Saunas are pleasant. Summer is pleasant. Working in an unairconditioned clinic in an exam room the size of an elevator is decidedly unpleasant. Our clinic, which is located in the bottom level of a large old building, has central heat and a/c. What that really means is that my office is freezing all winter, and as soon as the weather starts to heat up the exam rooms become stuffy little coffins. The temperature inside of the clinic hit 87 degrees this week–like working in the tropics, minus the ocean breeze and scenery. I spent all of my days this week sweating in my polyester jacket, trying to look attentive to my patients while secretly praying: Talk faster, so we can finish and I can open this goddamn door and get some air. Run-of-the-mill depression becomes mind-numbingly-dull depression, and poorly controlled diabetes goes from tedious to torturous. And any exam that involves bodily fluids or private parts…man oh man. Let me tell you, doing a pelvic exam on a very obese woman with yeasty, moist abdominal folds in a hot little room is not something I am looking forward to doing again. If I can survive the next few weeks, the building’s central air will finally kick in, and I’ll spend the summer in a frosty wonderland. Of course if last year was any indication, the central air will shut off before the last heat wave of the fall, and we’ll spend one more week of steamy hell before winter.
more haiku April 21, 2008
It’s sunny outside
Why am I locked in a room
With these sick people?
Our dog is puking
The fact that I am a nurse
Does little to help
Guy wants pain meds, but…
Positive for cocaine in
the urine tox screen
Love me some benzos April 15, 2008
I am noticing that one of my biggest challenges in mental health treatment is getting my patients to want to try anti-depressants instead of just benzodiazepines. Yes, benzos are fast-acting, offer immediate relief from anxiety and have the added benefit of making someone feel pretty damn good for a little while. Why would someone want to trade that for the orgasm-killing, disappointingly not noticeable short-term effects of an SSRI? And the vague threat of physical dependence seems pretty unimportant to most of my patients, especially when compared to the daily desperation of their lives. I spent a lot of time trying to explain to people why a benzodiazepine alone is not the optimal treatment for anxiety and depression. And even after all the explanations, patients still say “But my Klonopin works for me. Why do you want to put me on something else?” Arrrgh.
Out of the scabies closet April 14, 2008
I’m going to admit something: I have had scabies. And also headlice. Thankfully, not at the same time, but they are both horrible ailments in their own right. I got the scabies in college from a stereotypically hippie-esque box of unwashed free clothes. Sadly, I refused to admit that I might have scabies (a disease I associated with unwashed rednecks) until I had a comically disgusting full-body rash. Let me tell you, the itching from scabies is no joke! And the humility required to inform your sexual partner that you have probably given them scabies is also no joke.
I had headlice twice as a child, and once as a teenager (I got it from the kids I babysat). The awkwardness of confessing your scabies-infested status to a lover is not nearly as hard as telling your teenage friends that you may have given them all lice. And the tedious lice-combing is a form of torture in itself.
Why do I bring up all these traumtatic adolescent memories? Because I feel sorry for my patients that have scabies. Not only because I know firsthand that their itching is terrible, but also because the world is not very sympathetic to their plight. We have a lot of patients who have scabies, and the staff (including providers) can be pretty harsh. Yes, scabies is a contagious, parasitic illness. But it doesn’t mean that you need to make faces behind someone’s back or scream in horror when you hear that the patient that you just saw has it. Can’t we be a little more professional, people? As long as you don’t have extended skin-to-skin contact (which I never want to have with my patients anyway), you’re unlikely to get it.
My gay brothers and sisters April 2, 2008
When I moved away from San Francisco, I knew that there would be no more drag-queen nuns with names like “Sister Helen Wheels” or “Sister Flora Goodthyme.” Very sad.
But stuffy, East-Coasty Boston was a gay mecca compared to my new community. When I first started working in my clinic, the only gay doctor told me “Even though we live in a liberal state, we might as well be pre-Stonewall here in [town name].” Hmmm, I thought, that sounds rather exaggerated. Sadly, after working with several gay, lesbian and trans patients, it seems to be true. Perhaps it’s just a function of the poverty of my patients, but there is a certain fabulosity and sass that seems lacking here. Several of my LGBTQ patients know of only a few other gay people besides themselves. Most of them are not out and proud. A couple people are trapped in bad relationships–in part, I suspect, because the pool of single fellow queers in their neighborhood is the size of a kiddie pool. Even my cute, young butch co-worker who is going to college doesn’t seem to know about LGBTQ community. The other day, I asked her if she knew a word in Spanish that someone had told me meant “butch female” (machora? machua? still not sure how to spell it). My coworker, sitting there in her crew cut, men’s dress shoes and button down shirt, laughed and said “Well, I don’t know any of them so I guess that’s why I don’t know the word.” Um, hello? You’re living the life, sister!