My love-hate relationship with Christmas hospital

The hospital is a funny place at Christmas. I kind of have a love-hate relationship with Christmas hospital.

One part of me loves Christmas hospital. I love that everyone tries so hard to make it festive and that each floor or section have a different décor scheme (or lack thereof). I love that some people really rock the decorations. I get excited for the treats on the nursing units.

I love how people try so hard to make it a welcoming and festive place, even if for many people it is the last place they want to be.

But, I hate that people have to stay in hospital over the holidays. I’m glad we have the option and that these people are well taken care of. But, this weekend, I seem to have spent a good chunk of my on call rounds talking to people about their hopes to get out, their dismay about not getting out and trying to help them see or find the bright sides in the situation. It comes up a lot. And it is important, so it makes sense that it comes up.

I remember when I was about 5 (it was the year I got a Troll watch for Christmas), my Aunt was in hospital over Christmas. And she swore never to be there at that time again. I am too young to remember what was so bad about it, but I do remember her saying repeatedly she would never go to hospital before Christmas.

That is something I won’t forget.

I don’t want that for my patients. Because, unfortunately for a number of them, this probably is their last Christmas…

Our service is pretty good in that if there is any way the person is stable enough to go out even for a few hours, we try to make it work if the person and their family is wanting, willing and able.

I have one person who has the most festive room ever and plans on having their whole family in for Christmas dinner, although the logistics are still being sorted out. They are pretty excited and encouraged about being around for the holidays at all.

I saw another who only just realized home isn’t going to be an option and just wants to not be alone. Another who is going to get someone to bring in decorations. And a third who was working on Christmas cards and gift wrapping with their spouse.

Its not all that sunny, though. Some people say it won’t be Christmas this year, or get upset when talking about not being home.

I can’t make it better. But I want to. We can treat pain or nausea, but treating being in hospital over the holidays isn’t easy.

The nurses on our ward are awesome and make the best of it. We all, for the most part try to. That is what humans do over the holidays. And that makes it kind of a cool display of how people are decent.

Thus my love-hate relationship with Christmas hospital.

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Turning Tables – Treating Physicians

Today, one of the other residents and I had an interesting conversation.

Somehow, the topic of treating physicians came up.  And it is something that terrifies us both.  And not just for the reasons you might think.

I will confess, treating other health care people is always nerve wracking because you worry even more about saying something wrong or stupid because you always wonder if they are secretly judging your skills.

But the bigger thing is that when we see them, they are being faced with a cancer diagnosis.  And for some reason, most physicians and nurses get the bad ones and all the complications.   And that is horrible for anyone.

The issue is, they know too much.  Sometimes, having some uncertainty is a good thing.  But, when you have cared for people with the same thing.  When you understand the odds and get the treatments, it is a whole other level.  You know the worst case scenarios.  All of them. Sometimes the unknown bits of the known are the worst.  Especially when your whole world gets turned upside down.

That is the hard part.  The anxiety, the sadness, the anger and guilt.  The fact that sometimes, the person who knows too much coming in can’t be easily comforted.  That the numbers that scare everyone have too much meaning.

It also forces us to face our own mortality.

We both agreed that given we work in Oncology and given the odds in the world today, we will both one day have cancer.  And we will probably die from it.   Those are simply real odds.  And the “comedy” that is life.

And we know this and accept it.  In fact, we laugh about it in an uncomfortable kind of way.  Sure, I might have a heart attack or an accident, but it is more likely I get dementia or die of cancer… Or both.

Really, it is something I accept.  But, it is still something that is terrifying. And maybe that won’t happen.  Maybe I’ll just die in my sleep in old age.

Either way the reality of seeing people who dedicate their lives to healing others broken, afraid and unwell is terrifying.  They are “one of us” who became “one of them.  It is just too real sometimes.  Too close to home.

I just want to fix the hurt.  I want to prevent the hurt.  I want to be out of a job (kind of).

But I can’t.  So, we do the best we can.  With every person.  Because one day the tables will turn in one way or another.

