warriorsavant: (Chimerae)
DuckDuckGo. Does anyone else use this? It's an alternative search engine to The Borg. Their claim to fame is that they don't keep track of you/don't create a profile that follows you around. So far, their searches seem to give reasonable results, but I haven't done a head-to-head comparison with other search engines.

Office & Staff. Evil Secretary was actually out sick for almost 2 days. She takes sick days about once every 7-8 years. I came in Monday and she looked green, told me she'd just thown up, and needed to go home. Fortunately we have T on board now. Even though she's here as a nurse, she has secondary duties of filling in when ES isn't here. Also fortunately, it was a little slow, so she jumped in and did just fine. Yeah, lots of small things weren't perfect, but so what, this isn't her primary job and she's only been here a month. ES had initially told me she thought she'd need to come in for 1 day to clean up whatever mess was left, but there wasn't any. Good. Not having reliable back up of ES has always been a slightly worrisome issue for me, but this is another instance of T seeming to work out well.

RAMQ, fighting with. That's the government medical insurance bureaucracy in Quebec. Despite all our complaining (both as patients and providers), they generally get things done with a minimum of fuss. Had a couple of issues that I had to fight with them about yesterday, which is to say had to get on the phone with someone. Doesn't happen often (as best I can tell, most doctors in US spend more time fighting with gov't and/or insurance companies than actually seeing patients), and at least I got to speak to a human being.
     The Good. A patient who was falling between the cracks. He has horrible psoriasis, was put on one of the new biological medications with great results when he lived in Ontario. He moved back here, and the requirements are a little different, and I've been trying for > 6 months to get him approved. Discussed with them for 10 minutes, and today got the approval. They generally figure that if a doctor is willing to take the time to call them directly, it must be important.*
     The Bad. Only "medically necessary" acts are insured, which is reasonable. (Some of the backstory is not reasonable, but irrelevant here.) For example, a cyst that is not inflamed, infected, or physically troublesome is not covered for removal, so the patient has to pay. They may not like the cyst (or other benign growth), but the world is full of things one doesn't like, and that doesn't mean someone else has to pay for it. Anyhow, removed a cyst from a patient this past summer, duly warned him he'd have to pay for it, which he seemed to accept, duly charged him… and then he complained to RAMQ asking for reimbursement. Last fall they sent me a nastygram, asking for my notes on the patient and my justification. I sent that back, including a direct quote from their manual. They just sent me a letter saying basically, "illegal charge, we're collecting it back from you with a penalty." I spoke to someone who took the info, "and will get back to me." This is seriously annoying, but I am going to smack them down. If I let it go, besides the money immediately involved, it sets a really bad precedent. I've gotten the Assoc. Derm. Quebec involved, and they will help me for the same reasons. We'll win, but annoying.

*More on fighting for patients. It's part of the job. I'd hate to have to do it for every patient. Frankly, wouldn't have time to earn a living if I had to do that, but every 2-3-4 weeks, something comes up and I need to do it. It comes with the turf. Sometimes it really shouldn't be my job on a particular patient, but if he/she has been bounced around enough times, and is sitting in my office, I figure that morally it has defaulted to being my job, and I'll at least take the time for find out who should really be the one to see him/her, and make sure it happens.
warriorsavant: (Default)
"Ooh, you're givin' me the fever tonight...." I don't often quote rock songs, mostly because I don't know that many, but when I have a chance to, I like to show it off. The quote is the opening line to "Fire and Ice" by Pat Benetar. It also describes my day.

We've been having icy rain. At least not a million below zero, but equally unpleasant, plus snarls traffic really badly. It took me over an hour to get home from the hospital last night, a trip that usually takes 20 minutes. This morning the driveway was a sheet of ice, patients were late, and even Evil Secretary was late, which happens about once every 7-8 years.

