Work out work ethic

My new year’s resolution is to work out everyday, lose weight, look good, etc. I signed up for a 1/2 marathon in Napa on March 23rd as inspiration for my new identity, “athlete mom.”  I plan on having Michelle Obama arms and losing the Santa belly.  My resolve started out strong.  I ran 4 miles in the freezing Jan 1st weather while everyone was having New Year’s pancakes around a cozy dining room table.  That run felt good.  It was snowy.  The town was Hopkington, MA where the Boston Marathon starts.  It was symbolic and inspirational.

I have worked out every day since then, except that one time I fell asleep in my clothes at 8pm.  Unfortunately, my exercise work ethic sucks.  Fast forward to today’s run.   I planned out my winter running wardrobe yesterday with the extra warm tights, my running hat, warm running fleece.  I look so good when it all goes on, it’s hard to deny I’m an athlete mom.  I was planning on running in the woods but scrapped that plan A immediately upon stepping outside.  Freezing.  Not fun.  Instead, I schlepped it over to the gym, after nearly ditching my work out for a nice warm cappuccino at Smart World Coffee in Denville.  God I love that coffee shop.  The owners are from Vermont and serve Vermont coffee, Vermont chocolates, and have yummy croissants.  They Y is smelly.  But I did it.  Only because I still have the Season Finale of 30 Rock to watch.  Since the Y got wifi, I am no longer limited to the cooking shows, talk shows, and Fox News on the gym screens.  Unfortunately, I can’t run too fast when watching the NBC iPad application, it shakes too much and gives me a headache.

I sprinted across the Y parking lot to start off the workout (it was so cold).  I found my favorite treadmill, the one that is almost in the  middle of the TV screens but not the one that has an obstructive column over TV#2.  I got out my iPad, my headphones, and a large black shower comb (it seemed to be a stow away on the black iPad cover, perhaps sticking to it via static electricity).  I wondered if people thought it was gross that I brought my shower comb and wound my headphones on it to make it look like an ingenious Pintrest-like approach to keep my headphones tangle free.  I hopped on my treadmill, started the workout by pressing Quickstart (I never mess with any other setting), and went to work.  Went to work on getting my 30 Rock episode.  But alas. What is this?  1 bar for the YMCA wifi?????  Can’t even get past the GE limited commercial disruption???  I’m stuck with a blurry screen of Liz Lemon.  Netflix didn’t work either and I couldn’t watch a newly released comedy about butter, called “Butter.”  I gave it some time.  Maybe the cosmic waves in the inter web were very busy and the bars would come back.  In the meantime, I watched a cooking show about making meatballs in 3 different ways.  One was frying, one in the oven, one for appetizers to be served with toothpicks.  The cook is a middle aged white man with glasses who dresses up in period costume to demonstrate his points (his mother’s appetizer meatballs with the toothpicks had him in Greatful Dead clothes).  Still no 30 Rock.  I changed my treadmill to the other side of the gym.  Then again back even closer to the office (that must be where the router is).  And one last time.  I considered the bikes since they were the closest to the outside, but that was not going to help me run a 1/2 marathon. I got so frustrated, I left after I calculated a cumulative 2 mile run between all the machines.  I left angry.  And lost my comb in the meantime.  Asking about it was a little embarrassing, “Excuse me, I believe I left a black shower comb on that treadmill over there, have you seen it perchance?” and I tried not to bother any of the runners.  I have a white shower comb at home but this one was just better.

Our new digs

Like many New Yorkers, we decided that the only way to survive the urban jungle that is Manhattan was to buy a weekend house.   We looked in the Hamptons, we looked in Dutchess County, we looked in western Connecticut, we looked in Vermont.  Something was missing.  It was hard to put a finger on the problem, but it had to do with big hair, obesity, and strip malls (or lack thereof).  And the houses..they were OK, if you like the 1700s, red barns, wide plank floors, and stone fireplaces.  We were looking for something more…how you say…60s.  Something with not two very separated floors referred to as  ”upstairs” and “downstairs”, but 3 or 4 levels with little sets of stairs here and there.  Oh, where does one find such a thing?

