Patients, I love them, but they can drive me crazy some times. It’s okay, it’s my job to deal with it, and I’m sure I’m not always easy, but I’d like to take a minute to share a couple of pet peeves/misunderstandings. Try to avoid them, and you’ll make your doctor ever so much happier.
1. Please don’t talk when my stethoscope is on your chest. This isn’t some paternalistic, old-school medicine tradition that’s disenfranchising patients – it’s simple courtesy. A stethoscope is an amplifier, which is what allows me to hear your heart sounds. However, when you talk, that gets amplified too, and, not only can I not hear your heart, it also feels like you’re screaming in my ear. Not fun.
2. If you are on multiple daily medications, you DO have chronic health problems. 9/10 times when I ask someone if they have chronic health problems, they say no. Then I ask why they’re on insulin and anti-hypertensives and have a sternotomy scar on their chest. I don’t understand what people think chronic health problems are, but here’s a basic definition: if you have impaired function of one of your main systems (breathing, eating, circulation…), even if it is adequately treated, that’s a chronic problem. I’d like to know about it since it changes my management. Also, as a side note, if you were diagnosed with hypertension, prescribed hypertension medication, but didn’t take it because you “feel” like you don’t have hypertension, alas, you are probably wrong. There’s a reason they call it the silent killer.
3. If you are sexually active and not using protection, you are trying to get pregnant. This I don’t blame on patients, but on inadequate sex education. Most of the time when I ask young women if there’s a chance they could be pregnant they say no. All too often, however, further clarification reveals that they are getting it on regularly, never use condoms, aren’t on the pill, but “I don’t know, I just think I couldn’t be pregnant.” Yes, you could. I’m not judging, but again, this is important information to know because I don’t want to give you medications that will lead to a flipper baby, or miss one of the potentially life-threatening complications of pregnancy.
4. If you just want a pregnancy test, let me know. Sure, you could come up with an elaborate story about lower abdominal cramps, white discharge, spotting.. And, if you’re actually experiencing those things I do want to know. However, if you just want a pregnancy test, we can save you a blood draw, me and you time, and the over-burdened health care some money if you let me know so I can just order the urine test and call it a day instead of working you up for abdominal pain/STI/pregnancy/UTI/etc.
5. The pregnancy test in the ED are exactly the same ones as in the drugstore. Seriously, no difference except we buy them in bulk, and visiting us to get one involves a several hundred dollar facility fee. If you can find enough money to get one at the drugstore (DollarLand even has them sometimes), you can avoid 3+ hours in the waiting room.
Really, the first one is the most important – obviously I’ve worked out my own way of dealing with the last 4.
Guys, it’s getting hot here! Way too hot for curries and the like. That’s why you have to squeeze this recipe in on one of those last cool days, when it rains, and the sun is behind clouds, and the evening still has enough bite to warrant a light sweater.
This is an Ecuadorian fish curry, which means it isn’t particularly spicy but wrings a lot of full flavor out of some simple and very affordable ingredients. It’s minimally adapted from an excellent Ecuadorian food blog.
First, we start with a marinade for our fish.
I like to use cod because it’s inexpensive, easy to find, and is amenable to being cut into big chunks.
If desired, while the fish is marinating, we can start our bonus accompaniment, patacones! Recipe coming soon…
Next we assemble the curry ingredients
and go on a chopping spree! I slay myself, really. You may be wondering how I managed to get married with a sense of humor this immature – the answer is that his is only minimally more adult.
Incidentally the jalapenos were not in the original recipe and can be left out, but I wanted to add just a touch of heat. Rest assured, the coconut milk kills most of the picante nature of the jalapenos so the curry is still mild, but they can be replaced with additional bell pepper if desired.
After all the vegetables get a nice saute, the coconut milk is added.
Fish goes in, everything cooks, and, eh voila, you end up with a not 100% aesthetically pleasing, but decidedly delicious bowl of comfort.
Hobo cat is a fan, as seen in this image of him caught in the act of attempting to steal dinner.
- 2 limes, juiced
- 1/2 cup orange juice (or juice from 2 oranges)
- 4 garlic cloves, crushed
- 1 teaspoon cumin
- 1 teaspoon coriander
- 1/2 teaspoon smoked paprika
- 1 1/2 lbs cod or other mild white fish, cut into large pieces
- 2 tablespoons olive oil
- 1 medium onion, diced
- 2 roma tomatoes, diced
- 1 1/2 red bell peppers, diced
- 2 jalapenos, diced (or an addition 1/2 red bell pepper)
- 14 oz coconut milk
- Mix the orange and lime juices with the garlic, cumin, coriander, and paprika. Add the fish, stir to coat, and set aside.
- Heat the oil over medium in a large pot. Add the tomato, onion, bell pepper, and jalapeno and saute until the onions are translucent (about 8 minutes), stirring frequently.
- Add the coconut milk and cook until slightly thickened, about 8 minutes. Salt to taste.
- Remove the cod from the marinade (no need to rinse it) and add it to the curry. Cover partially and cook, stirring occasionally, about 15 minutes. Check the fish for doneness - it should flake easily.
- Serve over rice with cilantro and patacones to garnish.