Floating residents

I was talking to one of my interns the other day - she had a child in medical school, and is thinking about having another one - and she pointed out that our residency program (like many others, I imagine) has no maternity leave. Meaning: sure, you can have a child during residency, and no one will fire you for that (nothing short of killing patients will get you fired from a residency program, so desirous are hospitals of working diploma'd bodies) -- but you will have to cobble together your own leave, and it won't be any more leave than what is granted to any resident under our current schedule: namely, four weeks of vacation (two times two weeks) and several months of elective (still working, but pretty much nine-to-five).

On second thought, since employers are required to guarantee more maternity leave than that by law, I suppose our residency program is indeed guilty of failing to offer proper maternity leave. No one will take it to court for that reason, because residency programs have long enjoyed the benefits (and curses) of the twilight zone between educational establishment (students can work, and be made to work, as much as they agree to) and patient-care employer (subject to 405 regulations and all the rest of it).

If our residency program, and all others, were (made) to decide that they should offer proper maternity leave, in a block like other employers do, how would this happen in practicality? Two things would have to be true: residency programs would have to allow residents to finish in longer than the time customarily allotted to them; and "floater" residents would have to be available to fill in the gaps when others take leave. (You can't have residents in the same program fill in, as this would undoubtedly run afoul of work-hour regulations.)

Floater residents: why not? Our program hires moonlighting attendings, PAs, and all manner of other healthcare providers.


On Working With People Who Are Just Slightly Younger Than I Am

How old do you have to be before you no longer have to say "peace out" and "peeps" (="people," e.g. "patients": "Let's go down the list of your new peeps.")? Am I old enough to be exempt? I never got the e-mail.


On Having An Unasked-For Day Off Tomorrow

Thank you, Jesus, for giving our family this time together.


A Non-Profit's Molting Pains
The byuralistke speaks.

Yugntruf just changed its entire executive board and hired a new office manager. She's learning Yiddish as she starts her new job: her blog (in English) gives me some cause for optimism.


Not a haiku

I crave glass clear
to the other side, swimming
through the bottle
towards a reversed message:


Semper septic

It's the damn inevitability of sepsis in the ICU which is so tragic and frustrating. It's like every patient's story has the same ending.


Long umbilical cords
and other poetical equipment.

"...room upon room of song, smell, death, and dance from the four corners and the mixed races of his family, and much else besides: from Jews to African-Americans to Poles."

More in
H_NGM_N #7, and my review of Sean Thomas Dougherty's Broken Hallelujahs.


Frustrating idioms of the medical profession
First in an endless series.

"workup": tests, imaging, and the like which doctors use to analyze the cause of or prognosticate a given condition. "He had a full workup": the doctors did the tests they thought indicated. Unfortunately, when one uses "workup"without thinking, it can appear that all doctors agree what tests should be done, or that the tests are sufficient. "Had a cardiac workup" does not usually mean "exhaustively risk-stratify a patient for cardiac disease, determine its etiology, and plan for treatment," but rather "was ruled out for acute coronary syndrome [heart attack] or arrythmias."

That's first off. Second is the philosophy of medicine that "workup" implies: the body is a machine, lying there broken, and we approach with our tests to tinker until whatever broken part is repaired. Sometimes this philosophy is appropriate, but more often than not the patient is left dissatisfied after the "workup is negative."

Next up in frustrating idioms: "so we can see what's going on." ("Just get a CT scan of the abdomen so we can see what's going on.")