Archives for June 2002

Gone Fishin’

Gone Fishin’
Would love to tell you about the joys of watching a 10 year old watch her first professional baseball game (Rangers over the Angels, 11-5). Or about the offer we have in play on a tired house in need of a total redo in a neat part of town.
But, I cannot, as we’re off on our first family vacation, ever.

Death to Checks (and their writers)

I have been having these thoughts, but perhaps not so cogently nor profanely.
Required reading from FFM.

Bad Days and Good Days

I have just had two great days at work and they couldn’t have been more different. Yesterday I saw a terrific number of patients, many of who weren’t that ill but needed to see a doctor; today I saw many fewer but they were, on the whole, much sicker. I did my part to make people better, and felt good about my profession and life in general.
Should I ever need to remind myself what a bad day really is, all I need to do is read Newsweek’s article on Israeli trauma centers.


The good news: our house has sold! Yee hah! Did we get our asking price? No. Did we walk away clean? No. Do we get to write a (relatively) small check and be done with it? Yes. So, we enjoyed the house, took a financial bath and learned an important lesson. Ask nicely and I’ll tell you what that lesson was.
On the other hand, we spent 7 hours today in the company of a fine real estate couple looking at potential new homes. The main problem, as I see it, is that my wife and I want entirely different things in a house. No doubt our realtors believe us to be schizophrenic, or at least terribly bipolar, with us taking turns being down and up on the same property. We saw a few nice and many really average homes today, nothing that jumps out and says ‘this is our house’. Yet.

Correct Suicide Bomber Terminology

I have been following the evolution of the terminology describing those who kill themselves in order to kill others. I am not commenting on their inherent evil, and would like to be at the Pearly Gates when they arrive. It would probably be quite a spectacle.
Anyway, it started as “Suicide Bomber”. This was, appropriately, felt to be murderer-centric, and so then we had: Homicide Bomber. This is very technically correct and is certainly precise but lacks an inherent recognition-with-condemnation that the act implies.
Splodeydope was advanced for a while, and although it points up the ridiculousness and futility of the act, it was eventually abandoned as a viable alternative. Today I saw a new one…
On Tal G’s Spot, today I saw it and knew I had found my descriptive term of choice: Islamikaze.

In- and hyper- activity

My friend Rick hasn’t posted 6 times this month, then 6 posts in one day! The thing I like about Rick’s posting is that it’s usually about topics I haven’t seen, or is really useful (I am trying out the anti-spam software he recommended).

Give him a look.

Consults and Pain

I had today the worst Consult Day I’ve had at the new job. I consulted several physicians in various fields, and a few distinguished themselves by coming in and taking care of people who were ill and needed inpatient care. They will be rewarded in the afterlife if I have any input. Thank you for putting your patients ahead of yourselves.
The ones I dwell on, and the ones I’m making a list for in Hell should I be designated Tour Director there, were painful to deal with in the following ways:
a) the Prima Donna, never happy with anything, yelling and causing strife for the sake of their own vanity: “I’m Important”, they shout, through imperious demands and browbeatings. (I exacerbated this problem by not playing the game, forcing a fellow, more experienced Emergency Physician to take the heat for unnecessary lab results not being on the chart). This was all the more ridiculous, as the imperious Important Consultant hadn’t even bothered to interview or examine the patient. A patient who needed an operation, not a lab result (normal, by the way, as expected).
b) the I Cannot Believe I Have to Take Call for This: nice fellow who works for a living with a problem appropriately and by standard of care ALWAYS treated by this speciality. The pain of listening to this millionaire physician ‘colleague’ run on at the mouth about how hard their 1 day in X call is, and how unfair it is that they have to take care of this, and “…why can’t (another, severely undercompensated and overworked speciality) admit this”, etc. I listened to five continuous minutes of this whining prior to finally getting them to do the right thing (on the second call). All the while aghast at the irony of listening to someone making about five times my income bitch about taking care of a patient who needed care, who I see because it’s my job.
c) the ‘oh, we fired him from our practice, doesn’t matter what he has now’ consultant. Initially defiant about admitting a ventilated patient with a problem clearly part of their speciality, using the ‘non-compliant patient’ dodge to push this patient onto another physician (who was distinguished by not batting an eye to take care of an ill person who needed a Doctor, not an excuse).

OK, here’s the deal. Doctors are Big Winners in the Life Lottery, and Noblesse Oblige should be our life’s motto. Whining is for losers and sissies, and does the profession and patients a disservice. They deserve better.

Today, so did I.

Update: it occurs to me, on review, that this looks like whining, making me a loser by my own definition. As I’m not a loser, I will clarify my definition: Whining about taking care of patients is the problem. My whining is different, see?

