When is a hospital like a restaurant?

iStock_000014819000XSmall copy

Here’s a riddle:

When is a hospital like a restaurant?

The riddle came to mind after reading yet another idiotic piece on the festival of stupidity known as Mothering.com. The piece is entitled Breech Birth: Why Can’t Women Have it Their Way?, written by Lauren McClain, “one of the most passionate and knowledgeable breech experts out there”.

Under what rock do the clowns of Mothering.com live where giving birth to a breech baby and reading junk from other lay people makes you one of the most passionate and knowledgeable breech experts out there?

Pro tip for the folks at Mothering.com: In order to be an expert on breech birth, you must:

  • have advanced medical training
  • have delivered hundreds or thousands of babies
  • have delivered breech babies
  • be experienced with the Mariceau-Smellie-Veit maneuver
  • know how to prevent and resolve nuchal arms
  • know how to apply Piper forceps to a trapped after-coming head.

How many of these qualifications does Lauren McClain have? Funny you should ask; she has ZERO. Claiming she is an expert on breech is like claiming that she is an expert on structural engineering because she once crossed a bridge.

Lauren apparently believes that hospitals are like restaurants:

… [I]t’s silly to walk into a McDonald’s and ask for a salad Niçoise, almost as silly as asking for a vaginal breech birth at a major medical center…

In any good restaurant, you can have things a number of different ways. In excellent restaurants, you can even say, “I’m vegetarian, I don’t see anything that strikes me on the menu. Have the chef create something.” They want to serve you, they want to get you the best possible care and nourishment they can, and they care what you think when you leave.

Lauren then proceeds to whine in alliteration, insisting that hospital care of breech babies suffers from impatience, ineptitude, and impersonal care.

According to Lauren:

Though there are certainly exceptional doctors working within the establishment, the general truth is that the choices in childbirth are abysmal. Almost no one does twin or breech births. Few doctors can perform ECV or have much useful knowledge of fetal positioning. They can’t (or won’t) help turn a posterior. Since they make liberal use of sonogram, their ability to palpate the abdomen has gone out the window. Many have never even witnessed a planned un-medicated, un-induced and un-augmented birth, much less an active birth.

How does Lauren know this?

Duh! She knows this the same way all natural childbirth advocates “know” anything. Another equally ignorant natural childbirth advocate made it up and told her.

Lauren wants salad Niçoise (breech vaginal birth). Her local restaurant, Chez Amy, doesn’t serve salad Niçoise. Unbeknownst to Lauren, that’s because improperly prepared salad Niçoise can cause illness and death and Chez Amy doesn’t want to take the chance of killing anyone.

=Chez Amy offers filet mignon, but Lauren doesn’t want that. Lauren wants salad Niçoise. and, dammit, she’s going to get salad Niçoise. Therefore, she heads off to a self-proclaimed “restaurant” in her neighbor’s basement, Wize Wimmen Resterent. I say self-proclaimed because Wize Wimmen Resterent doesn’t adhere to any of the regulations governing restaurants and doesn’t even allow health inspections to ensure that the restaurant is safe, let alone high quality. But that’s okay with Lauren because she’s “done her research” and “knows” that she won’t get sick from improperly prepared salad Niçoise.

For Lauren, that’s the beginning and the end of the analogy. She goes to Wize Wimmen Resterent, gets salad Niçoise and lives happily ever after, empowered by the knowledge that she got what she wanted.

But let’s take Lauren at her word for a moment and extend her restaurant analogy.

Let’s imagine that Lauren eats her salad Niçoise at Wize Wimmen Resterent and gets food poisoning from contaminated tuna in the salad.

What does she do? She does the equivalent of what women do when their breech baby gets stuck at homebirth:

She has one of the wize wimmen drive her to Chez Amy, appears on the doorstep and demands entry. She insists that all other patrons of Chez Amy be ignored while her needs are met first. She demands that the chef at Chez Amy do something to immediately stop her nausea and vomiting, although she has no idea what that might be or if such a treatment even exists. Then she demands that the chef immediately produce a filet mignon since she is hungry because she vomited up her salad Niçoise.

Lauren “knows” that restaurants who care about providing good service would, of course, immediately usher in a patron spewing vomit and diarrhea who had acquired food poisoning elsewhere, prepare a remedy and offer a perfectly cooked filet mignon. And that’s despite the fact that Lauren is planning to sue Chez Amy because 1. the filet mignon was not the exact degree of medium rare that Lauren prefers, and 2. she only got sick because Chez Amy forced her to go to Wize Wimmen Resterent by refusing to carry salad Niçoise on its menu in the first place.

That’s what happens in the world of restaurants, right?

Wrong! As we all know, not only would no restaurant would cater to behavior like that, and no remotely reasonable person would expect them to do so.

We appear to have found the answer to our riddle. When is a hospital like a restaurant?

NEVER, and only a fool would think otherwise.

  • Elizabeth Neely

    when I was pregnant with my youngest I went to a baby shower for a friend, I sat next to a dear friend of mine, and somehow she started telling me about her son who was born breech in the hospital in like 1963, and how horrible it was, how it took the doctor something like 6 hours to repair her bottom from all of the tears and her bladder being torn etc. I thought it was a rather disgusting conversation. Until my son turned breech, and I had NCB friends telling me how they could manage it and I should just use a midwife bla bla bla…..Then I was so grateful for that lady’s honesty about her experience, I knew better than to fool with a dangerous situation like a breech birth. What happen to a good old wives tale that is truthful about the inherent dangers of a “natural” childbirth. WE need to get the truth out there.

