My Side

by Rob on July 22, 2010 · 33 comments

in Being a Doctor

I was planning on leaving behind the seriousness of the past few posts and going back to my usual inane writing, but some of the comments have made it too hard for me to keep quiet.  The response has been largely positive, and overall it has been overwhelming.  More people have read or commented on my letter to patients with chronic disease than any in recent history.  I am grateful that it is circulating around the web for others to contemplate, perhaps understanding the intent of what I wrote and improving their relationship with their doctors in the process.

The purpose of the letter was to give some helpful insight into the emotion on the other side of the equation.  I can’t understand what it is like to have a chronic illness without having the disease, but it is still fruitful for me to try to figure this out.  In the same way, patients with chronic illnesses benefit from a better understanding of the doctors they see so frequently and depend on so greatly.  I can sympathize, but I can’t feel the pain.  Still, I do need to listen closely to patients so I can have the best relationship possible.

Some folks felt that I was saying that doctors need their egos stroked and to be treated special, but that is not what I meant to say.  Each person needs to be understood and treated as their situation dictates.  People with chronic illness want to be understood (as witnessed by the incredible response to my letter!) and treated based on that understanding.  Doctors want to be understood as well.  So let me tell you my side of the story.  What is it like to sit in my chair?  I don’t say this for sympathy or pats on the back, I say it to be understood.  If I am better understood by my patients (and readers), my relationship with them is better, which is good for both of us.  I think I represent a fair percentage of primary care docs in these ways.

1. I care about my patients – As hard as I try to “just do the job,” and not expend the emotion I do during the day, I couldn’t live with myself if I let my patients down.  They depend on me for a lot, they pay for my service, and they deserve my best.  I’ve been told I do this to a pathological degree (along with my llama obsession), but it is there.  I want to help them.  I get frustrated at my powerlessness and am genuinely happy when they do well.

2.  I am tired – Each day demands an emotional price.  Some days the demand is not so high, others suck the life out of me.  Being “needed” cuts two ways; on one side it is nice to truly help people when they need the most help, it’s satisfying to see your life making a difference.  On the other side, it is a never-ending river of need, pain, and crises to be handled.  Being patted on the back (or patting myself) is nice, but it doesn’t mean anything for the future.  Each day brings new hands to hold, needs to meet, problems to be solved.  Each day is as much a burden as it is an opportunity.  That burden won’t leave me until I take down my shingle, yet the opportunities to make a difference will make it hard to take that shingle down.

3.  I also run a business – In terms of priorities, I need to pay my staff, pay the rent, and pay my personal bills to even have the chance to take care of patients.  I get frustrated when patients insinuate that I value money too much.  I get very frustrated by that, actually.  People seem more willing to pay for cable TV, cigarettes, or eating out than to pay me for what I do.  I earn less than most other medical specialists, yet some people resent my income.  The mess of a system we have works against primary care and works against complex patients.  If I spend 30 minutes with a complex patients (I do spend 30 minutes with people regularly), I am paid about 50% more than if I see a 5 minute ear infection visit.  Doing the math says that my mind is not valued and that I should see more ear infections and less chronic patients.  All of this adds to my daily stress.

4.  I am actually a person, not just a doctor – I have four children and a wife, and being a dad and a husband isn’t easy when I come from work with the emotional life sucked out of me.  I struggle with my own emotions and I get sick.  I worry a lot about money, and I feel insecure about the fact that despite being a doctor, I am not saving enough.  Hence I also struggle with working too much.  Life’s not easy for anyone, and despite my title I am not exempt.

5. I hate bad doctors – Many of the comments to the letter I wrote were lamentations about doctors who suck.  Unfortunately, doctors who take bad care of their patients make my life miserable too.  I have to clean up their messes, I have to re-teach their patients on what medicine should look like.  I have to wean their patients off of addictive drugs that they didn’t have the guts to deny. I am personally frustrated when I send a person to a specialist and they don’t do anything or upset my patient, and I hate the fact that they almost never communicate with me.  It makes my already hard job even harder.

