The Commute

Posted on August 28, 2016 by deconstructingdoctor

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I drive a little more than 30 miles to work and then 30 miles back home again.  Most weekdays.  For the past 9 years.  My husband does the same thing.  We both commute to almost the same area.  Over the years, countless people have asked, why?  Why don’t you just move closer to work?

 

  1. Concert shirts:  I have amassed quite a collection of concert t-shirts, ironic t-shirts,
    IMG_0439offensive t-shirts and I like to wear them.  A lot.  I never really got passed the age of 23.  Of course, I have to choose my shirts wisely, I have accidentally worn my “Museum of the Weird” shirt with skulls and skeletons on it to drop off my youngest at preschool.  They are not sure what to make of me.  Here’s my point:  People generally have no idea what I do for a living in my local community.  I don’t have a reputation to uphold.  So I can get away with my t-shirts without affecting the opinions of the people I serve.  I get to be an adult who deep down inside is still an adolescent.
  2. Bratty kids: My children go to school in my local community and they get to be IMG_1196normal little kids.  Not the kids of a doctor.  There is a mini-celebrity that goes along with being the kid of a doc.  Everyone is looking at them for some kind of magical sparkle.  They have expectations.  They may treat them differently.  Doctor’s kids may have certain advantages.  They may be liked not for their own personalities, but because their parent is held in such high regard.  Fortunately, most people don’t know what I do and my kids get to be themselves.  Bratty.
  3. Flashers:  When you live in the community where you work, you see patients everywhere.  Because of the close relationship that develops, patients feel comfortable talking with their doctor about their medical problems anywhere.  They also have no qualms about showing their medical problems to their trusted physician.  Hence the dreaded, hey doc, I’ve got this rash I want to show you.  In Walmart.  In front of God and creation.  That never happens to me in my town.
  4. Mommy Was a Racecar Driver: 100_0419 I like to drive.  I find it relaxing.  I turn up the radio.
    I sing like nobody’s watching.  I unwind from the day.  I equally prepare for the day on my commute to work.  This works for me.  Unfortunately, I have a huge carbon footprint.  I plan to rectify that when I get out of the minivan phase.  Maybe something electric…and convertible.IMG_0401
  5. Family:  Our families have helped us tremendously with childcare over the years.  We live near them.  If we moved, we would be too far away.  We would be close to our jobs, but far away from our lifelines.  Our support.  The people that truly care about us and our kids.  So we stay put.  And we like it.

 

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Flawed

Posted on August 24, 2016 by deconstructingdoctor

broken-saint-1422381-639x573I don’t always do the right thing.  I don’t always figure it out.  That’s the worst part of this job.  The not being perfect part because not being perfect means I’m flawed and flawed people make mistakes and my mistakes can hurt people.

One time I almost missed a lung cancer.  Oh God, the gut-wrenching weekend that I spent after that one.  I must have lost 5 pounds just from the nausea that I felt.  How could I eat?  How could I breathe?  My mind ground the details of the entire chart into a fine powder and then I sifted through that.  Trying to account for every dust particle.  How could I have failed so miserably?  I could have just died.  Truly.  What a miserable wretch I was.

The crazy part is it couldn’t have been helped.

She had lung cancer a decade before.  It came back.  My angst came from –could I have caught it earlier?  Should I have been doing more surveillance on her?  It was back.  It was bad and now she had blood clots.  I took every ounce of blame onto myself.

How does one surveil someone after lung cancer?  One can order CT scans periodically as a screen, but her insurance wouldn’t pay (it went to deductible).  And it had been over 10 years. She did have the occasional chest X-ray.  The last one just 6 months before and it was normal.  She neglected to follow up with her oncologist or pulmonologist.  She didn’t get mammograms or colonoscopies.  She continued to smoke.  Was it all totally my fault?  I just didn’t find it early enough.  Even if I did, lung cancer is so hard to treat…

This was such a lonely experience for me.  Who do I talk to?  I can not show anyone my weaknesses.  I could not show that maybe I wasn’t diligent enough.  Other better doctors would have done a better job.  I couldn’t let them know.  I just wanted so much to bounce the case off of someone else, like talking to a best friend.  Confidentially.  But I couldn’t.  We just don’t do that.

It stayed with me.  It churned in my gut.  It gnawed at my mind.  It stole my rest.  It consumed me.  And it wasn’t even that big of a deal.  Except for her.  It was a very big deal for her.

