To Boldly Go Where No Man Has Gone Before.

I'm getting a physical exam tomorrow—first one since 2010.

Yeah, big mystery why I’ve put if off for four years, right? Since turning fifty, I’ve been nothing short of pathological in formulating solid excuses for not walking the two blocks for a checkup:

a) I have to lose some weight first. The scales are out in a common area of the doctor's office, like between the paper cutter and master sharps bin. Everyone in the vicinity can hear your weight barked out by the nurse, so this time I'm giving her two choices—she either weighs me naked like I'm accustomed to, or she steps on the scales for some reciprocal humiliation in my best Don Pardo voice.

Here’s another idea for the nice folks at the clinic: how about we meet in the lunchroom around noon with a karaoke mic and the doctor can announce that I have the BMI of nacho cheese lasagna?

b) I know women’s exams are more invasive than men’s, but I’m still a quivering wimpster when it comes to the hidden finger wag. I’m always worried that I’ll do something involuntary, like giggle or tilt my head. 

c) Since I’m of an age, I’m not highly delighted about receiving input from this fella:

Does the gloved hand seems hostile to you? It mocks me.

It could be worse, though. I've heard that the older models were made of wood and powered by gerbils.

Seriously, I need to stop whining about some temporary discomfort and just be glad I've got the means and access to quality preventative health care. 

How long is that thing, anyway? Please tell me that pressure gauge or whatever it is, pulls over before entering the express lanes.

It’s time to be an adult—an older adult in fact; no more procrastinating, no more lame excuses. The asstronauts are sipping Tang, pre-flighting for their Journey to the Center of the Land of the Lost. 

Please bring them home safely.

Thanksgiving With the Doctor.

Welcome to the third installment of "Relatives of mine and their dangerous, scary, disgusting, highly difficult and courageous careers."

I can't believe how many of these people are sprinkled throughout the family along with the rest of us losers. While the majority of us make up life's vanilla ice cream, these people are the chunky, chocolaty, cookie dough morsels of society.

I've previously written about my two brothers-in-law, each of whom served at least twenty years in the Air Force and Navy. This month's ROASP family member of the month is my cousin—actually my dad's sister's son's daughter—Hillary Goodwin. She's been an emergency room physician for the past fifteen years.

I actually remember when she was born, and the reason I know this is that when I was around five, we went to see my cousin Craig's new baby girl at my aunt's (her grandma's) house. I remember thinking, "Hmmm. Hillary. Never heard it before. That's a good name."

We attended many Thanksgivings together during the experimental 1970s, an era when I was torn between being ten pounds overweight and fifteen or sometimes eighteen. I was determined to detract attention from my beaver teeth and black rimmed glasses with the glare of my multi-striped slacks. I looked like Bobby Brady in a funhouse mirror.

Oh yeah, back to her. She was never a brat to her brother and parents like my sister and I were. She never ridiculed my sweater vests. And I'd have to think that Hillary observed a few of my well-placed kicks to my sister's shin. There's a certain thud it makes when you hit the sweet spot.

I don't remember seeing Hillary much during her teenage years. Her comments are italicized:

We moved around a lot growing up which was a little hard at the time but I am so appreciative of that experience now. I was born in Pullman, moved to Delaware, cross country again to Tacoma, spent Junior High and part of high school in the small southern town of New Bern, North Carolina and then back to Kent, Washington to finish high school at Kentwood.

Were you already thinking of going into medicine?

I had wanted to be a doctor as long as I can remember but probably for all the wrong reasons. There are likely a few witch doctors in our family but I never had much exposure to the field of medicine. For me it was picking one of most challenging careers I could imagine and also proving that as a girl, I could do it. When I was in medical school, the majority of the students were still men and certainly when I went into my ER residency that was true.

One thing I do remember vividly as a child is the story of my grandma. She worked for a chiropractor for years. When she started developed edema, he increased the number of "adjustments" she got and after that didn't seem to work, he referred her to an "herbalist".

