I ♥ Laxatives

This past month I’ve been taking care of patients in a rehabilitation facility. If your grandparents have to go to one, they’ll think it’s a nursing home, because it is one. But the purpose is different. It is for physical therapy, occupational therapy, speach therapy, or some special nursing function for a short period of time until they are well enough to be at home.

If you are going to work here, it helps to enjoy the smell of urine.

Well, urine and poop both, really.


I have one patient who’s in his early seventies, with severe medical problems. He only has two out of the four limbs he was born with. He’s spent all week complaining about being constipated, so I kept increasing his laxatives, until yesterday the nurse came up to me begging me to stop.

‘He’s having two or three bowel movements per shift. He’s got to be cleaned all up after every one. Please. Don’t go any higher on the laxatives.’

I went back into the patient’s room and asked him, ‘Why are you telling me you’re constipated if you’re having all these bowel movements?’

He gave me a toothless grin and shrugged, saying, ‘I was afraid if you took the laxatives away, it would stop me up. I hate being constipated.’

I asked the nurse to cancel the enema I had just ordered for him.

Uncynical over Coffee

I’m on my way to meet the guy from the local news for coffee and I’m still leery. The media has tapped into the emergency department’s walkie-talkie system before to get exclusives on patients’ conditions, so my concern is that he may have an ulterior motive for befriending a physician.


But when we meet, he’s wearing these ridiculous sandals with patent leather straps, and they appear just a little too goofy for a man with an ulterior motive to wear.

Still, I have my guard up, trying to figure out the angles someone might have for wearing ridiculous sandals. Is he trying to put me off guard?

I do relax some, though. I don’t hang out with many college-educated people anymore except for physicians. And they don’t count because their college degree is a bachelor of science, which doesn’t create educated individuals. So I enjoy my conversation with him.

He tells me about some of the recent shoots he’s done, but I’m more interested in the details of the shoot than the stories they’re doing. He tells me about the sign in the studio that says ‘Talent: Don’t forget to turn your mic’s on.’ He tells me someone had crossed out ‘Talent’ and written in ‘Journalists.’

‘Did you major in journalism?’ I ask.

‘No, communications,’ he says.

‘My sister says that communications is a terrible major,’ I say, ‘because no one who majored in it can communicate what it was they studied.’

We both kind of laugh and I realize that might not be a good opening joke, so I try to soften it some by mentioning that my father majored in geography because it required the fewest credit hours to graduate. He likes this and says he identifies with my father.

‘Except that my family is terrible in geography,’ he says, ‘my sister took a geography course and my father told her he had failed geography and that she would likely fail it, too. And she did.’

We both laugh a bit.

‘And I’m no better,’ he said, laughing, ‘In western civ, we had to fill in a map of Mesopotamia and after the test the professor came in and told us how poorly we had done. He told us, “One of you,” and stopped right above my desk looking at me, “could not even figure out which way was North.’

We both laugh. But I start thinking about it, and think about the Tigris and the Euphrates and think that it shouldn’t be that difficult to fill in, or at least to figure out which way the rivers are going. I could do the modern map now, though the ancient one might be more difficult if they wanted territories named by fill-in-the-blank. So I ask, ‘Which period?’

He scowls at me for a second, then says, ‘Are you fucking kidding me? Let me clarify something for you: It’s my job to smile and read aloud.’

He smiles, sips his coffee, and adds, ‘I know my place.’

To be honest, I am not sure what to make of this. To be sure, it’s amusing. To be frank, it’s what I expect: personable, charming, and soft.

There’s nothing threatening about this guy. A trait useful if the senior crowd—who make up the last remnants of the local news viewers—is to welcome him into their homes.

‘The old ladies love me,’ he says, and I have no doubt that they do.

And what could I have against someone whom grandmothers love?

Next week: What I have against someone whom grandmothers love

Tonight, Reprising the Bill Murray Role from Groundhog Day…

At cocktail parties and other social events, when people find out that I’m a doctor, they often tell me they had been premed majors. Then, instead of finishing a two-sentence story, they ask: ‘Do you know why I quit?’