The fire part? Well T put some instruments in the autoclave (sterilizer - normally Evil Secretary's job), and didn't know she needed to put the wrapped instruments on a special rack/tray first, so the wrappings were touching the hot interior of the autoclave and caught fire. No damage done, but an unpleasant odor lingered for an hour or so.
warriorsavant: (Venice)
Last day before we break for the holidays. I love my work, but need a break. Usually on the last day we close at noon, then Evil Secretary and I go out for lunch. We'd accidentally already booked some patients at the end of the day, and didn't really feel like sitting in a restaurant, so we just blocked off 2 hours mid-day, and I brought in lox and bagels (and all the trimmings, and a toaster) and we had that for lunch. Also a bottle of wine (only 1-2 glasses each, since had to work later). Had lunch, and a walk (last pleasant day for a while), and a good gab. For the rest of the bottle, if patients were pleasant, we offered them a small glass of "holiday cheer." Good way to finish the working year.
warriorsavant: (Dr. Injecto)
I was seeing a patient in Room 1, when I heard Evil Secretary yelling, "Doc, doc!" very loud and excited and anxious. Not like her. I thought someone was assaulting her. I ran out. There was a dementor hovering over the patient who had just come out of Room 2. I pulled out my wand and exclaimed, "expecto patronum!" driving it away. (From Harry Potter Does Dermatology, the about to be released 8th book in the series.)

Uh, yeah, okay, not quite. I'll get my fantasy life in check. What actually happened was that I had seen a patient in Room 2, and removed a small growth. We usually can tell when a patient is feeling faint or dizzy, and get them lying or sitting down quickly (such as the next patient who was in Room 2). This makes only twice in, uh, never mind how many years, that someone slipped past our guards. Anyhow, he seemed fine, said thank you & goodbye, and went to the front desk while I went into Room 1. Apparently he suddenly went from 'fine' to starting to fall over. Evil Secretary grabbed him, but she was on the other side of the reception desk. When I came out in response to her shout, she was leaning across the desk, holding him under the arms. Couldn't let go or he'd fall, but had no way to get around the desk either. I got him under the arms, and laid him down with something soft under his head and a stool to raise his feet. Turned out he hadn't eaten all day. Those are always the ones who get dizzy, combination of low blood sugar and anxiety. Frankly, if I don't have a nibble mid-morning, I get light-headed by the end of the morning (just the blood sugar, no anxiety), and this was the early afternoon when the gentlemen saw me and had his episode. We got him some juice (we keep some juice boxes in the fridge), and half of E.S.'s granola bar. After a while, he felt better, sat in a chair for a while, and when felt even better, took a taxi home. I think we're going to lay in a supply of not-very-good chocolate (because if it's good chocolate, well, I have no will power and would eat it all). Raises the blood sugar, and besides, everyone knows that's what you need after a dementor attack.
warriorsavant: Family Tree (Family Tree)
I'm afraid that my siblings and I are getting to the age where ailments are conversation. I'm resisting the tendency, but from the tenor of some of the conversations, I’m beginning to think Bob is in better shape than any of us. Harrumph. (Halloween being over, he’s back in the back room of my office. Evil Secretary is displeased, but realizes that he scares some of the patients. And I’m talking about adult patients. Did have a little girl today (age 8?). She was asking a million questions about things in the office, and allowed how she was very curious. After mangling a translation into French of “curiosity killed the cat,” I then allowed how curiosity was a very good thing and should be encouraged. Then I offered to show her Bob. She was most pleased and impressed.

Sibs and I were also discussing different ways of measuring intra-ocular pressure (testing for glaucoma), known as tonometry. I mentioned that I recall when air puff tonometry came in, as the hot new gizmo. (Prior to that, they numbed your eye, and pushed a small measuring rod against it. Our late Great-Uncle B was an Ophthalmologist. Quite prominent in his day, but was not big on shiny new gizmos if the old ones still worked. Part of that was his old-fashioned frugality. He was raised in the school of “you never know when the next famine (pogrom, stock market crash, whatever) was coming, so use things until they can no longer be fixed." Having been raised by Depression Era parents, we all have that streak in us. I’ve gotten away from it somewhat, and I’m not entirely pleased with that. Not sure how I’m going to teach the next generation the value of money. Just because you can afford something, doesn’t mean that you should. Back to Great-Uncle. Had a small office in his house - dunno if he actually saw any patients there, or if simply for tax purposes. Anyhow, after he passed away, we found a pair of magnifier glasses in a drawer in the living room(?). Inside was a piece of masking tape, labeled “B: better pair in office.” So we looked in the office. Sure enough, there was a pair of magnifier glasses there. Inside the case was a piece of masking tape, labeled “A: worse pair in living room.” The hat he wore to his wedding to Aunt C was older than any of his adult children. (This was his second marriage, both of them having been widowed for many years.) Yeah, there are the jokes about “I have a hat older than you kids,” he really did. BTW, I still have my original canvas duffel bag from when I was very first in the military. Newer ones (say, oh, the last 2-3 decades or so) are nylon. My last deployment, a young troop asked me, respectfully, why one of my duffels looked different. I explained, then realized that duffel was indeed older than he was. "I have boots (well, duffel bag) older than the young troops…" And was actually bringing same on a deployment.

