Archive for the ‘Random Thoughts’ Category
Thursday, November 28th, 2013
When I first saw this article in Live Science about the strangest holiday ED complaints, I was interested in what other doctors’ perceptions were, but I first sat back and thought about what types of complaints I usually see more often on Thanksgiving than during other times of the year. I’ve given up on trying to time “strange” complaints. They occur so often that I lose track of any temporal aspect to them.
Because Thanksgiving obviously occurs on a Thursday and because many doctors offices usually aren’t open the Friday after Thanksgiving, the holiday often presents patients with difficulty in obtaining medical care. Office schedules are booked in the days leading up to Thanksgiving, few offices are open during the holiday or weekend, and the schedules are again packed the following Monday and Tuesday with patients needing care. So patient volumes in the EDs usually increase, and I typically see more patients with routine problems than I do during “normal” weeks.
Thanksgiving is also one of the times where families get together – many times when they haven’t seen each other since the last holiday season. When busy adults haven’t seen the steady decline in the health of their elderly family members over the prior year, they will sometimes bring in their family members for an evaluation of what they perceive is a sudden change in their family member’s health. Then, instead of spending time enjoying the company of their families during the holidays, many elderly patients are admitted to the hospital to rule out old age.
Thanksgiving is also a time of food and drink intake. The excesses of alcohol often result in reduced inhibitions and oversedation. So there are always the injuries from fights over such things as whose football team is better and who got to eat the turkey neck. Later in the evening, it isn’t uncommon for families to bring in family members whose excessive alcohol intake has made them difficult to arouse.
Getting back to the Live Science article … the strangest complaints for visits to the ED include burns from turkey preparation, lacerations from carving accidents, food contamination, overindulgement in alcohol and food, sports injuries, anxiety, and performance pressures. I wasn’t even close.
Lacerations and stab wounds, sports injuries and hurt feelings, heart attack and heartburn, anxiety and isolation – we’re there to take care of everyone so that hopefully families can reconnect next month to enjoy more of each others company. If you happen to be in the ED today, remember that the person taking care of you or your family member is probably giving up time with their family so that they can be there for you.
Safe and happy holiday wishes to everyone and their families.
And go visit a family member or friend you haven’t seen in a while. Bring a picture and a card. It will be worth a lot more to that person than will a “Doorbuster” you got by standing in line in the freezing cold waiting for a store to open up on Black Friday.
Thursday, November 7th, 2013
I like the Dragon NaturallySpeaking program. I like tequila, too. But I try to use both with caution.
Dragon’s speech recognition is good in that it saves a lot of time and costs in transcribing medical records, especially in complicated patients where it would take a long time to type out the patient’s history and the patient’s course.
The problem with Dragon NaturallySpeaking is that it isn’t perfect. Sometimes the difference between a doctor’s dictation of “no murmur present” and the Dragon transcription of “murmur present” can make a big difference in a patient’s workup. Other times, Dragon will misinterpret a dictated phrase for a similar-sounding but inappropriate phrase.
I’ve tweeted about a few of them.
For example, in the patient with GERD who was having repeated exacerbations, I dictated “bland diet” in the discharge instructions. Dragon apparently didn’t like the patient too much because it transcribed “plan to die” onto the chart. It’s fortunate that I didn’t miss that error while I was multitasking. Imagine those discharge instructions showing up in a patient complaint to an administrator.
Another patient was recently looking for a prescription for oral contraceptives. The Catholic hospital in which I work doesn’t allow prescription of contraceptives from the ED, so I have to recommend that patients follow up at Planned Parenthood. Dragon translated my instructions as “Follow up plan paranoid.”
And then there’s the colleague who dictated his findings that “examination of the patient’s breasts with a chaperone showed no lumps, masses ….” Dragon transcribed “semination of patient’s breasts with a chaperone showed no lumps, masses ….”
Dr. Grumpy regularly documents the foibles he has with his Dragon software as well.
Then I thought to myself … Self, you haven’t had a contest in a while.
