Category: Narcissistic self-involvement

There’s no way a day can be entirely predictable, but I do like sharing a glimpse into the personal/professional life every once in a while. You see, the personal and professional can’t be so easily disentangled, and whether you are a physician, scientist, grad student, or barrista, you only have one “real life”.

0600: Pager. Nurse reports Mrs. M. has a very high fever and foul-smelling urine. I order cultures and antibiotics, and wander sleepily toward bathroom.

0605: Offspring bursts into bathroom excitedly. “Daddy, I had an accident and I was a little wet and I changed my diaper and my pyjamas all by myself and now I have to go potty and I’m going by myself and can you get out of the way cuz I have to go now and please turn on the lights so I can see and I’m not tired can you come cuddle?”

0610: Cuddle in bed with four-year-old insomniac

0630: Give up and watch Disney while eating waffles

(the rest is predicted)

0800: Arrive at office and look at pile on desk, despondently. Accept scolding from office staff.

0830-1200: See patients at office

12:30: Visit elderly patient with foul-smelling urine and fever.

12:45: Visit dear friends in ICU, one of whom is getting a dose of chemotherapy, the other sitting next to her.

1300-1630: Supervise medical residents in their outpatient clinic.

1635-1700: Check back in with friends in ICU.

1700-2100: Supervise residents in outpatient clinic.

2200: Arrive home, tip-toe into precocious child’s room, kiss and tuck in.

2220: Hang out with spouse, finally.

2330: Fall asleep, hopefully.

There’s been a lot of talk about the work hours of resident physicians. Given that sleep deprivation has been shown to impair various aspects of human performance, it certainly seems reasonable to limit the level of “resident impairment”. But we have surprisingly little data to work from. And, for better or worse, physicians post-residency don’t have much of a choice when it comes to work hours.

My wife often remarks on how I’m able to answer a page out of a deep sleep, give orders, and go back to sleep. Upon morning review, these orders do, in fact, make sense. It was my training that allowed me to be able to function this way, and it’s a damned good thing. I’m not arguing that residents should be worked into the ground like in the good old days. We must take into account the impairment that lack of sleep may cause, but we must also recognize that learning to think and act under a variety of conditions is important. Also, patient continuity of care is important, and the more that a patient is “handed off” from team to team, the less likely any one doctor is to take responsibility for that patient.

But that’s not really what I meant to write about. Let me give you an a glimpse of doctoring in real life.
Continue reading “Doctoring in real life”

Perhaps because I don’t blog anonymously, or maybe for other reasons, I don’t write that much about my personal life. That kind of writing can be self-important, insipid, and boring. But it can also have real power. A number of the anonymous bloggers here describe the intersection of the scientific life and family life with powerful relevance. Still, that’s not my talent, and I don’t do it much. One of my med school classmates, when I showed him one of my first pieces, said, “that’s good, Pal, but how do you feel?” That has always stuck with me (thanks, S!), and it’s in that spirit, and not the spirit of kvetching, that I’d like you to know that doctors are human. Yeah, I know, no surprise there, but still, sometimes patients forget it, and more important, sometimes doctors forget it. Besides, since no one reads the blogs on Sunday, it’s a good day for self-reflection.

I come from a family of very smart people. Very smart—sometimes I feel like the village idiot (but in the best possible way). They are intellectually active professionals, all have advanced degrees, and many of them are musicians as well. Along with smarts, my family has been endowed with some unusual medical problems, so even the non-medical folks have used their formidable intellects to learn a little medicine. These are not “google scholars”—these are the real thing.

So when my family challenges me about my skepticism, I have to take it seriously, not just because they’re my family and I love them, but because unlike some of the vacuous trolls that haunt this site, they’re very smart and well-informed.

