Week of May 21, 2001
Monday
Tuesday Wednesday
Thursday Friday
Saturday Sunday
Most Recent Update
It's Monday again. Today started off with a meeting of our group's Leadership Council. Today's meeting was a little difficult as we had some issues to decide and the decisions were not unanimous even after a lot of discussion. That means that there were some very narrow voting margins and one issue ended up in a tie with our medical director, who is chairman of the Council, having to cast the tie breaking vote. He asked for time to think about how he should vote so I do not know what the result on that issue is yet. Even though we disagreed on what we should do, no one came away upset with anyone else on the Council which means a lot to me. I think we are all just trying to do what is best for the group rather than what is best for each individual member on the Council.
I did have one patient still in the hospital this morning. He is a man who is elderly and chronically ill with a pneumonia that is not going to resolve. I finally got together with his family, two daughters actually, and they are in agreement to stop all treatment and just keep him comfortable and do not delay the inevitable any longer. We transferred him from the hospital to the hospice care center this afternoon where he can have his family with him as much as possible at the end of his life. They do a great job at the hospice care center with patients at the end of their lives.
In the office, I was busy although I had three no-shows today. That is rather high for me lately but one of them had a habit with their previous doctor of chronically no showing which is one reason why she is looking for a new doctor.
Tomorrow night I am on call which means there will probably be no update. Nothing else to say tonight so I will say goodbye until Wednesday.
I have a little time after all. Tonight has been pretty quiet so far. The hospital is pretty quiet, probably due to the summer like weather we are having here. The temperatures have been in the 80's the last two days but will be dropping back down into the 70's for the next few days due to more clouds. It has been clear here for the last two days. This is unusual for this time of the year here. I guess it just goes with the drought we are having here so far this year.
I had several no-shows again today but still ended up seeing my usual number of patients. I probably picked up a lung cancer today in a patient who has had another cancer already surgically removed from the base of his tongue. He has continued to smoke however which increases the risk of a second cancer occurring in his body. This one is probably not an extension of the original cancer but a completely new one. His prognosis will not be very good. He is also anemic, probably from suppression of his bone marrow by the new cancer, or even invasion of it by the cancer. His workup will be continued over the next couple of weeks.
The patient I mentioned yesterday who went to the hospice care center yesterday afternoon, expired there tonight. I thought he would live a few days there but God chose to take him home quickly. He will now be in a better place.
Tomorrow I have an early meeting again; this one is in Vancouver again. It starts at 7 so I have to leave here by 6:15 to get there in time. I will try and go to bed now and get a little sleep tonight. Wish me luck.
I got a little sleep last night. Something like four hours worth between phone calls. I admitted two patients after midnight but both were stable and needed very little work.
I made it to the early meeting this morning. I then had another meeting at noon today here at the hospital. It was for the clinicians in our Family Practice team. It is a monthly meeting where we discuss problems we may be having as a team and find out how we are doing financially so far for the year. Currently we are in the black at about 130% of what we were budgeted to make. As you can see, we have been seeing a lot of patients this last fiscal year and we have another clinician starting July 16th. I think our team is the top performing Family Practice team in the group and we want to continue to be. I know our average number of patients seen daily is tops.
Today stayed summer like here. The high was in the mid 70's today rather than 99 as it was yesterday. Yesterday's temperature set an alltime record for May in this area. The humidity here is much lower than where we moved from in the midwest so Delanae said it did not seem that hot while she was outside yesterday. I would not know as I was in an air conditioned building until close to ten last night. The temperatures should stay in the 70's the rest of the week and for the holiday weekend coming up. We will enjoy the nice weather while it lasts.
Another beautiful day here, or so it looked like. Actually, my patients told me that it was beautiful outside. Evidently it was in the low to mid 70's and clear. It is supposed to be warm through the holiday weekend and dry but will be cloudy on and off. It is really strange for it to be dry this time of the year here in southwest Washington.
Not much exciting to report from the office today. I saw my usual number of patients through the day today without many major bumps in the road. I did get lunch which is always nice and had to attend a meeting this morning early. Tomorrow I have another early meeting and the two patients to round on in the hospital. Plus, I am the only physician in the office tomorrow so my schedule is already full. It may be a very long day tomorrow and we are supposed to be having a couple over tomorrow night for a cookout.
One of my readers is following in my footsteps. He is beginning to write an online journal and asked me if he could use my site as a template for his. I said sure as I had borrowed some ideas from other Daynoters sites when I put up this site. You can see the results here. If you like what he is writing please email him and tell him so; I know we journal keepers always like to hear from our readers.
I was very busy in the office today, especially this morning. I was about 30% overbooked this morning but managed to get finished in time to grab a 10 minute lunch and finish dictating the morning charts before my afternoon started. This afternoon was less hectic but still full. I did not have to admit anyone today so I was not slowed by that. I am seeing more and more hospital or corporation employees it seems. Today was no exception with two new patients coming in, both of whom were hospital employees. Tomorrow looks like a day to work in the yard after sleeping in tomorrow morning. It is supposed to be sunny and in the mid 70's again. A patient of mine gave me some sockeye salmon today which we hope to grill tomorrow and have it with the leftovers from tonight's barbecue which was excellent. Stephen just told me that some of his friends are coming over tomorrow afternoon to play music and will bring some hot dogs and hamburgers to also grill. Too bad, only Delanae and I will get the salmon!
It has been a beautiful day here today. Clear, sunny and in the mid to upper 70's. This kind of weather is really amazing for southwestern Washington this time of the year. We took advantage of it and got a lot of yard work done today. I pulled up thistle, cut weeds, and tried to level out some of our property by shoveling dirt from one area to another. Delanae spent the afternoon cleaning weeds out of some evergreen bushes. Both of us are tired and sore now and not looking forward to getting up in the morning for church. Stephen has five friends of his over spending the night. They are sleeping in tents in our backyard tonight. This was something they wanted to do. They are supposed to be in their sleeping bags and trying to go to sleep by 1 AM so they can get up and go to church and not fall asleep in church tomorrow morning. We will see how they do tomorrow morning. Tomorrow looks like more of the same. There is more shoveling to do and more clearing of evergreen bushes to be done. Also, we can watch the Lakers defeat the San Antonio Spurs once again. Have a safe holiday weekend.
Having five teenage boys spending the night outside last night was lots of fun. Neither Delanae or I slept very well due to all the noise from the dog who forgot that these boys were supposed to be there and other strange noises. There was also the compact pickup truck driving up in the wee hours of the morning. They had already had some other cars full of teenagers driving up earlier in the evening uninvited, they said, by any of the invited ones. We had to threaten to send them all home to finally get the cars to stop driving up. The invited ones said that they never invited any others to come up but the "uninvited ones" said they had been invited. The boys all left on time this morning so we were able to get to church on time. This afternoon we just took naps as we were all tired. I did watch part of the Lakers demolition of the Spurs this afternoon but also slept through some of it. Sunday afternoon naps are wonderful and getting to sleep in tomorrow morning will also be wonderful. Stacey has a friend spending the night with her tonight. They are sleeping outside in the tent rather than in the house. It will be colder tonight but they each have two sleeping bags to keep warm. We are keeping the dogs inside tonight so we will not be awakened by barking again. Stephen is spending the night with a friend tonight whose mother is going to take he and his friend to a guitar shop in Portland tomorrow to look at guitars. Stephen has some money burning a hole in his pocket now since he sold his Honda Spree motor scooter Saturday. He has plans to buy a new guitar with it but we will see if he can find what he wants for the money he has. At least it should be quieter around here tonight. See you tomorrow.
