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Doctor: What’s In A Name?

My friend and fellow blogger David Kroll just wrote an interesting post about the use of “doctor” as a title for a wide range of expertise, including medical. The discussion reminded me of the usual misunderstandings associated with my title…

Typical Val conversation with lay strangers:

Dr. Val: “Hello, I’m Dr. Jones…”

Person: “Oh, hi Dr. Jones. What kind of doctor are you?”

Dr. Val: “A medical doctor.”

Person: “Oh, so you’re like, a pediatrician?”

Dr. Val: “No, my specialty is rehabilitation medicine.”

Person: “Oh, my uncle has a drug problem. He’s been in and out of rehab for years. I’m so glad that there are people like you willing to help addicts.”

Dr. Val: “Uh… Well, actually my specialty is focused on physical rehabilitation – like patients with spinal cord injuries, amputations, strokes, car accidents, etc…”

Person: “Oh, so you’re a physical therapist?”

Dr. Val: “No, I’m a physician. But I work closely with physical therapists.”

Person: “So you’re a REAL doctor?”

Dr. Val: “Yes, I went to Columbia Medical School…”

Person: “Well, you don’t LOOK like a doctor.” [See example here]

Dr. Val: “Uh… thanks?”

***

Dr. Val: “Mom, why don’t people believe I’m a medical doctor?”

Dr. Val’s Mother: “Well, you picked an oddball specialty, dear.”

Dr. Val: “What’s oddball about helping the disabled population?”

Dr. Val’s Mother: “Well, you know ‘rehabilitation’ usually conjures up ideas of drug rehab.”

Dr. Val: “Yeah, my specialty has the weakest PR in all of medicine. Nobody knows what we do.”

Dr. Val’s Mother: “At least people don’t think you’re a hypnotist.”

Dr. Val: “What?”

Dr. Val’s Mother: “Did I ever tell you about the time I was on an elevator with someone at a Spanish literature convention?”

Dr. Val: “Uh…”

Dr. Val’s Mother: “My tag said ‘Dr. Sonia Jones, member of the American Association of Hispanists.’ A woman in the elevator with me was staring at my name tag and finally blurted: ‘Are you here with the convention?’ And I said, ‘yes.’ And then she responded: ‘Could you hypnotize me too?!'”

Dr. Val’s Inaugural Photos

Today I live-blogged the inauguration via Twitter. Thanks for all of you who followed my personal anecdotes and to those who felt it was TMI, sorry. I chatted about everything from Susan Sarandon’s Visine addiction, to police security instructions, to a near fight that broke out in a group of cold and frustrated people who weren’t allowed onto the parade route. And best of all, I speculated as to whether there may be an official “inaugural pooper scooper” to clean up after the horses in the parade.

I promised the folks on Twitter that I’d have photos on my blog later today. So here they are. Photo 1 was taken of me and my “peeps” in our parade perch at 601 Pennsylvania Avenue (thank you, AHIP). The rest are pretty self explanatory. It was a really fun and momentous occasion.

Having A Ball: Kentucky Style

I’m writing this post mostly to embarrass my girlfriend Gwen Mayes, but also because I’m mentally exhausted from preparing Grand Rounds for publication tomorrow, and thought I’d engage in some frivolity.

Gwen and her friend Scott are pictured here en route to the Kentucky Inaugural Ball in Washington, DC. Most states are hosting their own celebratory ball tonight – and Kentucky’s Bluegrass Ball won an “Editor’s Pick” from the Washington Post. It’s one of the largest and best balls, and I suppose that makes sense if one assumes that southerners do this kind of thing well (I lived in Texas for four years, so I’m allowed to joke about that).

The Bluegrass Ball has some predictable highlights, including the “Kentucky Bourbon Trail” sponsored by the Kentucky Distillers Association, and a guest list that includes everyone from Governor Steven Beshear and Senate Republican Leader Mitch McConnell to the band “Joey and the Cruisers.” What I did not expect, however, was that the caterer for the event would import “720 heads of Bibb lettuce” as part of a “Kentucky-friendly menu.” I soon learned that Bibb lettuce was first cultivated in Kentucky by Jack Bibb in the late 19th Century. Am I the only person who didn’t know this?

I’ll be attending a few events on Pennsylvania Avenue tomorrow during the inauguration day parade. Gwen and Scott will be spending the night at my place – and I can only hope that they bring me back a goodie bag filled with Kentucky goodness – especially the Bibb lettuce.