6. My blog is a refuge and a tool – I am thankful that I have this blog as a means to vent, to use another part of my brain (some may argue that point on some of my posts), and to make a difference.  I actually have a voice in the whole healthcare reform debate.  I actually can reach a large number of people and make their medical experience better (which was the most gratifying thing to hear in the comments to my letter).  I’ve made practically no money doing this, but I’ve gotten a whole lot out of it.

That’s my story.  Like it or not, it is what it is.  I am just a guy who happens to be a doctor – the same as the rest of the doctors out there.  There will always be angry people and idiots on both sides of the doctor/patient relationship, but no matter what, the doctor-patient encounter is a human thing.  Love is human, war is human, murder is human, and so is childbirth.  You can’t put humanity into a bottle, you can’t throw a single label on it.  The highest calling is to enter into another’s life, to see things from their perspective, and to add good to it.

That goes for all of us, regardless of letters behind our names.

Thanks for listening.

This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.
  • http://twitter.com/JillAllTradesMD JillofAllTrades,MD

    Thx for “representing” :)

  • http://secondbasedispatch.com/ jackiefox

    For whoever thought you were looking for ego strokes, I had the opposite reaction. When you said people with chronic diseases scare doctors in part because you can't impress them, I thought you were taking a shot at the all-knowing doctor stereotype–and that's about as far from egotistical as it gets.

    Great discussion (again). Glad you didn't take a break from the serious stuff just yet.

  • wxchick

    Thank you for writing about these things from your perspective. Even if most of us have a good relationship with our doctors, many of us never get to hear these things from him/her. Reading your blog really helps me to keep things in perspective during the rare times in which my doc does something that just frustrates me. It also reminds me to speak up for myself and to listen without getting defensive. We humans are just so dang complex!

  • http://tapati.livejournal.com/ Tapati

    I have read during the health care reform debates that primary care docs make less than all other docs, and this seemed very wrong to me at the time and certainly explained the stress level of most PCPs. Now that more people are poised to enter the system we are going to be woefully short of family doctors just when we need them most. We are already importing them to keep up with current need.

    I think most of us chronic patients don't imagine you will ride in on your white horse and brandish just the right miracle pill that will save us. But to have a doctor that can help us deal with the specialist, the medication side effects, and our own very real burnout and desire to give up fighting, that's a huge blessing and such doctors are worth their weight in gold. Success can't simply be measured in how long you kept a patient alive. Quality of life is also important–sometimes more so. Doctors that can recognize that are rare.

    I was also thinking that the very reason you got SO MANY responses to the post about chronic illness and the patient/doctor relationship is that there are hordes of patients whose needs are just not being met under our current system. Taking very ill patients and making them drive all over the place to see individual specialists, some of whom are nice and well informed, others who are…NOT…that just doesn't WORK. It's no wonder patients give up. What if we had a quarterly meeting with all of our doctors? Together in one place? Talking together about the whole patient and how each of their pieces fit into it. If not in reality, in virtual reality. Conference call, even. I am so often explaining to Dr. A why x treatment is going to interfere with something that is the province of Dr. B and so on. This is so inefficient and what do less educated patients do if they miss something that is contra-indicated?

    I almost think there should be some conference or series of conferences or online forum with panels of docs and chronically ill patients who can discuss and imagine the best possible system to meet our needs as well as be easier for the doctors too. Because what we have? It isn't working for either party.

  • http://www.bellaonline.com/articles/art32543.asp Pam

    As a mom I appreciated the earlier post as well as this one ~ especially as most of us have grown to admire good, great and adequate doctors in lieu of The Perfect One.

    I wish you had used the phrase 'angry people and jerks' in your closing paragraph instead of the term you used; my son was born with Down syndrome and developed type one diabetes when he was 7 ~ he has been a more thoughtful and responsible patient than most people, who I do agree, can act stupidly.

  • Dawn

    What I don't get is why you seemed to think that chronically ill patients don't know that it's frustrating for a doctor to not be able to cure them? It's not that hard to see, we're also frustrated with the level of medical care available and the system being broken. Doctors often ignore that.