 

Photo Credit:  Lorenzo Gonzalez

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Good Grief

Posted on August 18, 2016 by deconstructingdoctor

IMG_3343I remember the first time that I wanted to be a writer.  I was in the third grade.  The assignment was to write a story about a tin can.  I titled it, “The Diary of a Tin Can.”  I even made drawings to correspond with the tin can’s adventures.  I bundled it all in a neat little mini book and presented it to my mom to read before I turned it in to my teacher.

She was so excited about my little story.  She kept telling me how much she loved it.  How creative I was.  What an imagination you have!  Her eyes were so bright and her words so encouraging.  I basked in the glow.  I was onto something.

I remember the first time that I wanted to stop writing.  I was 15.  My mom had read my diary.  Oh the horror!  She stood with this look of absolute disgust and outrage on her face.  Disappointment.  Hurt.  She held my diary in her hand.  My mind reeling.  Dear God, what had I written?  It was so personal.  I felt so exposed, so betrayed.  I was angry at her.  Whatever I wrote, she deserved it.  She shouldn’t have read it.  It’s her own fault if she was mad, not mine.  Why did she do that to me?  She didn’t have my permission.

I was never the same.  I never felt safe to express myself in the same way again.  I was forever muted, edited, guarded, dampened.

My mother passed away in July.  I have been slowly, methodically cleaning out her room, packing up her things.  She didn’t have much.  The sum total of her 67 years on this earth fit neatly and cleanly in the bonus room above our garage.  Her room.  Everything in its place.  Nothing in excess.  Except cookbooks and coloring books and puzzles and markers and handwritten recipes.  All of this from a woman who hardly cooked.  Boxes and boxes of cookbooks.  At least a hundred handwritten recipes.  That she never made.

And in her room, I found that story I wrote in the third grade about a tin can.

 

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What My Microwave Says About Me

Posted on August 15, 2016 by deconstructingdoctor
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Full disclosure:  This is my microwave AFTER I cleaned it.  It was totally disgusting about 5 minutes earlier

It says I’m:

  • crusty
  • grimy
  • stuffed with bread, cookies, and chips
  • going in circles
  • a hot mess

I love soup.  I open up a can of soup and pour it in a bowl almost every day.  I cook my soup in the microwave because it takes just the one bowl.  The same bowl that you cook the soup in is the same bowl you eat the soup out of -no extra pots to clean, simple.  My microwave has a turntable and you can’t put a paper towel over the soup because as the turntable moves the paper towel gets hung up, falls in the soup, and becomes a soggy mess.  Therefore, I don’t use a paper towel.  I just put the bowl of soup in there and punch in 3 minutes.  Without fail, and for some unknown scientific reason, the carrots in the soup spontaneously combust and bits of carrot explode and then adhere to the walls of the microwave.  No paper towel to catch the shrapnel.  Every time.  Why???

Sometimes I have time to clean the microwave, but mostly I don’t.  Maybe I have the time, but not the inclination.  The carrot bits start to add up.  Maybe other exploding bits from potatoes, beef, and chicken are layered on top of the carrots and eventually I look in the microwave with disgust.  How have I let it get this bad?  What if I drop dead right now?  Friends and family would gather at my home, bring various covered dishes that need to be heated up quickly for the mourners, then open up the microwave and collectively gasp.

She was a good person, but OMG did you see her microwave?  How could she live like that?  Disgusting!  Maybe that’s what killed her…some kind of bacterial overload.

This is NOT how I want to be remembered, nor how I want to die.  So I cleaned the microwave today just in case.  I heated up Beer Cheddar Soup and it exploded as per usual, although no carrots were harmed.  This time it was potato.  The previous crusty layers were at maximum capacity.  It required a little chiseling action to get it all off.  It looks better now.  I can die in peace, but hopefully I will live another day.  It looks like I have a can of Italian Wedding Soup  in the cupboard waiting for me tomorrow.

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So you want to be a doctor?

Posted on August 12, 2016 by deconstructingdoctor

shocked-statue-1519967-639x852Are you f^cking crazy?  Ha, ha I’m just kidding.

No really, do you belong in a mental institution?  Yeah, that’s a joke, too.  My sense of humor takes some getting used to.

If you like being berated, abused, overworked, under appreciated, paid just enough so that you really can’t do any other job, owing hundreds of thousands of dollars to do a job that most people think they can do just by getting on Google, well then you should be a doctor.  You should do it.

When I wanted to be a doctor, I told very few people.  I learned my lesson early on.  My mom told me that she ran into one of my friend’s mothers at the grocery store and she said she heard I wanted to go to medical school.  “She probably won’t get in, she’s just not smart enough,” she said.  Maybe that was true, but I got in anyway.  So here’s a little middle finger for you, lady.  Those kind of comments only egged me on.

