Stories from the Stethoscope

PA Pet Peeves

I love my career, really I do. But my plan was always to work part-time as a physician assistant, part time as a stay at home mom. After Marty was laid off last June, I’ve significantly increased my hours and juggle two part-time positions. We all complain about our jobs, it’s only natural. If we didn’t complain about the long hours, impossible to please bosses, nosey co-workers, and demanding clients we would surely explode.

However, yesterday was a horrible work day. And the worst part was, it was for no particular reason.
My schedule was busy, but managable.
My co-workers were happy and helpful.
My patients weren’t exceptionally difficulty or demanding.

However, yesterday was one of those days. Those days when everything irks you. Every. little. thing.

I went home exhausted and frustrated with medicine and health care overall. And so, today I take a break from posting “mommy” stuff and will vent my frustrations. I apologize in advance… I think this job may be making me a tad bit jaded.

And so, without further ado, my list of my PA Pet Peeves (in no particular order):
**Dedicated to my fellow PA friends who undoubtably can relate to these…**

If you’re over-weight, really over weight, taking off your sandles prior to stepping on the scale isn’t going to make a difference. Trust me.

If you come in for treatment for a bug bite, please do not be annoyed when I can not tell you which insect gave you the itchy red bump. I studied medicine, not entomology.

If you are not on birth control, not using condoms, and are sexually active; according to biology you are trying to get pregnant. Please do not be surprised if you do.

Bodily fluid samples, if needed, will be requested. Please do not bring them in otherwise.

Regarding your appointment: if you are late, you’ll need to wait.

Headache, nausea, vomiting, and diarrhea are side effects, not ‘allergic reactions.’ If you experience one of these after taking a medication, you are not allergic to it.

I don’t know everything, I don’t claim to. But I did study medicine and my degree and license prove that. Please do not demand a certain medication or become angry when I suggest (or don’t suggest) a particular medicine.

This is a medical office, not McDonald’s. There isn’t a drive-thru window and you can’t get everything ‘made to order.’ Please do not call and request an antibiotic or a new medication without making an appointment to be seen by a provider.

It is your responsibility to know your insurance coverage. There is absolutely no way I can know what your insurance covers.

If you don’t remember what medication you are taking, telling me it is a “small, round, and white pill” is of absolutely no help. You wouldn’t tell a police officer that your stolen car is “red with four wheels” would you?

Sometimes, I can’t tell you what is wrong or what your diagnosis is unless we run further labs or tests.

Just because Dr. X wrote you prescription for #120 Xanax, doesn’t mean I will.

Pap smears and complete physical exams are not urgent. You do not need to be seen today. Make an appointment.

If you don’t have insurance, I sympathize, really I do. But it is really hard to feel sorry for you when you are holding a coach purse, an Iphone, wearing Jimmy Choo shoes and complain that the $10 antibiotic is too expensive.

Make sure you have your priorities in order when it comes to spending money on your healthcare. Requesting a prescription refill of your erectile dysfunction medication (which you are bound to pay out of pocket for) and then requesting a sample of your asthma medication is frustrating. One is more important then the other, trust me.

Please do not come and ask to be screened for “all cancers.” There are very few tests to screen for cancer and you may not be at risk for any of them.

Please, please, please do not come to the office for a Pap smear when you are on your period. Enough said.

When I suggest you go to the ER, please go. It is my way of saying, “The symptoms you are describing scare the begeezus out of me and I don’t have the resources to treat you here, so GO!”

Antibiotics do not treat colds or the flu. If you have a runny nose for 2 days, you do not need an antibiotic.

When I ask for your sexual/drug/smoking/pyschiatric history, I am not being nosey. I need to know for medical purposes.

I am human, I dont know eveything, I run late, I take a lunch break, and potty breaks to. Please respect that.

Being rude will get you no where. If you are rude to the office staff/medical assistant/nurse, I will know.

Be honest with the medical assistant/nurse when they ask why you are being seen in the office today. It is their job to prepare me for the exam. If you say you have an ear infection because you are too embarrassed to tell them you really want STD testing, I won’t be prepared.

When you refuse the flu shot, then come into the office a month later complaining of flu -like symptoms, in the back of my mind I will be thinking “I told you so.”