‘Chemistry was too hard.’ I say, flatly.

Almost Better Than a Shopping List

The line was long at the Walgreens, and in front of me in line were a father and his four year-old son. The son had gotten, not one, but two Rice Crispy treats after asking only once, so from my point of view he was pretty lucky.

But then he started repeating, ‘Daddy, I’m thirsty.’ At first a simple declarative, it evolved into a whine. I was thinking about saying: ‘Then you better put those Rice Crispy treats back. That will only worsen your thirst. You need a nice cup of water!’

But I did not.

The father started a distraction technique. There was some sort of jelly filled ball and the dad picked it up and patted his son on the head with it. The son looked up at it, and I guess it must have touched his eye or something, because then the kid changed his whine to a refrain of: ‘You hurt me, daddy.’

The father tried to reason with the child that the thing was a jelly ball. ‘See, feel it.’ He offered the ball to the boy. At that point, finally they were up at the head of the line. The father took the Rice Crispy treats and handed them to the cashier. The boy exploded at that point because, apparently, he wanted to give them to the cashier.

The cashier put the treats in an individual bag for the boy to carry on his own, but it was a lost cause at that point. The man picked up his son and left the store with the boy still screaming.

The cashier looked at me. I paused and looked at the lady behind me and the long line behind her.

‘You know what?’ I said to the lady and got out of line. ‘You go ahead. I just remembered I need condoms.’

The Opposite of a Raspberry Beret

I ended up with a nose bleed last night. It happened at the gym when my face hit the display/control board of the elliptical machine after I lost my balance.

Here’s what happened: the television was on Anderson Cooper’s 360° and they were doing a story on John Robert’s wife, who wasn’t seen in most of the coverage, but was to Bush’s left when the Robert’s announcement was made.

She was just standing there stiff and uncomfortabe, with an artificially sweet look on her face, regaled in a dusty pink, with a pearl necklace. (And not the good kind.)

She really reminded me of a box of Peeps leftover from Easter and not just last year, but several years ago. And not even the delicious yellow ones, I mean the neon pink ones.

Now by all accounts John Roberts is a thoughtful, intelligent and diligent man, not given to extreme ideology. Seems to be a lovely pick, as far as I’ve heard.


So it kind of threw me—enough that I lost my balance and hit my face as I fell off the machine—when the guy next to me saw Robert’s wife and said, ‘I’d be conservative too, if I had to fuck that every night.’

Hello… Is This Thing On? Can Anybody Hear Me?

I woke up this morning thinking about ham radio.


When I was a kid there was a fat, smoking man who lived two blocks from my house. He would sometimes be out in his front yard, wearing a stained wifebeater t-shirt, ill-fitting shorts, and flip-flops over black socks, looking up.

He had an amazing array of antennae that spread out above his home like an aluminum firework. The grid work of bars loomed larger than the house and backyard combined, hovering about fifty feet in the air, with a three-rod support beam anchoring it into the side of his home.

The kids in the neighborhood claimed that he could talk to people in China, that he could hear transmissions from astronauts in orbit, and that he had friends all over the world. I found each claim progressively less believable than the previous one, but it did make me wonder.


So this morning, I was thinking about ham radio, and wondered if blogs are kind of the modern day equivalent.

It’s more efficient to be sure, I don’t have to broadcast all the time, I don’t have to leave the system up and turned on to hear if someone is trying to call out to me, but the principle is the same, sending out a message and see who responds from the faraway and wonder who might just be listening in...

Uncynical and Undercover

I was heading into the police station and ran into an acquaintance. I’d seen him at parties and exchanged a few pleasantries before, but we’d never really talked.

I was a little horrified to discover what he did for a living. He was there, in front of the police station, with a van and camera and a sound guy.

‘Funny,’ I thought, ‘he didn’t really strike me as a jackal.’