Yeah, back again to Great-Uncle. He had a gizmo for measuring your existing eyeglass lenses, “reading” the prescription. He acknowledged that the then new-fangled (40 years ago?) electronic ones were more accurate, but pointed out that the human eye couldn’t perceive the difference, so why spend the extra money to get a new one that wouldn’t help his patients any better than the old one. I still have a quite old hyfrecator (what most people call an electric cautery) that is older than most of my Gentle Readers. (Possibly older than all of us, I don’t recall when or where I got it, but it was used then). The newer ones are slightly better, but they burn out after several years, so I keep it as a back-up.
warriorsavant: (Meh)
In Patrick Taylor's Irish Country Doctor series, the young protagonist, Dr. Barry Laverty, is introduced to his mention, Dr. Fingal Flahertie O'Reilly, when the latter physically evicts a patient from his office because he hadn't washed his smelly feet before wanting them examined. I'm not sure the College des Medécins would appreciate my doing likewise, but it was tempting today. There's a reason we keep a bottle of air freshener handy.

Don't sit in my chair. Really, it's not hard. The chair in front of the desk is mine, it's my office, you don't sit in it. Also, don't move the furniture. I thought carefully about the layout of the office, and the placement, and there's a reason why things are where they are. Don't move them. Not even moving the patient's chair, especially not 2-3 feet backwards. But really, keep out of my chair.

It's rare that a patient faints, but does happen. Super rare that we don't see it coming. Usually they're still in the exam room, I see them looking pale & sweaty, and quickly have them sit or lie down. Rarely they make it up to reception, and Evil Secretary is very good about spotting the signs and running around the desk and having them sit down. Only once that I can think of did someone give no warning. He (she?) was standing at the reception desk, talking, looking perfectly fine, and suddenly went out. Today it was the daughter of an elderly patient. Daughter looked at me, said, "Mom is feeling faint, can I get her some water." I said there was a glass by the sink, while quickly helped mom to sit down… when daughter fainted without warning. She was fine besides being embarrassed, but only second patient in this many years to faint without warning.
warriorsavant: (Warriordaddy)
Friday was my 2nd day at the new office. (Thursday I was at St. Anne's which was fairly light. Just as well as I wasn't in the mood.) Patients overwhelmingly like the décor, which is very, very gratifying.

Several "firsts" at the new office (nothing earthshaking, but firsts for there).
First student. I like having students. At the hospital, since it's a teaching institution, the patient is basically stuck putting up with students and residents. I rarely have students in my private office, but sometimes, and the patient certain has the option to say "no," although few do. I had a student, which in this case was Evil Secretary's daughter. She had to do a project for High School, some part of which required shadowing someone at an interesting job. I almost calling her a medical student then catching myself just in time. "Mr/Mrs Patient, do you mind if our med… uh student joins us." I think Daughter of ES got something out of it.
First biopsy. Since skin is very accessible, skin bx are no big deal, unlike, say, a brain bx, or any other of those fiddly little internal organs. Reminds me of when I was a resident, and one of our patients needed a liver bx (was on methotrexate, and still did a lot of liver bx in those days for patients on MTX). Paged the Surgery resident to do it, and when he arrived, I asked if I could do it with his coaching me through it. He scoffed openly. A mere derm resident thinking he could do such a thing. That required the skilled hands of a Surgeon! Stand back, mortal, I shall do this wondrous thing!! Yeah. Then the bx came back as "normal lung tissue." Mr. "I'm a Surgeon" managed to miss the largest internal organ in the body. I still don't actually do liver bx (especially in my office, but I'm far less impressed by those who do.
First cosmetics. Got a peel, a botox (actually 2), and a filler. For me, the trifecta of cosmetic procedures. I have no intention of being a glorified cosmetician, but I do want to have all of Friday afternoons be my cosmetics time. I'm slowly working toward that. I hope having 4 procedures in one day is a harbinger of getting there, but probably just stacked up from my being away.
First toes. The advantages of now having my own kids, I'm better at dealing the kids-as-patients. This one, as so many, didn't like, and was frightened of, doctors. Which is often because the parents are frightened, and the kid picks up on it. Regardless, there are some tricks that help: take off the white coat, get down to their eye level, make faces. And, when all else fails, bite their toes. My Peds Derm colleagues scolded me today for having done that, but really, it worked. I was transformed from Frightening Monster to New Best Playmate.
warriorsavant: (Cafe)
First day at the new office.
It is gorgeous. Everyone from Evil Secretary to my grumpier patients to my cheerier patients commented. ES had seen it in past week while we were unpacking and contractors still working on last details, so it was beautiful in her eyes to see it as the patients see it. Still a few details have to be finished, plus things needing to be sorted out and put away, plus inevitable changes later. All that having been said, I love it. Probably cost me a month's worth of patients to give it that elegant and slightly magical look (pix eventually), but worth it to me to not be working in what looks like a 2nd hand bus terminal, which is what half the doctors' offices around here look like. Although not as full-on magical-looking as I'd like, there is still an air of Hogwarts School of Dermatology and Witchcraft.
Of course, couldn't start off entirely smoothly, what with the ice storm yesterday and the walkway not properly salted. No one broke anything, which is a good thing. Booked fairly lightly until we get the hang of things. It's all the little things that feel wrong: where did I put this? Why is this 2 steps further away than I'm used to? (Doesn't sound like much, but 20+ years of muscle-memory makes things like that fell just slightly off.)