Recommended reading

Sorry for the paucity of posting, but I’m busy reading (yes, a book). I am enjoying the wit and wisdom of P. J. O’Rourke’s CEO of the Sofa, a humorous look at, well, life. I have read all the other PJ books I could get, and he’s one of the few authors who make me laugh hysterically, out loud, to the irritation of my sleeping spouse.
I was once an avid reader, but stopped reading for pleasure during med school. I figure I equated reading with work (there is a bit of required reading during med school), and the internet became an interesting diversion just after my internship ended, so little reading. Oh, there are significant exceptions (Tom Clancy comes to mind, but not the OpCenter series, which has to be ghost written), but for the most part I have been a reluctant entertainment reader.

Anyway, that’s why.

Family Reunion

our kids
A week or two ago I got to see my nephew, Andy, for the first time. Andy has loving, super-smart parents; someday he will no doubt control the world. Here’s a pic of my daughter and my nephew together (the only pic from then I’m posting for now).

Diplomate, American Board of Emergency Medicine

Diplomate, American Board of Emergency Medicine
I have passed both the oral and written examinations for Board Certification in Emergency Medicine! This is the end of a long road: Med school, residency and then the written and oral examinations. I still will need to recertify (there’s some cockamamie scheme for ‘continuous recertification’ on the horizon), but now I can say my formal training is finally done!
And, ultimately, I couldn’t have gotten here without a lot of support. I owe my family, and especially my wife, a tremendous debt of gratitude. Also, to all those instructors who felt their instruction was the educational equivalent of watering a rock, Thank You. I’d name you all but fear the slander suit that would follow, so just sleep well that at least some of what you taught me sank in.

Yee Hah! GruntDoc, FACEP

Update: NOT FACEP: from the American College of Emergency Physicians’ site, Requirements for Fellowship:

At least three years of active involvement in emergency medicine as the physician’s chief professional activity, exclusive of training, and;
Satisfaction of at least three of the following individual criteria during their professional career:
active involvement, beyond holding membership, in voluntary health organizations, organized medical societies, or voluntary community health planning activities or service as an elected or appointed public official;
active involvement in hospital affairs, such as medical staff committees, as attested by the emergency department director or chief of staff;
active involvement in the formal teaching of emergency medicine to physicians, nurses, medical students, prehospital care personnel, or the public;
active involvement in emergency medicine administration or departmental affairs;
active involvement in an emergency medical services system;
research in emergency medicine;
active involvement in ACEP chapter activities as attested by the chapter president or chapter executive director;
member of a national ACEP committee, the ACEP Council, or national Board of Directors;
examiner for, director of, or involvement in test development and/or administration for the American Board of Emergency Medicine;
reviewer for or editor or listed author of a published scientific article or reference material in the field of emergency medicine in a recognized journal or book.

So, in three years I can be a fellow, but I’m still Board Certified.

Microsoft upgrade troubles (again)

Today, I upgraded the laptop to Windows XP Pro (why the pro version, you ask? Because it was going on over Windows 2000 Pro, an it was the only choice). The installation went fairly well, although it didn’t recognize the synaptics touchpad on the laptop here; the big problem is that it didn’t keep my profile, but instead sent all my data into hiding.
Now, I’m not one for tech support; I figure if I got into trouble I can get out myself, but I had just spent $200 on this at CompUSA, so I called tech support. The fellows at Microsoft (Ford and Bruce) were knowledgeable and helpful, and I have recovered my Outlook info, which really was all I was worried about. Losing my preferences isn’t any big deal, and my last IE favorites backup (about 1 month old) was found and imported. So, no cookies (no big deal), but I’ve lost my wife’s e-mail address book, which I cannot recover until I get back home.

The touchpad is fixed and working fine, thanks.

Mother B

Mother B (the owner of the house I’m in) is here, after a protracted move-out. She did the vast majority of the packing herself, and drove out from California towing a trailer (the 17 foot truck was stuffed, as was the 12 foot trailer). The unloading took about 3 hours total, and the truck is on its way back to U-Haul. Her cats apparently are no worse for the adventure and are ensconced in the master bathroom.

From an unloader’s point of view, she mostly has boxes of books and furniture, with a few lamps and a lot of pillows thrown in for good measure. It was fun to work up a pretty good sweat in the Fort Worth summer; humidity is something I’ve only transiently experienced and it’s as bad as I thought it would be.

New Broadband

I’m now on a cable modem, via my new wireless network from Linksys. I had a wireless network in my last place, and really enjoyed it, and have gotten a new one here. It’s for my mother in law, who arrives any minute. Really.
It took me a day to make it work (bad driver on the USB antenna I brought from home), but now it’s screaming.

So, more posts to come.

4 days into the new job

and everything is going well, thanks. It’s what I wanted, a busier ED with better doc coverage. Today was probably the easiest day I’ve had, with several slack periods, and within 8 hours I had seen treated and dispo’d 27 patients. Several of these were really sick folks, going to the OR, to the ICU, etc. In may last job, 27 in 12 hours would have left me physically exhausted and emotionally ragged, but this one is different. So far, so good.

Too bad I had to get this as my second job after residency; however, would I have appreciated it then?

My friend Rick

My friend Rick has begun to post to his Weblog again, and I share his feelings on droperidol, the drug that helped a zillion of my patients while in residency.

It’s nice to have him blogging again.