Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Wednesday, September 29, 2004
    Fashion to Die For

    In the parade of patients I get the occasional goth-dressing type in the office. They're generally very pleasant, articulate people. One showed up yesterday, dressed all in black, jet jewelry, heavy eye liner, all par for the course. What threw me was her purse: it was shaped like a coffin. Looked exactly like the one in the link.

    Then there's the more annoying fashionista type - the retired woman who comes in dressed to the nines, dripping with jewelry, always talks about her next trip abroad and never ceases to complain about her copay going up. (Not to mention the cost of meds.) Grr.

    Then there's me. I am pretty damned hopeless at this sort of thing - I will never win the award for Best Dressed Doctor. I tend to go with what's comfortable (when I was a resident, it took a stern edict from the residency director to get me to stop wearing scrubs). This morning, for example, I got scolded by my secretary. I have a dinner meeting tonight and came in wearing my new ensemble. My secretary wandered into my office, noted the outfit with approval, fingered my earrings:

    "Now show me your shoes."

    I knew I was about to ruin my good impression. Reluctantly, I extended a foot. I was wearing my flat clunkers - not even my prettier flats, as one of them was lost and nowhere to be found this morning.

    "AAAH! I'm going to kill you! You need pumps with that outfit!"

    "I know, but I hate them."

    "Just little ones! They don't have to be high!"

    Ten minutes later she came marching in with a catalog and slapped it down in front of me, to emphasize her point:

    "You need these in navy, black, brown and beige."

    I cringed. We're going to be debating this one for a while.

    Tuesday, September 21, 2004
    Gee, Thanks, Dave

    If you find this challenge frustrating, blame Dave Barry. He's the one who linked it. Interestingly, I found it similar to looking at a microscope slide. (You have to navigate upside down and backwards when you're viewing a slide because it's a mirror image.)

    Thursday, September 16, 2004
    "You. Are. A. TOY!!"

    I just have one more comment on the whole Dan Rather thing. Here it is:

    Yesterday when I heard the "fake but accurate" comment on the memos, that's when I had my moment of Woody enlightenment. Dan, listen up:

    You. Are. A. REPORTER!! Reporters do not act this way. Your private sentiments do not come into this. You are supposed to be impartial.

    But somehow, I know what Dan would reply, and it's this:

    "You are a sad, strange little [woman]. You have my pity."

    Wednesday, September 15, 2004
    My Life Is Like a Stephen King Movie

    Saturday night, 10:30 pm. I was on call and had to admit a patient, and came into the office to look for a chart. I wandered around the corner into the adjoining office to get some water (our bottle of Arrowhead having gone dry), and smelled... aftershave lotion.

    Fresh aftershave.

    My God, I thought, there's some creepy guy in here who's going to grab me. I tiptoed back down the hall, glancing fearfully into darkened exam rooms as I went. I saw no one.

    Monday morning I went back into that office to chat with the secretary. As I walked in I saw her replenishing her little air freshener, the sort that squirts scent into the air every fifteen minutes or so. It smelled like... aftershave.

    "Oh yes," she said, "this is the lavender kind. Lots of people have said it smells like aftershave."

    I've always hated air fresheners and now I hate them more. My eyes bugged out as I howled, "Your %^&* air freshener almost gave me a heart attack!"

    Saturday, September 11, 2004
    In Other News...

    John Ritter's family has sued the hospital where he was taken for treatment:

    Ritter's wife Amy Yasbeck and their four children filed a wrongful death and medical malpractice suit on Thursday in Los Angeles Superior Court alleging that hospital doctors "caused the untimely death ... by misdiagnosing his condition and as a consequence, failing to provide proper treatment in connection with an ascending aortic aneurysm that would have saved his life."

    The lawsuit says that Ritter was initially diagnosed with acute myocardial infarction and then with pericardial tamponade. He actually had a large ascending aortic aneurysm.

    Sad to say, this isn't the first time this has happened (I don't mean at that hospital; I mean in general). Early this year the Wall Street Journal ran an excellent article about the diagnosis of aneurysms. They're often missed. If anything good comes from Ritter's death, I think it will be that aneurysms will attain a higher profile on the diagnostic list. They won't be the last thing considered any more.


    This morning I started with a long, self-indulgent post about where I was September 11, 2001 and what I did that day.