First day back at the hospital in a bit. Have been on-and-off between the Christmas Holidays and the move, but ramped up full time. First patient was easy: rectal melanoma. You read that correctly. What is usually a skin cancer, highly correlated to UV exposure, manifesting inside someone's rectum. Super rare. Had already been diagnosed and half-worked up, but she landed on my doorstep because she'd been shuffled around, didn't really know who to trust, or where to go. I told her frankly that I was not the person who would be able to treat her condition, but I would take charge of getting her to the best place and quickly.
A couple of other patients had odd cases of "who has been treating your case of xxx as yyy for how long?" Not grossly wrong, but the sort of thing that sometimes gets passed down as diagnosis xxx from one doctor to another, made sense initially, but nobody rechecked the facts when it didn't seem to be behaving as it should. Sometimes all I do is get people routed to the correct place. That can be a big thing by itself.


Came home, salted the walkway in front of the house, then had kids climb all over me (that's what is referred to as rearing children). Very tired, but life is good.
warriorsavant: (Renovations)
Moving day. That makes twice in-too-few months. This time to new office. It’s beautiful, but just found out a space is too tight to fit 3 filing cabinets across like it’s supposed to (only measured things 4 times). F***! As we say in French.

Spoiler alert: a certain amount of whining to follow. I’m drained. Too much renovations and too much moving in too short a time. Moving always takes wayyyyy longer than you think. When we moved the house, didn’t finish until after 10 at night. It’s 8 at night local time here, and still working. Biggest slowdown is that they had to disassemble then reassemble phototherapy machine. Much as with house, even though bigger space, somehow not everything seems to fit. Part of that is boxes everywhere makes space seem tight. Actually have a fair amount storage space. At the house, have finally unpacked all boxes and stashed things more-or-less where they belong. Then, neat-freak that I am, I will go through everything and put it properly in place, fix what is broken, and throw out what I don’t need. Yes, I’m a neat freak (Nom isn’t, and her father makes WWC look tidy), but I haven’t always done that. Somehow never quite did the last bits of stuff. Either waited “until I have time,” or “maybe I’ll need it later.” There is no “later.” Not planning on moving house again, and probably not office. Either way, it’s too late in my career and my life for “keep for later.” There is no later.

Tomorrow will really dig into the unpacking and putting away at the office. Fortunately Evil Secretary is even more organized and obsessional than I am. The in-laws are coming over to help in the morning. ES snarled, “don’t let them touch any of my stuff.” I pointed out (falsely) that they can’t read English, therefore wouldn’t know which is her stuff, and she should duct-tape her head so it doesn’t explode. (Anyone know the Vietnamese for “bwahahaha?”) In the afternoon, I’m teaching, which I usually enjoy, but I’m tired and don’t feel like it. Actually, I don’t feel like much of anything except hanging out with my family. And even then only just barely. Did I mention *whine?*
warriorsavant: (Springtime in Canada)

Þ I wonder how long until: (a) I run out of synonyms for miscellanea, and (b) I have the time and energy to write a serious post.

Þ We are going to have a White Christmas. Meanwhile, have to find my heavy gloves! Had our first real snow fall 2 days ago, then today the temperature dropped to below zero on that archaic scale used south of the border (i.e. below -17 Celsius/real degrees). Actually there is one aspect of Fahrenheit I appreciate: below freezing (32º F) is cold; below zero is !︎&⚔☔&*#-ing cold.