Honesty is the best policy and if you don’t understand something, ask me. No question or symptom will embarrass me. Trust me, I’ve heard stranger things. I would rather you ask me a ‘stupid question’ then to become pregnant because you were taking your birth control vaginally or find out you do have discharge while doing a pap smear but were too embarrassed to mention it before.

When I ask how long you have been having a particular symptom, please be specific. Saying you’ve had the symptom for “awhile, “not too long”, or “for a minute” does not help. Hours, days, weeks are appreciated.

Mommy Dearest

As a parent, I struggle with finding a balance between being strict and choosing my battles. I’ll admit that I have caved on certain occasions and handed my child the unnecessary two dollar toy at the grocery store, just to get her to stop crying. Likewise, I have raised my voice and put my child in time-out for something that probably didn’t warrant much more than a stern look. I’m constantly teetering on the edge, struggling not to slide down the slippery slope of being too overbearing or too lax; knowing full well that leaning too far in either direction could have disasterous results.

Up until last week, I always assumed that parents who were overbearing would end up pushing their child away and were destined to have a rebelious child that wore all black, had a pink mohawk and rejected any form of authority. But the other day, I met the queen bee of overbearing mothers, and the effect it had on her daughter took me slightly by surprise.

Recently, we had a mother accompany her daughter to the office. This in and of itself raises an eyebrow since the patient was over the age of 18, but since the patient had given consent for the mother to be present , the visit continued. It didnt take long for everyone in contact with the mother-daughter duo to realize that Mommy Dearest was in complete and utter control. The patient’s mother answered all questions regarding the patient’s medical history, allergies, current medications, etc… all of which the patient was quite capable of answering herself. She discussed her daughter’s major, her living environment, and her interests.

The most disturbing thing happened however as the provider began the ‘personal’ portion of the exam in which the patient’s sexual and gynecological history would be discussed (to which the daughter also gave consent for her mother to be present.) The conversation went something like this…

Provider: Are you sexually active?
Patient looks at mother who responds “Yes she is.”
Provider: What day did you last have sex?
Mom fumbles for her pocket calendar, opens to the current month, looks at her daughter and asks “Sweetie, wasnt it on October 14th?”

No joke.

You can’t make this stuff up.

Here sat a grown adult, capable of attending college classes, voting for the President of the United States, engaging in sexual activity and her mother was keeping track of her sexual escapades.

Mommy Dearest had engrossed herself in every aspect of her daughter’s life and the patient, who should have been eager to demonstrate her newfound maturity and independence as a college student, looked lost. Rather than rebelling against her mother and demanding independence, she allowed her mother to continue to hold the reigns. Her lack of self-confidence was blatantly obvious and her smile couldn’t mask her broken spirit. Her mother had tried to control every aspect of her daughter’s life, held her hand for the past 18 years and as a result her daughter was unable to stand on her own as a young adult.

When we were finally able to get 3 minutes alone with the patient, the resentment she held against her mother was almost tangible. It hung in the room like a dense fog.

She knew the relationship with her mother was the basis for her underlying depression, but it was all she had ever known. Seeing the way the daughter looked and talked about her mother was nothing short of heartbreaking.
The relationship between Mommy Dearest and her daughter has clung to me and left me (over)analyzing my relationship with my daughters and pondering the overbearing parenting technique. While I haven’t met overbearing mothers quite as terrible as this mother before, it seems as though more and more mothers are taking control over their child’s life, desperately making sure that their child doesn’t make the ‘wrong decision’ and never fails.

What ever happened to the idea of pushing the baby bird out of the nest and hoping baby learns to fly….. quickly?

Whatever happend to the days of “tough love?”

Is this why so many young adults seem to flounder and lose direction once they reach college? Why some seem incapable of having trusting and long term relationships? Why they live at home until their late 20’s? Why they are unable to manage their money?

Can overbearing mothers be held accountable or does there come a point in life when you need to cut the apron strings yourself, even if mommy is clinging for dear life?

With Lily just shy of her third birthday and Charley not quite a year old, I have many years ahead of me with inevitable opportunities to hover and at times be an overbearing mother myself. However, I am determined to instill the confidence in my children to stand alone, to walk their own path in life, and to feel comfortable returning home when they seek guidance, a shoulder to cry on, or even just a hug from their mommy.