I remember.

When she finally got so swollen and short of breath that she could barely walk, she agreed to see a medical doctor. Within a week she was in the hospital getting emergent surgery for critical mitral valve stenosis. It made me appreciate forever the value of science based medicine.

Our paths crossed again at the University of Washington, but not until your freshman year and my second senior year (yes, you heard right), during the spring of 1986. She showed up at a fraternity dance with a guy from the house I actually liked a lot. Which helped.

Hillary, what was your take on sorority life ?

My feelings about the sorority experience have morphed over the years. I was the sorority president and the editor of the Greek System yearbook so at the time I was fairly entrenched. went from this relatively conservative experience (one boyfriend used to have a pic of Ronald Reagan on his wall) to medical school which was very liberal. In the end I am pretty thankful for my Greek sorority experience. 

It gave me leadership opportunities, a smaller social network at such a big school and social skills that benefit me tremendously to this day. I also made some life long friendships with many men and women who have gone on to be very successful, generous people.

And now it's time for med school. Where did you go?

I attended the UW School of Medicine and during that stint spent six months in Boise, Idaho as part of the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) program. It's such a great way to see medicine practiced in our small towns; it is very different then the tertiary medical centers.

It's also where you met your husband Dan.



Dan and I couples-matched to Cleveland, where he did his ER residency and I did my pediatric residency at Rainbow Babies and Children's Hospital. I then did another residency at UC Davis in Sacramento in Emergency Medicine. (Interesting side note is that since I did that residency match independently, I found where I had matched in one of the daily editions of US World and News Report?! I guess they made a deal with the residency matching process.) I had the joy of doing two residencies before they had weekly hour limitations. Can you say six years of 80-100 hour work weeks?

Wow. One hundred hours? Since I turned fifty, I haven't gone for a good twenty minutes without nodding off. Sleep is what I do...and I do it well.

It is amazing what adrenaline will do, and I don't think my decision-making has ever been compromised by sleep deprivation. The rides home, however, after such long hours as a resident were always a little scary. I remember holding it together after one long shift, making it into my carport and falling asleep in the car. Dan woke me up an hour later with a cell phone call. 

We get pretty used to weird hours and pulling all nighters at work is par for the course for me. Ironically, the old-school docs among us worry a bit with the contracted work hours, that the new doctors coming out of residency aren't seeing enough cases because they are not logging the hours we did.

I'm sure you've been asked this a million times. You're a mom to a son and daughter. You work in the ER. How do you deal with seeing kids in such tragic situations, especially those that remind you of your own?

All ER staff develop a pretty good mental barrier between work and home life. I don't think we could function in either venue without that. A couple cases do stick however. I recall caring for a young girl who was critically wounded in a car accident during residency. She was so terribly injured it was difficult to identify her but she had tiny hair clips that made her death more personal somehow. She comes to mind on occasion when I worry about my own kids.

Oh, man, I can see how that could happen. Okay, switching gears. What's your take on Obamacare so far? Be honest, but remember my lefty leanings. I may have to edit your answer out or just make something up.

Obamacare? I don't know how this all is going to play out. In the ER since the rollout, we have seen a huge increase in census. Because it has been a major flu season, we in the Emergency Department worry that because the biggest increase in enrollees is in Medicaid, our ERs will be more and more overwhelmed. Unfortunately the reimbursement rate is so low with Medicaid that many primary care doctors won't take these patients so as a last resort they end up in the ER which is an expensive and inefficient way to deliver care.

Yeah, I thought the whole idea was to give people more choice and take some of the heat off the ERs. Let's hope that improves..quickly. Wrapping things up, what would you say are the best and worst parts of your job?

