Music, Marijuana, and Moving

Okay, this time Doctor D will be asking the questions!

Doctor D isn't answering questions this week because he's trying to take care of patients while packing up all his earthly belongings and he spent all last weekend camping in Tennessee with thousands of Hippies at Bonnaroo Music Festival, and is still recovering from sleep deprivation and a sunburn. But D did get to enjoy some excellent shows.

D got his musical groove on at quite a few shows such as Dave Matthews, Tori Amos, John Butler Trio, Regina Spector, Gillian Welch, Dave Rawlings, and a lot of no-name bands.

What was the best show, you may ask? Actually it was a British band that I had never heard of before: Mumford & Sons. You should check them out:



But even more noticeable than the music was the ubiquitous use of recreational drugs. Apparently D was the only person in the entire festival that was remained sober.

While I really appreciate all the friendly hippies that offered me all the free pot, if Doctor D ever fails a piss test the DEA could take away his prescribing privileges.

All of Doctor D's stoner friends understood and were kind enough to take all the free drugs themselves so as to protect D's license, but what really shocked them was that D had never tried drugs, even in his life before doctoring. They just never appealed to me. I was enjoying life enough without them.

By the way: Have you ever noticed how Baby Boomers (my parents) all say that they "experimented" with drugs in the 60's and 70's? Like it was so scientific! They weren't being irresponsible like kids these days—they were just doing it for science. They are all against drugs now because thanks to their rigorous research the hypothesis that drugs make you high has been proven beyond a doubt.

Doctor D's high friends were outraged that D had never been high. "How can you talk to patients about drugs if you never tried them?!?" They felt D's integrity as a physician was compromised by his lack of experience with recreational drugs.

Now my friends may have been high, but they bring up a legitimate point that a lot of AskAnMD readers have wondered as well:

How can a doctor care for people, when he or she has never experienced what they are going through?

Doctor D has never personally experienced 99% of the conditions he sees.

Of course, no one can experience everything, but why aren't we even trying to integrate personal experience into the training of doctors? Back in the old days they actually valued experience. They even used to intentionally infect medical students with diseases such as Typhoid or Malaria from time to time for research. They figured it was important they knew how it felt to be that sick. I can imagine that program went away after a few students kicked the bucket, but the idea behind it makes sense.

Why aren't medical schools intentionally recruiting students who have been patients with serious illnesses in the past?

What do you think: Should Doctor D try out a relatively benign mind-altering drug such as Marijuana, even if it doen't appeal to him, in order to better understand the experiences and motivations of his stoner patients?

I am eager to hear your thoughts.

...and while discussing:

What do you think of medical marijuana?

More and more states are asking doctors to be the "gatekeepers" for every possible way of getting high. Doctor D is kind of annoyed by this trend.

Doctors have had the pill form of marijuana available for years and its legitimate medical usefulness is very limited. Shift the responsibility to doctors and before you know it our offices get flooded with hippies who suddenly suffer from intractable nausea. If the legislature wants to legalize pot then they should do it in a straighforward manner. Doctor D, for one, will not be writing any prescriptions for weed.

I look forward to our thoughts in the comments. Thanks to everyone for your patience with D's lack of posting this month. The moving truck will be here in a few days and life has been too hectic for regular blogging.

I promise to be back on July 1st with a totally amazing answer post.

Do Chicks Dig Doctors?

Do women find you more attractive because you have an MD?

(Hard to tell, since all women swoon in the presence of Doctor D's masculine charisma even when he isn't wearing a white coat.)

Actually though, if you go into medicine because you are looking for a sexy and glamorous life you'll likely be disappointed...

Everybody reads House Of God or watches TV medical dramas and assumes that medical folks do nothing but save lives, kick ass, and fornicate like rockstars.

Millions of bright young people sign up for medical school every year certain the opposite sex will find them irresistible with MD behind their names.

"Irresistible? You know I am! ...and I totally just banged these hot nurses."

What they find instead is exhausting, banal work that destroys personal time, and patients too sick and coworkers too beleaguered to even consider romance.

