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... I talked to an old acquaintance from medical school the other day. He's a respected cancer researcher in a small but very vital facility back east.
We weren't good friends in med school but we ended up in the same residency program where "batttleground friendships" are soon quickly formed after 36 hour shifts and little sleep. Nothing like defibrillating an octagenerian at 2am to bring out one's true personality.
As it turns out, Jeff (as I'll call him) was a good guy - nice, smart, compassionate - and quirky. He was fun company on call.
We used to hit the vending machines in the hospital cafeteria at 3 am when we'd trade beepers so that one of us could catch a few hours of sleep. We'd grab something unhealthy and sign out to the other person. Then one of us would go to sleep and the other would go back to the floors or the ICU.
I'd usually get an ice cream sandwich or a Reese's peanut butter cup - chocolate would give me energy for the waning hours or fill my belly, allowing me to catch some z's. Jeff would go to the same machine every night but would always get something different. Sometimes he'd happily gobble down some Doritos or peanut butter crackers, but othertimes he'd disdainfully pick through an ancient bag of trail mix or choke down some dry nilla wafers. His choices seemed weird and totally random.
After a year or so, my curiousity got the better of me and I would discreetly stand behind him pretending to search my scrubs for a wadded up dollar while he make his vending machine purchase. He was always deliberate in his choice but always purchased random foodstuffs.
After a month or so, I realized what he was doing. And, for a budding oncologist, I thought it was quirky, endearing and brilliant.
He'd always go to the same machine and buy whatever was in the slot "B-9".
Say it out loud. It seems that the guy who was going into a potentionally depressing field was also a closet optimist ...
Wednesday, February 25, 2009
Thursday, February 12, 2009
And the Russian judge only gave me a 4.5 ....
I'm not a big fan of the treadmill.
As an engineer, I think it's ingenious - if you can't move relative to the ground due to space or weather etc, then have the ground move relative to you. As a doctor, I love it becuase it can literally be a lifesaver - it's recognized as the most effective piece of exercise equipment to get your heart rate up to "training levels". It's also pivotal in cardiopumonary stress testing, etc.
As a runner, who's more of a plodder, I hate it.
It feels artificial; it's noisy; it's boring. And as a few days ago, it almost killed me.
Well, not really, but let's just say it was a wild ride.
When I run on the treadmill in the way-too-early morning at the Y, I sometimes feel like the 6 million dollar man. I wear my insulin pump on the waistband on one of my hips that has small tubing that snakes under my clothes to the infusion port on the other upper buttock. On the same buttock that the pump resides I have a continuous glucose sensor tegaderm-ed to me that beams blood sugar readings to my pump every 5 minutes. Under my shirt and against my skin, a Polar heart rate monitor fits snugly around my body just under the chest. I wear the heart monitor watch on the left wrist (I hate wearing watches). I put my iPod on the treadmill stand itself and the ear phone cords are plugged snuggly in my ears. I usually wear a baseball hat because I have the worst "bed-head" imagninable every morning. And I occasionally attach the little safety thing from the treadmill to my shorts, in case I fall off - that is called foresahdowing.
About two weeks ago I was trudging along. Thump, thump, thump. Green Day was blasting away through my headphones and the talking heads from Fox news on the tv on the wall were blathering about something - however, whoever was typing the closed captioning obviously didn't have English as their first language.
I started to feel a little lightheaded which sometimes can mean that my blood sugar is dropping. I was wearing my sensor that morning, so instead of stopping the tradmill or straddling the belt, I decided to see what the pump meter display said while I still running.
Instead of unclipping it from my gym shorts waistband, I thought it'd be easy just to twist to the right and glance at it in mid-stride.
This caused me to veer a little to the left but I caught myself and quickly corrected. However, by turning my head to the right, it caused my iPod to pull a little bit off the treadmill stand and it was now dangling close to the edge.
In what was a bad decision, I whipped my head around to try to catch my iPod as it stared to fall and I tripped over my own feet.
Never do that on a treadmill.
While it's going at 6 mph.
I saw the iPod hit the treadmill deck and it was zipped out of sight. I was heading face first into the deck myself but was able to put out my hands at the last instant.
As soon as my hands hit the moving treadmill, they whipped out of the way and I was now forward rolling on to my back (instinctively tucking my head, thank god). I landed on my back, upside down on the treadmill and was instantaneously shot off the back of treadmill onto the floor of the gym where upon landing, I think I yelped like a little girl as the momentum flipped my over onto my stomach where I came to rest, facedown.
I quickly got up and mentally checked for blood and broken bones and despite a little rugburn on my back, I was fine.
I was in the back row of the treadmills because I am very antisocial at that time of the morning - so there is nothing behind me, thank god once again. There had to be 30 other people in the gym at that time, but no one saw it. Or maybe no one admitted it because this is Minnesota after all.
I started to laugh as I picked up my stuff off the floor. The "safety stop" cord was still attached to the machine and was dangling straight down - it had failed miserably in what it was supposed to do, instead of flinging me across the room. I was now fully awake, that's for sure. I got back up on the treadmill and slowed it down to an easy walk. I couldn't help just chuckling and shaking my head - like most people do when they have near death experiences.