How Did That Happen?: Human

This week’s How Did That Happen? should have been posted, well, last week.stethoscopes1

I have had some busy days including journal club prepping, trying to spend time with friends, go to Patrick’s work party, volunteering, keeping a clean house and getting a cold (I blame Patrick’s grubby kids). I actually had a long weekend thanks to an in-lieu day left over from Easter weekend call, so I have had the chance to do some movie watching and all around procrastination.

For any number of reasons both work and personally related, I have been feeling drained and down and all around kind of blah. It happens. I have a high baseline, so it weirds me out, but I must confess that it has been a recurring theme.

My How Did That Happen? is that I am human despite what medical institution says. I have known it all along, but just for the rest of the world, I will point it out.

People in medicine still get tired and sick and depressed.

We still have relationships.

We struggle with things like loss, fear and anxiety.

We have big joys and big sorrows.

We have regrets and make mistakes.

People in medicine still often have financial struggles. Just because we are there doesn’t mean we still aren’t paying off loans.

People in medicine are still learning. No matter where they are in their career. If they aren’t, there is a bigger issue.

People in medicine sometimes struggle with things we have to do in our jobs. Sometimes decisions we make haunt us.

We sometimes face our biggest fears in the eyes of others.

We don’t always have time to face those fears in ourselves.

Knowing that I am human is one of the best things I can know. Because it stops me from trying to be invincible all the time. Even when the world I am in sometimes acts as if that is not the case.

There is no fix for being human.

And for that I am glad (although, a cure for the common cold would be nice).

But, being human in medicine is a tightrope to walk with some of the pressures we all face.

Brian Goldman, an ER physician in Toronto and very talented speaker had this piece featured in the Globe and Mail today about physician burnout. I thought he voiced some of the common concerns about physician burnout today very well.

More accurately, the medical culture that fosters us is the problem. It’s a culture that implies you should strive to be perfect even though you’re human – one that encourages you to run from your feelings even though you can’t hide from them.

I don’t know how to fix burnout or how to fix our system. But, I think at least pointing out that I am human and treating the other humans I work with as human is a start.

During our first-year medicine exams, a classmate sent out this song to remind us that we are, in fact, not robots.

I still sing it to myself on days where I start being a bit too robot-like. It helps.

CAPO Review

It is the first Monday of the month and the last Medical Monday until September. Whoo. Time to check out some medical minded/affiliated blogs at the link below.


I am going to use this as an opportunity to expose you to some of the awesomeness I saw and learned about at the conference I went to this past week for the Canadian Association of Psychosocial Oncolology.

All last week, while at the conference, I was so excited, I wanted to tell the internet world about it, but resisted the urge in order to keep people from hating a million small updates about things that may not be as thrilling to everyone except me. But now, I will give a digest of some of the cool videos, tools and ideas that captured my attention at the conference and that I think might appeal to a wider audience.

First of all, every single keynote speaker pointed out that physicians are burnt out and that leads to poor communication, missing compassion and other issues. They also all cited a study of Internal Medicine residents showing that 76% displayed symptoms of burnout or depression. This made me feel depressed. Mostly because I know it is true. Also because I wanted to know what information was out there. So, I found a decent review article (IsHak et al. 2009) on the topic citing burnout rates to be anywhere between 25-76% and that self-care, counseling and system changes might help the residents and in turn improve patient care. Fascinating.

We have a system of health care, but not a system of caring.

Dignity is huge. Studies have shown that the factor that was seen as the make/break point in maintaining dignity was how the individual thought they appeared to others. Feeling dignity is supported if they feel they are being seen as a person and as a WHOLE PERSON, not just a disease.

One speaker talked about a thing they were doing at their hospital where they asked new patients to the palliative care service an additiona question, “What should I know about you as a person to help me take the best care of you that I can?” It changed care for many people.

Breast cancer risk is increased by smokng. But, interestingly, that risk is most increased when people smoke during periods of breast development. So, a group in BC designed videos targeting teens to try to make a change in this behavior. And it is working!