The local television news is to journalism—as far as I’m concerned—what pedophiles are to the priesthood. The perfect medium for empowering people to participate in local politics and issues—where individuals can have real impact—the local news is used for nothing more than fear mongering and lasciviousness.

I don’t think I need to expand on this. The Daily Show has been pointing out for nearly ten years how exploitive and useless the local news is.

I hoped he’d be reading his notes and tried to hurry by, but he saw me and said hello.

‘Hello,’ I said, feigning surprise, politely ignoring the camera beside him, ‘what are you doing here?’

‘Well,’ he said, gesturing to the van and camera, not even slightly embarrassed by it, ‘this.’

He told me about a child who had been missing for five months and how the ransom/reward was being increased and how the family--

‘Well, I really must be going,’ I said, walking into the station, trying not to sound repulsed by what I was hearing. ‘Good luck with the whole kidnapping, or whatever.’

When I came out of the building he was still there, talking on the phone with what I assume was his producer. He flagged me down, suggested we meet for coffee, and handed me his card.


See, here’s the thing. He seems really nice. I can’t figure out if he knows what evils he’s committing in the name of journalism. Do you suppose he thinks hearing about kidnappings will be useful to someone? Or that the ‘local angle on the Michael Jackson case’ is anything besides lurid? Does he imagine that those stories are the sugar they use in order to broadcast hard-hitting reports on… on… on what? Steroid use among professional athletes? The weather?


I’m well aware that this doesn’t sound very uncynical so far. But here’s what I’m thinking, I’m going to do some undercover reporting of my own: Looking into the mouth of cynicism. I’m going to have that coffee. I’m going to sit down and look into the abyss that I fear is there and hear out the confessions of a television ‘journalist.’

Stay tuned, true believers... for uncynical over coffee

Um, Thanks for Coming to the Rescue, Dictionary Man.

Dictionary Man’s little run-in with Dan made me think a little about the multiple meanings of words and how sometimes, when a less common (less popular?) use of a word is used, they can throw people for a bit of a loop. It reminded me of a story from quite a few years ago...

[Cue Flashback Sequence]

When I was doing my premed coursework I was interviewed by the ‘premed committee.’ It was their job to write a single letter of recommendation for my medical school applications. They tried to ask broad questions that included my hobbies and interests so they could pretend they actually knew me.

The interview was going really well, up until they asked what magazines I read. I mentioned some of them and then one of them said, ‘Those are impressive magazines,’ which I politely ignored. (Impressively large? Colorful? Impressively not science related?)

Then he added ‘Do you read the New Yorker?’

‘No,’ I said—and I’ll admit I should have stopped there since he was clearly hinting at his own prowess for reading ‘impressive’ magazines, but the whole thing is about showing an inkling of a personality—so I admitted, ‘I’ve tried, but find it kind of provincial.’

‘I think,’ the chemistry professor said, ‘you’re misusing that word.’

Now, I am typically deferential with people I don’t know very well, especially in situations like this. But this smug chemistry professor—chemistry for Christ’s sake—had recently been involved in a row because he wrote a letter to the school newspaper using the word ‘gypped.’ Apparently, some gypsy had taken time out of his busy, thieving, nomadic schedule to go to college and had complained about the use of this pejorative word.

The chemistry professor wrote an angry letter of defense, arguing—essentially—that no one thought of gypsies when they used the word and he didn’t even know that was the etiology. A ridiculous defense, really. I would have accused the gypsy of trying to steal a legitimate word, just like his cousins tried to steal my grandfather’s wallet.

(Just kidding, Gypsies. Please do not steal my blog)

Anyway, so maybe he was being defensive about his vocabulary after what had turned into a four or five letter-to-the-editor exchange, but accusing me of misusing a word was a mistake. Not that I don’t do it, but in most situations I stick with words I know, and this was one of them.

This was one of those awful situations where, push came to shove, and I shoved the guy who was writing my letter of recommendation for medical school.

