Thursday, September 22, 2011

Episode 23: Tell Me Sweet Little Lies

The silence in response to my last post was absolutely deafening. To date, I have received zero comments. How could this be? I’ve asked around, I’ve done the math, and I have a few explanations. 1. “This is what happens when you don’t post regularly.” True. Although I still have readers (unless all those hits are me, a possibility that I’m not totally ruling out), it does seem that I’ve lost a good percentage of my following by not posting regularly this summer. 2. The second, scarier, but probably more likely reason that the comments have fallen off so precipitously: “Uh..it wasn’t your best work.”

This second answer was not much better than the response I got after a night of disastrous Karaoke in 2007You can read all about it, but to sum up: After I performed what was the most unfortunate karaoke number in the history of really bad lesbian bars (and people, that is saying something), I confronted my "friends" for failing to support my (admittedly disastrous, train-wreck, but still my) karaoke effort in any way. I mean, shouldn’t your friends at least clap for you after you went through the trouble to sing in front of an audience of hostile strangers? After a minute or so of awkward silence, one of the group answered with, "Well, I don’t really consider you a friend.” Or something like that. What does this have in common with “Well, it wasn’t your best work?” Both are harsh. And both are probably true.


In my defense, the last episode was nobody’s best work. It rehashed a stale, overdone plotline without including much new material or any good one-liners. It was filler, and it was obvious it was filler, and maybe that led me to be OK with leaving the last entry of this blog as filler, and my readers (note: I am back to calling you readers instead of fans) could smell mediocrity from a mile away. For this, I am sorry. Or maybe I’m not sorry. Although I’m the one watching and writing about these crappy episodes, I’m glad that when the content of the blog is boring or worse, just bad, people don’t waste their time trying to think of something to say. Plus, I know that some of you are really my friends, so much so that you’re kind enough not to say anything when a post just isn’t good. I’ll admit I shouldn’t have put the 9/11 stuff in there. It was cheesy, and I knew it, and I still included it, like I was writing for the New Yorker or something. Maybe instead of bitching about the lack of comments, I should be thanking you for not saying anything mean.

Of course, there is another possibility, one that is some ways much worse: Perhaps I have neglected this blog so terribly and for so long that no one read that last post. It’s clear that we have reached the point of this show where the novelty of my blogging about it has worn off. It’s hard to make fun of the same, dead-end plotlines again and again. Nothing seems to have happened this entire season. Plus, I started this blog because of a breakup, and that breakup is long over. So maybe it’s time to call it a day on the blog. If it’s not making my readers happy, then what’s the point?

And yet…Am I over the breakup? I feel like I am, except in the sense that no one ever TOTALLY gets over a bad breakup-it’s a scar…or maybe more like a tattoo. It’s there. It doesn’t hurt so keenly, but I’m left, staring at the thing, and still wondering about the same thing I was wondering about in March: Am I at risk of just making the same relationship mistakes again and again? Because if so, I need some therapy, or maybe even a miracle cure.

Which brings us to today:

This episode, named after a Fleetwood Mac song, is really all about Cristina Yang, which makes it the best episode I've seen in a long time. As the title would indicate, the theme is:

“Our patients lie to us all the time. The rule is: every patient is a liar until proven honest.”

First, I don’t think this is true. I don’t think my patients are liars. I think patients, for the most part, tell the truth, and I think most doctors would agree with me. The only patients I don’t believe are the patients who have positive tox screens but SWEAR that they don’t do drugs. Liars. Every one. Other than that, do I have any reason to think that you’re lying about your history of hypertension and hypercholesterolemia? No.

“We lie to ourselves because…the truth? The truth freaking hurts.”

There’s a patient who is a guitar player who unfortunately gets his fingers cut off in some sort of stage accident. Even more unfortunate, the only hand surgeon on staff is…?McDreamy?  Even my humanities-oriented girlfriend picked up this. She watched him sewing the guy’s hand and asked, “Isn’t he a brain surgeon?” Why yes. Supposedly. 

Since when is McDreamy a hand surgeon, you ask? I don’t know, but I wouldn’t trust any neurosurgeon to reattach my severed fingers. (Well, I'm really hoping I'll never have to have anything reattached, but you know what i mean)
Alex is taking care of a competitive eater with an esophageal tear, and this inspires a pretty funny hot dog eating contest among Cristina, George, and Alex. Cristina uses the water on the buns trick and wins the contest:

But loses her cookies after the fact:
And this is why we love Sandra Oh! She's hot, and a touch butch, but not so hot that she'll refuse to do this scene or a scene where she stuffs her face with a hot dog.