While in training, too many doctors made too many comments about getting out.  Leaving.  Doing something else.  Get out while you can.  It happened A LOT.  Those comments only egged me on.  Those doctors lost something along the way.  Something was destroyed in them.  That wouldn’t happen to me.  I was different.

There was nothing that anyone could have said to me, about me, about the job, the patients, the life’s work, the cost -that would have stopped me.  I hope that is the same for you.  I hope nothing will stop you.  I hope that you are different, too.  I hope that you will see others along the way that are like you and you link arms with them, because here’s the catch.  You really can’t do this alone.  You really can’t isolate yourself.  You really aren’t that strong.

They say that doctors eat their young.  It’s true.  They tried.  I must have had too much gristle because they chewed me up and spit me back out and made me one of them.  Tough.  Guarded.  Compartmentalized.  And now it’s my turn to teach the young.  To teach you.  To make a doctor out of you.

You and I really aren’t different from those wise and aged doctors that had had enough.  The ones that wanted to leave.  The ones who have been on the battlefield.  War-weary and damaged.  The ones who just can’t go on anymore.  Our brothers and sisters in the fight.

And it will be a fight.  I hope you are ready.

You probably are.  Listen, don’t be discouraged.  The ones like us, our numbers are many.  Some day I hope we will truly realize that our strength lies in our numbers, that we stop competing with each other, stop trying to destroy each other, stop isolating ourselves, ban together, and make changes to our beloved profession for the better.  For ourselves.  For the ones that come after us.

Like you.

Before there’s nothing left worth saving.

 

 

Photo Credit:  Gabor Palla

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My Moist Blog

Posted on August 10, 2016 by deconstructingdoctor

drop-of-dew-1331679-639x947Somewhere out there in internet land I read that the most annoying, disliked, wretch-inducing word is moist.  It is pretty disgusting.  Except when referencing a cake.  A moist cake sounds quite delicious.  I don’t thing a dry cake or a wet cake sounds appealing, but a moist cake, now that’s something I could sink my teeth into.

I’m really not a fan of the word blog, either.  I think it sounds like a moist fart.  A burp.  A stomach growl.  Something that Jabba the Hut would produce from his nether regions.  In order to try to deflect from my personal dislike of both words, I decided to put them together.  Moist Blog.  Maybe by combining the power of the yuckiness of the two words, a more satiating concept will form.

Moist denotes something akin to being half-assed.  It is neither wet nor dry, it’s somewhere in the middle, sadly mediocre.  It is your brow on a humid day.  It is your armpits when the boss puts you on the spot at the company meeting.  It’s my bare toes in my ballerina flats when I forget to wear those little annoying footy socks.  Moist is a holding pattern.  It’s in between.  It’s stagnant.  It’s when I keep getting in and out of the pool and stay in my bathing suit all day.   Moist is where yeast likes to grow.  And fungus.  Mushrooms love a nice moist dog turd (are you guys still reading this?  Have you felt the need to hurl, yet?).

A Moist Blog perhaps is a blog that has been left outside all night, forgotten.  By morning, a nice layer of dew has formed.  Like potential.  Or maybe it’s been left sitting beside a waterfall and now a refreshing film of mist covers it.  Or maybe it is a perfectly baked cake.  Not too dry.  Crumbly bits of words hidden under a layer of chocolate icing.

I think it’s working, I think the two words together are much better than they are apart.

I think I might like the idea of a moist blog.  It is alive, refreshing, and full of potential, but without the calories of a moist cake.

What words do you find nauseating?  Perhaps the word, nauseating?

 

Photo credit:  alojzm

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Reconstructing Doctor: Part 2

Posted on August 7, 2016 by deconstructingdoctor

Reconstructing Doctor: Part 1

In my excitement and haste to make my rooms look amazing, I totally forgot to take before pictures.

I know, what a dork.

So instead I took pictures of my partner’s rooms, which pretty much mimic the way my rooms USED to look with just slight variation in the lame ass paintings.  I was going on vacation and I hired a lovely gentlemen to paint the rooms while I was gone.  I had to clear all that crap out of there before I left for Disney World -the greatest place in the world.  I was kind of in a hurry and just wanted to get everything cleared out so I could don my Mickey ears and get the heck out of town.  The last thing I was thinking about was taking pics.  Here are 2 of my partner’s rooms, aren’t they lame?  My rooms were somehow worse…but you get the idea.

