Cruisin' in style (or at least more room)

Time rolls on, and swallows us up in its passing. For over four years now, we have crammed our family of five into either a Hyundai Sonata, or (surprisingly, we fit better in the second) a Mazda Protege. We flirted with the idea of a minivan a few years back, when he had a foster daughter. However, we resisted, and have, in a very cramped manner, used the Mazda to cart around our family of five. Heck, we have even used it a couple of times to head down to North Carolina. Alas, with the impending arrival of Jones kiddo number four, we have no choice but to upsize. And so today we did:

There she is, our new van. Honestly, I am excited. It will be very nice. The room is wonderful, as is the fact that it is just a nicer ride than the Mazda. But I do bid a fond farewell to our Hyundai. She was the victim, as she was a couple of years older and not quite as easy on the gas mileage. Needless to say, the kids (the ones who benefit the most from the extra space) are thrilled. New wheels for the Jones family!

On being on call

Call as a resident is one of those dreaded things. No one wants to be on call, yet we all knew, going in, that this would be a requisite part of our career. Despite that knowledge, we all dread it.

Like the plague.

See, the problem is people don't understand what it means to be on call. After years of being a resident, my own parents still don't seem entirely comfortable with what that means. Granted, it is something that has changed over the years as I made the transition from General Surgery to Urology. So for that, I forgive them.

But it isn't just those of us going in who don't understand what call will really be like. Our "customers" don't understand what call is like.

Be they nurses, patients, or even colleagues, the tendency to abuse call is rampant. It is perfectly normal for a patient to call at 2 am to discuss something as mundane as when are they scheduled for their next appointment. A patient called me the other night to ask who was right, he or his wife, in regards to how a medication worked.

It happens all the time. People assume that, because they can call someone at all hours, that they SHOULD call someone at all hours. Nurses are just as bad. It is completely normal to get a page at 3 am about a medication that will be due at 9 am, or "just to let you know" that a medication (eg. an antiemetic) did what it was supposed to. Right. Because at 3 am I really want to know that the prescribed medication had its intended effects. Because at 3 am there is nothing else I would rather be doing. In fact, I was probably just sitting there, NOT trying to sleep, wondering if that Zofran that someone else ordered worked for that patient I didn't even know I was covering.

And that middle of the night call from the medicine resident who was told by the nurse who tried once to place a foley catheter that she couldn't? Those are the best. No, he/she didn't try themselves because "the nurses do this more than I do, if they can't, I won't be able to". What a great response. I will remember that one the next time my patient's blood sugar is elevated. I'll call you at 2 am before I try, oh, say, some insulin.

But you know, after a weekend like this last one, it is hard to complain about call. Until I remember that I have to do it again, and there is no way it will be as nice next time. One good weekend guarantees a couple more filled with severe pain.

What's this, a blog?

A good friend of Lis's (and mine) stopped by yesterday, out visiting from Utah. In passing she mentioned she had been checking our blogs on occasion to see what was up.

I thought to myself, oh, yes, I do have a blog.

Looking at the date on the last article, it is easy to see that I may have forgotten about this existence of this little corner of cyberspace. I stopped by. It was dusty, smelt musty, and looked a bit forlorn.

Well, since I am currently enjoying the, ahem, liberties of my research year, I thought it might be a good time to dust things off, improve my colloquial writing, and perhaps let people know, again, that I am alive and kicking. Well, maybe not kicking. That is for younger kids. I am getting on in years you know.

Hopefully this won't be a flash in the pan.

Hangin' in Maine

Thanks to my mother's generosity and willingness to take care of the kiddos, Lis and I had an opportunity to spend a few days together to celebrate our 10th anniversary. We loaded up the bikes and went to Kennebunkport, ME. We had a great time, cruising along the beach (though it was a tad cold), sampling the local food (lobster anyone?), and I actually had soup three days in a row. Those who know will realize just how amazing that is. All in all, it was a wonderful few days.

Be a follower

As a recent defector from another blog site, which shall remain nameless (but rhymes with SlowLoser), I have been enjoying some of the benefits of Blogger. While it doesn't have the built-in community of SlowLoser, it has one very important distinction: it isn't an ugly, red-headed step-child. As such, Google's Blooger team tweaks, improves and adds to the site regularly. It is actually, actively being improved. Yeah, yeah, that is new to me. I had placated myself with serial stagnation, whose only major change came in the form of a horrendous "site upgrade" that ruined the blogging experience for me. One of the recent additions/improvements to Blogger is the ability to "follow" another blog. If you haven't checked it out, you should. You can add blogs to your dashboard that you are following. From one, nice little spot there you can see if there are any new articles from bloggers you enjoy. They will also be able to see that you are following them, giving them that nice, warm feeling of being loved (or perhaps that cold, creepy feeling of being stalked). It also automatically adds them to your Google Reader, which, if you haven't used, you should. Next time you are in Gmail, just click the link at the top of the page that says Reader and there you go, all your Blogger favorites right there ready to read. Handy. I like it.

