Resident Wife

To Change a Lightbulb

It should be such a simple thing. I’m not inept around the house. I have my own tools, and did a lot of the work here at DIY Palace. The point is not that I can’t change a lightbulb, but that it’s way more of an arse-pain than it has to be.

Even with my (lack of) height, I can usually just stand on a stool and be done with it. But the unrenovated rooms still have 9-foot ceilings, and a household stepstool just won’t put me high enough to get leverage to take off the fixtures. So out comes the dreaded ladder. I have a bad history with ladders. Just dragging it up the rickety, narrow cellar stairs is no picnic, and I always feel unsteady above the second rung.

Why not jusk ask my husband? He’s considerate by nature, and at his height, 9-foot ceilings are no big deal. (He’s so bored by "How tall are you?" that he wants to start giving the answer in cubits or hands.) But I don’t want him to do it. It’s more than not wanting to bother him when he’s postcall or just plain tired. It’s about keeping my independence. I don’t want to give in to joint pain, and I hate feeling thwarted or helpless. So sheer bloody-mindedness leaves me twitching like Chief Inspector Dreyfus and muttering "It’s just a damn bulb! Why is this such a pain in the arse? Why am I so damn short? This house is falling apart, blah blah blah."

But it beats sitting in the dark.

Unintended Consequences: FYBIGMR Revisited

(To my non-medical readers: FYBIGMR ("F$%! You, Buddy, I Got My Residency!") is the party where medical students either celebrate getting the residencies they wanted or drown their sorrows over a disappointing placement. I also think it's an apt summary of the attitude that develops over years of dehumanizing training.)

Over the weekend, I talked to a couple of junior residents in my husband's program. These guys are PGY2, so they'll do their entire residencies under the new regulations. But both reported being treated like shit, working 100-hour weeks, and not learning very much during the preliminary/transitional year. The prevailing attitude was that "they won't be here next year, so let's squeeze them for all they're worth."

Neither of them made a report to the ACGME, figuring that it was an exercise in futility. Maybe it would have been, but then again, maybe not. Transitional residents may not be around long enough to see the smackdown, but it's still worth initiating. Why let yourself be treated like shit for an entire year? Why not help the transitionals who come after you?

I understand the reluctance of categorical residents (especially foreign medical grads) to risk shutting down their own programs by reporting violations. As much as residency sucks, having your program shut down after your first year would suck too. Remember, though, that while you may not want to report violations, somebody else with less to lose might. For example, an ER resident may rotate through a SICU that's run by surgeons who don't give a damn about the regulations. That ER resident probably won't give a damn if the surgical residencies get sanctioned by the ACGME. Or a fed-up resident in his last year may want to stick it to the rat-bastard attending who's been making his life hell for years. If the hospital is due for an ACGME visit anyway, one squeaky wheel might get all of GME investigated.

It's been more than a year since the regulations went into effect; some hospitals have made improvements, but there are are plenty out there that won't react unless their feet are held to the fire. The good news is that an ACGME site visit is sometimes enough to rein in egregious abuses. Sadly, though, variants of FYBIGMR may end up pitting residents against each other. ("F$%! You, Buddy, I'm Out of Here," and "F$%! You, Buddy, This Ain't My Department.") That's the last thing people need in such a stressful environment. It'll be years before the kinks are worked out. I keep telling myself "Progress, not perfection," but I'm impatient by nature, especially when people I care about are getting shafted.

Heard the New One About Teresa?

Is this the health care plan only an idiot would fail to support?

Kerry says he wants to help more businesses offer health care by requiring the government to pick up 75 percent of catastrophic health care costs, a plan the campaign estimates will lower premiums 10 percent on average. He would give small businesses a tax credit to help employers bear the rising cost of health insurance.

And how much will this premium-lowering plan raise everyone's taxes? (Where does he think the government's money comes from?) Kerry seems to feel pretty damned generous with other people's money; let him fund this bloody boondoggle out of his own pocket.

Seriously, though, government funding and tax breaks for businesses are not the answer.

Right now, if your employer buys health coverage for you, you get the benefits absolutely free of state and federal income and payroll taxes, without limit. But if you must pay for your own health insurance, you get no tax break at all. Every penny is paid with after-tax dollars, which means most people have to earn about $7,000 just to pay for a $4,000 insurance policy. If workers without job-based insurance were treated the same as workers who get coverage through their jobs, the effective cost of coverage would be cut nearly in half, allowing many millions of the currently uninsured to get health insurance.

But that's not all from the Kerrys' Better Living Through Big Government agenda. (Thanks to Galen, again.) A Department of Wellness? Good Lord. Every charlatan who couldn't get into a Mexican podiatry school will be trying to feed at that trough, claiming that we can achieve "wellness" if we put positive ions in our soup by wearing silly hats and yelling "Booga Booga".

I'm appointing myself Mistress of Wellness. Now grovel at my feet, worm, and I'll enlighten you. (Whoops, got a little carried away....) Anyway: Eat less. Move more. Don't smoke. Drink in moderation. Now where's my six-figure paycheck?

Disclaimer below

Hello, Pot?

It's Kettle. You're black! Surprise, surprise. The liberals are up in arms because Lieutenant Governor Kerry Healy pointed out that John Kerry presided over an economic disaster when he held the same office from 1982-1984 and has had his thumb up his ass for the last 20 years as a Senator. The whining begins:

''Given George Bush's record of failure on the economy, I can understand why the Republicans would like to drag out anyone else's record other than John Kerry's,'' Meehan said. ''Republicans would like to go back and run against someone from the 1980s. It's easier to fight old historic battles.''

Old historic battles? Did you know Kerry fought in Vietnam?

Why, why, why do I read the Bleeding-Heart Pinko Times Boston Globe? Is this some kind of recovering-Catholic self-flagellation thing? I have to stop doing this to myself, because the next one is a humdinger.

"We are a little bit fed up with the hypocrisy coming out of the governor's office about John Kerry and his record and what he has done for Massachusetts lately," US Representative Michael Capuano, a Democrat from Somerville, said at a State House press conference.

Romney and his lieutenant governor, Kerry Healey, have led the attack on Kerry's attendance record, saying he has neglected his duty to the people of Massachusetts by missing over 80 percent of the Senate roll calls this year as he campaigns for the presidency.

Eric Fehrnstrom, the governor's director of communications, dismissed the Democrats' charges, saying Romney has worked hard at his job and has accomplished significant reforms and fiscal successes....

Capuano, speaking for the state party, pointed to a Globe article this week that reported that Romney has been at the State House only seven of the 22 working days in August. (Note to Mr. Capuano: seven days out of 22 is an absence rate of 68%, which is less than 80%. Count it out on your fingers; I'll wait. And Romney is not even drawing a salary, as opposed to Kerry, who is still collecting a paycheck while not showing up. Try that in the Dreaded Private Sector and see what happens. How 'bout some sauce for your gander, Mr. Capuano?)

The governor's aggressive move onto the national political stage, which began earlier this year with his opposition to the legalization of gay marriage in Massachusetts, has fueled speculation that he is positioning himself to run for president in 2008 and that he may not seek a second gubernatorial term in 2006. (Sure you don't want some sauce? You can save some for later when you have to eat crow....) His national political activities have also prompted sharp attacks from Bay State Democrats, who argue that the governor's embrace of Bush campaign attempts to undermine Kerry's candidacy works against Massachusetts' interests....

Fehrnstrom said Romney supports the president's reelection because he believes Bush's leadership on terrorism and the national economy is better for the nation and the state. "Only in Massachusetts is it considered a crime for a Republican to support another Republican," he said.

I have a headache now. Ugh.