It’s a strange time on several fronts.
A pedophile is running for senate in my proud state. My old classmate, a decent guy, a pretty competent prosecutor, but a DEMOCRAT, is running against the pedophile, originally just as cannon fodder, and probably he still is, the evangelicals hell bent on getting their man in, and the black belt isn’t coming out. Nothing is black and white in Alabama, everything is black and white in Alabama.
Meanwhile, back in the real world, the worm has turned.
A quaalude rapist whose comedy I loved for decades has been brought to bay. Suddenly, it was Katie bar the door: rapists, creeps, gropers, fanny patters, tipsy mistletoe smoochers- mainly the foul, but maybe some of the fair- all lumped together, and run off the reservation. An accusation is hard wrought in most cases, I believe that, but it is harder to confirm that with certainty thirty years out, especially as this pendulum gathers momentum. Accusation is tantamount to conviction. Try them in public, screw due process. I should be sympathetic to the victims, I know this better than most- but really, Garrison Keillor?
The air is thick with hysteria, hypocrisy, “Why, I NEVER!”…the mark of every successful political movement.
At the risk of being branded a creepy old white guy, I wait for somebody to respond “At long last, have you no decency?”, and McCarthy, we’ll find a new normal.
Meanwhile, I’ve got problems of my own.
McKesson be gone, we adopted Cerner for computer records, beginning last Monday. All Ascension hospitals did it at once, presumably so we can all be hacked simultaneously, or so it seems.
It’s as though some god of entropy descended, and said:
“Y’all have been doing a very good job with all your record searches, making nice notes and summaries, easily accessed, Thank you. Beginning Monday, you must do them all in Portugese. Here, take this 4 hour course in the language- hey, if you know a little Spanish it’ll help…or, I don’t know, Italian, maybe.”
So… Monday came, and I walked through the whole mess of it. The admitting clerk made 200 keystrokes to get the first patient in the door, it took an hour. That’ll get faster, but it’ll still be 200 keystrokes.
Then the admitting nurse took another hour. That’ll get faster.
Then my stuff, took 20 minutes with a guide at my side. That’ll get faster, too.
Then the endoscopy, 5 minutes. Then it was time to go. Nobody can make any money at this, ever.
Chaos, mostly due to unfamiliarity.
But it is also partly due to excessive data mining- with this huge capable program and with prevailing fashion, the impulse to correct all societal wrongs must have been irresistible.
If you think Irish writers can really knock the ball out of the park, you are correct. It’s a talent lavished disproportionately on the emerald isle.
In the modern era, start with Yeats, a personal favorite because he got even better when he was old, which should resonate with the Cirrus pilot population. Don’t forget the obscure Joyce, or especially the modern Nobel laureate, Seamus Heaney, who stuck to his knitting, and can turn an ordinary dig in the garden into something ethereal.
But the point of all this- Roddy Doyle can write his ass off, he’s an incredible talent. No language, no perspective, is beyond him. From “The Commitments” a rock band story told in the vernacular, youda thought you were a roadie, to “Paddy Clark, Ha, Ha, Ha” seen through the eyes of a bright 5 year old, where you’ll be back in kindergarten reading it, to the subject in question here- “The Woman Who Walked into Doors”, a first person singular tale told by a 45ish woman whose husband had been beating her their entire married life, one dreary ER visit after another. Being Irish herself, she might have had a pint herself before he threw her down the stairs, so the ER docs looked over her head to the husband with requisite sympathy for HIS plight, standup guy married a sot- the whole thing plausible, painful to read.
Somewhere in the middle there’s a long paragraph every doctor should read, a simple list of her ER visits- broken wrist, broken ankle, broken zygomatic arch, teeth knocked out, broken finger, concussions, burns, another broken wrist- the terrible list droned on and on until I was squirming in my seat. Powerful, awful to read.
And then the punchline: “They never asked.” That slammed us, now we were complicit.
A short book, my wife and I read it the same weekend, and swore we’d ask.
We did, she in the newborn followup clinic, me in my GI office. In the first 10 minutes we were both 1 for 1, her’s with a live in babyDaddy who beat the mother until she’d kicked him out, leaving that teenager broke with a premie in marginal condition, and my patient, now 35, having grown up with a pederast stepfather and a mother who just needed to look at the whole picture… Let’s see if I could sort out her irritable bowels now.
Pandora’s box, and both of us asked if anybody’d asked before- they both said no. But I already knew that answer, the easy answer. The patients struggled on with it, we tried to join the fight, but we were adrift at sea, untrained. It’s a mess. The world is a hard place, or can be. They don’t like to tell any more than I like to hear.
So I can sort of understand how the social welfare computer geeks feel they should ask these questions of a patient in here for a screening colonoscopy. Dump that load somewhere, hope that next guy feels like PIC.
My third patient Friday was a hit.
I never met her before. Good thing I have photo ID, as she wouldn’t know me from Adam. I guess the question needs to be asked, even in what seems clearly the wrong setting
Here are the relevant questions:
So, there it is. Way too deep for the 30 minute turn around. What made her say yes now? I have no idea, she’s somehow ready, Anyway, it counts, we’ll have to think of something.
I took off a polyp and asked the good looking, well turned out, and not too anxious looking 60ish suburban housewife to see me in the office next week to talk about the histology. If she comes alone, we’ll talk about it, I’ll figure out where to send her for real help, and tell her I’m sorry this happened, on the advice of an earlier victim. If her very reasonable upper class looking husband of 35 years comes with her, we’ll have a tougher go- at an impasse, nothing to offer but guilt, or start a fistfight.
We have a “how much money do you have wrapped up in airplanes” survey thread going, should be interesting, but it’s drawing some flak for less than immediate results. I wonder if it may have similar problem- more data than can be easily analyzed, rendered to a guy with an already full time job, whose portfolio might have nothing to do with the data.
It’s a tricky moment, I’m asking around for help, called my oldest friend, an MSW, she’ll know what to do.
Well, Merry Christmas to all!
Hey, I already told you I was way behind the times!