease them.

L&D is still hopping...I'm in double digits for weekend deliveries now.

ER has me on speed-dial.

Having my car parked (and since it's a small town, all of the L&D nurses know all of the docs' cars) with flashers on at the hospital entrance this a.m. was not a good way to greet the incoming day shift nurses.

Night shift did not appreciate seeing me in surgical hat and booties when they walked in this evening.

I sign out tomorrow at 5 p.m. THANK GOD this was "spring ahead" weekend...

Thursday, March 10, 2011

I'm tired

We average 2.7 deliveries/day at my hospital. When I left, 7 had been done (4 by me) and I still have another one laboring.

There are no open beds on L&D/postpartum right now.

Here's hoping the labor goes relatively quickly so I can get some sleep tonight.

Friday, March 4, 2011

What part of no do you not understand?

Phone call last night:

Caller: Yada, yada, yada, pain. Yada ER CT showed ovarian cyst of 2 cm. Yada, yada, yada, sees Dr Johnson (my partner). Yada, yada, yada, need pain meds.

Me: I do not prescribe pain medicines for anyone I have not personally seen or examined.

Patient: But I'm in pain!

Me: I do not prescribe pain medicines for anyone I have not personally seen or examined.

Patient: Well, what are you going to do for me?

Me: If you are in that much pain, go back to the ER. Otherwise call in the morning for an appointment with Dr. Johnson.

Caller: But I can't afford to go back to the ER! Can't you call in a little something?

Me (feeling like a broken record by this point): I do not prescribe pain medicines for anyone I have not personally seen or examined.

Caller: Can you call Dr. Johnson and ask him what to do?

Me: He is not on call tonight. I am and I will not call him. Also, I can tell you that he will not call in pain medicine for anyone, so that's a dead end as well.

Caller: Well thanks for nothing.
Click.

Any bets on getting a complaint from her?