I have a number of good friends and family members with cancer. Is my hypertrophied skeptical sense depriving me of sharing with them “other ways of healing”? My sister, who is pretty good at reminding me that I don’t actually know everything, challenged me pretty rigorously on my medical skepticism. Of course, my wife and cousin had to help her out. These aren’t garden-variety challenges to my beliefs. A random blog troll can bring up the same canards and fallacies over and over, but when the people you love use good reasoning and good knowledge to call you out, you gotta take it a little more seriously. When the people you love have nasty diseases, it’s got that much more gravitas. Those of us who devote our intellectual resources to science-based medicine are often accused of lacking compassion, a charge I try very hard to avoid, not because it’s false (and it is), but because compassion is the great immeasurable, the ars longa in the vita brevis. Without compassion, science-based medicine might as well hand over the keys to the reiki shamans, the homeopaths, and other smiling quacks, because no matter how right you are, a doctor who lacks compassion can’t be an effective healer.

Continue reading “Why am I here again?”

I told you earlier about Proposal 2, a proposed constitutional amendment here in Michigan. The lies being spread about this proposal are thick and vicious. Orac also goes into a bit of detail about the dishonest tactics being used, mostly by religious groups, to try and stop this prop.

Just to remind you, Prop 2 would prevent the state and local governments in Michigan from passing laws against human embryonic stem cell (hESC) research that are any more restrictive than federal law. That’s about it. The law does not set up any government agencies, taxes, fees or mandates. It only keeps Michigan safe from theocratic laws that inhibit research funded by non-governmental agencies. hESC research is a growing and important field, which has the potential to give significant insights into human disease, and perhaps some day, treatments as well. hESC’s are different from other stem cells used in laboratories. They are derived as a byproduct of infertility treatment. When harvesting eggs from a woman, there are inevitably more embryos produced than can be safely implanted in the patient, and unused embryos (each of which is a microscopic blob of cells) are usually discarded. If the parents wish, they can donate these cell clusters to science.

These are not fetuses. This is not abortion. The cell clusters have no arms and legs, no faces, nothing to identify them as anything that could grow into an animal. Any arguments that equate stem cell research with abortion are patently false.

Now some religious folks have moral objections to stem cell research, mostly those who believe that “life” begins at conception. It is unlikely that any of these people will support Prop 2, and they have an honest, albeit misguided reason for doing so.

What really gets my goat is the campaign of lies that is hiding this religious motive. Commercials are saying that Prop 2 will require government spending, will encourage selling of human parts, and all manner of weird accusations (including the man-cow hybrid thinggie).

So my wife, who is a very busy person, took some time out of a very busy day to get the word out. She went to someone’s house to pick up Prop 2 literature, read it, asked questions, and went door-to-door in our neighborhood to spread the word.

She has a lot of reasons for wanting to do this, not the least of which is our nephew, a type I diabetic since the age of four, who may stand to benefit in the future from hESC research. She rightly thinks that he is more important than the “dignity” of a few cells in a dish.

My wife, who is an educator by profession, but not a scientist, did her reading, learned what she needed to, and put together a non-partisan message to bring to our neighbors. It took a lot of chutzpah, and I’m just so darn proud of her.

On Saturday, I’ll be heading up north. Way up north. To the north where the precious intertubes do not reach, where pagers are for skipping across the water, and cellphones are coasters. It’s that far north.

I’m going to take pictures, and take notes, and my plan is to have a bunch of non-medical, non-debunking posts to write when I get back. I think.

Anyway, just because we aren’t posting a ton over the next week doesn’t mean you should delete the feed.

I almost forgot! It’s my blogiversary! On May 21st of 2007, I opened my WordPress blog after keeping a few notes on Blogger, which I didn’t love. I started out blogging about the abomination that is Conservapedia, added my own medical musings that I had collected over the years, and then branched out into the world of medical science, skepticism, and whatever else I wanted to do. In the 10 months I was at WordPress, I published 332 posts. In my first full month online, I had 381 visits. In August of 2007, I had almost 22,000 page views.

In March of this year, the Hoofnagle brothers invited me to come over to denialism blog here at ScienceBlogs, and the opportunity to work with other dedicated writers has been terrific.

I love to write, and the blogsphere has been very good to me. Thanks for visiting.