Chicken and noodles over click-and-wait


They come in, the sneezers and chokers

The sick, the depressed, and the jokers.

It would be nice

If they’d take my advice

But alas, they want to stay smokers.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I went back to adventures in temporary positions until they have an Electronic Medical Record (EMR) system I can get along with. A winter in Nome, Alaska, assignments in rural Iowa, a summer with a bike tour in Michigan, and Urgent Care in suburban Pennsylvania stretched into the fall. Since last winter I’ve worked in Alaska and western Nebraska, and taken time to deal with my wife’s (benign) brain tumor. After a moose hunt in Canada, I am back on the job in western Iowa. Any identifiable patient information has been included with permission.

Seventeen patients came for help from me today.

More than half will get better on their own. I found adverse drug reactions in two of them; all I needed to do was stop the drug.

With one of them I drew on my own migraine experience.

While the US has the lowest rate of smoking among the industrialized countries at 15%, 53% of my patients got the diagnosis of tobacco addiction. I gently asked if they wanted to quit, 6 said “no.”  I hold no illusions that the others will quit soon.

One patient turned out much more complicated than anyone could have foreseen, my staff took care of setting up studies and getting pre-authorization. Still, these things take time.  I sat down to discuss results and make recommendations at noon.

Two of the nurses kindly asked if they could bring me lunch from the cafeteria, and I graciously accepted the offer. I inhaled the chicken and noodles they brought to me while I struggled to document a pre-operative history and physical that had come in on an ASAP basis.  Tap, tap, spoon, tap, tap, chug some water, tap, tap, spoon.  All in all, I can say I got nutrition but I can’t say I got a lunch break.  At quarter to one, my computer froze.

But I didn’t realize the problem for about three minutes. I attributed the delay in response to the click-and-wait feature that so many systems have.  I reached a particular part of the documentation process, and I knew the computer would have to think about things for a while, so I wolfed more food, and even took my eyes off the screen.  When I looked back, nothing had changed.  When I tried to click out of the field, nothing happened.

I will admit my tolerance for computer glitches runs thin. I think my fuse shortened during time when the frozen system ate two hours a day.  Those prone to bad puns say I’m wired a little tight when it comes to stuff like that.

I restarted my computer, came back to the time-sensitive document, only to have the computer tell me I’d locked it.

Normally annoyingly cheerful, I came perilously close to a normal mood when I couldn’t take a lunch break and the computer stopped responding.

I used my pediatric exam skills to examine four sick young kids without the use of force. Yesterday, for the first time in 9 months, I failed in the task; the child started crying when I came into the room.  So like every other person who cares for toddlers, I had the parent restrain the patient so I could look in the ears.  Today I applied extra patience because I didn’t want to have to admit I had failed twice in a calendar year.

And, really, patience invested now brings dividends of time saved during later examinations.

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