Leftovers

I was going to blog something truly witty. But I'm tired. So I'm serving leftovers - some thoughts on doctors and the medical community in the US. I wrote them in response to an MD who feels that I'm "anti-doctor" and is concerned over those of us who view the doctor/patient interaction as "just a service" rather than as "a relationship". So, here are my thoughts, with a few edits for clarification that wouldn't make sense without reading the entire thread otherwise.

Kiss those babies!
~Dy

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I am not anti-doctor, but I do view the exchange of services for pay that takes place in a doctor's office as a service. I have a sneaking suspicion that we aren't all working with the same definitions, as I've noticed some people take offense to offering a "service" - they want to be more, to be looked up to more, or needed more. I'm not sure. But to me, it's not "just a service" - a service has value, it has worth. It is not a derogatory thing to point out that doctors provide a service and they make a living from that service. That's an honest way to earn a living and there is no shame in it. Ok, on to my thoughts...

I have a relationship with my in-laws, with my children, my neighbors, and my pastor. I have relationships with many people, and some of the people I do business with are also ones with whom I have a relationship on more than a business level. But the two are not connected.

We do have a family physician. She has been my doctor for 15 years. She's seen the boys when we lived near her, and I told Zorak recently, after a scheduled consultation with her to hash out some questions I have about a therapy that's been recommended to us, that while I wouldn't follow her blindly off a bridge, I do trust her enough to know that she wouldn't lead me off one, either. Time and shared experience have developed a relationship on some levels beyond the original agreement, yet she still provides a service, and I still pay for that service. It has value - for both of us.

I used to see the general physician/patient interaction as a relationship, but now, for the most part, I don't. Relationships must go both ways in order to work, and relatively few practicing physicians in the US (I can t speak for outside the US) are currently willing - or able - to treat their patients as true partners in care (granted, the corollary of this is that few patients will step up to the plate and shoulder responsibility for their care - but that's another soapbox). Fewer still care to know their patients on a level required to have an actual relationship.

I don't begrudge them that, but I won't fool myself into thinking that the pediatrician or the OB with the assembly-line process and the five-minute visits is in it for the relationship. There's no way. I do spend more time than that with my mechanic to make sure he's competent before I'll let him touch my vehicle, and even then there isn't a personal relationship - there is a level of trust, certainly, or I wouldn't be willing to seek services there. But it's a trust in the person's abilities and competencies, not a trust in the person on an intimate level.

The climate of our medical care right now, increasing in size and regulation, heading toward nationalization, frivolous lawsuits, practitioners put against the wall, insurance loopholes, outrageous premiums for practitioners that are driving many of them out of practice, legislation that infringes on patient choices... b/c of those things (I definitely don't believe the negatives in the climate are all stemming from the doctors) the concerns have snowballed to a point where the doctor/patient relationship is painfully skewed. There's a power struggle in the medical community that has no place in medical care, and unfortunately, the quality of care and the degree of trust suffer on many levels because of it.

Yes, I know that patients aren't the only ones who can do the firing. It's a contract by mutual consent of all parties involved, and either party is perfectly free to sever that contract. I was fired by one physician because I refused to give my newborn child a *third* bottle of Nystatin for his thrush (which was not responding to the treatment), and suggested that we try a course of Gentian Violet instead. She said she could not see us if we were not going to be cooperative. We agreed that this was not a fitting arrangement and got a copy of our files. We left, picked up a bottle of GV and never looked back.

I don't mind that. Doctors have to practice the way they see fit, but I don't have to take orders from them if I disagree with what they want. I often hear that doctors are humans, too, and that we should "give them a break". That humanity includes fallibility, which is not bad, or horrible, but ultimately *I* am responsible for the health and well-being of my family, and I take that responsibility very highly. I won't abdicate it or permit treatments based on an unyielding trust in this utopian relationship. What I'm seeing the doctor for is the advice and the knowledge that I do not have so that I can make better decisions. The final decision is mine, and if a doctor is not comfortable with that, then by all means, kindly show me the door. No hard feelings.