So we’re having a contest for the best “Dragonisms.” What have you seen or read in a medical record that was misconstrued by voice recognition software? Add it to the comments section. Best Dragonism wins a free copy of Mark Plaster’s critically acclaimed “Night Shift” book (affiliate link). We’ll also try to find some EP Monthly swag for runner up prizes. I think I have an old coffee mug somewhere in my closet. Or perhaps a couple of Amazon gift vouchers.
Contest ends at 12AM on November 15.
Let’s see what
shoe grout you’ve got.
UPDATE NOVEMBER 21, 2013
It was very tough to pick a winner from all of these great entries. We smiled at almost all of them and laughed out loud at a few. The winner is …
#6 Ashley for the metaphorically true mistranscription about a referring facility transferring a patient because it had no testicles.
Ashley will receive a free copy of Mark Plaster’s new book “Night Shift.”
We also chose a couple of runner up winners who will each receive EP Monthly coffee mugs.
#14 Mati whose discussion about an advance directive turned into a discussion about an advanced rectum
#1 ndenunz whose patient’s warm feet turned into warm other body part
If the winners e-mail me at whitecoat-at-epmonthly-dot-com, I’ll get your swag to you. Thanks to everyone for their comments. Hope that the entries at least brightened your day a little.
Thursday, October 17th, 2013
I arrived at ACEP’s 2013 Scientific Assembly a day early to attend the Council Meeting and to meet up with some old friends.
The venue for the gathering was good. Transportation, hotels, dining, and shopping all within easy walking distance from the Convention Center. The Convention Center itself was rather oddly situated. Had to take escalators up four floors to get to lectures. Staff was uniformly pleasant and helpful.
Some of the issues at the Council Meeting that had the most vigorous debate seemed tangentially related to emergency medicine. If I hear one more proposed resolution about marijuana, I’m going to go postal on someone. We’re the American College of Emergency Physicians, not the American College of Emergency Potheads. If the “Joint” Commission wants to smoke marijuana during their days off, that’s their business. Don’t smoke it directly before or during your shifts and stop with all the resolutions about it. If you were in court and submitted the same topic for judicial consideration half as many times as it has been submitted to the ACEP Council, you would have been sanctioned a long time ago.
And a 25 minute debate followed by an emergency physician Council vote on breastfeeding? I’m a breastfeeding advocate and my wife has breastfed all of our kids, but how are breastfeeding rights relevant to emergency medicine? A resolution to follow state laws relating to breastfeeding is a waste of Council time. I’m just hoping that next year someone doesn’t submit a Council resolution asking that ACEP declare Britney Spears more popular than Nicki Minaj. Then again, maybe someone could submit a resolution that the ACEP Council will not consider any other resolutions relating to marijuana for the next 10 years.
I enjoyed the opening session. Shawn Achor was informative and entertaining. He summarized predictors of success in life including: Optimism, strong social connections/social bonds, perception of stress as a challenge and not a threat.
To create positive change, he had these suggestions:
1. Write down three new things each day for which you are grateful. Don’t have to be major things. The idea is to train your brain to look for positive things in life.
2. Doubling. Sit down for a half hour and write everything you can remember about a positive experience. Doing so helps you relive and “double” the positive experience. This trick improves ones positive outlook the fastest.
3. Exercise. Helps improve our health and shows us that intervention matters. Fifteen minutes of exercise each day is as effective as taking an antidepressant.
4. Meditation. Meditate daily for just a few minutes. We are all into multitasking. Meditating forces us to “singletask.”
5. Perform one conscious act of kindness each day. Doing so increases our social consciousness and improves our social connections. Strong social connections have a significant positive effect on our longevity.
His parting words were that “happiness spreads – create a ripple effect.”
Classes first day were informative. Tried to tweet pearls as much as possible. Made the top 10 list for most influential tweets, but left in the dust by @GruntDoc and @mdaware. Shout out to Team Health that provided wi-fi coverage for the meeting. The connectivity was usually quite good, although it sometimes lagged a little during peak times. My tablet kept having problems connecting which made keeping up with @GruntDoc and @mdaware even more difficult. Here are my WhiteCoat tweets from the ACEP 2013 conference.
