so i think it's no secret that i really like anthony bourdain. i wish we were friends. i wish he would forgive me my vegetarianism and just hang out with me anyways. and every time i wish we were to hang out, i wish i could take him places. mostly, places i've been for extended periods of time, like berlin, or hamburg, or kiev.
well, imagine my surprise when anthony bourdain went to kiev. i mean, i guess it was pretty much inevitable that, after seasons and seasons of traversing the world and ending up in asia, he would run out of asia and end up in lil' ol' ukraine. the problem is, sort of disappointed. it seems like the focus of the episode was seeing chornobyl. seems like right up anthony's alley: crazy postapocalyptic, nuclear disaster type shit. awesome. and then he makes this attempt to create comparison of soviet oppression vs the current oligarchic (is that even a word?) oppression and control, which in and of itself is a good parallel to draw, but he fails to provide evidence. the chornobyl bit is good, filled with irradiated and fried testicle bits, but the rest of it...
so first he goes to crimea, he explores the tatar culture, stalin's displacement of tatars and the revival of said culture post-independence. he eats some meat on a stick--typical--eats a cheburek, which is truly delicious. but then, ignores other beauties of crimea, like beer and dried fish on the shore, or steamed crawfish by the bucket...also on the shore. then he travels to kiev, ends up in some underground borscht place, which i'm pretty sure is not even real and was merely created for camera's sake (i mean 'le borscht'? really?!), and totally misses 'tsarskoe selo' (i think that's the name)--the place for ukrainian food which serves schmaltz (melted fat) instead of butter for bread. melted fat!! the whole time he is chugging vodka, refusing to drink beer. yes, i like honey chilli vodka like the next guy (actually, i dont really), but how do you end up in kiev and not drink beer? there is like at least 4 brewers in the 50km radius. delicious, cold, tap beer.
he ignores andrew's descend with its art culture (which i feel like was a bad mistake since he could potentially find like-minded individuals there..and maybe score some illegal shit), pokes fun @ some mcfoxy fast food place. again, i'm pretty sure that's fake, neatly dropped in the backdrop of the old train station. but totally fails to poke fun of ukrainianized mcdonald's food names. i mean, who wouldn't love mcchicken mcnuggets!? and if he were trying to make fun of capitalism in ukraine, why not make fun of the fact that ukrainian mcdonalds charges for ketchup? he ends up @ bessarabka, buys some leftist underground caviar and fails to mention that bessarabka has always been and still is the most expensive and elite place to shop in kiev and despite the fact that Caucasian men (that's from the mountains and not necessarily white) will give you the most exotic fruits and, if you're a girl, many many goats for a dowry to marry them, most ukrainians buy their fresh veggies from little old grandmas who raise them in their gardens and sell them on the side of the road, literally. nor does he even mention the TGIF behind bessarabka--the epitome of capitalism. he does not visit any of the 'fast food' places, which are really cafeteria style 'restaurants' serving the same crap your mom makes (no offense mom, but would you really pay for meatloaf for power lunch?!) he does not make fun of the ukrainian new national food--sushi. he does not have coffee in one of the austrian cafes in the passage (also, totally nostalgic and soviet reminiscent, since it was the top place to visit with family (or hot date, but only if she was hot) on a sunday). he doesn't even make fun of the 'tequila house', where potato salad is the staple of a taco. he never once ends up in pervak, where the whole place is meant to reflect the last like 100 years of history of kiev. he doesnt end up in 'tantra' (or karma or something else name it derives from the kama sutra) or 'apelsin', which, as the hottest night clubs, would provide so much material for fun poking of the hot kiev elite. but somehow he makes fun of the corn dog on the corner of khreschatik and lenin st (cant remember it's current name sorry), but doesnt mention that this particular donut corn dog was the first 'western' thing sold on a street corner in fast food fashion after independence (whose 20year anniversary was just 2 days ago), automatically making it, well, kinda cool. he did a good 'nostalgia' job in berlin, but here...
clearly, so much missed. i blame zamir. i think i would have done a better 'guide' job...and there would have been much more beer. :)
Thursday, August 25, 2011
Sunday, May 29, 2011
the pain scale
so maybe it's my post call delirium and lack of caffeine, but instead of doing work here i am contemplating about the pain scale.
