Sunday I drove up to Grand Mesa, over 10,000 feet. Wow. The aspens gold and the evergreens green and the perfume of the clear air. The high temperature was much lower then in Grand Valley. A sign says that Grand Mesa is the world’s largest flat top mountain and there are hundreds of lakes on top.
No nightmares about clinic since the one I wrote about two days ago. I do feel like a bit of a dinosaur in clinic, though. Most of my older patients seem to really be fond of dinosaurs.
I’ve heard from other docs that they don’t have time to talk to each other in clinic either. Patient time but primary care we read all the notes from everyone: specialists, PT, OT, xrays, CT, MRI, ultrasound, lab, lab, lab, lab, prescription refills, phone calls. I read that people are trying to insert Artificial Intelligence into this. I am fine with a computer learning to read mammograms, but condensing information from notes? The AIs currently can “hallucinate”, and make things up. Is that worrisome or am I being silly? Notes are often wrong ANYHOW, way more than I would like. I saw a patient yesterday who has a neurological disorder. The hospital discharge note lists the wrong one! The patient caught the error, I didn’t. I am very glad he corrected me, but the hospital note is still sitting there wrong. Having been labeled with wrong diagnoses myself, I think it is a big deal. In order to fix it, he would have to fill out a form and the form would go to the physician, who is supposed to respond and add an addendum to the note. How often do you think THAT happens?
The discharging physician suggests he see a specialist for testing. I call that specialist and they agree with me: that testing is not indicated, it won’t make one bit of difference in his treatment. The discharging physician also suggests lung testing. I don’t think it works or is useful with a serious neurological disorder that affects muscles! Think, people.
My patient is grumpy and asks how we know the medicine is working. I reply, “You’re not dead.” Which is true. Undiplomatic, but he does not mind, because he is already saying, “What is the point of this?” To explain more about the medicine working, I ask, “Is your breathing better than when you went to the emergency room?”
“Yes,” he says.
“That is because the medicine is working.” I explain how it works and what happens if he stops it.
Sometimes it makes me feel heavy, heavy, like a dinosaur.
But I think I will try discussing my clinic day with my cat. I think she might enjoy it and I can clear the grumps out. And it’s not a hipaa violation! She doesn’t like other cats and won’t tell them anything.
This map is in the Betty Ford Alpine gardens along with wonderful flowers from along that road. Think of people passing seeds to each other for thousands of years.
I went to the post office Monday. I am in a rental house, and get packages every so often for the previous renter. This time I realized at the post office that one was misdelivered and was to the house next door. Ooops. But the post office said they would redeliver it.
I love snail mail letters. I have colored pens and stickers and stamps. The whole thing makes my inner child very happy. Once I got a letter from my mother-in-law saying that my letters are national treasures! I kept that letter.
I haven’t written myself a letter, but maybe I should. What would I write?
I sent the envelope above out, but it came back. I will be driving home soon and wrote to a friend on the way, but I must have the wrong address. I bought the stamps here. The stamp pads were expensive, though, so I only got two!
The naughtiest postcard I ever sent was to my friend B, when he was living the romantic life of a government tax economist in New Zealand. He had been working for the US government, but went off to work for New Zealand’s government for two years. I felt rather jealous. Uprooting as a physician with a husband and two children to go work in a foreign country seemed a bit insurmountable. There was an awful lot of difficult family drama and illness going on, so that is the real reason that I did not do it.
Anyhow, naughty postcards. I sent B a postcard from Georgetown. It is black and white, a man lying prone looking up. A sheep is standing over him, so that no naughty bits can be seen, but one certainly suspects that the man is nude. He and the sheep are looking at each other. The caption is “No more sheepless nights.” Eeeeee. I bought two of that one, because it made me laugh.
B sent a letter back, along the lines of, “Cut it out, you are getting me in trouble with the postman.” I desisted. I did not have any more postcards like that one.
I have bought and kept blank cards and postcards over the years. Good thing, too, now that cards are a whopping $4.00 to $7.00 each. People must buy them, right? I have picked up blanks at garage sales too, once in a while. And the ones I don’t like can go out in the Little Free Library for other people.
I plan to make a calendar and maybe some postcards of Elwha’s cat art. He did it more than Sol Duc does. The photograph is one of the designs, from February 2023. I did see both of them adding to it. Perhaps there was some sibling rivalry going on, I don’t know. This installation is quite complex, with two toy mice, the earbuds, one of those glittery balls tucked under a mouse and the toy made of pipe cleaners.
The walls of rock at Arches National Park are so amazing. And are they arches or are they holes in the wall? And a hole in the wall doesn’t imply the majesty of arches or how amazing the remaining section of rock above us. Magical, amazing, unbelievable, astounding.
Discover and re-discover Mexicoβs cuisine, culture and history through the recipes, backyard stories and other interesting findings of an expatriate in Canada
Engaging in some lyrical athletics whilst painting pictures with words and pounding the pavement. I run; blog; write poetry; chase after my kids & drink coffee.
Refugees welcome - FlΓΌchtlinge willkommen I am teaching German to refugees. Ich unterrichte geflΓΌchtete Menschen in der deutschen Sprache. I am writing this blog in English and German because my friends speak English and German. Ich schreibe auf Deutsch und Englisch, weil meine Freunde Deutsch und Englisch sprechen.
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