a few more contractions and a doctor with sub-zero social skills

                                                                         

Sometimes you can just see the crazy in a doctor. (This is just a sample picture, BTW)

Jillian had a few more contractions yesterday morning, but they gave her more progesterone, which stopped them. her cervix is still as it should be. There is no leakage and no membranes have ruptured. they're shooting for a 36-week pregnancy, but they'll be happy for anything from 26 weeks on. Today she's 21 weeks officially. the plan is just to keep the progesterone levels higher. The first dose they gave her was minimal.

She had a very rude OBGYN was covering yesterday and happened to be on the floor when the contractions started. She was having trouble breathing, so the RN was reaching for the oxygen tubes, but the doctor stopped her. he got right in my aunt's face - actually put one hand on the aide of each of her face -- and practically yelled at her, "Just STOP it! Breathe normally. I've had it to HERE with girls who think they have asthma and go into attack mode the moment the first thing goes wrong. Just STOP it and breathe normally NOW!"

Pseudouncle asked the doctor if he had seen Jillian's chart. The doctor answered that there hadn't been time for looking at any charts. Pseudouncle argued with him that unless a patient is bleeding out seizing, stroking, or in acute cardiac distress, there's ALWAYS time to look at a chart.  He plucked her chart from the clamp that held it next to the door. on the outside cover of the file, in  red letters so bold and large that it could have been read clearly from  ten or more feet away , was printed "CYSTIC FIBROSIS."  "You didn't even need to take the file off the wall to see this!" pseudouncle exclaimed.  "And even if it had been asthma, there was no reason to speak in such a manner to her, and it certainly wasn't going to make anything better. Don't you ever speak that way to my wife again. In fact, don't ever speak to my wife again. I have access to a truckload of doctors. If  XXXXXX isn't available, I'll find someone else to take care of her. I'll deliver the kid myself before I'll let you touch her. And work on your bedside manner while you're at it!"

The jerk walked away, muttering "Doctors' families are always the hardest to deal with."

"That's because we know we don't put up with your bullshit!" Scott yelled at him.

A group of nurses and employees had formed an audience. They applauded in unison as the jerk walked away.

"Don't you people have work to do?" he shouted at them.

The charge nurse of the shift  answered, "You take care of your business and I'll manage my staff."

All day nurses kept coming up to pseudouncle and high-fiving him. He apparently lacks interpersonal skills when it comes to the nursing staff as well. In terms of physician skill, he's supposedly competent -- not anything that would earn him awards or world acclaim, but in possession of the basic technical skills an OBGYN should possess. He's such a jerk, though, that the nurses say they can't figure out why any woman would CHOOSE him as her doctor. the nurses curse under their breath (or over their breath0 when they know he's coming for a delivery. he's also a doctor who complains vociferously if he's called two minutes earlier than he needs to be called. He wants to walk in the second the baby is ready to make its exit. Consequently, he either spends a lot of time standing around cursing in front of laboring patients and expectant fathers (when pseudouncle used a few four letter words to the jerk, it was 5:00 a.m.. and no patients or family were present) because he has to wait two to five minutes after he's scrubbed up before his services are a technical necessity, not that there isn't help  he couldn't  contribute if he were not lazy and uncaring.

He's had several lawsuits because patients didn't wish to pay his full fee because he didn't make it to the hospital on time and wasn't physically present for babies' births, leaving the delivery to nurses and interns. (He missed a delivery yesterday morning just before his encounter with Jillian, which may have contributed to his foul mood. Jillian's brother Timmy, who has hospital privileges only as a physician's assistant because he's completing an internship with another hospital, but worked in the local E.R. for two summers, delivered the healthy baby without incident.) 

In most cases everything came out fine; In one case, a baby's shoulder and collarbone were damaged because it was a particularly difficult delivery;  the injury might have happened even had he been present, but presumably his expertise should have been a benefit in easing the baby out. He's lucky it was just a  clavicle, shoulder, and arm, which should heal, and not something that would have caused cerebral palsy or other brain damage. He's trying to claim that it's just Mother Nature at work, and that babies come when they come, but the nurses have documentation that he demands to be called later than any other OBGYN on staff. He'll fight it, but he'll  end up losing the delivery portion of his customary fees, and his insurance company will have to pay a  settlement on the baby with the injured arm. shoulder and collarbone.  The insurance carrier has to be getting somewhat irked with him. Hospital policy will probably change so that the charge nurse of the shift makes the call as to when the doctor is to be summoned regardless of the doctors' instructions, which is probably a good thing.

