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. Charlotte Member
    Charlotte
    @Charlotte

    Dr. Bastiat: Ok, Suzi, take one pill per day. Um…that’s about it.

    Suzi: Hold my beer.

    • #31
  2. EJHill Podcaster
    EJHill
    @EJHill

    I knew a young lady in my youth who spent three weeks in abject fear because she was certain she was pregnant.

    Why? Because she had fallen asleep on a boy’s shoulder at the movies. All her mother ever told her is that you got pregnant by sleeping with boys…

    • #32
  3. KirkianWanderer Inactive
    KirkianWanderer
    @KirkianWanderer

    EJHill (View Comment):

    I knew a young lady in my youth who spent three weeks in abject fear because she was certain she was pregnant.

    Why? Because she had fallen asleep on a boy’s shoulder at the movies. All her mother ever told her is that you got pregnant by sleeping with boys…

    A friend told me this story once when I FaceTimed him at his college. He had a next door neighbor in his dorm that he talked to on his way in and out, if they happened to run into each other, and on that day the guy seemed out of this world happy.

    “Hey man, how are you doing?”

    ”Great! She isn’t pregnant!”

    He didn’t know quite how to respond to that one.

    • #33
  4. Henry Castaigne Member
    Henry Castaigne
    @HenryCastaigne

    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?

    There are probably stories that involve goats. Haven’t heard about camels.

    • #34
  5. Clifford A. Brown Member
    Clifford A. Brown
    @CliffordBrown

    This was a true laugh out loud post. I almost fell out of my chair, and was thankful I had set my beverage down before beginning to read. Murphy lives and people are interesting.

    • #35
  6. Gatomal Inactive
    Gatomal
    @Gatomal

    Joseph Stanko (View Comment):

    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.

    Stop your microagressions, Joseph Stanko. It’s “person without a cervix” or “person who was assigned male at birth based on their biological sex” didn’t become a “gestational parent”. Jeez. 

    • #36
  7. Joseph Stanko Coolidge
    Joseph Stanko
    @JosephStanko

    Gatomal (View Comment):
    Stop your microagressions, Joseph Stanko. It’s “person without a cervix” or “person who was assigned male at birth based on their biological sex” didn’t become a “gestational parent”. Jeez. 

    Wait, wait, wait, how do you know he didn’t have a cervix?  Some men have cervices!

    (Two can play at this game)

    • #37
  8. Joseph Stanko Coolidge
    Joseph Stanko
    @JosephStanko

    This post illustrates why support for birth control and legalized abortion go hand-in-hand.  No matter how reliable any particular method of birth control might be in theory, in practice over a million women end up “accidentally” pregnant in this country every year.  The only reliable “solution” to this problem is abortion, and people will jump through whatever mental hoops are necessary to convince themselves that killing their own children is a morally acceptable option.

    • #38
  9. MISTER BITCOIN Inactive
    MISTER BITCOIN
    @MISTERBITCOIN

    @drbastiat,

    I think you have enough material for a book.

    MB

     

    • #39
  10. thelonious Member
    thelonious
    @thelonious

    Kozak (View Comment):

    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.

    Gives a whole new meaning to a peanut butter and jelly sandwich.

    • #40
  11. KentForrester Coolidge
    KentForrester
    @KentForrester

    thelonious (View Comment):

    Kozak (View Comment):

    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.

    Gives a whole new meaning to a peanut butter and jelly sandwich.

    I think she has a good case. They didn’t tell her what to do with the jelly.  One eats jelly, along with its mate, peanut butter.  Here only mistake was that she should have eaten the peanut butter and jelly while having sex. Between two slices of white bread.  I think all of that chewing and the smell of peanut butter might have reduced her partner’s ability to complete the sex act.  Hence, no babies.

    It works perfectly unless the partner is a big fan of peanut butter and jelly sandwiches.  Then it acts as an aphrodisiac.

    • #41
  12. GLDIII Temporarily Essential Reagan
    GLDIII Temporarily Essential
    @GLDIII

    Henry Castaigne (View Comment):

    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.

    You just stumbled on why the left is so invested in.planned parenthood. If you don’t believe me just refer to the comments made by our esteemed Supreme Court justice the notorious RBG.

     

    • #42
  13. OmegaPaladin Moderator
    OmegaPaladin
    @OmegaPaladin

    You ever wonder why safety warnings are so pedantic?  This is why.

    Here’s a tip from my father – use three – way communication.  First, you explain it or give the the information, then you ask them to repeat it back to you, preferably in their own words, before you tell if that was correct of not.  This works for phone numbers and other long strings of information.

    • #43
  14. Kozak Member
    Kozak
    @Kozak

    Hang On (View Comment):

    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.’

    There used to be a saying that aspirin was a good method of birth control.

    It needs to be held tightly between the woman’s knees.

     

    But that just showed a lack of imagination or poor knowledge of a woman’s anatomy….

