Wednesday, June 27, 2007

What Made You Think I Wanted Mayonnaise on My Sandwich?

I was a fussy eater as a child. I will admit that. Mealtimes were a real stressor for me and my family especially when we travelled or ate out. Over the years I have introduced a large number foods, that I hated or wouldn't eat as a child into my diet.

The exceptions however are mayonnaise and its co-offender mustard.

These two condiments are ubiquitously added to sandwiches and other foods without any consideration as to whether people would actually like them on their food. If you go to a self serve lunch counter or a 7-11 and pick up a sandwich, it will most certainly have mayo and may also have mustard. When I am at a meeting and someone brings in sandwiches, if I am really hungry I will have to choke down a sandwich slathered in mayo or mustard.

Why those two. There must be 100s of condiments we could routinely add to our food. Heinz alone has 57 sauces. Go to a supermarket or specialty store and look at what's available in the sauces category and there may be 100s of distinct sauces to flavour your sandwich. Why has our society chosen those two sauces. Better still, why does our society insist on putting any sauce on a sandwich when it is so much easier to allow people to actually make a choice.

Monday, June 18, 2007

Problems With Patients

I am very sensitive about my interactions with patients since that godawful RateMDs.com came up. So I try to please everybody but sometimes you are stretched thin.

For example.

I saw a young lady in the pain clinic several years ago. We tried various therapies but eventually she ended up on oral narcotics and went back to her GP who took over prescribing. Several months ago she phone me stating that her GP had retired (true) and that she was waiting for an appointment to see a new GP (this is called a meet and great appointment). She asked if I would fax in a prescription for her. Remembering her and liking her, I was happy to do so. A few months later she phoned stating that she had missed her appointment with this GP and now would have to wait a few more months and you know what... So I faxed in another prescription. There was a third request stating she only needed a few pills until next week.

Finally last week she called with a convuluted story about seeing the long awaited GP followed by referral to someone else and involving missing an appointment of course. She couldn't remember the name of her new GP so I couldn't phone to verify this story. I told her that I had already faxed 3 prescriptions and that I was unwilling to fax another without seeing her. I told her if she could find the name of her new GP I would phone the GP on her behalf. She never phoned back.

A few months ago I saw a new patient with fibromyalgia. She came accompanied by another lady and the two of them sang my praises. This should have tipped me off. She was on a lot of non-narcotic medications and after some discussion I agreed to prescribe a short acting narcotic to tide her over. I gave her 100 pills and asked her to come back in 4 weeks. Just short of the 4 weeks I got a faxed request from the pharmacy for another 100 pills. Guess what...she no-showed for her next appointment. So in about 4 weeks I got another request for 100 pills with a note from the pharmacist saying she had missed her appointment because of an MVA, I refused to refill the prescription without seeing her again. She no-showed for her next appointment and presumably she and her friend are no longer singing my praises. I can only hope she doesn't have internet access.

Sunday, June 10, 2007

My Time is More Valuable Than Yours

A few nights ago I was on call.

We had the usual collection of urgent cases, nothing really that couldn't wait for a few hours or even a few days. One of the surgeons had two cases. They were less urgent than the other cases we had so would normally be done after the more urgent cases.

Now this surgeon who is a nice guy, started asking if he could go before the other cases stating that he had to be home by a certain time because his wife was going out of town for a few days and he had to be home to look after the kids (and presumably have sex with his wife before she left).

Now the bottom line here is: he is on call. I am also on call and I have personal things in my life that I have to miss when I am on call. So when I need to do something in the personal area, I ask one of my colleagues to cover for me. Occasionally somebody is able to do that. Some surgeons are in very small groups or do procedures that only they know how to do. Now this surgeon has a large number of other surgeons in his group who could have covered for him and it was a very basic procedure. But instead of calling up one of his colleagues he instead makes the nurses and me feel guilty.

This isn't an isolated case, surgeons are always pulling this stunt to get their cases done.

The bottom line is we all have to take call some more than others. We all have a personal life (some more than others) which our work affects. But when you pull a stunt like this, you are saying, my time and my life is more important than yours.

Saturday, June 9, 2007

It's been a long time since I wrote

I noticed that the last post before the one I just posted referred to my distaste with the shootout which means that the entire playoffs passed without my commenting on them.

My comments.

1. Without any team that I cared strongly about, the playoffs passed relatively quickly not like last year when I watched just about every Oiler's game.

2. The Canucks lost because they had too many Europeans. Same with Ottawa.

3. While it is somewhat off-putting to see Chris Pronger's name on the Stanley Cup, Todd Bertuzzi's would have been more of a travesty.

4. Mike Comrie has excelled on Ottawa being something he couldn't accept that he was on Edmonton, a third line player (entitled to a third line player's salary)

5. The Canuck's loss in the playoffs only justifies what I have said for years, that the Sedin twins are the most overrated players in the league.

Tim Horton's Iced Mocha

Now I realize that Tim Horton's is a business and that if I don't like things there, I can go somewhere else; however face it Tim's has promoted itself as a national icon, the government issues currency thru it (remember the poppy quarters), and our current governing party used restaurants suspiciously like Tim's in it electoral ads etc. Besides I have a long relationship with Tim Horton's going back to my internship in Halifax where I discovered this strange chain named after a 1960s era Leaf player which didn't then exist in BC where I came from. Later I used to stock up on coffee and a donut in Truro on the way to my girlfriend's to gird myself for the amorous adventures that would shortly follow. I know where the nearest Tim's is to every hockey arena in Edmonton, and the location of every Tim's between Edmonton and Vancouver. So I think I have a stake in Tim Horton's.

But something is pissing me off.

It's the Ice Mochas. Tims brought these in a few years ago. I've had a few, they taste okay. The problem is the machines never work. So when you pop into Tims for a quick coffee on your way to or from somewhere, you are sure to be delayed by the person in front of you ordering multiple Iced Mochas. This not only ties up the person making the iced mocha but also the other employees who have to come over and try to make the stupid machine work.

Tim Hortons was built on doing two things well. Making a decent cup of coffee and baking donuts. Their success (thankfully) was not based on iced mochas.

And basically what is an iced mocha. To the best I can see it is a hybrid between a milkshake and a slurpee. Many places do either of these well. Leave it to those places Tim and let those of us who want their coffee, to get it quickly and efficiently.