Happy Saturday Night, everybody. I'm sipping on some nice apple-infused rum.

Whew! I sure had an arrogant sumbitch in my exam room just now.

He had a not-uncommon problem that is not always easy to diagnose, due to the number of things that could be causing it. I was assembling a differential while he gave me the history of the condition.

I was going over my list of things it could be (out loud, unfortunately), and he said: "Sounds like quackery to me! I was a corpsman in Vietnam! Improvise!"

Shit...

I came to the (probably correct) diagnosis that it was caused by an adverse interaction between two of the many medications he's taking, and recommended that, based on his current status, he could discontinue one of them.

I hope his condition improves, and I hope I never see him again...

America: "Love It Or Leave It".

America: "Love It Or Leave It." That's the schtick they're hitting us with again. Their jive is wearing real thin, considering the fact that that little how-do-you-do has been around for about sixty years. They need to get some new material.

My thing is: since what they want is a country radically different from the one we have right now, aren't they the ones who hate America? Isn't their vision of an all-white, all-straight, male-dominated theocratic military dictatorship as nebulous and unattainable as Utopia, Erewhon, El Dorado, or the Seven Cities of Cibola?


I don't know where they expect to find their longed-for Republic of Gilead, but it ain't here. So denizens of Trumptown, this is America; love it, or......well, you get the idea...

Just got word that one of my patients died. No word yet on cause; possibly overdose.

My Care Coordinator says all she heard was 'trauma', so that might not be it.

Life sucks so hard sometimes...

"We're becoming the Wal-Mart of medical clinics!"

I just said that to my clinical staff out of frustration that our electronic health records network keeps dropping out. My MA supervisor told me that administration doesn't want to pay for upgrades, and that a while back, the entire IT staff walked out in protest.

The administration takes home some sweet salaries and bonuses, while clinical staff constantly have to get their union to push for pay increases. And now we have these computer issues that the admins don't want to pay for because the cost would cut into their $$$.

I swear sometimes...

Friday Night Wine-Buzz. Ask me anything.

How is everyone doing tonight?

What is it with guys and their shoes?

I've seen guys who are otherwise exceptional dressers absolutely fail hard when it comes to pairing their shoes.

When I was in PA School, there were events for which the students would need to appear in business dress. The guys would all wear these natty suits. One could always tell who among the guys were military veterans, because we were the only ones who polished our shoes. Most of the other guys wore ratty-looking, unshined leather slip-ons even with the nicest of suits.

I was at the opera a few weeks back, and saw a guy wearing a very nice, well-fitted tuxedo; guy really knew how to accessorize, too; studs, cufflinks, the works. And he was wearing a pair of the above-mentioned ratty black slip-ons.

Dude? Seriously!

I admit I go a little over on the other side of the issue. I own probably sixty pairs of shoes. One doesn't have to go that far.

But put some effort into it!

If Trump is brought down by pedophilia and sex trafficking instead of collusion with Russia,

I'm cool with that.

Just as long as he goes away.

To prison.

For a very long time...

My clinic manager is really starting to piss me off.

Bad enough he's invented a personality conflict with my best staff member in an attempt to get her fired. Now he's sending us patients from the mainstream clinic who should really be sent home instead.

He's trying to boost productivity, but he's doing by sending us patients who don't really need professional medical attention. Now I'm doing the kind of clinical medicine that could best be described as kissing the patients' boo-boos to make them better.

He cares more about the quantity of medical encounters than the quality of medicine we practice. It's what happens when you put someone with no medical training in charge of people who do have it.

I'm just hoping he leaves or gets fired soon. I've outlasted seven clinic managers prior to him.

Tonight, vodka and some sublingual cannabis oil.