No more pockets full of change

The popularity of beepers exploded during the 1980s.

They were a symbol of status-a person of importance who needed to potentially be reached 24/7-such as doctors and drug dealers 😂!

I finished medical school in 1985, family medicine residency in 1988, and a geriatric fellowship in 1990.

A beeper was on my belt, or in my shirt pocket, through all.

During residency, I did come to dread 4 numbers: 2050.

This was the emergency room extension and always meant there was a patient who needed to be evaluated for possible admission.

Once, after finishing a 36-hour obstetrics (OB) tour, I was driving home when my beeper notified me of the need to return to the OB ward stat.

I was more than half-way home, realized I had forgotten to change the name and beeper number of my replacement on the on-call board and started to speed in order to get to my apartment asap.

I was almost immediately pulled over by police.

I hopped out of my car, frantically told the officer what was happening, and was allowed to get back in my car and speed the rest of the way home with a police escort.

If out and about when on call, a pants pocket was always filled with change in order to use a pay phone to call whatever extension I was “beeped to.”

Finally, around 1988,  during my fellowship, I had access to a Motorola portable phone when on call. I was participating in the call rotation with the family medicine faculty.

Whomever was on call would take possession of the shoe-sized phone, with two possible antennas (one with a 25-mile radius, and the other a 50-mile radius), and the shoebox-sized charger. A 10-hour charge would allow for approximately 30-minutes of talk-time.

A beeper was still my constant companion, but the absence of a pocket full of change clanging allowed me to be somewhat less conspicuous.

I also did not need to always look for restaurants that had a pay-phone nearby.

So, therefore, I’ve obviously been high-tech since at least the 1980s! 😂.

I’m sure many will be impressed.

Makes me laugh!

A comforting denial

I recently applied for a long-term health care policy and was turned-down.

The phone interview, done by an RN, was “interesting.”

Early into the call:

“What operations have you had in the past.”

“I’ve had bilateral total hip replacements.”

“Why?”

“I had advanced degenerative joint disease.”

“Oh, okay.”

A bit later:

“Have you had any abnormal X-ray studies in the past?”

“Yes, on my hips.”

“What was abnormal on the right hip X-ray?”

“It showed advanced DJD.”

“What was the outcome?”

“I had a total right hip replacement.”

“Oh (and not, oh yeah) okay, what was abnormal on the left hip X-ray?”

Me, after briefly contemplating if I was being punked:

“It showed advanced DJD.”

“What was the outcome?”

“I had a left total hip replacement.”

“Oh, okay, let’s move on to some additional questions.”

The interview continued with more questions, many of which were redundant.

Clearly the RN was reading through a list of questions, having had to, hopefully only temporarily, abandon her common-sense once our encounter had commenced.

Prior to the call, I had looked into what to expect for the over-the-phone cognitive screen.

One question always apparent was, “in the next minute, name as many animals as you can.”

(Naming 15 or more is considered normal)

I was ready.

However, I was queried , “in the next minute, name as many fruits and vegetables as you can.”

Despite being temporarily stunned, I quickly recovered and proceeded to peel (pun intended) off, greater than 30.

A few weeks later a thin envelope arrived with the insurance company logo.

Remembering college application days from the 70s, when a thin envelope was consistent with being denied acceptance, I knew a disapproval was most likely before I opened the letter.

However, I was oddly comforted: “A long-term health care policy cannot be underwritten due to having had bilateral hip replacements.”

There was no inkling of cognitive deficits!

I admit…I’d prefer to be somewhat functionally impaired and cognitively intact than the alternative-functionally intact and cognitively impaired-before leaving earth!

My work email compromise, remembered

I just got back from a long weekend, out of town, with friends.

Prior to my retirement, a colleague was always my surrogate for any urgent/emergent issues when on vacation.

Nonetheless, the email barrage continued.

I struggled with the following: keep up with work emails when away, or just face hundreds once returning to the office.

Keeping up adversely affected family-time.

Deciding to not keep up also had an adverse effect…intrusive thoughts, that I tried to suppress, about the hours of work pending once returning to the office.

But fortunately, the intermittent feelings of gloom did not usually kick in until the second half of a vacation, only when the vacation was winding down.

Eventually, I compromised.

I would spend the hours needed to address and clear at home, to whatever degree possible, the night prior to returning to the office, or would go into my office the day prior (usually on a Sunday), when nobody else was there, if/when travel arrangements allowed for the same.

It never stopped the “thank God you’re back, you won’t believe what happened when you were away” comments from my staff on most every return, but I did enjoy my time away to a greater degree and always slept somewhat better the night before returning to the office.

