Monthly Archives: June 2009

Jun29

No one told us it was Gay Pride!

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No one told us it was Gay Pride!

My friend and I moved out of my office today. We had planned it a week earlier, not knowing that the Gay Pride parade would be occuring on Fifth Avenue, where I work. Needless to say, it was hectic, being bombarded and surrounded by colorful characters, some barely clothed, doing erotic gyrations with their pelvis, Like a Virgin blasting in the background.

Amongst the chaos, were me and my friend, moving my stuff out, mostly heaped on top of a big rolling cart to my car parked on 22nd St. between Broadway and Park Ave. We would have to dodge the barely clothed guys handing out condoms on the street just to get to the corner. Fortunately, my friend is very attractive, so she caught the eye of one of New York’s finest and he cleared a path for us. Thank goodness for beauty. I prayed with each run back and forth from the car, that the policeman would make a special path for us, but it was only a one timer. *&@$!

I was sweating bullets and I had a craving for a tall glass of ginger ale with ice. I was dreaming of one. Neither my friend and I initially realized that parking is free on Sundays. Duh. Until a nice elderly gentleman strolled by while I was coming up with schemes to get as many quarters as possible. I actually lied to a nice bartender (never mind what I told him), and he felt so badly, that he gave me (for free) $1.50 in quarters. 

Aleyda and  I made three separate trips. Finally clearing most of the stuff out of the office. I have two more days in the Fifth Ave. office and I only have my laptop, portable printer, iPod dock (I can’t work without music), basic medical supplies, stethescope, centrifuge and vaccines. Which reminds me, I need to buy a refrigerator/freezer.

I came home, with my car full, realizing I need to get storage space. I am becoming more and more of a pat rack, which is very unbecoming. I set a space up for myself in Hoboken and bought some supplies online. Then I took a warm shower and ate Indian food leftovers.

I’m so tired, so sore, so achy. But I feel good. And when I finally sort through the mess, I’ve also hired Man With Van to pick everything up and bring it to the new office. Aleyda is an angel, and with my busted arm, I can’t carry and lift the way I used to, but there’s no way I can expect her (or me) to do any more heavy work.

Broadway, here we come!

Jun28

A stubborn mule rambling towards Jackson, NJ

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A stubborn mule rambling towards Jackson, NJ

Prior to today, I used to believe that my father was the most stubborn person that I know. I think I took his crown. I made an impromptu trip to the Jersey Shore, in desperate search of a massage. I rambled on down the turnpike and realized that I had no caffeine in my system. I made a pitstop at the Dunkin Donuts and realized that I had made a big mistake. Cars were parked helter-skelter. Three of the cars were having difficulty getting out. I was the only driver that pulled in. One of the cars just pulled right up to me and the driver (and her husband) kept gesturing that I should be the one to pull out.

***

Stubborn, stubborn as a mule they say. I refused to budge. Why should I have to move? I was not going to pull my car out into possible oncoming traffic. I just sat there and waited for them to move. The woman was shouting, and I might have stuck my middle finger up at her, but I really didn’t care. I was not going to move, not for any particular reason, but just because I wouldn’t.

***

I continued my sojourn towards the Shore Points, listening to KISS FM’s homage to Michael Jackson. And then suddenly I realized, my GPS had randomly picked Jackson, NJ as my endpoint. I listened to MJ’s voice in the car, turning up the volume when Billie Jean came on, which caused me to miss the sign for the Garden State Parkway taking me 15 miles away from where I needed to be.

***

I thought about my stubborness. Nothing new. Was born like this. But I have now surpassed my father, which is really intense. And then the words played on the speaker…If they say why, why? Tell ‘em that it’s human nature…

The songs and the massage gave me the forgiveness that I needed. It’s not a huge chance that I’m going to stop being stubborn, but I’ll try to keep it more in check.

Jun27

Type A+ personality

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Type A+ personality

I’m the first to admit that I have a Type A personality. As I get older (and hopefully wiser), I strive to get a lesser grade, maybe a Type A- or B+ personality. This is in stark contrast to most of my academic life where I was always an achiever.

I think this week, I definitely pushed myself up to a Type A+ personality. Moving offices, coordinating things for a new employee, making huge purchases, all of this has spelled STRESS. This has been a balancing act between taking care of patients. This week I had HAD IT.

I’m not proud of some of the things that happened: I blew a gasket. There were a number of expletives hurled at a pharmacist and a statement made of “I HAVE HAD IT, I AM DONE” directed toward an otherwise great patient who was involved in the pharmacy situation. Funny thing is, both ended up apologizing to me, and even though I am no longer angry at either of them, I still feel that I have had enough. And for some reason, even though I yelled at both of them, I have not apologized for it.

These are the pains of a growing medical practice. Nobody ever tells you about the day-to-day raw emotions. When I have spoken with other doctor-entrepreneurs, I get blanket statements like “Year 5, you’ll be fine”. But what happens on Day 268 of Year 4? I don’t even know what day of Year 3 I am in so I just randomly picked that time point. How does an expanding practice make you FEEL? I would like to know the answer to that question from an expert.

I came back to work today, feeling exhausted. The trigger points in my neck have acted up and the one in the middle of my left trapezius is just acting like an angry gnome.  In the morning I  waited to hear from my parents regarding some health issues, and didn’t want them to call when I was underground traveling. I made it late to work to a fully booked day. I ran into some red tape regarding some insurance bureaucracy that could have been avoided had the person returned my three messages, but of course, she hadn’t. I just didn’t have the energy to blow another gasket. This is probably a good thing.

Learning point taking the fork to a B+ personality: Let it go. I can’t control everything. Mistakes will happen. I will once in a while blow a gasket because I really want my patients to get the best medical care and I’m such a perfectionist. Get a hot stone massage on Saturday for 2 hours. Breathe.

