PookieMD's Blog: Where Physicians Learn About the Business of Medicine

Please join me in remembering a great icon of the entertainment community. The Pillsbury Doughboy died yesterday of a yeast infection and trauma complications from repeated pokes in the belly. He was 71.

Doughboy was buried in a lightly greased coffin. Dozens of celebrities turned out to pay their respects, including Mrs. Butterworth, Hungry Jack, the California Raisins, Betty Crocker, the Hostess Twinkies, and Captain Crunch. The grave site was piled high with flours.

Aunt Jemima delivered the eulogy and lovingly described Doughboy as a man who never knew how much he was kneaded. Born and bread in Minnesota , Doughboy rose quickly in show business, but his later life was filled with turnovers.. He was not considered a very smart cookie, wasting much of his dough on half- baked schemes. Despite being a little flaky at times, he still was a crusty old man and was considered a positive roll model for millions.

Doughboy is survived by his wife Play Dough, three children: John Dough, Jane Dough and Dosey Dough, plus they had one in the oven. He is also survived by his elderly father, Pop Tart.

The funeral was held at 3:50 for about 20 minutes.

If this made you smile for even a brief second, please rise to the occasion and take time to pass it on and share that smile with someone else that may be having a crumby day and kneads a lift.  

Thanks Dr. A for sending this on–humor is the glu(ten) that holds us together!

Today I was at one of my favorite sites on lifehacks.  There was a blog on the “10Tips to Create a High Performance Workplace”.  Me being the fun loving, efficiency afficiondo instantly started reading the blog.  So here is how my work place stacks up, and why I now have a really great excuse for low performance(!):

• “Clean”–sheesh, the card table with the two computers on it that the ED lets the hospitalists work at is covered with crumbs, coffee cups containing gel like brown material and used tissues.
• “Organized”–no organization here.   There is a stack of order sheets you can root through if you have the time.  Otherwise, it’s easier to print out your own.
• “Uncluttered”–see notes on food ditrius above, not to mention that there is no usable space–it’s all taken up by the computer monitors, the printer, and the random stacks of order sheets.  I frequently put my clip board in my lap ’cause that’s the only place left.
• “Walls painted a color–not white”–Ha, ha, ha.  The only color on the white walls is spatter from mysterious body fluids, whose origin I would prefer not to investigate.
• “Good natural light”–I have yet to be in an ED that has a window.  Were they afraid patients would escape out the windows when they designed the building?
• “Healthy live plants”–the only plants that are in the ED are the ones used for “medicinal” purposes, and they aren’t living–unless they survived their time in plastic baggies.
• “Intersting colorful art”–I guess the wall spatter could be an abstract painting of sorts…but the color scheme leaves alot to be desired.  At least in a primary care office they can put in some color and nice art work. Hmm, maybe primary care does have an upside!
• “Momentos that matter to you”–I don’t carry anything that matters to me in to the hospital for fear of losing it!

Wow, no wonder my brain goes to mush as the environment I work in is chaotic, cluttered, filthy, noisey and cold.  Seriously, however, I wonder if we would have better decision making and outcomes if our work environment was less chaotic (not to mention better behavior by some patients!)  I think a sunny yellow would pep me right up!

I admit that I am a bit of an Egyptophile (is this a word?). It was great fun to read “Ancestry and Pathology in King  Tutankhamun’s Family”, in JAMA’s February 17 issue.  King Tut, made famous by the Steve Martin song of the same name, was portrayed in tomb art (statues/reliefs/sculptures) as androgynous and having a “bizarre form of gynecomastia.” 

The authors of the article examined several mummies thought to be related to Tutankhamun via radiological and genetic studies.  They developed a family tree, and surprise, surprise, the Tutankhamun family intermarried.  Turns out the boy king was the product of a brother sister relationship, and he in turn, likely married his sister.  Tut’s apparent grandpappy, Amenhotep had a club foot,which he passed on to Tut.  In addition, Tut’s father, the beleaguered Akhenaten, had a cleft palate, which Tut had too.  Scoliosus ran rampant as well.

In addition, King Tut had evidence of Plasmodium falciparuminfection, as well as juvenile aseptic bone necrosis, and had may have had to use a cane for much of his life.  Images of Tutankhamun frequently show him sitting during activities in which one would usually stand, like hunting. When Tut’s tomb was opened over 130 canes were found, showing signs of wear.

