Recommended by Ricochet Members Created with Sketch. The Complexities of Birth Control Pills

 

As one who has spent much of his life trying to take complicated things and make them simple, I am often struck by the gift that some people seem to have for taking simple things and making them complicated. Take birth control pills, for example.

You would think this would not be a complicated matter. “Ok, Suzi, take one pill per day. Um…that’s about it.” But you would be amazed at how many different ways I’ve seen people goof this up. I have often heard the same line, “Hey doc, those pills you gave me didn’t work. I’m pregnant.” I’ve learned that after I hear that sentence, I’m likely to hear one doozy of a story afterward. For example:

Staci: “Hey doc, those pills you gave me didn’t work. I’m pregnant.”

Dr. Bastiat: “Um, ok, did you take one pill every day?

Staci: “Of course I did! Do you think I’m stupid? I took one every single day that I had sex.”

Dr. Bastiat: “Ah.”

Staci: “My boyfriend drives a truck, and is gone for a week or two at a time. But as soon as he got home, I’d start taking a pill every day. I never missed one.”

Dr. Bastiat: “Did you ever wonder why there were 28 pills in a four-week pack?”

Staci: “Huh?”

I thought to myself, “I could practice medicine for the rest of my life, and I’ll never hear anything more stupid than that.” Over the years, I’ve learned not to say things like that. As it turns out, stupidity is a competitive sport:

Kaci: “Hey doc, those pills you gave me didn’t work. I’m pregnant.”

Dr. Bastiat: “Um, ok, did you take one pill every day?”

Kaci: “Well, no, they made me sick. So I gave them to my boyfriend.”

Dr. Bastiat: “Ah.”

By this point, it was taking me longer and longer for me to instruct women on how to take birth control pills. Most of them looked at me like I was stupid as I said, “You – you personally – take exactly one pill. Every day. Regardless of your plans for that day. Or that evening. Every single day. One pill.” But my instructions got longer and longer as my patients displayed their creativity (if not their intelligence) by finding new and fascinating ways to screw this up:

Maci: “Hey doc, those pills you gave me didn’t work. I’m pregnant.”

Dr. Bastiat: “Um, ok, did you take one pill every day?”

Maci: “Of course I did! Do you think I’m stupid?”

Dr. Bastiat: “One pill.”

Maci: “Right.”

Dr. Bastiat: “Every day.”

Maci: “Of course.”

Dr. Bastiat: “With a glass of water.”

Maci: “Huh?”

Dr. Bastiat: “You swallow the pill with a glass of water.”

Maci: [looks horrified and offended] “I don’t do it like THAT!

So after I engaged in extensive and awkward questioning of Maci’s intelligence and my career choices, I finally realized that Maci had been inserting the pills where she had sex, and she was extremely offended that I was suggesting that she engaged in oral sex. She’s not that kind of girl.

You might think that practicing medicine is pretty boring. And on a good day, you’re mostly right. But my patients keep it interesting. Every once in a while, one of them will take my boring, simple day and turn it into something much more complicated than I thought it was. I’ve had patients who can’t read who I’ve trained to use insulin pumps, and after some work, they’ve become really good at it. And then, I have some who can’t figure out birth control pills.

I’ve learned to go with the flow. Rather than respond with, “You did what?!” now I just sit back in my chair, look up at the ceiling, and think to myself, “Hmm… I don’t think I’ve heard that one before…”

And as the years go by, my instructions for patients get longer and longer, and more and more involved. They call this practicing medicine.

After years of experience, now I can even sense when my day is about to become more complicated. For example, I start paying attention when I hear those dreaded words, “Hey doc, those pills you gave me didn’t work. I’m pregnant.”

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  1. Mark Camp Member

    Yeah, it’s tough. And it’s not just medicine.

    Any more, as soon as I hear “Hey, Mark. That Hayek guy, he was an idiot,” I lean back in my chair and mutter to myself, “This is going to be another long day.”

     

     

    • #1
    • August 6, 2020, at 3:34 PM PDT
    • 11 likes
  2. Percival Thatcher
    PercivalJoined in the first year of Ricochet Ricochet Charter Member

    Never, ever, challenge the stoopid.

    “Foolproof” user interfaces are a bad investment. There will always be a greater fool coming down the pike.

