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New critters

Friends of ours from the old days, the pre-Jake years, know us as critter-keepers, lovers of snakes and lizards and frogs and anything else with cold blood. Our collection has waned in recent years because moving is bad for pets and we’ve been moving a lot.

But now we’re settled.

And today, I saw something I couldn’t resist.

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I’d intended to write last night

I really did. If nothing else, I had to rave about Charlie Huston’s conclusion to the Hank Thompson trilogy, A Dangerous Man, which was every bit as good as the first two books in the series. If you’re shying away from these books because you’re not a fan of the hardboiled shoot-em-up genre, you don’t know what you’re missing, because this story is so much more than that.

But I am on call, and after a quiet first part of the week, I finally saw some action. Got called in for a pediatric foreign body, which was billed as dog food-in-the-nose and turned out to be peanut-in-the-nose. Big difference there, since a piece of dog food would tend to break apart with manipulation, might dissolve somewhat over time, and is, well, smaller than the average peanut. Peanuts, on the other hand, won’t dissolve, will tend to swell as they hydrate, and are HUGE compared to the size of the toddler nose.

I felt a little reluctant going in since I knew I wouldn’t have the right tool. The right tool is a right-angle hook, a delicate but strong instrument perfect for getting behind something and pulling it out. All they had at urgent care was an alligator forceps (so named for the way the jaws of the forceps are shaped, and the way they open), which was all wrong for the job.

I kludged together three right-angle hooks at home, one from a fragment of clothes hanger, two more from lengths of copper wire, but all were far too big and nasty for the job. In desperation, I went through our Big Black Box of Goodies, which is primarily stocked for stopping nose bleeds, draining pus, and suturing lacerations. And lo and behold, like a gift from heaven, I found (separately wrapped, nothing else like it in the box) the perfect right-angle hook.

After that, it was a simple matter of overcoming the feeling that I was the reincarnation of a gestapo torturer long enough to dig this thing out of the child’s nose. Half the peanut came out with my instrument. When the kid sneezed, the other half beaned one of the nurses assisting me. Hazard of the profession, I guess.

Mom was happy, the nurses were happy, and the child was relieved if not happy. Mom made her thank me, though. I’m not sure how I feel about that. It’s kind of like making your kid thank you for administering corporal punishment.

Anyway, that’s how my weekend started. And you?

D.

Makes Lola’s look like the 7-11

Here in Bako, I’ve found an Indian market, two Chinese markets, a Middle Eastern market, a Vietnamese market. I was beginning to despair of ever finding a market like Lola’s in Santa Rosa, where I could always find a quick and tasty meal for dinner, whether it be perfect tamales or a savory hunk of carnitas. The other day, I mentioned this to my medical assistant. Today, she brought me an ad for Pro’s Ranch Market.

Pro's Ranch Market, the Caesar's Palace of Mexican Groceries

Pro's Ranch Market, the Caesar's Palace of Mexican Groceries

Wandering Pro’s Ranch Market, I felt the same way I do whenever I visit Powell’s Books in Portland: I could spend all night here. I was already running late, though, so I hadn’t the time to look over the outdoor cocina, barely skimmed the offerings of the indoor cocina, and generally did a poor job exploring this wonderful place. I did notice at least four types of homemade mole (and chose the Oaxacan mole, which I hope is mild!), three different styles of chorizo, and a huge tray of pig snouts. In the pastry section, I rejoiced at finding a sweet potato pie. Yes, we’ve already tried it. Yes, it’s delish.

Un-adventurously I bought chile relleno and tamales, the sweet potato pie, wedding cookies and bunuelos (flour tortillas deep-fried and dusted with sugar and cinnamon). I goggled at the various organ meats and fresh yogurt and enormous slabs of flan and bushels of dried chiles . . .

I’ll let you know how the chicken in Oaxacan mole comes out.

D.

Perq of the profession

It used to happen all the time up in North Coast Country: I’d be in the gym, in the store, on the beach, you name it, and a patient would recognize me and say hi. The supermarket was particularly rich with my folks. Got so that sometimes, I’d have to steer the shopping cart down alternate aisles to avoid people I didn’t want to greet. (One guy who had once made a death threat cornered me, apologized profusely, then begged me to take him back as a patient. This was in the dairy section.)

I never expected it to happen in Bako, which is a much larger town. But tonight in the locker room of my gym, a man recognized me. He said, all smiles, “I KNOW YOU!” Since I’m not presently posting nude photos in the personals section on Craig’s List, I figured he must be a patient of mine. I said, “Sure, I’m your doctor!” And I was right.

Kind of a good feeling, really.

D.

The next big thing

Dragon Age Origins:

I love it when the creeps look creepy.

I love it when the creeps look creepy.

This guy must be the town dentist.

With dragons like these, who needs blow dryers?

With dragons like these, who needs blow dryers?

Kill this bad boy and you’ll feel like you’ve really accomplished something. Something more than, say, killed another 120 hours playing video games.

D.

Apropos of nothing

D.

Where the weekend goes

Hmm. Let’s see if I can reconstruct this.