Jillian's pulmonary medical specialist was also called, as is customary with comorbid (those with multiple diagnoses requiring different medical specialists) patients. He came in, assessed the situation, determined that things were under control with Jillian, then called the personal phone number of Jillian's OBGYN because calling the office number would have only gotten him to the answering service and to the jerk. Jillian's OBGYN may have been irritated at being awakened at 5:40 on his day off, but the pulmonary specialist didn't care. He apparently totally ranted about the jerk. Jillian's OBGYN, once he woke up enough to be coherent, said that he, too, was sick of the guy. He would offer to buy him out of the practice. If the guy refused the offer, he'd up the offer a bit, and if that didn't work, he'd either threaten to take him to court to have him removed from the practice with or without compensation or would disband the practice and reincorporate it under a new name with the other three doctors.  In the meantime, he would meet with the other doctors and reach an agreement that they would refuse to have him cover their patients. If he only had his own patients to care for, his finances would suffer to the extent that  he  could not survive financially without taking the buy-out and relocating to an area of greater need of OBGYN services.

The pulmonary specialist  also mentioned referring him to the hospital physicians' review board. If the man were to lose privileges at the hospital, he would be automatically out of the practice, because maintaining privileges at the local hospital is a prerequisite for being a partner in the practice, and losing privileges at the hospital removes him from the partnership with his only compensation being the buy-in fees he paid (less if the practice has diminished in value, though it hasn't).  That was pseudoaunt's idea, as she's read up on medical and hospital law in her free time since Scott got his license to practice medicine.

Anyway, there haven't been contractions for over thirty hours. Jillian's still on bed rest. The hope is that she will still go home Wednesday with  medical support.  She was a bit unsettled after the second set of contractions, but she's positive again. She knows she absolutely needs to get to week 26 to not have a really precarious situation, and that week 36 will give her a baby who goes home from the hospital on the same day she does.  her doctor has told her the best thing she can do is to follow all orders, eat everything she can, and be happy. She's giving it her best shot. She's not eating regular hospital food because the director of nurses, who is a close friend of the family, says a picky eater can't gain weight on normal hospita fod. sometimes food is brought in, but the director of nurses has examined the schedule and has picked out someone she knows who can cook on each shift to leave their other duties and to go in and prepar4e food for Jillian. it ticks off the director of food services, but when I was in the hospital they served me scrambled eggs that were overcooked (and I like mine sort of well-cooked anyway, but not THAT rubbery) to the extent that when the director of nurses took them into the kitchen and dropped them on the floor, they actually  bounced.  Pseudoaunt is picky as I am, so she has special cooks preparing her food. The director of nurses cooks if she's physically present, The other cooks are mostly black people, but there's also a sort of  Okie cleaning woman (she cooked for me, and she is good; the director of nursing wants to set her up in a part-time catering business in addition to her custodial duties), a Greek lady from the finance office, and an Italian man who's an X-ray tech,  on the cooking rotation. Olive, the director of nursing, says the other cooks enjoy the break from the monotony of their regular jobs.

Tonight a lot of musicians are going to Jillian's room to throw together a concert. I'm not allowed to mentioned names, but a broadway star, related to Scott by marriage, will supposedly be there. My dad said I can go if I'm feeling OK. I'm resting most of the day. I won't even complain if they make me travel in a wheelchair. 

I really need to travel north to look at the condo. My aunt is furnishing it, so I'm sure it will be fine, but it would be good if I could at least see it. I'm hoping I'll be able to go by next week.  My Godfather is paying for weekly housecleaning services, which is a huge break for us. All we'll really have to do is pick up after ourselves and do the dishes and personal laundry. Housekeeping will even wash our bedding and towels. It has a nice dishwasher, but it still has to be loaded and unloaded, and Matthew's not fond of either of those tasks. Maybe I'll do that if he'll be really  good about taking out the trash.

I'll let you know how tonight's impromptu concert goes. 

Ciao!