may i have the envelope please...

you may already know of my aversion to the proffered envelope or other item in the exam room (sure to contain something gross).  so when my patient reached into her purse and pulled out a sealed envelope, i ran from the room inwardly cringed.  in this envelope, she told me, were the pinworms she had pulled out of her carpet.  she described their pale bodies and hooked mouths to me in great detail.

i bravely pulled on my gloves and set out a drape to catch the worms.  i carefully unsealed the envelope and shook the contents out onto the drape.  oh, dear.

which of these things is a pinworm?

 a)  a down feather
b)  a piece of a pretzel stick
c)  the stem from a grape

answer:  d) none of the above

what is this woman's diagnosis?

answer:  sadly, hallucinations related to her underlying dementia.

the sounds of medicine

awesome sound:
the abbreviated ring of the phone before it kicks over to the answering service on friday afternoon.

not so awesome sound:
your pager going off at three am sunday morning. (that would be the patient who is too polite to wake her dentist...)

awesome sound:
the jet of fluid as it hits the side of the vacutainer telling you that you're in the pocket of acites you are trying to drain from your patient's abdomen.

not so awesome sound:
the whoosh of air sucking into the IV site as you pull a wide bore central line (but no so bad as the voice inside your head that is now saying oh, crap...)

awesome sound:
the rapid, but gentle and happy, thump of fetal heart tones

not so awesome sound:
silence when there should be none.

an honest answer

i asked my COPD patient how his breathing was, and he answered, 'expensive.'

may i one day find happiness in a can of paint

today i saw a very happy nonagenarian -- so much so that i was wishing i had a camera to capture the vibrant image before me.   her shock of unkempt white hair floated around her face.  her eyes were vividly blue,  and her skin was deeply tanned and wrinkled. turns out she has been painting the foundation of her son's house.  'i just love to be busy!' she told me through the kind of smile that even in your darkest mood you would immediately respond to with a smile of your own.

(later her son told me that he switches out the paint color slightly and she's already been around the house twice but, hey, whatever works...)

probably not

does running from my office to the front desk to hand something to my patient that i forgot count as exercise?  i probably do that 100 5 times a day.

a great patient quote on the joys of aging

my patient offered me the perfect analogy for aging the other day.  she said, ' you know how you don't know your baby can roll over until your baby rolls over? well when your old you don't know you can't get up off the floor until you can't get up off the floor.'

can't wait to get old -- so many adventures to look forward to!

senior parkour

as i was removing the sutures from my elderly patient's forehead, she informed me that she had been showing her friends how to fly when she fell off the curb.