FDA approval

During my career I would remind patients of the statements, “these statements have not been evaluated by the Food and Drug Administration (FDA) and this product is not intended to diagnose, treat, cure, or prevent any disease,” when patients would ask for my opinion on a dietary supplement or brochure/advertisement that they had seen.

Many had already purchased and some had already started taking the supplement in question.

I always tried to look into further for them.

I just finished reading, No More Tears (2025), by Gardiner Harris.

It’s extensively referenced and an excellent read.

I never knew the FDA was funded by industry, not taxpayers.

I should have made the following statement to patients, over my career, whenever I started them on any FDA approved medication/medical device:

This medication/medical device has been approved by the FDA but the approval may have been made by members of a review panel who had a financial incentive to approve and/or without the results of clinical trials that concluded adverse outcomes, due to being intentionally excluded from the submitted application, by the pharmaceutical company.

Gardiner Harris makes excellent recommendations on the last few pages on how to move forward from here.

It will be interesting to see if anything changes.

Working remotely

One consequence of the COVID pandemic: it’s now almost an expectation that working remotely, full-time, or for at least half or more of a work week, is the new norm.

Prior to leaving my most recent position, employees who were home “working” occasionally accidentally left their camera on during a meeting on Zoom or Teams while lying in bed, holding a crying young child, etc., or forgot to mute when spouses were letting them know breakfast was ready, dogs were barking, etc..

I even heard about one instance when an individual forgot to do both (turn off the camera and mute) while sitting on the commode without a shirt and visibly straining during a bowel movement.

When the federal government announced the return to work edict, national news aired interviews with federal employees who voiced anger at the increased expense and inconvenience of: 1. having to pay for gas and tolls to commute 2. having to purchase professional clothing and 3. having to arrange and pay for child care.

I know another person who noted she couldn’t return to the work place, to continue to work, because she was home-schooling her children.

My son, who has never worked remotely, sarcastically noted that there was one good outcome of the return to work proclamation: folks would rediscover an appreciation for housework (laundry, dishes, cleaning, etc.) that can only be done at night or on weekends.

It’s an interesting time for employers as they navigate through this expectation of their employees.

I completely understand, and have empathy for, the convenience, value, and privilege of having young children at home and the financial strain of all issues noted above.

Although its only been about 5 years since this change occurred for many, I’m sure it feels like it’s been much longer for all involved.

I did for me when I was the medical director of a large interdisciplinary team (with providers, nurses, social workers, nutritionists, pharmacists, rehab therapists, recreational therapist) and didn’t, except for an occasional weather event, work remotely.

I do wish all the best.

But, full disclosure, I’m not disappointed that I haven’t had to continue to tip-toe through this issue for the last 4 months.

Recycling myself

“For most of us, who we are, is based on what we do. If we become too dependent on this mind-set and our job ends, we lose our sense of identity. So before, or soon after retirement, we need to redefine who we are in a positive and meaningful way. Recycle yourself.”-Dr. Barbara Udell

I’ve had thoughts, during most days, of doing something part-time related to my medical career since it was a large part of my identity for 4-decades, especially when recalling wonderful encounters with patients, caregivers, and families

But while sleeping, I’ve had almost nightly dreams that include dealing with a difficult patient, caregiver, or family.

For me, a difficult encounter never had anything to do with complex or challenging medical issues.

It had to do with them being difficult to deal with, despite my best attempts showing empathy and respect, due to disrespectful communication and/or aberrant behavior.

I’ve awakened during these dreams, had a hard time getting back to sleep, and have consistently concluded, at those times, that I’ve “had enough.”

I suspect I’ll continue to navigate through these opposing thoughts during the day and night, until I make up my mind as to whether to do something part-time involving patient care.

Being a doctor was a honor and a wonderful career, but it wasn’t my whole identity.

Fortunately, I don’t need to completely recycle myself.

Being roasted

My usual work attire always consisted of khakis and a dress shirt, which was usually plaid.

At my last team-wide meeting, before I retired, the nurse practitioners all stepped out of the conference room at the same time

Shortly after, they came back in wearing khakis and plaid dress shirts.

A couple even donned a white wig.

I started to laugh, as did the others in the room.

They then proceeded to each tell a brief anecdote of something funny that had happened during our years working together, while also doing their best to duplicate some of my (many) mannerisms.

Roasting my work attire, as well as some of my idiosyncrasies, was greatly appreciated.

I’m sure to smile, when reminiscing about it, for the rest of my life.