Jersey baby.  So we bought this little puppy in Mountain Lakes, New Jersey.  For 2 real reasons.  It is in my parents’ town (a nice town) and it is on a lake.  Being a 60s split level, it needed more work than we realized and were ready to take on.  But we did take it on and are in month 3 of construction.  In the mean time, we also realized we can’t actually afford a weekend house and decided this was as good a time as any to take the leap from the city to the burbs.  So now we are bridge and tunnel.  And we are knee deep in renovations.

If you want to see what we bought, check out the house tour here and stay tuned for more before/after construction photos.

How to survive the burbs if you used to live in “the city”

1. Don’t eat out. Your restaurant days are over, unless you go into “the city” for a special occasion. Everything else will be an expensive and depressing endeavor. Instead, go to the grocery store and allow yourself to get giddy over the cheap prices (organic milk for under $7!). And forget about farmer’s markets because suburban ones are sad sad sad.

2. Resign yourself to your vehicle. Yes, you may have imagined yourself biking everywhere because the streets are so much less crowded and the ride to the grocery store (the only place you now go) would be so pleasant. You may have even purchased a bike trailer for the kids to make preschool drop off more fun. It will stand unattached from bike that is buried deep somewhere in the garage. However, the car will be right there, in front of your door. As you will be usually in a hurry, despite the theoretical “slow down” of suburban life, you will only use the car.

3. Good-bye Equinox. Hello YMCA.

4. Dress in work out clothes. Because you never know when the urge to drive over to the Y (which may actually be within walking or biking distance) will come upon you. Also, this gives the impression to the other mothers at preschool or the grocery store (the only place you now go) that you are about to work out or, even better, have just worked out (and still look so attractive!). This helps to negate some of the seemingly lazy car driving.

5. Tory Burch. If you decide to dress in something other than work out clothes for some reason, go with Tory. No need to be creative. But if you can make it into “the city” flagship store on Madison Avenue, items unavailable at the local mall distributer will be spotted and commented on immediately. Worth the drive to “the city.”

6. Commuting. Realize you will never, ever see your husband. While it may have seemed that your husband worked annoyingly long hours when you were living in “the city,” his commute will now be brutal. He will leave early in the AM to beat the traffic and come in late for the same reason. You, however, will probably cut down on your commute now that you no long need to work to support the expensive “city” life style. Just the grocery store.

7. Make playdates. You and your kids will never, ever, ever, see another child on a playground, on the street, on their bike, on a scooter, at ice cream, etc. unless intentionally premeditated and coordinated by parental figures. While in “the city,” sidewalks are packed with strollers and playgrounds full of frolicking children, this is not how it works in the burbs. Playdates are the only way to ensure your kids do not become antisocial misfits AKA total losers. This may put some strain on you to make friends and remember names of preschool parents who do not seem at all interested in returning the attention, but it must be done. It might help to wear work out clothes and try to get invited to the mommy triatholon training groups.

8. House Ownership. It’s likely you rented in “the city” with the cost of housing and all. Even if your apartment was fancy by “city” standards, it was probably disgusting to the majority of the developed world. Once you purchase your new home, you may find that whatever shape it’s in, it seems fine to you. And huge. And you will be confused as to why people keep calling it a “small house” that “needs work.” You will soon adjust to the new standard of living and decide to get a construction loan. Because a few thousand (or hundred thousand) here and there, really, what does it matter when you know you’re making an INVESTMENT.

9. Get past your hang-ups on schools. If you were lucky enough to move into a town with a great school system, you may soon be surprised to find out it’s actually not that good. It’s definitely not good if you compare it to schools in “the city” you’ve been salivating over but that charge 40K+/yr tuition and forced you to leave the city. It will be a little sad when you realize it’s probably not even as good as P.S. Whatever you scoffed at while living in “the city.” It’s OK to grieve a little, but you will soon get used to the idea that while the schools may not be great, no one seems to know this, and you will also forget.

10. Your minivan may have been cool in “the city” but it’s not in the burbs. While it’s hard to say a minivan can be truly cool anywhere, a brand new, shiny, enormous minivan with its own parking space in a covered garage is a unique and useful enough thing in the city to qualify as cool. As it can seat 8 plus all their strollers, baggage, etc. it’s close enough to a bus to be considered public transportation, which is cool. Anything that facilitates daytrips to “upstate” or the Hamptons or in general implies that you have a weekend home is cool. In the burbs, there is nothing cool about a minivan. Especially one that has bumper dents and scratches from “city” traffic. You will need an SUV soon to match your “working out” look. Work on convincing your husband of this starting day 1 because it will make no financial sense. Look into bundling it into the construction loan.

