Tuesday, January 17, 2017

Butt Doctors and Related Matters

I don't own this photo, but I do love it.



For numerous reasons but due primarily to the luck of the draw, I have somewhat lower-than-average immunity to many of the pathogens that surrounds all of us. My mother did not want me to pursue medicine as a career for that reason. My other primary vocational consideration was law. My dad's response to my mom was that courtrooms, jail conference rooms, and other places attorneys frequently hang out are not the most germ-free places on the planet, either. In the end, the decision was not either of theirs to make, and I chose medicine over law. Now that I'm in the thick of a clerkship rotation [OBGYN] that I am not thoroughly enjoying, I may be having second thoughts and thinking my mother may be smarter than she looks, but it's really too late to turn around now, and, furthermore, this is just one lousy rotation.

Actually, were it just the OB (or "obstetrical") half of the specialty, I might actually like this rotation. Hearing a baby's very first cry is an utterly awe-inspiring experience. Though it's something I've experienced only fifteen times (thirteen times here and twice with the births of my Godchildren), I don't think it would get old if I heard it every day of my working life. It's the GYN (or "gynecological" portion) that I'm not particularly enjoying. Not everyone feels as I do, though. Some doctors find the hours connected to delivering babies to be unmanageable, particularly after too many years in the field. After just over a week into the OBGYN rotation, I can attest to the lunacy of the hours obstetricians work. Babies will begin the labor process when it is convenient for them to do so with no thought whatsoever as to to how their timing is going to impact anyone else. Some doctors will attempt to circumvent babies' self-chosen schedules by inducing labor or by arranging for c-sections for highly dubious causes, including not only a preference for a 9:00 to 6:00 workday but for boat payments that will soon be due or Bentleys that need work. (C-sections result in larger fees.) Some scheduled C-sections are for perfectly sound causes, obviously, and I'm not criticizing the obstetrician who schedules a caesarean delivery for a mother who dilated a full ten centimeters yet couldn't push out her previous six-pound baby, and who is now ready to deliver baby #2, who is over seven pounds. That's a no brainer. Why torture, the mother, the baby, or the doctor? Get the scalpels ready. Additionally, malpractice insurance coverage is especially costly for obstetricians. An OBGYN who cuts his job description in half can still usually find more than enough work, and can do so working more reasonable hours and seeing more of his or her patients' fees deposited into his own account as opposed to the payment going in large amounts to his or her malpractice insurance carrier.

We need doctors to fill all specialties, so I'm not complaining about those who settle on proctology, or urology, or the gynecological half of the obstetrics/gynecology spectrum.  Sometimes I'm really tempted to pull the individuals aside who fulfill these specialties and ask them, "Confidentially, just what was it that led you to choose to look at and or up people's butts all day? You can tell me the truth. Your secret is safe."  Of course I'd never actually ask that, because the people in these specialties are usually highly sensitive about their lines of work. I'd be ratted out, and if I weren't bounced from my program, I'd be severely reprimanded at the very least. I'm not suicidal, professionally or otherwise.

Still, I wonder what calls doctors to these specialties. My guess is that the pay is quite competitive. I've never visited a proctologist (though my gastro man has done a bit of related work for me, and my insurance carrier alone  has forked over a good portion of his first kid's undergrad education fees) but I would guess that he is compensated quite fairly for his work.  I wonder if, in communistic countries, the system allows either those who score highest on exams or who praise the despots in power the most effusively to fill the choicest specialties. "You!" says the med school head-honcho, pointing at the guy sitting in the back row, "Got piss-poor score on exam. You be piss doctor, or what is it they call that in America? Urologist! You be urologist!" . . .   "You!" he says next, pointing at guy with sarcastic expression on his face . . . "You laugh at Kim Jong Il's hair cut  when you seven years old. You be butt doctor." Maybe that's how it goes down in such places. I really don't know. Regardless, I wouldn't place a high premium on the quality of medicine practiced there. For those of you who are world travelers who sometimes venture inside borders of countries ruled by dictators, you would be well-advised to ensure that you have at least one cardiologist and one general surgeon in your traveling party and that they are carrying the equipment and medications they need to get you through a basic procedure until you can be transported to a place that practices at least 19th -century medicine.

I haven't yet decided on a specialty, assuming I'm in a position to have much of a say in the matter. If our system changes much here, I may find that I'm assigned to be a butt doctor for having criticized President-Elect Trump's hairstyle. Just to keep my bases covered, I shall go on record as saying President-Elect Trump has a most stylish haircut (at least as compared to Kim Jong Un or his late father Kim Jong Il). I'm giving compliments freely because I really don't want to be a butt doctor.


in the event that you were wondering how they perfected their technique before trying it out on you



7 comments:

  1. Having been on the receiving end of a urologist because of prostate cancer I don't think it would be that much fun. As a lab tech, however, I thought urinalysis was quite interesting when something different would show up.

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    1. I wasn't a REAL lab tech but did an internship in a lab, and had a few interesting things thrown my way. It was really cool when I got to the point that I could spot things before they were pointed out to me. I could see making a way of life with pathology.

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  2. The money is great, but the hours really stink...

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  3. Depending upon which specialty of which you write, yes the money is great, but they hours may figuratively stink, or that job itself may literally reek.

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  4. Colo rectal surgery where I spend a lot of my time is not too bad. Much misunderstood. Google "The Colo- Rectal Surgeon " song',
    "Hail the colo rectal surgeon, misunderstood and much maligned
    Toiling away in the heart of darkness, working where the sun don't shine....."

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    1. Awesome song. The surgery probably is among the better parts of the job. I've had a couple of colon resection procedures. i'd like to hope the surgeon, whom I genuinely like, was more than adequately compensated for any unpleasantness. I've actually spend more face-to-face time with him than he's spent looking inside of any of my passages.

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