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Posts Tagged ‘doctors’

Ukiyo-e is Japanese for “pictures of the floating world.” It usually refers to scenes from everyday life, and was an art movement that inspired the early Impressionists. Imagine those prints of ocean waves, islands and cranes you once saw hanging in your grandmother’s home. Not this nana though; I’m more of an early 20th Century French advertising print sort of girl.

Still, with this torrent of spring rain, I’m beginning to feel as if I’ll be floating down to the Cumberland River any day now. Last night, during a rain-free respite, Bob and I visited our local Art Crawl – less a walk-about town and more an old factory brimming with live music, food trucks and artists of all media! We were especially taken with the paintings by Shane Miller. I asked if he works from a photograph or does he haul his easel outside? He said the photographs are all in his mind. https://www.shaneartistry.com/

He layers oils onto canvas in order to evoke a dreamscape. I could envision an expansiveness, a floating vista that spoke to a primordial self. I know, it sounds weird. But think about your happy place – the beach? The mountains? A long landscape of wheat grass at dawn bordered by a forest? Now stand back and squint your eyes to blur that image down into its essence. There, if you are lucky, you may find his work.

Our cousin, Stevela, is visiting his Aunt Ada (and us) from NY. He is an orthopedic surgeon who is grappling with retirement and recently started painting. What does a doctor do when he or she is no longer doctoring? Some like to pick up garbage in the neighborhood, while others might pick up a paint brush.

This is our second year in Nashville, and it was our very first Art Crawl. We told Steve that a visit to the Frist Museum is well worth it since their Mellon Collection of French Art (Van Gogh, Monet and Degas) just opened. We’ve seen it already with the Grands, where a docent told us that Van Gogh tried out being a missionary for a few years but failed. He was disabused of the notion that everyone has good intentions.

So he went back to France. “For my part I know nothing with any certainty, but the sight of the stars makes me dream.” 

Did you know that Diego Velazquez liked to paint himself into his Baroque paintings of royal families?  In Las Meninas you will find him painting in a corner, like a play within a play.

“…Manet went to Madrid to look at Velazquez’s work and later wrote to his fellow painter, Henri Fantin-Latour: This is the most astonishing piece of painting that has ever been made. The background disappears. It is air that surrounds the fellow.”  https://www.theartstory.org/artist-velazquez-diego.htm

I was lucky enough to hear Edward Friedman, the Gertrude Conaway Vanderbilt Professor of the Humanities, speak about analyzing literature to a group of Great Grandma Ada’s friends this week. He compared writers to painters.

He was using Las Meninas and “The Story of the Bad Little Boy,” by Mark Twain, to illustrate his point – the narrator can be reliable or unreliable. Twain is omniscient, his opinions float in the background of his narrative like the Mississippi River, brown and brooding.

I knew that my stories were all different colors swirling around, flowing fiercely sometimes and meandering at others. I knew that my palette was my laptop’s keyboard. But I had never heard the intersection of writing and painting so beautifully expressed before I met Prof Friedman.

Am I dreaming, or did the rain stop?

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You’ve all seen them while running through an airport. The giant ads – no, not the picture of the Parlor Mob at JFK – pictures of doctors in white coats, smiling in front of computers. Why wait for hours at your local Emergency Department? Can’t get an appointment with your actual doctor for months? Maybe you’re too sick to drive, and just too busy to take an Uber to an Urgent Care?

Well, the Virtual Doctor is in!

The first time I saw my very own Dr McDreamy at UVA I was slightly disappointed. Like many women, I had never had a primary internal medicine doctor before…ObGyns sure, and specialists to repair meniscus tears etc. Whenever something was seriously wrong, I always had Bob to remind me this was just a virus and it would get better with time. But a real doctor, this was something new to me.

Let’s go over the best parts first: the waiting room was almost empty; he was on time; his nurse was efficient, I was blessed with some very good genes so my medication list is mostly vitamins; his resident asked all the right questions; and finally, when I saw the doctor, he sat and talked with me for a very long time. I was in love!