Good bye NYC

Vet Receptionist: “My boyfriend loves your dog,” says the elderly receptionist while typing my checkout information

Me: “You mean labs?”

Receptionist: “Yeah, just loves them. You’re lucky you’re only spending $500 today. This one lady’s dog ate socks and had to have exploratory surgery. Was pooping socks for days.”

Me: “So the exploratory surgery didn’t work?”

Receptionist, somewhat insulted by the insinuation that an expensive and ineffective treatment plan was executed, “Well, no, it worked, but there were a lot of socks, you know. They couldn’t get them all out. Oh, I need more paper to fill out your certificate.” (gets more paper, loads into printer, answers several calls and places them on hold, settles back into her chair, away from the computer screen, gets far off look) “And my cats. Let me tell you how much they cost me. One has…(I stop listening, and glare at her computer to make obvious the fact that I’m trying to leave)… then I massage right here (simulating her cat’s facial massage by making small circles at the corners of her mouth. Now I wish I had listened because I can’t fathom why she’d need to do that. Gum disease? Parotid gland blockage? Really, sounds like too much effort and I resist telling her how I’d deal with it). The other one takes thyroid medications (waves her hand at me, resumes typing)….but they’re my babies.” Took 15 minutes to check me out even though I was the only one there for hours.

It’s not just her, it’s also the Vet who had never heard of drug allergies (!) and was incredulous as to my theory of why my dog has broken out in a generalized pruritic rash since starting doxy (“a coincidence”).

It’s that the Starbucks guy couldn’t remember the kind of coffee he was announcing (“I mean ‘soy’ late”). Minor, but glaring as it just would not happen on 17^th street.

It’s that most of the preschools I was looking at are in a strip mall and that “progressive” here means Montessori which is 100 years old

That no one’s heard of steel frame windows and you have to work hard to not get a McMansion when what you want is a run of the mill house built by a gay architect/designer who rehabbed an old cottage in the Hamptons or Dutchess County.

Restaurants are on route 10.

Some teenagers have acne. (Manhattan teenagers do not have acne, they have personal trainers. Not something I would have noticed except I was surprised when I did encounter it again after 10 years of thinking acne had been eradicated.)

When people ask me, “Do you miss NY?” I quickly say, “Not a thing!”

Partly because I really do love living in NJ, in the burbs, in a beautiful community where my kids are surrounded by nature, quiet, and family. And partly because I want to show those snobby New Yorkers that NY is not that awesome, that life in the burbs is, in fact, superior. Now that I’m suburbanite, I feel a certain loyalty to my fellow neighbors. Fucking city snobs.

But there are times when I miss NY. I miss the sophistication of Manhattan. People are extremely well dressed, thin, young, and straight up COOL. They can appreciate good food, wine, vacation spots. I assume the same for theater, ballet, whatever but I’m in no position to judge. They are on top of the world when it comes to quality of EVERYTHING they consume or present and they know it.

I’m excluding the 20-somethings and the gays in this analysis, because it’s easy to be cool if you don’t have kids. I’m just focusing on parents/families right now. Nowhere were the parents cooler than those at Tompkins Square Park, 2 blocks from Stuy Town. Many are still living in the same rent-controlled 1 bedrooms they had acquired 15 years ago when they ventured into the nasty alphabet city. Artists, freelancers, I don’t really know, but man are they hip. Their kids wear fedoras. Not because they wanted to impress anyone or to particularly stand out, as they don’t. Dad wears a fedora, kid wears a fedora. Dad wears a blazer, kid wears a blazer. I actually took a picture of a dad once, just because he was so cool. They hang out at the park with their Liquiteria juice (www.liquiteria.com) or Ost coffee (www.ostcafenyc.com) chatting with the other parents, not a care in the world, and get on their bikes or scooters (dads included) to go home. They are often international and it’s as normal to hear kids speaking Portuguese, French, Chinese as it is English. These foreigners don’t even know what a suburb is.

