Friday, July 13, 2012


Ask a Med Student

What is your access to drugs like? Are they locked in some huge magic cupboard? Do friends bug you for painkillers and stuff? Do professors/doctors give you One Big Talk about the morals of drug-guarding, and the responsibilities of prescribing, or is it perpetual? Do you know people who've given drugs to their friends? Also can you give me some drugs?

Access to drugs is basically nonexistent. In the hospital, residents and physicians can order drugs (med students can’t because we don’t know anything), but only the nurses get and administer them. In clinics and doctor’s offices, I guess students could probably access the free sample closet (I’ve been in them, and another student had a doc offer her some once), but it’s frowned upon if not outright banned.

All this is good, by the way! Did you know that doctors have a crazy high addiction rate? We don’t want them getting their grabby hands on all the drugs. (At the same time, doctors have by far the highest addiction recovery rate – like 95%. Compare that to something like 25% for Alcoholics Anonymous. What this means is that we already know how to “fix” addiction, but society is more willing to give money and support to get doctors to recover than they are for that guy on the street. This is incredibly sad to me … and now probably to you, too.)

Oh yeah, but your other questions: um, I guess drug-guarding is perpetual? But more like they have to teach us not to prescribe one million drugs to elderly people than they have to convince us not to pilfer. I think med students are more into alcohol than valium.

No one I know has given drugs to their friends, and, no, you can’t have any. 

Do you handwash like crazy in your personal life now? HAVE YOU CHANGED ANY HABITS since learning about disease and danger? What should we actually never do, vis a vis activities and injuries?

In the hospital, I foam like crazy (there are antibacterial foam dispensers everywhere … also, I’m really inept and always manage to squirt others, myself, the floor). But, in the bathroom, you kind of counteract the handwashing once you grab the door handle to leave. I still do wash my hands in the bathroom, but I know it isn’t protecting me or others that well! (Unless you are a dude, who is literally touching his genitals when he pees: please wash.)

(Also, did you know the Centers for Disease Control has a guideline for hand-washing that is 2.5 pages long? That’s crazy. TWO POINT FIVE PAGES FOR WASHING YOUR HANDS. Yet it’s important stuff, and only like 40% of hospital workers actually adhere to the guidelines.)

Things I have changed: I exercise more now, because I realize how incredibly important it is for health. Even if you don’t lose weight, even if you just walk medium-fast 30 minutes, 3 times a week. Seriously, this is so good for you on so many levels. You already know this. I did, too, but I was lazy and didn’t need to lose weight, and I hated running. But now I know, so I do the elliptical and bike and sometimes lift an embarrassingly small amount of weights.

Things you should change: okay, so for health itself, there are 3 big areas – eating, exercising, sleeping. All are very important. If you aren’t eating well, my advice would be to cut out all processed foods. If you aren’t exercising, my advice would be to start, even if (especially if?) small. If you aren’t sleeping enough, start scheduling it like you would a meeting.

There are also two huge topics that I'm hesitant to write about since they deserve way more unpacking than is possible in this answer, but I'd remiss not to mention them: smoking and obesity. Everyone knows that both of these things are bad for health, but it wasn't until medical school that I found out just how bad, and in just how many ways. Both smoking and weight can be really hard to change even if you want to, and, with the latter, obviously there is so much discrimination going on that it can be difficult to distinguish honest medical advice from fat-shaming. Like I said, I won't be able to give either of these issues the attention they deserve, but I'd be more than happy to unpack in a subsequent column if any Hairpinners want to ask me about it.

I'm curious about whether the increase in specialization in doctoring will eventually result in a big change in the way medicine is taught. Like, if you're a dermatologist, will you even HAVE some of these rotations eventually? Should we stream people earlier?

Sometimes our professors will put up a powerpoint slide of some complicated mechanism, and they’ll say, “When I was in medical school, I didn’t have to learn any of this because no one had discovered it yet. But now you have to memorize it!” and then they’ll laugh, and we’ll go home to memorize the coagulation cascade or some shit. Point is: I do wonder if at some point our knowledge will outpace our ability to learn, or at least it’ll outpace what is reasonable to expect all medical students to learn.

So yes, probably, there will be a big change. But since there is a shortage of primary care physicians, right now it’s not dermatologists who might see a change. For instance, Texas Tech is currently the first school offering a 3 (instead of 4) year medical degree for people who want to do family medicine.

I could go on and on and on about how medical education should and might change, but the short answer is: I don’t know, and I also don’t know what would be best.

Can you explain the hierarchy of scrubs? Is there a hierarchy of scrubs? Are you going to wear those "fashion" scrubs with balloons on them? (No of course you're not.) (Right????) What about footwear, is there a Croc vs. clog hierarchy? Fashionnn. Also why are stethoscopes so cold? Brrr.

No, I can’t, because it’s different everywhere. But there definitely IS a hierarchy. One thing I can tell you is that you will never see a medical student, resident, or physician EVER wearing those “fashion” scrubs.

Also, ladies tend to wear Danskos (because they are AMAZING), whereas men tend to think those are not macho enough (I guess?) and wear far inferior shoes.

Stethoscopes are so cold because they keep us so cold, which is also why our hands are always freezing. Seriously, I am always cold, always, and it’s like 105 outside right now.


Hahahahaha, not really! Toxoplasmosis is mostly asymptomatic in adult ladies, but if the fetus is infected, it can cause “severe mental retardation, chorioretinitis [swelling, irritation of the eye, blurry vision], blindness, epilepsy, intracranial calcifications [can cause mental & emotional problems], and hydrocephalus [build-up of CSF in the brain, compressing structures and causing various problems]1.”

However, all of this is undercut by something the above-quoted book emphasizes: “Only cats that hunt and kill their prey are reservoirs for infection; those that eat prepared cat food are not.” And just how many of you have cats that actually kill rats? None, that’s how many.

But, if you’re pregnant and have a bad-ass, rat-killing cat, don’t clean its litter box. Someone else needs to do it.

Do you have any rules of thumb for the uninsured along the lines of "when you need to go to the emergency room and when you can wait it out"?

This reminds me of when my father-in-law told me that he went to the ER for a cut on his thumb, and he was totally indignant at having to wait an hour and a half to be seen. I laughed and laughed. An hour and a half is like 0.5 seconds in ER time. Don’t go to the ER for a cut on the thumb. Unless your thumb is like about to fall off. Also, did I mention none of this is binding medical advice, and I can’t be prosecuted for it?

I’ll answer this as if you are young and relatively healthy, because, if not, if you have congestive heart failure or chronic obstructive pulmonary disease, and you have chest pain or you can’t breath: GO TO THE ER. Otherwise, young and healthy peeps: if you haven’t been stabbed or shot or seriously, like seriously, injured, chances are you can go to the urgent care clinic instead. (And keep in mind that the urgent care folks can tell you if you actually should go to the ER.)

That being said, sometimes you really need to be at the ER because they can diagnose something surprising, so there is no good rule of thumb. If you feel something is really wrong, and you have insurance, or even if you don’t but something is REALLY wrong, go to the ER.

1 Beckmann, et al. Obstetrics and Gynecology. 6th ed. Lippincott Williams & Wilkins, 2009. Print.

Disclaimer: The Hairpin is not a doctor! Please see a doctor if you need medical assistance.

Elisabeth Askin is a medical student who loves earrings, snail mail, biking, and avocados. She's interested in ob/gyn, primary care, health policy, economics, and having too many interests. She also just wrote a book with another med student called The Health Care Handbook: A Clear and Concise Guide to the U.S. Health Care System, which you can buy as an e-book here, read about here, or pre-order as a paperback here. You can email her questions at elisabeth@healthcarehandbook.com. She also tweets @healthhandbook, which posts one health fact a day.

214 Comments / Post A Comment


There's not necessarily a heirarchy of scrubs, but in some places scrub color denotes department, and it's sometimes frowned upon for nurses to wear lab coats (they're reserved for doctors/PA). Most places I've worked had a specific shade of blue that was reserved for surgical employees and only to be worn in the OR, but this varies widely. And the whimsical scrubs used to be the domain of floor nurses and people in long term care, but that seems to have changed over the years.


@parallel-lines There is a hierarchy of lab coats in my hospital-- gray for attending physicians and fellows (and I think our MRI physicist gets one too) and white for advanced practice nurses, residents, techs who get lab coats (no idea how they determine that), and researchers like me.

When I first started here I thought that was kinda disappointing-- wouldn't you as the higher ranking person want the iconic white coat? Now I get confused when when I watch TV and people do what someone in a white coat says.


@themmases I had to learn the lab coat lesson the hard way--you don't get a lab coat if you aren't advanced. Someone yelled at me to buy a scrub jacket instead. Poor lab coat is still in a drawer somewhere.


@parallel-lines I think we order ours through the hospital so they'll have the proper logo and everything which is all Brand Standards and serious business. When my hospital moved and everyone needed new ones, I was informed that people in my job now get to have them. I think this might have been a big step forward for us or something, because the committee of people with my job also paid for half of everyone's to make sure we got them.

Shouldn't it be covered when you start and they go over the dress code, though? I had to figure it out for myself too, but it's terrible that you were yelled at about it. :/


@parallel-lines This is slightly related, but I work in PR for a teaching hospital. We're always having to make our docs wear their white coats for photos/video (since it reads as "doctor"), but a bunch of them never wear them and they have to go find one.

