notageek

THIS is why it’s important that pharmacists keep up on the MMWR.

In which I alienate plenty of readers by using family history to make a political point.

RhoGam, the Rh factor immune globulin, did not exist in 1943, which meant that Rh- women who had Rh+ spouses were supposed to stop having children after delivery of an Rh+ infant. Anti-Rh antibodies (like other antibodies) cross the placenta, and in Rh+ fetuses could cause fetal death.

Rh-factor differential is not adaptive. It is not fair, and for women who wanted large families like my grandmother, it was a cruel blow. My grandparents rolled those blood-type dice three times that we know of between 1939 and 1943, and three times had a live infant and a sigh of relief to show for it.

Then in 1952 my grandmother got pregnant again. I do not know what happened in the intervening seven years; whether they were littered with a sad failed series of Rh+ pregnancies, whether my grandparents practiced contraception as well as they could at the time, whether they denied themselves the expression of marital love for the certainty of her living to raise their extant children.

What I do know is that my dad was the darling of the family, a huge relief to his parents when he emerged healthy at term, the biological capstone of the sibling group. My grandmother no longer had a small family, and (as far as we know) she devoted herself utterly to the work of mothering and housewifery.

My other grandmother had her first child in China in 1937; her second 11 years later at the Chinese hospital in San Francisco. Then a third, three years later. Then a fourth, fourteen months later.

My mother was not treated differently from her brother; their light-skinned sister was their mother’s darling. They were all equally beaten, thrown down stairs, worked to exhaustion in the family laundry. And while my father was the wished-for child his mother thought she could not have, my mother’s conception was a scare of more and more and more children, dragging an immigrant family farther and farther down. After my mother they did not have more children.

Discussing contraception with my mom as a teenager, I asked if my own conception had been accidental. My mom thought for several seconds. “No, I remember I stopped drinking coffee before we started trying,” she said. Does it matter? Probably less than the year when my brother was having a lot of trouble and my mom wished out loud that she’d never had children.

So today among your other blessings, give thanks for the mothers who decided to have you. And give thanks for the safety and legality of abortion, which made the decision a real choice.

People who work in healthcare are can be really, really annoying patients. I know this because I’m both. I do things like call my nurse-practitioner’s voice mail and tell her the full prescription I’m requesting (such-and-such antihistamine, quantity #N, sig take 1 by mouth every day).

I don’t do it very often, which I suspect is why she has not asked me to cut it out yet. Most of the time other healthcare workers will give a little grin when they recognize one of their own, and cut you some slack for muttering “flat affect” with the flattest affect you can muster, or for scheduling a hearing test because you learned in physiology that old folks’ hearing starts declining at the upper ranges first and OMG that’s what you can’t hear.

In that triage nurses are a gateway to the healthcare system, it makes some sense that they—like airport security guards—are not allowed to let jokes be funny. But working weekends at a retail pharmacy as I do, I thought that a primary complaint of “I’m here to beg for narcotics” was freaking hilarious.

(My formerly-sprained ankle still hurts; working weekends is not helping. Upon some more thought, I may ask for a bigger-gun anti-inflammatory instead at my appointment tomorrow, as in reviewing the pain lecture notes I noted that opioids are not fantastic for myofascial pain. I was not given narcotics.

Damnit.)

I had a dream in which the plot hinged on Katee Sackhoff eliciting sympathy from a passer-by in a post-apocalyptic San Francisco based on her diabetic foot ulcers.

I think I’ve been in school too long.

Q. You’re listening to Bruce Springsteen?

A. Yes. I had a boyfriend who gave me “Born in the USA” for my 16th birthday. “Downbound Train” is my favourite song off that album. It was the boyfriend who went out with a bang, not a whimper.

Sometimes it’s easier to wallow in the painful past than the painful present. I have an anaemia lab and a presentation on cumulative incidence of uterine leiomyoma tomorrow. I will get up and pretend nothing’s wrong, because nothing is.