I have 3 exam rooms.  Each now with their own unique nature/outdoor theme.  In preparation for the “reconstructing,” I ordered a few prints from Overstock.com and I found another one I really liked at World Market.  I spent a nice Saturday afternoon perusing our local antique show, wheeling and dealing and buying a bunch of junk to hang on the walls. That’s pretty much my most favorite thing in the world to do.  I wish Cracker Barrel would hire me to decorate their restaurants.  That is my true calling in life.

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I call this my “Take a Walk in the Woods” room.  The white thing on the wall is 1/3 of a folding screen.  The other 2 parts were missing.  So I thought, wow that’s a little gem, I’ll give you 5 bucks for it.  I wasn’t totally sure what to do with it. I consulted the staff.  The consensus was to write my favorite poem on it.  I left out certain words and allowed the staff and patients to write in the missing words with any color marker they wanted and in any way they wanted.

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The Road Not Taken by Robert Frost

Room #2 is probably most patients’ favorite.  When I first saw the single yellow wall, I thought I had made a big mistake.  It was really yellow.

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Obviously this is the “Beach Room.”  Once I hung the painting and saying on the wall, the yellow softened a bit.  I think this room is my favorite, too.

Room #3 is the “Lake Room.”  It reminds me of the end of summer, the leaves are starting to change, a slight nip in the air.  No one is on the lake.  They’ve all gone home.  The days are getting shorter.  Those are fishing poles and canoe paddles on the walls.  I placed a tackle box on top of the cabinets, high enough so no little hands could get pinched.

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I have a few more ideas to add to the rooms.  I want to have the staff and patients take photos of nature and I’ll hang them up.  I have a window in the first room that I can hang photos on.  I have a shutter for the beach room that I haven’t hung up yet -it would be a great place for photos.  I’m trying to talk Donna into making a star out of tobacco sticks for the lake room.  I could put photos on there, too.

My rooms are not exactly typical of a doctor’s office, but if you haven’t figured it out yet, I’m not entirely typical.  I think my rooms exude a bit of joy.  I’m certainly happier now.

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Reconstructing Doctor: Part 1

Posted on August 3, 2016 by deconstructingdoctor

Logan 3-4 months and winter 064I still work in the same practice that I joined when I finished residency almost 9 years ago. My partner did the same thing about 15 years before me.  It’s just the kind of place and the kind of people that you don’t leave.  And you don’t change.

A few months ago, I looked up from my laptop while seeing a patient and realized that my clinic rooms are hideous.  How have I let this go on for this long?  I haven’t changed anything about my rooms since I joined the practice.  The same ugly framed prints hang on the wall, the paint is chipping on the baseboards, and screw holes are showing through the drywall.

I did change one painting about a year ago.  A patient of my partners was seeing me for an acute problem.  She had never been in my rooms before.  She had a huge smile on her face when I walked in.  I was sure she had heard of my wonderful reputation and was so glad to finally meet me.

That picture.  Is it by so-and-so artist?

(So it wasn’t me she was smiling about)  Umm.  I don’t know.  Do you like it?

It’s a painting of my mom’s home place.  My grandmother’s home.  My mother was born there.  I have always wanted a copy of this painting.  It brings back such wonderful memories of my childhood.  –She stared longingly at the picture.

You can have it.

What?  I can have it?  How much do you want for it?  

No.  You can HAVE it.  It’s yours.  -I took the framed picture off the wall and handed it to her.

She was actually doing me a favor.  I am not really THAT generous.  I hated this picture more than all of them.  The excitement that I saw in her eyes over this particular picture was all it took.  It belonged to her now, it always did.

The picture was of a winter scene.  A dilapidated home was covered in fresh snow.  The trees were bare.  There was an outhouse.  Ancient farm equipment poked out intermittently and haphazardly from the winter wonderland.  The only thing warm and inviting about the picture was the smoke billowing from the chimney.  It must have been warm in the home, but everything else looked like ice cold hell to me.  Winter is depressing.  This painting was depressing and I always hated it.

But she loved it.

Now a painting of an urn of flowers hangs in its place.  Almost as bad, but not quite.  I took that picture off the wall of our procedure room.  No one seemed to notice.

I’ve decided to redecorate my clinic rooms for the first time in 9 years.  I’m going to pick out my own pictures, my own paint colors, and brighten things up a bit.  No winter scenes will be allowed.  I’m going to make some changes.  Want to see what I’m going to do?  Stay tuned for before and after picks…

Reconstructing Doctor: Part 2

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Waves

Posted on July 29, 2016 by deconstructingdoctor

IMG_3281It seems that the most common way to describe the feeling of grief is to say that it “comes in waves.”

