Snippets VIII

THAT LOOK WHEN the pregnant patient whom I am interviewing, trying not to get high myself as she emanates reefer fumes, asks me, “Is amoxicillin safe for my baby?” (This after I had diagnosed her UTI, and was in the middle of prescribing amoxicillin to treat same)

ANOTHER DAY, ANOTHER CHILD OF GHAWD relating that their malfunction is “I have a sinus infection”. I perform my usual review of systems, featuring denial of fever/chills, and no at home treatment over the 3 days of illness that drove this soul to my clinic.

Physical exam did NOT reveal any positive findings, except for mucus coursing down the back of this soul’s throat. I provided my assessment, and my basis for that assessment, including “…if you had a bacterial sinusitis, you would have leaped off the table and yelled at me when I tapped on your sinuses!”

This soul replied, “Oh, well, I NEVER get sinus tenderness with my sinus infections!”

Not being in a mood to argue, I smiled, did NOT observe that marked sinus tenderness is one of the CARDINAL signs of bacterial sinusitis, and said, “Here’s your augmentin prescription. Have a pleasant day!”

A FEW WEEKS AGO, TDW-Mark II had a migraine, and it took it’s sweet time resolving. I had to work, and came home to find my bride upright and preparing some soup (this being an improvement). I asked how her day had gone.

“Well”, she began, “the migraine was unpleasant, like they always are. This time, every time I woke up from my multiple naps, there were six cats perched on the bed, as if they were on watch. You know, if one or two others had joined them, I was going to call you and insist that you come home!”

Fortunately, her furry caregivers determined that, the next day, she only required 4 in attendance at any one time, and so, she recovered, as the cats weaned her off from a high level of feline supervision.

ONE DAY, my MA asked (it seemed to me, from out of the blue), “What do you want on your tombstone?”

I spread my hands, fingers wide, and stated, “Like this , with fewer fingers.”

She smiled. “Wow, kinda harsh! I meant on your pizza. THAT escalated quickly!”

Advertisement

Dressing For Success

One time, my family gathered at a restaurant in Greektown, celebrating one occasion or another. This was in Downtown Da City, and, at this time, there had developed the phenomenon of flash mobs, wherein high spirited youths would apparently spontaneously congregate at one location or another, and in the course of the festivities, civilians, otherwise uninvolved with the group, would be assaulted and robbed.

TDW-Mark II and I spoke of such an event, and the potential for same to develop when our children, and grandchildren were at hand, and decided that this Would Be A Very Bad Thing. We selected our wardrobes accordingly.

It turns out that my son in law, my daughter, and my brother, all feel similarly about this sort of thing, for, when I counseled my sister in law, a very nice (and very naive) soul that, “If a group of folks all enter this restaurant all at once, I will tell you to take the children into the kitchen of the restaurant, and keep them there. Under no circumstances are you, or any of the children, to re enter the dining room, unless one of us physically arrives to escort you out!”

She protested, “But, we aren’t allowed into the kitchen!”

I showed her my wolf grin. “If I tell you to do so, I guarantee that nobody will say a word about you and the children being in the kitchen. The noise will be way, way too loud for you to hear them, if they were to do so!”

She looked puzzled. My son in law explained. “Mary, if Brenda grabs the kids and beelines to the kitchen, two things: do not be left behind, and do NOT get between her and the kitchen door!”

“Why is that?”

“If you are between Brenda and the kitchen door, and one of the ‘celebrants’ starts into the kitchen, he will be shot. Do not be in the way.”

Mary turned back to me. “Why would they try to go into the kitchen?”

I wolf grinned her way, again. “Because I had failed to kill them.”

My son in law chimed in, “I will have missed them, too!”

TDW-Mark II joined in. “Me, most likely I will have run out of ammunition. I do not plan to miss!”

My brother observed, “And, I will police up the stragglers, if any!”

Looking aghast, Mary declaimed, “You cannot believe that anybody would try to hurt somebody at random! I just do not believe such a thing could happen!”