But to answer the question:

"Yes, there are women who might find a man with an MD more attractive, but it is not as cool as you might imagine."

(Sorry Dr. D can only answer from the male perspective. Perhaps a woman can tell the story of the female MD's love life in the comments?)

The Social Life

If you go around in your private life saying "Hey, nice to meet you. I'm a doctor!" the ladies will think you are trying too hard. And trying too hard is not cool.

And once people realize you are a doctor they still really won't care. Generations ago being a doctor may have meant something. Perhaps back in the day when a physician entered the room everyone was struck with reverent awe, but these days nobody really cares. Being a doctor means you might be intelligent, but you're also overworked and up to the eyeballs in student loan debt. Not so sexy!

Seducing the Silly Ones

The only place where being a doctor means much is in hospitals and clinics. In the medical environment the MD means something, and there's nothing women find more attractive than a guy who is in charge. But think about it: are intelligent, interesting women in the hospital going to be lead astray by silly teenie-bopper fantasies in which the a doctor replaces the handsome prince? Nope, only the ditsy or creepy chicks!

I don't know about you, but Doctor D isn't into silly women.

So it is a rare occurrence when a woman that you would actually be interested in is attracted to you because you are a doc. But it does happen...

The Femme Fatale:

There was once a beautiful and intelligent patient who had visited Doctor D several times. Then one day she came to D's office with a hurt knee. Doctor D was dutifully examining the knee when he couldn't help but notice that not only was this attractive patient wearing a short skirt, but she also was lacking underwear!

Now in other situations obvious signals that a beautiful person has the hots for me is at least flattering, but not at work.

Doctor D stood up, said "Excuse me," and walked out. He brought a nurse in to chaperone, and for the rest of the exam kept his eyes nowhere but the knee. The patient never returned.

Sorry to disappoint you, beautiful ladies, but at work Doctor D keeps it strictly professional!

Keeping It Professional

Apparently in years past there was a more lax attitude toward frisky behavior in the hospital. Older nurses tell stories about the 70's in which the entire hospital seems to have been one big orgy with doctors, nurses, and patients going at it like bunny rabbits. (It's hard to tell if these reports are true or just the sentimental musings of soon-to-be-senile baby boomers.)

"McDreamy, I'm just too busy with romantic entanglements to see patients right now."

Despite what you may presume from watching Grey's Anatomy such funny business is no longer tolerated in hospitals. With political correctness, sexual harassment, and lawyers circling like sharks there isn't any room for behavior that isn't totally professional.

The doctors and nurses of today may be more laid back than those of the generation before us, but when it comes to mixing business and pleasure we are downright puritanical.

So, attention to all lusty young premeds:

Becoming a doctor will not get you laid! And if it does get you laid, you might ruin your career and lose your medical license in the process.

If you want to live like a rockstar, you should probably join a band.

But don't lose hope. You can still have an exciting love life. It's just that the MD won't help.

D met the stunningly beautiful future Lady D when he was in medical school. First thing she said when she found out what he did, "Ugh, I hate doctors!"

D responded, "Really? Me too! Too bad I'm about to be one of them."

I won her despite the MD. How you like them apples!

Feel free to tell your stories and opinions in the comments.

Doctor D can't wait to hear the heart-wrenching drama of your experiences in the odd world of medical romance!

What's Up With Doctor D?

What happened to Friday Links? Is everything okay, Doctor D?

Okay, I must confess since Lent have not been the blogger I was before. Perhaps I should explain...

A couple months ago Lady D got a call from "The Man" offering he admission to his law school. She accepted and now the D family is in the midst of an epic move from a medium-sized town to a giant megalopolis. In addition to full-time doctoring D is spending most of his free time packing up boxes, which has cut down on the blogging time. The D family will start a new life in the bustling big city and D will start a new job. It is a bit of a shock for a doctor that did his training in rural medicine.

Wait, aren't doctors and lawyers mortal enemies? How could you let your beloved wife become one of those bloodsuckers?