One of them told me that, since residents are always psyched to wear their long white coats once they get them, constantly wearing a white coat marks you as a resident. Hence, a bunch of doctors avoid wearing them once they get out of residency.


@parallel-lines I volunteered at an ER in high school and they gave me a white lab coat to wear over my candy-striper shirt. People kept approaching me with urine samples or to ask about their wait or if I could get them meds. I was 17 and thought it was really funny because I was just cleaning beds and gofering.


@kmc That reminds me of when a photographer visited the lab of a friend. All these folks walking around Doing Real Science, and the photographer immediately fell in love with a bunch of vials with prettily colored fluids because they "looked like" science. The vials all held cleaning fluid.


@parallel-lines I thought short white coats were for med students and long white coats were for doctors. That's been the standard at the couple of teaching hospitals I've worked at. Where I work now, the residents and doctors wear business casual or lighter blue scrubs. RNs wear navy scrubs. LVNs/LPNs wear royal blue CNAs wear teal, and on down the line like that. So, if you go on a different floor or something, you still know the credentials of the person you're talking to. I think it's a pretty good system.




I'm seconding the urgent care recommendation -- in my case last week, they sent me to the emergency room for my gnarly GI issues and abdominal pain. Finding out I didn't have appendicitis was definitely a good thing.

tiny bookbot

@kentuckienne Yes to the urgent care clinic! Even if you are in rough shape, they can push you to the head of the waiting list. As a kid, I once had some kind of terrible stomach bug or food poisoning, so my mom called ahead to tell them I'd been throwing up every ten minutes for hours, and I pretty much went straight into an exam room. They ended up not sending me to the ER.

I have also been in an urgent care waiting room when they did have a guy walk in with a gunshot wound, and that was pretty insane.


@kentuckienne I work p/t in the ER and I'd say 85% of the people there could have been treated in urgent care and they really slow down the works. If you come in via Urgent Care you'll get seen sooner in the ER so do that.

Roaring Girl

@tiny bookbot I had the same thing happen to me with the horrible stomach bug. I was four, so I was admitted to the children's hospital. Fun times! I was showered with stuffed animals and learned that you can push the nurse button to have a nice lady come snuggle and read to you.

tiny bookbot

@Roaring Girl Awww cute! I mean, obviously not that you were sick, but the doting.

I was like twelve when it happened? So basically, they sedated me, had me chill in the exam room for an hour so they could be sure it worked, and then sent me home with firm instructions to my mom to get me rehydrated.


Here's vote one for having an entire column with real talk about healthy weights.

Is there a simple-ish way to determine if you're at a healthy weight? Like if you can run for an hour/bike all day/ swim to hawaii... but no amount of not eating cookies will give you a flat stomach? Or if you have low blood pressure can you eat all the cookies?


@garli I second this. I've gained some weight since college that I know I need to lose. BUT even before that, I was like a size 4 (and my stomach WAS flat) and doctors kept telling me my BMI put me in the overweight range. I know BMI is crap, or that is what everyone says and I instinctively feel this to be true, but if it is, why do doctors keep giving me my BMI???

Because honestly, I was very active growing up, I competed in Tae Kwon Do all through high school and ran, but I can't remember a time when my BMI was in the normal range. And I had muscles, but not hulk muscles. I just don't get it.

a small sea

@garli YES. My best friend went to the doctor recently and the doctor said "You look good but make sure you keep exercising because your BMI is right at 23!" I mean... whaaaaaaaaaaaaaaaat? I used to have an eating disorder and if a doctor said that to me.... SHEESH, would I be upset.


@MissMushkila BMI is useful for population studies about the health effects of being at a certain body composition, but it's not relevant for everyone and it's not really intended to be used on individuals, in part because it's not a very accurate measure of body composition. It's also changed over the years-- when I was in high school, my then-weight put me exactly in the middle of the "normal" range. Returning to that weight now would put me in the roughly the upper third of that range and there is no "moderate" category anymore, which there was when it was first applied to me as a teenager, because my friend fell into it.

(Also, people, if this was a weird outdated version my school was using at the time-- 2001-2005-- please let me know! Obviously, as a then-teenage girl, I remember how my friends and I were categorized quite distinctly. But if that wasn't the standard, I'll back off from it.)


@MissMushkila @a small sea : Yeah, it's just hard to know guidelines. It happens to dudes as well, so it's not just us. My husband's Dr told him to lose 20 lbs. (due to bmi calculations). His job is pretty physical, and he's into crazy active sports blah blah. Is having less beer/ more salad going to hugely change his life expectancy or quality?

I'm sure a bunch of people wonder the same thing (fill in your own details)

Judith Slutler

@garli I think the problem is that we don't have that much objective information on health and weight. It's such a hard subject. Personally I really appreciate the Fat Nutritionist, but like everyone else, she has an agenda of one kind or another. IDK. I just try to live reasonably.


@Emmanuelle Cunt Yeah, I always assume that if I can do all the shit I like to with out killing myself I'm probably healthy? (Like go on a snowboarding trip once or twice a year and still be able to walk the second day because my muscles are worked enough on a daily basis, or go hiking with a friend who runs marathons and not totally die from keeping up, or what ever else)

Additionally I try to eat mostly fresh foods that I make mostly from scratch.

That being said some times (many times?) I eat more cheese then is totally necessary. I could stop doing things like that if I knew it would keep my heart/liver/lungs/brain from exploding/stopping/being replace with robot parts.

Are there guidelines that are out there? How does certain ways of being overweight effect your health? Is there a difference long term of being 5 lbs over weight v 15 lbs?

I know there's no simple answers but I'd love more information from people who know more about how my body works then I do.


@garli This is the exact goal I was thinking about the other day! I typically only get 1 chance a year to waterski, so when I do I want to be able to go for absolutely as long as people are willing to drink on the boat (a long damn time). My boyfriend and I got to play badminton on our vacation, something I love and rarely get to do. We got some good games in, but in my dream fitness future we are out there so long we have to re-up our sunscreen in the middle.

Hello Jodi

@garli Watch this video/lecture from a doc:
Totally and completely reframed how I view exercise and explains, quite thoroughly, why Med Student says to do 30 minutes of walking. I wish I could show everyone this video.


@garli I'm sure someone has already beat this drum on here, but honestly, the best thing I have ever done for myself was to read Health at Every Size by Linda Bacon. The really story short of it is that you should try to eat better food, but that there's no such thing as "bad" food, and you should really try to walk more. There is no consistent clear demonstrable link between weight and health, so stop freaking out and just look after yourself better. But hey, not a doctor, etc, wtf do I know.


@a small sea I'm 5'0 and weigh in around 150, which puts me barely in "overweight" and almost in "obese." I mentioned this to my (large) endocrinologist one day and she just about inhaled her notes from the indignant snorting; she then poked my (very firm) quad and said, "you see, the BMI doesn't account for musculature."

So, yeah. Triathlons, 60+ miles of distance biking a week, jogging, swimming, walking or biking everywhere(, size 10)... The BMI doesn't really apply to me.


Just bought your book - it sounds exactly like what I've been wishing existed!

Let me know if anyone wants me to loan it to them, since I'm not going to get to it in the next two weeks.


Oh man, that last question would have come in handy a couple months ago. I am insured, though it would still cost me $500 to go to the ER OR an urgent care center, so I refused to let my husband take me to one when I thought I was dying. I had gone running, came home, eaten dinner, and then all of a sudden I felt like my lower abdomen/upper pelvis were being ripped apart by angry piranhas who were also carrying pointy pitchforks with which they were stabbing me at the same time. I was entirely unable to move, and I couldn't stop myself from loudly howling in pain. The whole incident lasted about 5 and a half hours. I still don't know what it was (though some 'Pinners had some good ideas the day after it happened) or if an actual doctor could have helped me. If it ever happens again, I kind of want to know what to do.


@olivebee Oh my god, this sounds fucking terrible. Is there some kind of cheaper doctor visit you can shoehorn this into? I totally asked my Ob/Gyn about some random chest pains I was getting.


@olivebee Something similar to that JUST happened to me. I was crying and twisting in pain and ended up going to the ER. Turned out to be an ovarian cyst! Got some sweet pain meds...


@OhMarie Yeah I need to set up my annual visit with my internist, and I will probably ask her if she's ever heard of anything like it. But damn, I hope to never ever feel pain like that again.


@olivebee This happened to me a few years ago and just like Stickynee it was an ovarian cyst. As they explained it to me, a cyst is basically a benign type of tumor (or sometimes just a fluid-filled sac, though mine was solid matter) that forms sometimes as a byproduct of menstruation. Thing is, if they get large enough like mine, they can cause your ovary to twist which is incredibly painful. If it is twisted enough the ovary may die, so I recommend you get checked out by a gyno. Hope you're okay! I remember how bad the pain was--sorry you had to experience it too!


@olivebee Thirding the ovarian cyst -- only when it happened to me, it was because the cyst had ruptured. I didn't realize it until an ultrasound a few years later revealed a scarred-over cyst and the tech asked if I'd had any unexplained, stabbing pain in my abdomen. I had to think back until I remembered the day I had to lay down on the floor of my office because I was in too much pain to move.


