December 1, 2019

Saw "Midway" yesterday.

It's was pretty good, and a damn-sight better than "Pearl Harbor". I know that's damning with faint praise.

It was pretty intense; one long battle scene, basically. Since hardly any of the ships and aircraft even exist anymore, most of the film had to be done with CGI. Unlike the original film from 1976, which used ships and planes that long post-dated WWII (the thinking was: "Who is going to notice?" Every professional and amateur historian on the planet, that's who.) Midway 2019 used CGI to reproduce accurately the ships and planes used in the war, which should satisfy every freeze-frame film historian who sees it.

November 26, 2019

"Oh, one more thing!" The phrase every medical provider dreads.

Not just because we're so strapped for time every single day in clinic, but often because of the disparity of the conditions the patient wants you to look at.

The complaint on the schedule: "Uncontrollable bleeding." We spend the entire visit addressing the issue.

The 'oh, one more thing' issue: "Can you take a look at my toenail? I think it's ingrown..."

November 25, 2019

My admiration for young kids coming up today increases.

I just had a twenty year-old patient in my exam room preparing for a trip to South Korea. He came in for a physical exam and the recommended travel vaccines. I finished his exam and my assistant stayed behind to give him his immunizations. A few minutes later, he came back to tell me that patient was light-headed and dizzy, and his heart rate was down to 35 bpm. Vasovagal response to the multiple immunizations.

I had the patient breathe deeply and perform the Valsalva maneuver several times, and his heart rate normalized. Once he was back to normal, I asked him not to let this episode put him off getting his yearly flu shot. He said "No way. I'm not down on vaccines. I'd rather have this than the flu. My parents are skeptical, but not me."

I thanked him and turned him over to my assistant again.

Young people know what it's all about. I salute the young generation once more!...

November 24, 2019

Saturday night. How is everybody doing?

Just had one drink tonight. Sparkling water for the rest of the evening.

November 23, 2019

Friday Night Wine-Buzz. Ask me anything.

I love you all...

November 22, 2019

Friday: Clinical feast or famine day.

Feast: Everyone wants their little aches and pains looked at before the weekend.

Famine: Everyone is checking out for the weekend, and isn't wasting any time at the clinic before getting started. Alternatively: if they're on Friday's schedule, they say "Hey, it's Friday! I don't feel so bad after all..." and blow off the appointment.

It's famine day here. Nice. The last few months have been so bruisingly busy that a quiet day is just what the Physician Assistant ordered...

November 18, 2019

I'm not Hispanic, but I have a question for improving cultural knowledge & sensitivity.

I'm a Physician Assistant serving a largely Hispanic community. I speak some basic Spanish, and am happy to say it is getting better all the time.

I have a question regarding my Spanish-speaking patients.

Nearly every day, I'll have an Hispanic patient on my schedule with the complaint "dizziness".

Then when I get them in the exam room and start taking the History of Present Illness, the symptoms they describe sound nothing like dizziness. (Some symptoms they describe will include things like heart palpitations, acid reflux, nausea, numbness; you get the idea. Anything but actual dizziness.)

Even my Spanish interpreters who speak English as a first language, but speak Spanish at home can't seem to tell me why this is so. One of my interpreters said she heard that Hispanic patients are often told by family members and friends to say 'dizziness' when complaining of an acute condition, but she was unable to explain why.

I'd like to be better at addressing my patients' needs. Does anyone know why 'dizziness'' is a thing among Hispanic patients?

November 17, 2019

Dammit! Why do You Tube ads have music that sounds like a porn soundtrack?!?

I'll select, like, a video about tanks or something, and the preceding ad has this oily music that sounds like it's accompanying a porn video! My wife will think I'm watching porn! Sheesh, advertisers! Use classical music like everyone else?

November 16, 2019

Friday Night Wine-Buzz. Ask me anything.

Pouring one out for Glamrock, whom I miss so dreadfully. A kind, fun, funny, DU friend who always has a word of encouragement. Speed his return...

Happy Friday to the rest of you...


I love you all...

November 13, 2019

I'm guessing every repub who announced their retirement is going to acquit and blow town.

They'll get cushy gigs as lobbyists, and never face a nanosecond of accountability...