I also know that it's not always over something the patient cannot work with, but something the physician isn't comfortable tackling. I've known doctors to fire patients for lying about medications they're taking, or for seeing other physicians and not permitting everyone involved to make informed recommendations. That's got to be scary. Doctors do have a right to protect themselves, too!

I was asked whether or not I feel that I have "an obligation to make it better for the next person", via letting the practitioner know why I'm taking my business elsewhere. No, I don't. I have never once seen a physician make any changes at all based on that kind of feedback, but I do think it's important to put it out there, anyway. It's rude, and it's bad business, to just jump ship. I wouldn't terminate a contract of any kind without specifying the reason (move/death/no need of services/poor service, etc.), and the doctor/patient agreement is the same thing, in my opinion. Anyhow, I tend not to bring up this point when putting in my .02 about whether to give a new doc some time, walk away, or run screaming from the office. Certainly, I think it's just the right thing to do to let a doctor know why you won't be seeing him or her. Communication, whether highlighting to your service provider the wonderful things you appreciate (also overlooked, but important!), or letting them know that something is not sitting right with you is important.

We had a FABULOUS pediatrician in MD. I love that man and would recommend him highly to anybody who wants to be involved, informed, and a true partner in their children's care. I'd also recommend Lazer Lube on 235 for oil changes. Again, because I feel they are a good value with highly competent folks who will do right by you. A relationship? No. They are services traded for pay - value added, honest exchange. There is no shame in that.

And now, *gingerly* I do wonder if some medical practitioners might be a bit sensitive to the idea that they aren't considered an indispensable part of the family. Perhaps a bit offended at being "lumped in" with mechanics and the grocer, which aren't "life saving callings". I'm generally leery when I hear that my philosophy is tantamount to being Anti-Doctor, particularly when I am not ranting and raving that all doctors kill patients or get them addicted to prescriptions, or any other such thing. (None of which I've done, or believe, or purport, but I can't think of why else the idea that a doctor provides a service and that you have the right to pick where you get your service is an anti-doctor thing.)

I think what some physicians may perceive as anti-doctor is actually nothing more than the repercussions of the power struggle the medical community is waging against the patients: doctors calling CPS for those who selectively vaccinate; innocent midwives facing prosecution by zealous DA's, when even the families refused to testify against them; the "what have you got to hide" mentality when patients feel doctors are asking questions they do not wish to answer (News Flash: sometimes we have nothing to hide, we just really don't think it's your business); anger over parents being held against their will and threatened with losing custody of their newborn if they do not permit certain procedures to be done to the child before leaving the hospital; concern over the kind of medical establishment that would seek custody of a pre-born child because a doctor wanted to do a c/s on a woman without any medical cause at all, which the woman refused - and fear toward the State that actually granted that custody to the hospital. This is a small sampling of what patients face in today's state-medical melee.

In this day of Big Brother as the Ultimate Benign Mentor, incompatible philosophies toward health care can signal red flags for those who don't tow the AMA-line. It's not the human doctors we aren't comfortable with, it's the machine that's behind them. I believe that we must seek out compatible physicians in all respects. Our families deserve no less. We cannot afford to stay on with physicians who do not offer the services we need, just for the sake of "the relationship".

Dy

Don't Blog With Your Mouth Full

Sometimes when I sit down to blog, it flows - it moves like cream swirls in coffee. (Which, to me, is a beautiful, beautiful thing.) It's good. Sometimes, however, it's like trying to communicate with an angry toddler. The words are there, but the meaning comes across only after great analysis. There's no flow, but more of a sobbing, hiccough-y blech.

I think I have figured out the problem, at least the problem for me. I've been trying to blog too early in the evening. The boys are in their room, listening to Zorak spin gypsy tales, and I've just switched out laundry, tidied the kitchen, read up on tractors and am sucking down coffee, still chewing on my day. You can't talk with your mouth full. You can't really share the highlights of the meal while you're still gnawing on the bone.