    • #2
    • August 6, 2020, at 3:35 PM PDT
    • 13 likes
  3. Jules PA Member

    I’m speechless. 

    • #3
    • August 6, 2020, at 3:45 PM PDT
    • 5 likes
  4. philo Member

    Reminds me of a story Doc Daneeka once told…

    • #4
    • August 6, 2020, at 4:06 PM PDT
    • 4 likes
  5. PHCheese Member

    I think nowadays I get most of my exercise shaking my head at the stupidity.

    • #5
    • August 6, 2020, at 4:08 PM PDT
    • 8 likes
  6. Kozak Member
    KozakJoined in the first year of Ricochet Ricochet Charter Member

    There was a patient in California that sued her doctor and pharmacy because she got pregnant using contraceptive jelly.

    Of course she would eat some before she had sex. But she got pregnant anyway.

    • #6
    • August 6, 2020, at 4:16 PM PDT
    • 17 likes
    • This comment has been edited.
  7. Kozak Member
    KozakJoined in the first year of Ricochet Ricochet Charter Member

    Percival (View Comment):

    Never, ever, challenge the stoopid.

    “Foolproof” user interfaces are a bad investment. There will always be a greater fool coming down the pike.

    I had a friend who was a medical products engineer. He said it was impossible to “doctor proof” equipment.

    One example he gave was having designed a connector for a piece of ICU equipment that could only be connected 1 way.

    One of the physicians had “fixed” this by taking a scalpel to it and carving it into a shape that would fit together… wrong.

    • #7
    • August 6, 2020, at 4:19 PM PDT
    • 20 likes
  8. KentForrester Moderator

    Doc, I know exactly what you’re talking about. I started with a short paragraph of instructions on the syllabus I handed out to my classes. But then someone would find a way around one of my instructions. So I would expand that section. Then another. Then another expansion. After ten or so years, my instructions were the size of a novel. Finally I gave up and went back to my simple paragraph. 

    I like the one in which the girl put a pill up her hoo -haw. Seems reasonable to me. 

    • #8
    • August 6, 2020, at 4:22 PM PDT
    • 10 likes
  9. Henry Castaigne Member

    How many of these people are allowed to vote Doc? If the answer is most of them, then we need sex robots to limit dumb people breeding and we need genetic engineering as a safety net.

    I will use this article to justify my beliefs from now on.

    • #9
    • August 6, 2020, at 4:46 PM PDT
    • 6 likes
    • This comment has been edited.
  10. Henry Castaigne Member

    Boss Mongo has a similar story about Afghanni sex education. Pretty sure it violates the Coc.

    • #10
    • August 6, 2020, at 4:48 PM PDT
    • 10 likes
  11. David Foster Member
    David FosterJoined in the first year of Ricochet Ricochet Charter Member

    It may be a corollary to Goedel’s Principle (which shows that no matter how many axioms you add to a formal system (at or above a certain complexity level), there will *always* be some theorems that you can’t prove or disprove.

    By analogy, no matter how carefully you explain something, there will be a way for someone to misunderstand it.

    • #11
    • August 6, 2020, at 4:52 PM PDT
    • 3 likes
  12. Limestone Cowboy Coolidge
    Limestone CowboyJoined in the first year of Ricochet Ricochet Charter Member

    Doc… a lot of Democrat women in your practice?? Just a wild guess of course..

    • #12
    • August 6, 2020, at 4:54 PM PDT
    • 5 likes
  13. Miffed White Male Member
    Miffed White MaleJoined in the first year of Ricochet Ricochet Charter Member

    As my brother says, “When they tell you the average IQ is 100, they mean it”.

    This is also the reason I never bother to produce more than rudimentary documentation for any software I produce at work. Nobody bothers to read it, and when they do, they misunderstand it anyway.

    • #13
    • August 6, 2020, at 5:00 PM PDT
    • 11 likes
  14. 9thDistrictNeighbor Member

    I guess that’s why they invented Depo-provera. 

    • #14
    • August 6, 2020, at 5:08 PM PDT
    • 2 likes
  15. Mark Camp Member

    Kozak (View Comment):

    Percival (View Comment):

    Never, ever, challenge the stoopid.

    “Foolproof” user interfaces are a bad investment. There will always be a greater fool coming down the pike.

    I had a friend who was a medical products engineer. He said it was impossible to “doctor proof” equipment.