    The problem was your post put the onus on the patient to be understanding without realising that often the reason patients are so poorly treated is that many doctors do not acknowledge their frustration, instead they blame the patient for it. One sided understanding is not understanding.

    All the understanding in the world doesn't do a patient a blind bit of good if they can't get past a doctor's own psychological issues in order to forge a two way relationship.

    It's also not as easy as simply getting another doctor, often doctors are oversubscribed, you're limited by whatever cover you have or the one specialist within two hundred miles is a terrible doctor. My back is in the state it is because the only back specialist within reachable distance is the one who caused it, my doctor can't even send me for x-rays on it, they have to ordered by a specialist in the hospital and by the time I managed to convince one to do it, the obvious injury signs were gone and I was suffering from a generalised instability which they could do nothing for.

    Basically your advice rubbed a lot of people the wrong way, we can empathise with the problem of a doctor being frustrated, but we're really tired of having to do all the leg work then getting condemned for doctor hopping or by old notes from bad doctors.

    The only way the entire mess can be fixed is to re-educate existing doctors and to change training for the up and coming ones so the don't inherit the prejudices and psychological issues of the existing doctors. Patients can't do that, doctors need to do it.

  • http://stuffhappens1.blogspot.com/ Professorsherlock

    I have been fortunate to find good docs who view patients as partners in health care. I've left a few who spent no more than 10 minutes, prescribed drugs, and left without answering questions (i have no qualms about “firing” a doc and moving on to someone else). My current docs are great and I try to be a good patient. When meeting a new doc, I ask questions to get to know the doc a bit and then at all subsequent appointments, I make a habit of asking about their kids or their vacation or their time with “docs without borders” or whatever (my pcp and my dentist always serve the same two weeks in Haiti every year — now how would I know that if I didn't take an interest in them as people?). I think patients need to take some responsibility for making the doc/patient relationship a cordial and cooperative one and the best way to do that is to show some interest in the doc as a person.

  • http://distractible.org/ Dr. Rob

    Reading the comments, I think the majority of people got my point, which was that doctors don't handle complex patients well and complex patients' reactions to doctors makes it even harder. That was not meant to be patronizing at all. It was meant to be open with the humanness of docs.

  • http://distractible.org/ Dr. Rob

    Sorry – I use the term “idiot” a lot and equate it with the word “dope.” “Jerk” is stronger than I wanted to covey – their actions are jerky, but they are more clueless than mean (most of them, in my opinion). Maybe that's just me overestimating them.

  • http://lifeinthefastlane.com sandnsurf

    We love you

  • Dawn

    Still Dr Rob, your entire explanation came off as “victim blaming” with your expectations.

    We'd love not to tolerate jerks but sometimes as patients we haven't got a choice, doctors wield tremendous power over whether we get treatment or help.

    It is not our job to make ourselves small and stupid so doctors won't feel offended or threatened by us, it is the doctor's job to either do their job or enable us to find a doctor who will do it if they're too threatened by something they can't “fix” to actually treat us well.

  • Gingerayoung

    I love your blog. I just stumbled on it the other day to see if there is anything on the web about the possibility of getting rid of trochanteric bursitis after having it many years. Havn't slept all night for pain in both hips that wakens me every 2 hours calling for more analgesic cream! I didn't find anything helpful really, but love your blog.
    I've been an RN for almost 40 years, and I loved to hear a doctor who is so human (like the rest of us), who really cares about his patients. I do not have that kind of PCP now, and when you are on Medicare (yes, another topic you could muse about), we have little choice. Where I live, if you have one at all, you are fortunate.
    Thank you for taking the time to post these very interesting thoughts.

  • Tricia

    Regarding bad doctors, I'm sure they exist, but it seems a lot of people equate bad outcomes with bad doctors. And, I always want to say something like, “they probably did the best they could.” But, I try to avoid saying that to people who have experienced bad medical outcomes. They tend to be fragile and angry. I guess what I'm saying is that there are fewer bad doctors than people think there are.