The attraction of fame

Fame is a funny thing. We seem to be drawn to it, like the archetypal moth to the flame. Even if we don't think we are.

I hate celebrity culture. The countless websites, magazines, TV shows that exist only to embarrass, expose, idolize or demonize celebrities really bother me. I don't get the fascination. In fact, my wife will tell you, I have remarked before just how stupid I think the whole thing is.

But my eyes were opened this past month.

You see, I met someone famous. Two someones, in fact. And not just sort of famous. Really very famous people. My interaction with them was limited, but did last 20-30 minutes. In that time I found them to be down to earth, kind, and, well, normal people. During my interactions, I didn't think I was star-struck.

Apparently I was.

Since my brief interaction, I honestly found myself very interested in these people, and for longer than I thought I would have. I now know what movies they have been in, what major awards (Golden Globe and Academy Awards) they have been nominated for or won. I know when they were married, born, etc. The internet makes all this so easily accessible. But what shocked me (and disturbed me) the most was that I found myself hoping for opportunities to see them or speak with them again. I was looking more closely, wanting to catch a glimpse. I found myself paying attention to celebrity news, wondering if I would hear or see their names. I was sucked in. Fortunately, it didn't last, and the brief fascination has now faded. But I am left wondering if I am no better than those celebrity-mongers who keep trash like The Enquirer, Star, and Us Weekly flying off the shelves. Talk about painful self-revelation.

Because it's there

My son is now three. He is also a boy. Anatomically, he has some parts that protrude, parts his sisters don't have. This, of course, can mean one thing, and one thing only. He has begun grabbing his unit. Much to my wife's chagrin, I might add. I can tell it drives her nuts (oops, Freudian slip?) when she sees him hanging on to things. With the exasperation that only mothers can muster, she will tell him to cut it out. He's a good little guy. He lets go. For a time. But, eventually, he is hanging on for dear life again. I tried to tell him the other day that if he grabs things too much, they will fall off. It didn't phase him. I suppose he just isn't yet at the age that scare tactics work. Saturday night, though, he cracked me up. I got him out of the shower. Naturally, he walks, naked, into his bedroom, where the putting on of the clothes will occur. As per protocol. Being naked, as he was, things were just that much more accessible. I look over, and there he is, hanging on like he is afraid he is going to lose it. "Dude, what are you doing?" I ask, in what I thought was a nonchalant manner. "Daddy, I'm just grabbing my funny bone," he coolly replies. I was speechless. Still, thinking back on the moment, I laugh. I mean, of all the things he could have come up with to call his package, this 3 year old comes up with funny bone. That is pure comedy gold there. You can't write that kind of stuff. What could I say? After all, he was just grabbing his funny bone.

Like father, like son. . .

Any parents out there who read this will understand quite a bit with this simple sentence: I am the eldest child in my family. As such, things were a little more, ehm, strict with me than with my siblings who have come after me. That is fine, I don't mind at all. I like to think it helped me out, and has gotten me to where I am today. But it also does occasion some good stories. My mother, in her efforts to raise a sensitive, noble, caring son had determined that toy guns would not be allowed in our house. It was an action motivated by love, a love so deep that she hurts sometimes. And so, there were no guns in our house. For a time, at least. I forget how old I was, though I am sure my mother remembers, as it was a disheartening moment for her. There I sat, eating a piece of bread. Of my own accord, I careful and selectively ate that piece of bread until I could get her attention. I pointed the piece of bread at her (eaten in the shape of a gun) and simply said "Bang." There it was, all her work to keep me from violent toys foiled in a little boys selective biting of his bread. Despite her intentions, I made my own gun. It was inevitable. Needless to say, after that I started seeing toy guns around the house. Fast-forward to today. There I was, in the kitchen. My three year old son was finishing his peanut butter and honey sandwich when he turns to me and said "Bang, my crust is a gun Daddy." All I could say was "That's my son."

