Setting Priorities

I sometimes think that all of our healthcare problems could be solved if people could just get their priorities straight.  I talk to patients every day who won't buy their high blood pressure medications because they "don't have any money until their CMSP kicks in" but yet they have the money to buy meth.  They can't get in to see their primary care doctor for a follow-up because they only have enough gas this week to get them to the E.D. and back, yet they insist on driving the most expensive 4x4 truck that gets 7 miles to the gallon.


I've had patients with dental abscesses buy their pain medications but not the antibiotics because "that's all I could afford;"  probably along with the pack of cigarettes they just had to have as well.  I've had to dispense Tylenol and Ibuprofen to children because their parents don't have "time to run to the store" but seem to have time to text on their cell phones while making appointments for their manicures, and asking if we can "watch the kid for a second while I run out for a smoke."


I had a child (18 month old) brought in who was three times the weight they should be because "grandma gives them a liter bottle of Pepsi" every day when she babysits.  When I suggested that Grandma not buy any, the parent responded "but ___ will cry if he doesn't get his Pepsi."  And, I've heard the same said about Happy Meals, ice creams, Starbucks, etc.  Which explains all the "Baby Hueys I've been increasingly seeing in the E.D.


Until patients start taking some responsibility for their health, we're going to continue to see medical expenses rise.  And, we're going to continue to be the nation spending the most on healthcare and not seeing a return on our investment as patients become even more obese, diabetic, hypertensive or continue with their narcotic, alcohol, or tobacco addictions which lead to their own special set of problems.  As a friend of mine likes to point out, "You call it annoying;  I call it job security."

Life in Dixie's Land

I got my puppy!!  Dixie is so cute, and so very smart.  It's scary how smart she is.  We got her yesterday, and already she knows Sit, Come, and is learning the concept of Fetch.  We had one oops... but, hey, housebreaking doesn't happen overnight.  Although, she did let me know twice during the night from her kennel that she needed to go out.

Her adventures are going to be detailed in her own blog lifeindixieland.blogspot.com where you can watch this amazing little creature grow up and develop into what I am sure will be a great dog!

spring is like...

One of my favorite poets is e.e. cummings, and I was thinking about his poem "spring is like a perhaps hand" the other day when we visited the OK Corral in Tombstone, Arizona.  As many of you know, I love to travel, and while in Tucson for a conference this last weekend, we did something fun for my husband which was to indulge his Wild West fancies.            Have you ever been to a tourist location before it "opens" for business?  That's what reminded me of this poem.  We got to Tombstone relatively early... around 9:30.  Since most of the stores didn't open until 10, and since it was the weekend, the town was still in the process of "waking up" when we got there.   We went into one of the small cafes for a quick breakfast, and while we were in there several of the store owners and tourist operators were stopping in for their own breakfast.  Everyone in town dresses in the style of the late 1800's, so it was fun to see the high boots and spurs on the men, and the long skirts and prairie tops of the women.  We walked out onto the main street just a little after 10, and you could see the town slowly coming to life. 

As we came in and out of stores, you started to see more people on the streets and soon the town was humming along.  More cowboys showed up.  Fights broke out on the streets.  A lot of tourists came in costume.  It's always an amazing thing for me to watch.  It reminds me of early morning walks in Boston when the city slowly comes to life.  We spent several hours in Tombstone, mostly to find my husband the perfect cowboy hat and to watch a live performance show at the Wyatt Earp Theatre (very reasonable, and good actors btw - better than the OK Corral show).

We drank ice cold sarsaparilla (very creamy smooth) sold by one of the local vendors who recommended we go to the town of Bisbee which is located about 20 miles south of Tombstone.  Since it was about time for lunch, we decided to go.  Bisbee is a copper mining town that has now turned into an artist/antiques touristy venue.  There are lots of small shops and restaurants to explore, not to mention the array of houses built onto the hillside.  All in all, a very fun "off the beaten path" road trip.

by e. e. cummings

Spring is like a perhaps hand
(which comes carefully
out of Nowhere) arranging
a window, into which people look (while
people stare
arranging and changing placing
carefully there a strange
thing and a known thing here) and

changing everything carefully

spring is like a perhaps
Hand in a window
(carefully to
and fro moving New and
Old things, while
people stare carefully
moving a perhaps
fraction of flower here placing
an inch of air there) and

without breaking anything.


El Fin (The End)

I can't believe it's over.... what will I do with my weekdays now??

If you haven't been following this blog long, you may not realize that I'm talking about the telenovela "Cuando Me Enamoro."  It had its Gran Final yesterday, and it did not disappoint.  Well, maybe in just one point.  But, we'll get back to that in a bit...

I started watching the telenovela in May... wow... and within a few weeks, I had my husband hooked.  We followed the trials and tribulations of Geronimo and Renata;  the main characters who had to battle lies, jealousies, obsessions, etc. to finally end up together.  Then in mid November, we learned that we were on "Ultimas Semanas" which means "Final Weeks."

Our only complaint about the soap is a storyline about an accidental pregnancy.  The main couple was separated;  in the process of getting a divorce.  Suddenly, a new love interest for Geronimo leads to an unexpected pregnancy.  My husband couldn't accept that a gentleman like Geronimo would have sex with someone.  But, ok.  Then, the pregnancy turned into twins.  Really..??!?  You get the expected threatened miscarriage where the woman has to be on strict bedrest... in Geronimo's home... with his newly reconciled wife... seriously...?

When the final weeks came around, we wondered how they were going to wrap up that storyline.  How could the two main characters live their perfect love story with twins involving another woman.  However, in true telenovela fashion, the "other woman" has a complication while giving birth and dies, but not before there's a tortuous 15 minute death scene where she asks Renata to raise the twins as her own.  Everyone's crying.  She dies.  Storyline closed.

We're not starting a new telenovela.... not unless hunky Juan Soler is going to do another one.... or maybe even if Silvia Navarro stars in it... she was beautiful and awesome as Renata.  I am sure she would do great in any roll... until then, though... there's always Enrique Iglesias on my iPod!

This is Your Brain...

I think I've commented in the past that there are some things I don't quite get... like psych patients.

Now, people on drugs or alcohol, yeah those I can understand because anything goes when you're under the influence, but psych patients are their own special flavor of interesting.  I was thinking about this a couple of shifts ago when I had a patient convinced that the scabs on their skin were due to worms invading their body... worms with antlers.

How did she know they had antlers...?  Well, now, because she took a scientific approach and viewed a skin scraping under the microscope where she witnessed said worms... and they had antlers on them.  Of course, there are a whole number of things wrong with that last statement; ie: like who has a microscope just sitting around the house...? (well, actually, I do... ) but, still.  It's just not something you hear every day.

And, she was quite convinced that the antlered pin worms that, by the way, came in assorted sizes and manifested in different colors as they made her way out of her body were slowly making their way up to her brain via her ears.  So much so that she came to the E.D. for us to do our own skin scrapings so we could begin treating her.  She kept trying to show me where the worms were coming out, but I just couldn't see them.  What I did notice was the skin infections she was giving herself from picking and scratching at her skin over and over again in an attempt to remove the worms.

I gave her antibiotics for her skin infection and antihistamines to help with the itching.  When she insisted she needed something to kill the worms I somewhat tongue-in-cheek asked her to bring me a worm sample in a jar so that I would know what to treat her with... She nodded and said she would try to catch one for me... oh yeah... can't wait for that E.D. visit.