After a minute I realized I never got a chance to see what my blood sugar was. I almost instinctively did it again - contorting my body instead of stopping and looking at the screen like a normal person, but I stopped myself at the last minute - I straddled the belt, unclipped my pump and was happy to see that my blood sugar was in the normal range.
I think I'll go back to the rowing machine next week.
As an engineer, I think it's ingenious - if you can't move relative to the ground due to space or weather etc, then have the ground move relative to you. As a doctor, I love it becuase it can literally be a lifesaver - it's recognized as the most effective piece of exercise equipment to get your heart rate up to "training levels". It's also pivotal in cardiopumonary stress testing, etc.
As a runner, who's more of a plodder, I hate it.
It feels artificial; it's noisy; it's boring. And as a few days ago, it almost killed me.
Well, not really, but let's just say it was a wild ride.
When I run on the treadmill in the way-too-early morning at the Y, I sometimes feel like the 6 million dollar man. I wear my insulin pump on the waistband on one of my hips that has small tubing that snakes under my clothes to the infusion port on the other upper buttock. On the same buttock that the pump resides I have a continuous glucose sensor tegaderm-ed to me that beams blood sugar readings to my pump every 5 minutes. Under my shirt and against my skin, a Polar heart rate monitor fits snugly around my body just under the chest. I wear the heart monitor watch on the left wrist (I hate wearing watches). I put my iPod on the treadmill stand itself and the ear phone cords are plugged snuggly in my ears. I usually wear a baseball hat because I have the worst "bed-head" imagninable every morning. And I occasionally attach the little safety thing from the treadmill to my shorts, in case I fall off - that is called foresahdowing.
About two weeks ago I was trudging along. Thump, thump, thump. Green Day was blasting away through my headphones and the talking heads from Fox news on the tv on the wall were blathering about something - however, whoever was typing the closed captioning obviously didn't have English as their first language.
I started to feel a little lightheaded which sometimes can mean that my blood sugar is dropping. I was wearing my sensor that morning, so instead of stopping the tradmill or straddling the belt, I decided to see what the pump meter display said while I still running.
Instead of unclipping it from my gym shorts waistband, I thought it'd be easy just to twist to the right and glance at it in mid-stride.
This caused me to veer a little to the left but I caught myself and quickly corrected. However, by turning my head to the right, it caused my iPod to pull a little bit off the treadmill stand and it was now dangling close to the edge.
In what was a bad decision, I whipped my head around to try to catch my iPod as it stared to fall and I tripped over my own feet.
Never do that on a treadmill.
While it's going at 6 mph.
I saw the iPod hit the treadmill deck and it was zipped out of sight. I was heading face first into the deck myself but was able to put out my hands at the last instant.
As soon as my hands hit the moving treadmill, they whipped out of the way and I was now forward rolling on to my back (instinctively tucking my head, thank god). I landed on my back, upside down on the treadmill and was instantaneously shot off the back of treadmill onto the floor of the gym where upon landing, I think I yelped like a little girl as the momentum flipped my over onto my stomach where I came to rest, facedown.
I quickly got up and mentally checked for blood and broken bones and despite a little rugburn on my back, I was fine.
I was in the back row of the treadmills because I am very antisocial at that time of the morning - so there is nothing behind me, thank god once again. There had to be 30 other people in the gym at that time, but no one saw it. Or maybe no one admitted it because this is Minnesota after all.
I started to laugh as I picked up my stuff off the floor. The "safety stop" cord was still attached to the machine and was dangling straight down - it had failed miserably in what it was supposed to do, instead of flinging me across the room. I was now fully awake, that's for sure. I got back up on the treadmill and slowed it down to an easy walk. I couldn't help just chuckling and shaking my head - like most people do when they have near death experiences.
After a minute I realized I never got a chance to see what my blood sugar was. I almost instinctively did it again - contorting my body instead of stopping and looking at the screen like a normal person, but I stopped myself at the last minute - I straddled the belt, unclipped my pump and was happy to see that my blood sugar was in the normal range.
I think I'll go back to the rowing machine next week.
Monday, February 9, 2009
Friday, February 6, 2009
Brother, can you spare a dime ...
... Well, this recession or correction or whatever is hitting people pretty hard.
I'm not going to pretend that I'm some financial wizard or economic know-it-all; I've always been a selfish bastard when it comes to the vagaries of the economy and the GNP et al. I want to know how it affects me and mine. What action do I need to take to ensure I get to retire before I'm old and limbless or let me buy the flat screen TV without having to skimp of necessities - fast food, "man toys" and Peter's shoes.
I thought that by being in the medical field, I was insulated against recessions. Hell, everybody gets sick - everybody needs health care.
Or so I thought.
My clinic schedule has been anemic the last few months; probably only seeing 1/2 to 3/4 the usual amount of patients. My phone and email "in basket" however is overflowing with work.
While some of my less fortunate patients have lost health care altogether, others can't afford the co pays. So instead of coming in for a cold, the medication refills for hypertension, the "itching down below" and the occasional growing lump - I'm getting deluged with people wanting to be treated over the phone or the Internet.