  • Buddenbooks

    I love your blog. You are an antidote to all the negative stuff about doctors in the US. I only hope that health care reform somehow manages to make your life easier instead of harder.

  • http://rawarrior.com Kelly Young

    I agree with Dawn that there is not good reason for docs to feel offended or threatened (“It is not our job to make ourselves small and stupid so doctors won't feel offended or threatened by us”) by patients who attempt to have intelligent conversations with doctors or participate in decisions.

    Medicine would work much better with 2 sentient persons on the same “side.” The only “side” should be the “bedside.” Both the patient and the doctor should have the same goal: finding remedies or opportunies to improve the patient's health.

    I've written a lot under the tag “Talking to doctors,” but recently I responded to a fascinating article about the way doctors pass down their attitudes. Here are my questions for that doc & what I wish I could tell him: http://rawarrior.com/response-to-a-blog-written…

    I really hope to see progress in my lifetime toward doctors & patients being on the same side. I know I will spend the rest of my life working toward that.

  • http://www.webhealthwriter.com Michelle

    I love your compassion and think your writing is exceptional. I am sorry you have been chastised for your honesty on this issue. But as a patient with chronic illness I really appreciate it and completely support everything you have said. Yes chronic illness sucks. And, yes, many doctors suck at dealing with it – in much the same way many patients suck at dealing with it. It is a constant challenge on both sides, but as I see it, your posts are trying to shine a light on the issue and shouldn't have been attacked. I didn't actually bother to read most of the negative comments, but I can tell by this response that you have been criticized and I hope you won't let that dampen your spirits. I don't blog much for this very reason – no matter what you say there is always the chance for misinterpretation. Regardless, it is clear you are one of the rare doctors who really tries to get it and you should be applauded.

  • Kr3ridge 2

    gingerrayoung, I also have have severe chronic hip bursitis for many years. I'd love to chat with you about what has helped me, and what you've discovered. (i'm just another person: I am not selling or recommending any sort of marketable items in any way.) If you are interested in this, would there be some way we can email off of here?

    kathy, another RN (and long-time Dr. Rob reader!)

  • Kr3ridge 2

    Dr. Rob, i (and most of the others here) appreciate hearing what you have to say because you are open and honest, and many of us have never heard that from a doc. I appreciate hearing your perspective. It's made me appreciate my PCP more, even tho i get frustrated with his office people!

  • Gingerayoung

    I don't know if we can leave an email address here, but it is the same as my screen name at hotmail. Be sure to put the a (as middle initial). The person who has the name w/o the initial is an exotic dancer. :) Love to chat with you. I feel that I am the only person in the world with this kind of chronic pain and would love to exchange ideas with a fellow RN.

  • http://www.the-first-step.com Char Brooks

    you're a gifted author and i loved learning more about what it's really like being you. i particularly loved this point that brought it all together:

    “There will always be angry people and idiots on both sides of the doctor/patient relationship, but no matter what, the doctor-patient encounter is a human thing. Love is human, war is human, murder is human, and so is childbirth. You can’t put humanity into a bottle, you can’t throw a single label on it. The highest calling is to enter into another’s life, to see things from their perspective, and to add good to it.”

    you are definitely adding good to life as you share what's true for you as well as what you acknowlege as true for your patients – as you say, you're not in their body so you can't know what it's like. but i do feel that you get it.

    and as someone who struggles with pain myself as well as wanting to help patients and providers speak the same language, i am so grateful that you've educated me on what it's like being you.
    thank you so much – for being the honest, dedicated provider that you are and being courageous enough to open up this conversation.

  • http://distractible.org/ Dr. Rob

    Thank you very much. I appreciate your comments as well as your post on your blog.

  • Shib

    Bravo! You have done an outstanding job giving insight into the emotion of docs and an even better job reiterating your points. Dr. Rob, you rock on with your bad self and keep informing us, that is what we are all craving.

