So that's today's memory lane

The Scene: An ICU, on an early July morning. A well-dressed man is standing at the nurses' station, scribbling notes. Our main character walks in.

Me: Hey, where's the post-call intern?
Intern: That would be me. Would you like me to tell you about the overnight admissions?
Me: Sure, sure... Say, if you're post-call, why are you wearing a shirt and tie?
Intern (defensive): I... I wore scrubs overnight. I just changed back.
Me (with genuine admiration): Wow. Good luck with that.

The scene: A Welcome Fete. The new interns are meeting the residents.

The mature, confident resident (to a group): Hi, I'm Nick.
Intern A: Hey! I read about you. You're that blog guy.
Me: Oh, ha. Um, yes. But, you know, that's just kind of a computer thing I do... on the side.
Intern B: Hey, I remember you from interview season. But the website you were talking about, it had something to do with free drinks.
Me: Hmmm...
Interns A, to Intern B: I love this town.

Cover me

After more than a few years of schooling and training, the day is approaching when my erudition and skills may be of some value. So, I recently applied for a disability insurance policy.

These insurers, they ask a lot of questions. When they got to the part about traffic citations over the past five years, I had to stop and think. It's been three years since I've even owned a car (but what a car it was). And I know I had a speeding ticket at some point in the early part of this decade. But was it 2002 or 2003?

I was reminded of Michael Moore's documentary, SiCKO, where a health insurance company denied coverage to a young cancer patient because she had forgotten to disclose an old, easily treated yeast infection. They called it a pre-existing condition.

And suddenly, it's became very important that I dig up old car documents from another state, even though I don't drive. God forbid I'm denied coverage at some point because of a misrepresentation in my original application (after talking to enough insurance agents, "God forbid" is a phrase that has worked its way into heavy rotation).

Does anyone know if I'm being paranoid about pinning down the date of an old speeding ticket?

Another question: I've often wondered why health insurance companies don't push harder for DNR status on elderly, moribund patients with dense dementia. Find and talk to the next of kin, work with the guardian, adjust expectations and prepare everyone for the inevitable.

Yeah, it's unseemly, but so much of what they do is already unseemly. And having seen too many of these unfortunate resuscitations, it seems that getting more aggressive about DNR status is more humane than trying to cheat otherwise healthy, active people out of coverage for out-of-the-blue health problems.

One that won't make me nervous

I used to read Andrew Sullivan's blog a lot in grad school. He's bounced around several times over the years -- both on the web and on major issues -- but I rediscovered him this primary season. I was drawn to his optimism and enthusiasm, even as some of his opinions are difficult to defend.

Anyway, he was recently musing about the latest ketamine-for-depression research, and wondering if this notorious drug could someday have a clinical use.

I wrote in to tell him I use it (clinically) quite often -- not for depression but for procedural sedation.

To my surprise, he printed the letter. And now I wish I had included more from my informed consent spiel, mentioned the sialorrhea, and maybe talked about that one time I pushed it too fast...