it is now a mandatory part of nursing assessment, along wiht vitals, to document pt's (that's patient's) pain level and adequate address it. the pain scale, for those who dont know, is based on 10 points: zero being no pain at all, 10 being the worst pain of your life. because pts are asked so frequently to assess their pain, this whole 10point system is pretty well known. so pts come in complaining of 10 out of 10 pain. and because it is so widely used, it is now being widely ABused.
so pts show up in triage, with something stupid like stomped toe and claim their pain is 10/10. now, i know pain tolerance is different for everyone. pain receptors, neurons, whatever makes you experience pain different (and sometimes even enjoy it ;) ) and i am in no way trying to discredit someone's pain as unreal or minimal, but sometimes i wonder if it's really that bad. of course, i've never been pregnant before so i arguably i dont know what labor feels like or how bad contractions can get. but i have been in pain before, maybe even significant pain (ask me about my injuries sometime), and when someone claims their pain is 10/10 and their cervix is closed....i dont know...
so i must admit i am a pain scale conservative. i do not give away pain points easily. and there is a whole rational reason behind it. if you had to rank your pain, ever, on a ten point scale, one should proportion points thoughtfully. if 10/10 is the worst pain of my life, then whatever i may be feeling now is probably not it. i mean i'm not dying yet, my limbs are all attached, it can potentially definitely get worse. now i've never been in labor, but i imagine having a baby squeeze through my vagina WITHOUT epidural is probably like a good 8 or 9. so we'll save that. now, i've also never had a kidney stone and that's prolly like a 7. so we'll save that. so how bad is this pain? now if i'm sitting in the ED trying to evaluate my pain and suddenly a bomb goes off and i have to run for my life, i'd probably be able to get up and go. i mean, despite whatever pain i'm feeling i'd survive this bombing thing. in fact, if push come to shove, i'd probably even push some little old lady in her wheelchair to safety. so i'm guessing my pain is probably like a 5. and so my worst ED visits, my pain has never gotten above 6. which just makes me think...next time someone asks you about your pain, be reasonable and dont just say it's a 10...because in all things possible...maybe just maybe it's not so terrible?
it is now a mandatory part of nursing assessment, along wiht vitals, to document pt's (that's patient's) pain level and adequate address it. the pain scale, for those who dont know, is based on 10 points: zero being no pain at all, 10 being the worst pain of your life. because pts are asked so frequently to assess their pain, this whole 10point system is pretty well known. so pts come in complaining of 10 out of 10 pain. and because it is so widely used, it is now being widely ABused.
so pts show up in triage, with something stupid like stomped toe and claim their pain is 10/10. now, i know pain tolerance is different for everyone. pain receptors, neurons, whatever makes you experience pain different (and sometimes even enjoy it ;) ) and i am in no way trying to discredit someone's pain as unreal or minimal, but sometimes i wonder if it's really that bad. of course, i've never been pregnant before so i arguably i dont know what labor feels like or how bad contractions can get. but i have been in pain before, maybe even significant pain (ask me about my injuries sometime), and when someone claims their pain is 10/10 and their cervix is closed....i dont know...
so i must admit i am a pain scale conservative. i do not give away pain points easily. and there is a whole rational reason behind it. if you had to rank your pain, ever, on a ten point scale, one should proportion points thoughtfully. if 10/10 is the worst pain of my life, then whatever i may be feeling now is probably not it. i mean i'm not dying yet, my limbs are all attached, it can potentially definitely get worse. now i've never been in labor, but i imagine having a baby squeeze through my vagina WITHOUT epidural is probably like a good 8 or 9. so we'll save that. now, i've also never had a kidney stone and that's prolly like a 7. so we'll save that. so how bad is this pain? now if i'm sitting in the ED trying to evaluate my pain and suddenly a bomb goes off and i have to run for my life, i'd probably be able to get up and go. i mean, despite whatever pain i'm feeling i'd survive this bombing thing. in fact, if push come to shove, i'd probably even push some little old lady in her wheelchair to safety. so i'm guessing my pain is probably like a 5. and so my worst ED visits, my pain has never gotten above 6. which just makes me think...next time someone asks you about your pain, be reasonable and dont just say it's a 10...because in all things possible...maybe just maybe it's not so terrible?