    One example he gave was having designed a connector for a piece of ICU equipment that could only be connected 1 way.

    One of the physicians had “fixed” this by taking a scalpel to it and carving it into a shape that would fit together… wrong.

    Thanks, Mr. Kojak. We are going to have to give that point to the non-Doctor team.

    Dr. Bastiat, you have 3 minutes to reply for the Doctors. You have the floor.

    • #15
    • August 6, 2020, at 5:23 PM PDT
    • 5 likes
  16. Hang On Member
    Hang OnJoined in the first year of Ricochet Ricochet Charter Member

    I’m supposed to put the pill where?

    Too funny.

    You need to specify once every 24 hours rather than every day. I can hear someone saying ‘I didn’t think I could take it at night.’

    • #16
    • August 6, 2020, at 5:26 PM PDT
    • 3 likes
  17. Jim McConnell Member
    Jim McConnellJoined in the first year of Ricochet Ricochet Charter Member

    Thanks, Doc. Some days a little levity is worth a lot. And this was one of those days for me.

    • #17
    • August 6, 2020, at 5:35 PM PDT
    • 4 likes
  18. KirkianWanderer Coolidge

    KentForrester (View Comment):

    Doc, I know exactly what you’re talking about. I started with a short paragraph of instructions on the syllabus I handed out to my classes. But then someone would find a way around one of my instructions. So I would expand that section. Then another. Then another expansion. After ten or so years, my instructions were the size of a novel. Finally I gave up and went back to my simple paragraph.

    I like the one in which the girl put a pill up her hoo -haw. Seems reasonable to me.

    That reminds me of my high school AP English class. It was ostensibly supposed to be composed of the people in our school who were best and brightest at English composition and comprehension but, because the honors teacher was (justifiably) universally reviled, 3x the pupils that should have been enrolled were in it. We spent two whole 84 minute periods on how not to write a 5 paragraph essay (the test doesn’t like them) and the amount of incomprehension was stunning; I spent the period counting how many times each student said “like” and sticking my tongue out at the teacher when no one else was looking (he was fine with it, we got along through mutual bickering and a massive degree of affection).

    The one class experience that topped that was Spanish 1 my senior year. To avoid shop, I enrolled in that, having already done every French course our school offered. The guidance counselor failed to inform me that the class was composed almost entirely of non-honors freshman and, more so, people on their 2nd or 3rd try at it. And it took effort to fail a level 1 language class. It took three weeks to explain the concept of verb conjugation, one kid threw a hissy fit every time the teacher spoke French to me or asked a cognate question (“we’re only supposed to be learning Spanish!”), and definite and indefinite articles were a lost cause. I spent most of my time contemplating elaborate escape attempts, or trying to see whether I could commit lingchi with the endless worksheets. The teacher finally took pity on me (once I left for a senior assembly and, after he stopped reprimanding me, I explained that I really wasn’t a freshman) and gave me level 2 and 3 sheets to keep me from snapping and throwing the kid who made a presentation of his “el trap house” through the window. My French teacher used to smile and wave at me cruelly through the window, while I mimed pleas for rescue. None ever came.

    • #18
    • August 6, 2020, at 5:50 PM PDT
    • 8 likes
    • This comment has been edited.
  19. Jimmy Carter Member
    Jimmy CarterJoined in the first year of Ricochet Ricochet Charter Member

    “I can explain it to You, I can’t comprehend it for You.”

    • #19
    • August 6, 2020, at 5:52 PM PDT
    • 11 likes
  20. JustmeinAZ Member

    Henry Castaigne (View Comment):

    Boss Mongo has a similar story about Afghanni sex education. Pretty sure it violates the Coc.

    Does it involve camels?

    • #20
    • August 6, 2020, at 5:55 PM PDT
    • 5 likes
  21. Mark Camp Member

    KirkianWanderer (View Comment):

    KentForrester (View Comment):

    Doc, I know exactly what you’re talking about. I started with a short paragraph of instructions on the syllabus I handed out to my classes. But then someone would find a way around one of my instructions. So I would expand that section. Then another. Then another expansion. After ten or so years, my instructions were the size of a novel. Finally I gave up and went back to my simple paragraph.

    I like the one in which the girl put a pill up her hoo -haw. Seems reasonable to me.