In other Cristina news, Cristina lied to Burke, telling him she moved in with him when she actually kept her apartment.
Meredith: Truth. Did you move in with Burke or not?
Cristina (sighs): I told him I moved in with him. I’m keeping my old apartment. (Meredith gives her a look) What? I sleep with Burke every night. My clothes are there. So I still have my apartment, big deal.
Meredith: You have to tell him.
Cristina: Actually, I don't.
Meredith: So I’m supposed to go to dinner at your fake apartment with the guy you fake live with?
Cristina: Oh, I would never have you over to dinner with Burke. That’s weird.
Meredith: This is my point. Stop with the lying.
Cristina: And you’re being honest? That last time you called him Mc Dreamy you were all a-twitter with love.
Meredith: We're just friends.
Cristina: Uh huh.
Meredith: We are.

Really, Cristina is having quite an episode:
Cristina is so right: Why is this neurosurgeon always in elevators with interns? Creepy.
Derek: What is your problem? I’m your boss. What’s the matter-
Cristina: No you’re not my boss right now. We’re in an elevator. That’s your specialty, right? McDreamy moments in elevators?
Derek (warningly): Dr. Yang...
Cristina: You know what, for a moment, I’m not Dr. Yang, and you’re not Dr. Shepherd. You’re the guy who screwed up my friend. The guy who drove her to get a dog she can’t keep, a dog she only got because her boyfriend lied to her about his wife.
Derek: I never lied to her.
Cristina: You know what? I know a liar when I see one, ‘cause I’m a liar. Fine you want me to lie to the patient. I’ll lie.

Bailey is having Braxton hicks contractions, leading Addison to tell her to stop working so hard.

There’s a patient who refuses to leave after being discharged:

George: “If she refuses to leave, what am I supposed to do?”
Chief: “She’s 78 and non-ambulatory. You have the upper hand. Use it.”

But George fails to get her out, and when the chief catches him doing her errands,  
George asks: “Have you met Mrs. Larson?”
Chief: “Why do you think she’s been here so long? In a private room? We can’t keep her. Not on the surgical service.”

This inspires George to spend the rest of the episode trying to transfer this patient to another service, an act that is known in medicine as:

The Turf.

The turf has long been touted to interns as one of the keys to success in hospital-based medicine. Learn how to turf your patients to other services and save yourself some pain, says the conventional wisdom. The concept existed before the book House of God, but was no doubt immortalized because of that book. HOG (which contains such “golden” rules as “GOMERs go to ground,” “They can always hurt you more” and “The only good admission is a dead admission”) was only following its own rule (“Rule #5: Placement comes first: Your absolute first question should be: ‘How am I going to TURF this patient?’”) when it provided very specific instructions on the best methods for turfing patients, including raising the bed to heights where your poor, confused aged patient is likely to fall off and experience trauma as a result of the fall. There is “orthopedic height” (Fall and break a hip, get turfed to ortho) and “neurosurgical height” (fall off, head bleed..turf to…well you get it). Of course, these days, patients with these problems stay on the hospitalist service with only the briefest of surgical consults, so such escapades are no longer beneficial to the primary team (and they were, ahem, never beneficial to the patient). More often than not, it’s hospitalists who complain that surgeons turf to medicine. It’s common practice for surgeons to refuse to take a patient onto their service because of “complex medical issues” (i.e., comorbid diabetes or hypertension).  Despite the grumbling about surgeons refusing to care for their patients, however, there is a practical side of this: surgeons are busy operating and taking care of post op patients and they don’t always have the time or knowledge to take care of the medically ill. In fact, I have recommended in my own institution that hospitalists should volunteer to care for most of the patients in the hospital, with surgeons only consulting-which frees the surgeons up to be in the OR. Of course, the danger is that hospitalists end up perennial interns, always taking care of somebody else’s scut and never getting any respect. Plus, I don’t think there’s any way hospitalists would be paid for this service directly-the hospital would have to figure out dollars saved by adding extra surgeries-which they’ll never, ever do. Hospitalists are already criticized for “Not making the hospital any money” and even "costing the health care system too much" (just like palliative care never makes money-until you figure that they talk to families and convince them to take terminal patients off ventilators days, weeks, or even months earlier than if the palliative care team wasn’t there. But nobody ever counts that cost saving as income), so I can’t imagine hospitalists caring for the entire hospital would be a popular option. But it makes clinical and, thinking out of the box, even financial sense.