Enjoyed the secret ED blogger dinner meeting Monday night. Always good to see old friends and catch up on the arguing and poking fun at each other.
Tuesday involved more lectures and also gave me a chance to visit the exhibits. Lots of interesting gimmicks to draw interest including the Deer Hunter video game, indoor golf, and a Chewbacca/Sasquatch emergency physician spokesperson … or perhaps it was a gruntsperson. Probably the smartest gimmick was fresh-baked cookies. A functioning oven on the exhibit floor was perhaps a little bit of a fire hazard, but the smell of cookies wafting through the air created a natural draw to find out where the smell was coming from.
Several neat innovations at the InnovatED. New Stryker wheelchairs are easy to maneuver, comfortable, but run about $2500 each. Also had some Lost in Space freaky robot chasing me around the exhibit. Neat idea, until some ticked off patient knocks it over. Not sure that this would be cost effective in many emergency departments, but if some rural areas could use it to screen suicidal patients and discharge without having to hold them in the ED for days at a time until a psych bed opens up, it may pay for itself over the long run. Monthly lease cost reportedly averages $1500 to $3000+ including IT support. Jason Wagner was also doing some demonstrations with Google Glass. Lot of hiccups in the demonstration. Have to nod your head to activate. People were doing this so often while trying out the glasses that I can see docs developing subconscious tics from using the glasses too much. Also, there can’t be any delay between verbal commands or the software resets itself. Shows some promise after you get past the HIPAA issues but I agree with @theSGEM that Google Glass just doesn’t seem ready for prime time use in emergency medicine.
One complaint I heard from several vendors was the placement of the displays. With the exhibit floor separated by a skybridge, few people seemed to know about the other half of the exhibits. One vendor said that his company would not be back because of the low foot traffic. ACEP might consider providing vendors on the far side of the exhibit floor with some give backs to maintain goodwill with those vendors. Just a suggestion.
Got to see a couple of short “flashmob” type talks while wandering the exhibits. Angela Gardner gave an excellent synopsis of the benefits of tort reform in Texas. Quite knowledgeable on those legal topics, she is. Jason Wagner was back discussing useful apps for emergency physicians. Unfortunately many of the apps he reviewed were exclusively for Macs and iOS. Wandered away mid-lecture since I’m not a Mac fanboy anymore. Would like to have seen suggestions for Windows, Android, and even Linux (which I also use).
Snagged a copy of Mark Plaster’s new book Night Shift – Stories from the Life of an ER Doc – a collection of his columns over the years. While visiting at the EP Monthly exhibit, Mark told me that many people stopping by the exhibit have just assumed he is “WhiteCoat.” I’m again dispelling that myth. We are not the same person. He’s much shorter and better looking than I am.
The trip home was a little trying. Both Sea-Tac Airport and the TSA in Seattle fell asleep at the wheel. It isn’t like they don’t have the ability to predict the volume of passengers based upon the number of flights leaving during a given time frame. Yet with a huge passenger surge and lines queuing across the entire airport (literally!), there were only two TSA lines open. But there sure were a lot of supervisors running around with walkie talkies and clipboards, though. Too bad they couldn’t have opened up another screening lane and helped move the passengers through security. I felt bad for the agents doing the screening. They maintained grace under pressure. Oh, and during the surge, the airport also shut down a runway for “inspections”. Don’t know the details of why, but the airport experience was definitely the worst part of the trip.
By the way, if you ever fly into Seattle and don’t want to pay $50 for a cab, there is a train that will take you right into the heart of the city and that costs a whopping $2.75.
Seattle ACEP 2013 Summary:
Pros: Location, Wi-Fi connectivity, courses, impromptu lectures and “genius bar”
Cons: Exhibit layout, cost ($770 is getting to be too expensive)
Overall Grade: A-
Looking forward to next year in Chicago October 27-30. Should be lots of fun.