ReThink Breast Cancer is a nonprofit all about young women with breast cancer. They have support groups and events and all that good stuff. They even have a blog.  They also promoted a super cool publication in the form called Cancer Fabulous Diary, which is a book with coping tips and musings for young some with breast cancer.  It is written with the blogger from Cancer Fabulous, which is basically the experience of a young woman named Sylvia Soo who is a breast cancer survivor diagnosed at the young age of 24.

The Canadian Cancer Survivor Network has a webinar series on Thursdays about things like advocacy, drug funding and really relevant political/medical issues. Who knew? They aren’t the only ones though. Lots of other non-profits in cancer care have webinars with relevant topics.

No man is an island.

I went to a series of talks on decision making in older adults with cancer. About how they make decisions, how people get information and how they enroll in trials. Many people factor in their age, even more than providers sometimes expect. Family members are often divided into two categories, the super involved and the not involved. Both can have their pitfalls. Also, subtleties in communication with the provider influence the decisions a great deal. Sometimes the appearance of interest of a physician in a clinical trial will convince someone who was on the fence. Also, older adults cope better with a cancer diagnosis and treatment decision making than younger adults.

I saw a really cool video documentary on sexuality in young adult cancer survivors that addressed a lot of big issues.  The maker of the video is designing a website and taking the show on the road.  Unfortunately, it isn’t up yet, so I can’t show you.  But, it was very real and honest and not sugarcoated like a lot of stuff out there these days.

Psychosocial oncology is cool!

Call Conundrums

This weekend is a call weekend. And tomorrow I am off (after 8 and once I give appropriate handover), followed by a trip half way across the country to present my research. I am excited.

My calls lately have had some odd streaks to them.

For instance, I had one that was, well, a complete surprise.

The program administrator sent me my schedule for the next block including my 5 dates for call in the next four weeks. I didn’t get a copy of the master call schedule, but so long as I knew when I was on call, that is all that really mattered. I could call locating to find out who the staff was.

But, then, I was in teaching one day when one of the staff docs came in and gave me a post-it note, said we were on call together and all his info was there and left. I though it was for when I was on with him that coming holiday Monday.

Then I read the post-it. It informed me that we had 2 beds available, the floor was quiet and that we were on together tonight.

But I wasn’t scheduled for call. So I thought.

Turns out I was according to the board in the nursing unit. And Locating. Apparently, they forgot to list one of my dates when they sent out my schedule. Fail.

So much for a date night out with Patrick.

Call is the worst when you aren’t mentally prepared for it. Even if it is home call. I was rotted.

This weekend, I was super tired Friday night and decided to go to bed early after a very quiet night. I went to bed just before 10 and fell asleep. I woke up to my pager just after 11 with a “I wanted to call before you went to bed” call. Little do they know I am like an old person and was already asleep for an hour.

Yesterday, I was in and out of the hospital much of the day. So much so, the security staff (two of them) got to know me by name.

Also yesterday, I had to go to the university library to use their computers to get access to SPSS, the statistics program I did the stats for my research on. This because I discovered the university only licenses the downloads for one year for staff. And both of my supervisors aren’t around to take the time to email computing services and get a new code for me this week.

I get in to the library, which is strangely quiet and am working away when a random guy comes in and sits at the next set of computers away and starts watching something that was making horrifying screaming-like-someone-was-being-murdered noises and other bizarre sounds. I looked around and nobody else seemed to notice. I questioned whether I was part of a weird social experiment for a bit because it kept happening and he was making no effort to turn down his sound or plug in headphones. The sounds of murder had just stopped when my pager decides to go off. And I get a dirty look from some people.

Seriously? We just heard screams of death and other weirdness for the last 10 minutes and the 2 beeps of my pager it took to turn it off is what earns a look of death.

The cat picked up my pager by its “bungee cord” and dropped it in his litter box this morning while I was getting out of the shower. It was in a clean patch, thankfully. I think he hates it as much as I do.

Blurred

This week, I thought my studying brought on some weird hypochondriasis.

I was being the cool cat that I am studying neuroanatomy and neurology stuff and feeling like I am finally starting to make some progress in my figuring out where certain presentations originate in the central nervous system, when this image of the brain seemed out of focus.