    • #44
  15. Kozak Member
    Kozak
    @Kozak

    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.

    As flight surgeon in the Air Force, I had a Jag Officer (military lawyer) come in one day and ask for a box of rubber gloves.

    “What do you need them for?”

    He replied, “we’re pee testing the pilots today and we have to witness them giving the specimen.  A lot of them like to piss all over the container before handing them to us.”

    All I could think of was “why didn’t I think of that during my test.”

    • #45
  16. Stad Coolidge
    Stad
    @Stad

    In the Navy, we called trying to make something foolproof “sailor proof.”  There ain’t no such thing . . .

    • #46
  17. Percival Thatcher
    Percival
    @Percival

    OmegaPaladin (View Comment):

    You ever wonder why safety warnings are so pedantic? This is why.

    Here’s a tip from my father – use three – way communication. First, you explain it or give the the information, then you ask them to repeat it back to you, preferably in their own words, before you tell if that was correct of not. This works for phone numbers and other long strings of information.

    Some general* kept the dumbest private in his army around headquarters. When he issued a written order to one of his subordinates, he read it out to the private and had the private repeat back what was to be done. If the private got it right, the order was sent.


    * Grant, maybe. Napoleon, maybe. Apocryphal, maybe.**


    ** So help me, if you google “General Apocryphal” …

    • #47
  18. The Scarecrow Thatcher
    The Scarecrow
    @TheScarecrow

    Stad (View Comment):

    In the Navy, we called trying to make something foolproof “sailor proof.” There ain’t no such thing . . .

    That explains something I heard years ago: If you give something to a bosun’s mate, he’ll either paint it, break it, or lose it.

    • #48
  19. Mark Camp Member
    Mark Camp
    @MarkCamp

    Percival (View Comment):

    OmegaPaladin (View Comment):

    You ever wonder why safety warnings are so pedantic? This is why.

    Here’s a tip from my father – use three – way communication. First, you explain it or give the the information, then you ask them to repeat it back to you, preferably in their own words, before you tell if that was correct of not. This works for phone numbers and other long strings of information.

    Some general* kept the dumbest private in his army around headquarters. When he issued a written order to one of his subordinates, he read it out to the private and had the private repeat back what was to be done. If the private got it right, the order was sent.


    * Grant, maybe. Napoleon, maybe. Apocryphal, maybe.**


    ** So help me, if you google “General Apocryphal” …

    It was actually Gen. Washington. Or Albert Einstein, or maybe Mark Twain.  I know because I saw it on the Internet I think.  No, it was Clausewitz, I’m sure of it.

    • #49
  20. Percival Thatcher
    Percival
    @Percival

    Mark Camp (View Comment):

    Percival (View Comment):

    OmegaPaladin (View Comment):

    You ever wonder why safety warnings are so pedantic? This is why.

    Here’s a tip from my father – use three – way communication. First, you explain it or give the the information, then you ask them to repeat it back to you, preferably in their own words, before you tell if that was correct of not. This works for phone numbers and other long strings of information.

    Some general* kept the dumbest private in his army around headquarters. When he issued a written order to one of his subordinates, he read it out to the private and had the private repeat back what was to be done. If the private got it right, the order was sent.


    * Grant, maybe. Napoleon, maybe. Apocryphal, maybe.**


    ** So help me, if you google “General Apocryphal” …

    It was actually Gen. Washington. Or Albert Einstein, or maybe Mark Twain. I know because I saw it on the Internet I think. No, it was Clausewitz, I’m sure of it.

    • #50
  21. philo Member
    philo
    @philo

    Percival (View Comment):

    OmegaPaladin (View Comment):

    You ever wonder why safety warnings are so pedantic? This is why.

    Here’s a tip from my father – use three – way communication. First, you explain it or give the the information, then you ask them to repeat it back to you, preferably in their own words, before you tell if that was correct of not. This works for phone numbers and other long strings of information.

    Some general* kept the dumbest private in his army around headquarters. When he issued a written order to one of his subordinates, he read it out to the private and had the private repeat back what was to be done. If the private got it right, the order was sent.


    * Grant, maybe. Napoleon, maybe. Apocryphal, maybe.**


    ** So help me, if you google “General Apocryphal” …

    Never read such a thing about Grant. It is possible he ran them by Halleck for such a purpose.

    • #51
  22. Percival Thatcher
    Percival
    @Percival

    philo (View Comment):

    Percival (View Comment):

    OmegaPaladin (View Comment):

    You ever wonder why safety warnings are so pedantic? This is why.

    Here’s a tip from my father – use three – way communication. First, you explain it or give the the information, then you ask them to repeat it back to you, preferably in their own words, before you tell if that was correct of not. This works for phone numbers and other long strings of information.

    Some general* kept the dumbest private in his army around headquarters. When he issued a written order to one of his subordinates, he read it out to the private and had the private repeat back what was to be done. If the private got it right, the order was sent.