    • Young CC Prof

      Absolutely. I am so glad I found this site a few months before I learned my son was breech near term. My c-section was fine, recovery wasn’t awful, and my peanut wasn’t subjected to the risks of breech birth.

  • ngozi

    I really enjoyed reading this.

  • Comrade X

    The Fugu Fish is actually an excellent analogy.

    It is my understanding that becoming a recognized Fugu chef takes years and years and years of work, practice and training. Because Fugu is dangerous, and it can kill people, so you have to know what you’re doing. You know, so you don’t kill people?

    Homebirth with an undertrained midwife is basically the equivalent of eating Fugu prepared by your mate Kevin who once watched a YouTube video about it. If you actively seek out Kevin to prepare Fugu for yourself and your family, despite knowing how dangerous it is and how clueless Kevin is, then you are responsible for putting yourself and your family in dreadful danger. If Kevin manages to con you into thinking that he has the equivalent experience and training to one of the top Japanese Fugu Chefs, then Kevin is responsible for tricking you into putting yourself and your family in danger.

  • guest

    don’t know if anyone has already said this, but…
    to answer the title question, how about the women who say they would prefer a homebirth but choose hospital birth so that they don’t have to clean up the mess? to them, a hospital isn’t a place with medical professionals who can provide care in life-threatening (and non-life-threatening) situations, but a place with janitors who can mop up the mess. then it resembles the service industry!

  • Courtney84

    Having just had a lousy “birth experience,” but a fabulous baby! I feel really defensive on behalf of doctors. My OB was great! She was so kind and sympathetic that things were not going as smoothly as one would hope. Since it wasn’t an emergency, we had a several minute conversation about the pros, cons, and hypotheticals of continuing to labor vs. moving to c-section. We talked about the aspects I was afraid of and what we could do to help ease those fears. Shockingly, she wasn’t heading to the golf course or a dinner reservation. She stayed and did my surgery when it would have been completely acceptable and appropriate to let the practice’s on call doctor do it. Heck, I’d even signed a paper when I established care about the call schedule and when you get your doctor and when you get the doctor on call. She took care of me because I was her patient and she wanted too. I know bad doctors exist, but I firmly believe they are the exception and not the rule.

  • melindasue22
  • Gunnvor Valkyrie

    Thought everyone should know the site kidshealth is really pro breastfeeding.

    “Although some women give their babies formula from bottles, many women
    still breastfeed their newborns. In fact, doctors recommend
    breastfeeding as the best way to meet a baby’s nutritional needs.” http://kidshealth.org/teen/sexual_health/girls/sore_breasts.html#cat20015

    • Jennifer2

      Eh, that doesn’t seem really that out there. In fact, as a formula feeding mom, I would say that’s about as even-handed, factually accurate, and non-judgmental and explanation of why women have breasts and the feeding of babies as one can get.

  • Young CC Prof

    Today’s “news”: Woman live-tweets home birth, almost bleeds to death. (Happy ending with both alive at least.)
    http://www.huffingtonpost.com/2014/01/08/photos-home-birth-social-media_n_4549531.html?ncid=edlinkusaolp00000009

    • Josephine

      I like how she thanks her midwife etc by name but can’t say one goddamn word about the people who saved her ungrateful ass by pumping transfusions and drugs into her and repairing the damage.

      • Josephine

        And pardon the aggressive language and cursing….sleepless night and twins in my uterus making my back and hips all but split apart (In between waking me up with kicking each other)…I’m feeling rather nasty today. Nevertheless I stand by my grumpy assessment that she sounds like a brat.

        • Sue

          Not as agressive as the poster’s own language, during that gentle natural birth (not).

      • Sue

        Right. Her ”totally natural painful as hell twelve hour birth” was rescued by totally unnatural ambulance, hospital, analgesics and blood transfusions. Ugh.

        Some people are so insightless. One can only hope that parenthood helps her mature.

        • Wow I would like to see how you deal with your entire belief system crashing down around you while it is happening. If you think you would realize “oh gee everything I believed in is a lie” in that instant, you’re probably wrong. Just talk to people who escape cults. Its like a glimmer of understanding comes through, and then you build on it and finally your mind is changed. I am not saying she will for sure change her mind, but give her a little bit of time before being assholes about how she reacted.

          • Josephine

            Of course I don’t think she would be suddenly transformed at the very moment she entered the hospital, but when she lists her midwives, doula, the EMTs, you don’t think she could give a quick shout out to the medical team who worked on her? I wouldn’t care if she named them, just there was absolutely zero acknowledgment after apparently everyone else involved got their kudos. I couldn’t have cared less if she didn’t publicly thank anyone, but to make a list like that and very obviously leave off something like “thanks to the awesome doctors, nurses, and staff here for acting quickly and keeping me alive” or SOMETHING is ridiculous.

            It’s not as if I’m expecting her to make a tweet or FB post about how it was a bad decision and homebirth is dangerous right away. I’m not an unreasonable person. But it angers me that she can’t admit for a moment that medical staff was an important part of keeping her from DYING when she’s throwing roses for everyone else.

    • Dr Kitty

      Well those tweets don’t come of in ANY way as narcissistic. What is with the shot in hospital of the sanitary towel?Why was THAT necessary?

      12hrs of unmedicated labour (apparently a whiskey sour doesn’t count as a drug), a shoulder dystocia, retained placenta, large perineal tear, PPH, hospital transfer, IV fentanyl and several units of packed red cells…sounds *magical*.