And now for the not so good parts: I had to drive 40 minutes to park in a gigantic cement parking garage I would later get lost in; the walk to his office was well over a mile; and the worst part of all, he never actually touched me. I never got undressed and jumped onto an exam table clinging to a paper robe. No physical exam…I left his office with appointments for tests like blood work and a mammogram.

Let’s skip ahead to that week between my fall off the steps in Nashville, and our trip to the South of France. I called my Primary Care doctor and he was away and they couldn’t fit me in. I called my Orthopedist and his office said since I didn’t break any bones, he doesn’t do muscles! I didn’t bother trying to see my Dermatologist. I wondered aloud, is this what it’s like for everybody? When you finally really really need to see a doctor, like you can barely walk and you’re about to get on a plane, they are nowhere to be found?

Well folks, I think Bob may have found his retirement second act. Emergency docs have to know a little bit about every disease and a whole lot about the ones that will kill you. And isn’t that what we all want to hear? You don’t have a terminal illness. It’s just a cold, get over it! Well, maybe they will say it with a bit more finesse, into their monitor.

Dr Ali Parsa, founder and chief executive of digital healthcare app Babylon, sees the (remote physical and mental) health trend as an undoubted force for good.
“It’s time to do with healthcare what Google did with information – using the power of technology to democratise access for all, and put a personal (digital) doctor in everyone’s pocket regardless of geography or income,” he says. http://www.bbc.com/news/business-40629742

Bob’s been doing this for years already with our relatives and friends. People send him pictures of rashes, x-rays of broken bones, brain CAT scans. He’s functioned as our collective consultant at seders and dinner parties. “My foot’s just not getting better.” Or, “Will you just take a look at all the drugs I’m taking?”

I’m pretty sure I wouldn’t want an App or a Bot to speak to about my medical condition, but having a real, live physician on FaceTime or Skype? Sure! And the doctor or the patient could be in Katmandu, so long as the WiFi is working – this takes boutique medicine to the next level.

Lots of hospitals do this already. Did you know in most rural parts of the country, smaller community hospitals have critical care ICU docs checking in via monitors from their big city university hospital? At night, radiologists in other countries read X-Rays that are sent  digitally from the US. This has been going on for years.

I’m feeling hopeful today after the Senate saw fit to drop their misguided bill to “fix” the ACA and throw millions off Medicaid. The sheer irony of Sen McCain delaying the vote because he was busy having a surgical procedure his insurance covers illustrated their sinister deliberations. http://www.cnn.com/2017/07/18/politics/how-the-republican-health-care-bill-fell-apart/index.html

I hate that we politicize health care in this country. Until we see fit to have Medicare for all, maybe technology will help restore access and autonomy to the doctor/patient relationship. And at the very least, we would know if we need to go sit in an ER because our neck is tender and we must rule out meningitis. The doctor is on deck!IMG_0846

 

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“Do we have any plans?”

A simple question yes, but I’ve been hearing it alot lately. At the end of this month my husband Bob will retire. You heard me correctly, he will hang up his stethoscope for maybe the last time. And like most American housewives of the newly retired, I am beginning to wonder what the rest of my life will be like.

Our cousin Anita tells me that men who golf do much better in retirement. Her friends are not complaining so much. They don’t require lunch, they make dates with their friends and get their manly fix swinging sword-like putters on the golf course, returning home from their natural habitat conquering (or quivering) heroes.

Bob doesn’t golf. But he does fly.

Unfortunately, someone is flying up from Florida this weekend (we shall see how Hurricane Matthew affects this plan) to buy his little Arrow four-seater. It’s been on the market since his surgery last year; so hanging in the hangar so to speak will be off the table.

Our friend MJ tells me that when her husband retired, at about the same time her daughter’s family moved out of her second floor and into their new newly built home, she was trepidatious. After all, her husband was a businessman who travelled the world frequently. But men in the business world can remain as consultants, and that is exactly what her husband has done. Plus, he can drop in on his grand daughter anytime he wants.

Bob’s always been the leader of his pack, the director, the owner.

Bob’s grandkids are in Nashville with my grandkids and doctors rarely consult after retirement. When we visited his UVA doctor this past year for a check-up – a man about the same age who is cutting back on patients and teaching more – he swiveled away from his computer and looked Bob right in the eye, saying bluntly.