But lately, that's exactly what I've been doing. In an effort to get to the computer before Zorak gets sucked into the abyss that is steel buildings online, I hop on and start talking with my mouth full, spewing chunks of day all over the monitor.

But now, it's quiet. Zorak is in the garage, not looming over my shoulder asking me to look up concrete specs. The boys have been blissfully quiet for a couple of hours, and I have had a chance to digest a little of our day. It was far better than it sounded right after supper. Come with me, if you will, for an after dinner highlight:

Dessert:
Smidge's deep and abiding belief that the library book must go outside with him came from his newfound love of books. He hasn't been without one since we returned home. It's not just to eat the pages, or throw, or thwap people on the head, but to touch, talk to, and turn the pages one at a time, pointing out the interesting things that we who can read no longer notice. Couple that with his need to be in close proximity to his brothers - who were both outside - and that was one heckuva frustrating situation for the little guy. I'm still not letting the book outside, but a little perspective does help.

Coffee:
Today I pulled off one of my wifely fantasies: I had supper ready to serve within five minutes after Zorak came home. This isn't one of his fantasies. He's just happy to know I actually hit the planning stage before he got home. But today, I needed to do my job right. He called a little after one to say he finally had a break and was coming home for lunch. He called again, three hours later, to let me know his boss had asked him to go to a meeting and he'd been in that all afternoon. He said he was going to work for another half hour and then head home. He came home two hours later. I figured he would be ravenous, so I had goulash and tortillas ready to go, a beer chilled in ice, fresh coffee, and the a/c cranked. Today couldn't have been easy on him, but I figured coming home should be. That felt good all the way around. Someday I'll get the hang of this job. I'm thankful he puts up with my steep learning curve and splotchy performance in the meantime! :-)

Those pastel minty sugar things that make your mouth hurt if you eat too many:
The intuitive reader award goes to Hornblower and Jo, as a tie, for spotting the age-old symptom of which I've been suffering. We wanted to wait until after the wedding, and the trip, but yes, we're expecting WeeOne#4! And I can't tell you how difficult it was to blog about the past few weeks without blurting that out to everyone! "I'm not lazy, I'm pregnant! I'm not anemic - I'm making blood!" So there you have it, the reason I've been sleeping in the laundry piles lately.

Anyhow, I'm off to try that Yahoo album invite thing again and edit more pictures. Y'all have a GREAT Thursday (I cannot believe it's Thursday already! This is just wrong, wrong, wrong, but boy am I glad we homeschool year round!)

Kiss those babies!
~Dy

So this is summer?

Wow. It's quite hot. And a little sticky. So it is officially hot 'n sticky. That's "summer", in the language of my people. Thankfully though, I was wide awake as we drove through Arkansas, where it was so muggy there was condensation on the inside and the outside of the windshield. It was unbearable even at midnight, and I can say that Alabama has nothing on Arkansas for humidity! Talk about small blessings.

I talked with my friend, Michelle, today and she filled me in on all the fires in Arizona. I hope and pray y'all get some rain (without lightning!) soon! If you're the praying type, please keep those smoke jumpers in your prayers. They work so hard, in such adverse conditions. It's really scary.

And, as if I needed further proof that summer is certainly here, my children checked out today. Mentally, that is. They were nowhere to be found. We tried to muddle through lessons, but in the end we settled on reading aloud and building things.

James spaced the difference between area and perimeter, and even the "P =" part on the answer line didn't ring any bells for him.

John could not identify a single letter of the alphabet. Not one. Or at least he wouldn't admit it.

And Smidge decided that, yes, actually, he DID have to take a library book outside today. I'm not one to deny a child a book, but library books at our house don't get outside unless under controlled circumstances. Smidge begged (well, screamed) to differ.

I am hoping today was some sort of child-oriented joke, because if we have to go back to square one right now, I might cry. Fortunately, the older two didn't seem to be bothered by this mild setback and had a splendid day together. I dropped a dollar into Smidge's therapy/college jar and called it a day. It may honestly have been nothing more than a day for re-calibration after all the travels and adventures of the past week. That's why I didn't push it, or send them in for shock therapy. When in doubt about what's causing a mental vacancy, Zorak and I opt to err on the side of snuggly. So far, that seems to work out well.