TDW responded, “You just keep on believing that. In the meantime, if The Stretcher Ape tells you to get into the kitchen with the kids, do so right fucking now, pretty please?”

Abandonment, and Trust Issues…

A while ago I had an MA assigned to me. She was (is) capable, focused, intelligent, and engaged; she maintained awareness of what else was occurring in the department, and reacted promptly and appropriately. (She was the protagonist of the tale of the early morning floppy child)

As things developed, she had an opportunity to transition to a day shift, Monday to Friday, 9 am to 5 pm, work-no-weekends-or-holidays job (in contrast to our present work-til-9-pm, every other weekend, every other holiday scenario). And! Get a raise in pay!

Naw, I cannot see why she would entertain such an opportunity for a single second, either.

So, of course, I teased her. “Oh, I see how you are! You would rather spend time with your husband, with your children! Oh, yes, I suppose all that is just fine for you, but what about ME?”

As you might expect, she started her new job, and, occasionally, took some overtime, working with me from time to time. Of course, each time I would tease her. “Oh, I see! Now that you are dead to me, NOW you come back, just as I was resolving my grief at your cruel abandonment of me!”

My partner joined in, observing, “You know, if you came back to work in this department again, you could never break up with him ever again! He has been an embittered husk of a man, since you left!”

(This is the same partner who observed, when I once wore a fleece prominently displaying the fact that it was an item from the National Rifle Association, by means of the 2 inch tall initials “NRA” over the left breast, let me know, “You know, they spelled your name wrong on your coat!”)(My name is “Tom”)

We reached a lull one overtime night, and I renewed my teasing. “You know, I taught you everything I know, while I was standing on one foot, and you abandon me! Oh, yes, you have a ‘HUSBAND’, and you have your ‘CHILDREN’, you have dreams, and plans for your life, but, what about MEE?!?”

She chuckled.

Serendipitous Connections.

Among the maladies that motivates folks to come visit me in the clinic, is that their infant has diaper rash, also known as diaper dermatitis. Should this persist past, say, 3-5 days, there is an increased likelihood of Candida (you may recognize it as yeast) joining in to add to the discomfort. Yeast (Candida) is commonly found in stool, and, well, with infants, stool in the diaper is a common occurrence. If there is diaper rash, susceptibility to candida climbs.

So, microorganisms really, really like a particular set of conditions in order to grow and proliferate. Generally, that includes warmth (like you might find beneath a diaper, for example), moisture (which just MIGHT be found, beneath a well fitted, and perhaps, oh, gosh, let’s spitball here: wet! diaper) as well as darkness, so that those pesky UV rays do not disturb the microorganism’s DNA, as well as that nasty old sunlight not drying out the area of operations.

This being The Un-Named Fly Over State, and deer hunting being nigh unto the State Religion, once you get into the outer ring of Big City Suburbs, most folks recognize the existence of a program known as Quality Deer Management (QDM). The premise is that, should the landowner provide for high quality food (acorns, or suchlike), access to water (ponds do nicely for this), shelter (like deer tend to find in a woodlot), AND you avoid hunting young bucks, then you tend to hunt, and harvest, larger, healthier bucks in later years simply because you provided an environment conducive to such bucks reaching maturity, in an environment providing them with their needs.

Therefore, when I suggest that parents who attempt to provide an environment that DOES NOT provide these elements to the germs in their child’s diaper, the child is likely to have fewer episodes of diaper rash, of shorter duration, and less likely to require my attention. That means, naked babies (generally in the kitchen, on the linoleum), kept meticulously clean using bland soaps and tepid water, with their (the babies) bottoms protected from the irritant effects of urine and stool by such means as petroleum jelly. That means, to those steeped in such things (like your Mark 1, Mod Ø deer hunter), that concerned parents do THE OPPOSITE of what QDM practitioners do for deer. Take you kid’s germs, and dry ’em out, blast them with sunlight, cool them out, and let Nature, and your child’s immune system, take care of business.

Serendipitous connections.