  • http://brilliantmindbrokenbody.wordpress.com/ Kali

    I have sometimes wondered what the cost of treating me looks like.

    I'm a complicated patient. No matter how often I manage to come in, there will always be multiple issues every visit. I live with a number of conditions that together might best be summed up as a long series of overlapping things going wrong. (Ehlers-Danlos Syndrome, POTS, bipolar, hypothyroidism, migraines, asthma, GERD & hiatal hernia, functional bladder disorder, IBS, fibromyalgia, allergies that tend towards sinus infections, Raynaud's, and I'm sure I'm forgetting something – if you were curious) The same things go wrong over and over (hip, shoulder, and back injuries) and I have a singular talent for having new things happen to me.

    Because of the long list of things that go wrong, there's always the long list of medications to consider, and a great many treatments (medicinal and otherwise) are counterindicated by other conditions on the list.

    I try to come in with my list of issues in descending order of importance. I try to make sure my specialists report if he can't get access to EMRs from them. I treat him with courtesy. I remember to (gasp and egad) thank him because I know that while I'm paying him, he can't possibly be in this for the money, or he'd be a specialist. I try not to waste his time or get upset with him if he's running late, because I know I'm not the only patient.

    I figure respect and knowledge should be a 2 way street with my doctor. I treat him as an intellectual equal with specialized knowledge that I don't have. If I read something from a reputable source that has me concerned (especially if it's to do with one of my rarer conditions), I print it out and bring it to him. I know he doesn't have infinite time to read, but I also know he doesn't have infinite time to research, so I try to balance between those two issues.

    I think of my doctors as consultants for my health – I'm the CEO of my health, and I make the final decisions, but I'll do a lousy job of it without good consultants. I'm not afraid to fire doctors who I feel don't have respect for me or who don't take my health as seriously as I do. On the flip side, I do what I can to add 'fringe benefits' for the doctors who are good to me – I send them cards, especially when I go on vacation, I make sure to tell them if a new treatment is helping a lot, I send little Christmas presents. I can't get my GP paid more (though if I could, I would!) but I can make sure he knows that his work makes my life better. Yeah, he can't get rid of any of my major health conditions, but it is due in no small part to the quality of care I have from him that I've been able to continue going to school.

    ~Kali

  • http://brilliantmindbrokenbody.wordpress.com/ Kali

    I forgot to mention – I apparently am a good patient, because my doctor recently recommended me to act as a chronic illness mentor to the medical students at the university hospital he works at. They get a couple meetings a year for 2 years with me to learn more about treating patients with chronic illnesses, and have a chance to ask questions about what it's like, what makes doctor's appointments better for me, and about what I look for in a doctor.

    I'll get 5-6 of them (I may do 2 groups) to educate. I hope this program really makes an impact on these future doctors! I find it really encouraging that at least some med schools have instituted programs like this – people are recognizing that there is something fundamentally wrong in the way the medical system as a whole treats people with chronic illnesses and they're trying to take steps to change that.

    ~Kali

  • Jsnowden

    Thank you for writing this. In the six months since my father was diagnosed with stage IV RCC, I've met quite a few members of the medical profession, some of which were completely compassionate and had my father's best interests at heart, and a few who have left me breathless with their lack of regard for their patient and his family.

    Physicians, like patients, run the gamut from good to bad, caring to cold. I've learned to appreciate the good, and to fire the bad. And maybe now I'll recognize the bad a little more quickly so as not to waste precious time.

    When your oncologist thinks eight months of life is “success,” you'd best not sit back like my father did. Make every day count, whether you're terminally ill or not. And try to add good not only to your own life, but to the others' lives around you.

    Thank you for your serious posts as well as your 'inane' ones. I love that you strive to bring your A game to every aspect of your life. You and those who encounter you are better for it, even on days when you don't live up to your own expectations.

