Most laypersons and medical personnel have no idea what an indirect ophthalmoscope is. I always get suspicious glances when I’m carrying around my indirect scope in the hospital. It’s black, and looks like a weapon. Ophthalmologists use it to examine the fundus. It provides a light source parallel to our sight, and gives us a stereoscopic view. Last night I got about 5 double-takes when I was walking to the emergency room around 2am. One security guard actually stopped in his tracks and grabbed his gun from his holster.

Bastard. What do people think I’m doing? I’m sure that everyone tries to be particularly alert, but there’s no reason to be paranoid.

misc ophthalmology, rant

One of the consequences of carrying the hospital ophthalmology on-call pager is that you end up becoming the primary eye consultant for anyone who knows your number. ANYONE. This includes people outside the hospital’s referral network.

Last week I received a call from a gynecologist who worked at the hospital but was 2 hours away. She noticed that her eye was  “bloodshot”, and described to me signs of a subconjunctival hemorrhage. Of course there was nothing I could do except offer her a ticket to my emergency room if she wanted an examination. She declined.

On Saturday morning at 4:30am, I received a page from the hospital’s cardiothoracic (CT) surgery fellow worried about his own red eye. I had just stepped foot in my apartment 10 minutes earlier, after a horrible slew of ED consultations. I asked him to drop by our weekend clinic at 8:30am for examination, but he stated that he was scrubbing into “a case” and probably would not be finished until 10am.

As angry as I felt for being paged for likely non-emergent personal consultations, I actually felt sorry for the CT fellow.

Then I realized the reason for the high volume of non-emergent calls is that people, no matter how educated they are, know very little about the eye. Who knew that you shouldn’t wear daily contacts for 4 days straight? Yes, if you wear inch-thick eye liner, some of it will get into your eyes.

I guess that’s why ophthalmologists still have jobs.

medicine rant

Every year, the Academy of Ophthalmology holds an annual meeting that most ophthalmologists attend. Those that are usually left behind are junior surgeons who end up covering the on-call pager.

I was unfortunate to be covering the primary pager for the hospital this weekend, which is Academy weekend. Generally speaking, this is the worst weekend to have an eye problem, because your primary ophthalmologist is probably out of town in a meeting (or getting drunk). My pager rang early yesterday morning with a long distance callback number. Bad news. When the emergency room or floor resident pages me, I usually receive the hospital extension. A long distance number always means that you’re getting shit that you don’t want to (and should not have to) deal with.

The call turned out to be from one of my attending’s wife. She woke up with an itchy eye and foreign body sensation. Her husband was at the AAO meeting in San Francisco, and she did not wish to bother him with a call. Her son-in-law, daughter, nephews, and nieces were all ophthalmologists at the meeting as well. Her primary ophthalmologist was in town, but she did not wish to bother him either because it was Saturday (Jewish sabbath).

WTF?

I suppose that leaves me, the on-call resident. I offered advice to the best of my abilities over the phone and offered to see her in the emergency room (the one where patients wait 4 hours to be triaged). She politely declined.

Lesson to be learned: if everyone in your family is an ophthalmologist except you, you should go with them to the Academy meeting.

medicine ophthalmology, rant, work

I remember when Instant Messaging flooded the workplace computers back in the tech-boom days. My colleagues working at IBM would get company-wide emails stating that IM decreased productivity and was prohibited. When company threats weren’t heeded, port 5190 was blocked on the company firewall.

Now that instant messaging has been superseded by text messaging and MMS, I see my colleagues “texting” away during conferences and lectures. It’s become a nuisance. If you’re simply notifying your spouse that you’ll be late for dinner, that’s one reason to be texting during fluorescein conference. However, checking the stock ticker? Chatting with your medical school classmate? What are you thinking? That is simply abusing technology. Perhaps I say this only because I don’t have a data plan on my phone, but there is a point in which your attention should be directed toward the lecturer and not your iPhone.

Our eye clinic is in the basement, where our cellphones unreachable by the outside world. You’d think that there wouldn’t be any contact with the outside. Wrong. Last week one of the technicians (who are supposed to be obtaining visual acuity for our patients) was logged onto her MySpace page. Another computer was logged onto Facebook.

I wonder how much social networking affects workplace productivity. A quick search online shows that this actually increases productivity. USAToday also states that we work better with social networking… The caveat? None of these companies are involved with healthcare.

computing, medicine rant, tech, work

An obvious facet of owning a business is knowing your competitor’s prices. If you don’t, then you’ll likely be out of business soon. We see this with taxi drivers. In NYC, there are city-governed yellowcabs and unmarked private cabbies. Most private cabbies command a higher rate, not because they provide better service but because they lurk around areas where yellow cabs are not as readily available. As a customer, the key is to negotiate a price prior to getting into the cab. However, even with informed preparation, you can still run into trouble.

I hailed a grey taxi to help me move an air conditioner 5 blocks away from my apartment.  I offered $10 for his assistance in carrying the unit to and from the cab in addition to driving me. He agreed. Afterward, he didn’t help me move the A/C, AND he charged me $15 because my A/C was “big”. Asshole. A $15 cab fare would normally get you at least 20 blocks.

My friend Bob had a more harrowing experience. After agreeing to a standard $8 fare to travel between hospital campuses, the cab driver demanded $14 when they arrived at the destination. Bob refused, and the driver locked the doors to the cab and refused to allow him to exit. He spent over 30 minutes in the cab until the driver gave in and let him out.

I understand that any business is difficult to run these days, but knowingly ripping off your regular customers is no way to remain profitable.

medicine rant, travel