Tag Archives: photography

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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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rural doctoring

I read Grampa’s Solo Visits this am and it makes me laugh.

Since I have been a family doctor in my town of 9000 for 22 years, the grocery store and coffee shops can be interesting. When I moved here, my daughter was two and my son was seven. We have three grocery stores. I usually go to the one 7 blocks from my house. I would see patients. My diabetics would sometimes look guilty and scurry away when they saw me. Another patient comes to peer in my cart.

“I want to know if YOU are eating healthy food.” he says.

I laugh.

“I don’t see any vegetables.” he says.

“I am in a CSA,” I say. “I get a box from the farm once a week.”

He frowns. “Do you get to choose?”

“No,” I say. “But since I hate throwing vegetables out, we eat more vegetables. Also, we eat ones that are unfamiliar. The first time I got celery root, I had to look it up. I didn’t know what it was.”

He nods. “Hmmm. Ok. We want to be sure you practice what you preach.”

I laugh again. “I sneak in to get the ice cream at midnight, ok? And where is YOUR cart?”

“My wife has it,” he says. “You don’t get to see it.”

“Ok, then. Have a great day.”

When we were first in town, occasionally someone would come start talking about their health in a store.

“I can’t discuss your health in front of my children. HIPAA.”

“Oh,” they’d say, “Uh, yeah. I should call the clinic Monday?”

“Yes, please.”

We had a coffee shop that made the best pastries that I’ve had since I was an exchange student in Denmark. I wished they’d make tiny pastries, bite size, for the diabetic folks. Those folks would slide a newspaper over their plate when I walked in with my family. They looked terribly guilty. I might nod, but I wouldn’t say anything. Sometimes they would confess at the next visit.

There are lots of jobs in small towns where people are very much public figures. Not just doctors, but the people who work for the city and the county, the ones who redo the taxes for homes, the realtors, all sorts.

After I was divorced, another doc at the hospital asks, “Dating someone new?”

I frown, “How do you know?”

She grins, “He lives on my street. I saw you.”

Dang it. The rumor mill is very very efficient and can often be fabulously wrong. That time it was correct, though I don’t think she passed it around. Other people live on the street.

A few days ago someone that looked familiar walks by me. “What are you doing with so-and-so?”

I laugh. “Rumors abound.” I say. “You would not believe the rumors!”

I took the photograph of the coyote yesterday, driving home. Stopped dead in my lane, no one else on the road. People will be stopped in the road here, talking to each other in two cars going opposite directions, or talking to a friend on foot.

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Volume of water

We check the tides before we go walk the beaches on the Olympic Peninsula. I am learning the patterns of the tide locally. On North Beach, the tide is about an hour later each day. However, low tide is at a different time further out the Olympic Peninsula. I had to think about that a bit.

Picture the tide a low with the Salish Sea volume down. Then the tide turns and starts flowing back in. The Salish Sea is like the roots of a tree, with a main trunk and then branches and branches and more branches. There is water coming in from the land, from streams and from rivers, but the tide rolls in from the trunk first and then spreads through all of the roots. I have a tide table for the peninsula for this year, and it has tables for multiple different sites! Most days we have two high and two low tides, but once in a while the low goes out so little that it matches both highs, and we only have two tides that day, a high and a low!

I took the photograph at Dungeness Spit this month. The tide was nearly low when we started walking and we only went 2-3 miles down the spit and turned back. It is beautiful! Check the weather, check the tides and always take something rain proof, even in July. Our water is not warm.

For the Ragtag Daily Prompt: volume.

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Bird talk

A photo tale from a hike last week.

Her: “I think we should discuss our future.”

Him: “Well, um.”

Her: “Wait. Are you trying to tell me something?”

Her: “Is there someone else!!?!”

Him: “I was going to tell you!”

Her: “You lying scum.”

Him: “Wait! Oh, no, she’s GONE.”

__________________________________

For the Ragtag Daily Prompt: create.

These are Pigeon Guillemots, more here.

Photographs taken on Marrowstone Island last week.

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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