Excellent point: doctors still live in dread of lawyers. Even more reason to have my own spy right in the enemy camp!

Doctor D is staying faithful to write one answer post each week, but beyond that his game has slipped a bit. He doesn't even get time to read his favorite medblogs. Even Dr. Grumpy sometimes goes unread. Dr. D will occasionally throw up a cool medblog link on twitter, but otherwise he's too busy to go find a brilliant post every week.

But never fear! After the boxes are packed, then loaded in a truck, then unpacked again D shall bring back the Links, along with new Big D Awards and some other cool stuff D has in mind. We might even try to host Grand Rounds here one of these days if Doctor D survives gridlock and the company of lawyers.

Until then keep sending in those questions and every week D will keep providing you with brilliant and entertaining answers every week (even if he isn't hitting that Monday deadline as well as he used to)! I might even take to that odd habit a lot of medbloggers have of filling you in on little details of my personal life.

Wish me luck on my move!

Hurting My Patients

An email to Doctor D:

What does it feel like to cause pain or disfigurement to a patient? Is it troubling or do doctors not let it affect them?

Believe it or not, most doctors are not sadists.

Hurting patients is distasteful to those of us who went to medical school because we wanted to "help people."

But the fact is that the really cool gadget that Dr. McCoy waves over sick people to fix them hasn't been invented yet. "Dammit Jim, I'm a doctor not a butcher!" Unfortunately, for the foreseeable future even high-tech medicine will involve some butchering.

People come to Doctor D feeling rotten and I sometimes stick them with needles, electrodes, blades, and tubes which at least in the short run makes them feel worse.

Sorry, I know, it sucks.

Doctor D fully realized the cruelty of his profession as an intern when he was performing a lumbar puncture on a squirming, screaming 2 year old with meningitis. The terrified kid couldn't understand why sticking a needle into his spine was required. He just thought we were torturing him. It sucked. That day D wished he had chosen another profession.

But young Doctor D got over the trauma he caused. The fact was that the lumbar puncture helped save the kid's life. Many of the painful things we do save lives, so we grin and bear it.

After a while we get used to hurting you:

It doesn't help patients for doctors to get emotionally distraught every time we cause pain. You want me thinking clearly so I can do procedures quickly and efficiently, with as little pain as possible. The doctor who hesitates to do an urgent painful procedure can be dangerous to patients.

Empathy must kept in check by necessity.

But occasionally the doctor gets too hard... forgetting your pain altogether and focusing only on the job.

Or even worse, we enjoy hurting you. It's easy to feel for a helpless toddler we have to hurt, but a whiny grown up who asks to be "knocked out" just to get an IV and has more tattoos than skin is a lot harder to feel for. Patients who thrash around can be dangerous to work on because needles and scalpels get knocked all over the place. "STFU and be still!" We sometimes even fantasize about performing painful procedures on belligerent patients.

Our work in proximity to so much suffering has a natural hardening effect. Doctors must constantly be wary lest we become cruel.

I believe that we can find a middle ground in which we perform the difficult task of hurting to heal without losing our compassion.

If I must cause pain adding kindness and understanding can sometimes be more therapeutic than morphine.

Doctor D always enjoys hearing your stories and perspectives in the comments.

What are your experiences with doctors causing pain? What was done well? What was handled wrong? Have you ever felt a doctor was being intentionally cruel in a painful procedure?

A Voice In The Wilderness

So you're probably wondering why there hasn't been a post this week.

Doctor D is visiting primitive relatives who still live in the wilderness beyond the world wide web. He only briefly escaped to connected civilization to send out this message.

Next week he will return with a new answer to your questions.

Spreading The Love!

The Last Post of How To Thank A Doctor.

Okay we've almost beaten this topic to death. You asked Doctor D and you received! You now know every nuance of the physician psyche in the realm of gratitude. Your thanks should now reduce MDs to putty in your hands!

But one last pearl of wisdom to take home:
If you thank a doctor and then treat the staff like crap, you just come across an insincere ass.

