Catholic School

My husband and I are very grateful that our son is able to go to Catholic School.  It's a small school, where there is only one class for each grade and everybody kind of knows everybody.  So far, there have only been benefits to that.  I'm sure at some point in the next couple of years we might see a disadvantage to the "small town" effect, but overall I feel that most parents and staff are so busy that no one is really a busybody.  At least so far I haven't seen gossiping and I think the no-gossip culture is because there's a no-gossip principal.

There are tons of reasons I love my son's school, but one of them I witnessed the other day in two

kids at lunch who were having a disagreement.  One of them came to me to tattle on the other.  The two girls were telling each other they weren't friends anymore.  It was a classic she-said, she-said.  I had flashbacks to mean girls in my youth.  As the conversation became whining nonsense, I said, "Wait!".  They stopped talking.  I said, "How about you pray a Hail Mary for her to have more patience," and turning to the other girl, "you pray for her to have more patience."  I went on to the next distraction in the lunchroom and turned back watching the girls finish their prayers with the Sign of the Cross.  I also witnessed them back to playing with each other on the playground.  I was shocked on a couple of different levels.  They actually listened to me and they actually did what I asked and it seemed to work!  I thought to myself, "wow!  that's a tool in the toolbox I wouldn't have been able to use in public school for sure!"

My husband and I also really like how every day starts with prayer in the Church.  The whole school gathers together and says morning prayers and prays for everybody.  They also have a time of quiet before their busy day starts.  The principal also engages them in a lesson and they might practice singing.  We think it's a great way for them to start the day.

There is one downside to this way of starting school though...Everybody in the whole school is together so if you are tardy.... Well...  I call it the "Walk of Shame".  Fortunately my kid doesn't seem too ashamed, but it's certainly embarrassing for me when it is obvious that I brought my kid to school late.  The Kindergarten sits in the very front, so everybody, from all the kids and staff and teachers to the principal can see who came in late.

The other day, my son was having a meltdown during this time and several people, even days later said, "We saw him crying the other day, he was so sad."  The science teacher and both of his teachers came out to the back of the church to try to make him feel better.  My kid wasn't embarrassed by his meltdown, but I was.  Oh.. the shame.  Thankfully, one of the other parents related a story to me that made me feel I was not alone.

The next day (I'm not sure if there's a connection) the principal came up to me and said, "We are so glad you are here, your family has been a wonderful addition."  My husband asked me why she would say that.  I told him, "Maybe because I spend half my life around the school volunteering and stuff?  I don't know, but it was nice she said that."  Maybe the next time my son has to do "The Walk of Shame"  I won't be so ashamed, maybe I will remember that all of us parents are just trying to get to school and work on time and some days... Well, some days are just some days.

Sensitivity and Specificity

This is a topic that I think doctors- both of the human and animal professions do not explain very well.  Another thing we don't explain very well is about testing, and the consequences of testing.

A highly sensitive test means it will "catch" all of the positives for a disease and a few (or even quite a few) false positives.  A highly specific test means if it says it's positive, it's positive, but it might come out as negative when it's really positive (or a false negative, if that's not confusing).

If you come up positive on a sensitive test, you might find yourself quite scared for a bit and then find out your diagnosis was incorrect.  You might even get put on medication that isn't necessary or even worse, could hurt you.  That's why most of the time if we perform a sensitive test, we try to follow it up with a specific test for confirmation.

There has been talk about breast cancer screening, prostate screening and colonoscopy screening and that some organizations are actually advocating reducing screening and increasing the time between screenings.  While it's easy to think this is due to a embattled health care system and cost issues, there are actually some legitimate reasons to think that maybe we screen too much.

First of all, is the issue is that not all screening tests are without risk.  I actually knew someone who went in for a colonoscopy screening, and due to a medical error walked out with a colostomy bag for the rest of their life.  That's obviously a extreme circumstance, and I still plan to get colonoscopies as I get older, especially if I ever develop clinical symptoms.  I don't mean to talk anyone out of screenings.  They can save people.  I'm just trying to discuss that everything should have a cost-risk analysis that should be discussed with your doctor.

Breast cancer screenings have radiation.  They are highly recommended for people with a family history of breast cancer.  They also can expose people to extra radiation, which can cause cancer. It seems kind of like a catch-22.  In looking for cancer, you can increase your risk of cancer.  Again, this is an individual's responsibility to talk with their doctor.  In my case, I had a aunt who died of breast cancer.  I spoke with my doctor about mammograms and she went over the thinking that yes, we still do them, but not as early on in a woman's life and not as frequently unless there is a clearer genetic risk.

Sometimes the treatment for things is worse than the disease. I sometimes find myself looking at blood work on a pet and feeling stuck between a rock and a hard spot.  I'm a doctor.  I'm supposed to treat disease, but in a pet that is feeling great and the only problem is their lab work isn't normal, I have to have a careful conversation with the owner.  A disease, such as Cushing's Disease, or hyperadrenocorticism can cause problems like increased thirst and urination, obesity and higher risk of infection.  It can be worthwhile to treat if the pet is experiencing medical problems from it.  However, if the pet is just a little overweight and otherwise happy, I'm less inclined to put them on medication that is actually meant to kill their adrenal glands and may send them into a life-threatening crisis.