Friday, October 4th, 2013
Remember all of those “do not use” abbreviations?
I wrote a post about them a loooong time ago, but since then things have changed.
We went from written medical charting to almost exclusively computer [hack hack] generated medical records.
So the whole Joint Commission issue about a “>” looking like the number “7″ or the notation “cc” looking like two extra zeroes is – or at least should be – a moot point.
And I still believe that if someone can’t tell the differences in dosing between “MSO4″ and “MgSO4″ then they shouldn’t be prescribing or administering those medications. Again, it should be a moot point since orders have to be made from dropdown lists.
But some organizations don’t understand the concept of “moot.” Rules just keep
At the start of my shift, a very pleasant member of the chart review team was waiting to talk to me. This same member of the chart review team had reportedly chastised a nurse because she hadn’t completed a “medication reconciliation” on a young multiple trauma patient that was flown out of our ED to a regional trauma center less than 30 minutes after arriving. Because obviously whether the patient medication list states that he took Motrin and Zyrtec on an as-needed basis was going to have a profound effect on whether he would survive his rib fractures, hemopneumothorax, and open femur fracture. In fact, wasting time documenting nonessential information such as ASA scores and medication reconciliations will very likely have a detrimental effect on patient outcomes.
As a side note, it is rather sad that government regulations force hospitals to hire multiple full-time employees – mostly trained nursing staff – whose sole job is to comb through the work of those caring for patients in order to pick minute errors making no clinical difference in a patient’s treatment or outcome from a document that is likely thousands of words long. Then, instead of just making the changes themselves, they have to find whomever failed to properly document this nonessential information, interrupt them during their clinical duties, and stand over their respective shoulders while they correct their “errors.” Again, the documentation changes rarely if ever have any beneficial effect on patient care and often cause delays in patient care due to all the requirements for extraneous information. If the chart reviewers instead were able to use their time to provide care to the patients, hospitals would be safer places.
My chart review error was heinous. I wrote “cc” instead of “ml” in one of my notes. It wasn’t even an order or a prescription. It was a notation of how much medicine a child was taking prior to coming to the emergency department.
“Dr. WhiteCoat, you’re going to need to change this in your note. It says “cc” and should say “ml.”
“I can’t change it in my note. The note has been finalized and can’t be edited.”
“You’ll need to put an addendum clarifying the notation, then.”
“It is on the Joint Commission’s ‘unapproved abbreviation’ list. The notations can be confused. In this case, the ‘cc’ could be confused with ’00.’”
“You’re kidding me.”
“No. It has to be changed.”
Then that little gremlin whispered something in my ear.
“I’m not sure what the problem is. The notation says ‘ml.’”
She stopped and read through the chart.
“No. Right there. It says ’15 cc’. See it?”
“Yes. I see where you’re pointing. It says ’15ml.’”
She started getting frustrated and raised her voice.
“No, Dr. WhiteCoat. It clearly says ’15 cc.’”
“OK. If it clearly says ’15 cc’ then there’s no chance of people confusing it with ’1500′ – which by the way would mean that the child was taking a liter and a half of medicine every day. So remind me again what the problem is.”
She gathered her papers and left in a huff.
The nurse who had been chastised earlier gave me a thumbs up sign.
Fifteen minutes later I get a phone call from the head of the medical staff.
“Will you just make the change, please?”
All in the name of patient safety.
Monday, July 29th, 2013
I got a few e-mails asking whether I’m still blogging.
Short answer is “yes.”
The number of posts has been a lot less than usual, which sometimes is a sign of a blog on life support.
Have had several things that have required my time over the past couple of months but now most of those things have … stabilized. I’ve got a few days off now that I’m dedicating to putting all the scraps of paper on my desk into posts. Even have a few guest posts that I’m looking forward to putting up.
For the few of you out there who are still reading, thanks for sticking around.
Now to get back to having some fun …
Sunday, June 30th, 2013
I’m not sure if I’ve had a stroke and am slurring my speech or if the Dragon NaturallySpeaking voice recognition engine is just messing with me, but lately I’ve had to triple check my charts to make sure some bad transcriptions don’t get finalized into the record.