I spent the last week at the beach on vacation with my family.  It’s one of the only places that doesn’t remind me of my mother at all.  She hated the beach.  I can not remember a single moment spent with my mother at the beach.  No summer days at the ocean getting lathered in suntan lotion, no long walks or talks, no frolicking -even though we lived only minutes away.  She feared the water.

Her father was in the navy and he moved his family all over the country, living closest to the most beautiful beaches in the US:  Honolulu, Key West, San Diego, Cocoa Beach.  Her entire childhood spent near the water and she never learned how to swim.

My father was the one who took me to the beach.  He taught me to swim.  He took me out on the boat to go fishing.  He showed me the joys of the ocean, the secret swimming spots and fishing holes near the coast.  He taught me how to bait the hook, reel in the line, and captain the boat.  Once we even caught a shark.  The beach reminds me of him, an old navy man, just like my mother’s father.

As I stand on the edge where the ocean and sand meet, the fact that the ocean doesn’t remind me of my mother at all, brings on a wave of grief.  I feel the tears stinging my eyes.  I felt the same thing earlier when the saltwater got into my eyes.  It occurs to me that they are one in the same.  I imagine that the ocean is a vast collection of all the tears from all the sorrows in all the world.  All the pain.  All the loss.  Became the ocean.  The waves lap at my feet.  I hope that no one will notice my tears.  The families all around, my family.  Everyone oblivious to the pain that is squeezing my chest.  “I can’t breathe,” she said.  My own breath catches.  For a moment I hold my breath in solidarity.

My youngest stands beside me now, her hand reaches for mine.  I dare not look at her.  I can’t make this moment a sad one for her.  I remain fixed, staring out at the ocean.  She positions herself in such a way as to mimic me, standing like I stand, staring where I stare.

“Mom, did you notice that if you stand in the sand long enough the waves dig a hole under your feet and you start to sink?”

“I hadn’t noticed that before.”  But it was true.  With each wave, I could feel my feet sinking deeper into the sand.  How long would it take to be overcome by the sand?  To become buried?

I felt the need to move forward.  “Want to go for another swim?” I asked.

And with the mere suggestion, she smiled and pulled me forward into the sea, passed the breakers, where the waves smoothed out for a while and the sand no longer gave way beneath my feet.

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I’m No Nutrition-ista

Posted on July 24, 2016 by deconstructingdoctor

IMG_3141Listen.  I know what I do for a living.  I know the expectations of others when they see me in the office, at church, at the grocery store and in the liquor store (just kidding, I never go to the liquor store).

If a patient sees me outside of the office, they are totally sizing me up.  No too long ago, I went to the grocery store just around the corner from the office to pick up some groceries before the drive home.  I saw at least half a dozen patients in there.  Each one gazing into my grocery cart checking out what magical food options I chose.  Each one with a little puzzled look on their faces.

Probably because I have the same crap in my cart that they have in theirs.

I’m not proud that my kids have started eating Lunchables at an alarming rate.  Or Doritos.  Or Cheez-Its.  Or Foot Long Fruit Roll-Ups.  Or that I had a 6 pack of Mountain Dew in my cart.  Who needs liquor stores when my drink of choice is the Dew?  In very small doses, mind you, because that shit is like poison.  Delicious, sugary, syrupy, caffeine-y poison.  And the color of pee to boot.  Glow in the dark pee.  Who wouldn’t crave such an attractive drink?

I try, just like everyone else, to eat healthier.  To exercise more.  To get more rest.  To manage my stress.  And I fall short, just like everyone else.

To be sure, there are folks out there that eat perfectly.  They avoid all the pitfalls of too much salt, too much sugar, too many calories.  They drink plenty of water, avoid caffeine, eat the recommended amounts of organic fruits and vegetables.  And gosh, they are a dream come true to someone like me.  Or just really annoying to everyone else.

They never taught nutrition to me in medical school.  I learned it on the fly.  Mostly from reading, some from good old-fashioned common sense, and the rest from a nutritionist.  So much of my work is about helping people change their bad eating habits to avoid, reduce, or reverse chronic health problems (i.e. diabetes, hypertension, hyperlipidemia).  I have to educate them about the right way to eat and live.  How much money would we save the system if we all avoided things like Mountain Dew and Fruit Roll-Ups?  If we got up from the couch instead of binge-watching our favorite mindless shows?  If we taught our children those same healthy habits?

I am aware that I am a role model of sorts.  People are watching me and taking cues from my behaviors.  I want my patients to see me as someone that lives the life that I encourage them to live.  I want to live the best life that I can and I want the same for all of them.  I maintain my weight.  I make healthy food choices.  I exercise and I enjoy it.

And once in a while I want a Mountain Dew.

 

 

 

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