There are many diseases where the treatment and side-effects can be worse than the disease.

I recently had personal experience with a doctor wanting to do numerous tests on me.  I went in for one concern and the doctor wanted to test over $5,000 in testing that with my medical knowledge was not related to my concern.  I tried to ask for the reason for some of the testing.  I don't have a problem paying for something that is beneficial, but from personal experience, I do have a problem with unnecessary testing.  If you are on a fishing expedition, you are bound to catch something.  It could also be completely unrelated to whatever you were looking into.  It could (and it has) in my case sent me down rabbit holes of unnecessary diagnosis, treatment and consequences.  As I say often to my patients, "There is some truth in- if it aint broke, don't fix it."

Astonishingly, when I asked the reasoning for the tests, the answer I got was, "Because the doctor said so."  I guarantee you if I ever used that as a reason for doing anything to my patients, that would not go over well.  After 2 weeks and about 5 phone calls,
I was able to get in contact with someone who had a little bit more knowledge.  We discussed that my medical issue they wanted to investigate was well managed and of little concern to me at this time.  Furthermore, I informed them that my husband and I were trying to get pregnant and I knew that the medical treatment they were interested in putting me on would be contraindicated.  It was a nice, civil conversation in which I basically said, "Please investigate the issue I came in for and maybe I will look into those other things later, but not at this time."

I share this information not because I enjoy putting my personal experience out there, but I realize that I'm blessed to have the medical knowledge and experience to understand these situations and articulate them with the medical profession.  I share this information to empower others.  I'm not discouraging people from doing diagnostic testing and I recommend tests far more often than I discourage them in my profession.  I do believe though, that one of the keys to improving our healthcare situation- the cost of healthcare, the care that we get; is to empower people to have conversations with their doctors.  It is your right to understand what is being done, what the consequences are and if the treatment is worse than the disease.  Empowerment to understand and own your healthcare is a key to better healthcare.


This post is NOT designed to give medical advice.  I am not a licensed human medical professional and am not qualified to give people medical advice.  Every reader should consult with their doctor regarding the best decision for them.  This post is just advocating that you HAVE a conversation with your doctor regarding the best decision for you, as an individual.

Are we called to be "spicy"?

I used a term the other day to describe a patient of mine, "spicy".  I obviously was not using it in the version of taste, but of temperament.  The kitty did not like us.  It had sass.  He was "spicy."  I thought it was a more agreeable term than, "cranky, nasty" or other terms.  It wasn't derogatory.  It was acknowledging the innate nature of the being.  All of us respect peppers, right?  We know not to cut them and then rub our hands in our eyes.  We know if we are unfamiliar with the pepper we take a tiny bite until we know how much to respect it's power.  A tiny bit of pepper can add a blast of flavor to a recipe.  A pepper is not innately bad, it just needs to be respected for it's potency.  I liken cats who are "opinionated" to that.

My techs liked this term to describe a cat.  They created a scale of "spiciness".  They said I was "chipotle" because I had just stood up to a client who tried to attack me for the fact her pet had an illness another vet in the practice had been unable to diagnose.  I calmly and respectfully explained that there are not always easy tests, sometimes we had to investigate further and it required multiple tests.  Sometimes problems aren't easy and don't have easy fixes.  She was looking for sympathy and I gave it to her.  I also didn't give in to her.  There's a difference.  Earlier on in my career, I would have given her a ton of sympathy and I would have been made meek.  According to my tech, there was no meekness in that room.  There was controlled spice.

In life, we are called to be merciful and just.  Sometimes it's easy to fall into one or another camp.  Everyone gets mercy, it's all good, it's all ok or rigid justice.  It's sometimes hard to separate the two and it's often on emotional issues.  Just look at current events.  I need not say more.

We are called to be a people who seeks justice.  There is such a thing as righteous anger.  There are things so horrific that they need to be called out and there needs to be consequences.  At the same time, there needs to be mercy.

Parenting also calls for mercy and justice.  It's a hard tightrope to walk sometimes.  When my kid does something bad, I know there needs to be justice, but I so want to give him mercy.  When my patients get "spicy"  I can give them a calming pill.  There's not something nor should there be something like that for my 5 year old.

Justice is difficult with parenting.  While you don't want to make rash, emotional judgments, you know that whatever the bad act was needs to be responded to immediately or else the kid won't understand cause and effect, won't understand that there is a consequence for the action.  I find mercy, easier to give as a parent.  I want my kid to do right, to heal and to know he's at heart a good kid.  If the left hand is justice and the right hand is mercy, they need to work together.  Like a jalpaeno and cream cheese.  My son actually likes slightly spicy food and I do as well.  We are not called to be a "bland" people.  We are also not called to burn the tongues of others.  Do you have any recommendations on balancing mercy and justice in family life?

Who knew I could discuss spiciness, difficult cats, parenting and mercy and justice all in one blog post?  Hopefully it's not too disjointed, but I think often we can find crossover between God's natural world and human nature.