Þ Montreal urban highway planning strikes again. Was my monthly visit to Ste Anne's (former- and still-partly, veterans hospital), which is in west end of the island. The entrance I usually take was closed, with a detour to the east. Got to the next entrance, which was also closed, with a detour back to the west, via a narrow street, which was having construction.

Þ One of the patients had a problem on her toe. Understand that she, as so many of these patients, was infirm, wheelchair-bound, & rather demented, who didn't have to go outside to see me. The floor staff dressed her in tights.

Þ We've sent out the letters for the change of address (the move will be next month). At least 5 people called Evil Secretary to ask, "so are you moving?" ("Uh, no. We only sent those letters out to patients we don't like, so in future they will go to the wrong address and stop bothering us, but since, darn it, you caught us, you can continue to be seen at the old address.") Over the past 20 years or so that we've been at this address, we've had patients who went to the wrong address blame us because: (a) we gave them the wrong address, and/or (b) we moved the building. ("Uh, yeah, it has wheels on it, but darn it, you caught us.")

Þ Finished reviewing the files for our residency applicants for next year. As promised (to Nom), I've started putting away the last boxes of stuff (with a slight detour to post this).

warriorsavant: (Renovations)
Did I mention how much I love having kids, especially their endearing little tricks and adventures, as they develop and become more capable. For example, the other day, Wallstreet pushed a chair so he could climb up on the counter, manipulated the lid on my coffee canister… and spilled it all out on the floor so he could play with it like sand. Arggggghhhhhhh. To quote Evil Secretary, "Fish! I shoulda had fish. Then I could have flushed them when I got tired of them." Or at the very least, fish can't climb onto counters and don't have prehensile grasp. BTW, Hedgedfund is figuring out how to open the magnetic childproof locks on the kitchen drawers. Not that worried, as she's past the age where she'll randomly take things out of drawers, and so far Wallstreet hasn't figured those out. These were planned at the start of the renovations; by the time we'd actually moved, we'll have need of them for maybe 6 months. Didn't even bother to put in childproof gates on the stairs. Hedgefund is okay on stairs by herself, and Wallstreet is close to being okay. I'm considering hiring a nanny (or six), or alternatively getting more duct tape and taping them to a wall until they're 18. Naw, that would damage the new paint.
warriorsavant: (Composite)
It will come as no surprise to my Gentle Readers that I'm a "wee bit" obsessional. Part is my medical training, part is my Army background, and part is, well, uh, just always been that way. Believe it or not, Evil Secretary is worse than I am.

Most of our billing is paperless/cashless via the Quebec Medicare system. There are some sundry charges. Even today, some people actually pay cash for them (ask your grandparents, younger generation), plus there's always some need for petty cash in an office, so we always need to have on hand a number of small bills. For time-to-time, when I'm at the bank, I pick up a packet of small bills. Banks usually give you the money all facing the same way, and ordered by denomination. (Although I've noticed they've been getting lazy about that "all facing the same way" thing. Bah humbug on modern life, those slackers.) One time, some years back, I'd dropped the envelope of neatly-arranged bills, and being a hurry, just stuffed them back in willly-nilly. When I got to the office and handed them to Evil Secretary, she accused me of deliberately messing up the order to play with her head. No, I didn't have the time to do that. She then immediately started to put them in order. At that time, Canada was in the middle of changing over the design of the bills, so there were two different versions of most denominations in circulation. I realized that she was not only facing them all alike, and putting them in order of denomination, she was separating the old and new billls of the same denomination. I laughed at her for that.
"Oh, like you don't in your wallet?" she asked indignantly.
"No."
"I don't believe you," she scoffed.
"Really."
"I don't believe you. Give me your wallet."
I handed her my wallet. She actually pulled all the money out of it, and rearranged it. She wasn't joking, it really bugged her that my wallet wasn't in the "proper" order. I almost fell on the floor laughing.

Today, I brought in another packet of small bills for petty cash (all $5's of current design). She grabbed it and started checking if it was in order, "good, you lined them up already."
"It came that way from the bank. What are you going to do now, put them in order of serial number?"
"No," she scoffed. A moment's quiet shuffling of paper. "Hey, they are in order of serial number." She was actually delighted - and yes, she had actually checked when I'd teased her.
I looked over the bills. They were sequentially numbered. They must have been from a series of new bills that were being put into circulation. Regardless, it actually made her day that the pettty cash was in perfect order for once.
Bwahahaha.
warriorsavant: (Wedding/Romance)
Evil Secretary had some family issues today, so we had booked lightly to allow me to see patients while also signing them in and out. (Answer phones? Heck no. That's almost a full time job itself.) I've done it before. It's stressful, I'm hopping around like a one-legged paper hanger, but doable.