If you were in a crowded place and someone shouted loudly, "Is there a doctor here?? We need a doctor, is there anyone here a dcotor??" would you rush over? Or would you, like, slink away because you didn't want to deal with it?


@Emby My sister-in-law is a doctor. One time, we were driving together and we saw this dude on the ground, his bike a mangled heap next to him. A few people were standing around him, and he looked pretty hurt. "Should we stop so you can see if you can help?" I asked my SIL. She said she couldn't. That it really really sucked, but people now SUED doctors who stopped to help (like, even if she saved his life but he got whiplash or something from the way she moved him), and she wasn't willing to take the chance. Really really sad. She lives in fear of getting sued (she's mentioned it a few times. She has "being sued insurance" just in case it happened, and apparently it's crazy expensive). And she's a really really good doctor, too. Like, a Doogie Houser type (i.e. a genius. Graduated at 15 or 16 and went right into medical school).


@Emby Five of my friends were recently travelling in Europe, when a lady sitting on a plane next to them passed out. They called for a doctor, and they kind of just... looked at eachother? (They've all finished 2 years of med school - so basically have no useful experience whatsoever.) I believe, technically, we aren't supposed to come forward yet, because people will believe you're the authority on what to do and how to help, when really you know just enough to cause more harm than good. (They did talk to the lady on the plane, and she did turn out to be fine.)


@Gilgongo I thought "Good Samaritan" laws applied to professionals as long as they aren't on duty at the time? I lifeguarded for a long time, and (at least in MA) you can be sued for not properly performing CPR while you're on duty, but if you come upon someone when you're just driving down the road, you can't. (Also possible that the rules are different for actual medical professionals, rather than just ppl trained as first responder-types?)


@Ophelia I believe you're right, at least in Canada, that you are under no obligation to help while you're off duty... although some would argue that there is an ethical obligation, of course.


@Gilgongo So, let's be clear: she could have, but she didn't because she didn't want to get sued. I have a couple of doctor friends and they totally stop to help in an emergency, some even saying that they have to stop and help because of the hippocratic oath.


@crookedlegs Sorry, yes - it's not that you're not obliged to help if you're off-duty, it's that you can't be SUED for helping! I think you're generally ethically bound to do what you can (as long as it wouldn't put you, the helper, in danger)


@Gilgongo i think doctors sometimes overstate the risks of being unfairly sued (and understate the risk of actual medical malpractice causing harm to patients). one horror story about some nice doctor's life being ruined by a crazy lawsuit is a lot more powerful than statistical evidence or, you know, what the law actually says, even if you are somebody with statistical training.


Yeah, all doctors will get sued at some point in their careers no matter how talented or intelligent they are. Same with architects. Why we have malpractice insurance.


@liznieve Same with lawyers. And my malpractice insurance is crazy expensive, also.


@Emby I was a lifeguard for 3 years in Georgia, and you CAN be sued off duty. Because good Samaritan laws don't protect you if you have Red Cross certification. The assumption is that you are a trained professional, and therefore any mistakes on your part are negligence.

However, you cannot be sued for not stopping to help, unless you are in uniform and someone directly asks for help. If you leave after they request help, or after you begin helping, that is negligence. This might be different in other states, but those were the guidelines when I was working. (Granted, this was four years ago).


@Emby My mother said part of the reason she became a midwife was in case someone had a baby in the aisle of Woolworth's or Tesco and she could deliver it. But she won't volunteer as a nurse if, say, we're on a plane and a call for a doctor goes out unless they ask three or four times, as she says she generally would be a hindrance. Unless, of course, someone was giving birth.


Fucking toxoplasmosis is the reason 8475786485 people bring their cats (that they have had for years!) back to the cat shelter at which I volunteer.

"Oh I'm pregnant, so no more kitty!"
"Kitty will make the house too dangerous for baby!"
"My completely unfounded fears about the relationship between kitty and baby are allowing me to give up this loving pet that has been in my life for ten years guilt-free!"


@olivebee How inconvenient, my horrified sad face button seems to be missing.

How is it possible that someone who's had a cat that long could know so little about them? You'd think you'd at least, like, Google it when deciding whether to give up a member of your family and literally never see them again.


@themmases I've had a cat for 10 years and it boggles me! If you know so much about cats, smartypants, why hasn't it laid any eggs yet, huh? I bought this thing for the omelets!


@olivebee I really don't understand how people can drop their pets so easily. Isn't it an agonizing decision?? Because I love my cat a whole friggin' lot and would only give her up if she was in severe danger/suffering from a diminished quality of life by living with me. And yet, somehow people still think that a cat will smother a baby? Besides, I read some article the other day about how growing up in a house with pets makes kids' immune systems stronger, or some other crap that I'm happy to regurgitate without fact-checking first. (Then again, people tend to keep their dogs when babies come around. It's only cats that get the bad rap.)


@olivebee Having been a volunteer for a breed-specific rescue for several years now, I can tell you that people do the same thing with dogs, for what it's worth, without even any toxoplasmosis to blame it on. People just suck, sometimes.


@themmases @frigwiggin Right?? Ugh. I think the entire reason I am such a cat lady (hence spending several hours a week at a cat shelter) is because my parents weren't ignorant assholes (well...at least about pets). The day they brought me home from the hospital as a newborn, our cat jumped into the crib and curled herself around me. She slept curled around my head every single night of my life (that I was home) till she died when I was 14. And I grew up totally healthy and normal save for my obvious defensive love for the felines.

fondue with cheddar

@olivebee Isn't toxoplasmosis a concern for people with immunodeficiency, though? I'm definitely not asking this because of Trainspotting. Okay, maybe I am.


@olivebee I am glad my dog looooooves babies, just in case. Like, he saw a baby across the street and I had to tell him that baby wasn't there for him to play with/lick.

Roaring Girl

@Megano! My cat is in love with babies, too. If you bring a baby to my house, he goes from zero to snuggles in three seconds flat.


@olivebee My grandmother was certain that my cat was going EAT the baby. Like, what? She said that it would try to steal milk OUT OF THE BABY'S MOUTH. She said that. I am not making it up. But wouldn't that be the baby eating the cat anyway?


@jen325 It is an issue for people with compromised immune system, and pregnant women do have somewhat compromised immune systems. This doesn't necessarily mean you should get rid of your cat, but you really shouldn't change the litter box.

fondue with cheddar

@ba-na-nas that's what I figured. I know that if you're pregnant having a cat is okay as long as you aren't coming into contact with the poop, so I guessed that this was the same.

Don't Get Rid of Your Cats, Seriously, They're Not That Revolting?

Bob Loblaw

Yay cats and babies! My first word was not "Mommy" or "Daddy" but "Cat". Charlie was my very best friend.

Now I have a cat who is an asshole and meows all night long but I still love him. What does he want? I don't know!!


@Bob Loblaw Ah, me too! My first word was "kitty" :)


@jen325 I should probably confess that I do find cats kind of revolting (in part because I am insanely allergic to them), but that's why I don't have one.


@Bob Loblaw My first word was my aforementioned cat's name, too. "Ab-uh." (AKA Abby). My husband says I was pretty much raised by that cat, so it makes sense that her name would come before Mama.

fondue with cheddar

@olivebee Let's not talk nonsense to @Bob Loblaw.


@ba-na-nas I am curious if the Omega Paw litter box(BEST THING EVER if you have cats) would lessen the danger involved in the pregnant ladies + litter-cleaning equation. Any idea?

fondue with cheddar

@Little Sassy Bonebreaker I had that and it was great! The only problem is that my one cat pees a lot and always pees in the same spot so I always had to clean it by hand anyway.

sceps yarx

@olivebee My mom had four pregancies with a bad-ass, rat-killing pet cat. We were all fine. I think the bad-ass cat pooped outside though, for whatever that's worth. Maybe she thought litter boxes were for pansies.



My dad got toxoplasmosis (in part because he had a weakened immune system from some other more common form of pneumonia). My dad almost died. It was absolutely terrifying. My mother had never been so scared in her life. I remember going to visit him in the hospital for weeks. And you know what? Not once, not even for a tiny second, did we ever consider giving away/getting rid of/blaming our cats. Even after my dad got better, no way, no how. The worst thing that could happen to you for owning a cat DID happen to us, and it didn't matter. The cats were family. They stayed.

Megan Friddle@facebook

@Diana That's terrible about your dad, I'm so glad he's OK, and that the kitties stayed!
I also just wanted to say that Toxoplasmosis can be transmitted through undercooked meat and contaminated vegetables. Plus, if you've had your cat for a while and he/she is a 100% indoor cat there's basically zero chance it could give you the parasite. The CDC sez: "cats only spread Toxoplasma in their feces for a few weeks following infection with the parasite." (And don't most indoor-outdoor cats poop outside? I've always been confused by this part of the toxoplasmosis concern). Source: http://www.cdc.gov/parasites/toxoplasmosis/gen_info/faqs.html


@olivebee My mom used to tell me that (about the cat trying to get the milk off the baby's mouth and thus smothering them). My mom had cats and I had a screen door on my bedroom when I was baby so they cats wouldn't come in and do that.

barefoot cuntessa

um, what is this about fixing addiction? what is it doctors do differently then say, a pinner's dad who may be going back to rehab for the second time this year? asking for a friend, of course.


@melissamachete Seriously! Is it a secret formula IV drip?