So did some of the side margin boxes.  And the next picture of a brain.

I stared at it confused.

Then I looked around the room.

I have complex migraines, that can  include a slight diplopia (double vision) and other symptoms (unilateral facial paresthesias, scotoma) so getting a slight amount of altered vision from time to time isn’t the most crazy thing to happen.  The issue is that it didn’t feel like my usual aura and when I looked up, the vision change went away.

I looked back down and it was still weird looking.

It isn’t like I was studying for a long time (this particular episode… If you factor in my million years of schooling, then it is obvious I have ben studying for a long time).

Then, it hit me.

I was having a stroke.

No.  That was definitely not it, although strangely enough that was the topic of this particular chapter – cerebral bloodflow and stroke presentations.

There was some sort of printing error in my book.  As a result, a few images were blurred.  Not enough to make them useless, but enough to make the reader crazy.

This doesn't quite give justice to the blurred sensation the pictures give when looking at them in person.  From "Neuroanatomy through Clinical Cases by Blumenfeld (2002).

This doesn’t quite give justice to the blurred sensation the pictures give when looking at them in person.
From “Neuroanatomy through Clinical Cases by Blumenfeld (2002).

I showed Patrick to confirm and he has the same confused reaction.

From "Neuroanatomy through Clinical Cases by Blumenfeld (2002).

From “Neuroanatomy through Clinical Cases by Blumenfeld (2002).

It makes me wonder how people can exist with the changes in function due to a stroke and not report to medical attention.  I mean, if you can’t see right, something must be wrong?

My mind has been blown on this service by the number of people with acute stroke who chill at home waiting for things to get better. Even when it isn’t their first stroke.  Time=brain, people!

And yet, I get it.  Because in this case, there was something else to blame.  We look for that something.  Anything that is less scary even if, at times, it is less plausible.  We hope the problem just goes away.  Sometimes we make it worse when we wait on things like that.

The scary part is that I used this same textbook to study neuro in med school and I only very vaguely remember this problem.  I think I realized the pages were blurry because of printing, but it isn’t a clear memory.

The highlights are proof that I did read these pages before.  Again, the picture takes away from the blurriness that is experienced in person. From "Neuroanatomy through Clinical Cases by Blumenfeld (2002).

The highlights are proof that I did read these pages before. Again, the picture takes away from the blurriness that is experienced in person.
From “Neuroanatomy through Clinical Cases by Blumenfeld (2002).

In retrospect, that was before my migraines were controlled, so it wasn’t unusual for me to have an aura in which I couldn’t see proprerly, so maybe I just chaulked it up to my weird brain.  Or maybe I blamed it on too much reading.  Or maybe I just wasn’t paying that much attention (although the highlighting on the page tells me otherwise).

Clearly, I need to learn my own lesson and pay attention both to my body and my books.

This also brings to mind a song that was popular this summer that I quite disliked, except for this version by Jimmy Fallon and The Roots…

ID compared to House, MD

It is Medical Monday, yet again.  Actually, I feel like it has been a long time since the last Medical Monday.  Either way, it is time to hook up with some other medical related blogs for some medical and Monday-ish goodness.

As some of you who read this blog regularly know, I am currently on an Infectious Diseases rotation and I have likened it a bit to the TV show House, MD.

I have been giving it some thought (and noticing the continued strange popularity of my post General Surgery Is NOT Grey’s Anatomy) and decided that it is time I both prove and dispel some more TV related medical show perceptions, this time referring to House, MD.

First of all, why House?

For starters, it is one of the other medical shows I watch(ed).  Also, when I think of real medical specialties that are kind of like “diagnostician” I think Internal Medicine and, more specifically, ID or Rheumatology because they get to see some of the weird and wonderful.  And I am sure in some big places, someone really is a diagnostician specializing in the really complex cases.  That being said, it isn’t a residency or a common position.  At least, I don’t know any, so this is my reasonable facsimile.

The similarities:

  • There really is a gaggle of people who deal with the complicated cases.
  • People do sit in a group and bounce ideas off of one another complete with internet and journal searches and a white board, or more commonly, a sheet of paper.