“What are you going to do? You’re not the kind of guy who goes to Lowe’s every day.”

True. And do doctors ever really retire? I’ve known some to work right up into their 80s, but these are usually Internists, GPs who sit and swivel mostly. Not ER docs who run around the clock moving all sorts of serious and semi-serious emergencies in and out the doors like a Roadrunner…24/7 every day of the year…

It’s hard to imagine my husband doing nothing, literally. And to be honest, there are a few new things he can dabble with in medicine. After all, he’s been doing telemedicine his whole life with our family and friends. Rashes are sent via text, foreign objects in the eye are discussed. But the cord to a hospital will be cut for good.

He doesn’t do laundry, even though he likes folding. He is an excellent sous chef in the kitchen, when asked. And strangely enough, I didn’t think this whole retirement phase would bother me. After all, he never worked a 9 to 5 job and often works weekends and holidays; I am used to him puttering around the house, mowing the lawn on good ole John Deere, editing medical journals in his office and catching up with charts. Once upon a time he would cut down trees for firewood and tend a garden…

Long ago I put my foot down – I don’t do lunch. So when Bob’s home during the day, we often go out to lunch, or just “pick.” That’s one of those generational things, like Ada makes lunch for the world should they stop by. That greatest generation would leave a cooked dinner covered in the fridge for the hubby if they happened to be out one night. Millennials order food online and cook it together.

My generation was stuck in the middle, fledgling feminists feeling the need to hunt and supply a “home-cooked” meal every night. Last night I made bangers and mash. WHY? Because sausages were on sale at Whole Foods, and I was thinking about those beer gardens in Eastern Europe since a friend is posting her travel pix on Facebook! Thank God I didn’t Instagram it.

Last night I politely asked Bob to stop asking me about plans. He said he thinks maybe he should get another job! Will we travel more? Take long walks on the beach? Talk? Make more vegetable soup? To quote Disney’s Chef Gusteau:   793759230-f6b3178ce351ee8f3901fe91febe95fb

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After our sudden trip North to Sue’s funeral, followed by our planned trip North for Ada’s birthday party, followed by a week of the Bride and Bug visiting, Bob and I were supposed to have a few days mid-summer to ourselves. He might get to mow the lawn, I might actually get to finish doing laundry. Maybe we’d go out to dinner? But no, the Joints have arrived!

The Joint Commission http://www.jointcommission.org/accreditation/hospitals.aspx is the national agency that wanders into your hospital without warning for a few days of fun and relaxing oversight. I remember when I was teaching and was told the Principal would have to evaluate my performance, but I’d get a few days notice and would I mind sending him my plans for the week? Brand new to the profession, I thought well that’s kinda like cheating. If someone really wants to evaluate you, why not just walk in one day? Well, the teacher’s union would have none of that.

And a few years ago, the Joints felt the same way – unannounced visits are now de rigeur.

You never know when they might arrive to evaluate your system. If standards are not met, a hospital might lose its accreditation, ie funding, ie money. A residency may have to shut down, which happened recently at Berkshire Medical Center, where I delivered my children. Surgical residents in the Berkshires are now scrambling for another hospital to accept them. So as you can see, it’s a very BIG deal when they show up, and poor Bob is one of three hospital board members not on vacation.

People have always assumed that because we have so many doctors in our family, that I would know about such things. In fact, I don’t. I cannot tell if a baby is dehydrated, or if a cut needs sutures.  I can’t tell heartburn from a heart attack. And I certainly can’t distinguish between a bug bite and shingles…or psoriasis. I knew very little about the Joints until Bob told me about them this week.

But if you live in VA and want to know what it feels like to go to medical school, you can sign up for UVA’s Mini-Med School in the Fall! http://www.medicine.virginia.edu/community-service/more/minimed/about-mini-med.html

During the 7 week program enthusiastic UVa faculty members, with assistance from current medical students, will lead the group in exploration of a wide range of topics in medical education. Participants will experience such integral parts of medical school as match day, research labs, patient interviews, and more. Mini-Med will provide a behind the scenes look at the training of those we entrust with our health, a greater sense of health literacy, and forge new connections between the health system and our community. Mini-Med will also feature entertainment provided by our talented medical students. There is no cost to participate and while participants will not leave Mini-Med School with a medical degree they will leave with knowledge, resources, and a certificate of attendance.”

