The first day back at work is always a bitch, and today was no exception. It could have been an easy day, but I had to take one of my patients back for post-op bleeding, so everything ended well past 5 when it should have ended around 2:30. No trip to the gym for me, only a hurried visit to the supermarket to scrounge some heat-uppable food for my family. Oh, and toilet paper. Gotta have toilet paper.
And there you have it, my excuse to rerun an old favorite of mine: fatigue! I’m always griping about fatigue, I know, I know. Maybe if I weren’t so damned tired, I wouldn’t gripe about it so much.
Anyway, this memory got jostled today. The old gf and I write one another, as some of you know, and she was creeping out over the fact a friend of hers was following the advice of a psychic. That reminded me of how negative she was about my tarot-reading shtick back in the old days. I think she even made me swear never to touch them again, but we broke up soon after, so you can guess how well I honored that promise.
In my email today, I finally (after 25 years) told her the story below. Of course, I told y’all the story nearly two years ago, which means she could have read it two years ago if she would read my blog, which she doesn’t. Go figure.
But before story time, I want ALL of my Iowa readers to make it to the caucus tomorrow.
And now: Wheel of Fortune, originally posted here, in case you want to read the comment thread. It was a good one.
After a crappy night’s sleep, I saw 32 patients today (if not a record, it’s close), and when I got home, I had two hours worth of catch-up charting to do. My brain is a blancmange, and when that happens, you get reruns. Kwitcher bitchin — I don’t do this all that often.
Kate and Anduin might remember this one, but I suspect it will be new material for many of you.
Historical note: this post first aired July 31, 2005. Somehow, the Smart Bitches caught wind of it, shouted it on their blog, and suddenly I had me scads of romance readers/writers. Speaking of the Bitches, did you catch their April Fool’s Day front page? Bloody brilliant. It rices my kishkes from jealousy, it’s so brilliant.
Without further ado:
Everything I know about sex I learned from my tarantula
Yeah. Keep readin’.
My sis suggested I do a Thanksgiving-themed Thirteen: Thirteen Ways to Mitigate the Suckitude of Thanksgiving. (My spin. I love the combination of ‘mitigate’ and ‘suckitude’ in one sentence.) I like the idea, but I’m going to up the ante.
Thirteen Paths to a Memorable Thanksgiving: a feast which will have your family and guests talking for decades to come.
Yes, it’s not quite Thursday, but some of these suggestions require a modicum of preparation. Get shopping, people.
In the spirit of Graham Greene’s Dr. Fischer of Geneva, follow me below the fold . . .
Seems like Corn Dog and I are trading wacky childhood stories. Here’s another . . . kinda, sorta.
As a child, my first love was a woman who imagined herself perpetually on the verge of death. I am not a well woman! she would holler, and what did I know? I believed it.
The irony is, she wasn’t a well woman. Axis II diagnoses aside, my mother was a breast cancer survivor in the pre-chemo, pre-radiation, pre-tamoxifen era. She beat the odds.
Somehow, I was responsible — for the loss of her breast, her health, her youth. You took the best years of my life. Did she say that to me or to my father? Doesn’t matter; four- or five-year-old Doug took the blame.
I woke up early one Saturday morning (kids: in those days, we only had cartoons on Saturdays. I had no intention of missing a single one) to find a hole in our den’s screen door. My older brother woke up soon afterward and convinced me I had done it. It didn’t take much convincing; I felt certain I was responsible for everything. And so I made up a lie to deflect my mother’s inevitable anger.
“It was a bird!” I told her when she woke up and came into the den. “It, it flew in, and then it flew out, and it made that hole –”
“That bird was your father’s fist,” my mother said.
You mean it’s not my fault?
(Smart guy, my dad. A dumber man would have punched the wall and broken a few fingers.)
Yeah, it was all my fault. And I was always trying to make it better.
One of the problems with being shameless is that I have no chance whatsoever of (successfully) running for political office. My opponent would skewer me with my own words — as, for example, when I said yesterday, “I am no longer a sexual predator.” (So, Dr. Hoffman, when did you stop being a sexual predator?)