In a switch, Nom got her parents to come babysit and came by to help me. It made life much easier, although hard to resist the urge to smooch/fondle the help. She didn't do everything Evil Secretary normally does, but did a lot, which was great. Plus got to have lunch with my lovely wife during a working day.

When we got home, the kids were delighted to see us. Uh, deep down. Hedgefund was napping, and Wallstreet exclaimed "no!" and went to find his grandparents. After all, we only mostly indulge and spoil them, the grandparents completely do. All parties concerned loved it, but I think the PIL's then go home and lie down for 10 hours to recover.
warriorsavant: (Springtime in Canada)
It is a perfect (Northern Hemisphere) Christmas Day: not too cold, with snow falling gently and looking pretty. As noted before* I prefer wishing all a Merry Christmas, regardless of if one is Christian, Jewish, Thean, etc, so Merry Christmas to you, Gentle Reader.

Friday, we only worked half a day, then told Bobbi Cratchett (a.k.a. Evil Secretary) that it was an excuse for picking a man's pocket of half-a-day's pay once every year, and I expected her to be in all the earlier on the morrow. Not really, I took the entire office staff out for lunch (that would be Evil Secretary), then we closed for two glorious weeks. Have tons of stuff that I have to do, but did nothing on that Friday. Went home, actually shut off my computer and phone, and chilled with the kids. Okay, with small children, not sure “chill” is ever le mot juste, but basically enjoy playing Mr. Family Guy. Probably after a few days, I‘ll be longing to go back to the peace and quiet of working with patients. Joking. Mostly.

Saturday night we celebrated the first night of Hannukkah, as much as I celebrate things. I didn't give the children the entire speech** but as we lit the candles I whispered to them that they must always bring the light back into the world.
Lighting the candles )

There is a tradtion in my tribe of going out for Chinese food for Christmas. Traditionally Christmas Eve, but this year will be Christmas Day luncheon, what with being married to an Asian, and they have a tradition of the family getting together for bad Chinese or Vietnamese food for holidays.

Documentation )


* http://warriorsavant.livejournal.com/607965.html - paragraph 2 to be precise, and I do like to be precise when quoting)
** http://warriorsavant.livejournal.com/555667.html and http://warriorsavant.livejournal.com/501898.html
warriorsavant: (Venice)
The day got better in the afternoon, when two different Italian families came. One bringing chocolate, and one bringing cannoli. Not that they weren't delightful people without that, but more delightful with. I reminded Evil Secretary that in future, has to be careful to book them on separate days to spread out the goodies. (Yes, they have the grace and good sense to bring some for her also.)

Being the wonderful father and husband that I am, I brought them home for Nom and the kids. Well, Nom, the kids just got a bit also. That was the second best part of dinner. The best part was when the kids crawled under the table and nibbled on Nom's toes. Okay, me and the kids. Well, okay, me, and the kids followed my lead. Can't blame me, her toes are almost as good as fresh Italian cannoli.

PS: Keeping with the Italianate theme, the icon is from Carnivale in Venice.
warriorsavant: (Cafe)
Recently found out that my late Mother drank coffee years ago. I didn't know that, her having stopped by the time I could remember. The only exception that I can think of, was that when they had company, they would break out the big percolator, but I don't recall if she, specifically, drank any. (BTW, with the long perking, those extracted far more caffeine than "classier" ways of brewing coffee.) For Mom that I can recall, coffee was on the list of things that when mentioned, she would say “ugh,” like smoking cigarettes. I don’t recall Mom ever having much tolerance or open-mindedness for things she didn’t like or had put on the “that is bad” list.

I seem to recall that I deliberately learned to drink coffee as a social thing. "Social" wasn’t my strong suit, but I had figured out that if you went somewhere, people offered you coffee and/or cigarettes (obviously this was a while ago), and cigarettes were on the “totally evil” list. I think I went thru a brief phase of plastic-tipped, flavored, cigarillos in HS? JHS? but it didn’t last. Will still once in a very long while have a cigar, but that’s super rare.