‘You might want to check your dictionary. You’re thinking of provincial meaning rural and unsophisticated,’ I said, pausing and staring at the chemistry professor as I said those last three words. ‘That would not make sense if aimed at The New Yorker. But provincial can also mean narrow and self-centered; believing that your province is better than any other province. I think that applies to The New Yorker.’

It’s also very boring.

Plush

So this is kind of different: I came out to my car yesterday morning and an envelope was under my windshield.

This is what was written on the outside of the envelope:

Somebody told us what we wanted to be,
it was candy for the mind.

It was fantasy and fantasy galore.
It was everything we ever wanted,
It was that and so much more.

Damn it all,
Damn everything
but the circus.

Wonder who said that?

I recognized the perfect script of the (woman’s?) handwriting; so I wasn’t suprized to find a new In/Out list inside the envelope. But I’m not sure why I received it, I haven’t given any signal asking for one, and the headaches haven’t been particularly bad lately. Here it is anyway.

In	Out
Promiscuity	Discretion
Alienware	Dell
The Jody Grind	The White Stripes
Berries	Legumes
Pink	Aquamarine
Ninjas	Wonks
Discretion	Open-mindedness
Gazpacho	Chicken and Stars
Community Athletics	Television Programs
Aspirin	Plavix
Futurism	Nostalgia
Oregon Pinot Noir	Australian Shiraz
‘Soup Spoon’ Tricepts	‘Washboard’ Abs
Architecture	Sculpture
Magazines	Short Stories
Earnest Pretention	False Humility
Lunar Park by Bret Easton Ellis	Laguna Beach on MTV
Slack Lalane	Jason Mulgrew

What’s the difference between God and a doctor?

You wonder why doctors are such smug assholes? Why we think we’re gods?

It’s because of you. You come to us as you would approach a god, beseeching or angry, demanding or plaintive.

Blaming your inability to breathe, not on your smoking for fifty years, but on the price of the medications that I prescribe.

I can watch your heart rate go up—or down—when I walk into a room, can see the fluctuations in your breath. My presence alternates between creating comfort and anxiety. But it isn’t love that’s affecting you.

Desperate for the words ‘everything’s fine, you were silly to be worried,’ instead you hear other words fall from my lips. You close your eyes and pretend to pray. Pretend you believe in a power greater than mine. But, mostly, you don’t. Not really.

When you get sick enough, you come back to me, fearful and repentant. Hopeful for a benevolent, forgiving god.

And there I am, restarting your medications, pushing the hopeful science into your veins, and lo! Your pain stops. You rise and walk. And you believe! Hosanna! You sing my praise. You take my hand. You kiss my ring.

Or the other.

You are just too sick. And your angry, pleading eyes try to haunt me. As surely as the man who died within three hours of telling me ‘If I die tonight, I will come back and haunt you.’ Your daughters and wives and sons gaze at me with—not sorrow—but anger and confusion. Their eyes convey a vendetta prayer against the god of science who has let them down.

And I return to my empty home, read my medical texts, and do not believe.

Do not take your praises or prayers seriously.

I let your words fall empty—and shatter?—onto the floor. Sweeping them out into the trash.

But everyday they seem to stick a little tighter. Like sand burrs, I find myself now having to pick them off sometimes. I find one-here on my elbow-how long has that been there? It’s dug into the skin. And it hurts to pull it out.


But I’m merely a man, clever to be sure; maybe even smart, but merely a man using the tools of his trade. Stop believing in me. The hubris is gaining mass. I don’t want to feel the fall that I know will logically follow.


From the stereo speakers, I hear the wail: ‘Please stop loving me. Please stop loving me. I am none of these things.’

There’s a Reason They Say Hog Tied

So last night in the ED, a nurse came up and said we had a patient who’d been bitten by a hog. I just looked at her, saying nothing, waiting to hear the story.

