Barely tenured

Linkorama

So the Times alerted me to an utterly awful piece in Time. By a "doctor."

Susan had chosen me because she had researched my education, read a paper I had written, determined my university affiliation and knew where I lived. It was a little too much — as if she knew how stinky and snorey I was last Sunday morning. Yes, she was simply researching important aspects of her own health care. Yes, who your surgeon is certainly affects what your surgeon does. But I was unnerved by how she brandished her information, too personal and just too rude on our first meeting.

Every doctor knows patients like this. They're called "brainsuckers." By the time they come in, they've visited many other docs already — somehow unable to stick with any of them. They have many complaints, which rarely translate to hard findings on any objective tests. They talk a lot. I often wonder, while waiting for them to pause, if there are patients like this in poor, war-torn countries where the need for doctors is more dire.

Let me ask: is this really about Google, or about annoying hypochondriac patients? Sure, I can believe that easier availability of information makes those who misuse it harder to deal with. But I also can't imagine what it must have been like to do an IVF cycle in, like, 1990—to take that huge leap, make that huge monetary bet, inject those drugs and cry those tears—without knowing what it had been like, what it is like, for other people going through it. Do I ask my doctors more questions because of what I read on line? You bet. And that's how it should be.

What's really ugly about the article is the open contempt for patients. Sure, he changed "Susan"'s name—but I'm shocked the author left his own on the article.

Meanwhile, there's a James Lang First Person column that I—gasp!— sort of agree with. I'm using Blackboard for the first time this semester too, so far just for doing things I used to hard code on my own page, and it just isn't all bad. Some of the committees I'm also use it for distributing documents, and I'm trying to convince my department to do the same. (We're, um, not meeting enough this semester. No, really, we're not, and it's a problem, and having another forum for group discussions would, I think, be helpful.)

Metaphor seeking target

This morning there was frost across the fields as I walked to my office^*. There's a huge specimen oak i the middle of campus which still has its leaves^*. It's symmetric and full, with no branches below maybe 15 feet off the ground.

Beneath those branches, all the way out to the dripline, the grass was still green. Sheltered ever so slightly by the tree through the night.

^* Elided: How much I hate leaving for work before Miss T. wakes up. Weather ≠ climate.

Blood and fog

When does an IVF cycle really, truly begin?

I'm going to argue for the first needle stick. And now I've had mine, for the cycle that I am desperately hoping to carry off in January.

Cornell likes to do their own FSH testing. They want frozen serum. For aging me, they wanted day 2. I thought about just flying to New York (as I did last time), but that would have been outrageously expensive and inconvenient.

We sent Beaker off to get pounds and pounds of dry ice. We sent me off to find a lab that was open over the weekend (!) and willing to take my blood, spin out the serum, and hand it back to me. The phlebotomist clearly thought this should be illegal, but neither her supervisor nor the lab objected, so she gritted her teeth and stabbed me anyway. Stuffed it all into a cooler left over from some of Beaker's refrigerated medication and dropped it off at Fed Ex on Saturday for Monday delivery.

Remaining obstacles to actually cycling include: The results of that test. Locating an actual LH surge later this cycle (I tried, and failed, last cycle, which was only 24 days long, grrrrrrrr). Getting on the co-culture schedule for November. Figuring out how to manage travel and childcare and all that during the cycle itself. Handing over the money.

ADDENDUM: FSH came back about the same -- a little lower in fact, 6.71 vs. 7.26 -- as three years ago, and the other hormones were right where they should be too. Hot diggety. Dr. Data says, same protocol, and let's go!

ADDENDUM: Except then I went and looked at the stats. Last time I was still in the under-35 category, with a 40% chance of taking home a baby. Now I'm in 35-37 and verging towards 38-40. Where it's down to 20%!

Yes, I know, I know, there's no actual cliff, I was at the upper end of the box before, so MY odds were worse, and I'm just heading into the lower end of that upper box now, but still... I think I have a personal threshold of a substantially better than 50% chance of success in 3 tries, and I may be aging out of that fast. Also, I hadn't realized how much of the decrease in live-baby rate is due to increased miscarriage risk. That's a major buzzkill.