But I feel bad for my future opponent’s research team. I mean, on this blog I’ve written so much, it will take them days to dig up the necessary dirt. In kindness to them, I have assembled the following thirteen incriminating and/or embarrassing items (that ‘sexual predator’ one? That’s a freebie).
Hmm. Just thought of something.
Jake, you reading this? Stop.
Now we can get started.
Your son asks, “Why are you wearing your leopard armor?”
We got some dude off the street to model those undies. Really. Some guy who just happened to be hairy like me. I mean, you don’t really think I’d put my butt up on this blog, do you?
For all of you folks living on the edge of despair, take heart. Things can turn around overnight. I can’t go into details — would you believe it? I have limits! Who knew! — honestly, I’m happy to tell you anything about myself, but when it affects my family or my friends, I have to keep shtum. But let’s just say that starting with this, I have become a happy man.
Of course, since I’m Jewish, I know it can’t last. I’m already cherishing the memory.
I have an overwhelming desire to regurgitate an old post — my favorite — because when I’m happy, what do I want to do most?
Share my ‘nads with the world.
From nearly a year ago, I present,
Say Hello to My Little Friend
Over at Writer’s BBS, there’s a custom for noobs: you gotta get nekkid. For those square BBSers, getting nekkid means telling something revealing about yourself.
Here in the blogosphere, getting nekkid means GETTING NEKKID. Hell, as for that other getting nekkid, I do it nearly every day I blog. But for the record, I recently gave you this:
Getting nekkid nekkid, that takes a special breed of cat. Or, should I say, Vixen. Yes, this evening, Dean’s very own SxVixen joined the esteemed ranks of nude bloggers. And not to be one-upped, Dean has done it, too. Nice legs, Dean, but next time smile for the camera. It’s not a high school football team portrait, for heaven’s sake.
Erin O’Brien got the ball rolling, today posting an historical review of nekkid-model- with-chair photography (and she’s right. Christine Keeler really is one hot babe). So the question stands: who is next?
Here’s my short list of folks I think might be just crazy enough to take the nekkid challenge:
Gabriele! Instead of a chair, you can use some strategically positioned chain mail.
Kate! Impress the hell out of your sons. Or squick them out, one of the two.
Kris! You’ve already given us clickable cleavage. Now we want a bit o’ thigh, too.
Candy! You’ll be the talk of the Smart Bitchery.
Monica! I would never forgive my own cowardice if I didn’t include you on this list. I figure you’ll either (A) oblige the request, or (B) come up here and kick my sorry ass. Either way, you’ll be satisfying a fantasy.
No guys on the list . . . imagine that. But of course, you have Dean and me. That should be enough manhood for the whole blogosphere.
P.S.: If I didn’t put you on the list, please do not be offended. The more people I include, the greater the chance someone really will come out here and kick my ass . . . probably some smelly biker named Bubba.
Which is not one of my fantasies.
Bear in mind I’m writing this WEDNESDAY night and I’m tired, and maybe you’ll forgive me for this no-brainer thirteen.
1. The cure for tapeworm. No, I don’t have a lisp, and I don’t know why Stickam saw fit to supply me with one.
3. Here’s an old one you’ve probably heard.
Butch goes to heaven and discovers, much to his chagrin, a horrific line leading up to the Pearly Gates. He waits. And he waits. He wonders, Is this a test? Will I get thrown in Hell if I show any impatience? And he waits longer still.
Suddenly, a man runs forward, jumping the whole line. He’s wearing a white lab coat and holding a little black bag.
Butch asks a passing angel, “Who was that?”
“Oh,” says the angel, “that was God. He likes to play doctor sometimes.”
(Hey, I’m saving the good ones for video.)
4. Rick, a pre-med, had to pass Organic Chemistry to qualify for med school. But when the professor launched into another hour of endless blather on the reactions of carboxylic acids, Rick snapped.
“Professor,” said Rick, “why do I need to know all this crap?”
“To save lives,” said the professor.
“Save lives? That’s the most ridiculous thing I’ve ever heard. I don’t see the relevance of an Organic Chemistry class to saving lives!”
“It’s highly relevant,” said the professor, “if it keeps morons like you out of medical school.”
