Fill in the blank

I'm on call this weekend. And the answering service is killing me. Killing me. Apparently the entire city of Houston decided not to call their doctors this week for refills but to wait for the weekend so I'd have to do it.

Patient: Hi, I see Dr. Smith, and I'm out of my blood pressure pills.
Me: OK.
Patient: I've been out since Thursday, so I really need them refilled today.
Me: Um, your rheumatologist gives you the blood pressure pills? Not another doctor?
Patient: Yes.
Me: OK. So which medicine is it?
Patient: I think it's enalapril.
Me: OK. How much do you take?
Patient: I'm not sure. I think it's 17.5 mg.
Me: Enalapril only comes in whole numbers. Like 5 or 10 or 20. There isn't enalapril 17.5.
Patient: Well, I don't know.
Me: Hm. What pharmacy do you use? They might have it on file.
Patient: It's a Walgreens.
Me: Do you have the phone number?
Patient: No.
Me: Do you have the address?
Patient: No.
Me: And you don't have your old pill bottle?
Patient: No. But I use a Walgreens on Main Street.
Me: I'll look into it.

Right. An unknown dose of an unknown pill at a Walgreens on Main, which might be the longest street in Houston, TX. I'll get right on that.

Where credit is due

I've kinda always known I would do internal medicine. Yes, I'm a rheumatologist now, but medicine is my first love. And a thankless, fickle lover she makes. I had my first glimpse of just how thankless during my fourth year of med school. I was rotating with the pulmonology consultant to the CVICU (where the surgeons ship their post-op valve replacements and CABGs [coronary artery bypass graft], etc). The patients came out of the OR in horrible shape. I mean, you don't wind up needing a triple bypass from eating right and exercising every day of your life. These guys had poor protoplasm, and the surgeries were brutal. Brutal.
My attending spent days weaning the vent, managing the sepsis, dealing with the inevitable kidney failure. Days later, after the sedation was lifted and the tube out, you know what the patients told their families?

Oh, Dr. Surgeon saved my life. I wouldn't be here today if it weren't for him.

And I thought... Huh? What about Dr. Medicine? He saved your life! Dr. Surgeon cracked all your ribs, ripped open your chest, and cut open your heart! That should have effectively killed you, except for the fact that Dr. Medicine swooped in and saved the day.

But the patients never saw it that way, and they never will. Sigh. We don't get no respect from nobody.

Here's to you, Dr. Medicine. Cheers.

Me and King Solomon

What do I have in common with the smartest man ever to walk the earth? Apart from our obvious shared state of intellectual gigantism, we both know too well that there is nothing new under the sun.
I got a call today to see a patient with a very rare joint condition. A condition that, believe it or not, doesn't respond to steroids. In fact, it doesn't respond to any of my parlour-trick immunosuppressants. Why? Because it isn't an autoimmune disease. It has always been and forever will be an orthopedic surgeon's problem, not mine. But I had to see the patient. Today. For a problem he's had since the early 1990s. A problem that, as mentioned, I can't fix. Ever.

But see him I did. And he already knew everything I told him. I guess once you've been through nearly two dozen ortho procedures, you get wise about your disease. So that makes three of us in the too-smart-for-everyone-else club.

Please see me for an application if you dare to join us.

Story time

Oh, the sweet, sweet lies you tell me. You paint a beautiful picture with your deceitful words. You draw me in with a story of the perfect rash, joint swelling, and just the right pattern of labs. Please come see your patient, right now.What if he needs high-dose steroids?
But the truth alawys comes out. I always find out you're lying to me because the patient doesn't know he is only supposed to tell me the things I want to hear. The patient tries so hard to please me, answering all my questions honsetly. And the holes in your tangled web get bigger with every word.

It's still not lupus. Better luck next time, Kafka.

Like mother, like daughter

I'm sure I've told some of you the story of my first real Christmas tree. It was our first Christmas as a married couple, and Nick wanted to have a real tree, like he did growing up. While the tree turned out beautifully, I discovered my skin allergy to certain varieties of conifers - mainly the cheap ones. Seriously, I haven't had a reaction to the Noble fir in subsequent years, but the more wallet-friendly Douglas really does make me break out.
I told you that story to tell you this one...

Nick got a great deal on a new brand of diapers on Amazon. A really great deal. I wasn't too thrilled because I liked the brand we were using before. And this new brand smelled funny. Not like baby poo or anything, just way too heavily perfumed. Whatever. We've been bickering about said diapers for almost two weeks now. But over the last few days, Elle has developed a rash. Not a standard diaper rash, but a more allergic-type rash, exactly corresponding to the super wetness protection band (or whatever they call it) of these new diapers. This didn't happen during the previous two months with the old kind. I showed Nick the rash to prove I wasn't just making this up to win the argument. He sadly agreed that we probably need to nix this new brand. Turns out Elle has expensive skin, just like her mama.

My stunt double

Babies can't see very well. I therefore have the perfect childcare situation, in which Elle may not even realize she's got another mother. Just take one look-alike Auntie Laurie, spritz her with my perfume, and keep the baby at arm's length. Ta daa! Fooled you, baby!Kidding. I think Elle can still tell the difference. But this is the next best thing.

Thanks for being me...oops, I mean thanks for being you. Hm, thanks for being you being me, Aunt Laurie!

Battle of the sexes: He said, she said

You know how sometimes, when you know someone really well, you can tell what he/she is going to say before the words are even out of his/her mouth? Well, here's some common phrases uttered at the Scholz household, and we've been married for so long that I forget who said some of them first.

You're killin' me.
Mostly from me, to Nick, with nothing but love.

Are you broken?
Mostly from Nick, to me. Often followed by something like, "Can't get it yourself?" He usually says this as he's getting up to get whatever it is for me. Because I am a delicate flower who shouldn't strain herself with heavy lifting, such as getting a new roll of toilet paper.

And whose fault is that?
I blame... you.
These invariably go together, and this conversation regularly runs both directions. Why blame yourself for your own inadequacies when you can blame your spouse? After all, he is supposed to keep my schedule, grocery list, and to-do checklist memorized (and alphabetized) at all times.

Shut your traphole.
I know, you probably think I have to tell this to Nick all the time since he's constantly yapping his trapper. But, surprisingly, he has been known to say this to me. This often follows the "And whose fault is that?" scenario immediately above.

You know what they call that. The three P's, that's what.
Not funny, Nick. Not funny.

Look at me. I can [fill in the blank]. Who am I?
A really smart person, that's who.
I like to mock Nick every once in a rare, rare while. But somehow, he seems to think I'm paying him a compliment instead. A "shut your traphole" falls nicely at the end of this little exchange as well.

And there you have it. Scholz speak, 101.