I will post more pictures. Right now I'm having trouble getting the Yahoo "share your album" feature to work. It'll let me get to the last page and then it gives me an error message that I just can't get around. So, if you're waiting for a link, don't give up - it'll be there soon!

Oh, and I have a Smidge climbing on my lap. Better go.
Kiss those babies!
~Dy

Big John

Anybody remember that song? "Big John. Big Johhhhhn. Big Bad John." We used to sing that to John when he was a baby and James, who was about two at the time, would get so mad and cry, "He's not bad! He's my brother!" So we changed it to "great big John". That made James happier, and John still laughed every time we sang to him. He's sure grown and changed a lot since then. Since we've done the Smidge-A-Palooza, we thought a montage for John's birthday would be fun (sing Big John while you scroll for the true montage feel) Our digital capabilities only began in '02, so here is one of him from shortly after his birthday that year.



And here, three years later, is our Big John, enjoying his bowling prowess...



... who'd have thought a bowling pin would elicit such a response?



Here's a picture from our stop over with Amy (I haven't had a chance to email her pics yet and ask about posting pictures of her children, so out of deference I edited this shot- it was a very sweet scene, though).



And a couple of cute pictures from the wedding dance. This boy is going to fit right in at Corona Days! The mother of the little girl in the first picture asked not to have her daughter's picture on the net, so I cropped this one. She's a little cousin, and these two danced for most of the evening. They had a great time.



This one is John dancing with T, another cousin. Who knew he could cut a rug like that? She is so good to him, and such fun to be around.



And just for fun, I saw this profile and thought, "Oh, this needs to be in black and white!" Wouldn't this shot make a great Wrangler ad?



Notice the boots. He picked them out himself, and if they're any indication of this boy's approach to life, we are in trouble! If you're familiar with the mojo of boots, you'll understand when I point out that the child picked out greentops with tan toes and an easy working heel. *sigh* Zorak couldn't stop grinning as we left the Justin outlet. Them're some good-lookin' boots, there, boy!

So there we are, almost up to date! But it's late, and so more will have to wait for tomorrow.

Kiss those babies!
~Dy

Home Again, Home Again

Wow, well I know I was going to blog again on Saturday, but the internet access subscription ended at noon (it's $10 to have in-room access) and we didn't get back from our in-town excursion until the afternoon. I'd planned to go ahead and subscribe for another day's worth, but then we had lunch... HOLY COW! Here's what we had:

John: a bare hamburger patty
James: 4 oz of trout on a bed of rice
Smidge: side order of french fries
Me: a CUP (not a bowl, a CUP) of tortilla soup
Zorak: Indian Fry Bread topped with beans, rice and avocado
Drinks all 'round: WATER

Grand Total: $60!!

Yikes! We'd have gone into town to eat, but the boys needed a nap before the wedding and they needed to eat, although not in that order, and we were short on time. SO, we *cough, cough* sucked it up and ate at the hotel. Oy vey. For the record, the soup was good, but you can get the same stuff at Chef Lupe's in town for about a buck fifty for a full bowl!

So the blogging had to wait until we returned home to our sweet highstream connection. I will upload photos from the wedding this afternoon, while Zorak takes the larvae to the lake for a little fishing, and will fill y'all in on the wonderful adventure.

We're on a high. It was nice all the way around. And while it was still difficult to leave the beautiful New Mexico terrain, it was more just a little bittersweet and not actually depressing this time. After all, we have our beautiful forever home to come back to. The boys even felt it, and Zorak is one Happy Daddy!

I'm going to go snuggle these little guys. They did so very well on this trip, and I want to tell them again. :-)

Kiss those babies, and we'll see you this afternoon!
Dy

Look: Spaces! :-)

Wow, well, I was going to critique some of the amenities here at the Inn of the Mountain Gods, but what can I can? How many hotels will send an IT guy to your room at one in the morning to fix your keyboard? Now, that's service!