After multiple TURF attempts, George finally discharges the patient to a nursing home.


There was one pretty good line that I am too PC to ever use but still made me chuckle:

Chief to nurse administrator: “Don’t you speak nurse?”

And, finally, the moral (just to irk those who don't like morals):

“No matter how hard we try to ignore or deny it, eventually the lies fall away, whether we like it or not. But here's the truth about the truth: It hurts. So we lie.”

14 comments:

  1. I liked it, but I'm a little shy to comment due to the fact that english is not my first language.

    You're doing a great job! :D

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  2. Well I just wrote a whole long comment but it wouldn't let me comment using my Blogger ID so I think it all disappeared... Ignore this one if you already got my other comment somehow. I'll attempt to repeat all that I said...

    I read your last blog post and I liked it. I liked the part about 9/11.

    If I could offer you some advice, it's that you need to blog because you enjoy it, and not because you want instant gratification from comments and readers. In order to gain consistent comments/readers, yes, you need to blog consistently. You probably are suffering a little from your hiatus, but I'm sure many people (like me) were looking forward to your return to the blogging world. I hoped that you'd be back.

    I like your blog because I like reading your personal opinions on Grey's, especially because you're a person that hasn't been a fan of the show in the past. I like the show in a guilty-pleasure sort of way, and I like reading your more level-headed opinion on it. Most of all, I like knowing your medical opinion on the show, since you are a real doctor. I like finding out what things aren't plausible and which ones are, and how you would deal with similar situations if they happened in your place of work. I think that you are smart and witty (although you can be a bit egotistical with things like calling readers "fans", but I wouldn't expect anything different from a doctor), and your blog idea is unique and a good idea.

    Just keep up with what you're doing and like I said, the most important thing is to blog because you enjoy it. People like reading genuine posts more than ones that are aiming to please an audience. If you're genuine and honest (as you usually are) in your posts, people will read and comment.

    As for the actual lack-of-comments problem, I think that people may feel that it's not really "worth it" to comment on your blog because a lot of the reason that people comment is so they can participate in conversations within the comment area. With your blog, however, comments can take days to be accepted and show up on the blog, and it's a pain to have to go back through and see if you or anyone has commented on your comment or answered any questions you may have asked.

    Often times people comment because they read something someone else has said and want to put their two-cents in. I once commented to ask you a question, and didn't see that it was answered until days later. Then I noticed that you had answered my question (which is really good), but someone else had written a snarky (almost rude) comment about my question, and it would have been nice to respond to that when it happened. People like to interact with one another in the comments section so I'd suggest either allowing comments to appear without moderation, or moderate the comments more quickly.

    Look at the blog that inspired yours, Lawrence's one on Julie and Julia. There are plenty of posts of his that only have a couple comments, but he keeps on! Keep on, and do it because you enjoy it, and comments will come. We readers are glad you're doing what you're doing! :)

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  3. Hm. There is another possible reason for a lack of comments. Some people, like myself, are in the "lurker" category. While I enjoy reading, I don't feel compelled to comment, particularly when I know there's nothing I could say that would be half as entertaining or interesting as what I'd be commenting on.

    And you are entertaining and interesting, although what I find most interesting is not really the plot deconstruction (not to say that it's not still amusing), but the deconstruction of hospital life from your insider's perspective. Ok, so I don't always completely follow what you say. (I had to look up what a hospitalist was.) But the fact that I'm still checking back here for new posts after all this time should say something.

    That being said, I think the time factor, not a lack of content, is the largest reason for a lack of comments. Let's be honest. You estabished a fairly regular pattern at first, with 6 posts a month for February, March and April. Then there were only two in May, followed by a silence of over three months. Then you again disappeared for another two and a half weeks.

    I understand that you're a busy professional with a life to live, but if you expect a committed readership, you need to exhibit a commitment of your own, even if it's a just a quick post to say "Hey, I'm still here. Life's gotten busy, but I'll be back as soon as I can."