      • Jennifer2

        Note that the hashtag is not #homebirth or #nyeshomebirth (the baby) but #ruthshomebirth. Yup, it’s all hers. I’m not saying that you can’t refer to the day you give birth as your birth, but to me it seems weird. When I talk about my birth, I talk about the day when I went from being inside my mom to being outside her. When I talk about the day I gave birth to my son, I talk about it as *his* birth or when he was born or when I had him.

    • OBPI Mama

      That was so disturbing. But, of course, she thanks her midwife!!! I want to go throw up.

    • Lynnie

      I don’t have twitter, but I can’t imagine tweeting or posting my labor to Facebook. (I did post that I was going in, and several hours after my son was born that he was, infact, born.)

    • realityycheque

      Seems like she got ahead of herself saying that “labour feels like bad period pain”.

      I wish “newspapers” like huffpo wouldn’t glorify and advertise this stupidity any more than the women do themselves. We shouldn’t be normalising the idea that a home birth with SD, severe tearing and PPH is a “beautiful”, desirable way to give birth.

  • Lynnie

    So, from what I read of her article (I couldn’t read the whole thing), she sounds like a restaurant snob as well. She has a real disdain for the fast food industry. Well, the fast food industry IS usually a first job for most teenagers and service is definitely lacking. Is she REALLY expecting first class service at Wendy’s????

    Of course, that REALLY shows her disdain for doctors and hospitals. Ugh. Yes, a good hospital staff will consider the patient’s requests in their care, but there are times when health and safety overrides the “experience”. Complaining about a healthy baby after a life saving C-Section is the same as a person whining about incision pain after an appendectomy in my mind. Sure, my life was saved, but it hurts and there is a chance I could have survived with out surgery. Yeah, and there is a much higher chance of a bad outcome.

    In MY opinion (I am rather lacking in the medical knowledge area), a main reason that most doctors and hospitals don’t want to do tricky vaginal deliveries is that hospitals and doctors are being sued so many times for bad outcomes that are out of their control. So many people sue for medical malpractice over bad outcomes that are unfortunate, but aren’t the doctors’ faults. I might be wrong about this, but I think the insurance companies have a large say in what doctors do and do not do. And it may make doctors hesitant to “allow” breech or twin deliveries.

    The hospital I gave birth in tends to induce or do C-Sections rather “quickly”, and it’s “easy” to think that they are doing them things unnecessarily. But take into consideration that this hospital is a SMALL hospital in a small town and the closest NICU is a couple hundred miles away and they would rather not have to transfer the baby by helicopter to the NICU. They would rather be a tad bit overly cautious and save the trouble of transfers and the babies’ lives.

    • Elizabeth A

      The nuance that I (a moderately informed layperson) would add to your post is that when doctors take risks, they aren’t sharing that risk just with their malpractice insurers and business partners, they’re taking that risk with your life, and the life of your family. A doctor who doesn’t allow breech vaginal deliveries, or VBACs, isn’t necessarily worried about being sued as much as they are genuinely worried about their patients’ lives.

      In a perfect world, everyone would have easy access to fully staffed, tertiary care facilities that could handle everything imaginable. Alas that we don’t live in that world.

      • Lynnie

        Yes, true. They also don’t want the baby or mom to be injured or die. I do know that. I also got distracted when I was typing my long rant and didn’t reread it before posting.

      • Josephine

        Psh, please, doctors don’t care about anything but tee time or making their flight to their frequent vacations in the Caribbean.

      • Sue

        ”A doctor who doesn’t allow breech vaginal deliveries, or VBACs, isn’t necessarily worried about being sued as much as they are genuinely worried about their patients’ lives.”

        That’s it.

        I’ve seen so many dedicated clinicians who were severely affected by a perception that they had harmed a patient – becoming withdrawn, risk-averse, depressed. That is not to minimise harm to patients, but to explain that clinicians are not heartless automatons.

  • Zornorph

    Q: Can I have an order of Soylent Green without people, please?
    A: No, because Soylent Green IS people!

    • Guest

      I’m still trying to figure out if eating your own placenta is considered cannibalism. I know it is if I eat someone else’s, but what about my own? Same as eating my own finger or different?

      • An Actual Attorney

        The placenta that comes with your baby is your baby’s DNA, so… We’ll just call you Hannibal.

        • The Computer Ate My Nym

          Fussy correction, but, IIRC, the placenta contains maternal and fetal elements. Creepy little organ.

        • Captain Obvious

          Ffft ffft ffft ffft fava beans

      • Ainsley Nicholson

        Differant- the tissue in the placenta is derived from the fetus as well as the mother. So it is more like chewing on your child’s finger.

      • I tried to figure that out about the sacrament in catholic church too. I guess cannibalism is in the eye of the beholder

      • rh1985

        When I had my embryo transfer, I got a picture and the RE showed me which part would become the placenta. Pretty neat. Would feel way too weird to eat it in any form.

  • Ainsley Nicholson

    OT: Interesting article “Breastfeeding: Was there ever a golden age?”

    http://www.bbc.co.uk/news/magazine-25629934

    • carovee

      I just read the feminine mystique written in 1962 and Betty Friedan blasts the homebirth/breastfeeding movement of the 1950’s. I had to keep checking the copyright to see if it was really written that long ago.

  • Carolina

    A better analogy would be demanding puffer fish 🙂 Isn’t that the fish that will kill if not prepared perfectly? (too lazy to google and my knowledge comes from a Simpson’s episode).
    I wonder how many fine dining establishments she frequents. While they accomodate allergies, most do not seem to embrace special orders or substitutions.