As for the bizarre body type seen it statuary and artistic renderings of the period? The authors found no evidence of  inherited syndromes that would cause androgynous features and “bizarre” gynecomastia.  The authors conclude that the artistic representations of Akenaten and Tutankhamun were likely stylized and idealized according to the wishes of the king.

The great thing is, the boy king is not likely to sue if the authors are wrong!

Photo

It was a busy evening last night at the hospital.  Things were hopping, but unfortunately, I was not.  I was, well, we’re friends here, I was just pokey!  I looked back at last night, and tried to figure out what made me so gol’ dang slow.  Here goes:

• Fatigue.  I didn’t have my game face on, and I had lost my groove. Maybe I needed Josh McDaniels (the potty mouthed Denver Bronco coach) exhorting me to get my f*bomb behind in gear.
• Chatty patients with lots of medical problems that were actually quite funny.  Like the elderly gentleman that kept calling me “Dr. Porkie”.  Finally he looked at my name tag and  exclaimed, “You’re not Dr. Porkie! You’re Dr. Pookie!”  And guess what, he was sent in for confusion.  Any patient that can figure out my name isn’t Dr. Porkie is definitely not confused in my book!
• Tons of pages, some appropriate, some not–like the one about the low glucose at 5 am, when it was 7:30 pm, some 14 hours later!  “I just didn’t have time to call until now,” said the regulation following nurse.
• Finding ways to manage the mess we call health care delivery.  Example: the chronically ill patient who needed nursing home placement until her knee surgery, but couldn’t get placed because of some SNAFU with medicare.  Welcome to health care dollar wasteland!  And no, I never found a way to get the patient to a SNIF, and ended up admitting her.  God Bless the case manager for trying for 8 hours, though!
• Lack of medical records.  One patient from a SNIF had no medication lists, because the family gives the patient medications daily. And of course, I tried all the phone numbers listed for the family, but no one was home.  The charming but demented patient had no idea of what medications he was on.
• A “code blue”–not much I can do about this one!
• Slow brain syndrome–my fancy new diagnosis for one fatigued doctor, working too much, with too little coffee, in a strangled health care system on a busy night.

Be careful out there! Keep the cappuccinos coming!

Thanks to Dr. S. for sending this in!

Via: Solodoc from salon.com.  Yes, I’m biased.

I’m going to be honest here.   Sometimes work is just no fun.  Sometimes it’s just darn right stressful and I can’t wait til the day is over.  Sometimes I wish I had gone ahead and opened a coffee shop, and the other day I was wondering how I could get a job testing Black Diamond climbing gear.  There are two trains of thought involving work: #1 it’s called work for a reason or #2 you spend most of your life doing it, so it should be fun.  I go back and forth between the two, depending on my mood, my caffeine level, and how much time I’ve spent outdoors recently.

I think we in medicine have been regulated out of fun and in to seriousness.  Yes, health care is a serious business, but we are human beings, and enjoying ourselves is part of our make up. So to that end here are ways to make the day fun:

• Go outside at least once during the day and breathe.
• Joke with a coworker.
• Carry around a picture of your kid/dog/S.O./next vacation spot.
• Have something to look forward to.
• Treat yourself to a great cappuccino before work.  (Don’t forget the post coffee mint!)
• Look up something you don’t know. 
• Spend some time making light chit chat with a patient or family.
• Say hi to the house keeping staff.
• Have a pot luck, and PARTICIPATE.  C’mon, you can bring in a crock pot full of beans ‘n’ weenies!
• Keep the candy jar stocked in the lounge.
• Have a themed Friday, say Hawaiian, and wear that crazy shirt.  Let your staff play Hawaiian music, and decorate the lunch room.  Give  plastic leis to the patients.
• Have a barbecue at lunch and play basketball.  I love it when I see a bunch of people playing basketball in the parking lot where they work. Kids aren’t the only ones that need recess!
• Go to your hospital’s lunch ‘n’ learn and yuck it up with your colleagues.  Sometimes we are so locked in to our little routines we miss the importance of spending time with our friends.  Besides, you might learn something!

Get out there and have some fun! Leave your responses on how to have more fun and email pictures to blogatextramddotcom and we’ll see if we can up load ‘em!

Now, does anyone have an in with Yvon Chouinard?

Spam aint just campin’ food!  Yesterday I got 17 spams from the same carpet cleaner company.  Puh-leaze–we physicians have tile in our office!