    Image from teichdoesmedicine.blogspot.com.

  • Someone who is generally much smarter than everyone else does lead the pack (and sometimes bosses people around).
  • Often times, much of the staff are not fans of the person in charge of the hospital.
  • Patients do lie.  For reals.

    Okay, not everybody. Image from Iamilliontrees.net.

  • The days can be crazy long and chaotic, but also interspersed with mind numbing waiting and boredom (or time for other antics).
  • When you just think you have someone or something figured out, there is a twist (sometimes).

    Image from eatliver.com.

  • Sarcoidosis, lupus and obscure infections are often somewhere on the differential.

    Or is it? Image from http://www.quickmeme.com.

  • You do have to work in places you don’t always like to or want to in order to keep the hospital running and such.

The differences:

  • Patients do tell the truth.
  • One does not generally have a team of fellows who were staff in every other area of the hospital.  Those people often just stick to their own jobs.
  • You can’t just go around running your own lab tests, diagnostic scans and procedures all willy nilly.  There are people specially trained to do all of those things better than the doctors on the show.
  • You would lose your job for screwing around with a clinical trial, stealing drugs, blatantly endangering patients, etcetera.
  • A good start to making a correct diagnosis is a good history and physicial.  They tend to skip that step.
  • A next important step to a correct diagnosis is doing the correct diagnostic test.  Most of the scans they do aren’t appropriate and then the images are not actually of the scan they claimed to order.  In fact, they often put the patient in the incorrect machine.
  • You can’t order everything STAT.  That would make “STAT” routine.
  • There are more staff in the hospital than the “Diagnostician” and a lone oncologist who happens to treat EVERYONE (including children) with cancer.

    I do quite like their bromance, though. Image from tinyobsessions.wordpress.com.

  • As a consultant, you consult, not make all the decisions.
  • People don’t code that often.  At least they don’t code that often and survive.
  • Patients die.
  • Sometimes you just don’t figure out the answer and the person either dies or gets better and you don’t know why.  That isn’t a failure.  Just life.
  • Breaking into someone’s home, car, workplace and so forth is a felony, not medicine.
  • It takes much more time to figure out complicated and novel cases.
  • You can’t just throw drugs at people (or take them away) and expect them to get better.
  • If it walks like a duck and quacks like a duck, it is probably a duck, not a zebra.  House almost always gets the zebra.
  • Sometimes, it really is lupus or sarcoidosis.

    Image from housemdconfessions.tumblr.com.

  • Nobody would let you practice medicine on that many drugs.  No matter how good you are.
  • You can’t just go taking over in the OR, bursting into the OR or really, doing anything in the OR if you are not currently practicing as a surgeon.

    No. Just, no. Image from housemd-guide.com.

  • There is a financial and ethical limit to how much you can and should do.
  • Doctors aren’t immune to whatever the guy in the bed has.

“Never withdraw care”

We should never really withdraw care.

This was a quote from a fabulous talk I went to today about communication.

It is true.

In medicine, we often say things like “withdrawal of care” and mean things like withdrawing life support or stopping “extreme” or “heroic” measures.  Sometimes it is even about things like stopping active treatment for incurable disease.

Taking those things out of the picture does not equate not doing appropriate supportive care.  Everyone needs supportive care.  Always.  Just in different ways.

But, if you are a family member, it can sound like you are taking everything away.

Like the health care professionals don’t care.  Like hope is gone.  Like they are being left to die.

That is where this quote came in.  How the language we use can really portray the wrong message.  Context is everything, but really, we need to try to keep context out and keep things clear.

And no matter what, we should still care.   It is in the term healthcare.  It just makes sense to care in medicine.  Medicine is a caring profession. Because sometimes caring is all you can do.

Care is always in the equation.  The definition of care is what can change.

Sometimes the most caring thing you can do is to stop intervening beyond basic symptom management and emotional support.

It isn’t giving up, it isn’t even always changing focus.  It is about context.  It is about our humanness.   It is about care at the root of the word.

Just some food for thought.

Painful procedure

I think we are mean sometimes in adult medicine.