Physician, heal thyself

"Physician, heal thyself" Luke 4: 23

My professional goal is to assist the human body in healing itself. Be it through medication, lifestyle changes, surgery or other interventions, my efforts are for people to live better, healthier lives. I have spent 11 years since I graduated from High School working toward this, with at least another 4 to go. The vast majority of my waking hours are spent caring for others. It is truly one of my passions.

And yet.

We spend so little time caring four ourselves. It is our own doing. There is no question that there are not enough doctors to truly see the patients who need medical care. There is a supply/demand mismatch, and we created this. With restrictions on the number of new medical students every year, as well as restrictions on the number of residents who match, we are ensuring there will always be a significant demand for our services.

Likewise, rigorous entry requirements, significant time and financial investments also put limits on the number who apply. With a population that is growing significantly faster than the number of doctors, there will be no shortage of work for those who pursue medicine as a career.

And this job security is the very thing that hinders our own self-care.

Though time has passed, the memory of my kidney stone is still fresh. Yet even more clear is the realization that I did it to myself. See, the stone hit on my last day of three continuous months on the Trauma service. Three months of 14+ hour days, 6-7 days a week, with 1-3 30 hour shifts per week thrown in for good measure takes its toll on the body. Add to that the fact that all day long you are running: to the Trauma bay to run the traumas, to the ER to see surgery consults, to any and every floor and clinic in the hospital to see consults, dealing with and organizing transfers from smaller hospitals, to the OR. Most days, the first time I had anything to drink, let alone to eat was at 7 pm or later when I finally sat down to have some dinner.

Fact: That is not conducive to being healthy. This is only compounded by the paucity of time available to exercise. We try to fit it in when we can. Often the choice is between one more precious hour of sleep, one hour of actually seeing your family before they head off to bed, or getting in that workout. It isn't hard to guess that the workout often loses.

How do we reconcile this seeming hypocrisy?

I wish I knew. I refuse to try to justify it. I know we need to work long hours to get the work done. I recognize that medicine is a rather unforgiving career, and has a history that is much worse than its present. But that doesn't excuse the self-abuse. I told my daughter that it has probably been at least 13 years since I could honestly say I wasn't tired. Most of that has been due to my efforts to get where I am today. That isn't healthy, and it isn't sustainable.

Yet the winds of change are blowing. A new generation of us are entering the profession. A generation who believe that a well balanced physician, who cares for him/herself, who has at least a little time to nurture a family or friendships, is better equipped to really connect to his patients and care for them as human beings.

Not as diagnoses.

I could care less

In the written language, there are few phrases that irritate me more than this: "I could care less."

Why does it irritate me so? Because it makes no sense. It is often used in place of the original phrase (penned by the British) of "I couldn't care less." This statement works. It makes sense. When I say it I mean exactly that: I care so little about [insert particular comment/rant/article/person here] that I actually could not care less. That is to say, on my care-o-meter I am officially at or below zero.

So where did the illogical derivative come from? Well, leave it up to us good old Americans to take something that actually makes sense, and turn it around so that it doesn't. But this raises the question: What happened to the negative? Perhaps some sarcastic punk wanted to really emphasize his/her apathy when he/she said to his/her equally stoned mate "Dude/ette, like I could care less." Now, that makes sense. The person is, in a sarcastic manner, emphasizing that he/she is totally apathetic. Sounds like a reasonable language permutation to me.

In the ensuing years, though, this phrase was repeated again and again, by ignoramuses (my own personal bias there) until it actually came to resemble a proper use of language. Now, there are plenty of places discussing this improper use of the phrase. I link because I care. The point that some (not all) of these references clearly make is that, in the spoken language, vocal inflection can lend meaning to the phrase "I could care less." Delivery can emphasize the sarcasm the speaker may have intended.

However, the written word cannot. I have previously evangelized that all written communication on the internet should have 'sarcastic green', a vile color that is used to warn the unsuspecting reader that the offensively colored words are meant to be sarcastic. Think of the confusion this would clear up. Lamentably, this idea has not gained widespread acceptance, and we, the readers, are forced to infer (often from barely literate writers) what passes as sarcasm. In the end, failure ensues, ideas are miscommunicated and a visual diarrhea of smileys is used in an effort to smooth things over.

My personal bias (again) is simply this: Most people who write and say that they "could care less" are simply stupid. They aren't trying to be witty or sarcastic. They are ignorant, and haven't given thought to just how silly it sounds/reads when they say/write "I could care less." Perhaps I should give them the benefit of the doubt.

Unfortunately, most bloggers haven't given me a good reason to. In the end, as evidence by the fact that I wrote this article, I actually could care less.