As to the food and beverage… Living in the East Village was a culinary paradise. When in Paris, all Tim and I could do was shake our heads and assess that Parisian food is basically like dining in the East Village, so why bother the trip. My favorite places, in addition to Liquiteria and Ost, were Luke’s Lobster (lukeslobster.com) and Puddin’ (puddinnyc.com). But we hadn’t been able to try even 1% of the food of the East Village. Nothing could be less than excellent, as it wouldn’t stand the competition. Even stuff I’d normally never be into, like Southern Friend Chicken was gourmet. On the upside, I have lost 6 lbs since moving to Mt Lakes.

It’s not just the class of the food I miss, it’s the stores, the schools, the mayor (who’s cooler than Bloomberg???). I used to raise my nose on NYC public schools but I’m pretty sure the best public schools in Manhattan are better than the one here in Mountain Lakes. People just expect more. Don’t get me started on the magnet gifted and talented schools, like NEST+m that teaches Singapore math (who cares what it is, it sounds effective) and Mandarin from kindgergarten. Or The 3^rd Street Music School Settlement where serious musicians produce serious musicians. Check out the teacher’s bios: http://www.thirdstreetmusicschool.org/who. The museums, the UN, the theater classes-all the best possible in the world. Will my kids hate me for denying them the best???

I keep reminding myself that that’s not what makes happy kids. Living in a nice, relaxing, place near family, amidst nature is more likely to make healthy kids than the urban jungle. It’s saying good-bye to the smog, the rats, the crazy people, the nursery school admission essays, the leaded paint, the crowds, the garbage. But man, it would just be so much easier to think about it all over a nice cup of Ost coffee.

I bought a house today

I bought a house today.  Sort of.  And by I, I mean I.  Not Tim and I.  It took me about 3 hours of signing the following no less than 300 times:

“Timothy J Hannan by Anna E Ringwelski-Hannnan Attorney in fact”

Because, in fact, it appears that I own Tim.  In the eyes of the law, as soon as our Attorney, the one with the strip mall office behind Burger King on Route 46 in Parsippany, charged us $250 for a power of attorney form and $25 to download the signed copy back in his office, I became Tim Hannan.

So while Tim was in the cush offices of midtown Manhattan, enjoying a fancy espresso from the fancy espresso machine, hob nobbing with NYC’s richest and most powerful men, (Ok, so actually he was stuck for 4 days without sleep with a team of analysts doing powerpoint presentatios and modeling excel spread sheets, but the espresso part is true), I got to sign his name, my name, and my new title over and over again for 3 hours in an attempt to close on a 1960s dilapidated bilevel.

I was not doing so well myself as I had just gotten off a 14 hour night shift and drove to do the closing, a solo deal at the last  moment.  Being Tim allowed me the bit of excitement I needed to power through not crash on top of the 6″ stack of papers with drool smearing expensive lawyer ink.  I could buy this house today and another house in Southern France next week.  MeTim could escape to the Caribbean with all our cash, given MeTim could figure out where HeTim keeps it (damn that mint password).  One day in court, MeTim and HeTim would aruge over who is the rightful owner of the yacht.   “Pull the plug” I could say one day, and no ethics committee could stop me.

The mundate repetitiveness signing,  my near-psychosis fatigue and the clatter of the lawyer/real estate convention who had long lost interest in my work and changed subjects to the bitchy town clerks of Denville (“I mean, hire more people for god’s sake if you can’t process the proposals, right?!) caused my signature to be less than ideal.  Never consistently, it is found in different places as following, including many combinations:

“Timothy J Hannan by Anna E Ringwelski-Hannan his attorney in law”

“Tim Hannan, by Anna Ringwelski his attorney at law”

“Tim Hannan by Ania Ringwelski his attorney”

or the worst:  ”Tim Hanna, attorney”

I would sometimes actually blank after writing “Tim Hannan” wondering, hmm..what commes next?

I don’t think the “his” was necessary but the lawyer said it once and I kept it in.

The signing of the MeTim and HeTim almost did not happen at all. While getting an armpit wax at a strip mall Asian beauty salon, 5 minutes from closing time, I got a call from my frantic dad.  Apparently he ran into his good friend Rita at town hall today who gave him a last minute warning.  Since Bartek Construction buys her a miniature christmast tree every year, she keeps my dad in the loop.  Per Rita, the carbon monoxide and above ground oil tank inspecction did not happen and all the paperwork was not in order for closing.  Given this information and the presumed delay it would cause, I had time to cross the strip mall green of the armpit wax to the strip mall with the Burger King and think about things.  Nothing says buying a house in Jersey like strip mall armpit waxes, BK and lawyers.