We made it to New Mexico, a wee bit exhausted, but safe and sound. The trip over went surprisingly well, considering we drove during the day and stayed at hotels both nights (we normally drive through the night, thus eliminating the issue of fidgety boys). They had a pretty good time tormenting one another from Alabama to Texas. Then we stopped at a Cracker Barrel and bought some nifty gadgets to occupy busy little minds (and fingers). The last thousand miles were relatively fuss-free.

We got to meet Amy (of Good Soil fame) and her two awesome children! They were kind enough to meet us at a park in the middle of Texas somewhere. Zorak did the Uber-Dad thing, running herd on Smidge while the children ran from turret to turret.so Amy and I could visit (he is so sweet about things like that!) The boys have asked repeatedly if we're going to meet them on the way home.

From there, it was a hot and dusty day's travel to Las Cruces, where we stopped in to visit the family. I can't tell you how refreshing it was, or how much fun the boys had running amok with their cousins. They treated us to the traditional Nopalito's family meal (if we have many more additions to the family, it's going to take the entire restaurant to hold all of us!) I finally finished the lap blanket for Gram, and I think she liked it. It's nothing like the beautiful things she creates, but I do hope she enjoys it.

Although we weren't ready to leave, we had a room ready and waiting for us here, so we headed up the mountain. Tomorrow we'll enjoy the pool, do a little last minute shopping and then round everyone up for the wedding come evening.The weather shoul be beautiful, and the boys can't wait to wear their new boots and cowboy hats!

On that note, I'm typing this from a little remote thing in my lap and I can't see a thing on the screen. Please excuse any typos or sentences that don't make sense. The format/display is a bit different, so this is like typing with only half a screen. However, I did want to pop in and let y'all know we didn't slip into the Rio Grande. Will blog more tomorrow, when I'm rested and fed!

Kiss those babies!
~Dy

BuenosDias

OKIwasgoingtoblogbutjustrealizedthereisnospacebaron
thiskeyboard.I'llbebackinabit.
Kissthosebabies!
Dy

Um... something is wrong!

John wanted to talk to his Granny today (since we so callously refused to drive him to New Mexico last night), so on the way home from our outing, I gave her a ring.

She sounded AWFUL when she answered the phone. I was stunned. Her speech was slurred, and she didn't seem to recognize me. Was she drinking? No. She doesn't drink like that. She sounded like my mom when the hospital upped her morphine doses, but I know she doesn't take medication like that...

"Hi, ______?" I asked.

"Ooo, Boff."

(Boff? What?)

"This is Dy. Is this _____?"

"Boff. Bum nod elink oo well ooday." She mumbled.

What?! Then my translator miraculously kicked in. She'd said, "Yes. I'm not feeling too well today,"

Huh. This is awkward. I'm thinking maybe in the future I'll just let Zorak call her. But, hey, I was already on the phone and she has call waiting, so it's not like I can just hang up and pretend that wasn't me.

"Hi _____, this is Dy! John wanted to talk to his Granny, so I thought we'd give you a call."
"Oh, I'm not feeling well today. I had another one of those attacks yesterday."

Alright, this is going from weird to worrisome.

"Attacks? What attacks?"

"Heart attacks."

"HEART attacks?! What? When did you start having heart attacks!?"

She's starting to get impatient with me, so she yells, "YES, heart attacks. Just like I've been having the past few months!"

What in the world?!?!?! I'm thinkin' Zorak's brother is SOOOOO in deep trouble for not mentioning that anything at all is wrong. And I'm really worried. When did she start having heart problems at all, let alone full-out heart attacks?

"And then I had another one of them things yesterday."

OK, whoa. There has to be something I'm not catching. Granny doesn't use dialect like that.

"This is _____ _____, isn't it?"

Suddenly, she can't understand a word I say. "What? I'm not feeling well."

