Scrappy Blog

Last night, we had a dinner for the group of college freshmen I’ll be mentoring this year.  So there’s leftovers in the fridge.  The salad seemed most likely to spoil, so I had a big salad around 11:30.  Was starving by 2.  So had another big salad.  It’s now a bit past 3.  Starving.  At least this will finish off the leftover salad!

Walk in, turn in jury summons and sign in.  Sit for ten minutes.  Rise for judge.  Judge spends another 5 minutes mumbling over some sort of paperwork, calls out a couple names (no one answers).  Then judge tells us we can all go home.

Ah, civic duty…

K’s birthday was last weekend and he dealt with it (as he does) by sitting down and engaging me in an long discussion about what things he wanted to accomplish over the next year.  Somewhere on the path of very pragmatic discussions about how we’ll handle getting the dying tree removed and the roof repaired and scheduling time for grant writing and so on, we found ourselves discussing the details of our wedding.  In the midst of putting together a plan for notifying our friends and family, I realised I was engaged. 

Ah, well, I guess I’m just not the “pick a romantic moment and surprise the heck out of me by getting on your knees and proposing” type.  At least this time, the words “Shit or get off the pot” didn’t enter into the discussion…

Also struck by how un-dramatic it feels. Happy, of course, but not particularly worked up or excited.  I’d already decided to spend my life with him, he seemed to feel the same, and getting married just seems like another step in that process. 

So probably will be posting random bits about planning a wedding over the coming months… I understand it’s a big task.  Last time, Mom did it all for me.  Hopefully she can share a few tricks!

Ah, people’s attitudes towards their doc.

Had a call from a patient – wanted me to refill a medication.  I had my staff respond by explaining that this medication is intended to be used once only for a very specific type of infection; if she thinks she has this infection again she should set up an appointment so we can test her for it.  If she has it, we should figure out why she’s had it twice in such a short time.  If she doesn’t, we should figure out what’s making her feel bad and give her a more appropriate treatment based on that.

So the return call simply said she understood and had set up an appointment with X specialist to be evaluated.

Excuse me?  I’m good enough to call in medicines (for no compensation) for your own self-diagnoses, but not good enough to actually pay to come see? 

Uh-oh, I’ve been tagged! This is from ciaracat

1. Grab the nearest book.
2. Open the book to page 123.
3. Find the fifth sentence.
4. Post the text of the next 3 sentences on your blog along with these instructions.
5. Don’t you dare dig for that “cool” or “intellectual” book in your closet! I know you were thinking about it! Just pick up whatever is closest.
6. Tag three people.

First book I grabbed had a list of chapter headings on P 123.  So cheated and reached a little further..

Designing procedures to make errors visible can also improve safety.  Although human beings will always make errors, procedures can be designed so that many errors are identified before they result in harm to patients. For example, pharmaceutical software can alert the prescriber to an incorrect dose or potential interaction with another medication (ref).

OK, that’s a  boring book… Institute of Medicine’ “Crossing the Quality Chasm” report.   Should have known better than to do this at the machine where I work.  Instead, let’s look for the closest “fun” book…

The desk work required of an acting lieutenant had not helped the muscle tone in Jim Chee’s legs, nor his lungs.  He was tired. He stood at the rim, looking across the saddle, dreading the long climb down.

That from Tony Hillerman’s “The First Eagle” which is sitting by my desk so I can print up a book-crossing label for it before releasing it to the wild!

Hm…OK, I’ll do some tagging.  How about follybard, arenson9, and drelmo?  I bet y’all read interesting stuff…

So I just got off the phone with ATT/SBC/Yahoo/whoevertheyare, setting up my new DSL account so I can blissfully dropkick roadrunner across the room.  Griped to the guy that I was reduced to working in coffeeshops.  The guy asks if he can sell me the service that lets me log into the AT&T hotspots (places like airports, and Barnes and Noble).

I hadn’t done so because, well, I feel like I should be supporting the businesses that give out wireless access for free.  But he tells me that the AT&T thing costs 2 bucks a month. 

Who knew?  I’d always assumed this would be a much more expensive service.  For under 25 bucks a year, which I’ll feel was worthwhile just for the chance to surf while waiting to get on flights at IAH?

Yay technology. 

Meanwhile, think I’ll pack up and relocate to a coffeeshop that has better music playing.

I kind of knew when I embarked on the current career path that somewhere in there I’d start having people approach me about jobs (rather than the other way around). Thus far, the only flirting has happened locally, and with jobs that weren’t really more attractive than the one I already have.

Just had a head-hunter approach me about a pretty high-level position in a major corporation. The candidate description they sent fits me awfully well.  The job is out-of-state and probably wouldn’t allow for a clinical practice.

Suddenly I’m being faced with a fork in the road.  If I really want to make a top-tier career in my area, I should probably go for this job.  If I place my career secondary to other concerns – like living in a city I love, surrounded by people I love – it’s not as attractive of a job.

Sigh.  Soul-searching time…

Of course, it could turn out that there’s tons of people far more qualified than me for the job, and that I haven’t a snowball’s chance of getting it anyway.

In the background is playing some lovely piano by Brahms.  Which is great, except that something kept triggering a “I know that song!” feeling in the back of my head.  It would follow perfectly my memory of the tune, and then suddenly veer off in the wrong direction – so I knew I wasn’t actually just remembering the Brahms piece.

Thought back on albums I recently listened to and realized I was hearing big bits of the song “Love of my Life” from Santana’s grammy-winning album Supernatural. OK, so that’s why I knew the tune.  Doesn’t look like Santana acknowledges Brahms anywhere on the album; Google tells me that many people found that offensive. I don’t suppose Brahms cares much, really – he’s dead and all.

No real point here, just feeling clever that I noticed it and bemused by how hard it was to place the song out-of-context like that.

I’m redesigning the forms people fill out when they come into the clinic.  There’s two reasons for this:  first, the existing forms are confusing and somewhat redundant.  Second, I want paper forms that easily compare to the electronic forms so that we can easily move back and forth from people filling out computer forms directly, or filling out paper forms that a staff member transcribes to the computer.

So I was looking at the various questions we ask: Marital Status, Who lives with you, Profession, Education.

Found myself thinking “what’s the purpose behind these questions?” I’m not planning to judge anyone, after all.  So the real questions are actually things like “are you having sex with anyone, because if so I should consider pregnancy and STDs as possible diagnoses when you’re sick”, and “when you’re really sick, is anyone there at home to call 911 for you?” and “Is it possible to do your job with the symptoms you have”, and “are you likely to understand what I’m talking about when I discuss your diagnosis with you”….

And those questions sort of miss the point for a lot of people.  A high-school educated lab tech understands more biology than many PhDs in areas like art or literature. Married people sometimes live alone.  Homosexual patients may live with a life-long partner, but only “single” technically applies. Heck, the most accurate box for me is technically “divorced” even though I’ve lived with K now for longer than I was ever married.

So redesigning, to avoid being all judgemental and not asking what we really want to know, how about things like:
Describe your living situation: (checkboxes for “I live alone”, “I live with one or more roommates”, “I live with a spouse or partner”, “I live with my children”, “I live in a nursing home or assisted living facility”…  maybe “I live in a dorm”

So the question is – what new set of things am I missing with my new questions?