Mar 31, 2012

Surprised by progressive people...

I wear my scrubs home from work a lot because I'm lazy and never sterile anyway. I'm a short female frequently wearing a backpack, so General-Populationville usually thinks I'm a nursing student, which I've stopped really giving half a crap about since it's easier than explaining what I actually do.

The CSI watchers jump to autopsy (Yes, I carry a gun and chase criminals around crime scenes. In heels. I'm badass that way. I also used my kelp knife to fight great white sharks rather than using it to avoid being murdered by algae), and any further explanation of what pathologists do, ie, most of our job, is lost on people.

I would say that etiquette would dictate erring on the side of highest education/deepest loan burden, thus I insist all people noticing my scrubs address me as "You must be the program director of neurosurgery at Johns Hopkins!" else be branded as sexist pigs. On the other hand, I'd note that my hospital is one of the biggest employers in this city, as well as being a medical school, so seeing someone in scrubs should usually prompt people to not guess what you do, since they have as much chance of getting your profession correct as you do seeing someone in a suit.

Still, imagine my surprise:

Rite Aid cashier: "Oh, are you a doctor?"

Me (shocked stutter): "Yes!"

Rite Aid cashier: "Surgeon?"

Me (double shocked stutter for the double un-sexism): "No, uh.. pathologist."

Rite Aid cashier: "Ah! Heh. 'Are the margins clear?? Are the margins clear??' "

Me: "You appear to know more about pathology than most doctors."

It's true too. In med school, I had a frigging anesthesiologist hear my interest and go "Oh, but don't you mostly deal with dead people?" Dude, you're in the OR when they send specimens. You have to sit there and wait for the phone to ring so the operation can proceed. How do you not know what we do?

Then I remember I've been on autopsy for two months and feel like I'm fulfilling some sort of stereotype, like if I'd been caught painting my toenails and watching Fried Green Tomatoes while crying into a kitten's fur and asking a man what he's thinking.

Mar 29, 2012

And now for something completely different

I had a request for a new blog post today, and responded with something to the effect of "I'm in the middle of trying to get an abstract accepted and everything I'm doing at work right now is confidential", so I came across a colleague's link of facebook which led to a post that really moved me a lot, while also reminding me that I became a pathologist to help with situations like this while not having to directly deal with situations like this:

An Ode to a Patient

There's a bunch of fighting about health care currently, and if I were a truly good politically aware doc, I'd be paying more attention, but honestly, this whole health care legislation/insurance company screwage is so confusing that it's honestly not because we don't care. We don't get it either.

This doesn't really relate to the current bill either. It's just a general observation.

Common situation even as a medical student:

Patient: I have insurance. I have a complaint. Please address my complaint.

Doctor: I am a doctor, thus interested in your complaint. Let me examine you and run tests and get images.

Patient's insurance company: We're going to cover 60% of this and some of this, but this image you ordered we aren't going to cover because... blahblahblahfishcakes. So you're not going to really get paid much, but the patient's general expenses are going to still be life altering, and patient still isn't going to be able to afford the MRI, and if you want the MRI, you're going to have to cough the two grand out of your bank account, since while you can comp your services, you don't own an MRI or an MRI technician, or a radiologist. Addendum, we're adjusting our provider options, so the specialty treatment your patient requires is going to be at a hospital across town. Double addendum. Those lab tests got sent out to a lab that wasn't covered, so the patient's getting charged four hundred dollars she's going to blame you for. Meanwhile, people are just going to keep thinking you're a Mercedes driving golf club swinging douchebag while you drive your used jetta to work and pay off a quarter million in loans, cool?

Doctor: Super.

Patient: Why can't YOU treat me???

Doctor: I genuinely don't know.

Mar 20, 2012

This is why the boys don't call me

Financial advisor: Is there a time you can talk tomorrow morning?

Me: Uhhh... I don't know yet.

Financial advisor: You don't know?

Me: Well... I'm on autopsy this month, so it kinda depends on.. ya know, who dies.

