...and yet another good reason not to bring your 5 year old daughter with you to your appointment.

my patient is busily telling me how he's never smoked a cigarette in his life when his daughter pipes in with, 'except when you're drunk, daddy.'

evidence of the seriousness with which i undertook my medical studies

i was trying to remind myself of some bit of foot anatomy today (i don't really want to admit it, but i couldn't remember the name of the first joint of the little toes), so i pulled out my Netter and found this.

i think the big toe invokes a  gentle spaniard...

my theory of the mind-body dysynchrony of aging

there is a common thread to my interactions with people as they age.  they say things like, 'why am i so tired?', 'why do i need to take a nap after lunch?,  'but i don't feel xx (insert any age over say 40 or so).'  when they use the term 'i' they are not referring to their physical selves, they are referring to everything else, call it your mind, your soul, your essence or being, or whatever else describes the non-physical you.  the older you become, the wider the chasm that seems to develop between your physical self and your non-physical self.

so here is my theory:  unlike our bodies, that are only ever one age at a given point in time, our non-body selves are every age we've ever been or at least can remember being.  even at eighty, when our bodies are clearly and irrevocably 80 years old (except maybe that knee replacement), we are still the flirty teenager that fell in love with her high school sweetheart, or the young man that went to war.  we actually forget at times what age our bodies have become, at least until they gently remind us.

as an extension of this, i believe it is a mistake, made easily in medicine when the focus of the work is so often in the here and now, so embedded in the physical self, to look at someone at 67 or 75 and see only the 67 year-old or the 75 year-old.  it is much more fun and interesting to see the deeper, broader person that they are, the every-year-old in them.  so that is what i try to do.  and i hope some day that someone will do the same for me.

primary care moves a notch lower on the totem pole

my partner took a call last night from a patient with a toothache.  when asked if she had tried contacting her dentist, the patient responded, ' i would never call my dentist at this hour.'

some new year's resolutions i've already blown

1)  finish each note immediately after i see the patient.

2)  don't leave any phone calls for the next day.

3)  stop eating buckeyes.  (unless the fact that there are no more because i've eaten them all qualifies.)