I generally drink my coffee black, regarding milk and sugar as being for weenies, not to mention diluting the true essence of coffee-ness. I do sometimes have cappuccino. I did drink same in my late teens/early twenties in the Village when I lived in NYC (probably got that habit from [livejournal.com profile] ravensron) . I stopped when I moved away from NYC during my Active Duty military time, and for a long time regarded them as weenie drinks, but have rediscovered a taste for them. I have a general rule that if I do have a cappuccino, then I don’t have dessert; it is my dessert. No doubt a sop to some puritan or purist side of myself.

These days I either get Illy Coffee, or something from a local roaster. Used to go to Brulerie St. Denis, but now usually Micro Torréfacteur St. Henri. (Yes, about every other street in Montreal is "Saint" or "Sainte" Something.) Nom doesn't drink coffee. When her mom is over, if I’m making some for myself, she'll have a small cup. On weekends, I add spice into the coffee. I used to crush cardamom pods in the bottom, but now I sprinkle cinnamon into the grounds (wire mesh filter in a Melita cone, if you care). Evil Secretary is a total caffeine addict - free coffee is one of the perks (pun intended) of working for me. Dad didn't drink any more coffee than Mom did. WWC has come over to the dark side although since she hates the taste, will put lots of milk and sugar into it, but [livejournal.com profile] ravensron appreciates fine coffee. I'll be starting Hedgefund on coffee soon enough, followed by Wallstreet. Joking, of course; Mom would turn over in her grave, as she firmly believed coffee stunts your growth.
warriorsavant: (Composite)
Subtitled: How to gross out your secretary.

Where to start on this one? There are 3 relevant facts. Okay, we'll start with Evil Secretary. She is very good at being a secretary. Also at being evil, but that isn't relevant here. What she isn't good at, is blood, pus, or nasty-looking skin stuff. Y'know, the 1% of the time I'm not Botoxing Hollywood starlets, but actually practicing Dermatology. Okay, that's more like 99% of the time. What can I say, it's such a glamorous job, but someone has to do it. Anyhow, the reason ES is a secretary and not nurse or clinic assistant, is that she tends to turn green and gag when looking at oogy, disgusting things. (Not sure how that woman managed to raise kids, but that's neither here nor there.)

Second fact. Sometimes those oogy things are on the male genitalia.

Third fact. If you want to follow something over time, to see if/how it's changing, you can measure it, or this being the modern era, take a photo. What generally works best, since most people today have a camera-phone, is using their phone. They safe guard the photo and bring it to next visit, so no storage and confidentiality issues for me.

However, in this case, the patient's phone was company-issued, and he didn't want pictures of his nether regions (with or without oogy skin lesions) available there. Reasonable. So I took a picture with my phone. Used to keep a separate camera handy, but like everyone else now, I just use my phone. I took the picture, then emailed it to the office account for ES to print out for his file. I did warn her not to look, but that's easier said than done. The first print out didn't work, so had to do it again. I was busy, but at some point, she interrupted to ask me if the second print out was okay (it was), and if so, could she please delete the email, so she wouldn't have a penis popping up at here every time she looked at her computer. What with her having kids, I'd imagine she knows what a penis looks like (but she's been married for quite a while, so maybe she's now forgotten), but I guess she prefers them without gross stuff. Popping or otherwise.
warriorsavant: (Wedding/Romance)
Up 'till now, Nom & I have been POSSLQs, which is to say we've been partaking of conjugal bliss without benefit of law or clergy. To put it more succinctly, in the old British terminology, married but not churched. Even more succinctly, in the old American terminology, shacked up. I was fine with that; really didn't want to screw up an excellent marriage by actually getting married, but what with the second child on the way, and this-and-that, recently we regularized the relationship1. Which is to say, we are now married and churched. Well, married and notarized2.

It was a very small event, essentially immediate family3. Perhaps we'll have the big to do reception in a year, when both children are here, and maybe we even have a real house. For now, holding the ceremony in our condo worked well, followed by a luncheon at Milos4.