Earlier this month, I tweeted about one case where part of my discharge instructions to a patient suffering from GERD symptoms included: “Bland Diet.”
The Dragon NaturallySpeaking program translated that to: “Plan to die”.I could only imagine those instructions hitting the front page of our local newspaper if I hadn’t caught them.
The latest Dragonism was during a recent physical exam of a patient who fell.
He fell down some stairs and injured his ankle. I examined the rest of his body to make sure that there were no other injuries.
I dictated: “Left lower extremity with no pain to the hip or knee …”
Dragon transcribed: “Unfortunately with no pain to the hip or knee …”
Another one that probably wouldn’t look too good while blown up on a courtroom exhibit or in front of a state medical board.
I suppose typing has its advantages sometimes.
Wednesday, June 5th, 2013
I think I’ve discovered what elderly patients feel like when everyone thinks that they’re too senile to understand the conversations around them and just talk about them as if they aren’t there. Like this …
In one emergency department, the nurses regularly talk about me in loud voices as if I’m either deaf or unable to comprehend.
Nurse 1 [to the ceiling]: This patient’s been ready to go for 6 milliseconds. Where are the discharge papers?
Nurse 2 [loudly, standing 3 feet behind me]: I don’t know. He’s still charting on the patient. I’m not sure why he can’t just print up the prescriptions and discharge instructions now and chart later.
Of course, the charting system doesn’t allow the nurses to print discharge instructions until the doctor finalizes the chart, but that’s only been the case for 4 years.
Nurse 1 [walking up to the desk directly in front of me]: Hey, has Dr. Whitecoat put in the admission orders on this patient yet?
Nurse 2 [standing right next to me and watching me enter the admission orders]: I think he’s trying. He’s not very good with computers, you know.
Nurse 1 [loudly behind me]: The patient down the hall and around the corner looks like he whimpered in pain like a minute ago. Is Dr. Whitecoat being stingy with the pain medications on your patients, too?
Nurse 2: Not yet
Dr. WhiteCoat [in crackly old voice]: Meeehhhhh. Can someone change my undergarments?
Both nurses then look at each other with furrowed brows, look at me strangely, and leave the nurse’s station.
Was someone talking about me?
Friday, April 12th, 2013
So much to rant about today.
The girls are doing a dance competition this weekend. I’m trapped in my own little version of Dance Moms. Aaaaauuuuuggghhh. Somebody help me. One daughter complains because she’s in the back of one dance the whole time. Another daughter is upset because people are mad at her because she’s in front during one of her dances. Glitter is all over our fricking kitchen and it doesn’t come up with wet wipes, either. We have to purchase hair extensions with curls for $25 for the girls, and we have to make SURE to purchase the color that most closely matches the girl’s hair. We can’t just curl the girls’ hair because judges can apparently tell the difference between real curled hair and fake curled hair and that makes a difference on how they grade the performance. Sounds like a Joint Commission inspection.
I just keep thinking that they couldn’t pay me enough to participate in a reality show based on this crap.
Junior WhiteCoat is ramping up lacrosse season. He’s loving it. Playing in a huge tournament at Notre Dame next weekend. Junior was also one of the main characters in a movie that won first place and multiple other awards at an indie film festival last week. He’s now getting requests for auditions with some bigger movies. Hear that, Adam Sandler? Pick him and your movie could grace the pages of WhiteCoat’s Call Room.
On the doggie chew list for the past week include a Jenga block, a decorative pillow from the couch, a garbage can in the office, the leg from a “Monster High” doll (since when did it become cool for young girls to go from modeling themselves after Barbies to modeling themselves after zombie high school kids, anyway?), and the middle of her doggie bed. The last one is most interesting. You see, she’s chewed half of the inside out of her own bed and now she no longer wants to sleep on the bed. So when it gets dark out, she runs upstairs to the bedroom and lays on the other dog’s bed before he gets there. That means that the innocent dog is stuck sleeping on a disaster of a dog bed that he had no part in creating. After the first couple of times that happened, I started moving the doggie garbage disposal off the good bed and letting our other dog lay on his bed. By the morning, though, there was more foam filling sitting on the floor, Chewmeister was laying on the good bed, and our other dog was laying on the floor. I’m getting to the point that I’m going to start making little Chewy sleep in a cage … on her own frigged up bed.