Addendum: My friends make a b-line for the Maker’s Mark booth…


And here they are horsing around:



And no, they didn’t bring me any Bibb lettuce back from the ball (dang it)… just a floral arrangement they picked up from some guy in the subway who was returning home from the Indiana Ball. Oh… and some Maker’s Mark.

Cute Kid And Animal Photos

My brother-in-law is a police sargeant and amateur photographer. His wife is an elephant keeper. Chuck took a headshot of me in the past, and I just couldn’t resist sharing some of his recent work with you. Which one do you like best?

My 85-Year-Old Eye: Dr. Val Goes To The Ophthalmologist

Fortunately for me, my recent brush with the healthcare system was not as frightening as Dr. Dappen’s (he blogs here every Wednesday and recently had a mild heart attack). However, it was provided me with some amusing blog fodder.

Last week I was minding my own business, planning to purchase a new batch of contact lenses from a local optometrist, when I was required (under threat of withholding my lenses) to undergo a vision exam. Much to my disappointment, my right eye was not behaving itself, and refused to correct to 20/20 despite a good deal of lens fiddling on the part of the doctor. A slit lamp retinal evaluation followed, and the optometrist concluded that my right eye’s macula “looked like an 85-year-old’s.”

Well, that was not the most welcome of observations. I asked for the differential diagnosis (being that I’m quite a few years away from 85) and wondered how I’d developed macular degernation. He suggested that it could also be a “central serous” which is (apparently) a stress-related swelling of the macula that requires no treatment and usually resolves on its own.

“So basically you’re saying that my eye could be ‘bugging out’ because of stress.” I said. “And you’d like me to see an ophthalmologist just in case it’s something worse and equally untreatable?”

“Right.”

So I made an appointment with a local ophthalmologist – one of the few working on Christmas Eve – and was sorry to have him confirm that there was indeed something wrong with my retina.  He even ordered an eye angiogram (I didn’t know those existed, but it makes perfect sense) and I was injected with a vegetable dye. Photographs were taken through my dilated pupils at regular intervals as the dye wound its way through my retinal vasculature.

“It’s not a central serous.” He said with a serious tone. “And you can see the macular defect here on this photograph.”

“So my right eye is like an 85-year-old’s?” I asked, wondering how I’d been so fortunate to have one part of my body on the aging fast-track.

“Well, not exactly. I think it’s unlikely to be age-related macular degeneration. You probably have retinal thinning caused by your nearsightedness.”

“You mean all that straining to see the chalk board wore out my retina?”

“No. What I mean is that your eye is supposed to be shaped like a baseball, but yours is an egg shape. So your retina is stretched thin and is starting to wear in your macula area.”

“Well can you suck out some of the vitreous gel and shape my egg back into a baseball?”

“No. Unfortunately that doesn’t work.”

“How do you know?”

“The Russians tried it in the 1960s.”

“Ok, well how do I take some of the tension off my stretched out retina?”

“You can’t.”

“Well if I lose weight or eat carrots or exercise, or stop wearing contacts, or get lasik… would any of that help?”

“No.”

“So there’s nothing I can do to prevent further damage, and nothing to repair or treat it.”

“Right.”

Pause.

“I don’t like this condition.”

“Well, you’ll have to come and see me once a year so I can monitor the progression. Sometimes the body responds to the retinal damage by growing blood vessels in the area, and that can cause further visual deficits. But we can zap those new vessels with a laser and decrease the damage.”

“So my eye might overgrow with blood vessels like weeds in a garden.”

“It might. But it also may stay exactly the same for the rest of your life.”

“Well, the uncertainty is anxiety-provoking.”

“I’ll see you in a year. You’ll probably be fine. Don’t worry. Oh, and if you see any ‘floaters’ or flashes of light, come in to see me immediately.”

“What would that indicate?”

“A retinal tear that would need laser therapy right away. People with thin retinas can have spontaneous tears. Just keep that in mind.”

“Um… ok.” I said, smiling feebly.

So here I am, with one wonky eye, not knowing if it will get worse or remain the same indefinitely. There’s nothing I can do but watch the progression once a year with an ophthalmologist. Like so many patients, I’m in a gray zone where prognostication is a challenge and reversal of disease is not possible.  I have one 85- year-old eye. May it bring me wisdom, courage, and more empathy for patients.

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