    • Fugu. The liver in the male and ovaries of the female are deadly.

      • Carolina

        Yes! Now I remember Homer screaming: “I WANT FUGU!” 🙂

        • The Bofa on the Sofa

          You know, after about 15 years, I gave up on the Simpsons…

          “Simpsons did it!”

        • Jennifer2

          This was exactly the first thing this made me think of!

  • Dr Kitty

    Can we stop pretending that medicine is a service industry please?

    You know what industry is often used in healthcare analogies? The aeronautical industry. Certainly when it comes to safety.

    So…here’s an analogy for you.

    Imagine instead of a breech birth, she wants to smoke on an aeroplane.
    Think of her arguments: it is “safe”, they used to do it in the 1970s, she couldn’t manage a 14 hr transatlantic flight without smoking and not suffer anxiety, nicotine patches make her itch, she paid a large amount of money for her ticket so the airline should accommodate her.
    Oh, but of course, should the smoking cause some sort of cabin fire, OF COURSE she’d sue the airline.

    Guess what happens if you try to light up at 30,000 ft?

    “Because I want to, and it isn’t THAT unsafe, but I’ll expect you to bail me out if it goes wrong” doesn’t work for airlines any more than it works for hospitals.

    Which is why I guess the MDC readers will allow their flying experiences to be constrained by airport security, will adhere to the list of permitted substances in their luggage and will buckle their seat belts, stow their luggage in the overhead lockers, remain seated when the captain turns on the seatbelt light and keep their seats in an upright position…even though the risk of dying in a plane crash or being hijacked by terrorists during a flight is orders of magnitude less than the risk of your baby dying during a breech birth.

    • Trixie

      Hospitals do market their labor and delivery care as a service industry would, though. They all compete for best food, nicest suites, etc. etc.

      • Dr Kitty

        Just like airlines market their reclining seats and legroom…but you don’t expect to be able to take your favourite firearm into the cabin with you!

        • Trixie

          Ha. I started following the TSA on instagram. An alarming number of people do still seem to have this expectation.

          • Dr Kitty

            A scary amount of my maternity leave involved watching “Australian Border Patrol” while Breastfeeding at 2am. Australian customs seem more concerned with plant and animal matter bringing disease into Australia than illegal aliens, and episodes usually involved elderly people visiting their grandchildren in Aus with 5kg of delicacies from the old country sewn into the lining of their suitcase!

            My enduring memory of my trip to Australia was the airport security/customs in all the stopovers.

            LAX- one TSA agent made a joke about my British chocolate bar and told me where I could buy some “proper” American candy…and to remember the drinking age in the USA is 21!

            Auckland- absolutely no security questions, but an assumption we’d all like coffee and a shower before our flight to Sydney and so everyone got directions to the bathrooms and cafe.

            Sydney-“Are you absolutely sure you didn’t bring any shamrocks with you from Ireland?”

          • Gene

            Bless the Kiwis. We were laid over once there (honeymoon in Aus) and the TSA (or NZ equivalent) chided us for visiting Australia instead of NZ. Proclaimed it was MUCH better and we should schedule a trip back ASAP.

          • Sue

            LOL. As dwellers on an enormous island nation, Aussies pride ourselves on being free from lots of foreign insect pests, plant diseases, and rabies!

            We tend to only worry about unexpected immigrants arriving by boat – not plane.

    • Sue

      In my view, hospital is like a restaurant attached to a soup kitchen.

      On the restaurant side, you get your elective surgery, booked in advance, with your own table (or you might have to share).

      On the soup kitchen side, you can arrive any time you like, starving, and get fed. Even if there are no free tables available when you arrive, if you are really starving, they’ll re-arrange to make roon for you. The menu may not be to your liking, but you’re generally grateful that the kitchen staff know what to give you – even if if is basic – to help you feel better.

      The labor and delivery wards would be somewhere between. You have a booking, but they might have overbooked. You can try choosing from the menu, but availability might change. You may or may not emerge satisfied, depending on whether your main aim was just to get nourishment and have your hunger satisfied, or whether you wanted a gourmet meal with the trimmings.

      Enlightened delivery units will have a more extensive menu with more choice and more trimmings, but a disclaimer that tells you that not all the options might be available to you, but they will do their best to make your stay both nourishing and satisfying.

  • Meerkat

    I can’t speak for restaurants, but I have worked in luxury industry, where the motto is usually “anything to make a client happy.” That motto worked as long as the measures didn’t waste too much time or money. As soon as the client became too difficult or demanding, their choices quickly disappeared.
    Oh, yes, Mrs. McClaine, I know we spent 6 months designing a special piece that doesn’t feel special enough now. Our designer has drawn up these 3 choices for you. He really feels that you will like them. Nope, no other choices!
    I have actually turned away especially difficult customers and refunded their deposits. Hospitals can’t do that…

  • Dr. W

    I have said, more than once,”This is not a TGIFidrays, and I am not your waiter.” Some folks act as they are their own hostage and that that entitles them to whatever crosses their non-expert minds. A hospital is obligated to offer you care and a plan that makes sense. It is not obligated to give you whatever you ask for. You want that? Become a billionaire. Frankly, her restaurant example is pretty darn entitled. Have the chef create something? Many a fine restaurant would inform you, kindly, that you may order or leave.

    • Anj Fabian

      The best places are booked solid. They’ll happily give your table to a less troublesome guest.