5. Chuck’s phone rings. It’s his doctor.
“Chuck, I have some bad news for you and some worse news.”
“Gimme the bad news, doc.”
“You have 24 hours to live.”
“Twenty-four . . . Doc, that’s terrible! What could be worse than that?”
“I’ve been trying to reach you since yesterday.”
7. ‘Kay, I have to give you at least one inside joke. If you’re outside the biz, this will probably be meaningless to you. Sorry. Also . . . if you’re super-PC, you’ll probably find this one vaguely offensive.
Q: How do you say “fuck you” in Tagalog?
A: “Yes, Doctor! Yes, Doctor!”
8. A man goes to the doctor complaining of headache. He has smashed bananas in his ear canals, peas up his nose, and a cluster of grapes up his ass.
“Doc,” he says, “why am I having these headaches?”
Doc says, “You’re not eating right.”
9. Another inside joke. You have to know surgeons to get this one.
Two vascular surgeons are discussing their morning’s cases.
“What did you do this morning?” asks Dr. Schmidt.
“An abdominal aortic aneurysm repair,” says Dr. Barron. “And, oh, it was awful. Got into some bleeding, couldn’t stop it. The guy bled to death on the table.”
Dr. Schmidt roars, “WHO THE HELL WAS YOUR ANESTHESIOLOGIST?”
See, cuz we blame everyone else for our shortcomings. Get it? Get it?
10. A guy limps into the urgent care center and is greeted by the triage nurse.
“Hello!” she says. “How may I help you?”
“Well, it’s kind of embarrassing. I’d rather discuss it with the doctor.”
“Oh, don’t worry. I’ve heard just about everything,” says the nurse. “Besides, the doctor expects me to take a complete history before he sees you.”
“If you put it that way . . . well, look, it’s like this. I have an erection ALL the time.”
True to her word, she notes down what he has said without blushing. Then she taps her pen against the intake form and says, “Hmm. Well, the doctor is awfully busy this afternoon, but I think I could squeeze you in.”
11. In the ER, the patient clutches his groin, moaning with pain. He gasps, “I have . . . blue balls.”
The ER doc calls out, “GET THE HEAD NURSE — STAT!”
12. Hold it for me.
13. My longtime readers will remember my favorite ENT joke (audio clip — yup, that’s me telling the joke).
Leave your comment below, and I will (shall? who knows!) link you below.
Apropos of yesterday’s discussion, and in the absence of any other bright ideas, I thought I would remember a few patients today. We’ll begin with me and go from there.
1. Me. I loved my pediatrician, Dr. Johnson. I especially loved taking off all my clothes whether he asked me to or not. When I became 9 or 10, my parents decided I was too old for a pediatrician and switched me to their GP, a guy I never liked. There’s something wrong with a dude who thinks it’s necessary to give a kid a rectal exam every time he sees him. But did my mom ever question him on this? Nope. And did he bother to wipe away the lube afterwards? Nope. The bastard.
2. My first history and physical was on a VA patient, a Korean war vet in his 50s who looked like your typical Silicon Valley businessman. We were instructed to ask everything. EVERYthing. And it was embarrassing as hell for this young med student to take a sexual history, and somehow worse still to ask whether he did any illicit drugs.
Imagine my surprise when he told me he did a few lines of coke every weekend with his pals.
3. Not long after, I had another patient, a young man with Wernicke-Korsakoff syndrome due to alcoholism. He was in his 30s but he looked 50, and the only word he could say was “Beer.” Ask him how he got here, and he would smile, shrug, and say, “Beer beer beer.” Kinda funny, but really very sad.
4. Another Wernicke-Korsakoff patient: funny thing, both this guy and patient #3 weren’t depressed about their conditions. I wonder if that’s part of the psychosis — if so, it’s a bit of a blessing. (Alzheimer’s patients, for example, are often extremely depressed in the early and mid stages of the condition — understandably.) Anyway, this was back during the first George Bush’s presidency. When we did a mental status eval, we would ask questions such as, “What year is it?” “What city are we in right now?” and “Who is the current president?”
On that last question, my patient responded, “President Bushwhack.”
