It's not that it's not all happening

It's not that I haven't had anything noteworthy happen in the last few weeks.  It's not like I haven't had a patient come in asking for the pill that will make his sweat smell better.  Or the 300 lb 38 year old G14P10 (that means 14 pregnancies and 10 babies!!) woman for her annual gyn exam/pap smear come in stating her last period was in February (Understatement of the century: "Do you think you might be pregnant?"I ask.  "Yes, I am." is her reply. Not sure what took her so long to get in to see me... oh maybe the 10 other kids at home).

It's not like I haven't seen my lovely octogenarian pessary-wearing patient who is unable to change/wash her own pessary due to mobility limitations.  It's not like I didn't attempt to mitigate the horrific smell created by my having to remove, wash, and replace said pessary by putting peppermint oil directly in my nostrils which did, in fact, help the problem of my having to dry heave quietly into the skin with my back turned (maybe it's just my pregnancy?  But the whole clinic assures me it's not... since the smell lingers for hours after). But it turns out that direct application of a large quantity of peppermint oil to your nostrils results in severe nostril and facial pain and numbness for hours (not to mention me freaking out about what pregnancy safety category peppermint oil is for topical application to the nares).

It's not that I haven't angered 2 patients recently leading to hasty, dramatic clinic exits when I had to break the news that their cocaine/methamphetamine habits made it such that I would not prescribe them opiate pain medication under any circumstances.

And it's not that I haven't seen my very sweet 280 lb recovering meth addict for depression and weight gain (and yes, the TSH was normal sadly for her) and had to break the news that her 50 oz whipped cream and chocolate sauce drenched frappuccino was likely not helping her failed attempts at weight loss.  Her reply:  "Damn I knew I should have waited to get the drink until after I saw you." (is it just me or is she precontemplative about diet/exercise changes?)

It's just... work/life balance is tough!  One active toddler + part time primary care clinical work + third trimester of second pregnancy = time management challenge.

But I'm still here.  Sweating it out with my patients.  Taking their struggles to heart. Savoring the victories (I managed to get an IUD for an uninsured patient through an amazing foundation that will provide Mirena free of charge!  And my Haitian diabetic with an A1c of 12 when I met him in January just saw me and is now at 7!).  All the while desperately trying to figure out how in a few short months (weeks?!@#$) I'm going to manage all this with an infant in tow.