      • Trixie

        Depends on your city. In my mid-size city you can pretty much just walk into the best restaurants on most nights.

  • UNCDave

    Shouldn’t it be Chez Aimée, if we’re keeping with the French theme?

  • Guest

    Yeah, go ahead and go into an “excellent” restaurant and say, “I’m vegetarian, I don’t see anything that strikes me on the menu. Have the chef create something.” Probably you would be better accommodated in a hospital where at least the staff wants you not to kill your baby so they’ll do whatever it takes to shut you up and get your baby out. These are not the stakes at a restaurant. “Create something for me??” WTF are you, Duchess Kate? If you don’t like the chef’s menu, get out I promise no one will chase you.

    • Siri

      She wants special treatment, and she doesn’t even say please?!

    • AlisonCummins

      I’ve done it. It’s not usually a problem.
      “Hi, I see you sell BLTs. Can you make me a grilled cheese and tomato sandwich?” “Yes of course.”
      “Hello lovely little motel dining room in the middle of nowhere, I see you don’t have any vegetarian items but you do have spaghetti and you do have steak with mushrooms. Could you make me spaghetti noodles with mushrooms?” “Oh dear, we can’t let you go hungry! Yes we can do that. What else can we do for you?”

      The only time it was a problem was at an ultra-fancy french restaurant that was all about the meat where my grandparents invited us for their wedding anniversary. They knew about me in advance so they had something prepared: a bowl of boiled potatoes and carrots. They explained that was all it was possible to offer me because it’s not possible to make good food without meat. Still, they gave me something not on the menu even though they were snotty about it.

      • Guest

        Alison, you are generous and open-minded. What you are describing here is a common dietary accommodation that most restaurants will gladly make for lovely patrons such as yourself. “I’m sorry, I don’t eat meat. Would you be willing to make that spaghetti with a vegetable of some sort instead?” = “When the baby is born, I’d like my husband to look and tell me the sex of the child, please don’t you tell me.”

        This article says, “I don’t see anything that strikes me on the menu. Have the chef create something.” Which equals, “Dr. bring me a painfree unmedicated childbirth exactly as I like it STAT. And don’t open your mouth when you talk to me!”

        • Trixie

          “Is it possible to leave the bacon off the salmon?” Sure, most places are happy to accommodate you if they possibly can.

          This lady is like the person who self-diagnoses “gluten sensitivity” on the internet and then snootily gets indignant about every item on the menu, and in the process ruins it for everyone who actually has celiac and actually needs special accommodation.

          • Dr Kitty

            I have relatives with actual food allergies (both the kind that require Epipens and the kind that cause severe and immediate gastrointestinal distress).

            Asking nicely if you can have food served without sauces, and being willing to accept that you might end up getting a green salad, a piece of grilled fish and a plate of chips (again) isn’t a problem.

            Saying that you really can’t face another piece of fish, green salad and plate of chips and demanding the chef make you something unique and special…that is a whole different kind of obnoxious.

      • Bombshellrisa

        I have done this at In n Out Burger, but I was ordering the grilled cheese with tomato from their “secret menu” so I wasn’t being impossible, just a little picky.

    • Guest

      This whole discussion makes me laugh. In the restaurant that I manage, if you came in and said, “I’m vegetarian, I don’t see anything that strikes me on the menu. Have the chef create something”, we would. As long as we had the ingredients of course.
      Although I think hospitals need to change some policies to make women in labor more comfortable, you can’t in any way, shape, or form compare them to a restaurant.

      • The Bofa on the Sofa

        Heck, at BK you can get a Whopper without the meat.

        • Zornorph

          Yes, but why would you?

          • The Bofa on the Sofa

            Because you are Indian and don’t eat beef? That’s where I first learned that you could do it, from Indian friends.

          • Certified Hamster Midwife

            A grilled cheese at Five Guys is effectively a cheeseburger without cheese.

    • Therese

      I had to do this travelling as a vegetarian in Spain, because Spanish restaurants only include meat entrees on their menus. It was never a problem and the vegetarian meals that were created for me would often be the envy of my meat eating companions. I guess the way the question was phrased sounds pretty snotty though.

  • LovleAnjel

    Many restaurants now refuse to serve burgers cooked less than medium, due to the risk of food poisoning. Some will cook to medium rare but make you sign something promising not to sue if you get sick. Some will bring you raw meat on a plate. I suspect this person would be the type to whoosh into a TGIFridays and demand steak tartar, then have a raging fit when they try to explain their policy. She would then go to a friends and complain about how TGIFridays MADE her eat raw meat at home because they refused to serve her, and it’s THEIR fault she had raging diarrhea for three days.

    • DaisyGrrl

      Where I live (Ontario, Canada), you don’t get to choose how you want your burger cooked. It’s well done. End of story. The first time I ordered a burger in an American restaurant I was so confused by the waitress asking about how I wanted my burger, she had to repeat herself then clarify that she was asking how well I wanted the meat cooked. I still think it’s crazy to cook a burger less than fully and I love rare steak.

      • carnitarian

        Well done burger? That sounds disgusting.

        In my experience, the higher-end the restaurant, the more likely they are to accommodate rare meat (whether it’s burger, pork, or what have you.) You’ll get laughed out of Waffle House but at the bistro Kumi, where you can expect to drop $100/person without booze? Yes sir, right away sir. If meat is locally sourced, appropriately handled, and safely prepared, the risk drops precipitously.

