Now it's personal

Mountains driving into Roseburg.

Driving around rural Roseburg

A winery near Roseburg

When are we going to stop our national insanity? These are some pictures from my recent trip to Roseburg, OR. Gorgeous small town. Lovely scenery. Now infamous for yet another mass murder site. I'm sick and tired of hearing this. I went to Roseburg for a girls' weekend (hence the winery picture). I visited my son's godparents (and their kid, my future daughter-in-law). First thing I do after seeing reports: text my friend to make sure she or her husband and daughter were no where near the college.

Why should this be a frequent occurrence? Why can't we have some reasonable conversation about guns? WHY?!?!?!?!?!?!?!?!?!?!

And feel for those ED and surgery doctors there - this is a small town, 1 hospital. It would overwhelm everyone to have suddenly that many serious traumas brought in. They are going to be having nightmares.

oooohhhhhhhhhhhhhhhhh

Please don't check your cervix yourself.

At 18 weeks.

Please. I can't handle keeping a straight face.

OK People

If you are going to wake me up at 3:56 am, it better be good.

NOT for pain that you've been having for a few weeks.

Things

OK, 2015 should not be half-done.

I hate spontaneous abortions.

Especially as the last patient of the day.

I hate being a patient.

Especially since I know I'm a horrible one.

I love seeing the newborns at the 6 week postpartum visit.

I hate not having my usual m.a.

I'm honored that some people trust me with their feelings as much as they do.

I'm so not good at psych stuff.

We needed more training in residency.

Pregnancy is NOT a reason to be on bedrest.

Oh, don't you EVEN go there about me not knowing about working whilst in pain.

Trust me, I've worked through worse.

My partners are fucking nuts.

Seriously nuts.

I'm just as bad.

England was wonderful.

And yes, they spoke English.

Kids are tired of seeing ruined castles.

Why was I stupid enough to volunteer for another hospital committee?

Even on my days off...

So today I'm running errands before we leave for our family trip to London. I take my daughter to the orthodontist to recheck her retainer.

The tech, making small talk, asks my daughter if she had any plans for the summer.
"We're going to England tomorrow."
"Really? So do you speak the language?"

REALLY?!?!?!?!?!?!?!?!?!?!?!?!

Bang my head

Caller #1: Goes on and on and on about a nothing symptom - it's normal 3 days postpartum to bleed. I tell her this multiple times over the course of the 10 minute call. I finally hang up, since it's obvious she's not listening to a word I'm saying.

Caller #2: Diarrhea at 2 am is not an emergency, but take some Immodium.

Caller #3: Term pregnancy, thinks her water broke. Me: Go to OB. She then starts in on 50 million other symptoms. Me: Go to OB. She then tells me about her discharge. Me: GO TO OB. Her - well what if my water isn't broke? Me: Just go to OB.

I fucking hate call.

randomness

I hate 3 am deliveries.

I hate 4 am deliveries.

I really hate 5 am deliveries.

I hate my shit magnet status.

I wish laboring patients would come in for my partners and not me.

Seriously, why do they all come in for me? (in fairness, I have one other partner who has similar luck)

6% section rate? REALLY? REALLY?!?!?!?!?!?

This weekend killed my 0% episiotomy rate, however. Oh, well. Everyone came out the intended route.

My vacation cannot come fast enough.

I'm sick of post-menopausal bleeds. Lately I've been the D&C queen.

I hate computers.

I LOATHE meaningful use.

Got my first 2016 EDC patient this week.

Being a high-maintainence drama queen will kill office morale quick.

Being the easy-going one means you get walked upon.

I hate vag hysts.

But I got a nice compliment from multiple OR nurses - they tell me I do a nice vag hyst & if they need one, they'll have me do it.

I daydream about GYN only sometimes.

I am not a miracle worker.

No, I did NOT know about crazypants' heroine use while pregnant. Hell, I didn't even KNOW she was knocked up again.

New phrase

Coined by me, today.

Booty cooty.

Can be anything from trich, or the clap, to the ever popular chlamydia. It works no matter what.

Thoughts

I'm in an employed group of OBs, fairly largish group. We are looking at expanding due to increased volume - lots of solo docs in this area have left for various reasons. The closest OB group (next town and hospital over) has imploded and those patients are coming to us now. My last few calls have been hellish. My office manager just says "RVUs! Think of your bonus!" Fuck my bonus, at that point, I just wanted sleep.

We're looking at a laborist model when we add our newest doc (and yay, she starts soon!). I have to admit, I would be all over that, no running back and forth between office and the labor deck (which is worth about 4K steps per call according to my new fitbit). No trying to juggle over where we need to be. Just spending shifts on OB, in-house. Or staying in the office & being able to fully be THERE. No need for rescheduling patients because of a delivery.