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Kindness: an ambiguous case study

After rounding on my patient this morning, I had breakfast at a downtown coffee shop. I took a seat at a counter next to a gaunt black gent with a nice wooden cane and a dapper fedora. First thing I noticed, the waitress took my order before his, even though he’d clearly been there before me. When she took his order, I heard him say, “Would I have enough left over for the blueberry muffin?” She told him no, he nodded, and that was that.

It set me to thinking whether I could pay for his breakfast without him knowing. The “without him knowing” part — this wasn’t so much “random act” B.S. but a desire not to embarrass the guy. The cash register was about five feet from me, seven or eight from him. Would he hear me if I explained to the waitress that I wanted to pay my neighbor’s bill, too? I was confident I would finish my breakfast quickly; I always do. Old and bad habit from internship and residency: I bolt down my food.

Before I had much time to consider, the waitress brought over a wrinkled, greasy paper bag and plopped it in front of the man.

“I didn’t want this to go!”

“Take it and leave. You were panhandling our customers so you can’t eat here.”

“This is rude.”

“It’s rude for you to panhandle out front. Our boss says you panhandle here, you can’t eat here. Take it and go.”

He asked to speak to the manager, but the manager wasn’t there. The senior waitress came over.

From the conversation that followed, I learned that one of the customers entering the restaurant had given the waitress at the register some money to cover the guy’s breakfast. So even though his breakfast was bought and paid for, they weren’t allowing him to eat there.

When the waitress told him it was rude of him to panhandle, he said, “It’s never rude to ask for help.” Then he launched into an odd bit about how “all of you are happy to take Obama’s bailouts, but I’m different somehow.” Which I thought was interesting.

After he left, two of the waitresses involved apologized to me. Didn’t help; I still felt like they had handled the situation poorly. What, did they feel like they’d be encouraging him if they let him eat at the counter like a normal human being?

Another woman came in, placed a to go order. They packaged her breakfast in a crisp, non-greasy paper bag. Hmm.

And what about the guy who paid for his breakfast? I understand the logic: “I’m going to pay for his breakfast. I don’t want to give him cash for drugs or alcohol.” On the one hand, the charitable party didn’t have to give the guy money. On the other hand, doesn’t it taint the act if you make the assumption that you have to pay for the guy’s meal, or else he’ll use the money for drugs or booze? Shouldn’t we be treating people with more dignity than that?

I’m not sure what to make of the whole thing. Restaurants do have the right to refuse service, or at least they claim that right. Clearly, the fellow who ponied up the breakfast money put them in a bind. If they refused the money (really the only way to refuse service), they might offend the donor. On the other hand, they wanted him out of there as fast as possible. So they took the money and proceeded to do as little as possible for the older man.

It left me with a bad feeling for the place. I won’t return. This man was well dressed, he didn’t smell, he wasn’t dirty. I would have eaten my breakfast next to him and never suspected he was down on his luck. He wasn’t bothering anyone and it wouldn’t have caused anyone any grief if they had treated him with respect. For that matter, it doesn’t make me think less of an establishment if there are panhandlers outside.

Seems to me there was more than a little vindictiveness in their behavior.

D.

Come it ran dumb axe of cents less kine, Ness

I’ve learned that Bakersfield is famous for three things:

buck_owens_cover

Buck Owens

korn-band

Korn,

random_act_mug

and the creator of this bumper sticker slogan.

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Work

I doubt many of you still check the Other Blog since I haven’t posted there in months. I haven’t posted there in months because that’s my place to bitch about work, and I haven’t felt the need to bitch.

Things are actually pretty good.

Today, I had two separate docs — one an internist, one a pediatrician — tell me they’re very happy with the feedback they’re getting from their patients. Both invited me to come talk to their groups. Not that I enjoy lots of extra work preparing talks, but educating one’s referral base is a useful thing to do, and it’ll be a great way to meet my colleagues (also known as the people who will one day vote on whether I make partner).

I’ve got back the first round of numbers from patient surveys. They grade you on a one to ten scale on a variety of questions. How well did your doc explain things to you, do you feel confident in his abilities, did he use language you could understand, etc. The Kize wants us to get 8.5 or better, and all of my scores except one were above nine. My one “low” score, which was still better than 8.5, was for the question, “My doctor was familiar with my medical history.” So now I make a point of dropping info to prove I’ve been snooping around their charts. Sneaky me.

They keep me busy. The schedulers overbook the day, figuring on a certain percentage of no-shows, so it’s a bitch when I have no no-shows. When I was in private practice, my patients didn’t often no-show because word had gotten out that I would discharge patients for repeated no-shows. Can’t do that at the Kize, of course, but I suspect my no-show rate won’t be that high, at least not for my followups. Most people like me. Anyway, I like it busy; the day flies by.

It’s taken a while, but I’m finally getting that comfy feeling I had back up north — the feeling that I know the ropes, I understand the system, and that I’m able to deliver for my patients. It’s one of the main things I hated giving up when I left private practice.

So life is good, which is great for life but crappy for humor. Which, after all, thrives on pain.

D.

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