"I am trying to reach ______'s home, and I have a suspicion I have the wrong number..."

"Well, I talked to my doctor, but I'm not going to the hospital. I won't do it."

"Yes. Well. Of course." (Awkward pause.) "Ma'am, I am very sorry to have disturbed you, but I'm trying to reach my mother-in-law, and I have the wrong number. I apologize."

Suddenly, her speech cleared up and she sounded just fine.

BUT, it wasn't my mother-in-law. And yes, it was a wrong number. I said my good-byes and hung up, breathing a huge sigh of relief.

And that's when I noticed Zorak, eyeballing me furiously while trying to navigate the Interstate, veins popping from his neck, eyebrows not only touching but actually overlapping. His head seemed to be leaning much farther from his body than physically possible.

And I looked back at him with that, "What? What are you doing?" expression... then it hit me - he'd only heard half that conversation. If I thought it was weird on my end, I can only imagine what ran through his mind! He didn't hear the last few bits about being a wrong number. Oops.

In the end, we did get through to Granny. She is fine. She got a chuckle out of the story, talked with John, and can't wait to see the boys soon.

*whew* And then I put her number in my speed dial, just to be on the safe side.

Will fill you in on John's adventures tomorrow. For now, however, I am one tired Mama.

Kiss those babies!
~Dy

Happy Mantis Day, Zorak!

I hope today was a beautiful day for all of you. It was, here. Zorak, Wonder Dad to three little mini-mantii (mantisses? mantae?) had an adventurous day with his little ones.

It started slow. He got up, then meandered back to bed. He's fighting off whatever we had, so we skipped church and let him sleep in. The boys made cards, played frisbee, snacked and hung out.

Around lunch time, they couldn't wait any longer. In they crept, to serenade him with coffee and song. When that didn't quite wake him up, they pounced (what kind of a holiday would it be without the pouncing?)

We made brunch, planned the day, and everyone was off. The boys helped Zorak work on the motorcycle. The neat part is that they actually helped. Not "helped", as in the way Smidge "helps" unload the dishwasher (bowls, cups, plates, and silverware all go into the silverware drawer), but they made good hands today. That feels good for a daddy, and for his boys. Zorak guided and they did most of the actual work of taking things on and off, comparing parts against the photos in the manual and had a blast figuring out what was wrong. They all worked together to change the oil, clean the plugs... beyond that my knowledge is fuzzy, but everyone agreed it was a great time. Once in a while, one of them would come running back to the house on an urgent errand, looking so very responsible and so very "big". The mama would help as needed, but she mostly just stood by and smiled from her heart to her eyebrows.

The evening called for a fishing trip. I went to the market, then came back to the house to prepare supper for the Expedition Crew. I guess it was quite the adventure. John caught a turtle. James caught the only fish big enough to keep. Smidge did not fall in the lake. That's a successful outing! Zorak usually props his pole while he helps the boys release a small fish or untangle the line from the tree tops. In ten years, he's never lost his pole, but today he lost it, and how! A catfish snagged that thing and *bloop*, in it went. I wish I'd taped John retelling the story, as he saw it wriggle loose and go in. The wonder in his voice was incredible. He tried to save the pole, but to no avail, and I guess he was pretty heartbroken for Zorak. (It's sad to lose your pole when you're four.) But Zorak has such a wonderful way of conveying his "it's all going to be okay" philosophy; John's sadness was soon replaced with the rather exciting knowledge that he has a really good "Daddy Story" to tell his children someday. As a matter of fact, when he came flying in the door, that was the main headline, rather than the turtle catching adventure.

Time and again, I am overcome with this pervasive sense of comfort when I stop and look around me. I know today was Zorak's special day, but it was beautiful for me and for the boys, each in different ways, but every way just as meaningful for all of us. Granted, every day should be a day we lift our families up and praise them, savor them, and cherish them; it's nice, though, to take advantage of these little mini-holidays amidst the daily things to stop and remember how much we cherish, savor, and adore them.

Kiss those babies!
~Dy