Put this baby to bed

NewFNP was on her way to work today and was wondering why her steadily moving flow of traffic came to a grinding halt. When she got to the intersection, she saw a person laying in the road with a woman kneeling by her side. NewFNP stopped, noted the decent sized pool of blood under the woman's head and checked for a pulse. Thankfully, there was one and the woman was responsive. She waited until the paramedics -- the super hot paramedics -- arrived and basically put the ky-bosh on well-meaning bystanders trying to move the woman who had been hit by a truck.

That's a hell of a way to start one's day. One minute, you're crossing the street and then next, you're slammed into the pavement.

That's what 2010 has felt like for newFNP and she is ready to put this piece of dump year to bed. Two thousand and ten has been for the motherfucking birds.

NewFNP went about her day, sent a pregnant patient to the hospital with fetal tachycardia, treated another's chlamydia, et cetera, et cetera, and then got a message from the title company that her grandmother's house is in escrow.

NewFNP should be happy about this, what with this economy. She is trustee of the estate and has been wanting to get the home sold for some time now. Selling the house will help newFNP to continue paying for her grandma's care.

But newFNP is a little sad. NewFNP's three-year old footprints are in the cement of that backyard. Footprints from the seventies. NewFNP and her grandma made newFNP's prom dress there. NewFNP has quite literally a lifetime of happy memories from that home -- which, by the way, was built in 1962 and has one of the glorious pink bathrooms featured in today's NYT.

In the past month, when newFNP has gone to visit her grandma, it's clear that her grandma no longer recognizes her -- she just stares ahead as though she is still alone.

The selling of that house feels like the end.

Dis-gusting!

No Monday could be worse than last Monday when newFNP took one to the kisser.

But newFNP had a close second in terms of building her case against Mondays. (And this Monday is in the shadow of a three-day weekend and a newFNP cumpleaños so bitches better start coming correct!!)

NewFNP was going about the same old business of performing a pap. Using her gentle touch, of course, she grabbed an endocervical sample with the cytobrush and, upon removal, noted a viscous, gloopy, stringy mucous hanger-on. Not wanting it to drop, newFNP began an attempt to loop it around the brush using a circular motion.

No luck. A glob of it was hell bent on attack and launched itself Pyongyang style, landing directly on newFNP's forehead.

Fucking. Disgusting.

But newFNP felt like she lucked out by not having that shit land in her eye. She brushed off the attack, literally and figuratively, and went about her day.

Hit me with your best shot

NewFNP has had better days at work.

To begin with, newFNP's back is jacked up and she is walking like she has a stick up her ass. Then she saw 17 patients before lunch.

Then her last patient hit her in the face. Open hand, but with the force of 202-pounds of mother-fucking crazy behind it.

NewFNP has never, ever been hit before. She is a white girl from the suburbs who went to top tier schools and watches Jon Stewart and goes to spin classes and shops at J. Crew. She does not engage in fisticuffs. And, quite frankly, she could go the rest of her life without ever being hit again if she has her way. It hurts. NewFNP was actually dizzy. And she was completely fucking shocked.

After her patient was forcibly removed from the clinic 5150-style and newFNP spoke with the officers about her being a victim of battery (not her words, but noted on the very official police report), she was told that she should go home for the rest of the day.

No shit.

It's one hell of a way to get half a day off, but you don't have to tell newFNP twice to get the hell out of dodge. Why couldn't her patient unleash the crazy at 9 AM instead of at 12:30??

Hipst-astic!

If there is one thing that newFNP sees very infrequently at work, it's white people. And today newFNP had a white hipster (subtype 70's-inspired) in her exam room.

He looked as though he had rolled straight out of Williamsburg on a fixed-gear skinny-tire bicycle while listening to Deerhunter and had somehow managed to end up in newFNP's clinic via some kind of fashion/anti-fashion vortex.

He had many of the markings of hipsterdom:

- shaggy hair-do and beard

- tan corduroys and a plaid tan & white shirt a la Oliver from the Brady Bunch

- American Spirits

- canvas Aasics

- a college degree yet a job at a camping store (possibly related to the economy and not hipsterdom)

- understated ennui.

How did he find newFNP's clinic and end up in newFNP's exam room to discuss the communicable scourges of scabies and HPV? After all, her clinic is in a very non-hipster and seemingly ungentrifiable area of town.

In his honor, newFNP is listening to her Hipster Harvest Mix CD, courtesy of her BFF, and laughing once again at the hipster dinosaurs.

Tech Talk

As we all know, the DSM is getting a do-over. As the NYT pointed out today, narcissistic personality disorder is on the chopping block.

Well, newFNP can help pad those empty pages. She is here to offer a new criterion for "psychotic disorder NOS" that should make it into the new psychiatry bible.

NewFNP is a fan of technology helping her out throughout the course of her workday. Where would she be without her iPhone and its BMI calculator, its OB wheel, its ICD-9 coder and its access to her gmail account so as to enable newFNP to track her online package shipments while at work? (Damn you, Madewell, and your cute new sweaters for 25% off!!) NewFNP's clinic is en route to electronic health records and newFNP is very much looking forward to forgoing the search for a decent black pen every day.

But these technologies are not those of interest to newFNP in regards to her hypothesis of how technological advances are shaping the scientific and clinical milieu.

NewFNP has noted time and again that people who are somehow psychotic attribute profound significance to the shitty photos snapped on their cell phone cameras.

NewFNP has seen many, many a flip-phone and Blackberry image and has been told that the image in the blurry photo of a sex partner was the aura of a snake, that there was a hand coming out of someone's head, that there were angels reflected in the mirror. In each and every photo, newFNP saw essentially the same thing -- a crappy, blurry cell phone picture utterly lacking in reptiles, odd appendages or the supernatural. And she can say definitively that the more expensive phone did not take a better crappy ass picture.

In one patient, newFNP gently asked if anyone had ever told him in the past that he may have a mental illness? No, he told newFNP, he was a Christian and he had burned the curtains in the living room after having sex with the snake-aura partner in order to purify himself. His response did not diminish newFNP's concern.

Perhaps the criterion can be "On at least three of the past seven days, the patient has engaged in excessive cell-phone photography (excluding those on iPhone 4 with flash and photography apps) and has inappropriately placed religious or spiritual significance on the incomprehensible images attained."

You're welcome, APA. You get that one for free.