Then I thought to myself … those beds are a lot like, say California and Texas right about now. (more…)
Thursday, April 4th, 2013
A patient was sent to the emergency department to have an ultrasound of her uterus performed.
She had been having abnormal bleeding which coincided with about the time her period was due – only it was a little heavier and lasted a little longer than usual. She decided the best course of action would be to make an emergency appointment with the gynecologist. She was seen the day before she was sent to the ED and the gynecologist performed an ultrasound in his office … which was normal.
The patient called the gynecologist the following day and said that the bleeding was still there, so the gynecologist told her to go to the emergency department for another ultrasound and some blood testing.
The patient arrived stating “I’m here for my ultrasound. Dr. Speculum sent me.” Since patients need orders for testing to be performed, the patient was given the choice of waiting to be seen in the ED or of getting a prescription from her doctor for the exam. She chose the former.
After examining her, we performed a pregnancy test which was negative and a CBC which was normal. So I told the patient she was likely just having a heavy period and that she could follow up with her gynecologist as an outpatient.
The patient demanded an ultrasound. After all, Dr. Speculum sent her to the ED specifically to have an ultrasound done.
So I called Dr. Speculum.
“Hey, it’s WhiteCoat here. Your patient is here with metrorrhagia and I’m trying to discharge her, but she insists that you want her pelvic ultrasound repeated.”
“Yeah. Can you do it?”
“Well what are we doing it to look for?”
“OK, well if she does have fibroids, are you going to admit her? Her hemoglobin is fine.”
“Noooooo. Discharge her after the ultrasound.”
“So then why … nevermind. If all you’re looking for is fibroids, weren’t you able to see that she didn’t have any fibroids on the ultrasound you did on her in the office yesterday?”
He must have really wanted that ultrasound by his response.
“Naaaaaaah. The ultrasounds I do in my office aren’t accurate.”
The repeat ultrasound was still normal. I guess he was more accurate than he gave himself credit for.
Wonder if she’ll be referred back to the ED tomorrow for repeat pregnancy testing.
This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on WhiteCoat’s Call Room, please e-mail me.
Sunday, March 31st, 2013
My gosh. I actually get angst when I haven’t posted for a few days.
Actually, I have angst for other reasons, but not posting just adds to the angst.
So what’s been happening lately?
First, the poor WhiteCoat children are having trying times in their love lives.
Oldest daughter WhiteCoat found out from a member of her track team that her boyfriend of 6 months was cheating on her. Another member of her track team was apparently going around and telling everyone that she had a “secret boyfriend” and was also telling everyone the sordid details of the interactions she was having with her “secret boyfriend.” So daughter WhiteCoat dumped Mr. Two-Timer. Mrs. WhiteCoat called his parents to let them know what was up. Papa Two Time said that he didn’t know what we were so upset about because the other woman “pushed herself” on Daughter WhiteCoat’s ex and that the other woman was a “two bit whore” anyway. I’m kind of thinking that this breakup was a good thing.
The next day, Junior WhiteCoat’s girlfriend texts him and says she “wants to be single.” The text gets posted to Instagram. Then about 60 comments later, there are accusations flying back and forth that she’s been dating someone else and that he deserves better. When I was 12 years old, I was climbing up trees with a bag of tomatoes and tossing them at cars. Now my kid is 12 and he’s in need of relationship counseling.
Health hasn’t been great lately. Pretty much every person in the family has had vomicking and/or diarrhea in the past week. Zofran is our friend. But it gets a little frustrating when you’re working in the ED and patients who puked once or who have had a couple of loose stools want work notes to be off for the rest of the week.