For me, well I think I’ll pass. Unless they have a really good jazz singer this year. I’m happy giving kisses to the Love Bug when she gets an “ouchy,” and for now, that and some well placed Disney band-aids always do the trick!

PopBob entertaining the troops in Dover

PopBob entertaining the troops in Dover

 

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Trumpets please. The cast came off and a splint went on, my dominant right hand that is. It seems that despite being told there is nothing one can do about a fractured pinky finger, the UVA Hand Clinic has me doing some serious physical therapy. I’m sure that my three week wait to actually see a doctor after the bounce house fall, planting in my garden and mailing 90th birthday party invitations, didn’t help my hand heal. But that’s just me; delay, deny and avoid doctors at all costs since I have so many at home. That’s my problem.

You might think that a doctor’s family has it made in the shade. But I’m here to tell you that’s not the case. It’s pretty well known that anyone involved in health care will be treated differently in a hospital. It’s kind of the opposite of selection bias – once the person treating you finds out you’re in the same field – nurse, doc, therapist or spouse of same, whatever – they may subtly change their strategy. The person treating you may not even realize they are doing this, but by being nicer, kinder and making exceptions to their rules and treating you differently, they are shortchanging you.

Let me find an example. When I came down with West Nile before moving to VA, after a week of unendurable headaches and fever, I finally got to an Opthalmologist who knew what he was doing. I was sent pronto to the nearest hospital’s MRI machine and ended up waiting in the hallway until one became available. I was in such pain and going blind that I hardly registered what Bob was saying to all those people who knew him so well, all I remember is everybody apologizing for me being in a hallway.

I really didn’t care about the hallway at that moment, I wanted the pain to stop.

They didn’t do a lumbar puncture (LP) because well I didn’t see the ER doctor on duty, and they didn’t have an available room, and besides I didn’t want an LP and nobody wanted to question my husband and his wife as to what they wanted in this emergent situation. I hope you’re getting my drift…

If I hadn’t been with Bob, if I’d have been anybody else, the eye doctor probably would have called an ambulance and I would have been whisked away toute suite to a hospital with a bed and an available MRI machine and an ER doc who would have punctured my spine alright, and I would have been admitted to the hospital. Instead I was sent home on steroids.

In the worst of circumstances the very best people in health care will try and make our (meaning everyone else in the health care field) lives easier – thereby putting us at greater risk.

This is why when I went to another state while pregnant with the Rocker for my “older mother” test – the one where they stick a needle in your pregnant belly to get some amniotic fluid – I told the receptionist that my husband was a contractor! Yes sir, I lied because A) this amniocentesis test was fairly new, and 2) I didn’t want anyone to know my husband was a doctor because I was unconsciously already aware of this selection bias.

I know I’m complaining in a sort of ‘poor privileged me’ way – first world problems. And I know this anecdotal bias has probably never been studied, but I’m not the first to notice it. Ask anyone you know in the health care field. Oh, and when my wonderful NP asked me at the UVA Hand Clinic to rate my pain on a scale of 1 to 10, I had to smile.

Because Bob has always said the day he hammered his thumb accidentally putting up a shelf was a BIG 10. He saw stars, he couldn’t speak, and finally when he could, all he could do was swear. When he walks into a room to see a patient and they are texting, he remembers his thumb and knows this is not a 10 on the pain scale. But pain is pretty subjective, your 7 may be my 3?

This is the first time in 2 weeks I’m using more fingers than two thumbs to write. And for that I am grateful. It’s good to start off your day listing two things you’re grateful for, soooo 1) Yay for 9 fingered typing

And B) I’m also happy my 6’3″ son and Ms Cait came to visit this past weekend. That baby who backed away in the womb from the needle in the ultrasound of my amniocentesis test, is going to turn 30 this summer! And his Grandmother Ada just turned 90! Bring on the fanfare!   IMG_0699

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