I understand and I can treat sometimes, but most times, I can't - practically (ever have a patient try to describe a rash over the phone? "It's red") or legally (who wants to be the doc who misses the patients signs and symptoms of a stroke because they aren't able to do a good neurological exam?).
Patients invariably get upset and complain about high-deductible plans and that I'm saying they need to come in because I need to pay off my yacht, etc. Or serve my poodle steak tartare.
I empathize, but believe me, I don't have a yacht and my wife's allergic to dogs. Yes, I make a good amount of money but I'm 39 and still will be paying off my student loans (which amount to a nice sized mortgage payment every month) until I''m 50!
I feel the recession too. Less patients mean less income for me. Most physicians are not paid on salary, then get paid according to a compensation package that is based loosely on seeing patients. So, at this point in my life, I'm getting trickled down upon - or is that trickled up? Who knows? All I know is that it sucks.
Getting back to patients who don't want to come in - I had a gentleman, whom I knew pretty well, contact me to complain about belly pain. This is a big, old stubborn Minnesota man who never complained of anything - ever - even after getting shot in the head in the Korean War. We played phone tag with symptoms for days and finally I told him he had to come in for an exam and there was nothing else I could do over the phone.
He reluctantly showed up for the appointment and bitched the whole time. After a few minutes, it became clear that the "belly pain" he was referring to was actually lower chest pain (I guess he missed anatomy class in high school). I got an EKG and a chest x-ray ("doc - this isn't covered by my deductible!") - it looked like he was having a stuttering myocardial infarction probably due to an aortic aneurysm that was slowly rupturing in his chest. I told him we had to get him to the ER immediately and he needs surgery within the hour or he was going to die.
He sighed, looked at the ground for awhile and finally said, "shit ... this is going to fuck my premiums up."
He had the surgery and didn't damage his heart (too much) and is doing well postoperatively, thank god. But if he didn't come in, he would've died. If he came in sooner, he might have saved some of his heart muscle that infarcted.
As stated earlier, I don't know what's wrong with the economy - but for all my reasons, it's gotta get fixed. Soon.
For now, I'm just waiting on my tax refund.
I'm not going to pretend that I'm some financial wizard or economic know-it-all; I've always been a selfish bastard when it comes to the vagaries of the economy and the GNP et al. I want to know how it affects me and mine. What action do I need to take to ensure I get to retire before I'm old and limbless or let me buy the flat screen TV without having to skimp of necessities - fast food, "man toys" and Peter's shoes.
I thought that by being in the medical field, I was insulated against recessions. Hell, everybody gets sick - everybody needs health care.
Or so I thought.
My clinic schedule has been anemic the last few months; probably only seeing 1/2 to 3/4 the usual amount of patients. My phone and email "in basket" however is overflowing with work.
While some of my less fortunate patients have lost health care altogether, others can't afford the co pays. So instead of coming in for a cold, the medication refills for hypertension, the "itching down below" and the occasional growing lump - I'm getting deluged with people wanting to be treated over the phone or the Internet.
I understand and I can treat sometimes, but most times, I can't - practically (ever have a patient try to describe a rash over the phone? "It's red") or legally (who wants to be the doc who misses the patients signs and symptoms of a stroke because they aren't able to do a good neurological exam?).
Patients invariably get upset and complain about high-deductible plans and that I'm saying they need to come in because I need to pay off my yacht, etc. Or serve my poodle steak tartare.
I empathize, but believe me, I don't have a yacht and my wife's allergic to dogs. Yes, I make a good amount of money but I'm 39 and still will be paying off my student loans (which amount to a nice sized mortgage payment every month) until I''m 50!
I feel the recession too. Less patients mean less income for me. Most physicians are not paid on salary, then get paid according to a compensation package that is based loosely on seeing patients. So, at this point in my life, I'm getting trickled down upon - or is that trickled up? Who knows? All I know is that it sucks.
Getting back to patients who don't want to come in - I had a gentleman, whom I knew pretty well, contact me to complain about belly pain. This is a big, old stubborn Minnesota man who never complained of anything - ever - even after getting shot in the head in the Korean War. We played phone tag with symptoms for days and finally I told him he had to come in for an exam and there was nothing else I could do over the phone.
He reluctantly showed up for the appointment and bitched the whole time. After a few minutes, it became clear that the "belly pain" he was referring to was actually lower chest pain (I guess he missed anatomy class in high school). I got an EKG and a chest x-ray ("doc - this isn't covered by my deductible!") - it looked like he was having a stuttering myocardial infarction probably due to an aortic aneurysm that was slowly rupturing in his chest. I told him we had to get him to the ER immediately and he needs surgery within the hour or he was going to die.
He sighed, looked at the ground for awhile and finally said, "shit ... this is going to fuck my premiums up."
He had the surgery and didn't damage his heart (too much) and is doing well postoperatively, thank god. But if he didn't come in, he would've died. If he came in sooner, he might have saved some of his heart muscle that infarcted.
As stated earlier, I don't know what's wrong with the economy - but for all my reasons, it's gotta get fixed. Soon.
For now, I'm just waiting on my tax refund.
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