Really kid?

Patient number 21 for the day today was a 14 year old with a cold....and an attitude.
So as I'm examining this snot filled snot, my stethoscope on his chest, he opens up and coughs phlegm all over my face. Not bothering at all to cover his cough or turn his head, just coughs all over me.
Now, I'm kind of used to this behavior from children under the age of, oh, say four but a 14 year old???? Come on.
His mother scolds him. "Patient 21*, don't cough all over her." *Name changed to save my my husband tracking him down and throttling him.
Patient 21 replies, "If she didn't want to be coughed on all the time she wouldn't have been a doctor."
Now back in the day I might have kicked this kid in the nuts (No, I don't regret that at all, creepy guy at Aerosmith concert if you are out there), or maybe I'd have made a comment about his pizza face acne resembling leprosy (OK, so I'm a little sorry about that one, kid from Chilean night club the night Pisco Sours were free for the ladies)
But I didn't I just moved around him and listened to his lungs, checked his ears and prescribed him something for his nasty sinusitis.
Why didn't I say anything? Because he's kind of right. I knew what I was signing up for when I went into pediatrics. It's why I don't mind wresting a kid to the floor to look in his ears, I don't flinch when someone else's two month old vomits on my sweater first thing in the morning. It's why I love to talk about poop and snot and even acne.
And lets face it, that kid ain't got nothin' my immune system hasn't seen ten times before.

Football According to...

Football According to my 2 year old daughter:

Daughter: "Mommy let's play football in the basement."
Me: "Sure sweetie let's play."
Daughter: "I'm the quarterback, I throw you the ball and then you run."
Me: "And then what?"
Daughter: "And then I tackle you. No touch-touch."
Me: "You mean no touchdown?"
Daughter "Yes."

Football According to my husband:

Husband: "Who are the Lions losing too this week."
Me: "Shut it and go knit something."

10 Things I Wish My Patients (and their parents) Knew.

Warning: the following is not meant to diagnose or treat any ailment, nor has it been approved for sale within the United States.





10. Corn is not a vegetable. Neither are V8 Splashes.



9. Baby Einstein will rot your child's brain just as fast as sponge bob, it just starts at an earlier age. Don't fool yourself.



8. Chicken nuggets can be "all natural" and "100% white meat" but they are still chicken nuggets.



7. Yes your child can get 8 colds in a year. No green snot does not equal sinus infection.



6. When you come 20 minutes late to your 15 minute appointment you are being seen out of the goodness of somebodies heart.



5. The problems you are having getting your medication filled are the fault of your insurance company. It's not as if they tell us what they cover (even when they say they do).



4. Adolescent depression does exist and it is very serious. Don't take it personally if your kid is depressed. It's not your fault (most of the time) and it's not theirs.



3. I'm serious when I say that your 15 month old doesn't need that 4am bottle of formula.



2. If you don't buy it and bring it into your home, your child will not eat it. If they don't have a TV in their room they won't watch it.

1. I'm not here to break the news to your 8 year old that there is no Santa. Don't bring him in for that.

ADDICT

My husband regularly accuses me of being an addict. Sometimes it has to do with not being able to get off the treadmill but more often (especially these days) it has to do with books.

I
Love
Books

I love the smell of them, the feel of them, the way a spine cracks when you open it for the first time. I blame my parents. They always had a ton of books. The walls in the office, the loft and several bedrooms in their house were lined with shelves. Those shelves were lined with books. they've gotten rid of quite a few of the books and shelves but they still have a lot.

I see myself heading in the same direction. Yes I know there are libraries. TC has a very nice one with about any book you would want to read but it's not the same. For the same reason I don't see myself giving into the ebook revolution though I do support the idea of ebooks with great enthusiasm. It's also not the same.

As a consequence the UPS guy regularly drops an amazon box at our doorstep. Joel shakes his head and I add another book to my "too read" pile. The nice shelves Joel built in the basement for me are full and I'm starting to eye other potential shelf locations.

If that wasn't bad enough I've pulled my innocent daughter into the fray. I can't take her downtown without a trip into Horizons Books or a swing past the book department at Meijers.
At a garage sale recently I bought 12 books for her for a mere buck! It's not as if she insists on getting a book, but it really gets her excited and she LOVES, LOVES, LOVES, to read. Yesterday we read for about 3 hours total, not including her usual 4 bedtime books.


So here's what I'm reading now:





And here is Dela's current favorite:

Place In Life

Or Why Is The Med-Student Pimping Me???


OK, so I get that you're a third year student. I get that you are doing your reading and that you've acquired a lot of very useful (and a fair amount of not so useful) medical knowledge. But you don't have to prove it to me by asking me questions and then telling me "Good job" or "That's right" when I get them right. Its MY JOB to get them right....Incredibly annoying.

I don't usually pimp students. I do ask questions, reinforcing what we've seen or have them come up with differential diagnoses. I like to have them work through mini-cases which I think is way more helpful than asking pointless questions like "What kind of media does campylobacter grow on and at what temperature?" But this afternoon I think I'm gonna have to change the game....Watch out kid, here comes the pimp.

Balance

Not to long ago I had a mom asked me how I balance my home life and my work life. At first I was taken aback. After all, how did this woman know I had any kind of balance? And then I thought, how does anybody know if they have reached the right balance? Isn't life as a working mom more a a pendulum that swings constantly and erratically from one side of life to another?
It seems that one week I think that my family life is wonderful. I'm able to spend time with my daughter and husband, sit and relax at the beach with a little G&T watching every little change in my daughter happen right before my eyes. Those are the weeks where I forget about work. I don't read my journals, I get lax about my usual "Get there 15 minutes early" rule. I'm just not focused.
And then there are weeks where I'm on at work. I have my paperwork in perfect order. I've called every patient that has been haunting me back to check on them. My "to read" stack is gone but I come home and feel that I've missed something...
The funny part is that these feelings aren't related to the amount of time I spend doing each one. The time (with the exception of time on call) is the same. I feel my balance swings where my focus takes me. My pendulum is tied to my mind and not the time clock. I guess that it's good that I can shift back and forth, I just wish I didn't have to miss anything in between.

What Happened?

I just want to know...

What happened about 9 months ago that made people want to make so many babies that my census sheet is overflowing and my fingers are sore from using the gomco clamp? Don't get me wrong... I like the babies. Rounding on happy, healthy families is a great way to start the day but my goodness...

Here are my theories:

-H1N1 ("We're all gonna die. Let's make a baby.")

-The Recession ("No work to go to. Let's make a baby")

-The first snows of winter ("I don't have my snow tires on yet... Let's make a baby.")


What do you think?
-