Sorry, but I just have to complain...

There are two things that drive me absolutely bonkers when dealing with doctors from other specialties. Numero uno: I HATE it when they TELL me what to do when they are REQUESTING a consult. Numero dos: I HATE it when they tell the PATIENT what they think I should do.

Why the hell consult me then? Just do the damn thing yourself, if you know so much.

I mainly get it from the ER. The fastest, best, easiest way to bring out the raging bitch in me is to say to me when I answer a page, "You need to come down and do surgery on this patient." I'll tell you EXACTLY what YOU need to do. It involves you eating your fecal words. And perhaps a satisfying kick in the perineum, or as the high class folk call it, 'taint. Seriously. I am the gynecologic specialist. I decide who I take to surgery. I am THE 'taint specialist, aren't I? That's why you called.

Here's a tutorial for all you ER doctors who aren't reading this blog on what to say to a physician you are consulting, "Hello Lu, this is Jose. I think I have a patient here with a ruptured ectopic. Will you please come and evaluate her?" I will be halfway to the hospital by the time you finished saying "ruptured ectopic." You do not have to order me to do surgery. Because, half of the time, you are wrong, and she's just on her period and having the motherload of all menstrual cramping (or she's just really wanting to take a pregnancy test but didn't have $10 and a ride to Walgreen, so she call an ambulance at 2am to bring her to the ER instead. Happens all the time. For reals.) And half of those times, you've already told the patient that I, the gyn specialist who as yet to even LAY EYES ON HER, will be taking her back for surgery. Arghhh.

I was recently double teamed. I answered a page, basically one of my general surgery colleagues was calling to inform me that I was to take a particular patient to surgery . OK, I thought. This weird. I and several of my partners had been following her and deemed her issue non-gynecologic. So, no, I will not be taking her to surgery. His argument was, another doctor and he have decided that this WAS a gyn issue, so I HAVE to take her to surgery. Silly me, I thought I was the specialist in this field. I suppose if two psychiatrists, one dermatologist, and Joe Smoe on the corner of 8th street SAY its gyn, then it MUST be. Hand me the scalpel!


My answer to him was No, I am not taking this poor woman for unneccesary gyn surgery. I almost laughed when he sputtered, So you aren't going to take her to the OR? What are you going to tell the patient?

I was thinking in my head, YOU go talk to the patient. You made the mess.

Of course, at the end of the day, all this is B.S. What really matters is the patient and her health. My partner did go and explain everything to the patient and offered to help in anyway. She offered a myriad of medical treatments for the possible diagnoses on the differential. She offered the patient that someone from our practice would be willing to participate in the operation as a consult, should surgery decide to operate. And general surgery did end up taking her to the OR, and surprise! surprise! there were no gyn abnormalities, just general surgerical issues.

So I win. I may look young and inexperienced. I maybe short. Very, very short. I am woman practicing medicine in a good ole boy's club. But ain't nobody's gonna bully me into practicing bad medicine. So SUCK IT, BOYS!

Who am I?

I just got home from the hospital and its 4am. The reason I am not snuggled in my bed is because I got thinking about how I portray myself to others. There was a time, a loooooong time, when I really cared about how others perceived me. Mostly like a moron, I know, but the point is that it bothered me that many people thought I was a moron.

Now that I am where I am, I don't care. I really don't. But I wonder if I should. I think I am part 12 year old boy and it's trying really hard to come out. There is a new show on Discovery Health about three female OB/GYNs who trained together and now practice together in LA. I have watched a couple of the episodes and thought, "That's totally me!!! They stole me and my partners! We were them first!" Except not really. All of the them are articulate and put together. I am not. I can sound pretty smart if I really really try. The thing is, I AM pretty smart. But when I am relaxed and talking without thinking I sound like a 12 year old boy. From the hood.

Example: coming out of the a patient's room, I was holding a glass slide a heading towards the microscope to examine it. The charge nurse looked up and asked me what I was holding. Immediately I said, "Cooter Juice."

