Day 248 - work and blog

Today I have a couple of observations to make. One is that as I get better the blog gets less interesting. That is not only my opinion, but also the opinion of my faithful readers who are numbering smaller numbers which is OK. It is becoming less interesting, but less interesting is more normal and I'm OK with that. I am having the experience of having to tell people in real life anecdotes that I have put on the blog because they have not read the blog more and more. It's a little surreal to start to tell someone a story and to have them say "I read it already" or for them not to say it, but their facial expression indicates that they know what's coming. I took early on to starting stories that I had told in the blog with "do you read the blog? I was just thinking of blah blah" because most of the people I spoke with did read the blog. Now, it's reversed (both because fewer people read it and my world is bigger) and I don't routinely say that. It's an OK change.

The other observation is that I really miss primary care. I saw one of our palliative care in the home patients today because Eva, the nurse practitioner who runs the program, felt like she had run out of ideas for this patient. The patient has a whole bunch of interacting big ticket medical problems and it's not clear which ones are causing which symptoms and how, to say nothing of in what manner we might treat said symptoms. I felt like I really get to dig my teeth into some medicine in a way that I don't get to as much in hospice. Yum, yum! I am feeling very impatient for the outpatient palliative care clinic to start going. People who know me really well might have already started a pool about how long I stay away from primary care.

The bad thing about visiting patients at home is that if they smoke, you stink afterwards. I didn't think ahead of time and wore my really nice Patagonia jacket that I totally love into the house and when I came home, I hung it out on the clothesline to air before I did anything else. Later this evening, when it started gently raining, I didn't hear it until the jacket was so wet that it had collected a little pond inside the hood. The bright side is now I know exactly how rain resistant it really is and it no longer smells.

I haven't mentioned it, but Maggie has been off her food again. As a lab, she loves nothing more than eating so when she is hesitant to approach her dinner bowl or to accept the empty yogurt container, one knows something is up. I thought I could just call the vet and they would see her because she was sick (I don't know why I thought that; I couldn't always see my human patients when they were sick), but it turned out we had to wait two days. She's better, but not all the way. Her appointment is tomorrow morning so I'll guess we'll find out what her deal is. I'm betting on picked up from eating  gross debris in the woods and will be given flagyl.

For me, for tomorrow, I'm hoping for a serious attack of genius regarding today's patient. For you, I will hope for movement on a puzzling situation you would like to improve.