In the ER, we see the best and worst of humanity, which is a blessing and a curse. It can give you a distorted view of the world when you see unbelievable tragedy. I remember helping with a young woman who was dying from a pulmonary embolism (blood clot to the lungs) a few days after she had elective plastic surgery. It was a horrible case as she was a mother and her husband was sobbing in the hall as we were coding her.

She ended up dying and I finished my shift to run pick up the kids from school and go to a PTC meeting. I sat in one of the small kindergarten chairs listening to the parents talk about collecting box tops and looked down to see a dot of this poor woman's blood on my scrubs. The discussion seemed so inane with this perspective, I felt like telling the PTC where they could put their box tops.

I got up and quietly left instead. . .

The huge number of people struggling with addiction is also a challenge. On the flip side, many of these experiences are also big blessings. Most of us have a huge appreciation of how fragile and finite life is. We also don't suffer fools well which is pretty helpful when you have teenagers.

Amen to that. Thanks, Hillary.

This medication is fantastic. Except for one thing...

Before I begin today's tale of personal awakening, a few caveats:

If you currently feel sated with my personal medical data, and I wouldn't blame you, go ahead and click back to the Walmart shoppers site.

You might consider putting down your pepperoni and Velveeta Hot Pocket, or anything else you may be eating.

If you happen to be married to me, take this opportunity to contemplate my plethora of other awesome physical monuments.

Okay, now that that bit of housekeeping is behind us, I'll get on with it.

I've been experiencing some skin issues lately; two warts, to be more specific. One lives on the top knuckle of my right index finger, and, after repeated skirmishes and all-out "wartfare," this alien has merely returned meatier and more robust. I'd even consider calling in a priest, but I'm not interested in listening to a wart shout profanities about what my mother does and where she does it.

The other offending body resides on my left little toe. After years occupying mere nuisance status, it's apparently experienced a puberty-ish growth spurt and has surpassed its neighbor to the north on the distraction meter. Walking has become painful, as the rubber toe of my Converse often sandwiches this fleshy growth like a cauliflower-stuffed panini.

I, like most people, have been putting off addressing these unwelcome house guests with my doctor, but, just as I awoke that fateful morning determined to sever a toxic journey with my girlfriend,  yesterday morning greeted me with a similar resolve.

I scheduled an appointment for the afternoon. Quickly summoned to the exam area after walking the two blocks to the Medical Dental Building, I was pleased to be finally addressing these nagging blemishes.

Okay, just a side note, here...why the hell do they have to weigh a guy who's having a couple of warts looked at? It's cruel and unnecessary, and my clothes are extremely heavy. Also, I found it highly inappropriate to hear, "Damn, son," whispered by a medical professional.

I was led into an exam room and told to remove my shoe and sock, sit on the tissue covered table and wait for the doctor. They always know how to throw you off a little. You can never be at your witty best with your ass sticking out of a gown, nor can you when fully clothed except for one bare foot which is five degrees colder than the rest of your body.

These rooms are all the same, and they usually have a magazine rack. I always struggle to decide whether to grab some literature or just stare at the sharps container. Since the stack included Sports Illustrated, I hopped off the table, crinkling the paper beneath my butt and grabbed the magazine.

I'd only flipped open the cover when I heard a cheerful tappity tap on the door.

"Hello, again."

Again? I thought. I hadn't seen this guy in seven months, for a physical. We'd been intimate, yes, but come on, it's been seven full months, man.

The way he poked his head around the door gave me the feeling I'd been caught in the middle of something. I felt an eerie deja vu as I held the magazine with a tube of personal lubricant resting on the counter just inches to my left.

I quickly shed the 1976 flashback and we got down to business.

"Okay, here's the course of action I'm recommending." I liked his decisive attitude.

"We're going to freeze the warts, probably four to five treatments for each. I've also been prescribing a pill which has been very successful in ridding the body of all its warts, not just the ones treated topically."

Perfect, I thought. Finally, we're gonna make some headway.

"There is one side effect, however. It's very rare, but I'm obligated to tell you that this medication can cause breast pain..."

