Sunday, December 11, 2005


Today I went for breakfast at Rosa's. Rosa is a friend of mine who is mother to two charming and intelligent pre-teenage boys, wife to a charming and intelligent man, and mistress to three of the largest dogs I've ever met. Rosa is also from the Phillipines, so breakfast with her consists of rice, eggs, and some sort of dried marine life.

Today it was a combination of squid and fish, dried and then deep-fried. Normally, I'm game for almost anything edible and a number of things that are dubious, but I've got a skeevish reaction to eating anything that stares at me while I'm consuming it. Hence I stayed away from the dried fish and concentrated on the squid.

"Try the baby ones," Rosa said, "they're crunchier."

I eat them, as does her husband, Americano style: in small bites, with bits of garlic rice on the same fork. And they're delicious, especially the baby ones. The fish was a bit too salty for my taste, but the squid were just right.

As I wolfed down squid and rice and eggs and vegetables, three dogs crouched at my feet, not out of affection but because there was room at my end of the table.

The smallest dog, Dallas, is a shiny spaniel cross who weighs about 60 pounds. She's intelligent and suspicious and has decided after repeated exposure to me to delay ripping out my throat until some later, as yet undetermined, time.

The next larger dog is Sam. He's elderly and has had a rough life. If you pet him, he'll follow you everywhere, begging more affection with rolling eyes and a grin.

The chief of the household is named Soldier. He's either a Great Dane and Akita cross, or perhaps Great Dane and Catahoula hound cross; nobody is quite sure. He could be half flying flapdoodle and half Shetland pony for all I know; he weighs more than the other two dogs combined. Unfortunately, unlike the Brontosaur that he resembles, he has no second brain halfway down his spine. He is, however, a sweet-tempered (if dumb) animal with a soft spot for me. We sit on the floor and have a little mutual admiration session every time I go over there.

Which I desperately needed after this last couple of days.

When "they" say that doctors make the worst patients, "they" are discounting those patients whose family members are doctors.

I don't know why it is that everybody who wants to fake something ends up faking neurological disorders. Maybe it's that there are no sure, definitive tests for most neuro problems, barring tumors and abcesses and such. Maybe it's that they think neurologists are too flaky to catch the frauds. Maybe it's that the vast majority of people, even health-care professionals, look at neurology and neurosurgery as some sort of weird half-science practiced in the dark of the moon.

Whatever the reason, the wackos always fake neuro problems. Well, not *always*; sometimes they fake obscure autoimmune disorders with neurological components. Either way, there's Xanax and Valium and Dilaudid involved.

The wackos I can handle. They're generally undemanding, provided they get their needs (for drugs) met, they're normally pretty stable medically. It's the wackos' family members that drive me over the edge. And nothing is worse than a wacko with two close family members who are doctors.

Why? Because those family members will monopolize the lightboxes in the nurses' station as though they were their own personal property. They'll wander off for hours with the chart, ignoring the new orders that need to be posted. They'll call from their cell phones, demanding that you change medications on *their* say-so, even if they're not the primary physician. They'll medicate those family members with stuff they haul in from the office, then forget to mention it to you. They might even start sitting in wheelchairs, having discussions about their family member's case in the hallway, and then leave their detritus and the wheelchairs scattered for you to clean up.

Thankfully, this was not my patient. If it had been, there would've been fireworks. Unfortunately, the antics of the Family Doctors made life miserable for all of us--it's difficult to do your job in a confined space when there are people lurking, answering the phones because it might just be the person they paged, and monopolizing your time.

The last straw came, for me, when one of the Family Doctors opened one of my patients' charts. Note that this patient was not that doctor's family member; it was a patient with the same attending physician. Apparently, Family Doctor #1 wanted to "get a feel for" that doctor's "style" and the way that he comes to a diagnosis.

I learned yesterday that an icy "I. beg. your. pardon." and an equally icy "How *dare* you?" have the same effect on a doctor, even a wacko doctor, that they do on anyone else. Unfortunately, I didn't get an apology from said wacko, but I did extract a promise that the Family Doctors wouldn't be going near the chart rack again.

I fixed them, though. They'd left their family member's MRI and CT films all over the back of the nurses' station, so I just tidied 'em up. The resident and the attending both know where they are, but I doubt that the Family Doctors will be able to find them again.

The sad thing is that all of this hoohaw could've been avoided if somebody in a position to do so (like the charge nurse, or the manager, or the attending physician) had set some limits at the outset.

Maybe I should bring Dallas in on a nice, long chain. Those of us who want to get past her to the station can carry dried squid in our pockets.


Judy said...

Being charge nurse does have its benefits. Lately its been, "piss me off and your assignments will suck."

Yep. I can be that way. Do NOT make out your own assignment before I get there. Especially do not re-write it once I've erased it. Her assignments could suck for a long time.

When dealing with wacko family members who are healthcare professionals of any sort (latest was a respiratory therapist who demanded to see xrays he clearly coudn't read), HIPPA goes a long way. He had permission and it was quite entertaining to watch him trying to assess breath sounds too. Apparently his neonatal experience was quite limited. I trucked out all my big fancy words when I talked to him - the ones I'm generally careful to avoid when I explain things to family members.

shrimplate said...

Sometimes it's hard to explain how smart my black Lab "Kije" is compared to your average neurosurgeon.

He's bigger than some of them. And he likes bones. Sorta like an ortho guy. But with teeth. And better hair. Way.

Prokofiev is big in our household, especially the 2nd Violin concerto and the 1st and 3rd piano Concertos Right up there with Bartok. Love that stuff.