Category Archives: woman

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Passe

Today’s Ragtag Daily Prompt is anachronism. I guess that would be Helen Burling Ottaway’s watercolors, since an AI can do them, and my work as a physician. The American Academy of Family Practice (AAFP) wrote: “So, the AAFP looked into an AI assistant for clinical review that can “pull the data together in a problem-oriented manner and give you a snapshot of exactly what’s going on with your patient without having to search and click and find things.”

Um. Ok, I am thinking of a patient who was about to be transferred from our small hospital to a bigger one. His notes came across my desk. I called the hospitalist. No less then four physicians during the hospitalization, starting with the emergency room physician, had written that his abdomen was “flat, soft, non-tender, no masses”. What this told me was that 1. Not one of them had done an exam. 2. Not one of them had read my notes nor the surgeon’s notes. 3. The bigger hospital was going to laugh themselves silly if they did an exam. Why? He had an 8 by 8 inch enormous umbilical hernia present for 20+ years, which had not gotten fixed yet because of other medical issues.

Great. So let’s make it worse by having an AI pick out what is important from the patient record and have it make up exams, which people are too lazy to do. Physicians are too lazy to do. People, you had better read every single note your doctor or nurse practitioner or physician’s assistant writes, because you want to go on record in writing when they get it wrong. It is an absolute horror show. Read your notes, because your doctor is most likely not reading the notes from the specialists. I find it amazing, horrifying and sloppy.

I learned to paint watercolors from my mother. I am not primarily an artist, but I learned all sorts of techniques from her. We do not learn from plugging an idea into a computer. We learn from doing. And yes, it is work to learn techniques, but it is worth it!

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Small wounds

Small wounds over and over.

“The band is invited to Arizona. We’ll be on the radio. And I am trying to set up a recording.”

She keeps her eyes down. Tries not to hope. She has time, she could take time off. She has saved so much vacation, hoping. They would have to have someone stay with the kids.

“It’s going to be a great trip. I haven’t spent anything from the last big sale yet, been saving it for something like this. I was hoping we could record.”

She is wiping the counter slowly, over and over.

“That sale was amazing, just when I needed it. Debts paid and caught up.”

She works in the local government. Steady. It gives them health insurance. Secure retirement. Nothing spectacular. She turns to the sink, to rinse the cloth. The counter is clean enough. She isn’t going to think about it any more.

“That is great.” She tries not to hate the band. “At work–“

He is behind her and hugs her. “You are so great, here for me. We are going in three weeks. February. Perfect time for Arizona, I can’t wait for some sun.”

She tries to feel comforted by his hug and yields to it, as always. She is silent.

“Now make sure you don’t let the kids talk you into giving them too many things while we’re gone.”

She nods.

He kisses her head. He lets go and gets his guitar and coat. “Have a good weekend. I have to practice.” He is headed for the trailer, in the next county, alone for the weekend, to immerse in music.

She turns and watches as he leaves.

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quiet woman 2

mirror mirror

I am culpable as the mirror
hiding hiding hiding
curious about you
what is it you want to see?

I am always surprised
when a man lays his fantasy over me

I have hidden and studied people
for many years
now realize that that is why
the fantasy gets overlaid

I did not know
I was hiding behind a mirror

I think about four men
serial monogamy
over fifteen years
a year break after each

a mirror reflects
a man’s own anima: his ideal woman

all four so different
yet there is a thread that binds
trauma like my trauma
and closer and closer to an opposite

I do not want to be a mirror
any more

the connection of the damaged child
I tried so very hard not to trigger
until the mirror broke
I hold pieces up in my bleeding hands

they leave when the mirror breaks
now I understand

this time was hardest and least hard
at the same time
I could almost see what was happening
almost

and now I can see
and break the pattern with the mirror

my friend says
why don’t you let them see
who you really are?
they would never have let me work

I had to wear the doctor mask
even with other doctors

the nurses and the staff saw through it
right away
they’d call me for patient needs
and knew I’d answer

did I have to wear the doctor mask
or did I wear it to feel safe?

water over the dam
but it’s time to take down the dam
and be myself
and not a mirror

I didn’t know this quiet woman is me

_________________________

For the Ragtag Daily Prompt: ART!

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Lit

My friend Maline Robinson is an artist, paintings and silk screens. This one fits today’s “luminous” prompt, pale lit color and layers and texture.

Meanwhile my brain starts playing one of our choral pieces: Luminous night of the soul. It builds and builds, layers of sound and complexity. Here is another group doing the piece:

For today’s Ragtag Daily Prompt: luminous.

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Not a fox?

I think I have a photograph of a fox somewhere. I know I do. Not on this laptop. I do have a coyote.

As I think this, I am looking though photographs. Oh, this.

I am not going to outfox someone. I am going to outleopard them. After all, I am a single older woman. A fox? A leopard? Usually we are called cougars.

Fine with me.

For the RDP: outfox.

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Robust healthful manhood

The photograph of “a healthy man” to go with my Ragtag Daily Prompt conflate post.

I LOVE the caption. “Robust healthful manhood is the source of mental and physical power.” How differently the author portrays health womanhood, as shown in the conflate post. The book is Macfadden’s Encyclopedia of Physical Culture, in three volumes, 1911. Volume I is 500 pages. It is easy to read but it’s a different style from now. Here:

As a rule, if you will simply retain the idea that food should be swallowed at all times without effort, that is, that never, by any means, wash it down with water, milk, tea or any other liquid, that you should masticate it until it seems to disappear without swallowing, you can rest assured that you are masticating sufficiently. p. 97, volume I.