Okay, no big deal. I don't really like my breasts referred to as "breasts"; "pecs" or "chiseled chest chops" are better, but, whatever. I can handle a little discomfort.

He continued, "...and possible lactation."

Oh, my god. Have you ever been shocked and highly amused simultaneously?

"Are you serious?" I asked.

"I'm afraid I am."

Wow. If my wife had known about this medication eleven or sixteen years ago, I'd have been popping these things like Skittles and providing daddy smoothies while she went back to work. If people think they're repulsed by mothers who breastfeed in public, what would happen if they'd seen me at the mall food court, gently stroking the head of an afghan-covered infant as it burrowed into my nourishing torso?

Honey, come one. Let's eat our Cinnabons somewhere else.

Despite the total freakiness of this medication, I think I'm going to give this a shot. Warts are a drag, and if I can rid my body of them, I suppose I'm willing to assume the risks.

And besides, I've heard that terry cloth shirts are in this fall.

Obviously, obese is the new skinny.

Self-pity is an unattractive trait. Would you agree?

I suppose that, occasionally, I enjoy the attention garnered from someone feeling sorry for me. For instance:

When I’ve got a nasty fever and body aches, I appreciate the gift of non-Safeway, brand name raspberry sorbet.

When my child freakishly vomits into my mouth a bit, I'm grateful to be the beneficiary of sympathetic dry heaves from another understanding parent.

But I don’t expect your sympathy, your kind words or your understanding, when I require stitches for attempting to open a beer without a bottle opener or tear a hamstring because I was racing my daughter to the faster go cart.

And most certainly, I am petitioning no one to convey pity toward the following revelation, which I learned on Thursday:

I am, technically at least...obese.

Like most middle-aged men, I visualize myself far younger than I look. Upon hearing the sound of my voice, I feel no different than that mall-cruising, mesh-half-shirt-wearing, lean prince with backne (that's pimples you don't see when you're checking your shirtless self out), who inhabited my body thirty years ago.

Naturally, these days, the lumbar aches a little in the morning, a couple of new facial developments tend to get nicked by my Gillette Sensor, and the whole concept of the thirty-two-inch waist appears to have been reconfigured by the denim industry. That metric system must've finally caught on.

But, other than that and some bladder skirmishes, I feel absolutely fine-ish.

Last week, a couple of the medications on which I rely—excuse me, which I’ve chosen to maximize my health—were denied refills pending a physical exam. Always taking the half-full approach, I interpreted this pharmaceutical blackmail as an opportunity to touch base with my physician, much like an oil change and lube, where you can't really count on the oil, but you're certain about the lube.

Since I’m closer to fifty than forty, and I’m not naive, I had fully girded my loins for the traditional “straight to third base” physical, the kind where, after a thorough exploration from rain forest to desert savanna, the final chapter involves a spelunking excursion into the stalagmite caves.

The doctor's feedback of my topographical area went something like, "Okay, this, this, that, this and those are moles. They'll always be benign, so don't worry."

I wanted to say, "Yeah, but what about this one over here that's growing eyes and the beginnings of hooves?" I kept quiet.

And then, the elephant in the room made his presence known. It was time.

Earlier, as I entered the exam room, I had noticed two Costco-sized tubes of personal lubricant on the counter. One appeared to have never been used, and the other had squeeze marks all over it, like a four-old-had been handling it. I may have reprimanded my kid about wasting toothpaste this way, buy I decided I didn't give a rat's ass whether or not the doctor started from the bottom of the tube or not. I wouldn't be watching, anyway.

As I mentioned, I was as hygienically prepared as going to a dentist appointment, except this time, only flossing was obligatory, and a certain part of me was clean enough to play Yahtzee on.