@melissamachete I don't know if this is universal, but when I worked at a psychiatric hospital one of the psychiatrists had a substance abuse issue and the agency that issues medical licenses mandated oodles of treatment and followup and care in order for her to keep her license and eventually be able to practice again. That's probably only part of the reason and coupled with other things, like there is a good chance that physicians are high functioning to begin with and that they can afford to take months and months off to focus on treatment.

barefoot cuntessa

@megadith Yeah, and maybe the high stakes of possibly losing everything that you've dedicated you're entire adult life to has something to do with it. Plus, physicians are more likely to get an ultimatum from someone who will actually follow through (like, their boss), as opposed to the common codependent, passive aggressive BS that I've witnessed in my, uh, friend's family.


@melissamachete My dad is a doctor and an addict. He's been clean 10 years as of this month. I'm really proud of him.
In his/our family's experience, the reason his (and his co-workers; I think if my memory serves me correctly, almost EVERYONE in his department is either a recovering addict or is actively dealing with addiction issues) success was based largely on the fact that 1.) he went to a rehab that specialized in treating doctors 2.) his job required him to be clean, and by this I mean they randomly drug/alcohol tested him for years after he'd completed treatment and required that he attend multiple AA meetings, at the risk of losing his license if he failed to comply, and 3.) he was also involved in outpatient rehab therapy for a year after completing the inpatient program. I think he stayed sober not only because he wanted to stop the craziness, but also out of obligation to his job (they paid for something like 60ish% of the cost of everything), and out of fear of getting fired, probably. That's my take on it,not his, though.

barefoot cuntessa

@OaklandBooty Congrats to your dad! Seriously. Mine was at almost 8 years sober five years ago. His relapse is due to doing pretty much the opposite of everything your dad is doing. My siblings and I are much more aware than we were when he quit the first time. I think now we can be more supportive and call him out when starts sabotaging himself. The hilarity of it all is that my mom is a therapist who often councils people who are recovering addicts and she is the biggest obstacle in dealing with my dad's addiction in any kind of sane way.


@melissamachete Oh man, I'm sorry you guys have to go through that...addiction is rough. :( My mom is a nurse who has dealt a LOT with addiction in her career/family life, and at times was a big obstacle in my dad's recovery too, so I know where you're coming from on that one. And secretly, because my dad has emotional/other issues he's not been the most fun to be around since getting sober. I think I had expected rehab/getting sober to "fix" him 100%, and that's not really possible, at least for my dad. Has your family joined Al-Anon? I strangely have taken 10 years to decide I wanted to go, and my first meeting is next week. I'm...terrified. Regardless, good luck on this journey to both your family and your dad!

barefoot cuntessa

@OaklandBooty My mom goes. I cringe at the thought of group prayer and God talk, so I haven't made it to a meeting yet. I've thought about sucking it up and going just to know the lingo so I can reach my mom when she's in crazytown. Good for you for going. I know a huge part of the reason I resist going is just because I'm scared to. My family are are classic proud Irish idiots who never need help of any kind. For the longest time talking to my husband was enough to get me through, but lately I've been getting anxious ragey and that's no good. I hope it helps!


@OaklandBooty and melissamachete... good luck you guys... I tried going to al-anon a couple of years ago. they say to go to 6 meetings, I only made it to two in the end. basically, while I can see the effects of alcoholism on my family, I was not in any way in as difficult a situation as some other people there, and I just felt dragged down. I did take away a couple of coping methods and some different ideas about alcoholism, though. I didn't like the group prayer and god talk either, but then, it was a pretty relaxed group.


@melissamachete My therapist tells me that 90% of my behavior as an adult will make sense after Al-Anon. I feel like that's a pretty loaded statement, but I'm going to attempt to go in with an open mind. Learning the lingo will probably be helpful, and maybe it'll help your mom deal with things better if she's got an ally who understands the program? We're a family of psycho Croatians who also refuse help, so I hear ya. I hope it helps you too - and if you ever need an ear, I'm always around. @sevanetta Thanks! This is good to know - I'm freaked out by the unknown, so any info I can get is comforting. I'm also not a fan of group prayer or god talk...hopefully this will help.


@melissamachete I found a list of 12 'Behaviours of children of alcoholics' on the net (on the al-anon website that my coworker pointed me towards). I am the grandchild of alcoholics (both grandfathers), but 10 of the 12 items described me perfectly. My parents aren't alcoholics but the emotional patterns left by alcoholics run deep. Not blaming my grandfathers, they had hard lives, this stuff just happens. Anyway, I reckon that is the kind of thing your therapist is talking about. xo



lovin' it


Will urgent care do stitches? My ER decision tree is always,

Y - have to go to ER
Does it look like it needs stitches? <
N - don't go to ER

Escapade Dunfree

@noReally I got urgent care stitches for a small but deep/not closing cut in my finger I got from missing the pit of an avocado with a large knife. The stitches were done well and quickly. The worst part was everyone in the clinic telling me I was pitting the avocado incorrectly. That's how Ina Garten does it!


@Escapade Dunfree Holding it in your palm and hitting it with the knife so it grabs it?

I did it once with just a table knife, not even a real knife, and gave myself a slash down the side of my thumb that didn't need stitches, but did scar.

Maybe Ina uses only perfect avocados. I don't have a better method.

Escapade Dunfree

@noReally Folks there said to just scoop it out with a spoon. "Never go at the pit with a knife! No!"

My mom bought me an avocado multi-tool thing ("so you'll never do that again") which has a serrated plastic edge to slice open the fruit, a scoop thing to get the pit, and a sort of potato-masher to smush up your guacamole. It works ok, but lacks the panache of Ina and her fancy tricks.


@noReally My daughter got a cut over her eyebrow last year (she's 2.5 now). We brought her to urgent care (I honestly thought they'd clean it and put a band-aid on it), and they said it was a really bad cut that needed stitches. They said they COULD do it, but the ER doctor would do a better job, so we took her to the ER, and they stitched her up and did a great job although it was pretty horrifying at the time. If I ever needed "important" stitches (like, on my face), I would go to the ER.


@noReally I have received stitches at urgent care. But in my case, it was just a few stitches in my hand -- I don't know if they are equipped to handle deep or severe wounds.

Roaring Girl

@noReally When I learned that trick, I was taught to hold the avocado in a kitchen towel to protect myself. I mean, I don't actually do that (because I like to live dangerously, of course), but the advice is sound.


@noReally Eek, that's how I remove pits, except I use the biggest, wave-it-at-a-murder knife I own. D: I guess I'd better stop that.


@noReally Ugh. I worked in an ER for 3 years, so my rule is: Do I think I will probably die if I don't go to the ER? No=don't go, Yes= only go after your mom and roommate freak out at you for not going even though you've been having chest pains


@Escapade Dunfree my mom showed me this method of avocado pitting because I do it like a baby with a spoon (SORRY GUYS, I'M A LITTLE CLUMSY) and I was absolutely terrified. Shewas very upset that her otherwise "mildly dangerous" (her words) daughter would choose an innocent teaspoon over a 9 inch chef's knife, but I know myself and I really like having my fingers.


@noReally Excited about this thread so I can post this relevant Jens Lekman song! http://www.youtube.com/watch?v=-nlC3ioS5h8 (I always go after avocado pits with the knife because I am a jerk, but in my heart it's ok because I am a culinary professional.)


@Escapade Dunfree I go after it with a knife (and I only just learned how to deal with an avocado this year - gentleman friend loves guacamole so we make it a lot) but I refuse to have a knife working on something that is in my hand (I was not impressed when he taught me how to cut mangoes), so I lay it on the cutting board. I feel that this greatly reduces the risk of slicing myself open when taking out the avocado pit. Also, I use the absolute minimum required force.


@Escapade Dunfree
Did they give you anesthesia?

I took a friend to urgent care for a cut in her thumb, and they put two stitches in, but without anesthesia, for reasons I have never understood. She's really sensitive so, I ended up having to hold her/holding her down while she screamed and they stitched. While it was happening, we just sort of trusted the nurse practitioners. It was only afterwards that we both thought: that's really weird; why on earth no anesthesia?


@harebell I have gotten stitches in my toe at urgent care (actually it was super fascinating, because I had caught my foot in a bike wheel which pulled out the toenail on my big toe, and they STITCHED THE TOENAIL BACK IN PLACE) - they gave me some kind of novacaine/numbing shot and I couldn't feel anything.

sceps yarx

@apb Yay, I love Jens Leckman!!!


@Blushingflwr : Hold half of avocado in palm of hand, big end toward you. One quick jab with tip of knife to embed it into the pit, then kind of flick/pry the pit out. Bonus points if the pit then flies across the kitchen instead of into the trash can you were aiming at.

Step 2: Leave avocado half in your hand and GENTLY cut closely spaced lengthwise slices, and then crosswise, being careful not to cut through the skin. Then just flip your hand over and squeeze the perfectly sized pre-fab avocado chunks into your mixing bowl. VOI-FUCKING-LA. Man I love doing that.

Also, I still have a half-dollar-sized scar on the inside of my left elbow from my one accident that necessitated a trip to the ER. 1st attempt at a Thanksgiving turkey, 2nd degree burns.

Reginal T. Squirge

Ladies, I know that you suspect that men often don't wash their hands but you have NO IDEA how often this actually happens. If I had to guess, I'd say less than 50% actually wash their hands after using the bathroom.