        The crazy who wrote the analogy would probably blame the farmer who raised the cow for not feeding it by hand and singing it lullabies, though, rather than the wombyn sneezing in her salad and not washing her hands (can’t disturb the auras!!!11) before touching ingredients, though.

        • AlisonCummins

          Hamburger is different from steak.

          In steak, the bacteria are on the outside. Cook the outside, kill the bugs.

          In hamburger, the bacteria —most of which come from the slaughterhouse (there’s **** in the meat) — are mixed all the way through the nice, juicy, ground-up meat. They can grow in the meat before it’s cooked and they aren’t killed by just cooking the outside of a patty. “Hamburger disease” — E. coli poisoning — can permanently damage kidneys and it can kill. Especially children.

          So if restaurants refuse to serve you raw hamburger, that’s why.

          • carnitarian

            My husband’s a high-end chef and I’ve worked in food service myself, so I do know the difference between ground meat and whole meat. But thanks for playing. My point about food safety still stands.

  • DaisyGrrl

    Why did I click the link and read the full article?? Aside from the completely ridiculous claims she makes (without citation), the whole attitude annoys the heck out of me. I’m guessing that doctors and hospitals stopped delivering breech babies vaginally at about the time that the risk of a c-section was less than the risk of vaginal delivery. It is sufficiently less that I can only imagine what an informed consent conversation would be like and I suspect that most mothers with a breech baby would quickly and readily agree to c-section (this doesn’t mean everyone, or that it’s not a valid choice, but c’mon, most people choose to minimize risk when the opportunity presents itself).

    Hospitals are not restaurants. They are not department stores. They are not factories. They are a place for people who either require or may require significant medical intervention by a team of highly trained professionals. That is why we have babies in hospitals. This doesn’t mean that patient preference is meaningless, but it does mean that the default practices are going to focus on the safety and wellbeing of the patient.

    • Siri

      I think her problem is, she accepted caesarean delivery for her own breech baby, and so she spends her time trying to convince other women to have vaginal breech births in a bizarre attempt at compensating for her own ‘failure’. For every woman she converts to vaginal breech, a little bit of (misplaced) guilt is chipped away. That’s my guess, anyway.

      • DaisyGrrl

        Ah. Makes sense I guess. I didn’t go to her website because the article infuriated me so much. Too bad she can’t look at it from the other perspective of how awesome it is that she didn’t have to risk her baby’s life and brain function thanks to medical science.

        • Siri

          I agree!! You chose caesarean birth, presumably for good reasons; now own your decision, enjoy your baby, and don’t set yourself up as some vaginal breech guru to meet your own needs. The website is pretty infuriating too, minimising the risks of vaginal breech.

    • Young CC Prof

      In 1990, the very large Term Breech Trial clearly proved what many OBs already believed: That c-section had become the safer option. At that point, a vaginal breech became an indefensible choice in normal first-world circumstances.

  • Also, since when do restaurants give “nourishment and care?” Aside from “healthy vegan gluten free joyous harmony cafe” that is, most places seem to be more interested in polite, friendly service and food that is tasty, we’ll prepared and unique enough to stand out.

    • DaisyGrrl

      And restaurants will stock food to supply their menu. If I go to a seafood restaurant and demand venison, they’re going to tell me to order from the menu or go to a restaurant that serves venison.

    • Siri

      I think she’s confusing restaurants with her mom…

    • Elizabeth A

      I have eaten at a lot of restaurants. They are almost universally in the business of selling an experience involving food. (Some are in a different business involving pissing people off. This is not a profitable business.) After I eat enough restaurant food, even truly excellent restaurant food, I inevitably start to notice a certain underlying monotony. The dishes are all constructed to sell.

      This is why a home-cooked meal, even leftovers, after a lot of eating out, is such a treat. There’s no substitute for a plate of something intended to make you feel good, prepared by someone who cares about your heart and soul.

  • Amy M

    I get the impression that many of the NCB people who spout these tropes haven’t actually been in hospitals lately either, or if they have, they went in with such big chips on their shoulders, that they were treated with a bit of the disrespect they expected, and probably deserved. Of course there are doctors and nurses out there with terrible bedside manners. Of course there are some hospitals that haven’t quite made it into the 21st century in terms of top care in the L&D. But, there are PLENTY of wonderful hospitals, with excellent (well trained) staff, providing excellent care. Staff that is at least respectful, if not downright friendly. Meanwhile, some of the stories we hear about the treatment by the midwives makes me wonder if these people are just masochists.

    • excuse me, but patients do not ‘deserve’ disrespect. ever. I don’t care what they have done or said. If someone can’t handle that they shouldn’t work in medicine. Patients have made me cry before from how mean they were, some were neo nazis with swastika tattoos all over, homophobes, etc. It has nothing to do with if someone deserves care or not. It is *terrifying* to be at the mercy of people who openly disrespect you, btw. In a hospital the power and authority rest with the staff, its theirs to either use responsibly or abuse because they happen to not like someone under their care.

      • Dr Kitty

        Absolutely, I agree. Patients should be treated respectfully.

        As should medical staff.
        The NHS has a “zero tolerance” approach to abuse of staff.

        This came in handy when I was working in A&E and was racially abused by a drunk with a minor injury.
        He was quickly informed that as I was the only Doctor in the department, and he obviously had a problem being treated by me, it would be best if he left the department and went elsewhere.

        I do have to provide professional, respectful care.
        I do NOT have to tolerate verbal or physical abuse while I do it.

        I have ended telephone consultations because I am being sworn at.
        I have asked patients to come back when they have calmed down.
        I have told patients that the consultation was over and they needed to see another doctor.
        I have told patients that if they do not leave I will call the police.