It would mean that I could effectively work full-time while keeping multiple days off per week. I like the part-time gig, it gives me time to keep my household functional. I can run the kids to lessons and fix dinner. I don't need to hire a cleaner because I can do things over the course of the week. It means I can chaperone field trips (which remind me why I am not a teacher).

Interesting things to ponder. I'm a year into this contract, will need to renegotiate if all of this comes to pass. Overall, this place was a good place for me to land. Reasonable administration, good group, nice hospital, great nurses. It's not perfect, but it's good enough. I'm not stupid; I'm planning on retiring from here unless my husband gets a better teaching job elsewhere. I hope not, I'm not up for moving yet again.

Like I told one of my partners, I'm too old for this shit. OB is hard on your sleep schedule. OB is physically draining. I got home the other day from a post-call office day and made it to the couch. I literally was feeling my legs throb and ache. I just wanted to do something mind numbingly dumb, so I harvested supplies on my Clash of Clans game.

Grumble

So we took in my mom's dog after she died. My brother-in-law hates that dog & refused to take it in, but they did take her cat. I like her cat. Wish we took her instead of this evil demon spawn of a dog.

I hate this fucking dog. With the burning passion of 10,000 suns. She is 4 years old and not housebroken yet, despite us having her the last 9 months. My dogs are housebroken, Nymeria was trained within a few days of us getting her as a puppy.

I am currently shampooing my living room due to a massive diarrhea attack (I will grant that diarrhea is not her fault). Next up will be mopping my kitchen floor. Her crate is outside, where my hubby will wash it after he gets home because I'm laundering the stupid bed. This is my only day off this week.

I am not a happy camper. Fucking dog.

Last night

11:something pm. Fortunately, I am still awake because the %^%^*&%*^$%#%^% Oscars last FREAKING FOREVER:

I hang up the phone and sigh "Oh, honey."
Hubby rolls over and looks at me. "That's your Bless Your Heart Voice."
At least I didn't facepalm - been known to do that before during extremely dumb phone call questions.

:)

So I'm in a bit of a style rut...OK a HUGE style rut. As in I still wear clothes from high school (hey, they still fit). My oldest shirt is from 1987 - it has the date on it (summer camp T-shirt).

So my staff has finally had enough. They have done a What Not to Wear intervention. Today, one of the secretaries took me to the big city. I have never shopped at Macy's before. Several hundred dollars later, I have a good start to a new wardrobe. My credit card is crying "You spent money at a department store!!! What gives?!?!?!?!?!"

My office manager has a salon day planned for next week, since I've had the same hairstyle for a long time. I pointed out the ground rules - I don't own a hairdryer or a curling iron, so it really does have to be wash and wear. Oh, and I am bad about keeping up on stuff, so dyeing my hair may not last.

I have great staff at the office. Truly a second family.

nope

I'm thinking that your chlamydia was NOT caught from the stripper pole you dance on at work.

Ewwww.

I really can't make this shit up.

Complications

If you don't get complications, you don't do enough surgery - every attending's motto when I was a resident. Back then, I was sure complications were an excuse to torture us at M&M.

Complications suck. I hate them. I hate being on the other side of them (the last surgery on me had a post-op complication). But there is no way to COMPLETELY eliminate complications.

You can reduce them - certain post-op infections without prophylactic antibiotics approach 25%. When I give pre-op antibiotics, less than 2%. But it is still a number larger than 0. Post-op DVTs can occur in up to 1/3rd of all women undergoing hysterectomies, according to the literature when I was a resident. With SCDs and anticoagulation, we can greatly reduce - BUT NOT ELIMINATE - this complication.

Distorted anatomy can easily cause iatrogenic injury. Endometriosis, previous surgeries, large fibroids, severe pelvic prolapse can all change anatomy. I have transected a ureter because of endometriosis. I have injured bladders because of scarring from previous c-sections. The key is recognition and awareness.

It's hard. We surgeons all like to think we are the best at this - it's how we got here. We all hate having a patient experience a complication.

As I told my ortho - who was feeling horrible for me - I was the best person for a complication because I understood.

OK, World

Can I PLEASE go just 1 week without some drama from my kids' schools? I'm really not liking these trips in. And then the ER visit either...

I really don't ask for much.

Prank

So I'm walking into the patient's room after being called in because she's ready to start pushing. Patient asks "Can I give birth in the tub?"

"That is not an option."

Turn to look at her mom, my good friend and coworker. "YOU put her up to that, didn't you?"

Whole room bursts into laughter.

I caused my friend to lose the bet - I didn't say "No fucking way."