Monday, May 2, 2011
the thing about birth plans
so here is the thing about birth plans. i don't like them. seeing a birth plan immediately sends me into this ugh feeling that makes me want to roll my eyes. which is ironic because i feel like i would be exactly the patient that will need a birth plan.
so birth plans. they are actually a pretty good idea: it allows a woman to have a controlled and positive birth experience, the way she wants it. after all, it is her body adn this way she voices her wishes as to how to bring a child into this world, showing that she has thought about it and planned ahead. in theory, everyone should have a birth plan. in reality, it doesnt work that way.
first of all, as far as i know, creating a birth plan is basically a guarantee that everything possible WILL go wrong. it's a like a death sentence to have all the wrong things happen and doctors intervene as much as possible. second, it offends me as a provider...a little. because i feel like i'm a reasonable human being, you can tell me the things you want or dont want. dont write them down in a definitive manner, in a list-like fashion. it makes me feel like you dont trust me as a provider. just tell me what you want, i'll do my best to make it happen.
the birth plan itself, however, possess for me the biggest difficulty. while some things on the list are completely reasonable, like having the baby's father cut the umbilical cord or having you breast feed the baby as soon as humanly possible, others are either ridiculous or just impossible. yes i can completely relate to the fact that you want to keep your contacts/glasses on as long as possible. i'm pretty blind, i know the feeling of complete and utter fuzziness. so please, keep them on, you dont need to write it down. i also dont really care if you listen to music. i mean if cardigans, or yoyo ma or lil' wayne help you focus during contractions, be my guest, listen on. if you want to try for a natural birth and want to refuse all pain meds, by all means, try. chances are you wont make it, but i am not in any shape or form am going to MAKE you get an epidural. i dont care! what i do care about are ludicrous things on the list. like fetal monitoring. in this country we monitor babies during labor. if you dont want to be monitored, i'm sorry you need to be somewhere else giving birth. similarly, things on the birth plan that have to do with intervention are also ludicrous. you cant say that you, under any circumstances, do not want a csection. i mean, technically, you as a patient have the right not to consent one, but then you're basically consenting to letting your unborn baby die. similarly, with episiotomies. we dont cut those, only if absolutely necessary, again, to save the baby's life. so for someone to say i would never ever want one....this is what bothers me because then you're just dictating medical care, whcih you cant do. it';s sort of like telling your oncologist that you dont want chemotherapy but want your cancer gone--some things just dont work that way.
i think that's really the thing. intervention in medical care. i get it, hospitals are scary and deliveries can get hectic and emergent and out of control and as a patient you want to maximize your control in an uncontrolled situation. but birth plans just make it sound like you dont want to be in a hospital at all. home births do exist, that is an option. so the goal of the patient should be sitting down with their obstetrician and figuring out what their practice is and what can be compromised on. dont write it down like a list, that will only make me roll my eyes and think that you dont trust me. and that's not cool. and when i'm a patient i promise to do the same: let go adn allow my obstetrician to make the decisions, and not freak out.
so birth plans. they are actually a pretty good idea: it allows a woman to have a controlled and positive birth experience, the way she wants it. after all, it is her body adn this way she voices her wishes as to how to bring a child into this world, showing that she has thought about it and planned ahead. in theory, everyone should have a birth plan. in reality, it doesnt work that way.
first of all, as far as i know, creating a birth plan is basically a guarantee that everything possible WILL go wrong. it's a like a death sentence to have all the wrong things happen and doctors intervene as much as possible. second, it offends me as a provider...a little. because i feel like i'm a reasonable human being, you can tell me the things you want or dont want. dont write them down in a definitive manner, in a list-like fashion. it makes me feel like you dont trust me as a provider. just tell me what you want, i'll do my best to make it happen.
