Supposedly the last few days have each broken successive records for the hottest days on planet earth, at least since modern humans began keeping accurate weather records. Given the oppressive sauna bath that is Alabama July going on outside of my comfortably air conditioned condominium, I’m inclined to believe it. It’s been somewhere in the 90s all week, and then add to that a rather nasty level of humidity. Occasionally the skies cloud over, thunder rumbles and there’s a brief respite of rain and a quick plunge of temperature by twenty degrees. But half an hour later, the cell is past and all that extra moisture is now in the air, raising the humidity and making it feel worse than it did before the rain. I shall not miss this climate should I ever move elsewhere. There are things I will miss – fireflies, mockingbirds, lighting storms observed from the safety of my back deck – but Alabama summer is not amongst them.
I remain a West Coaster in terms of what I believe is proper for climate. That begins with minimal humidity and temperatures topping out at about 80 to 85 at a maximum. I did learn to appreciate the dry heat of California Central Valley summers during my years in Sacramento but even that could get ridiculous at times. My first summer there, we had a heat wave in July. I was on night shift in the ER and it was nearly 90 degrees at 3 AM. They have no idea how hot that week actually got as the official thermometer stopped functioning at 117 and the temperature was still going up when that occurred. It did mean that the population of Sacramento was all out in the streets at all hours that much and imbibing far more beer than was good for it. I spent a good portion of those night shifts sewing up head lacerations on various young men who had made serious errors of judgment when it came to motor vehicles and power tools and, in one memorable case, a fight with someone armed with a shovel.
I’ve been watching some old reruns of ER late night on Hulu before bed. I never saw it during the 90s when it was in its heyday. I was busy living it and had no need to introduce those storylines into my home as entertainment at the time. Having worked in a few ERs over the year, they got the pace and the chaos and the camaraderie down pretty well. The soap opera plots involving everyone’s love life generally don’t happen in the work place and are a bit fanciful. And I hate it when the actors mispronounce a technical term. There’s nothing that takes me out of the moment faster than someone screwing up pseudomonas aeruginosa. Medicine does have its own language. I refer to it as Medicalese. It has about 50,000 words and most clinicians know and use roughly half of them. Which ones you use depend on specialty and job description. It has more acronyms than the military and even a few bizarre standard mispronunciations. Those of us who work in health care become fluent during our training as a matter of survival. The problem is that a lot of clinicians forget that the whole world is not privy to the language and they have grave difficulty reverting back to common English usage when discussing health subjects with patients or other lay people. I spend a good deal of my time as a translator and have worked very hard through my career to develop a bedside manner and language that can be easily understood.
One of the issues that’s currently bedeviling medicine in the wake of the pandemic is certain attitudes put forth by some in administration. The three year gap with work from home and other slowing down in clinical functions allowed them to become much more familiar with the power of big data sets. (An enormous part of my clinical effort is data entry to supply this unending appetite). More and more proposals are coming down from above on chronic care programs which have the stated goal of improving care. The problem is, however, that most of these administrative types are of upper middle class/professional class background and they therefore make certain cultural assumptions based on that, thinking that their way of viewing the world and problem solving is always correct. They have no practical field experience with case management, house calls, home health, long term care and the other areas in which I spend my days. They do not understand that huge swaths of the population do not have smart phones, well appointed homes with all the latest appliances, budgets that allow for dietary manipulation, resources for child care and elder care, or the hundreds of other battles that most of the population who live outside of gated communities must contend with. And then these administrators get very put out when I explain basic facts of life to them. My colleagues and I get together sometimes, look over the latest directive, and just laugh. It’s either that or cry. I’d be more than happy to introduce them to the real world of home care – to places where you dare not touch the furniture for fear of picking up some unpleasant insects, to places where you need to spray yourself down with Febreze before you get back in the car, to places where you can barely move from room to room because of the garbage piled everywhere. It might give them some ideas for more practical research projects.
I received an email today from the brand new chief of geriatrics at UC Davis inviting me to consider joining their growing division and looking for ways that UC Davis might collaborate with my own work. I wrote back explaining why I vowed never to set foot back on that campus again because of how that institution treated me and Steve, more or less destroying our lives. It may have been petty, but I felt better after sending it and even though those events were 25 years ago, the current chief better have a good handle on that history as the fallout from all of that caused significant problems between UCD and most of the eldercare service agencies in the region and reverberations went on for years and years. I wish her the best of luck in her endeavors.
I’m still in a bit of a churlish mood after that but I do have some things to look forward to this weekend. The Dungeons and Dragons group meets tomorrow for brunch (mimosas will be had) and I’m seeing the matinee of a new play, Boy, at Birmingham Festival Theater on Sunday. I’ve also got to figure out where to write the fourteen unfinished progress notes for the week in there somewhere. At least it’s not thirty two.
Life, The Universe, and Everything 