Okay… Not this mean… Image from quickmeme.com.

I don’t mean the heartless jerky kind.  Well, at least I am not, although buddy who I refused to give a narcotic script for a knee sprain may argue that I am.

Today, I did a lumbar puncture.  A difficult lumbar puncture.  On someone who may have had a subarachnoid hemorrhage.  Meaning, they had the worst headache of life.  And then I came at them to stick a needle in their spine.

This is something you have to do from time to time.

I have done many lumbar punctures.  All of them to this point were in kids.  Sedated kids.

Now, I am doing one in a large, not sedated, uncomfortable adult.

Big difference here, boys and girls.

Sure, we use freezing.

That alone hurts like stink.

But we do all this.  And it took a few adjustments before we got fluid.  All without sedation.  Fully awake with just the pain meds for the head.

Image from diagnosisms.org.

It seems mean.

Then, I saw someone with a huge laceration.

You know the bigger they are, the harder they fall?  Well, it is true.

I couldn’t find any topical anesthetic, so I had to inject lidocaine into the area.

Have you ever injected something that stings into the appendage of someone three times your size who is terrified of needles?

I can now say I have.

I actually had to get sedation.  And even that didn’t really help.

It took me and two people holding, as well as enough sedatives to make me comatose to get the freezing in, let alone suture the wound.

And then someone found something topical.

Just in time to make me feel like a big jerk.

We do that to kids.  But, they have topical cream and if they are really stressed we give them drugs to make them loopy.  And generally they aren’t big enough to kill me.

I also want to argue that adults should know how to suck it up.  But, that isn’t always the case.  But, sometimes I feel like we don’t do great when that is the case.  When someone has a legitimate phobia and can’t cope.

Why do we routinely sedate kids for lumbar punctures and make sure their procedures are as pain free as possible, but for adults, we often make them suck it up?  It isn’t that much more complicated to do it.  Sure, sometimes there are observation and airway concerns.  It is more time consuming.  But, sometimes, as someone who isn’t big on procedures, I think it would make the procedure easier on everyone.

Ah, sedation. Image from animal-space.net.

Do I think everyone should get emla cream before needlesticks?

Heck no.

But, I do think we should offer options for more painful procedures more readily than we sometimes do.  Especially people with irrational fears.

And that is what I think makes us mean.  In, reality we are just doing what we can with the time, resources and training we have.  The culture is not always one such that change happens quickly, especially if it isn’t a huge safety concern.

I won’t be doing tons of procedures in my future career (thank goodness), but I hope that the combo of the peds experience with seeing people go through icky stuff with some procedures in the real world will make me remember to try to offer good pain/sedation options when doing procedures, especially those that are extremely anxiety provoking.  I know I won’t be perfect and sometimes things can’t be helped because it just isn’t practical or reasonable, but at least it will be worth a try.

And just so you know, sometimes painful procedures are painful for the person doing them.  Maybe not as much for the person on the receiving end, but nonetheless, it can still be unpleasant.

Lunch gym people, inactivity judgement and other gym-related musings

I went to the gym this afternoon at around 1:30.

I have never been to the gym at that hour.  I generally either go first thing in the morning or in the evening after work.  But today, 1:30 was pretty close to first thing in my morning because I was in the ED working a night shift last night, so I went to bed at 5am.

I was shocked to see the sheer volume of people there.  I had to weave my way through a sea of naked women (ick… So not a fan of naked strangers) to hunt for a free locker, but by the time I did that I did manage to snag an empty elliptical machine.

My first thought was, “Do these people work?!?”

Then I realized as the gym rapidly seemed to clear by 2ish that indeed they do.

These are a new-to-me species.  The lunch-hour gym people.

They blow my mind.

First of all, taking my lunch time to workout is basically an impossibility.  Because, well, what lunch?  Most of the time, I inhale food at a desk or run to the cafeteria and challenge myself to a speedy eating competition.  My Family Med rotation did offer the perk of an hour long lunch, but by the time I finished writing notes from the morning and prepping for the afternoon clinic, it worked out to about a half hour.  Still better than I normally expect!

