Monday, October 22, 2007

Butt Cake

My wife Gina is a family nurse practitioner ("FNP" for short, or as we say around here, "' P!") who works (and I mean she flat-out big-time double-dog works) in the women's division of the Infectious Disease Program of Grady Health System, the local public hospital/healthcare system in the Atlanta area. She treats some of the sickest individuals I have ever heard of, who are all some combination of tuberculin, crack-addicted, HIV-positive, unemployed (and unemployable), non-English speaking, psychotic and/or smelly.

Some of these women have stories that would break your heart, while others seem to me to have virtually no redeeming qualities other than that they are one of God's children. Although a few manage their HIV status quite well, others run up hundreds of thousands of dollars of taxpayer money every year while barely lifting a finger to take care of themselves, and still others just seem to quietly curl up and die with barely a sound or ripple. I could not do this work for five minutes or a million dollars and yet she does it full-time for half of what she could earn in the private sector.

In addition to the patients, the healthcare system where she is employed is broken beyond measure. What you read about Grady is not true. It's much worse. Its administration is cumbersome, the various departments are territorial, the bureaucracy is staggering, and a general sense of accountability and professional pride is lacking among many of its employees (the best of which have been actively driven off by mismanagement and poor administrative practices). Anything that can be done to improve morale among the embattled workers who somehow continue give a damn is a good thing.

Enter butt cake.

One of the procedures Gina is certified to perform is a colposcopy, which is an illuminated, magnified examination of the cervix and the tissues of the vagina and vulva. One of her coworkers in the men's HIV program recently became certified to provide a similar procedure called an anoscopy, a rectal examination in which a small tube is inserted into the anus to screen, diagnose, and evaluate any problems that may be happening in there.

If we all worked at jobs we imagined having as children the world would be overrun by firemen, teachers, ballerinas, astronauts and football players. Nobody started their life thinking they'd earn their living looking up butts. So when her colleague earned his buttchecking license Gina made him a cake to commemorate the occasion. She baked it in one of those heart-shaped "Valentine" pie pans, lopped the pointy end off, turned it upside-down and voila! Butt cake!

If you heard rumbling coming from midtown Atlanta a few months back it was because this one simple act just about brought the house down. The laughter is still echoing down the halls.

So to those of you who work in places where spirits tend to sag low, remember that morale comes from many sources: raises, recognition, awards.....and butt cake.

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