Should we even buy this house?  I mean, it is just a split level from the 60s in Jersey.  It is a nice town with a great (adequate?) school system where my parents work and have tons of ins.  It is on a lake and near a presevere.  It is theoretically close enough for Tim to commute, although in reality if he can’t even make it to closing, I wonder how much time he would actually spend there.  A far cry from my dream house, a 300 year old rehabbed by Steve Gambrel in Hanover NH, overlooking the CT river.   I ate my grilled sandwich and crossed the green back to the strip mall with my attorney’s building, one that looked like it had been built to match our split level in 1962.

Without the proper paperwork being filed (a fact apparently meant to kept hidden from us) I could sign everything fifty times, hand over hundreds of thousands of dollars,  but still leave without any keys or rights to even step on a piece of NJ property.  Assuming that the inspector could come tomorrow and the carbon monoxide certificate was completed the closing would be official then, after which, the paperwork could be filed and only then would our relator hand over the enormous bag (not kidding) that had all the keys.  Any delay beyond 24 hours and all the signing was for naught.  If I had known I’d be signing for 3 hours, I’d have probably postponed, but at the time it seemed like a “hey, well, I’m here now, so let’s do it.”

The signing took place only after our lawyer went over the numbers on pages called things like HUD, HUD supplement, Escrow the titles of which alone could be written in Mandarin as far as they meant anything to me.  He started by  saying “some of these are off, but it’s not a big deal, just make a check out for $459.68,” which perked up my ears. This lawyer had irritated Tim for letting too many errors slip by, so I felt I needed to step up my math game. For the first time in 3 months, I cared about the details started by calling Tim and asking him if our mortgage rate was correct. Otherwise he was unavailable and I did my best by double checking the attorney’s calculations with his calculator.  It was slow and painful for everyone.  Only then did the signing begin.

After about an hour, the agents and the seller’s lawyer, a guy who couldn’t look more like you’d imagine a Jersey lawyer to look like, overweight, double chin, cocky, hating on Denville, all got a check and got up to leave.  They waved good bye to me on their way out the door,”We usually say Congratulations! at this point but we won’t today since the house isn’t yours yet!”

For me, it was just the beginning as I still had about 2 hours to go.  Just me and our irritating lawyer, sitting there in silence with small bits of monologue on his part, “Here, and here, and here.” Interjected with comments about how he hopes Tim had a good reason for making me do this alone, as if trying to transition his role into divorce attorney.   It was awkward, painful, and so tiring.  I walked out to the parking lot and walked up to a gold SUV and put my keys in the door.  Then I walked over to our Odyssey and drove off for my parents house, wishing you could just buy a house on Amazon after reading some reviews and seeing a lot of photos, with all inspections posted for perusal, with an option to return within 3 months.

Lord of the Flies Sprinkler Park

Imagine a scenario in which you have been waiting your entire life for item “X”.  It may be the new Ipad 3, a Prada Bag, a Corvette, a top-of-the-line racing bike, whatever.  At first, you see it.  Your heart fills with awe, you start to get palpitations, your  mouth salivates, you experience the euphoria
of material goods (which only lasts so long).  You touch it, you love it, this is your time.

And all of a sudden, some perfect stranger walks up to you, shows the slightest bit of interest and your mom tells you to share.  You are pushed aside for “Richard’s Turn.”  You hate that dude, he’s always interrupting your presentations to the Board.  So cocky, that dick.  Now you have to pretend to not be furious as he drives off in your Lamborghini.  Fuck.  Fuck everything.   You could just hit someone.

My poor sons and their peers experience this pain every day in the sand box, at the sprinklers, at birthday parties, on Christmas day.  They are asked to “share” their most valuable, most sacred items.  Just to give them up.  It’s bad enough when it’s a brother or a cousin, but really, most of the time, they are asked to “share” and “play nice” with total fucking morons from down the block.

Maybe some of this pathology comes from my problems with sharing. I really don’t.  I can barely remember the last time I asked to borrow someone’s car (in college, my roommate, and was denied), someone’s phone (only my husband’s and he is stingy with it for fear I might “lose it”), someone’s clothes (Kate Hannan’s gap khakis in HS).  My favorite items are my computer, ipad, iphone, kindle books, car…none of which I ever borrow or am asked to lend out.  The last things I ever let anyone borrow were 2 Bill Bryson books before the era of ebooks (Shakespeare-Alfred Chang) and (Sunburnt Country-Cappi Lay), neither of which I have seen since. And I regret giving them out because they were great books.  God I miss them.

