Full moon

Was a day or two ago.

In this week, I've had more SHIT than most people get in a year. My tertiary center is asking me "WTF?" I'm asking the same thing to the Flying Spagetti Monster.

I've raced to hospital in excess of 70 mph more than once this week (don't worry, country roads are flat and straight). Nurses are so worried they are incoherent when they call me. "Linda! Shut up and calm down!" (to be fair, a bp of 270 over 150 scared me too!) More than one true crash section under general. Lab values that are consistent with very bad things happening.

I'm blaming the full moon.

How did you forget?

You FORGOT this was in your uterus???????

I think I have figured out why you and your third hubby couldn't have kids.

Conferences

I like going to conferences. This one was in the city where I did my residency...lots of catching up with various people. I was introduced to one of the BIG NAMES tm in our field...he was impressed when he started quizzing the audience during his presentation and I answered every question correctly. He even went into minute trivia trying to get me! Neener-neener!

Heard some data that made me think. Heard some info that will change how I practice. The best one, though, was from an ID doc who presented an update on laws involving HIV testing in our state. Woo Hoo! Less paperwork is now required!

The nice thing about going to conferences is being able to bounce ideas off of other docs. I have challenging patients, so it's nice to hear other people's thoughts on how to care for them. The hard thing about solo practice is that I've lost this.

Damned knee

I swear, I'm "this close" to asking for it to be amputated.

I went to see Jeff again yesterday. X-Rays again are normal...but he aspirated a fair amount of fluid from it and injected steroids. It's feeling ok...better than last week but I'm getting frustrated. I'm in my late 30s and I walk like I'm 70! We talked...it's likely that I have a strong inflammatory reaction and neither one of us thinks surgery again would be prudent (well, I wouldn't let him back in so fast anyway).

Grumble.

Sometimes wrong, never in doubt

At least that's the saying about us surgical types. We're denigrated as non-thinking monkeys, snap-decision makers who always KNOW what they plan to do.

But that's not the case.

We puzzle. I have many options that are non-surgical for multiple diseases. Patient may have PPP (piss-poor protoplasm) and surgery likely would have a prolonged aftermath. The more medical illnesses, the higher the risk of surgery. Chronic pain folks rarely have a good result from surgery...but I'm not going to feed strong pain meds for that. (let the flaming begin).

And that's just before the operating room. We get into a belly...and find stuff we weren't expecting. A hot appy in a person with chronic pelvic pain (call in general surgery). Omental caking in a person with a normal ultrasound (FUCK!). Adhesions everywhere so that we can't even put in our usual port sites (grumble, grumble). Aberrant anatomy so that we're mumbling under our breath "I'm not sure WHAT this is". It's times like these where we think...and then make a decision.

Easy to hard. That's the mantra of a difficult case...Dissect out what you know. Gain control of the anatomy slowly. Plus this gives you time to think and to plan the next step. It also gives the circulating nurse time to run and grab an instrument that you don't usually use, but want this time.

Almost anyone can do the technical part...the trick to being a good surgeon is
1. Knowing if surgery is a reasonable option and
2. Knowing which technical part to do when it's not a straight forward case.

Stupid other doctors

I don't give a fuck what your religion is. But if you pretend to be an OB-GYN and refuse to give OCPs for ANY cause (including treatment of laparoscopic biopsy proven endometriosis) because "My religion doesn't believe in birth control" then you are an idiot and a danger to patients.

Period.

OTOH, thank-you for adding several patients to MY practice.

21 years

So we've been together now for a long time.

Like you said this morning "Our relationship is of drinking age!"

I still love you. I even still like you. And here's to many more years together.

I am a dipshit

Figured out why my garage door wouldn't open when I repeatedly pressed the button.

I was using the remote for the doc's lot, not my garage.

I am a dumbass.

I now remember

Why gardening is such GOOD exercise...

Hoed the area I'm going to be using for my veggie garden this year. It's about 10 by 10. Also weeded 2 flower beds and mulched one. Still have lots to do...

Looking to plant tomatoes, assorted peppers, carrots, and maybe some broccoli. My herb garden has dill, cilantro, thyme, oregano, chives, mint, and sage as perennials. I'll plant some basil in there as well and maybe some rosemary.

Ummm, homemade salsa fresh from the garden...fresh chives on baked potatoes...fresh dill on salmon

I'm getting hungry just thinking about it!

Guys, don't say this

So a patient shows up onto L&D. By golly, she was in labor so I kept her.

She called her husband, who is a contractor.

His response?

BTW, she did not think highly of it...

"But I got concrete coming!"