    Blogger ate it. Fortunately.

    Instead, I've got a better story to tell you - the aftershock of September 11. It was months later, like the aftershock of an earthquake, and it came packaged in my university's alumni magazine.

    Flipping through the pages, I noticed an inset box in the Obituary section:

    Obituaries of the 14 alumni who were
    killed in the September 11 terrorist
    attacks appear with those of their
    classmates. Their names are: [omitted]

    I hadn't known anyone personally who was killed on September 11. My brother knew someone who was on Flight 93. V., who was born and raised in New York, lost two childhood friends: One in each tower.

    I started to read. (Note: I'm going to omit the names for the sake of privacy.)

    A 1983 alum: ... a financial consultant with Salomon Smith Barney; Sept.11, at a breakfast meeting at Windows on the World restaurant on the 106th floor, One World Trade Center. His sister said he was the high-energy family organizer, who planned the annual reunions of 70 relatives, ordering Lebanese food; he created a game for these gatherings based on family trivia. "He was pretty much perfect."

    A 1989 alum: Sept.11, One World Trade Center. This was her second day at work after maternity leave... [She] did not like working in the World Trade Center tower because she did not like heights, and as her brother-in-law had been in the complex when it was bombed in 1993.

    Then the gut clincher: 1985. My year. My school within the university. My classmate.

    Eleven others: One World Trade Center. Two World Trade Center. Flight 11. The Pentagon.

    That was when I realized I had lost family after all. I sat at the kitchen table and cried for I don't know how long.


    Yeah. Perfect.

    Friday, September 10, 2004
    Pessimists 1, Optimists 0

    Hope magazine is going under:

    After operating for nearly nine years at a loss, the magazine created to inform and inspire readers to strive to make a difference in their worlds will cease publication in its current form at the end of the year, according to Publisher Jon Wilson.

    Wilson launched the magazine in 1996 in an effort to counter the "bad news" journalism he saw every day with stories about people who were striving to make the world a better place.

    I never heard of this magazine. It's a great idea, but sadly, I'm not surprised it tanked. Why is it that bad news is more compelling than good news?

    Thursday, September 09, 2004

    Here it is: the In-N-Out Burger secret menu! I'd heard that there was one but never got details on it before. The Animal Burger sounds good. For those of you who have never eaten at an In-N-Out, next time you're on the West Coast, go to one.

    Hands and Feet

    Last week I saw a patient who's been coming in regularly to get some warts frozen. She has two large, stubborn ones on her right hand. That day, she had two other problems: a recent bee sting on the right forearm and a new large ganglion cyst on the right wrist.

    "Why is it all on that hand?" she lamented.

    "Bad hand karma?" I suggested. She liked that idea.

    Then yesterday I saw a patient who came in with the complaint of swelling and pus on a toe. By the time I saw it, he was improving; the abscess had burst the night before. I put him on antibiotics anyway since he has circulation problems. His wife accompanied him on the visit (they are a charming Armenian couple); as I was examining him, he said with a laugh, "My wife put eggplant on it!"

    "Whatever works," I replied. "Was it raw eggplant or hot?"

    She explained that it was cooked, and a teaspoon of sugar added; it sounded like some sort of homemade poultice. It could well have been enough to get the infection to drain. I said that sounded fine.

    His last comment of the visit, with a grin: "Tomorrow we try hamburger!"

    Friday, September 03, 2004
    Project For a Three Day Weekend

    Via Bookslut:

    How To Write a Best-Selling Fantasy Novel (it's funny!)

    Get cracking. You should be finished by Monday night.

    Internet Turns 35

    As of yesterday. And it plans to get its own place soon.

    I'm Going To Hell

    This morning I was calling back some patients, catching up on the messages that were left on my half day out of the office. (Yes, I got out of the office on my half day... but only to go to the dentist. You can't win.) Now, to understand what happened next, I need to explain (briefly) our message system. We use preprinted forms that contain info like time, date, and -- in the upper right-hand corner -- the name of the secretary who took the message. I should also explain that yesterday we had a pleasant young male temp working the front office, whose name I did not catch.

    So now maybe you'll understand why, in the middle of leaving a message on the patient's voicemail, I boggled when my eye caught the name in the upper right-hand corner:


    And all I could think was, Since when is the Son of God taking messages for us?