This should be totally obvious, but you wouldn't believe how many people do it.

"Oh, thank you so much Doctor D for diagnosing my UTI. You are awesome!" Then they go disrespect the nurse who had to crawl under their panus to get the in-and-out cath. Not cool and not really grateful.

The truth is that doctors get thanked too much for what nurses, phlebotomists, paramedics, and other healthcare staff do. We get to ride in at the end with the triumphant diagnosis. All the people who do the hard stuff rarely get thanked.

You thank Doctor D he'll probably think you're a cool patient. You thank the phelebotomist who stuck you and he'll recommend you for beautification. You cuss out the phlebotomist and D's cool vibe about you vaporizes.

What if the phelbotomist really deserved to be cussed out? I know the healthcare system has a few jerks in every job, but if you let them bring you to their level the only person you shame is yourself.

So spread the love! Treat the healthcare team nice and your doc will love you. By the way, it's Nurses Week (which is totally a more legitimate holiday than Doctor's Day) so go hug a nurse or something!

There you have it! You know all there is to know about thanking doctors.

But honestly, as long as you're polite you don't really have to thank your doctor. We work in a service profession. It's not like we are war heros or humanitarians. You don't always have to thank someone for doing their job, but it is nice when you do.

Thanks for reading!

Next week Doctor D shall take on more interesting questions... Email me some!

Be Cheap!

Cheap Gifts Are Better!

Part 5 of How To Thank A Doctor

Doctor D has been amazed at all the kind things readers have done for their doctors, but D's a bit disturbed by the funds some of you are putting into your gratitude!

Believe it or not, the less money you spend on thanking your doc the better! A doctor is not your niece at Christmas who will only be impressed if the gift put you in debt. In fact, any gift you obviously spent money on is likely to make your MD uncomfortable.

Why?

Reason #1: Lawyers

As I've mentioned before, we doctors live in constant dread of bloodsucking lawyers. A clever lawyer can turn even a friendly gift into a felony, so doctors have all been taught to shun gifts of any value.

A gift worth anything can be legally considered a payment for services. If Doctor D took care of you for free and you give him a gift he loses all of his "Good Samaritan" legal protection and can be sued vigorously. If I accept a gift from someone who already paid through insurance I'm in even more trouble. One of those slippery lawyer-types could point to Doctor D's gift and scream, "Fraud! Kickbacks! Felonies!"

Doctor D likes his job and doesn't want to lose it on a legal technicality, so please keep the gifts worth nothing: a written-in card or some cookies you baked is as valuable as you should go.

Rule of thumb: If your doc could conceivably resell your gift for more than $1 on eBay, don't give it!

Reason #2: Doctors Are Overpaid

Let's face it: physicians aren't hurting for purchasing power.

While the business of keeping a medical practice afloat may be frustrating and getting worse, the actual annual salaries of those of us in medicine are usually much higher than our patients'. Doctor D is in one of the worse paying medical specialties and he still makes almost twice as much as his friends. D isn't getting rich doing this, but he's never going to worry about keeping food on the table.

I also know how much medical care costs: way too much! A serious workup or a chronic illness can bankrupt you. I'm glad you're thankful, but when you bring me an expensive gift after you just paid thousands to be poked, prodded, and embarrassed in the medical meat grinder it just kills me. I don't need things of value. I wish you'd spent the money on yourself, and just written me a heartfelt thank you note.

If you like giving really valuable gifts then give them to teachers or police officers. Those guys sacrifice just as much as doctors to make the world a better place, and the pay they get is just sad.

Listen to Your Inner Cheapskate When You Thank Doctors!

Doctor D tries to politely decline expensive gifts, but it still ends up awkward.

So go cheap: really cheap—don't even worry about paying Hallmark for those fancy cards. The patient gifts that Doctor D treasures most are simple homemade cards, produced with simple paper and pen.

Have you every given or received an expensive gift in a doctor-patient relationship? How did it go? Ever have a gift declined?

What is the coolest "worthless" gift you ever got?

Doctor D always loves to hear your stories in the comments!