    * Grant, maybe. Napoleon, maybe. Apocryphal, maybe.**


    ** So help me, if you google “General Apocryphal” …

    Never read such a thing about Grant. It is possible he ran them by Halleck for such a purpose.

    Halleck was overly cautious, but otherwise pretty sound. When Grant took his job, Halleck was put in charge of logistics for all the armies, and they improved substantially.

    • #52
  23. Mark Camp Member
    Mark Camp
    @MarkCamp

    philo (View Comment):

    Percival (View Comment):

    OmegaPaladin (View Comment):

    You ever wonder why safety warnings are so pedantic? This is why.

    Here’s a tip from my father – use three – way communication. First, you explain it or give the the information, then you ask them to repeat it back to you, preferably in their own words, before you tell if that was correct of not. This works for phone numbers and other long strings of information.

    Some general* kept the dumbest private in his army around headquarters. When he issued a written order to one of his subordinates, he read it out to the private and had the private repeat back what was to be done. If the private got it right, the order was sent.


    * Grant, maybe. Napoleon, maybe. Apocryphal, maybe.**


    ** So help me, if you google “General Apocryphal” …

    Never read such a thing about Grant. It is possible he ran them by Halleck for such a purpose.

    philo (View Comment):

    Percival (View Comment):

    OmegaPaladin (View Comment):

    You ever wonder why safety warnings are so pedantic? This is why.

    Here’s a tip from my father – use three – way communication. First, you explain it or give the the information, then you ask them to repeat it back to you, preferably in their own words, before you tell if that was correct of not. This works for phone numbers and other long strings of information.

    Some general* kept the dumbest private in his army around headquarters. When he issued a written order to one of his subordinates, he read it out to the private and had the private repeat back what was to be done. If the private got it right, the order was sent.


    * Grant, maybe. Napoleon, maybe. Apocryphal, maybe.**


    ** So help me, if you google “General Apocryphal” …

    Never read such a thing about Grant. It is possible he ran them by Halleck for such a purpose.

    Now now, philo. Let’s not get nasty.

    • #53
  24. cdor Member
    cdor
    @cdor

    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.

    Surely you are not intimating that Doctors do stupid too!

    • #54
  25. MiMac Thatcher
    MiMac
    @MiMac

    The best case of misuse of birth control is the lady who sued Dart Drugs for her pregnancy. She took the contraceptive jelly everyday-on toast- yet still got pregnant. She claimed since it was sold in the aisle next to the food section she thought she should eat it.

    • #55
  26. Skyler Coolidge
    Skyler
    @Skyler

    Joseph Stanko (View Comment):

    This post illustrates why support for birth control and legalized abortion go hand-in-hand. No matter how reliable any particular method of birth control might be in theory, in practice over a million women end up “accidentally” pregnant in this country every year. The only reliable “solution” to this problem is abortion, and people will jump through whatever mental hoops are necessary to convince themselves that killing their own children is a morally acceptable option.

    This is a good case for why birth control should be illegal.  Otherwise, we’ll have a population that is predominantly stupid.  In fact, that might explain a lot of current events . . . 

    • #56
  27. Kozak Member
    Kozak
    @Kozak

    Thats the one I was referring to earlier.

    I remember her whining she was ‘humiliated ”  when they laughed at her at the pharmacy after she explained to them how she was eating the “jelly”.

    • #57
  28. Kozak Member
    Kozak
    @Kozak

    Nah.

    Never happens.

    • #58
  29. KirkianWanderer Inactive
    KirkianWanderer
    @KirkianWanderer

    Kozak (View Comment):

    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.

    As flight surgeon in the Air Force, I had a Jag Officer (military lawyer) come in one day and ask for a box of rubber gloves.

    “What do you need them for?”

    He replied, “we’re pee testing the pilots today and we have to witness them giving the specimen. A lot of them like to piss all over the container before handing them to us.”

    All I could think of was “why didn’t I think of that during my test.”

    https://terminallance.com/2012/08/28/terminal-lance-221-messing-with-the-cock-watch/

    https://terminallance.com/2016/04/12/terminal-lance-420-messing-with-the-cock-watch-ii/

    https://www.duffelblog.com/2018/04/soldier-bob-marley-poster-really-just-doesnt-need-pee/

    I have a good friend in the Air Force, and we delight in sending each other stuff like this. I started choking in the middle of a grad seminar on small wars I was very kindly allowed to sit in on, because he sent me a Terminal Lance cartoon when I went to make sure I had no missed calls, and I was tried to stifle my laughter.

    • #59
  30. Caryn Thatcher
    Caryn
    @Caryn

    I recall hearing that Planned Parent staffers were encouraged to suggest birth control pills to teen-aged patients because the non-compliance/incompetence rate was so high that unwanted pregnancies were highly likely to occur.  Leading to the much more profitable abortions…  How incredibly cynical and–even worse–cruel.  

    • #60
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