The fact that people actually have enough time to go to the gym, shower and get back to work is insane to me.  Even at my best jobs, this would have been a stretch and would have led to starvation.

On that whole starvation thing… I see lunch time as eating time.  So, I can’t imagine taking my fueling time to burn more calories.  Maybe this is part of the reason I will never be a size 0, but I am okay with that.

It occurs to me that in order to basically lose your lunch hour to going to the gym, you must actually love going to the gym.  Maybe not.  I guess I am so used to being down a lunch, that if I did have enough time it would be worth it.  But still, there is a lot of clothes changing.

I don’t hate going to the gym.  I quite like it.  Once I get there.  I love the feeling you get after a good workout.  I love knowing that I am doing good things for my body.  I love realizing that I am able to workout longer and harder without wanting to die.

Image from carrotsncake.com.

Plus, I have this new app called Fitocracy that gives you points for work outs and then you get to do challenges or up levels.  It makes it a game.  And a challenge.  I am pretty competitive, so this is a big win for me.

Nonetheless, there are many other things I would rather do with my time.  I am definitely a person who goes sometimes just to make sure I get my moneys worth.  And sometimes because I know I should.  And then the other few times because I like it.

I don’t like changing clothes (I know, I am such a typical girl), and the gym requires changing.  I often don’t like the TV they show at the gym and it is too hard to run and read simultaneously (plus the books always flip closed and frustrate me).  I don’t hate sweating.  But, I sweat like a man.  Even my ears sweat (I know, TMI) and then my headphones fall out and that makes me a crazy person.

Because of all this, it amazes me when people LOVE the gym.  And by that, I mean love it enough to go every single day or take in their work day to do it.  I just can’t imagine.  Maybe that will change someday.  But really, I have never been a sports person.

I think my other beef is that I am not a good land beast.  I am that person who stumbles off the elliptical.  Who refuses to run on a treadmill because I envision myself shooting off (I have a friend who did this and I will never forget the moment) and the person who pinches their finger on a weight machine.  When I was a kid, I swam.  I love swimming.  But, joining a pool is significantly more expensive and less portable than my gym membership.  Plus, pools are even more high maintenance with regards to changing and hair removal and such. And they have a notoriously higher rate of naked and scantily clad individuals that I like to avoid.

So, I will stick to the gym.

The good bit is that when I get to go in the morning, the gym is empty, which means I don’t hear other people grunt or see naked people in the locker room and all that good stuff. Plus, I get my pick of machines.  In the evening, not quite so much.

Image from Facebook.com.

The better bit is that it is good for me.  Even when I don’t want to think that.

But the gym isn’t the only way to get activity.  This time of year rocks because we can go for walks or outside swims and all that good stuff.

And this brings me to my last bit of rant.  I do judge you if you say you don’t have time to do physical activity.  I admit it.

In medicine, we suggest that people get out and get active.  And then people tell me how busy they are with work or kids or what have you.  And I get it.  You are busy.  And I can’t walk in your shoes to see what it is like. So, maybe I should accept it, but I don’t want to.  Maybe because if I have to, you should too.

There are plenty of ways to be active without braving the gym or spending the money for classes.  Go outside for a walk.  Play with your kids.  Take the stairs.  Some jobs are already super active.  You can be active without a formal program.  People in nursing homes even do some sitting exercises.  Anything is a start.

Image from weddingbee.com.

Trust me, I hate playing organized sports, I work a million hours per week and I don’t love the gym, but I still at least fit in a walk or some stairs or something.  And so can you.  It is kind of like the take a lemon and squeeze it into other people’s eyes kind of thing.

Maybe that is unfair of me because I know everyone is different. And I am not a crazy person who thinks everyone has to work-out every day  I sure don’t.  I am more referring to the couch potatoes out there who drive in circles for hours to get the closest parking spot when they have no disability preventing them from walking.

There is harm to doing too much activity.  But more people have the opposite problem.

And yet despite all this, the lunch break gym people still blow my mind.

For some humor, check out this Jimmy Fallon clip entitled #myweirdgymstory.