Jun25

Michael Jackson was my childhood

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Michael Jackson was my childhood

Michael Jackson was strange, unhealthily strange.

But his music defined my adolescence and college years. My 20th high school reunion is this weekend, but somehow, my spirit is now low and I don’t know if I want to go.

Thriller…Billie Jean…Beat It…Human Nature.

I remember those lonely high school days when I felt so left out. I would come back home and play Ben on the piano and sing,

Ben, the two of us need look no more
We both found what we were looking for
With a friend to call my own
I’ll never be alone
And you my friend will see
You’ve got a friend in me

Ben, you’re always running here and there
(Here and there)
You feel you’re not wanted anywhere
(Anywhere)
If you ever look behind
And don’t like what you find
There’s something you should know
You’ve got a place to go
(You’ve got a place to go)

Never mind that Ben was a rat. It was about the music, soul and feeling.

So, when I think about Michael Jackson, I think about staying up at all hours of the night in college waxing poetic with John, mixed tapes, making bizarre dance moves with my sister at strange Indian dance parties, desperately trying to do the Moondance and convincing others that I did it right, thinking about the sadness and happiness in my life.

Rest in Peace M.J.

Jun24

Doctors are not the bad guys

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Doctors are not the bad guys

A patient came to see me for a “well visit” and one of the issues that came up was tobacco cessation. After dealing with a few patients who came in for similar reasons, I have decided not to code for tobacco cessation visit, unless I specifically know that the payor covers it or if the patient has Medicare.

I prescribed Zyban, which was not covered. Initially, the pharmacy and I were told that it was “non-formulary” . I switched to Wellbutrin SR and was subsequently told I needed to get prior authorization for the patient. Before going through the hurdles, I had already realized that the patient probably had no coverage for smoking cessation, but I could technically get the medication covered for behavioral health reasons. Of course, this is what turned out to be the case.

The patient requested that I get the medication authorized again for behavioral health reasons, she was informed by her insurance that they would cover it. I told her no. My reasons? Heaven forbid she has a seizure or some other adverse reaction to the medication, then some sleazy lawyer and subsequently her insurance company would be all over me for “authorizing a medication under false pretenses”.

It’s just a shame that we, as caring providers, have to jump through these hoops and end up being scapegoated. The patient probably thinks that I’m just being difficult, but in reality, I am just protecting myself. The issue, dear patient, is not with me, but the coverage that your insurance provides. Without putting too much blame on the patient (this is more about the payors), look into your coverage prior to selecting the package. It’s not always about saving the most premium dollars. You get what you pay for. Before selecing a package, look into the particular coverage and ask which insurances cover it.  For example, if you need counseling, make sure your insurance has good out of network behavioral health benefits. This is especially important in Manhattan, since most therapists don’t accept medical insurance. This way, you will get about 50% back from your insurer.

Jun23

Divantics and literary inspirations at the office

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Divantics and literary inspirations at the office

Meez 3D avatar avatars games

Today was one of those days when I felt truly blessed to be a physician. One of my patients inspired me to start the second chapter in my memoir. For privacy, I won’t yet describe what he had, because the workup is still pending, and I know some of my patients probably read my blog. The ideas just started flowing through the crevices of my brain, almost like they were careening through a river. I could FEEL IT!

Those who know me pretty well, know that I am always listening to music in my room. It can range from Bach to Biggie, but today was definitely a Maroon 5 day for me.  Adam Levine’s sultry voice, reminds me of a polished violin, reverberating with the harmony and melody of This Love. Naturally, I just sing along:

I was so high I did not recognize
The fire burning in her eyes
The chaos that controlled my mind
Whispered goodbye and she got on a plane
Never to return again
But always in my heart

This love has taken its toll on me
She said Goodbye too many times before
And her heart is breaking in front of me
I have no choice cause I won’t say goodbye anymore

When you love music as much as I do, you don’t remember where you are, you just get lost in the words and notes. Imagine yourself surrounded by notes and treble clefs. I had no idea how loud I was singing, or that I was singing at all. It goes in perfect sync with completing patient charts, contacting specialists, insurance companies and pharmacies.

I came out of my office and was greeted by a waiting room full of patients and two receptionists who had the same goofy toothy grin on their faces. “What?”, I asked. “You really like Maroon 5 don’t you?”, asked one receptionist. Suddenly it became clear! The waiting room, my patients,  had heard me singing. “Oh my God!”, I exclaimed. I don’t know if I ever visibly blush, but I could certainly feel the blood rushing to my cheeks. “Oh no Doc, you were in perfect tune, it was actually good!”, said the other receptionist. I looked at the patients, and they still had the wide grins, some nodding their heads in agreement.

After I got over the embarrassment, I started feeling thankful.  This morning I had some literary inspirations from a patient, and in the afternoon, I was allowed to be the true diva that I am.

:)

Jun19

Happy Birthday Soma Says!

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Happy Birthday Soma Says!

I started my blog on June 19, 2008, Juneteenth, as pointed out by my friend Pamela Wible, who commented last year:

“You started your blog on an auspicious day. Your first post was on “Juneteenth” which celebrates freedom and emancipation. It commemorates the announcement of the abolition of slavery in Galveston, Texas on June 19, 1865. Congratulations! You have recaptured your creative force and you are free to be everything you ever wanted to be and more…”

Thanks Pamela!

Acoording to juneteenth.com, Juneteenth emphasizes education and achievement. It’s a time for reflection, rejoicing, assessment, self-improvement, and planning for the future.

Writing has allowed me to recapture my creativity, imagination and spirit. I didn’t realize that starting my blog on this special day would be so liberating and exhilerating.

Here’s to the creative spirit in all of us!