Obviously of sound mental status, politically speaking. Made me wonder if he was faking the rest of it 😉
5. She wasn’t even my patient. But she was eleven, had a family who loved her, prayed for her at her bedside every day, left prayers for her written in Hebrew, and she died of meningococcal meningitis. Life really isn’t fair.
6. I took care of her lacerated scalp following a traffic accident and she became my private project from then on. She wanted a new nose, I gave her a new nose. She wanted Julia Roberts’ lips, I gave her Julia Roberts’ lips. In exchange, she dressed like a vamp and shared Madonna’s photography book with me, the one with the airbrushed anus.
Nothing ever happened between us, but I suspect we both thought about it.
7. Skip back to med school for a moment. She was a young mom with a loving husband and she had a nasty breast cancer. (Yes, they’re all bad, but some are worse than others.) She wanted my opinion: should she do chemo, or not? My usual protestation (I’m only a med student, I don’t have the knowledge base to answer that question) didn’t wash with her. She wanted to know, if I were her, would I do it?
She couldn’t ask her family or friends. They only wanted her to live, and they would have had her do anything to get those extra few percentage points’ chance of cure. She needed to ask an impartial individual.
I told her I’d do the chemo. I wanted her to live, too.
8. I would be remiss if I didn’t link back to my dos piernas story. Considering the fact I based my romance on a real event (a med student who couldn’t manage to place a urinary catheter), that dos piernas story could probably inspire a trilogy.
9. During internship, every call night the nurses asked me to push Dilantin on Mr. M. He had been unresponsive since the mid-70s; for the past 17 years, all he ever did was grunt in response to pain. Every so often, he would get pneumonia or a bed sore and find his way back to County.
His head looked like a basketball that had seen too many decades on an inner city ball court. Scarred, patched, a war zone unto itself. He was a bull of a man, too. His family kept him well-fed through that feeding tube.
During the last month of my internship, he woke up, just snapped out of it wanting to know where he was, what had happened. I can’t begin to imagine his or his family’s emotions, but for us docs who had taken care of him, it was eery. He seemed like a time traveler . . . and, you know? We didn’t know whether to be happy or sad for him.
10. Flash forward five years. When I was one month out of training, this patient came to see me in the private practice office asking for a third opinion. Two ENTs had told her she needed sinus surgery: the self-perceived ‘top sinus surgeon of LA County’, and one of the top academic sinus surgeons in the area. All I knew was that she’d had an abnormal finding on her sinus CT, discovered when she’d had a head CT for her headaches.
So she had seen some of the best talent in the area and they both agreed she needed surgery. What could I possibly add to this discussion?
I took one look at her CT scan and started laughing. She didn’t need surgery — she just needed an honest ENT. Her only abnormality was a maxillary sinus mucus retention cyst. These are incredibly common and rarely symptomatic.
Moral: don’t hesitate to get those second (and third) opinions, people.
11. You occasionally save lives in medicine — it’s inevitable — but you don’t expect to forget the patients you save. She approached me in a local restaurant, said, “Are you . . . are you Dr. Hoffman?” I’m thinking, What did I do wrong now? Nothing, it turns out. I had ordered an MRI scan on her five years ago and discovered her benign (but life-threatening) tumor. I’d changed her life. And now, I didn’t even recognize her.
12. Sometimes you know in your bones that it’s bad. The sound of a patient’s voice, or a constellation of symptoms that can only mean one thing. Worst of all is when the patient is a child and you hope you’re wrong but you know you’re not.
One came in soon enough that a prompt diagnosis made a difference.
13. He had a terrible diagnosis, the worst. The one that kills you within a month no matter what you do — surgery, chemo, radiation, this tumor laughs at everything and grows. And grows.
I brought him and his family into the office and told them everything. I asked my patient if he had any unsettled family business, like estranged family members he should square with. He didn’t, but he did have a son in Europe in the military. I wrote a letter. We faxed it to the son’s C.O. If I remember correctly, his son was back home within the week.
He died soon thereafter, as expected. There was nothing I or any other doctor could do about it. And yet I feel more pride in that case than in anything else I’ve ever done in medicine.
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