​I know even less about writing than medicine. But here's what I've figured out so far. I'm certain in another few weeks/months/years, this information will change dramatically. But for now….

1) That English writing major? Doesn't help one bit. Neither did that erudite senior seminar paper "Analyzing Literary Analytic Style: The Major Works of Stanley Fish's Literary Criticism." Means nothing in the real world of publishing. (That was a real title for my real senior seminar class that subsequently cemented my desire to study harder for the MCAT and go into medicine and NOT shoot for a masters in English.)

2) I thought I knew grammar, but apparently 4 years of college and I still don't know where to stick a comma. That's why God made editors.

3) Just when you think the book is perfectly logical and well-thought-out, some smarty pants comes along and totally punches holes all through the book. Stuff you hadn't even considered but then later are like, "Yeah, why DID the hero suddenly leave? That makes no sense."

4) A good editor is worth their weight in gold. And chocolate.

5) It's easier to negotiate a book series when you've already written the entire series. 

6) It's fabulous to have great ideas. It's another thing entirely to get them written down. Coherently.

​The practice of medicine has been part of my life for 15+ years now. The lessons keep coming. Just when I think I've got a great handle on things, new information comes out or I see something I've never seen before. 

Here's what I've learned so far in medicine.

1) The learning doesn't stop at med school, residency or fellowship. That just scratches the surface. God, I was such a little punk then. Clueless.

2) Most of what is learned doesn't come from a book. It comes from experience, or it comes from instinct (a fancy word for experience + gut feeling). And it comes from trial and error.

3) Dr. House is right. Patients lie. All the time. Unless you can get them to trust you and tell you the whole ugly truth. Sometimes this will happen. But usually not when it involves controlled substance prescriptions.

4) There is humor in anything, even the process of dying. Sounds sick, right? Many patients have told me that they appreciate feeling "human" when I can still make (appropriate of course) jokes with them, even as they enter hospice. Everyone deserves to be treated like a human, not a collection or organs.

5) Emotional separation is necessary and possibly career-preserving for the physician. It's possible to care but not absorb all of the pain and suffering. Not having this ability to separate from the situation leads to depression and burnout. (been there)

​Public service announcement : I am alarmed by the amount of disease symptoms found in the typical text of romance novels. For the health and safety of the hero/heroines, I feel it my duty to alert my author colleagues of potentially life-threatening character conditions and suggest care and management options that all authors can employ.

So without benefit of typing symptoms into WebMD, here goes.

#1) "Her flashing eyes" -- Could be conjunctivitis, bilateral cataracts, or retinoblastoma (RB). Forget that RB is typically fatal by age 5 if untreated and your character is 25. We're not dealing in 100% reality with this romance novel thing anyway, are we?

#2) "His heart beat a tattoo against his chest" -- Clearly this description represents atrial fibrillation with rapid ventricular response. Give IV cardizem and if that fails, push amiodarone. FYI, expect to personally drop a load when you give amidarone. This med causes a prolonged pause in the heart where the person looks, well, dead, as they can be pulseless for several seconds until the heart rhythm resets and "jump-starts." (hopefully restarts)

​Every year, I'm either on call for Christmas or Thanksgiving. This year, it's Christmas. My colleagues have bailed out of town, and I don't blame them. But for a sold 11 days, yours truly is it if you're sick or pregnant or have an impacted piece of steak in your esophagus. And here's what happens….

On the twelfth day of Christmas my call group gave to me….

12) Twelve refill requests (at 3pm on Christmas Eve, appreciate y'all planning ahead, there, folks)

11) Eleven blue haired ladies (but they're super cute and smell like White Shoulders and like to give hugs)

10) Ten lice-a-leaping

9) Nine (million) sperm-a-swimming (hey, bro, congrats!)

8) Eight teens-a-smoking

7) Seven social nightmares (nursing home placement on Christmas Eve or a Pop Drop, anyone?)*

6) Six Percocet honeys**

5) Five requests for the "fat pill" (ba DUM dum dum) ***

4) Four spewing kids

3) Three STD's

2) Two "emergency" scopes****

1) And a drug seeker in a nut tree….


Every single item contains true material, I am sad to say.

Don't try to sing the song, it won't match up well, my apologies. This author is a little punchy tonight. Writing deadlines + being on call and hospital calling for pediatric admissions = challenges in time management. 

Therefore, I'm rewarding myself with yet another list. And a Skinny Cow treat. Just because.

On the twelfth day of Christmas my editor gave to me….
12)  Twelve dangling participles (Hurrying to complete the second edit, my computer locked up.)

11)  Eleven instances of "look" (Thanks to Gwen Hayes, for pointing out 150 instances of that word in my very first manuscript!! Don't worry, that hot mess got shredded.)

10)  Ten adverbs maximum. ("If you see an adverb, kill it" -- Mark Twain) 

9)    Nine passive verbs. (We were happy.)

8)    Eight character arcs (How many journeys do these people need to travel?)

7)    Seven hanging participles (Where are those phrases at?)

6)   Six new Swedish curse words (very useful for international travel!)