We actually had several "ceremonies," covering different traditions. Only Western culture actually has a defined "you must do xxx, presided over by yyy, in order to be officially married." The rest are really ancient traditions, but don't actually have an officially required format. Regardless, we did 4 traditions, rather like touching 4 different bases, which makes it a home run.
            First, we had the Buddhist ceremony. Nom' s father presided over that. Nom wore a red ao dai, and I wore my Army Dress Blues. After that we went to the park nearby and took pictures. We came back, and Nom changed into a white, Western-style wedding dress. She descended the stairs, with our little nieces & our daughter strewing rose petals.
            Second, we took elements of Jewish tradition. My brother said the traditional 7 blessings, followed by my breaking a glass.
            Third, we had the official, legal, secular ceremony, presided over by the Notary, exchanging rings, and signing all the paperwork.
            Lastly, just be certain, we jumped over a broom.
            Ani leh-dodee veh-dodee lee (Hebrew: I am my beloved's, and my beloved is mine)



Wedding pix )


1 Yup, we're the original hard-core romantics. "Hey, what with a second child on the way, maybe we should do the deed." "Yeah, with this-and-that, not a bad idea." Okay, not really that off-hand. Serious love and commitment and all that, but we're at a stage in our lives where the marriage is far more important than the wedding, and where a big "do" would be ludicrous.
2 I didn't think Quebec would recognize our jumping over a broom as sufficient. Originally they did require a cleric to do the deed. Then it was a cleric or judge. Now in Quebec, a notary can do so. Understand that Quebec follows the French Civil Code, including that a notary is a type of lawyer who deals with contracts, properties, and wills, rather like the British solicitor. There are advantages to this system, for instance, a will by a lawyer has to go to probate court, but a notarial will does not. Actually, apparently any citizen in good standing can preside over the wedding. I think "good standing" equals "no criminal record," but you have to wait several months until they check he/she is in good standing, send them the booklet on how to do the paperwork, then hope they do it right. Faster, simpler, and more certain to have had our Notary do it.
3 Evil Secretary & her family were there also. She claimed I just wanted to increase the body count. In fact, I was the only one besides the two witnesses who was supposed to be her at her wedding (at City Hall). Was supposed to be, but I was on call that week, and the one time I actually got called was as I was going out the door to be at her wedding. I only managed to make it for dessert.
4 Have mentioned them before, one of our favorite restaurants. They usually aren't open for lunch on a weekend, but opened for a special event. It's true Greek style, with superb fish and meat and vegetables piled in the center of the table for everyone to share. There's one area with a slightly recessed floor, making it more intimate, and that's where we feasted and celebrated.
warriorsavant: (McGill)
Had a scut puppy medical student in my office today. It was fun. Evil Secretary didn't even tease him too badly. He was good: interested, polite, asked intelligent questions. There was one particular thing he's interested in, which I only do on certain days. When asked if he needed some paperwork to make it official that he come back on one of those days, he said he didn't care if it were officially credited, as long as it was a good learning experience.

Up until now, 3rd year medical students didn't get any official exposure to Dermatology in McGill (nor at most medical schools). Since I took over as Director of Dermatology teaching for medical students 2 (3?)  years ago, I increased how much Derm they have gotten. When I started, they got a few hours of lecture during their 2nd year (Medical School is 4 years in Canada), which total meant they had the fewest hours of required Derm teaching in Canada. By happy coincidence, my tenure coincided with McGill's revamping their curriculum. There is still no official "this is the block when you learn Dermatology," so I tuck it in wherever I can in bits and pieces. This actually worked to my advantage, as there were always little nooks and crannies that needed filling, and I volunteered for us to fill them. We're up to 20-something hours during the first two years, which likely gives us the most in Canada. In the 3rd year, medical students begin their clinical rotations (also called clerkships or externships). I'd love to give everyone 2 weeks of Derm, but we just don't have enough space to take all the students for 2 weeks, or even 1 week. I settled for giving them 2 half-days of "shadowing." Shadowing is basically following the Staff doctor around and getting a feel for what happens in Derm, with the student have zero responsibility for doing things with the patients. The school prefers that this happen in the hospital, but since they just moved to White Elephant Super Hospital (doesn't effect me since I'm at The Other Hospital JGH), the Staff there isn't ready to take extra students until they get a better feel for the flow, so for now a few of us are having students in our offices intermittently.

It's a trade-off: it disrupts my flow (said his obsessional, curmudgeonly side), but I like teaching (said his enthusiastic, pontifical, pedagogical side).
warriorsavant: (Meh)
There's: black, green, white, oolong, and vinegar.

Not supposed to be vinegar, but our coffee/tea maker (one of those Keurig machines that drip-brew individual cups) had gotten scaled up and stopped working. Evil Secretary ran two cycles of white vinegar through it, which removed the scale. She then ran two cycles of water through it which removed the vinegar. Well, was supposed to. I'm told the look on my face when I took that first sip of green vinegar water tea was priceless. Drinking vinegar is supposed to be healthy, according the Little Rascals School of Medicine. Uh, no. Besides, it took ten minutes for my lips to unpucker.

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