I plan to read the entire set. I think I will find lots of wonderful words for the Ragtag Daily Prompt (hey, I don’t think we’ve used masticate yet!) and material to write about.

Are there still interesting medical ideas out there? Oh, yes. LOTS. Only now they use the internet. I have subscribed to some of the series of videos, telling people how bad and wrong minded allopathic doctors are. Sigh. We do our best. The scam is that they let folks watch one a day for a week, or let them watch one, and then want you to buy the series. “Only $349.99!” Nice scam that is proliferating rapidly. I have now gotten emails saying “Health coaches should make as much or more than physicians and we can teach you how to market and target people and make that money.” Ugh and ick. Really?

I have patients in clinic who present by saying, “I don’t usually go to MD doctors, I go to a naturopath, but I am here because I need an antibiotic.”

I learn to respond gently. “Oh. If you need an antibiotic, maybe you have signs of infection? What are your symptoms?” I have to get past their dislike of allopathic medicine and find out what the symptoms are. Usually if I can diffuse them by getting the story, we can work together. Once in a while it doesn’t work: I have people come in and give me orders. “Do these labs.”

“Uh. Where did this list come from?”

The answer could be a video (by a naturopath, a biochemist, a biologist, whatever. I have watched some of these series. They start by saying that doctors are wrong/stupid/stubborn/misguided/etc.) or a “cash only” doctor or a magazine.

“Why are you coming to me?”

“I want medicare/my insurance to pay for it. I have done my research.”

“Well, medicare does not work that way. I have to list a symptom or diagnosis code for every lab ordered.”

“WHAT?”

I try to be patient. “Every lab has to have an attached appropriate diagnosis code or medicare will not cover it. There is a place in town where you can order your own, but it does not take medicare. You pay for it.”

“Just order it!”

“No. I am a medicare/insurance provider, which means I have a contract with them. It would be fraud and illegal to make up codes. Does your cash only provider use diagnosis codes? Can your bring their clinic note to me?”

One person replies, “My provider doesn’t take notes.” Oh, how nice. That provider does a very expensive panel of labs three times a year that the person is paying for out of pocket. “My provider checks EVERYTHING.” Um, and makes a boatload of money off you too, I think. That patient is very angry that I won’t take her orders and switches clinics. Oddly enough, this does not break my heart.

Some days I hate Dr. Google. There are lots of websites and people on line swearing that they can improve your health. There are scientific looking papers that swear something has been tested, but read the fine print: if the sample is 8 people, how does that stack up against the Women’s Health Initiative, where one arm of the study had 27,000 people? The evidence is weighted. We get multiple articles in medical school and subsequently about how to read a paper, how to weigh the evidence, how to recognize fraud or a poorly designed study.

I do not object to people looking on the internet and I have had people who came in and said, “Is it possible that I have THIS?” and who are correct. However, I see more fraud, always.


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sending flowers

I was “separated” from a website for “not explicitly breaking the rules”. Hey, it’s a “woke” website and wow, I guess I was annoying, or the editors are insane, or something. The eds who had become friends over the years didn’t know a thing about it. The owner removed me.

Now I am removing every reference to that site from my blog, over time.

So here is a poem from a week ago, to “honor” the insane editors. I do think they need to vet them a little better, heh. But if the owner doesn’t mind the site imploding and dying, hey, he has chosen the best editors for the job.

______________________

Eeeeeeeeeew eww

eeeeeeeew eww
I’m annoyed at you
don’t you see you’re inconveniencing me?
don’t you see you shoot yourself in the knee?
don’t you see choices so dumb I could scream?
don’t you see
you’re destroying the dream

eeeeeeeew too
I’m so annoyed at you
but I’ll forgive you your sins
after I stick you with pins
and laugh many many grins
you’re sent to bed without dins

eeeeeeeeew too
I’m so annoyed at you
but I don’t really care
I think it’s totally fair
that you’re dissolving out there
in the cloud unaware
and no one else cares

eeeeeeeeew too
don’t cry a boohooo
you reap what you sow
I won’t cry when you go
sad to see you sunk so low
advertisment ho
drunk funked skunked bro
yeah, ed, he don’t know
sentimental slop woe
stinking slow to grow

eeeeeeeeew too
is yo owner a ghoul?
I think you raised up some fools
I mourn the loss of some jewels
when sad stupidity rules
some eds is fool mules
I carve yo gravestone with tools

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spring fur

A friend has a dog that sheds in the spring in great piles. On first glance the yard looks like rabbit murder, until you realize that it is dog fur.

And why would it be in my car? I’m not sure I want to say. It has something to do with rocks and eggshells and feathers and a project that is forming in my mind.

For the Ragtag Daily Prompt: allergy.

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Upstage

I am reading Kim Addonizio’s Ordinary Genius, A Guide for the Poet Within, for a class. In the chapter about cliches, she suggests choosing a cliche and playing with it. The first example on her list is “A sudden fear gripped me”, so she inspired this:

Upstage

A sudden fear gripped me by my nipples
I hear my mother: Colder than a witch’s titty
Why must the witch’s titties be cold?
Must they dance naked even in the bitter winter?
Can a witch retire at a certain age
Sit warm, clothed, with her cat and tea
By a fire with enough fuel for winter?
You’d think they’d get pneumonia dancing naked
In any weather; yet witches are usually old.
Maybe it acts like jumping in to cold water
To dance around a Beltane fire; maybe witchery
is hot work and they aren’t cold at all.
Maybe a witch’s titty is warm all the time
And meanwhile the fear is gone, upstaged by titties.