Tongue Depressors and Depressing Tongues

Over the recent month of Family Medicine, quite a bit has been made of the need for us to have conversations with our patients concerning their diet and tobacco smoking habits. As a Minnesotan, I was shall-we-say less exposed to the ailments of smokers than most. If I am not mistaken, they have banned the activity in public indoor spaces and pushed most cigarette sales into the tiny, poorly-lit part of gas stations. Down here in the south however – It’s pretty pervasive, as are its effects.

They teach us not to react to the amount patients smoke, not to speak condescendingly, or remain overly fixated on the effect it has on their children. A conversation with a state representative revealed that libertarianism runs so deep in the south that they believe no law should exist that bans families from smoking in the car with confined kids. As you can imagine, I was crushed to examine the mouths of a couple kids in this rural clinic to see that they’d had some pretty extensive dental decay, multiple extractions, and visible tar on their tongues.

It’s rough out here in rural America. Even rougher if your parents decide that your lungs aren’t worth the pain of breaking away from an addiction.

The flipside. I had a mother tell me that she quit smoking (Like a G.) As soon as she received a positive pregnancy test.
Boom – Just like that. A doctor told her that smoking increased the chances of a premature pregnancy…and she tossed the habit like a dirty vacuum bag.

Her kid looks like it. Happy, energized, and maybe just a little too curious about my examination of his ears. We discussed the teenage mutant ninja turtles (donatello is our shared favorite), and as I examined his oral cavity with the tongue depressor the poor guy burped, gurgled a bit, and threw up…

I’ve never laughed harder. Hearing that his mom quit smoking before his birth made everything that followed look, sound, and smell wonderful. He was a great sport about it too…and seemed awfully concerned about my white coat. There was no need, I dodged that flying fluid like Neo in the Matrix.

Medical education is crazy. In one day you can see a best and worst case scenario and experience helplessness while realizing your power all in an hour.


These are a few of my favorite things…

Like most families, my Winter/Christmas traditions have often included that same album of Christmas jazz that never made it out of the CD changer, and that aging copy of “The Sound of Music” that keeps making it back (despite multiple conversions) into rotation on network television. But as this new year prepares to turn, I’ve noticed the dawn of some truly exciting changes in my study of medicine and the overall practice of healthcare. I will write about them in my next post. For now, I will break down a more appropriate series of thoughts.

Raindrops on Roses)
Freezing rain here in TN. MSU is going to the Rose Bowl. and this year I discovered – the single greatest thing to happen to long-distance-boyfriends in need of an “I love you” gift. $40 bucks for two dozen roses? ($30 with a coupon? dear sweet Lord yes!)

Whiskers on Kittens)
I NEVER recommend cat videos….except for this one. (Trust me, you’ll appreciate the level of awesome so-sufficient that I felt the need to share.)
Corridordigital Kittens on the Beat

Bright Copper Kettles)
Rediscovered the power of the french press this year! My favorite combination thus far has been raw ginger, peach tea, and whatever crumbs of earl-grey I can pull from the bottom of the can.

(&) Warm woolen mittens:
Bought my first pair of gloves since leaving MN.
Haven’t used them.
Instead – I’ve been wearing a pair of fingerless mitts that make me look like the artful dodger.

Brown Paper Packages (tied up with string) :
Lost it a bit on Black Friday…and yet never left my house. I’m not a retail guy….too much of that stuff can be found on Ebay/Craigslist, but the occasional pair of kente socks, or the keyboard to your tablet….those benefit immensely from 50% off. Besides…NPR just reported that for the 5th year in a row, the discounts deepened, but the profit margins stayed the same…and yet, in store shopping experienced a 20% decline. (Something is fishy about the pricing schemes here)

yes….these are a few of my favorite things.

Cream Colored ponies
Seems like as good a time as any to talk about my new stylus!
purchased one of those fancy “pencil”s by the company “fiftythree” known for their app “paper”
It’s awesome.

Crisp apple strudel:
Had to advise a patient that pop-tarts shouldn’t be part of their kid’s balanced breakfast. It tore me up inside given how much I loved pillsbury’s toaster’s strudel. It seems a season has ended in my life, and the one that followed left no room for sugary sweets.

Over the course of family medicine, i’ve been assigned to a rural post….2.5 hours out of town. As such, two days weekly – I show up to my professor’s apartment at 7:45 AM and we drive in his (Sleigh-like) Range Rover all the way to Tullahoma TN…a place so rural that Santa probably sends his gifts via Amazon like the rest of us.

& Schnitzel w/ noodles:

Wild geese that fly (with the moon on their wings:
Let’s take a moment to talk about how glad I am that these birds are gone…because parking under trees in this state had become a bit hazardous…you leave your black sedan and return to find it a white-speckled shell of it’s former prom-bound glory.

Girls in white Dresses w/ blue satin sashes:
Duke lost that game to FSU…so I doubt anyone is currently wearing white and blue.
P.S – to all those whose weddings I missed this year congratulations…I couldn’t be happier for you.

Snowflakes that stay on my nose and eyelashes:
Can we talk about the fact that TN closes its schools a day in advance because of the THREAT of freezing rain?
not the presence of 15 inches of snow that morning w/ a layer of ice underneath it NooOOOoo…..Over here, they shut you down because the weatherman got nervous.

Silver White Winters that melt into springs:
It’s right about this time of year that I actually do miss Minnesota. In the winter, River Road along the Mississippi at 7:00 AM is among this world’s most beautiful sights. Snow caked on the branches of trees turns one whole side of the world into a white canvas, dotted lightly with stubborn evergreens.

When the Dog Bites:
A classmate of mine has adopted a pet Chihuahua (despite a no-pet policy in the campus apartment) and has been leaving poo-bombs all over the apartment lawn. Well today, THEY FINALLY NAILED THAT B’…..wait…uh..that female dog. I can see how you’d get confused though.

When the Bee Stings:
Health Biz Decoded – 3D printing in Healthcare
I wanted to badly to share this…and I didnt know where to put it.

When i’m feeling sad:
The Passing of Mandela was a loss for which this world could never prepare itself. But let it be known, I do not mourn the death of those that live to 95. I celebrate their life. If anywhere you hear that Mandela “succumbed” as CNN might have you believe, “call-shenanigans” He didn’t succumb “to nutt’n’ “. Rather when this life was out of challenges for him to beat….he rolled out like a combination of John Wayne and the Terminator of Judgement day with his Peace fingers in the air.

May you have a merry Holiday Season and a Blesse’d Christmas
and remember, you have been apptly chosen.