(no subject)

Double bill at the Fox last night: Sabah and Enron: The Smartest Guys in the Room. Both excellent, although I think a reverse in viewing order would have made for a happier ELL.

Was driving myself nuts trying to figure out where I'd seen Fadia Nadda before, and I still haven't figured it out. It was also very odd to see Crown Attorney Menon Kathryn Winslow as part of an Arab-Canadian family.

Anyway, if you get the chance to see either, do.

memo to the brain

Dear brain:

In future, please remember to turn Track Changes off before updating all the EndNote fields in your 136-page, 75-reference document. Accepting all the changes individually is very tiring.

Best,

The fingers

cc: the eyes

(no subject)

Still simmering quietly over my ER visit. I don't mind so much about me -- I knew I wasn't in imminent danger of death -- but when nobody at all seems to be moving out of the waiting room, there does come a point when you start to think "OK, seriously. There are no doctors working at this hospital, are there?" For instance, waiting with me were a mother and her teenage daughter, who had cracked heads with another girl while playing soccer and was now woozy and vomiting. They'd been there since, I'm not exactly sure, but no later than 9 p.m., and they were finally called around 3 a.m. That is Just Not Right.

The triage nurse told me it wasn't that they were especially busy -- and I could see they weren't -- but nearly all their examining rooms were full of people waiting to be admitted. Which, I'm sorry, is just a sign of basic bad management. Not underfunding, not understaffing, nothing to do with how our health system is funded -- just inefficiency and a lack of will to change. Meanwhile, nurses are sitting over at the desk chitchatting. I should add that not one person came to check on the girl with the head injury while we were waiting.

At 9 a.m. they opened up a section (which to add insult to injury was called "Minor Treatment") and started calling us in batches of five. And it didn't exactly go fast, but as I mentioned it took a doctor all of 5 minutes to come in, ask me a couple of basic questions, poke and prod a little, measure the circumference of my calves and send me for a Doppler ultrasound. Are you seriously telling me that a doctor could not be spared for 5 minutes over the 9 hours I was sitting in that waiting room? Even if the vascular lab wasn't open at night, poke me and prod me, send me home to my own bed and tell me to come back in the morning or if I start to have chest pain or shortness of breath. I can do that. Same with the kid who needed a couple of stitches on the bridge of his nose. Same, I'm sure, with any number of people who needed to see a doctor but would really have preferred not to spend their night in that very un-urgent ER.

So I went hunting and found a couple of interesting sites -- I'm sure there are many more:

Institute for Healthcare Improvement (patient flow section)
Society for Health Systems (a lot of it is members-only, but they've got some good stuff in their newsletters)

Slightly related thought: on Friday at book club I was chatting with SS, who recently had an excisional biopsy following an abnormal Pap smear. She said the doctor was one of the best in the country for what she might have, but she didn't like his bedside manner -- he never said "S, you must be really nervous, don't worry, you're doing great," or anything of that kind. Which struck me because my response to any statement like that would be "Of course I'm nervous, you idiot, I might have cancer. Can we get on with this very uncomfortable procedure, please?" Mind you, I tend to prefer my doctors clinical with a side of flippant, so it sounds like this guy and I would get on just fine.

Bedside manner is such a fuzzy concept. As long as my doctor isn't actually insulting or belittling me -- which is why Dr. Gregory House and I would not get on at all -- my main criterion is competence. Likability is optional.