5)   FIVE SENSES USED! (ba DUM dum dum…)

4)   Four turning points

3)   Three comments to "repurpose the sex scene" (Is that like eco-friendly recycling?) (Thanks Julie Sturgeon)

2)   Two tortured souls (well-adjusted characters need not apply)

1)  And a crazy writer in a nut tree! Yahoo!

​1) Cups of ice with a splash of diet coke. (Come ON, just give me the rest of the can. I swear I can handle it.)

2) That toddler behind me kicking the back of my seat for 2 hours. Fabulous. Parents, ever heard of discipline, or are you just happy that ADHD/Junior is securely fastened in place by a seatbelt?

3) Inconsistent signage. (Thanks for directing me to pass through the exit/baggage claim, instead of veer off to the next terminal for my next flight. That was a fun re-TSA hour of my life I didn't have to spare.)

4) The flight attendant (can't call them stewardesses) with the really loud voice who is talking nonstop about safety (ok, important), miles earned (if I were a loyalty member, I would earn a free flight in, like 20 years), and destination information. It wouldn't be so bad, if she didn't pause to come up for air once. Like she's got  a third lung.

5) The pilot who I can never hear, who could be telling me about the distance to destination and the weather conditions, or could be telling me about how the right engine just blew a johnson rod and we are about to spiral into the face of the Earth.

​1) Public bathrooms. Have you ever watched how many folks DON'T wash their hands afterwards? Ewwwwww. Ebola is the least of our problems, if we can't get this simple task hardwired into the public psyche. Go to tooter, wipe, then wash hands. With SOAP. Rinse and dry hands. You can achieve the twelfth level of Resident Evil. I know you can do this simple thing to prevent enterohemorrhagic e-coli. Or measles. Actually, with measles you're screwed no matter what you do. Good luck and get your MMR boosted.

2) Panda Express. Dadgum, my stomach just got queasy thinking about it.

3) Customer service reps who fake-type on their computers. I know those perfect, evenly spaced keystrokes in concert with your vapid expression cannot be connected to any aspect of reality. The entire dog and pony show was created by some psych major-turned customer loyalty director who did a study (n = 4) that showed lots of assiduous typing prior to a boarding pass being produced correlated positively with customer service experience.

4) People talking on cell phones. While talking to customer service reps. Or while getting fast food. Or while in the bathroom. Dude, seriously? No one, and I mean absolutely NO ONE is that important. EVER. Ever, ever, ever. And you, Mr. Wall Street talking loudly on you bluetooth while gesticulating wildly? You don't look super cool and business savvy. Just schizophrenic.

Let's be clear here: I'm not the poster child for skinny. However, I at least walk the walk. If I tell my patients to do something, you can bet I'm trying my darndest to do the same thing. For example, it's not BS when I tell my patients to get an hour of exercise 5 days/week. It hurts, but by golly I'm on the treadmill after office hours walking my miles to the tune of "Bad Things" (the opening song to True Blood). To be brutally honest, I walk faster when Joe Manganiello's chest is on the screen. Carrot. Stick. I'm about as willful as Pavlov's dog.

1) (patient) I don't have time. 
2) (me) I walk even if I have an 80 hour week. There's always time. Exercising cuts down on louging-in-jammies time, but there's always time.

3) (patient who is morbidly obese sipping on a mocha-choco-latte) I eat like a bird yet I gain weight. 
4) (me) If by bird you mean pterodactyl, then ok. By the way, you're mainlining cream and sugar.

5) (patient) Just give me "the fat pill." If I had that pill, I'd lose weight.
6) (me) Folks can out-eat any pill I give them. Last week, I had a fellow explain to me that the cholesterol medicine I gave him "made it ok" to eat at McDonalds. (doctor explanation fail, logic fail, patient reality check fail)

7) (patient) It's my metabolism that's the problem.
8) (me) If you do no exercise and eat no fruits and veggies, you're correct. The journey of a thousand miles begins with a single step.

9) (patient) What about the new supplement/magic beans/super omega something that Dr. Oz is hocking this week?
10) (me) Sure those work great, if that's the only thing you eat all day. And congratulations. By purchasing the snake oil of the month, you've also paid for his kids and grandkids to go to college. That's money that could go to your Rec Center membership.

1) If she has an opinion of me, at least she won't blog about it (no opposable thumbs)
2) Never asks to change the channel
3) Listens to me with undivided attention
4) Does not judge me when I'm naked
5) Every time I come home, is briefly thrilled that I'm back
6) Does not argue
7) Does not use all the hot water
8) Never questions if I spend my day off in jammies
9) No snoring
10) Never corrects my grammar

1) Orthopedist's Guide to Bedside Manner
2) Family Doctor's Manual: Making Lots of Money in an Accountable Care Organization (ACO)
3) Losing Weight Without Diet or Exercise
4) Sparkling Personality Traits of Neurosurgeons
5) What Cigna Covers: The Complete Listing of Covered Procedures, Medications and Medical Equipment
6) Hospital CEO's Handbook: How to Compose Concise Emails and Reduce the Number of Committees
7) Fashion Trends for Pathologists
8) Dermatology Rash Treatment (here's a hint, it's always "steroids")
9) Chief of Staff's Guide: How To Run a Meeting in One Hour or Less
10) Early Retirement For Primary Care Physicians