    That reminds me of my high school AP English class. It was ostensibly supposed to be composed of the people in our school who were best and brightest at English composition and comprehension but, because the honors teacher was (justifiably) universally reviled, 3x the pupils that should have been enrolled were in it. We spent two whole 84 minute periods on how not to write a 5 paragraph essay (the test doesn’t like them) and the amount of incomprehension was stunning; I spent the period counting how many times each student said “like” and sticking my tongue out at the teacher when no one else was looking (he was fine with it, we got along through mutual bickering and a massive degree of affection).

    The one class experience that topped that was Spanish 1 my senior year. To avoid shop, I enrolled in that, having already done every French course our school offered. The guidance counselor failed to inform me that the class was composed almost entirely of non-honors freshman and, more so, people on their 2nd or 3rd try at it. And it took effort to fail a level 1 language class. It took three weeks to explain the concept of verb conjugation, one kid threw a hissy fit every time the teacher spoke French to me or asked a cognate question (“we’re only supposed to be learning Spanish!”), and definite and indefinite articles were a lost cause. I spent most of my time contemplating elaborate escape attempts, or trying to see whether I could commit lingchi with the endless worksheets. The teacher finally took pity on me (once I left for a senior assembly and, after he stopped reprimanding me, I explained that I really wasn’t a freshman) and gave me level 2 and 3 sheets to keep me from snapping and throwing the kid who made a presentation of his “el trap house” through the window. My French teacher used to smile and wave at me cruelly through the window, while I mimed pleases for rescue. None ever came.

    Kindred spirits, though we are generations apart.

    • #21
    • August 6, 2020, at 5:55 PM PDT
    • 4 likes
  22. JustmeinAZ Member

    KirkianWanderer (View Comment):
    It took three weeks to explain the concept of verb conjugation

    !. So they never learned this concept in English grammar?

    2. Good thing they were spared declensions in Latin, German, etc.

    • #22
    • August 6, 2020, at 6:01 PM PDT
    • 5 likes
  23. KirkianWanderer Coolidge

    JustmeinAZ (View Comment):

    Henry Castaigne (View Comment):

    Boss Mongo has a similar story about Afghanni sex education. Pretty sure it violates the Coc.

    Does it involve camels?

    Not quite the same thing, but it made me think of this: 

    I took two semesters of Arabic last year (night class at a well regarded uni for non-Western languages), and some of the guys in the Thai class definitely didn’t look like they were learning because they wanted to read Veeraporn Nitiprapha in the original Thai. Of course, my very nice Arabic teacher was going on about learning dialect works in order to blend in at the souk (in a mostly heritage learners class), and then just kind of looked at me and sighed, because she knew no amount of dialect words were going to do that.

    • #23
    • August 6, 2020, at 6:01 PM PDT
    • 5 likes
  24. KirkianWanderer Coolidge

    JustmeinAZ (View Comment):

    KirkianWanderer (View Comment):
    It took three weeks to explain the concept of verb conjugation

    !. So they never learned this concept in English grammar?

    2. Good thing they were spared declensions in Latin, German, etc.

    Not going to lie, if they were on their third attempt at Spanish 1, their English grammar probably wasn’t too hot (though they were all native speakers). As I recall, the lower level English classes also eschewed most grammar, and reading more than one or two books. 

    I’m a Russian double major, if the declensions (and their five million #$%^&*! exceptions) don’t kill me, the verbs of motion will. 

    • #24
    • August 6, 2020, at 6:08 PM PDT
    • 8 likes
  25. JosePluma Thatcher

    If a urine sample was needed, I started out giving the patients a small plastic tub to carry the sample cup, so they wouldn’t be carrying around a pee-coated cup. I stopped doing that after a patient handed me a small plastic tub full of urine.

    So I started giving out zip-lock sample bags with the cups, until I got a bag full of pee.

    So I started giving out very specific instructions:

    Pee in the cup, put the cap back on the cup, put the cup in the bag and place the bag here. (Pointing to a sample bin in the room.)

    Even so, about once a month, a patient will come out of the toilet with a sample cup wrapped in a paper towel and try to hand it to me.

    Or this:

    Me: Where is your pee sample?

    Patient: I threw it away. I didn’t know you wanted it.

    • #25
    • August 6, 2020, at 6:22 PM PDT
    • 11 likes
  26. JosePluma Thatcher

    JustmeinAZ (View Comment):

    Henry Castaigne (View Comment):

    Boss Mongo has a similar story about Afghanni sex education. Pretty sure it violates the Coc.