@Reginal T. Squirge Depends on the environment, but yeah. In my office? Probably 80-85%. At a sporting event? Gotta be less than 25%.

elysian fields

@Reginal T. Squirge yeah but ... urine is sterile, right? I just can't make myself feel especially horrified about this.


@elysian fields It's not the pee necessarily (although, ew), it's the super horrifying penis bacteria. Boy junk has its own disgusting ecosystem of bacteria not present elsewhere on the body. My husband doesn't actually touch his weiner when he pees but I've still shamed him into washing his hands every time because it should be done periodically anyway. With non-antibacterial soap, of course.


@Reginal T. Squirge It's OK, we don't either.

elysian fields

@megadith right, I thought the point of hand-washing after peeing was simply that you should wash your hands often anyway and it's a good moment to do so. But penis bacteria? Really? Tell me more! I didn't know this was a thing.


@Reginal T. Squirge I'm just going to go on with my life as if you hadn't said that.


@Reginal T. Squirge One time I was at a Gentleman Caller's apartment, and I informed him that he forgot to replace the hand soap in his bathroom... and he informed ME that he doesn't wash his hands after takin' care of business. EVER.


@elysian fields Urine is not sterile. Your own urine is sterile to YOU EXCLUSIVELY since it already filtered through your body's unique toxic makeup.

@klemay Please tell me you didn't see this person again. Good god.

Reginal T. Squirge


So does he just, like, piss all over the place?




@itmakesmewonder We're Just Friends now, and he does not handle any of my food ever.

Baby Fish Mouth

@megadith At my former company we were running a wash your hands campaign for flu season. I got a phone call from a guy indignant that we would tell him to wash his hands asking me if I thought his penis was dirty. He was serious, he wasn't trying to be a pervert or anything. I still shudder at that.


@elysian fields Google "penis microbiome" (you might want to also try it with "-circumcision") it's really interesting. Vaginas have them too! So do our guts and the rest of our skin. I like microbiomes.
@Reginal T. Squirge He has remarkably good aim and if he drips he cleans it right up. He was raised by a single mother and I credit her with his excellent bathroom habits.
@Wiscowhitney Ahhhh gross! I would have said "Yes, yes, a thousand times yes."


@klemay My ex boyfriend's house was always like this, even when his otherwise very clean seeming mother still lived there (maybe she never used the downstairs bathroom?). They would dilute the little bit of soap at the bottom until it was just water, then take a few weeks to replace it.

I think I went out the kitchen and used dish soap a lot.


@Reginal T. Squirge TRUTH. I find this so disgusting and stupidly macho.


@elysian fields Urine is only sterile when it is inside the body - once it travels through the urethra it will pick up whatever bacteria is hanging around.

The human body as 10X more times bacterial cells on its surface (and I'm including the GI tract as a surface - gut flora!) than it does its own cells. Bacteria is everywhere, all the time, forever, and it will always win in the end because it is endlessly adaptable.


@Reginal T. Squirge Uck, there's a guy in this building who always exits the men's room immediately after flushing, every time.


@Reginal T. Squirge The less I know about men's bathroom habits the better. WHERE DOES ALL THAT HAIR COME FROM???


@Reginal T. Squirge *Technically* shouldn't I be washing my man parts after touching them with my filthy, bacteria-covered hands, not the other way around?


@stuffisthings Yes, Stuff. Go right ahead and Stuff your Is Things in the office sink after peeing. I think that that is the best way.

"Oh, hey brosef. Just washin' my junk in the office sink. No biggie."


@Beaker "Bacteria" is also plural.

OMG OMG I'm so sorry ack I'm an annoying person and snob. (But that will drive me around the bend and back again. Sometimes there's no greater burden than being a writing teacher who used to work in a bacteriology lab. #firstworldproblems #thatguy

(Ha - I can't believe I just typed "thirdworldproblems." Further evidence I'm not cool.)


I was traveling with a male companion and he got into the habit of urinating in the sink (there was no toilet attached to the bath/sink portion-- really strange set up). This habit carried over to when we were having cake at the Cafe Demel in Austia-- he walked out (looking a bit abashed) and explained he had almost peed in the sink. Classy fellow.

My younger brother used sink-peeing in our shared bathroom as a potent threat.


@elysian fields - Ummm...fecal bacteria and particles, as in - feces. They cover your junk cause your junk is where? In your pants, inches from your arse. All day long. In the heat and sweat and ickishness that are man pants (or lady pants as the case may be - feces don't care, feces is everywhere).

If knowing you have fecal germs on your hands after handling your junk doesn't weird you out enough, look up "hand to mouth" illnesses. What that really means is "ass to mouth" as in - whoever placed the tasty lettuce on the hamburger that made you sick didn't wash the fecal particles off their hands in the bathroom. It got from *their* arse to *your* mouth. That's right. Think on it. Now go wash your hands.

For the love of God - if you touch your junk, unbutton your pants, or even walk in a bathroom and touch the handles, doorknobs and fixtures - wash your freaking hands!

Girls too. Do this. For the love of God. For the love of all that is holy. Please.


@FoleySparrow I'm not convinced that ass-bacteria somehow migrate to one's junk - human microflora tends to be highly specific to one body part - but we're walking around covered in fecal matter anyway if we use either low-water toilets or "industrial" toilets (like in schools, rest stops, etc) -- the pressure and speed of the water coming in aerosolizes whatever's in the bowl and flings it all over. I don't know that I still have a copy of the original study - if I have time today I'll look for it - but the researchers tagged a culture with fluorescent dye, poured it in a toilet, flushed, and then found evidence (under whatever kind of light they were using) of bacteria within something like a 25-foot radius. You don't even have to touch your junk to come out of the bathroom covered in poo - just touch anything in the bathroom itself. All the more reason to wash our hands (Let's All Wash Our Hands?).

That said, there have also been a ton of studies suggesting that the constant flow of water is what keeps the inside of a toilet bowl cleaner than the average kitchen counter -- not enough time in between flushes for bacteria to really form biofilms. If that's true, then imagine how revolting the average kitchen counter is.


@Xanthophyllippa - I hear you on the toilet flushing probs. I put the lid down and then flush when I'm at home. It only does so much. I also keep my toothbrush in a closed cabinet with a door - not sitting out on the bathroom sink. Ewww. In public restrooms, I wait to flush the industrial toilet until I'm ready to walk out of the stall, then I do it, and immediately get the eff out of the way. Ughhh. Other People's Grody Public Bacteria Flying in my Face. Gah!

So I think we're on the same wavelength here.

As far as fecal ick, I read somewhere that farts come with fecal ick. And what do we do all day in our pants? We fart. Lots of flying poo particles settling in different parts of our pants. Mmmmm. Pleasant thoughts. And the reason it particularly pissed me off when my pantsless ex-bf used to fart in my bed and laugh. As if he wasn't already the worst!

Wash you hands people. Wash your hands.


What I'm hearing is that everything is covered in poo and germs, always, so really there is no SPECIAL reason to wash one's hands after touching one's junk.*

* Also I'm just winding you up, I always wash my hands after going to the bathroom.


@stuffisthings Well, there's always the problem of VISIBLE poo.

@FoleySparrow OH YEAH. Can I just take a moment to bitch about the toilets with the automatic sensors that don't even give you a chance to pull your pants up before they flush and spray their contents all over? Because nothing says "hygenic" like a urine bidet. I almost crashed through the stall door in a new building here on campus trying to get out of the way when the toilet flushed the exact second I stood up.

Genghis Khat

@Xanthophyllippa Jam the eye with tp preemptively and then pull it out as your flush mechanism. That's what I do with my overzealous work toilet.


@Genghis Khat I WILL TRY THIS.

Incidentally, "Overzealous Work Toilet" is a great name for a punk band.


Will your career path be determined/affected by student loans?


@Kate Croy As a med student I can say it depends on the person. For me, nope, not at all. I want to be a family doctor. Nothing makes me happier than working in an office, getting to know about your patient's lives, and managing everything from cuts and colds to chronic diseases and mystery illnesses. For most of my classmates, they want to do a specialty because it's what they love, and the money that happens to come along with it is just a perk. I know other people who would be perfect for primary care, but refuse because they, "won't make enough money." "Bad" doctor money is still really good money. Average salary for a PCP is $160,000


@Kate Croy Depending on where you go to med school/what you want to do, where you PRACTICE can be affected by med school loans. I'm fortunate that I practice in an underserved...uh...STATE and so I get loan repayment for practicing where I want to live...but some people will intentionally move somewhere rural or underserved (Alaska, Indian reservations etc) to get help paying back loans.
But as sexy as it sounds, most people do NOT go into medicine for the money... You actually have to love 10 hour (minimum) days and lots of hassles dealing with sick people and unhappy administrators and systems, knowing that when something goes wrong, the buck stops with YOU. If you're not ok with that, there is no amount of money in the world that can MAKE IT ok.

squid v. whale

That whole no-access-to-drugs thing? Med student isn't looking hard enough. My then med student, now resident friend came by my place with an IV she filled with anti-nausea meds when I kept throwing up every 30 minutes and lacked insurance. Not hard drugs, but certainly something you can't get OTC.

squid v. whale

@squid v. whale Did I fail to mention how grateful I am for this friend? Forever grateful. She is an amazing person (adopted 4 shelter dogs and can make her own wine! what?) and going to be an amazing family doc.