Got kind of a kick out of one patient walking into the emergency department as I was leaving work. He was heading toward his car in the parking lot and I saw him suddenly turn around and head back toward the hospital. He was walking like he had a load in his pants. He gets closer to me and he starts shaking his head.
“Ya try to do the right thing and what happens? It bites you in the ass. I’m holding in my gas in the ER and I waited until I get outside to pass it … then I crapped my drawers.”
He did have a load in his pants.
Although if he passed gas in the ED, it probably would have been just as embarrassing.
Grandma and Grandpa WhiteCoat have been having issues. Their health has deteriorated to the point that they were unable to stay independent, so they moved in with my brother. The only problem is that Grandma WhiteCoat has a few cats … like 10 … and that Grandpa WhiteCoat has a book collection … like about 30,000 … all in boxes. He also has a good thousand or so small plastic boxes of pictures that he has taken through the years. All categorized, but none of them ever seen by anyone but the person at the photo lab who initially developed them. And if you want to look at one of them, you can’t take it out of the house because you may copy it and the pictures are copyrighted. Fortunately, he converted to digital pictures about 7-8 years ago, so now it’s just a matter of storage on his computer drive and no additional plastic boxes. But then he sends pictures to you and the pictures have copyright marks all over them.
Well things came to a head when the grandparents wanted to move their things into my brother’s house. My brother had a bad experience with a cat and a muzzle loader once and doesn’t really want any cats near his house. There was a lot of arguing and hand wringing. Finally, Grandma WhiteCoat talked a friend of hers into keeping the cats in her basement. Grandpa WhiteCoat is upset because he has to rent out a storage facility to keep his prized book collection and all of his pictures.
I get caught in the middle with all of the phone calls. Brother WhiteCoat is at his wit’s end. Grandma WhiteCoat says that the cats are the only thing in her life that keeps her happy and that Brother WhiteCoat is just trying to keep her from being happy. Grandpa WhiteCoat just walks around the house in his tighty whities (which are reportedly still white but not quite as tight in certain places) complaining about how these schlubbs at the storage facility better not ruin his book collection.
If you ever wondered whether your family was dysfunctional, it isn’t. Trust me.
The biggest source of my angst lately is a change for me. I’m changing my blog site. I registered a new site at DrWhiteCoat.com and have been working to get it up and running for months. Over the past week, I put a lot of my non-ED time into trying to finish it and it’s almost there. But that was at the expense of posting. As a result, I have a stack of notes on my desk about all the things I want to write about. Literally. There are 11 pieces of paper. Several of them have more than one topic on them. So I’ve got a lot of writing to do.
I’m not leaving EP Monthly, but I’m planning to expand this blog beyond just emergency medicine and I don’t want to keep straying from EP Monthly’s mission, so I’m going to split my time between the sites.
I want to try to do a more regular posting of Healthcare Updates perhaps 3-4 days a week rather than doing them once a week. I don’t like pushing out stale news.
Also planning to do a hospital administrator/hospital rating page within the site – a health care worker satisfaction page. Still need to come up with some cash for that project, but it is already planned out and I obtained a list of all the hospitals in the US to populate the site.
Planning to write some more articles with information to help patients.
Also planning to reincarnate Grand Rounds. Creating a separate page just to promote other medical blog posts.
And I’ve got a few guests who are going to help me with the blogging.
Hoping that it will be a win-win-win for readers, EP Monthly, and me. One way or another the site will be up this week. If you want to be notified when it is up and running, click over to the site and enter your e-mail – you’ll get a notification when there’s new material.
The past couple of days have been spent hanging out with family. Lots of the Rock kind of things. After the kids got sugared up on Peeps and jelly beans, we went out to the park and flew kites. Then we came back, had a great dinner and laughed. Mrs. WhiteCoat opened a bottle of wine, and we are getting ready to watch a movie.
Now I’ve at least gotten my blogging fix and am not in need of intravenous benzodiazepines.
Time to go have a glass of wine and relax.
Back to blogging as usual in the morning.