Apparently, this guy had pulled the hog’s head up so that he could slit its thoat and lost his grip and it turned around and bit the shit out of his hand.

‘Good for the hog,’ another doctor said. So now, I looked at the other doctor, puzzled at the turn this conversation was taking.

‘The guy’s in pain,’ the nurse continued. ‘You want me to give him something?’

‘How bad’s the pain?’ The other doctor asked.

‘Well, he’s crying, and he’s a big guy,’ she said, ‘the kind of guy who slits hogs’ throats.’

‘Not very well, apparently, if it bit him,’ I said. ‘And it doesn’t sound like he’s got a very strong grip.’

Uncynical Wednesdays: Public Service Announcement

If you’re getting ready for a date that you’re excited about, and you’ve already bought everything for your menu of sautéed asparagus with cocktails, an appetizer of artichokes with garlic butter, and an entrée of pan-seared, curry dusted sea scallops on a bed of oven-roasted, vine-ripened tomatoes, and you get a phone call while you’re roasting the tomatoes and you hear:

‘I’ve been in an auto accident. I’m not going to make it.’

Do not default into putting the scallops and artichokes into the fridge, walking to the liquor cabinet and start drinking scotch.


This is important, because ninety minutes later you might get a call saying,

‘Everything’s worked out. Do you still want me to come over?’

Because then you have to: 1) Get the smell of scotch off your breath, 2) Cook dinner while being full-on drunk, 3) Remain functional as you continue with Lillet over grapefruit slices during the pre-meal, still cooking, and then the 2003 Groth sauv blanc with the meal, to say nothing of the after-dinner drinks 4) For the rest of the evening keep telling yourself: ‘stay witty, not drunk; stay witty, not drunk; stay witty, not drunk…’

This has been a Public Service announcement from your friends here at Playing Doctor.

Proof

This is the classic use of a Venn diagram, proving that I am, indeed, an asshole.

Just as all German Shepherds are dogs, and Rex is a German Shepherd, thus rex is a dog.

Here is your proof.

Q: What kind of an Asshole am I?A:

A few weeks ago my friend Yuval and I were having a beer and he was giving me some parting advice, which is not to say words of wisdom. He’s a year ahead of me in the program and was leaving to begin a fellowship in critical care.

‘Just because someone’s not as good a doctor as you, doesn’t mean they’re an idiot.’

I looked at him, feigning confusion.

‘You consider yourself a mediocre doctor, Erik. You know all your weaknesses and gaps in knowledge. You’re painfully aware of every time someone has pointed out a diagnosis or suggested running a test that you didn’t think of ordering. But you’re not a mediocre doctor, Erik. And when other doctors aren’t as good as you, it doesn’t mean that they’re idiots.’

‘I don’t think they’re—’

‘Save it,’ he said. ‘Don’t even bother. I’m going to get another beer, want one?’

He was halfway to the bar before I could think to say, ‘Yes. I want another beer.’

Tomorrow: Proof

Art Quiz

A lesson I learned the hard way:


If you are making small talk with someone and for some reason they ask you who your favorite painter is, please remember, the answer is not Lucien Freud.


Apparently, the answer should be ‘I really like the impressionists, like Degas or Monet. His Waterlillies show so much about sunlight. I had no idea how large the canvas would be!’ or ‘Georgia O’Keefe is so wonderful. Her abstractions of flowers remind me of female genitalia.’

Alternatively, change the subject to television programs on the WB and then just tune out. People will blather on about them forever. You can smile and laugh without paying any attention to them, because that’s the correct response to everything aired on the WB.

Venn Diagram of the Month:Medicine Is Magical

Uncynical WPA: See America

Eulogy

This is the eulogy I’m delivering at my Grandfather’s funeral this morning.