Hahahah, did RH&C write that scrubs question?


I just went on a 15-minute Dansko shoe-staring binge. Those things look really freaking comfortable.


@Scandyhoovian I bought two pairs of Dansko sandals on sale a couple days ago and my temperamental flat feet are SO HAPPY.


@Scandyhoovian they are great, if you are a person who stands a lot. Not so much if you are a person who has to move a lot, and not at all if you are a person who has to move a lot and who is also very clumsy/unsteady on her pins/turns her ankles frequently. I mean, I hear this from a friend.


@stonefruit They are also not so great if the tendon in the back of your ankle JUST hits the back of the shoe in a weird way that makes them really uncomfortable no matter how much you want to love them. Sigh.


@Scandyhoovian Try Sanitas too!! They used to be the same company and Dansko and then they split. Danskos aren't comfortable for me but after 3 weeks of ObGyn as a med student, I'm obsessed with my Sanitas!!


They're SUPPOSED to be, but if you have a bone on the top of your foot AND high arches do NOT buy them. The rest of the shoe will break in, but that part will forever feel like someone is directly stabbing a nerve. Seriously, those things hurt so much it made me feel like I was going to throw up.
(to be fair, I tend to work 10+ hour shifts, but it didnt take that long for them to hurt.)


@Scandyhoovian I cannot for the life of me wear Danskos - even if all I'm doing is standing in one place or only walking between my office and the bathroom. They're heavy, they're stiff, and I threw my ankle(s) more times wearing one single pair of Danskos than I did in eight years of playing softball.

Everyone I know loves them. I feel so left out. :(


Yes! An ER doctor is pretty much who diagnosed me with my shitty, rare disease that no one else would even consider that I had.

I'm wondering how true my sister's theory on the whole thing was:
Doctors in a clinic have the (comparative) luxury of time, and thus work from best to worst case scenario when trying to solve something.
ER docs, having NO time, assume the worst and work their way down from that.

Makes sense, and seemed true in my experience. It took over 2 years for me to get diagnosed and Pulmonary Hypertension was never brought up or considered, but within an hour of entering the ER it was the first thing out of the doctor's mouth.


Toxoplasmosis is NUTS. And might make you nuts, under certain circumstances. I don't think it's anything to freak out over but there's some super fascinating research on its (possible) effects in humans. http://www.theatlantic.com/magazine/archive/2012/03/how-your-cat-is-making-you-crazy/8873/


@crocuta OH EM GEE, toxoplasmosis is so interesting from a microbial standpoint! Apparently the little Toxoplasmosa gondii protozoans can actually change the behavior of the host that they inhabit. So, for example, they have found that the little fuckers make mice less fearful, because that makes mice more likely to be caught and eaten by a cat and thus enable the protozoans to complete the next phase of their life cycle.



@wee_ramekin I just imagine the protozoans that get eaten by a kitteh in mouse meat being all "HA! LEVEL UP BITCHES!" to the protozoans that are still in live mice.


I totally enjoyed this, thanks Elizabeth! ...and am now going to walk somewhere swiftly for 30 minutes (perhaps to buy some Danskos?)


Oh god people who refuse to go to the ER for chest pain. I worked as a medical receptionist in a primary care office and we had elderly patients with heart disease calling like, "my daughter is taking me out to lunch but I'm having chest pains. Tell me I don't have to cancel my plans for this minor inconvenience." or "I'm on my way to the airport to board a ten-hour trans-continental flight, I'm having chest pain but I have my digitalis with me can I just keep going? it's expensive to reschedule and I probably won't die on the plane and scar all the passengers for life, right?" ARGH.


@Amphora This is what we just had to go through with my father. Such a stubborn man - thought it was appropriate to just wait and see for a couple of weeks and then finally he thought he'd test it by running up and down stairs! After the chest pains got a little worse by the stairs, he finally called his doctor who insisted he go to the ER. However, my father insisted on just going to the doctor's office where the doctor promptly sent him to the cardiac unit at the hospital next door. Well, one stint later and tests showing he had 95% blockage in one artery he's now on a low salt diet and feeling much, much better.
Needless to say we all voiced our unhappiness with his stubbornness! And we're grateful it wasn't worse.

Mad as a Hatter!

@Amphora On the other side of that, when I worked in the ER I noticed a lot of people came in complaining of chest pain that was really just abdominal pain or back pain. However, they all had to get a full work up and some were admitted just in case. Better safe than sorry though.


I used to work for 911 and it's wasn't unusual to get a sweet little old lady, sometimes on a non-emergency line, saying, "Oh, I don't want to trouble you, but I'm having a little chest pain..."

Meanwhile people are calling 911 and SCREAMING at me over parking complaints.


I would very much like to know what's up with over prescribing medication and possibly lying about the side effects. My kinesiologist claims that doctors are brainwashed, by pharmaceutical companies, to over-prescribe. I've known so many people that this happened to. My husband was on Lipitor and having all sort of muscle pain. He went to 3 doctors who told him the muscle pain wasn't related to Lipitor. He finally did some internet research, found out it WAS the Lipitor, went off of it, and no more muscle pain. My dad was prescribed Wellbutrin. He started having seizures. Went to SO MANY DOCTORS to figure out what was going on. When I found out he was on Wellbutrin, I said "You DO know that it can cause seizures... right?" He didn't. "I'm sure my doctors have already considered that. They have a list of the meds I'm taking" he said. "PLEASE PLEASE PLEASE talk to them about the Wellbutrin!" I demanded. He did. It was the Wellbutrin. His doctor told him it was very very rare, and, like 1 in 200,000 had that happen. I've, personally, known 4 people it's happened to. So I don't buy it. Long post, sorry. After so many very very horrific things have happened to me (and other people I know) because of doctors, I no longer go to them. I don't trust them. I go to my local health-food store and talk to them about whatever my particular issue is. And that's worked for me since 2007. My sister-in-law is a doctor, and I love her dearly, but I just don't understand you guys. All the medicine all the time! It's KILLING us! She told me, in med school, they had no classes on nutrition. ???


@Gilgongo Last year my brother was put on antidepressants, and before his doctors prescribed them I was talking to a friend who is a nurse about it and the very first thing she said after I mentioned he was going on them was "Don't let them prescribe Wellbutrin."


@Gilgongo This happened to me when I got the HPV Shot! I threw up after my first one and the NP I saw the next time I went in told me it wasn't the vaccine but a quick internet search revealed it was. Why the lying??


@Gilgongo Physicians are taught how to treat disease with therapies that have been tested extensively and either cure the disease, improve quality of life with the disease, or extend the length of life. Right or wrong, looks like people have to take charge of the prevention part themselves. I think that's starting to shift, but slowly. Your anecdotes may be compelling to you but they don't actually prove anything, and I bet you'd choose a doctor over some rando at the health food store if you had pneumonia or cut off your foot. That is what they're there for and that is what they're good at.

Also, seriously, are we going to trust the internet before trained healthcare providers?


@megadith I think it's also important for people to find a health care provider who has a similar philosophy--lets say you're someone who has moderate hypertension, but doesn't want to take blood pressure meds. You want to find a doctor who can give you specific diet/exercise advice, and/or refer you to a nutritionist or personal trainer for 6 months, before checking in on whether you need medication. If you're someone who just isn't likely to change lifestyle, then you're probably better off going to a doctor who will find the right medicine and get you on it quickly. Thoughts?


@Ophelia Yeah, definitely. Doctors have to take into consideration a patient's willingness and ability to carry out their treatment plan - if they know someone isn't going to go to the gym and change their diet and stop smoking (it's not uncommon for patients to flat out refuse to make any lifestyle changes from the get-go) then the doc won't hinge their treatment on this and will instead go right for the pill, which is all many people want anyway.

Side note, if someone has a problem that their doctor is ignoring then that doctor isn't right and they should go see other ones until they find one who will listen.


@megadith I have only once been successful in using the internet as a doctor (I thought I might have appendicitis and WebMD pretty much confirmed I had all the symptoms, so off to the ER with me! And then I saw several real doctors anyway). But the rest of the time if I try to Google what's wrong with me it tells me I have a brain tumor and I am going to die immediately.

I'm all for people seeking out extra information, or second opinions, but you just need to be careful about your sources!


@Gilgongo Thats' funny, because when I was on Lipitor, the prescribing physician specifically said "if you get muscle cramps, call me" and so I did, though it's likely they were actually caused by the fact that I had also just started a new job that involved a lot of hills/stairs.

My current doctor is an awesome human being. The fact that he works at a low-income clinic may have something to do with that, but I am always so happy by how he treats me. "Do you want X?" not "you need X". "You want a flu shot?" "No thanks" "Okay." "You want an IUD?" "Yes Please!" "k, we can do it right here in my office!" I love having a doctor who treats me like an intelligent adult capable of making rational, informed decisions.


@megadith I have never come closer to breaking my "never jokingly propose to strangers on the Internet" rule than I have just now. Bless you.









@wee_ramekin I won't marry anyone who hasn't read and wept at Maurice.