    I do hope you renew your commitment and finish your project because I have enjoyed reading. Just because I don't usually post comments doesn't mean I'm not interested in hearing what you have to say.

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  4. OK! I have a lot to think about:
    1. post comments more quickly or allow immediate posting..which can lead to spam-I've got to think that part over (because SPAM comments are so annoying), but I will definitely try to post comments ASAP.
    2. Post more frequently (This one i know-It was a really crazy summer. Sorry everyone) even if I'm not posting about an episode. Interesting idea about not posting about an episode.
    3. Maybe I'm a little egotistical! If you met me in person you would immediately recognize my air of self confidence overlies deep insecurity and self-doubt, which may be why I"m always looking for positive feedback. Either way it's my issue, not yours, so point taken.
    4. "Be genuine"-so what you're really saying is: "No matter how hard we try to ignore or deny it, eventually the lies fall away, whether we like it or not?" Hmmm..there really IS a moral.

    Thanks to all of you. Very much appreciated.

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  5. I'm definitely a lurker too... I have your blog in my feed reader, so I definitely read everything you write. But that doesn't mean I'm always going to take the time to click over to your blog to leave a comment. I enjoy reading what you write... that doesn't mean I want to turn around and write something for you too.

    I do, however, hope you keep it up. Your insights into the show are great and usually give me a chuckle or two.

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  6. Oh, I am TOTALLY reading. And checking the blog for updates. I didn't think the last post was mediocre at all and that's not just because I was overjoyed that you started blogging again. It's likely that it had been so long and I was so overcome with happiness at your return I was struck dumb (typing dumb?) and unable to post a comment. :)

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  7. You've got it exactly right. :) And hahahahhaa on point #4. I even read it in whatsherface's narration voice.

    And Danny brings a good point- the majority of readers are just "lurkers" that will never comment anyway.

    I have a modest blog and even though I thought I started it "for me" and "for fun" I started feeling pressure to produce good posts and started trying to please my audience (I use tumblr so we have "followers" and "reblogs" and "likes" and comments on each post). I have found that the posts that the most people like and comment on are the ones I thought were stupid personal things that no one would care about and I hesitated even posting.

    I also forgot to add (that I had in my original comment that got lost in the interwebs) that I love your blog so much that I tell my friends about it when someone brings up Grey's Anatomy. You are good at this. I love your intelligent writing style and the way you recap episodes and your professional opinion.

    Keep it up! :)

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  8. thanks all. So so kind. I really appreciate all the feedback.

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  9. Don't quit the blog! I've enjoyed "rewatching" the show through your medical perspective, and I am eager for you to get to the seasons where there are lesbian relationships so you can weigh in on how well (or poorly) they portrayed those, too. I don't generally comment because I subscribe through Google Reader, and I have to click through to access your blog page to comment. But I'm here and quite entertained, so thanks!

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  10. Yeah, but sometimes the medicine people randomize all the sick patients to the placebo arm, and then you have to reverse turf them and voluntarily take them on to the surgical service. Just saying.

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  11. I think I should be offended, Dr. McAwesome, but i don't think I'm smart enough to follow your comment. Reverse turf? What's a reverse turf?

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  12. HEY

    SORRY.

    suffice to say that i still find the blog interesting and enjoyable from a grey's-nostalgia standpoint, insider's view perspective, and blend between the show and your life, etc. for example, i sometimes deal with hospitalists, but it's probably closer to the side of the spectrum of "where is the money?!" than "look at all you've done" and the difficulties in calculating money saved.

    that said, i ultimately understand the original drive of the blog, and while i am sad that that original purpose has been resolved (all it took was 20 episodes, really!?!?), i am incredibly happy for you and glad it worked out! and dare i say, a little jealous. but congrats :)

    totally randomly, lawrence of LJ&J had a job in SF for the summer, and my friend and i invited him over! and among the things we talked about (including.... the most ridiculous blogging and J&J questions i could come up with) was THIS BLOG and how i was really upset that it was retired! lawrence admitted that this blog was awesome and the other one about the proposal was garbage.

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  13. Like, WOW! Lawrence was talking about me????

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  14. Also, I have a request. Can a surgeon please loudly demand that someone "GET OUT OF MY O.R.!" Grey's Anatomy style? Dr. McAwesome?

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