Facing a hella day in clinic today. Saturdays always bite.

Pop in and say 'hi', will you. I'll check in every now and then if I get a chance. A friendly word or two will get me through the day.

Thank you.

I love you all...

Enjoying a day off today. Ask me anything.

Getting ready to head out for a nice breakfast. But don't worry: they have wi-fi. Talk to you then...

Da-Who Dorays, Fa-Who Forays, Welcome Christmas, Come This Way.

Da-Who Dorays, Fa-Who Forays, Welcome Christmas, Christmas Day!
Welcome Christmas, Fa-Who Ramus
Welcome Christmas, Da-Who Damus
Christmas Day Is In Our Grasp,
So Long As We Have Hands To Clasp...

Saturday, December 22nd. The Newtown Memorial Edition of William Shakespeare's Thought For The Day.

Fans of WSTFTD, there will be an edition posted tomorrow. If you have tears, prepare to shed them.

I considered passing over the horrible events of Newtown, CT as a subject for the feature; especially since the original intent of WSTFTD was humorous. (It has varied from funny, to cynical, to bitter, to tragic over the years; a lot like Will's plays.) But I found one that I want to share. It will be posted with respect for the heroism, and mourning for the loss, of the victims.

See you tomorrow morning...

A medical provider's pet-peeve phrases.

We all have them. Some of us have a lot of them. Every list is a little different. But I'm sure there is some overlap.

Here are mine:

"Check-up". If you want a clinic visit, please tell me what you want. Don't ask for a 'check-up'. I don't know what that is. They didn't teach us how to do 'check-ups' in PA School.

"Stomach flu". There is no such thing. Influenza is respiratory in nature. If you're throwing up every ten minutes, you have gastritis. If it's vomiting and diarrhea, it's gastroenteritis. Not 'stomach flu'.

"Fever". Fever has an actual medical definition: 101 degrees Fahrenheit or 38 degrees Celsius or higher. Don't walk in with a temperature of 99.1F and tell me you have a 'fever'. Don't tell me that since your normal temperature is lower than the 98.6F average that 99.1 is a fever 'for me'. Fever is fever for everyone.

"I could feel my blood pressure rising". No you couldn't. You felt your stress level rising, and increased stress can lead to increased b/p levels. But hypertension is often called 'The Silent Killer' because it doesn't come with any symptoms. You won't have any symptoms until right before it's about to kill you, and sure, then you'll have headaches, fatigue, dizziness, disorientation and shortness of breath. But if your b/p is mildly elevated, (say, 144/92) you can't 'feel it rising'.

"I'm trying to quit smoking, doc." No you're not. If you are still smoking, you're not trying to quit. Trying to quit means putting it out and not lighting up another one. Basically the same definition as 'successfully quitting'. If you're still buying or bumming cigarettes to smoke, you're not 'trying to quit'.

"How long is this going to take, doc?" As long as it takes. If you have something else to do, go do it; I won't hold you up. And I will be here when you have time for a proper evaluation of your medical complaint.



I read a lot of complaints from patients about their medical providers, and many of them are justified, especially in a society where nobody has enough time, everybody is frustrated, and everyone is in a hurry. And on balance, I love my work, and I love my patients, even the ones who smoke or are not compliant with their treatment plans. These phrases above are pet-peeves, not sources of fury and inexhaustible frustration. I thought writing them down and sharing them might make for a mild catharsis.

Thank you.

I love you all...

Having some Greek food and a couple of drinks. Anyone care to join me for the end of the world?

May as well go out with a buzz...

An appropriate beverage for the end of all things: Irish Death!

Slunge!

Anybody want to hang out?

I'm relaxing with a nice Caesar salad and a red IPA. (If it's red, how can it be an India Pale Ale?... )

Talk to me...

Pajamas, bathrobe, warm socks, and DU.

I'm starting to feel better now.

It's nice to be warm and indoors on a night like tonight. It's raining like sixty out there, and there's the usual bone-chilling, damp Northwest cold, as well.

A liberal's guilt is never far away, though. I couldn't help but think of at least a few of my patients who are out in this weather. Most of my patients stay at the shelters. But I have a few campers, too. Hope they're able to stay dry...

To all of my kind, thoughtful Lounge friends: Thank you for being there.

I love you all...

Depressed. Hold me.

No, no; I'm fine. My life couldn't be better right now, as a matter of fact. Just depressed about recent events, and the things that won't happen in spite of them. Hurting for innocent lives lost, and for those who loved them.

I don't need an intervention; just some kind words.

Because right now, I can't get the words of Eugene O'Neill out of my head. He wrote:

"There is no future. And there is no present. There is only the past, happening over, and over, forever."