@franceschances I'm going to take serious issue with your language here. Offering a diagnosis/assessment based upon statistical likelihood does not equal lying, even if the doctor is ultimately wrong. It equals offering a diagnosis/assessment based upon statistical likelihood. Part of why it is so important to report adverse effects is so that medical professionals can get a more accurate picture of how widespread bad reactions might be; if every doctor treated every correlative set of events as directly causal, we'd end up with falsely high rates and alarmist fears of all medical therapies.

Besides, just because you threw up after the HPV shot and you read somewhere that it causes vomiting doesn't mean it WAS the shot. It might be possible, but if only a small percentage of people (say, just for argument, that N < 0.01%) report vomiting, then claiming direct causality is probably premature. What, did you read somewhere that the HPV shot always causes vomiting?

Bottom line: just because your doctors didn't think it was likely you'd be within that very tiny minority doesn't mean they're lying to you.

Sorry if that's overly harsh. But jeezus, these folks are understaffed, overworked, and expected by the general public to know everything about every drug/procedure and their effects, and diagnoses by statistics is often one effective way of managing those (often competing) demands.


Anyone out there able to chime in on OB-GYN vs. Nurse-Midwives for prenatal care? We're talking about having kids, and my primary care is with a midwife/nurse practitioner practice. I LOVE them. My husband is in the "white coats! More degrees are better!" camp, and is kind of freaking out about me "not having a doctor." If there's any sort of useful website that can clearly and articulately explain the training a Nurse Practitioner has, what that means in terms of medical care, etc., I'd really appreciate it. I've gone through some of the resources on the ACNM website, but if there's some "compare and contrast" material out there, that would also be really helpful.

For what it's worth, I'm otherwise healthy, and not opposed to seeing some sort of specialist IF it were necessary (but at this point...it's not).


@Ophelia I generally see NPs for my general concerns and they've always been part of a practice that's included MDs/ODs. The way I understand it, NPs can prescribe drugs, but cannot prescribe opiates (in Florida) or perform surgery.

I've always preferred NPs because they go through the whole experience with me and generally take fewer patients and have always had more time. When I discussed the prenatal/birth scenario with my old midwife (out of curiosity, not necessity), she said that, if/when that time came, she'd be with me through the whole scenario, in the location of my choice, but with docs nearby in case an intervention was necessary. But for regular, healthy life things, there's not really a functional difference.

Of course, this is my completely unprofessional, non-scientific assessment based on being really nosy about the people who provide my healthcare, so other people in other states, please chime in and support and/or clarify and/or tell me I'm full of it.


@sam.i.am Yep, that's been my experience, as well. I travel a lot for work, and for a decade, have gone to a NP practice for travel medicine/vaccinations/etc., and the philosophy of the NP I just saw for a gyn visit just...fit me better.

Mrs. PotatoHead

@Ophelia Yes to nurse-midwives!
I saw hospital-affiliated CNM's throughout two somewhat-challenging pregnancies, and it was the best experience, ever. The delivery occurred in the hospital, not a Center, but things went as close to what we hoped for as possible, even when one ended up as an unexpected c-section (physicians become involved then, but the midwife is there throughout). And follow-up care was wonderful, too. I love midwives!

soul toast

@Ophelia I think the key for choosing between and OB or a midwife is that whatever you choose, you have to have a good, communicative relationship with your care provider. I think there could be downsides or benefits to either. On one hand, if you see a midwife, you'll probably want to be able to trust them to escalate you to an MD if something beyond their abilities came up. Or if you were seeing an OB, you'd want them to support your medical decisions and listen to you if, say, you wanted fewer medical interventions. I've heard of jerks on both sides, and also wonderful, supportive practitioners on both side. Personally, I think that if you already have a relationship with an NP, it makes sense to keep going with that. You might want to explore the levels of risks for whatever birthing situation would be available to you (in either scenario), and assess for yourself what that risk means TO YOU. (Everyone will have an opinion on this. Everyone.)

For what it's worth, I'm seeing an OB for my pregnancy right now, but that's just how it worked out. I like her, she listens to me, and is supportive of my decisions. If I didn't like her, I probably would consider changing to a midwife.


@soul toast @Mrs. PotatoHead Thanks, guys :) I really like these NP/Midwives, and they actually do their deliveries in a hospital (which I think is going a long way to alleviate the worst-case scenario planning my husband is undertaking...). I definitely lean on the non-intervention side, but if there ever were an issue, I'd clearly want to know my options as well.

In any event, it's still a hypothetical for us now, but I'm happy having a caregiver who can talk about Star Wars while doing a Pap smear ;-)

soul toast

@Ophelia "I'm happy having a caregiver who can talk about Star Wars while doing a Pap smear ;-)"

Um, this is decision making info we should have gotten upfront! :) Don't ever leave your NP!


@Ophelia I'm a med student doing my Ob/Gyn rotation right now and I think the nurse midwives are amazing!! As others said I would totally suggest that if you are inclined to see a midwife you should see one that is affiliated with a hospital. In just 3 weeks I have seen three cases where a woman had to be rushed into the OR for a C-section within minutes because the baby's heart rate was dangerously low. For that "what-if" scenario alone I would absolutely want to be in a hospital near someone with a scalpel. That said, I worked on a delivery with a midwife this week and seeing how she managed the labor was completely amazing. It seemed like the way it should always be!!


@Ophelia I agree with the others. Nurse-midwives and/or NPs are great if they are hospital-affiliated. I think the best scenario is to give birth in the hospital with the midwife or NP present, and extra physicians and nurses are nearby if needed. The midwife or NP (or doula) will be much better at advocating for you and sticking to your birth plan than the hospital docs. I work in a NICU and there are way too many cases where something unexpected happened and the mother and baby were put at risk. The sooner the specialists can provide help, the better.

Citizen Cunt

1) What are your thoughts on Health At Every Size?
2) What if there was a nurse who had a PhD in nursing, would all the doctors get all butthurt about the nurse being a Doctor but NOT REALLY A DOCTOR DOCTOR? I've always wondered that.


@Citizen Cunt #2: yes.

dracula's ghost


"I didn't become a doctor to take orders from a nurse, nurse."
"Well I didn't become a doctor to be called nurse, doctor"


@Citizen Cunt Yes! Especially because a PhD in nursing isn't additional medical education, or clinical experience, it's business/practice management credits.


@Citizen Cunt - I would like to second this. I've always been curious to hear a doctor's thoughts on HAES, because I think I've only ever heard laypeople address it and having a medical professional talk about it seems...relevant. I can't decide if I've never heard/read a doctor talk about it because none of them believe it, or because it goes against the grain.


@Citizen Cunt re #2 a "Dr. nurse" in the hospital has nothing to do with butthurt and everything to do with roles and expectations. A physician in a hospital is called "doctor" and the expectation is that this is the person whose job it is to diagnose, treat, cure, and prevent illness. If someone is walking around introducing themselves as "dr. smith" to patients, families, and co-workers, because that person had a PhD but is NOT the person responsible for directing the medical care of that patient, it is confusing AT BEST and has the potential to be deceptive and damaging to patient care. To be a good doc nowadays you HAVE to be a team player, but part of a food team is clarity of roles--who does what, and when.


Thanks! This was interesting since I work in a medical library, but don't actually know anything about any job that's not a librarian.

I will say that when you watch hospital dramas and wonder how all doctors can be that attractive, it's the truth. So many gorgeous people in here on a regular basis I am astonished.


@mackymoo One of my friend's parents met this way. He was a doctor and she was a librarian at the medical library.

And then they got married and had two gorgeous, intelligent children who are both doctors. Let the circle be unbroken.


"embarrassingly small amount of weights"

Yes, this is also me.


Can we have a whole post on how truly awful smoking is? Because I am quitting and it is hard and that would help (but it's been 6 days so far!). Thanks!!


@PomoFrannyGlass And also? Yes, there is a lot of fat shaming in the world, but it's a little silly to imply that smokers get less grief about their health than overweight people. I am both a smoker and overweight, and I've literally never had strangers or acquaintances tell me I should lose 30 lbs. Not that I have a problem with that, just sayin'.

elysian fields

@PomoFrannyGlass Go to the "Bodies" show and look at the yellow-gray shriveled-up lungs of a smoker vs. the fresh, pink, healthy lungs of a non-smoker. As I recall, the smoker's lungs look like they've been rolled in garbage and dirt and then run over repeatedly by a truck.


@stuffisthings I was working as a teacher last year, and it was HEARTBREAKING how mean kids often are to children of smokers. We had one girl whose mother smoked, and all of the other students would make faces if you sat them next to her. She did not smell terrible, just maybe FAINTLY smoky. And then you call their parents (of the students being rude) and their parents are like "well Jimmy is very sensitive to smoke, don't sit him next to her"

People are rude. My parents are still smokers, and my mom has come home crying because a professional development leader told her she smelled like cigarettes when she came into the room at work one day.


@MissMushkila oh, what is wrong with people. That is really sad.


@harebell Wow yeah, I wasn't expecting any kind of sympathy at all. I mean I started smoking at 22 and I know it's idiotic. But to do that to kids? Unbelievable.

I'd tell the PD later to go screw, though.


@elysian fields The very first year I taught, one of my students did a persuasive paper on Why Smokers Should Quit. For the presentation, she brought in two sets of cow lungs: one normal set, and a set that had posthumously been put through the level of exposure a pack-a-day smoker incurred. They were each in an apparatus that involved a bellows, and the difference in inflation was staggering. I watched the jaws of at least three students (freshmen!) drop.