Once Dr. Spelunker led with the cold, gooey advance party, Cavequest 2011 was underway. I tried to play it cool, thinking that women endure this type of exam far more frequently than my whining self, so I attempted to toughen up with thoughts of baseball. Unfortunately, it wasn't long before I was imagining being the new kid at prison.

Finally, the doctor was finished, and we agreed to still be friends and see each other in another year. After putting out so easily, it's really all I could have hoped for.

"And by they way," he added, peeling off his latex gloves, "your body mass index indicates that you are .5 over the "obese" cut-off mark. If you lose five pounds you'll be down to "overweight," so let's shoot for that. Take care, now."

Nothing quite like being told I'm just barely obese, and that with a little work, I'll be overweight.

As I slowly re-applied my clothes and my dignity, I resolved, I don't care what anyone says. By this summer, I'll make it even further and just be fat.

We're awaiting results on your dignity

Maintaining one's dignity can be synonymous with keeping one's "cool." I've already established that, overall, I've been super cool my entire life. One setting, however, has proven to be the Waterloo of my human dignity and humility—the dental/medical office.

We learn from an early age that we must face discomfort with a calm demeanor, especially if ice cream awaits us pending a successful behavioral outcome. I faced my first true medical adversity when, as a six-year-old, I was informed that my molar was abscessed, and that an oral surgeon would need to put me under and dig away at the festering alien beneath my precious, little gum line. Naturally, I was quite apprehensive, until informed that I would be receiving nitrous oxide, otherwise known as "laughing gas."

"You won't feel a thing," spun my mom. "It's laughing gas. You'll feel pleasant, fall asleep and wake up all better." I'd recently watched an episode of Batman, where the Caped Crusader pulled some laughing gas spray from his utility belt and incapacitated the villain in fits of laughter. Enter power of suggestion, stage left.

Abscess-emancipation day finally arrived, and little Timmy was prepared. I hopped into the dentist chair, cool as a cuke, and prepared to lightly chortle from the effects of the impending anesthesia. As the doctor lowered the breathing apparatus onto my mouth and nose, I began giggling. After six or seven inhalations, I was writhing in uncontrollable spasms of laughter. Soon, everyone in the room—my mom, the doctor and his assistant—also began laughing, harder and harder.


Imagine being six years old. You've never experienced any type of euphoria-inducing chemical and here you are, high as a blimp and watching your mother, in a baritone James Earl Jones voice, slowly yet hysterically guffawing as she disappears down a warm, colorful tunnel.


I later awoke, threw up several times and realized that when in the able hands of medical professionals, we control nothing, including our dignity.

I believe each patient should exercise his or her medical Miranda rights, or the right to remain silent in order to avoid discrediting themselves. I most assuredly should have invoked this right prior to my vasectomy. After several minutes of flirtatious and witty banter with an attractive nurse, she asked me to drop my trousers to begin the wonderful procedure.

She surveyed my pre-operative shaving job, looked at me and said, "Mr. Haywood, have you ever shaved before?"

"Umm, not there."

"Obviously."

Her sunny demeanor instantly U-turned. The next three minutes were not fun, as somehow, I had added some unwanted labor to her day by performing shabby work down there. Call me old-fashioned, but I don't do male Brazilians, especially on myself.

But that's not the end of the vasectomy dignity assassination. Four months later, I returned with my "post-operative requirement" sealed in a plastic jar, inside a brown, paper bag. I felt dirty, but I had to ascertain that my days of siring offspring were behind me. That same nurse took my sample from me and asked me to sit in the waiting room while she tested it. Five minutes later, she popped her head through the door, raised a rubber gloved hand and gave me the thumbs up. The room was crowded, and I'm sure everyone was quite relieved to know that I was now sterile.

I could continue with other examples of medical humility, but I won't. I'm fully aware that most women suffer even worse indignities on a yearly basis, so believe me when I say that I don't feel sorry for myself.

Just please remind me, next time I go to the doctor for a prostate check, just to keep my mouth shut and not to shake his hand afterward.