Things I can't change but wish I could

This afternoon I had one of those patient experiences that makes me want to scream. I was the only provider in my team area this afternoon, so all walk-ins are automatically mine. The two patients we had walk in (show up wanting to be seen without an appointment) were assigned to me, so I would have seen them, anyway. One of them was a pregnant lady who is not doing well since she stopped her psych meds because of her pregnancy. Not such a hard visit, really, despite the tears. Yes, psych meds do carry some risk of harm to the fetus, but trying to grow inside a mom who wants to hurt herself isn't real healthy, either. So we re-started the psych meds, and I'll see her again next week and see how things are going.
The encounter that made me so upset was the 10-year-old Boy who presented with Aunt to be seen for "head injury." Not usually the sort of thing that one takes care of in the family doctor's office. Well, when I got a chance to go talk to Boy, Aunt wasn't even in the room with him. So the only story I got was from Boy. Apparently, Uncle had been driving Boy and Cousin home from school yesterday afternoon when he ran out of gas. He told the boys to start walking home, and he'd catch up with them after he got gas. Along the way, Boy and Cousin ran across some Hoodlums. Not especially hard to do in the neighborhood where Boy lives. Hoodlums were angry at Boy for something (noble) he had done earlier in the week, so one of them (age 9) hit him in the back of the head with a large stick. I asked Boy if he passed out, and his answer was "I didn't pass out completely--I was only out for a few minutes." He, predictably, had a headache after this incident, but Grandpa (with whom he lives) didn't have any medicine in the house, so his plan was "If it's still hurting you tomorrow, we'll take you in to see the doctor." Well, guess what. It still hurts. And when I went to check Boy's pupils, he wouldn't let me shine the light in one of his eyes. It hurt too bad. So right off, we have at least two bad markers: head trauma with loss of conciousness, and photosensitivity. I sent them off to the ER--do not stop, do not pass go, do not collect $200. I tried to explain this to Aunt, but I think she was so drunk she didn't catch much of it, so I made sure Boy understood what I needed him to do. I think he's the most responsible person in his life, anyway. When I explained to Aunt that Boy REALLY needed to go to the ER for a Cat scan of his brain, all she wanted to know was "can he get his flu shot?" Well, of course he can have his flu shot, but THAT'S BESIDE THE POINT!!!!!! I just hope they actually show up to the ER. I hope the ER takes him seriously. I hope some adult in his life grows up in a big hurry. I hope Boy doesn't end up like his dad.
Happy Thanksgiving.

One down, a million to go

Well, after all the procrastinating I've been doing lately, I finally finished something. No, not something important like my licensing application or the presentation I'm giving to the state SLP convention in March. My mom's pillow. But since I was supposed to give this to her for her birthday (August) and it's now November, I still think this counts as finishing something important. And I closed all my charts from a half-day of clinic in about an hour. Pretty cool, considering that today I had a third-year's clinic session that actually felt like a third-year's clinic session. For the last month or more, it seems like my clinic template has only been about half full. Not that I'm complaining, mind you......it's just that all those half-full days make me doubt myself. Does somebody Upstairs think I can't handle a full half-day? Or worse, do my patients not want to come see me? Arg. Self-doubt strikes again.
On a brighter note: plans for Thanksgiving. I'm so excited, I'm about to pop. I can't wait to have time off to spend with my family. This is the same anxious, I-can't-get-anything-done-for-wanting-to-be-somewhere-else feeling that I always got at the end of the semester in undergrad. Which is sort of inexplicable, as I haven't really been doing anything that strenuous. And it's not like I don't see my parents about twice a month, at least. Point is, I'm ready for the holiday to be here. Food, family, fun, shopping....what's not to love? And for once, I actually have ideas about what to get DH for xmas.
Happy hunting!

Hot cocoa, hot tea, hot cider and me

Ah, the ups and downs of Texas weather. Last week at this time, I was complaining about the heat in November. Now I'm enjoying hot apple cider. God bless apples.
Next week, as everybody knows, is Thanksgiving. I am so anxious to get home with my family I can barely stand it. I REALLY don't want to work for the next three days. I know it could be worse--I could be working the holiday and not get to go home to my family at all.
On the needles: one sock, just past the post-heel gusset; one pair of socks, just needs the ends tucked in; cotton bathrug, 1/6 way through the edging (I'm worried I won't have enough thread to make it all the way around with the edging I'm currently using); monk's cloth throw, about 8 inches from done; aran throw, about 1/2 done; throw pillow for my mom, needs to be sewn up.

Fulfilling my obligations

It's amazing to me the differences in priorities from one person to another. This week I have been struggling with a thousand and one things that need to be done soon, but not necessarily today. I haven't done them yet. And some of them are VERY important for my future. But I have done everything that supposed to be done today. Or yesterday. You get my point. One of the other residents apparently has a different view of what "has" to be done. He cancelled one of his clinic sessions this morning. A common occurrence. Up to this point, I haven't done anything about it. But today he was the only doc scheduled for the morning. And he didn't call to cancel until about 5 minutes before his first appointment. That was more than I could accept. I happened to be in the office this morning tying up some loose ends from my day yesterday. Rather than leave my team completely without a doctor when the first patient was already there, I stayed in the office to make sure there was a doctor there to see the people who HAD to be seen this morning.
Now, I understand being sick. In fact, I was sick two weeks ago. I used 6 half-days of sick time. But I made sure that I was at all 4 of my clinic sessions that week. My responsibility to those patients who have a scheduled appointment with me is stronger than my right to stay home in bed sick. What really annoys me about this resident is that his sick days are all for migraines, and he seems to be gone more than all the rest of us in his year put together. All the rest of us have headaches. Some of us, including me, have migraines, even. When we have clinic, we suck it up and come to work miserable. Not him. The worst part, in my mind, is the disrespect this behavior shows for his patients. No matter that they had an appointment to see him; no matter that they arranged their whole day to make sure they could be here to see him. That's really why I stayed this morning. I couldn't let the really sick ones dangle in the wind just because their doctor doesn't value them enough to hold up his end of the appointment bargain.
In happier news, I'm going to a CME dinner tonight. At my second favorite steak place in town. It's the newest place in town, very trendy, and very close to my house. I suppose nearness might make it tied for favorite, but the other place is in a period home, so it gets more points for atmosphere. Neither of these places are somewhere I would be able to eat if somebody else wasn't paying for it. So I'll admit it--I go to drug rep dinners. I flatter myself that I have more self-control than to blindly prescribe whatever buys me dinner. Besides, I can only write what's on Medicaid or whatever Medicare part D drug plan my patients have, anyway. Because we all know that insurance companies have more control over medical decisions than I have. But that's a different soapbox for a different day. Tonight's dinner is paid for by the Texas Academy of Family Physicians. Which means guilt-free steak and asparagus for even the drug-rep squeamish among us.

November in Texas

I should not have to run my A/C in November. Not in the Northern Hemisphere, which is where I happen to live. Not that you can tell sometimes. Like when it's 90 F in November. October was, uncharacteristically, acutally seasonal. I've had to wear a jacket several days in the last month. But this weekend, we're back to hot.