    Does it involve camels?

    More likely goats. Very few camels in Afghanistan.

    • #26
    • August 6, 2020, at 6:25 PM PDT
    • 6 likes
  27. KirkianWanderer Coolidge

    Mark Camp (View Comment):

    KirkianWanderer (View Comment):

    KentForrester (View Comment):

    Doc, I know exactly what you’re talking about. I started with a short paragraph of instructions on the syllabus I handed out to my classes. But then someone would find a way around one of my instructions. So I would expand that section. Then another. Then another expansion. After ten or so years, my instructions were the size of a novel. Finally I gave up and went back to my simple paragraph.

    I like the one in which the girl put a pill up her hoo -haw. Seems reasonable to me.

    That reminds me of my high school AP English class. It was ostensibly supposed to be composed of the people in our school who were best and brightest at English composition and comprehension but, because the honors teacher was (justifiably) universally reviled, 3x the pupils that should have been enrolled were in it. We spent two whole 84 minute periods on how not to write a 5 paragraph essay (the test doesn’t like them) and the amount of incomprehension was stunning; I spent the period counting how many times each student said “like” and sticking my tongue out at the teacher when no one else was looking (he was fine with it, we got along through mutual bickering and a massive degree of affection).

    The one class experience that topped that was Spanish 1 my senior year. To avoid shop, I enrolled in that, having already done every French course our school offered. The guidance counselor failed to inform me that the class was composed almost entirely of non-honors freshman and, more so, people on their 2nd or 3rd try at it. And it took effort to fail a level 1 language class. It took three weeks to explain the concept of verb conjugation, one kid threw a hissy fit every time the teacher spoke French to me or asked a cognate question (“we’re only supposed to be learning Spanish!”), and definite and indefinite articles were a lost cause. I spent most of my time contemplating elaborate escape attempts, or trying to see whether I could commit lingchi with the endless worksheets. The teacher finally took pity on me (once I left for a senior assembly and, after he stopped reprimanding me, I explained that I really wasn’t a freshman) and gave me level 2 and 3 sheets to keep me from snapping and throwing the kid who made a presentation of his “el trap house” through the window. My French teacher used to smile and wave at me cruelly through the window, while I mimed pleases for rescue. None ever came.

    Kindred spirits, though we are generations apart.

    Put me in mind of this, a long running joke with my Taiwanese friend. 

    • #27
    • August 6, 2020, at 6:26 PM PDT
    • 6 likes
  28. KirkianWanderer Coolidge

    JosePluma (View Comment):

    If a urine sample was needed, I started out giving the patients a small plastic tub to carry the sample cup, so they wouldn’t be carrying around a pee-coated cup. I stopped doing that after a patient handed me a small plastic tub full of urine.

    So I started giving out zip-lock sample bags with the cups, until I got a bag full of pee.

    So I started giving out very specific instructions:

    Pee in the cup, put the cap back on the cup, put the cup in the bag and place the bag here. (Pointing to a sample bin in the room.)

    Even so, about once a month, a patient will come out of the toilet with a sample cup wrapped in a paper towel and try to hand it to me.

    Or this:

    Me: Where is your pee sample?

    Patient: I threw it away. I didn’t know you wanted it.

    I couldn’t resist (warning for strong language and inappropriate humor): 

    • #28
    • August 6, 2020, at 6:28 PM PDT
    • 4 likes
  29. Richard O'Shea Coolidge

    I overheard my late Aunt Jemima (really) once explain to my sister that birth control pills are 100% effective if you hold it between your knees.

    • #29
    • August 6, 2020, at 6:29 PM PDT
    • 13 likes
  30. Joseph Stanko Coolidge
    Joseph StankoJoined in the first year of Ricochet Ricochet Charter Member

    Dr. Bastiat:

    Kaci: “Hey doc, those pills you gave me didn’t work. I’m pregnant.”

    Dr. Bastiat: “Um, ok, did you take one pill every day?”

    Kaci: “Well, no, they made me sick. So I gave them to my boyfriend.”

    Dr. Bastiat: “Ah.”

    Sounds like they worked just fine: the boyfriend didn’t get pregnant. 

    • #30
    • August 6, 2020, at 6:29 PM PDT
    • 15 likes