In the early eighties, Grandma and Grandpa were hosting the entire family up at Clear Lake on one of their many fishing trips. On each of these trips, they would usually pick one night to get dressed up and treat us to a big night out. This particular trip, they took us to the Holiday Lounge to watch a lounge singer. After the performance, Larry, Chris & Robin put me up to asking the lounge singer for his autograph. They used to tempt me into minor mischief frequently, as older cousins tend to do. Of course, I asked the lounge singer for his autograph, as younger cousins tend to be tempted into mischief quite easily.

The singer was a good sport and signed a cocktail napkin, asking where we were from. It wasn’t long until we somehow figured out that grandpa had once sold him a home. He went over and shook my grandfather’s hand, telling him how thankful he was for some favor grandpa had done that allowed him to buy a home.

Grandpa didn’t really remember him much.

As a child, I remember being impressed that Grandpa had touched so many lives, helped so many people, that he wasn’t able to even remember all of them.

As a young man, I continued to be impressed by him, his life and his character.

I spent several summers working for grandpa as his handyman. He’d take me to rental properties, and we’d do things like work on their plumbing while trying to avoid flooding their apartments. He taught me many valuable lessons during those summers, far beyond simple plumbing.

I remember once, we were driving to a duplex to clear some debris from a fallen tree. When we got to the address, I pointed out that the tree actually was growing from the neighbor’s lawn, the same neighbors who had called to complain about the debris. I didn’t think it was our responsibility to clean up someone else’s tree.

Grandpa told me: ‘Sometimes it’s easier to do something then explain why you shouldn’t have to do it.’

Another time, we were painting a tenet’s shed. The tenet had offered to do it himself a year previously, and grandpa had told him to do it whenever he had the time. The tenet had never gotten around to it.

Grandpa told me: ‘If you want to stop something from happening, tell someone to do it whenever they’ve got the time. No one ever has the time.’

We, however, spent a fair amount of time hauling things around in the pick up truck, often people would ask us to haul something for them, and Grandpa would just about always agree to do so.

Grandpa told me: ‘If you ever need friends, buy a pick up truck. When you have a truck, everybody will be your friend.’

He said that for my benefit, though. Grandpa didn’t need a pick up truck for friends; everywhere we went, grandpa had plenty of friends. Everywhere we went, people were glad for his company. He told stories. He gave council. He solved problems.

Grandpa liked to say: ‘You can pick my brain, just don’t pick my pocket.’

He said that even though he was generous with people on a constant basis.

And he could tell a joke. I tried to learn from him. Listening to his set up, his pacing, his timing for a pause. Do you know the one about the guy who goes into a restaurant and all the waiters have spoons in their breast pocket and strings hanging from their flies? If you don’t, you probably never waited on my grandfather, it seemed like he told that joke to darn near every waitresses from here to Sanibel Island. I’ll admit I cringed every time I heard the set up for that one.

But now, it’s my fall back joke. It’s been so heavily road tested, I know everything that can go wrong and everything that can go right in telling that joke. Though I still don’t tell it as well as he did.

Grandpa got into his share of mischief, too. I’ll keep some secrets safe, but on the trips back from the farm, sometimes he’d work with me on perfecting bootlegger turns.

There were other–simpler–lessons too: the best way to cut cardboard, how to back up with a boat hitch, how to tell if someone’s switched off the wrong circuit breaker and left you with a live wire when installing an exhaust fan.

Other lessons he taught by example: He taught me that the entire farm was a urinal. He taught me how to smile while biting my tongue in a way that somehow conveyed a relaxed wisdom. Or rather, he tried to teach me. I think he might be the only person to ever pull that one off convincingly.

Now, as an adult, I continue to be impressed by his ethos.

I’m in a position now where I have the opportunity to share some of my grandfather’s sensible, ethical approaches to problems. A few months ago, one of my interns was teasing me. She said, ‘you know, if your grandfather was here in person, we could just cut out the middleman.’

She was right, and yet she was wrong. I’m not–we are not–simply middlemen. We are the heirs to a legacy of his wisdom, his wit, his acumen, his prudence, his unflappable charm.

And I’ll spend the rest of my life trying to live up to that legacy.