Ups and Downs

Things that make my day awesome (in no particular order):

Mini diet coke cans (7.5 fl oz is exactly the serving size I desire!). Yes, I realize I may be the only American who actually wants to miniscule-size things rather than super-size them.





My adorable doggie snuggling his new favorite stuffed (5-legged octopus) friend. Or maybe that makes it a pentapus?

A complicated patient coming back to follow up on symptoms that make no sense to me (bilateral intermittent facial numbness, dry mouth, fatigue, normal exam and labs) to say that she is all better (love it when tincture of time actually works). Sorry no photos of that one.


Things that make my day less than awesome (also in no particular order):

A non-english speaking patient coming in with a form he can't read that he thinks needs only my signature. The form is from DSHS stating he must get treatment for his severe depression and alcoholism or else he will lose his medical and financial benefits. And he must do this within 2 months. Wow, treat years of depression and alcoholism in just 2 months (is this some sort of infomercial?)? I'd love to hear the letter writer's idea of how to go about doing that in 2 months. If only it were so simple.

A 44 year old woman, new patient, who arrives with a mammogram report from New York, done last month stating she has worrisome lumps in both breasts needing immediate follow up. I ask if she just moved here from New York and she says no, she's been living here for 6 years. I ask if she has had other mammograms and she says yes, last year she had one in China. I set her up with follow up and encourage her to come back for a well woman exam. The patient states that she lives in Tacoma and can't travel to Seattle very easily, and that when she is sick she just goes to New York for care. Is something being lost in translation here?

Currently extremely over-priced tickets to Hawaii. Ok, I realize that is trivial compared to issues of major depression, alcoholism, and potential breast cancer, but as I said these are in no particular order. And a spring trip to Hawaii might just be my carrot for getting through the crazy days here.