        I’m not sorry about that, I’m protecting myself and other staff members, and almost always the patient will come back later (sober) and apologise for their behaviour.

        Patients deserve respect, but I do not have to put myself at risk to care for someone who shows me that they have no respect for me.

      • Lynnie

        One major problem is that some people come in with such a diva complex that the tiniest little imaginary “slight” is considered disrespect. If they have to wait longer than they want for pain medicine or the doctor doesn’t cater to their wishes, they cry foul. They go in EXPECTING to be mistreated and it’s a self-fulfilling prophesy. I have worked both in the service industry and in a hospital and some people have such diva complexes they can’t ever be pleased.

        • Dr Kitty

          People with genuine pain need it sorted out as a priority.

          I did not enjoy sitting in A&E for the 20 minutes after the 10mg of IV morphine wore off and before the surgical doc came to write me up for more. I get it was an unavoidable wait, but it wasn’t pleasant.

          My top tip-ask for sustained release analgesia, that way they can be late with your meds a maximum of twice a day.

      • Sue

        ”excuse me, but patients do not ‘deserve’ disrespect. ever”

        Maybe so, but people who work in health care are human beings, and therefore short of perfect. If a human is tired, stressed, perhaps young and immature, and you press all their buttons, sooner or later they might react. Like any human.

      • PoopDoc

        I provide medical care.
        I treat patients with respect.
        If my medical opinion and recommendations are not in accordance with what they want I will not change my stance to suit the patient.
        Not doing what you want because it is not sound medical advise is not “disrespect”.

  • Are you nuts

    As an aside… I can’t imagine how annoying this woman must be at a restaurant. I’m picturing the first episode of Portlandia where the couple goes to the farm to see the conditions in which his chicken was raised.

    • Karen in SC

      or any scene where Sally (Meg Ryan) orders food. 🙂

      • “‘On the side’ is a very big thing with you.”

  • SarahSD

    Wouldn’t it be great if you could choose your labor from a menu, though? Hmm, let’s see, what looks good … I’ll take a short, uncomplicated labor, and healthy baby, please. Wait, are there any sides to choose from? If “no or minimal tearing” is available on the side, I’d like that. And I see you have pain level indicated with these little chili peppers. No orgasms on the menu? Darn. Oh well, I was curious about it but it actually seems kind of creepy, so that’s ok. I guess I’ll settle for painless natural, then. Wait, you’re all out of the painless? I’ll guess I’ll take manageable to mind-alteringly excruciating with pain relief offered upon request.

    It’s easy to see how one’s expectations can become unreasonable when one thinks one has the power to choose what kind of labor one gets.

    • Siri

      I don’t like any of these birth options. Have your top OB create something different for me.

      • SarahSD

        And then send it back when it isn’t to your taste.

  • Are you nuts

    “In any good restaurant, you can have things a number of different ways. In excellent restaurants, you can even say, “I’m vegetarian, I don’t see anything that strikes me on the menu. Have the chef create something.” They want to serve you, they want to get you the best possible care and nourishment they can, and they care what you think when you leave.”

    Thank God hospitals DON’T do this!!! If I have an obstetric emergency, I want research-based protocol to be followed, not “hmm what flavor of castor oil/nipple stimulation/fairy godmother BS shall we use today?”

  • MaineJen

    GENIUS.

  • Zen

    I work in a hospital. To quote a coworker, “This is NOT Burger King, this is a hospital. You can NOT ‘have it your way’.”

    Which applies to many situations within the establishment, not only L&D.

  • Susan

    No shoes, no shirt –no service doesn’t fit with emtala or medical ethics.

  • I’m so sick of people who truly don’t know what they’re talking about drowning out people who do. Take your pick: NCB, vax deniers, creationists…The restaurant is a buffet of stupid.

  • PrimaryCareDoc

    I am SO sick of this NCB trope that OBs have never seen an unmedicated unaugmented birth. Where did this start? Was it BoBB? Wherever it started, it seems to get repeated now ad nauseam.

    I’ve said it before here and I’ll say it again- I spent 3 weeks on the L&D service as a med student. During that time I saw at least 10 unmedicated unaugmented births. In 3 weeks! How is it that I managed to do multiple times in 3 weeks what supposedly the “vast majority” of OBs have never done? So sick of that line of BS!

    • attitude devant

      I was thinking of this the other night when I was privileged to attend the labor and birth of one of my favorite L&D nurses. Very high-risk pregnancy, but natural labor from start to finish. She did great. BONUS: her blood-clotting disorder was managed according to the standard of care and she and her baby were healthy!

    • Susan

      The best I can tell Suzanne Arms made up that meme in the seventies and the nuts have been passing it around ever since.
      Gosh and some cultural groups almost never take anything for pain. And the nice thing about them is they just are grateful to have a safe place to have their babies. They don’t brag to their friends about their unmedicated births they just do it.

    • Bombshellrisa

      I want a doctor who has seen every complication in the book and knows how to proceed. Then they don’t call everything a variation of normal and sit back until things reach dire straits. What team doesn’t want to be present at an uncomplicated, unmedicated birth? Less work that way!

    • PrimaryCareDoc

      Oh, I forgot to say that one of those unmedicated births was the vaginal birth of twins. You know, yet another thing that NBC supporters say never happens in the hospital.

