Confessions of an Intern

Week Thirty-three and Thirty-four

Office medicine is where my goal is. That said, being in the office in residency is somewhat of a let down. I often am booked to fullest, which is great, but most days I have about a 50% show rate. The vast majority of these are people I have never seen before. The rest of them are those whom I may have seen once in these last 7 or 8 months, but who have a record of no-showing about half the time. It is very frustrating to hear people say they could not get in with me because I was booked, and then sit with no patients when people don't show up. So here is my little soap box for these two weeks, then I'll tell you a couple funny stories. Please, realize when you make an appointment with a care provider, you are taking time from another person who needs to be seen as well as the provider you are scheduled with. I would far rather hear "I forgot", "I'm late" or anything instead of just nothing. Please have the decency to call and say you can't come instead of just leaving it in the air. Even if I cannot schedule someone in, I could still spend more time with the ones who showed up.

That is only slightly worse than those who show up thirty or more minutes late and get indignant when we say they will have to wait to be seen or that we will not see them. I'm sorry, but at 5 pm I also have a life waiting for me. I have children and a husband and things I would rather do than work. I am a doctor, always a doctor and yes, my job is to care for sick people, but it is not my job to give up everything for your convenience. Those who are the angriest are most often not ill. They are there for a well child visit for their child, or for a refill on a non-urgent medication, or such. That is not always the case, but often. I am far more forgiving of those with small children, because it is not the kids' fault. But when you give an inch, they often take a mile. This will open up a whole can of worms, as the clientele I work with are most often with small children are on Medicaid, and some rely on Medicaid transportation. This requires them to call and ask for the charity transportation to come, then depend on the driver's punctuality, etc. Sometimes I want to say beggars can't be choosers. That seems crass and uncaring, but if you saw some of the people who think they are entitled to government (tax-payer funded) health care, you would be appalled as well. One of those who has routinely no-showed me (three times in the last six weeks) was a new patient who is young (mid twenties) with six children all under age six. She is Medicaid AND Medicare!!!! When I first met her, I did a new patient interview and during our conversation, we discussed her pregnancies and her desire for possible birth control. I asked about her health and any illnesses she'd had besides the chronic back ache she was in with and she said she was healthy. That she did not have ANY medical problems. I double checked the header on my screen and asked again, "What medical problem do you have that you qualify for Medicare?" She at first was very evasive and answered simply that her other doctor 'gave it to her'. I pressed on, "For what? You should have some disability to qualify at your age for SSI benefits." She got more evasive and then said it was for her depression and 'other stuff' which she did not go into. I dropped it, treated her muscle spasm (from chronically carrying an infant on her hip) with OMT, which she said was better than any medicine she'd ever been given and sent her on her way. She has no need to be on Medicare. She is getting DISABILITY pay for being pregnant over and over. This is totally inappropriate. If she returns to me and asks me to fill out any forms to maintain it, I will not. No wonder we have such a screwed up system. Men with real medical problems cannot get Medicare or Medicaid without being paraplegic or worse, it seems, but women seem to get it really quite easily. I don't understand it. I am more "disabled" than half of the people drawing SSI. It's BULLSHIT!

Ok...enough of that. On to some funnies. I'll take you back to Valentine's Day. Romantic day, right? I got roses delivered to me at work by my wonderful husband, for the first time. It was the first time I was working somewhere he could pin me down, haha! They were beautiful and fragrant. I shared them with all those I worked with that day. I felt so special and loved! I saw a couple new patients and a couple old patients. One of them was a stereotypical Viet Nam Vet, with love hair pulled back in a ponytail and beard, torn jeans, a limp and the 'Nam ball cap. I am related to many Viet Nam Veterans, so I mean no disrespect, but he fits the picture. He is in to see me for worsening hip pain, and he walked several miles to see me. He is worse shape than the last time I saw him, and I spent some time trying to get some things pulled together for him.

Remember, I spent some time...making calls and getting prescriptions, etc. I knock and hear a mumbled answer, and open the door. I quickly shut it behind me and start talking about what I've found out. At the same time I notice that this patient is looking out the window facing away from me, and for some reason he is fumbling with his jeans...his jeans button and zipper. He turns to me and reaches out for the papers I have in hand and I quickly put them on the counter, to avoid hand contact, realizing he was pleasuring himself (I'm fairly certain...read on). I back to the door and open it and try to get it between us, as he is coming closer and keeps talking. He changed the subject and asked if I'd done something different with my hair. In that moment, I was nearly speechless, but muttered something about maybe hair color or something (now I realize it was much shorter the last time I had seen him). He smiled and said, "Whatever you did, don't change how it is now. You look good." I cannot get the inflection in well in writing, but just draw that out to you look guuud. **Shiver and suppress dry heave here** I tried to thank him graciously, but he followed that up with a giggle and asked, "Are ya' married?" I quickly answered yes, seventeen years, happily. He gave that aw, shucks face and said, "Well, I was gonna ask you if you wanted to be."

I tried to be nice and just changed the subject, laughed it off and ran! Everyone at the office thought it was pretty funny. I was the only one proposed to that day. It makes a funny story, but I don't know how I'm going to look that guy in the eye next time he comes in.

My next funny comes at home. Kind of funny, kind of scary. You'll think I'm an awful parent for sure, but it was funny. I think it was anyway. That Friday night after V Day, we had been invited to a little soiree at my husband's boss' new house. I was the DD (designated driver) for him, and he had several beers. We had to leave around eleven pm for two reasons, our kids and two extra 14 year old boys were home at our house and I didn't want them home alone much longer; and it had started snowing. We were in my little yellow sports car that has enough trouble on rain, let alone snow or ice. I white knuckled it home while my tipsy husband made fun of the Prius that passed me on the uncleared highway. To say the least, when we got home, I was ready for a drink. I poured one with a new liquor I had never had, some type of cherry rum and diet coke. It went down easily, and I thought one more would be fine, it did not do much. My middle son (please don't crucify me now) offered to pour me the next drink. I don't let him drink, he's only ten, but he thinks it is fun to pour. So I told him how much of each to put in. He brought me the drink and it tasted like only coke, so I said he could add some more.

Big mistake. He had layered the diet coke, rum and topped with more diet coke. You know, that first drink makes it so you really don't taste the liquor in drink number two. Well, that held true. After a few minutes, I was much more drunk than I thought I should be and I asked him to show me the bottle. It was 2/3 gone!!! I still had half of the second drink left. All I will say is, don't let 10 year olds pour, and don't be suprised the interesting things you will tell 14 year olds when they start asking after what is essentially truth serum. OMG! Had the second hangover in my life the next day. Lesson learned!