Whyyyyyy??????

Easily could have said, "ruling out rupture of membranes" or "checking for ferning" or something professional. But nooooooooooo. I said "Cooter Juice." And yes. With capital letters, like it was an official medical term.

I feel..... not bad at all. But, I know that I have shamed my family (by family, I mean husband who works in the same hospital)

I routinely go to work with no make up and in scrubs. On the one or two occasions that I see my husband at work, he always tells me I look a mess. He never goes to the hospital without dressing in at least business casuals, even on weekends or ungodly hours of the night.... just in case. I think that I have run to the office in my pajamas to grab paperwork.

Professionalism is important. As a doctor, I know how important it is for my patients to have confidence in my abilities. I will never show up to work in ripped jeans with a hot pink thong peeking out from my plumber's crack. I will never use dirty curse words in front of my patients. I will never consciously walk around with my fly open and boogers on my face. But I suppose I need to find a balance between the pimple faced adolescent and the specialty trained surgeon in me. So next time my answer to the charge nurse will be, "I am checking for presence of amniotic fluid in this Cooter Juice."

My Auntie says...

The following words have come out of actual patients' mouths. I am in private practice and my patients are generally well-educated... supposedly.

Patient #1: Doctor, I've been doing the "Dairy Diet" for a few months now and I am gaining weight instead of losing it! I think there is something wrong with my hormones.

Me: What's the Dairy Diet?

Patient #1: Well my auntie told me about it. She said that I had to eat a lot of diary throughout the day, so I've been eating at least 4 bowls of ice cream a day, but I still keep gaining weight!

Me: Oh my...

_______

Patient #2: I don't know why I keep getting yeast infections.

Me: review ways to avoid yeast infection, blahblahblah, including eating a lot of active cultures, like yogurt.

Patient #2: Oh, you are suppose to eat the yogurt?! My auntie told me to put the yogurt up my vagina

Me: Oh my...

_______

Patient #3: There's something wrong with your office. Every time I come, your scales say I weight over 300 pounds! I know I don't weight 300 pounds. All my friends and aunties say that I don't look like I weight 300 pounds.

Silent Me: sucka...

Decisions

Life for me is a daily struggle between giving enough of myself to my children, my husband, and my patients. These three things are just so important to me and I feel like all of them deserve my everything. But to do that is an impossibility. Therefore, I live in constant guilt.

Occasionally, I get a little glimpse that I've made a correct decision. For example, when I say "screw it" to all the paperwork and charting I have to finish, and just sing and dance like crazy with Little Ninja (2 year old daughter) or just lazily breastfeed Meat Ball all afternoon. Or when I miss out dinner, bath, and bedtime with my kids to stay late with a patient in the hospital just because I get a gut feeling that extra attention needs to be paid.

Today I was seeing a routine postpartum patient who I induced because she just had a very strange presentation near term. She had a strange fever, nonspecific symptoms, and just a bad feeling. I got it too. I found a reason to proceed with the induction and she delivered a healthy baby. The fever spontaneously resolved, and she and her infant did very well and went home normally.

So today, after I completed her postpartum exam, she turned and hugged me. "Thank you so much for listening to me, " she said. "I really felt like something bad was going to happen to me if I didn't deliver that night. I had a feeling that I might die." This patient is extremely sensible, not melodramatic in the least bit. It scared me a little to hear her say that, because I had a similar feeling as her doctor. I can't explain medically what her ailment was exactly, but I just had a strange premonition that if I just sat on her and waited it out, she would have fared poorly. There are a lot of reports of patients who had premonitions of impending doom closely before their deaths. As a medical doctor, the more I practice and study medicine, the more I see a connection between mind and body. It made my shudder to hear her words, since I didn't know it at the time. But it also felt good to know that sometimes sacrificing a little bit yields greater rewards.