    • Sue

      Spot on, PrimaryCareDoc. It’s been many years since I had anything directly to do with obstetrics (except for my own) but, as a medical student, I was at a Catholic maternity hospital where youngunmarried girls had their babies, where essentially all the births for uninsured patients were unmedicated (except for emergency cesars).

      This trope matches the ”doctors only do two hours on nutrition in their entire training” – also nonsense. Doctors are not taught to be dieticians (ie to PRESCRIBE diets), but they learn about nutrition intimately, from the Krebs cycle to the anal glands, from folate deficiency to gastric acid, from bile secretion to insulin secretion. That’s knowing about nutrition.

  • nomorequestionscatherine

    OT: But I found this article extolling the virtues (and claiming virtually no side effects to mom and none to baby) of nitrous oxide in labor interesting in light of Dr. Amy’s recent piece on American midwives clamoring for the ability to use nitrous.

    http://www.slate.com/articles/double_x/doublex/2014/01/laughing_gas_for_labor_could_nitrous_oxide_be_the_next_big_thing_in_american.htm

    SMH

  • Here’s the problem – NCB advocates have taken over patient education and as a result instead of an “informed patient” you have an “indoctrinated patient”, someone who has been indoctrinated that there is one right way to give birth and that all can and should be done to facilitate that one right way. I believe women are reasonable people, and if truly informed on the options and the local resources most will make the best choices for themselves and their babies. No hospitals aren’t restaurants, and patients aren’t hamburgers – there’s real consequences to messing up the “product”.

    • yentavegan

      and the promoting of an ” alert and awake labor and delivery” has morphed into homebirth advocacy.

    • The Bofa on the Sofa

      Yeah, the comparisons of baby classes has always fascinated me. Our baby class was given by the hospital. It was run by an LC, but it was basically, “Here’s what to expect when you give birth here. Here’s an unmedicated delivery, medicated, and c-section.” There was also a feeding session, focused on BFing, but in dad’s Boot Camp, there is discussion of formula (and where to get it cheap).

      In the end, I’d say that the focus was on what to expect and survival, with very little advocacy, aside from the “breast is best” and “breastfeeding welcome” signs.

  • yentavegan

    But breech is just a variation of normal. If nature did not want breech births, then there would not be any! Medical doctors are trained to see birth as a sickness that needs to be fixed. Doctors lack the patience and they have no profit motive in just letting birth unfold naturally. We have over educated ourselves and we as a culture has lost touch with the lessons of birth our ancestors possessed.

    • Dr Kitty

      You need to use more smiley faces…you are TOO good at the parody!

    • workwithmehere

      just as diabetes is just a variation of normal. If nature did not want diabetes there would not be any diabetics…… oh.

      • workwithmehere

        I like these discussions.

    • Young CC Prof

      “lost touch with the lessons of birth our ancestors possessed.”

      Indeed, some of us have lost touch with one very important lesson about birth. It kills.

  • The Bofa on the Sofa

    Actually, I think it more in line of the electrician. It’s like if I want to hook up something, but the electrician tells me, no, I can’t do that, because it violates safety code. BUT I WANT TO!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    So I can either look around and see if I can find an electrician willing to ignore safety codes, or I could call my friend’s brother-in-law who is not an electrician, but he’s pretty handy with the electrical tape.

    As long as I can insist that the electrician do it my way, regardless of whether it violates professional standards…

    • Lynnie

      My husband is an electrician. You should see the messes he has to fix because people skimp on wiring and electrical work. He has remarked more than once, “I am surprised their house hasn’t burned down.”

  • An Actual Attorney

    This makes me giggle, specifically because I used to date the son of a restaurant owner. Son was a great cook.

    When son was small, his mom used to take him and his sister to the restaurant almost every night for dinner. He would try asking for something that wasn’t on the menu, or fixed differently. His father would always say “These people are my employees, not your servants. If you want something else, I will let you go cook it in the kitchen.”

    So, no, even in a restaurant, when you are the son of the owner, you get what’s on the menu.

    • Trixie

      Whenever I ask them to change something for me, I make sure to tip extra. I believe in tipping well anyway, but if I’m being even a little bit of a pain, I will compensate for it with a 25% tip.

  • almostfearless

    OT: But I came across this article about the reality of growing up unvaccinated: http://www.voicesforvaccines.org/growing-up-unvaccinated/

  • “few doctors can perform an ECV”????? WHAT?

    • attitude devant

      Apparently they make this stuff up as they go along.

      • Sue

        And what about losing your palpation skills due to ultrasound? Dramatic revelation: ultrasound is better. Lots of procedures used to be done ”blind” (by feel) that can now be done under direct vision.

        There are all sorts of areas of medicine that are now more precise because of ultrasound. Direct imaging = less guess work. We can regret the loss of old skills on a personal level but not when the new method is safer and benefits the patient.

        This stuff is like regretting the development of writing because everyone’s memory would be less exercised, or regrettting the invention of the radio because people lost the skill of singing around the piano – things change.

        • araikwao

          If palpation skills were that great, none of these homebirth stories would ever involved “surprise breech”. Yet an awful lot seem to, hmm?

          • Young CC Prof

            My OB trained in the pre-ultrasound days. She’s all in favor of natural birth (except when circumstances dictate otherwise, at which point she intervenes rapidly and with skill.)

            At I think my 36-week appointment, she palpated me and incorrectly told me the baby had turned. Ultrasound showed otherwise a few days later.

  • auntbea

    “They want to serve you, they want to get you the best possible care and nourishment they can, and they care what you think when you leave”

    Or….being businesses, rather than charity food banks, they could want to turn a profit.