the birth plan itself, however, possess for me the biggest difficulty. while some things on the list are completely reasonable, like having the baby's father cut the umbilical cord or having you breast feed the baby as soon as humanly possible, others are either ridiculous or just impossible. yes i can completely relate to the fact that you want to keep your contacts/glasses on as long as possible. i'm pretty blind, i know the feeling of complete and utter fuzziness. so please, keep them on, you dont need to write it down. i also dont really care if you listen to music. i mean if cardigans, or yoyo ma or lil' wayne help you focus during contractions, be my guest, listen on. if you want to try for a natural birth and want to refuse all pain meds, by all means, try. chances are you wont make it, but i am not in any shape or form am going to MAKE you get an epidural. i dont care! what i do care about are ludicrous things on the list. like fetal monitoring. in this country we monitor babies during labor. if you dont want to be monitored, i'm sorry you need to be somewhere else giving birth. similarly, things on the birth plan that have to do with intervention are also ludicrous. you cant say that you, under any circumstances, do not want a csection. i mean, technically, you as a patient have the right not to consent one, but then you're basically consenting to letting your unborn baby die. similarly, with episiotomies. we dont cut those, only if absolutely necessary, again, to save the baby's life. so for someone to say i would never ever want one....this is what bothers me because then you're just dictating medical care, whcih you cant do. it';s sort of like telling your oncologist that you dont want chemotherapy but want your cancer gone--some things just dont work that way.
i think that's really the thing. intervention in medical care. i get it, hospitals are scary and deliveries can get hectic and emergent and out of control and as a patient you want to maximize your control in an uncontrolled situation. but birth plans just make it sound like you dont want to be in a hospital at all. home births do exist, that is an option. so the goal of the patient should be sitting down with their obstetrician and figuring out what their practice is and what can be compromised on. dont write it down like a list, that will only make me roll my eyes and think that you dont trust me. and that's not cool. and when i'm a patient i promise to do the same: let go adn allow my obstetrician to make the decisions, and not freak out.
Sunday, January 2, 2011
contraception and celebrities
so i hung out with my mom yesterday in celebration of new year. my mother informs me (as she is apparently now the gossip central) that natalie portman is pregnant and engaged, in that order. first of all, black swan--great movie and natalie portman was amazing in it. just reconfirms my firm stance that she is my favorite jew. and she and mila kunis had the hottest lesbian sex scene. if i had a lesbian fantasy this portrayed it pretty damn close. and as mila kunis is also a fellow jew, it makes me proud of my people: we make hot sex scenes :) but i digress. so i'm not sure if this natalie portman rumor is true, but i am suddenly sad as this is just another 'accidental unplanned' celebrity pregnancy. which makes me think: why is no one in hollywood using birth control? i mean with all the recent accidental babies, you would think there is not a single gynecologist in beverly hills. with today's advances in contraception, no one should ever get accidentally pregnant, unless they truly lack the resources. there are so many options out there that you can pretty much figure out what works best for you. cant remember to take pills everyday? no problem! cant touch the inside of your vagina? no problem! yes some people are stuck with less than optimal options,. like residents cannot be on pills because our schedules suck and we would never remember to take pills. obese women cannot be patched up with a patch. but i doubt anyone in hollywood is walking around with a DVT or a clotting disorder, or is a smoker over 35...although wait. but even then, there is always Depo. and yes depo does make you gain weight, but only if you give into your cravings. and since A list celebs dont eat anyways, that's not a problem. i mean, we see unplanned pregnancies all the time: little 15 year old girls from inner city chicago who either dont know better, or cant get access to forms of contraception that would work for them. or who cant make their dumbass boyfriend put on a condom even. but hollywood crowd? let's be serious. so that makes me wonder: either celebs are stupid, or this is a secret trendy thing to do--get pregnant, cause then you can just decorate your kid like the newest accessory puppy and name it weirdo names like crayola colors or inanimate objects. but if that's not the case then i may have discovered an employment niche. i should just move to LA (although god knows i hate southern cali) and open a clinic, providing contraception and abortion services to the rich and famous. i would have a back door so patients can leave without being seen. and we could conceal the front with some posh, dimly lit spa (so oyu can get your nails done while you wait for your pee sample to cook) and i could get juicy to design the mirena models. and there'll be plenty of propafol for everyone!! and that's how i'm going to pay off my med school loans. until then the celebs can just come to uic and i will be happy to sit down with them and review all of their contraceptive options, in details. they might just have to wait for their clinic appointment. cause we're booked. always.
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