The truth is, we don’t share much in this society.  We are taught to be self-sufficient.  We have enough resources to satisfy all of our needs and desires and it’s looked down up on to need the help of others.   If you need to borrow something of mine, you are probably either disorganized or cheap (buy your own).  Really, the only thing I ever borrow is pens at work occasionally and I feel like a retard, not a doctor, for doing it.

The “Stuy Town Moms” facebook page sometimes has a mom asking if anyone could lend something like a hiking baby backpack for a weekend or an air mattress for a family member.  My thoughts are, “what if she ruins it?” “what if she gives me bed bugs when that mattress comes back to me?”  No thanks.  A backpack is $100 bucks and mattress $30 on Amazon.  Unless you’re poor, you can afford it if you really need it, and this is not a poor neighborhood.

Maybe my strong reaction to sharing comes from the fact that growing up in Poland, everyone was always borrowing everyone’s stuff.  There was not enough to go around.  My mom’s friends all borrowed each other’s clothes, cars, summer homes, jewelry, whatever. The whole country ran on the barter/favors system.  Paradoxically, my upbringing made me paranoid about borrowing.  The first thing we did to any borrowed item was wrap it in a protective coating and keep it in a place of worship, lest it get ruined.   All of the romance novels my mom borrowed from her friends had covers made from ShopRite paper bags like Social Studies text books.  We once visited stayed at a condo in Utah lent to my father by one of his clients and I swear we had to walk on walls to make sure the carpet stayed unsquished and clean.

Or maybe I have an aversion to sharing because it makes my current life hell.  I spend approximately 98% of my playground time in conflict resolution repeating things like “Now, that’s not nice, let’s share and take turns.  Ok, 2 minutes Calee’s turn.”  Kids have such weird names nowadays that the unpredictability of the name +  the 3 year old’s slurred speech causes me to approximate most names to such things like “Calee.”  I get out my iphone and “set timer for 2 minutes.”  Now that I lost my Iphone, I get out my Blackberry and pretend.  It’ s painful, I always have to be involved bc my kids are either ripping someone’s backhoe out of their hand or being kicked in the gut by a 4 year old who wants their water balloon.

And I have to assume my kids sense the angst I feel at the approach of “what a nice little girl come to make bubbles with us.”  This is what they will be able to trace their lack of social graces to.  When they have no friends and discuss with their therapist, no doubt this blog will be printed out as evidence “A.”

“Mine is mine, yours should be mine and I will take it if I can” seems to be how kids are born.  And when they grow up and become dictators of small backwards countries, they recruit child soldiers to carry out revolutions to enforce the belief.  It’s the basic problem of humanity, which as led to petty theft, murders, wars.  It’s ugly, but it’s human.

I would prefer a more National Geographic playground.  If my kid whines about wanting your scooter, feel free to whack him in the face to point out that it’s yours.  He will do the same to the smaller kid to express his views about his helicopter.  Eventually, a natural order would settle out as this microcosm of the Lord of the Flies sprinkler park establishes some alphas and omegas.  And I could just relax.

If you’re going to the ER….

If you’re going to the ER…

There are some things you should know.