Financial advisor: "..."

Mar 17, 2012

Happy St. Patrick's Day!!

I'm pilgrimming to Savannah tomorrow for what I'm told is an incredible celebration, and most importantly, I made these:

I got the recipe from here which is an adaptation off the Smitten Kitchen.

Pretty much it's an Irish car bomb shot that's been made into a cupcake. More significantly, *I* cooked. Which I can't generally, but I've been on phase 45 of trying to become a grown up at the tender age of 31 and eat something that hasn't come out of the hands of a delivery boy or out of a microwave or through my car's window.

And I get to see New York friends again! Which is super awesome.

Other news:

The fire: I replaced my fabulous alligator head purse which I loved so much and feel a little more complete.

I attended another hearing for the little shit that started all this and this time got to see him, look him in the eye, and tell him what he did. Heard his mother talk about his neighborhood and how he wasn't a bad child even though he's already committed a decent smattering of felonies and misdemeanors without being beaten to death. I love my mom, but somewhere between larceny and assault, I would have concerned myself with finding and recovering tooth fragments rather than progressing to arson. Not that she beat me, because I didn't give her a compelling enough reason to do so, because I knew better. Anyhoo, the next hearing was waved and next step is a trial, so I don't have to worry about it for a while and getting to say "This is what you did" in a court and have people listen to me for a change felt a lot like closure.

I feel comfortably settled into my new life. My roommate's dog is hating me me less. My car is awesome, shuttled me to and from Maryland last weekend without incident, and tempts me every time I shift into first gear to really rev the engines and let it run, but I'm trying to behave myself for the sake of my greatly inflated insurance rates.

Work: Pretty not bad. Autopsy is calming; I like the attendings, and I'm beginning to not feel like a complete idiot. The heart used to panic me since there's a whole process for it and it's usually what kills someone, and now I can teach it to med students so they can cut it shakingly while I watch. I can toss stuff off while I'm dissecting. Here's the conduction system; here's the substantia nigra; what's the significance of it? Why don't you see it in babies? This is a pulmonary embolism. This is a postmortem blood clot. This is how you can tell. Do you remember the liens of Zahn?

I still feel an odd sense of fascination about the snapshot of a person we get from their personal effects. Especially since the police usually take wallet and phone (and guns and such) so no picture, no identification, just.. cough drop wrappers. A crack pipe. A penny. A photo. Fifty dollars and a gap coupon. A handful of tree leaves and branches from where they died. When someone's tried to help, the sequella of events is extremely clear, the laryngeal edema from the endotracheal tube, bruises on the chest, the rib and sternal fractures, the punctures all over from rapid indelicate IV attempts. The battle scars of the good Samaritan.

A word of advice though, which I reserve for myself a lot. It's never as bad as you think it is. Tomorrow will always be better when you've had time to process it. The idea that you're going to "show someone" you're fighting with and teach them a lesson either leads to you hurting someone who cares about you or killing yourself over someone who doesn't. Just sleep on it. The bridge or the gun or the chainsaw or the pills will always be there tomorrow, so why be hasty about it? No one will ever find you? Of course they will. And it won't be as bones or a memory. It'll be bloated and stinking and that's the legacy you'll leave to a room full of people that refer to you by a number. So therapy and some perspective guys; just saying.

Mar 1, 2012

My handwriting...

Forensic fellow: "Oh! I've been looking for you. Did you add an addendum on to an older case but crossed out some stuff, because it's a different case number?"

Me: "Uhh... I have the attention span of a goldfish, thus no idea what you're talking about if it doesn't relate to a case I've been doing in the last day."

Forensic fellow: "It's a girl's handwriting."

Me: "Oh, then it's not mine."

Forensic fellow: "Oh, do you write like a boy?"

Me: "I write like someone in the middle of a seizure."

Follow up: Yeah, I did it. Apparently, my handwriting is 'curvy', thus I write like a girl. I defended myself by saying that I can't write like a girl because I don't dot my i's with little hearts. He wasn't buying it.