The magical mystery land of community health

I don't make this stuff up!…but I do change identifying information.

Sunday Haiku November 29, 2009

Filed under: Uncategorized — lesbonurse @ 9:51 pm

New vocal hoarseness:

Move turtleneck aside and

Whoa!! Giant goiter.

Your blood sugar was

four hundred after dinner?

Happy Thanksgiving.

Got a thank you card

from a sweet, thoughtful patient.

Shed a little tear.

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Yes, some doctors have a warped sense of humor November 25, 2009

Filed under: Uncategorized — lesbonurse @ 2:48 am

Overheard while sitting in the staff office:

Doctor Cuts-a-lot (he loves to do I & D’s) returns from draining someone’s abscess and states happily “Now that was some export-quality pus!” Um, yes. Our community is known for its fine, export-quality pus. Perhaps we can shore up the horrendous economy here with a side business in pus exportation.  wtf?

 

Reflections on growing up November 22, 2009

Filed under: Uncategorized — lesbonurse @ 3:33 pm

November is my birthday month, and it’s also the month that it starts to get really dark at 5pm. These two things never fail to put me in a reflective, somewhat melancholy mood. This year I’ve been thinking a lot about what it’s been like to have left my wild adolescence behind. I’m basically a totally respectable adult now, in my 30’s, with not just a job but a career. Frankly, it feels weird. Some part of me never thought that I would grow out of my rebellious youth, despite all evidence to the contrary that most adults do (and in fact, it’s a little creepy when adults try to maintain their youthful rebellion past their 20’s). Although you could argue that I am still fighting The Man every day with my LGBTQ-friendly community health services, it’s a very different kind of “fight the power” feeling than it was to show up at a big protest march with a bunch of black-clad anarchists. Arguably, I’m actually doing more to fight the power now, but it’s just not as dramatic.

I’m not trying to say that I didn’t want to grow up. You can only sleep on a thin futon mattress in a dirty shotgun flat for so long before it stops being exciting and starts being uncomfortable. Likewise, dancing and drinking and picking people up in bars and then going to work the next day is only sustainable for so long, and after that it gets exhausting. Now I get a good night’s sleep and march into exam rooms, wearing a white coat and authoritatively giving people instructions and diagnoses, standing in my fun-but-not-too-funky-for-work heels and pantyhose (i mean seriously, pantyhose?! i really never pictured that when i was younger), and people look at me and see someone respectable. It’s weird, I tell you. Just weird.

I feel very lucky to have made it through my adolescence and young adulthood relatively unscathed, despite some very poor choices that I made along the way. I credit a few things for keeping me on the thin line between rebellion and disaster. My parents gave me a strong foundation of literacy very early on. They may have made some mistakes in other departments, but my love of reading really took hold and kept me at least partially invested in school. I was also in a magnet program throughout my public school education–where the prevailing attitude wasn’t “IF you go to college…” but “you WILL go to college”–and lo and behold, I wanted to go to college. In fact, I wanted to go to college so much that I made damn sure I was on birth control so I wouldn’t get pregnant and ruin my life when I started having sex, and I stopped doing drugs when I got worried that I might develop a habit. Partially, this is due to genetics. I was born pretty smart, and that helped. And I must not have the genetic predisposition for addiction, because certainly I had the opportunity to develop one. I am eternally thankful that I dodged that bullet. I guess it was luck, with a little hard work and some drive to succeed thrown in, that finally brought me to where I am today. And now I sit at work–my white coat covering tattoos, facial piercings long since removed, the ghost of my youthful self marveling at at this new specter of adulthood.

 

I remember you November 20, 2009

Filed under: Uncategorized — lesbonurse @ 11:20 pm

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https://i0.wp.com/www.transgenderdor.org/wp-content/uploads/2009/09/paulina_ibarra1-450x250.jpg

Paulina Ibarra
Location: East Hollywood, California
Cause of Death: Stabbed to death
Date of Death: August 28, 2009
Paulina was found dead inside her apartment, she had
been stabbed to death. Paulina was 24 years old.

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Kamilla
Location: Volgograd, Russia
Cause of Death: shot to death
Date of Death: June, 2009
Was shot to death by her boyfriend Vladmir after he discovered
that she had been born male. Kamilla was 30 years old.

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Jimmy McCollough
Location: Fayetteville, North Carolina
Cause of Death: his murdered body
was found on Joseph Street behind the old Club Spektrum
Date of Death: April 14, 2009
Jimmy was a drag performer whose performance name
was Image Devereux. Jimmy was 34 years old.

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Cynthia Nicole
Location: Comayaguela, Honduras
Cause of Death: Shot 3 times in the chest and once in the head by three
unknown men driving a blue car in Barrio Guaserique, Comayaguela, near Tegucigalpa.
Date of Death: January 9, 2009
News sources believe that the killing of Cynthia Nicole may be related to her legitimate human rights activities, in particular her involvement in the defense of the rights of the transgender community.

There were 91 more reported deaths of trans people worldwide. And these are only the deaths that were reported.  I am praying for the day when no trans person has to live their last moments surrounded by hatred and cruelty.

 

Not the best way to get a promotion November 17, 2009

Filed under: Uncategorized — lesbonurse @ 1:57 am

This morning I had a patient that combined several of the key ingredients for an annoying encounter. Forms that needed to be filled out TODAY? check. Chronic health condition that patient has not been proactive about treating? check. Non-specific mental illness that results in rambling, semi-coherent long monologues? check. Multiple requests for specialty referrals, medication refills and letter for parole officers? Check, check and check. To top it all off, after our 40-minute counseling session when I stood up to usher the patient out the door, he announced “Oh, I forgot to tell you that last week I lost control of my bowels for no reason and my back really hurts and my doctor said to say something if that every happens because it’s really important.” OH. MY. GOD. Are you serious? After all of this effort and time you’re going to make me work you up for cauda equina syndrome with 2 more patients waiting for me?

I asked him to wait a moment while I went into the next room. That room happened to be the staff office, where I announced to an attending physician: “I am filled with a murderous rage. A rage towards my patient. I kind of want to kill him right now.” Note to self: things that sound funny inside the brain sometimes sound crazy when spoken out loud. This may be one of those things. Maybe I won’t mention the “murderous rage” part next time.

 

Thursday is Haiku Day November 12, 2009

Filed under: Uncategorized — lesbonurse @ 2:11 pm

Trying to do work

Remote account–can’t log in

Angry…yet relieved.

Crazy man in hall

Patients gather to watch the show

Hello?  Privacy?

Stressed doctor mutters

“Should have chose different field”

Not having good day.

 

Furious like me November 10, 2009

Filed under: Uncategorized — lesbonurse @ 2:35 pm

Yesterday I saw a patient that is always angry about something.  You probably know the type.  The cholesterol medication “almost killed me” with its GI side effects.  The topical steroid cream “didn’t help this rash that is killing me.”  Her PCP “doesn’t help me” and usually “nobody here cares.”

During the visit we were discussing her lower extremity edema.  As I informed her (in Spanish) that I would be prescribing some furosemide for the swelling, she looked delighted and asked me to repeat the name of the medication.  “Furosemide?  Haha!  Furiosa, como mi! (it’s furious, like me!)”  Hey, at least she has a sense of humor about it.