@MissMushkila I try hard not to be conspicuous or rude about it, but I have, on more than one occasion, had to get up and move during my own class (when I'm sitting in the back watching presentations) because the student who plonks down next to me is a smoker. I try to offer a more polite excuse - "oops, sorry, I'm going to need to move so I have enough space for the recording equipment" - but once a kid came in late after I'd already set up, and I wheezed, watery-eyed, for the entire class. After that I started trying to build in a buffer zone of three seats on either side by sprawling out with my materials.


@stuffisthings I strongly suspect your experience would be different if you were a female smoker who was overweight.

@MissMushkila I feel bad for your mom, but what Xanthophylippa said - it's powerfully uncomfortable for some of us to be working alongside people who carry cigarette smell with them. One of the IT ladies at my office is a heavy smoker and she wears a lot of perfume to mask the cigarette smell. My office has no windows and crappy ventilation, and it's really unpleasant for the rest of the day every time she comes in here. I don't know how to balance our competing concerns.

Fiddle dee dee

The CDC estimates that 60 million Americans have already had toxoplasmosis. I have been around indoor/outdoor cats all my life so I assume I have had the disease.

@ mackymoo Sadly, most male veterinarians do not look like Sam Shepherd in "Baby Boom".


@Fiddle dee dee Wellll I wouldn't necessarily assume that! (Vet here, for the record.) The most significant risk often comes from undercooked meat. We did a fun thing where we all submitted blood for toxo titers in my parasit class during vet school and I think only 1-2 out of 90 had markedly elevated titers? And we spend a lot of time around cats, as a group.
Also there are some pretty cute male veterinarians in all fairness! Unfortunately, in my class, they were almost all taken by the time they got into vet school. But, good news, we divorce pretty frequently as well. But we are deeply and hopelessly in debt. So you probably don't want to marry a vet. The end.


@kavitha My vet. Is gorgeous. But also married with two small children? Maybe I can wait it out.


@C.SanDiego Sure, wait it out! The odds are against marital success. (I mean, vetmed is awesome! Tell your kids to live their dream of becoming a vet! We have the funniest stories at any party, which is worth a lot, right?)


Third year med student totally nerding out over here!! Can you talk about the wonders of Osteopathic Medicine?? Unless you don't know the wonders, in which case I would gladly enlighten any and all 'pinners interested in listening!!
Also, who the hell has time to write a book during med school???


@thislilpiggie Are you in DO school?? How/why did you decide to do that vs. allopathic med school? I'm planning on applying to med school probably next year, and the osteopathic philosophy is appealing to me, I just don't know that much about it and worry that it won't be as "accepted" by patients and whatnot. Is that silly? What I'm saying is I'm interested in listening!


@thislilpiggie Is there anything to cranial manipulation? My dentist is trying to get me to go see a DO who will, like, gently touch my skull a little bit and this is supposed to immediately cure the TMJ problems that have been plaguing me for the last 12 years. I am a biostatistician MS with a pre-med BS so I know how to read JAMA articles (since I often write large chunks of them) and everything I've seen so far is like, nope, that's pretty much unmeasurable bullshit. Which is what my gut tells me, but I'm so sick of the insane painful clunks every time I open my mouth and the muscle fatigue that prevents me from being able to eat a damn bagel without taking a 5 minute rest between each bite that I'm almost considering it.


@tibia I am in DO school!! I have a bunch of docs in my family and most are DOs so I'd been exposed to it for my whole life but I didn't really know what it meant. When it was time to apply I ended up only applying to osteopathic schools. Like you said, the philosophy just makes so so much sense to me!! When it comes down to it the medicine is the same and we learn the same stuff that the MDs do BUT we also learn a completely different way of looking at things. Treating the patient as a whole person not just a symptom is not mumbo jumbo its just common sense. I also love that I have that extra tool of osteopathic manipulation that I can use and have the patient see results, sometimes immediately.
As for not being accepted, that completely depends on the area of the country you are in and what you think you might want to do. If you want to be a neurosurgeon then yea, you might not be as competitive with MD students when you are applying to residency because there can be a bias. Even still my school has had someone match at Johns Hopkins for Anesthesia every year for the last few years. Once you are actually a doctor, most patients don't even realize that they are seeing a DO because most people don't know that we exist. If anything I meet more people who say "WOW! I go to a DO and I love them and I always seek out DOs when I'm looking for a new doc!!" rather than "DOs are quacks and I would never see one" or something like that.
Sorry that was a crazy long rant but its my life, haha!! I love what I do and I urge anyone who is curious to check the option out. Another completely biased comment is that DO schools tend to just be nicer places and less cut throat.


@megadith Ok, so cranial totally feels like voodoo. But I've been taught how to do it and you really can feel the bones in the skull move and feel when things are just plain stuck. Some people who are super into cranial say that they can treat anxiety and things like that with it which I am skeptical about even though I do understand the concept behind that sort of claim. As for TMJ, I really think there is something to trying cranial. It won't be immediate relief and you might not even really notice at first but then you'll realize "hey it doesn't seem to bother me so much anymore." I was treated with cranial for migraines and that's how it went for me. The first time I thought it was complete bull and then I realized I wasn't using my medication as often. For TMJ you can also treat the muscles of the jaw which loosens up the joint and makes it less painful (that technique really helped my TMJ). So even though I have it done and do it I'm still not totally convinced that its not voodoo but it does work for me. If you have insurance and a DO who does OMM, I say try it!! Besides, I think acupuncture is kinda voodoo too but plenty of people still swear by it and find relief.


@thislilpiggie I love DOs - my physician is a DO and she is the bomb, and also was the only person who correctly diagnosed my sister when she had a torqued ovary. Once I had to get a physical for a government study abroad program though, and they refused to accept the DO signature, so I had to go back and she had to get an MD to sign it, which was dumb.


Are you a med student, or a resident? If you are a resident, hello! I work for the ACGME, and you probably know what that is, which is awesome, because no one else does! So I guess if any medical students/residents have any 'ask ACGME' questions, I am here for you, though in no official capacity.


@hotdog Cool! I work for a hospital that is really encouraging residents to do more scholarly research, so they send their med students/residents/fellows to me to assist them in that endeavor. It's a good thing to do, and it's also to make the ACGME happy.


@megadith We are so big on scholarly activity lately; I'm super psyched to see that the hospitals are taking that seriously! It's important for residents!

lemon mint fizz

I'll be going to medical school in the fall, and so I'm really excited about this column (will it be a regular thing??)! On the waitlist for your paperback book! Congrats on your successes. :)


Vet here.... If you're concerned about toxo, get your titers done when you're first Pregnant. I've been around cat poo and gardening all my life, but was negative when tested. The risk is if you have your first exposure/ infection when you're pregnant. Great excuse for my techs to clean up messes at work.
(also had a great midwife & a no-drug birth in a hospital. That was a great idea, as- while I was fine and the birth went well, my girl had aspirated meuconium and got suctioned out, and spent time in the nicu. Very glad I wasn't in a pool in my living room for that...)

Miss Beans

OH HIGH EVERYONE! Hi :) I just wanted to say I have toxoplasmosis! When I was in kindergarten, the teacher noticed I had something weird going on with my eyesight (I used to close one eye to focus) and mum took me to the optometrist and they found that I have a scar on the back of my eye right near my macula. I used to have to go for check ups every couple of years to make sure the thing wasn't growing but it's pretty well stayed the same since I was a kid. It effects my eye sight in that my right eye is particularly short sighted and when I close my left eye everything goes smaller and darker but I've never worn glasses or anything.

There have been some really interesting papers on toxoplasmosis over the years and the traits that women with parasite possess and the difference between the sexes. That's something that's really interesting actually. For reference, I probably got it through one of our cats when I was growing up. We lived on a farm and the cats we had most definitely killed rats that lived in the hayshed. And kids are (innocently) gross. Touching lots of stuff then shoving hands in mouth etc. Daring each other to lick weird things...

Also, just wanted to show off and say I work in a children's intensive care unit and our hand washing compliance is pretty damn high. The nurses win the day with our compliance rates but everyone else is up there around the 80% mark.


It is such a foreign concept to me that people have cats that aren't badass and don't kill things on the regular. When I was pregnant with my daughter I CANT EVEN TELL YOU WITH WORDS how happy it made me not to have to clean the litter box. That part of pregnancy almost counteracted my aggravation with having to microwave all my deli meats in order to avoid listeria.

Vanessa Steck@facebook

I wish you could address the ways in which its impossible to separate the BOOGA BOOGA OBESITY CRISIS nonsense with any kind of actual information. We know that being fat is not always unhealthy (http://kateharding.net/faq/but-dont-you-realize-fat-is-unhealthy/) and that being thin sometimes is, but its so impossible to figure out which piece of research is proving which. And also we know that diets do not work for 95% of people (long term) which means that what the fuck are we supposed to do, if we're fat but fat is unhealthy? The "cure" you guys have obviously does not work for almost anyone.

John Craig Buchwald@facebook

I wouldn't say the 95% recovery rate of doctors (compared to the much lower rate in AA) has anything to do with doctors getting better treatment. Those in the medical profession undergoing treatment typically have better outcomes because they tend to be more compliant with the treatment.

Francesco Colasuonno@facebook

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