1.  You probably don’t need to go to the ER.  You definitely don’ t need to go if you have a runny nose  or a sore throat AND cough or sinus pressure or itchy eyes.  Same for knee pain for 3 years, low back pain since the car accident in 1986, most rashes.  If you had a minor car accident today and feel “fine,” don’t go “just to get checked out.”   Don’t come to get a refill of your script (your doctor’s office can do that over the phone).  You will wait for hours just to be irritated that you weren’t given anymore more than a very expensive Advil.
2. It’s not the ER.  It’s the ED.  It’s the “Emergency Department,”  and not the “Emergency Room.”  “Room implies “corner” or “janitor closet”.  It lacks a certain legitimacy that our specialty is constantly trying to assert.  We practice “Emergency Medicine” and are “Emergency Medicine Physicians” although we are not consistent about this and often refer to ourselves as “ER docs.”  But if you refer to your doctor as an “Emergency Medicine Physician in the Emergency Department,” you will sound in-the-know.
3. EDs are not given prime hospital real estate.  When you ask about how to get into the ED, you will likely be shown some backwards basement dilapidated swinging door on the side of the hospital in some alley way.  This may not be true if you live in the Midwest or South but it is a certainty if you are going to the ED in NYC.  It is likely that you will see signs about the renovation/construction project currently undergoing in the ED.  These same signs will be up the next time you return to the ED in 5 years.
4. The Payment.  Your first stop is the registration booth where your insurance information is taken.  If you do not have insurance, DO NOT HAND OVER YOUR CREDIT CARD.  Better yet, don’ t hand over anything, tell them you lost your wallet.  Unless you are rich and that is why you don’t have insurance in which case, please go on and subsidize the poor people.  A visit to the ED costs about $1,500.00 for stupid shit like a bruised knee.  I had some European tourists at NYU lament that their credit card was charged $1500 after I repaired a finger cut.
5. The Wait.  Once your history and vitals are taken you will wait to see the doctor.  And wait. And wait.  And wait.  Bring a book or two.  Expect it to take all day or all night, or both.  And, if admitted, you won’t get a room for a long time although the exact time is impossible to predict.
6. Your doctor.  Your doctor in the ER/ED will not be a Gastroenterologist if you have belly pain or an Orthopedist if you have knee pain or a Neurologist if you have a headache.  It will be an EM doc and don’t ask what specialty your doc is planning on pursuing.  EM is a specialty and we’d have to do residency all over again if we wanted to do something else.
7. Pillows.  Don’t ask for a pillow.  I don’t know if those stretchers are so uncomfortable or what but everyone wants a pillow and ERs never have them.   You could maybe get a blanket, or a sheet, maybe a sandwich or a water (after asking 5 different people and finally getting it yourself).  But a pillow…unlikely.
8. Honey.  Don’t ask the female doctor for a pillow and don’t call her “honey” or “nurse.”
9. The butt of our jokes.  You are likely to get made fun of.  The doctors usually sit in the computer area in the middle of the ED where they write their charts, present patients to the Attending doctors, order imagery, etc.  ER docs have sick senses of humor.  They claim it’s because they under so much stress and see such disturbing things, that a sense of humor is a defense mechanism.  I’m not sure if it’s this or that we are just sick people.  Jokes about death, morbidity, ethnicity, sex, religion…you are bound to be the butt of one.  I just reprimanded my resident yesterday for making a bombing joke about a Muslim patient’s vagina.  It may not be right, it’s ugly, it’s reprehensible, but that’s just the way it is.  It’s nothing personal and since all the doctors sit in the middle  with only a curtain between you and them, you are likely to hear it.
10. Your butt.  You are likely to have something put up your butt.  It will either be a finger or a rectal thermometer but there is about an 80% chance that it will be requested that you bring your legs up to your chest.
11. Privacy.  You will have no privacy.  As much we claim to care about your privacy, we have no choice but to ask you about your STDs and medication s in the hallway.   During rounds you will be referred to as “the kidney pain with a history of Chlamydia” for all to hear.  Probably for historical reasons, HIV/AIDS gets more respect and is referred to by the code name “High 5” or something similar.
12. Your gross neighbors.  Your neighbors might be gross, especially if your ED visit is in the city.  By gross I mean homeless, drunk, not showered for weeks or months, covered in feces or urine, or infested with bugs or maggots.  At Bellevue, a nice British tourist spent so much time next to her homeless drunk companion that her sheets were crawling with something winged.  She was so cute, “pardon me, but I believe there is something walking upon my gourney.”   Or they might be a Riker’s prisoner or an arrested druggie.  It will be eye opening.
13. Disposition.  If you are admitted, you might not find out until you are in the elevator on your way to the telemetry (heart monitoring) floor.  If you are discharged, you will likely be diagnosed with something vague like “gastritis,” or “concussion,” given an illegible yellow carbon copy of your discharge instructions, and  told to follow up with your doctor in 1-2 days.  You might look at us funny if your only reason for visiting the ED was to get a pregnancy test that turned out negative  or something clearly unlikely to need follow up, but we are pretty much required by law to advise you to seek further medical evaluation no matter what.  Also, see Point #1 about not needing to go to the ER.