  • http://www.howtobesick.com Toni Bernhard

    I'm a bit behind on my blogs and so just read this. I appreciate your honesty. It gives me some things to add to the list I keep in my head when a doctor doesn't live up to my expectations. I've learned to say to myself afterward, “Maybe she was just way overbooked today” or “Maybe he's worried about something at home.” Now I can think about how tired the doctor may have been that day and about the stresses on his or her business. As a chronically ill person, I've been in a lot of doctor's offices the past nine years. I'm trying to find a balance — to be sure to use good judgment about when a doctor is just “having a bad day” as opposed to just being a bad doctor (or at least not the right doctor for me). It's tough — for both of us.

  • Lorivickery

    I have a degenerative disease(Stickler's Syndrome) and Colon Cancer (previous resection) and have felt so much frustration with doctors. I have really started avoiding them even though I need to go because I'm so fed up with trying to deal with them. I swear they act like I'm crazy or faking when these tests do not show something. It is so humiliating. The arthritis doctor I was rec. to go to by my insurance company because he is the only one in Athens even said “There is no such thing as Fibromyalgia.” This was a great letter and in some ways give me hope to try again with some specialists but I have been burned so many times sometimes I'd rather sit here and hurt than go try to solve any issues because going to the doctor is so stressful.

  • Pingback: Dr. Rob shares what it’s like to treat patients with a chronic illness | Tombolo

  • Thequintessentialkeeper

    New here, thank you for sharing what you have to give in the way of expressive writing. I am neither vain or arrogant enough to think I know more than any doctor. I wish I had been fortunate enough to have found a good GP to acknowledge that he/she is neither a God or Shrink. I have fired more than I have kept because it seems easier to say I have a mental issue (which mind you, if I acutally did, I would accept help for it. I am accutely aware chronic illness can bring on depression etc) than to accept I am a very complicated case. After 22 surgeries, several treatment plans & lots of trial & errors, I am still standing, still waiting, still practicing seek & destroy missions on my body & still trying to dig deeper than my frustration to find the right team to help me feel better before I put two feet in the grave. I found the 3 articles related to this one inspiring, eye opening & to be honest a bit skeptical. I hear you saying, “not all doctors are doormats (essentially) and some still believe in the oath they stood proud and agreed to. But at the same time, I hear honest fear in your voice. I hear, albiet off in the distance “I don't want to see another of my patients lives destroyed or worse yet another family members tears over their early death.” I get it. BUT, understand, I've been …. hmmm…. sickly for the better part of my life. I have had more surgery than all my familiy members put together, more deficiencies than one body should tolerate and still my specialist is unsure with 100% accuracy on what to call what I have. now, I have a leaky heart valve too. I'm exasserbated, frustrated and damn scared of what my future holds. I have successfully raised a son with Asperger's Syndrome/Bipolar Disorder and failed with my daughter who no longer spends time with us, communicates with or acknowledges us because she can't see a wheelchair or a cain, she can't IV's hooked up to me on a daily basis. She, as do many, thinks I am makin more of this than what it is. 22 surgeries, pills for breakfast just to get up and get moving, resting at any given moment in a day, can't work (surgeons won't release me anymore) therefore she thinks me lazy. I mean I'm sure you've heard it all. I got the flu one day. For 8 weeks I was bed ridden and sicker than I had ever been. For 10yrs August 28th, I have slowly gone downward. I have not given up. I refuse to. What God doesn't fix, Spirituality gets me through. I listen, I choose carefully what applies to me and toss the rest. I refuse to watch commercials anymore, get involved with groups where drama is the focus not the ailment. I dismiss anyone who believes me a seeker of attention. I stay current on all things that apply to me. I still walk into a new doctors office with both fear and hope that he/she will care as much about me as though it were his/her own family member. Admittedly, I too can be overwhelmed by my mysterious health. I just wish doctors would look at me and tell me, I don't know but I won't give up. They ask it of me and yet I have not found one who will be my partner in care. They MUST trust me when I tell them something has changed. I kept telling my family doctor, I'm beyond faitgued. I can't even mow my lawn without stoppind a dozen times. He told me I was pushing to hard. WHen I spoke with my Pulmonologist, he says good news, you have better lungs than 13/20 percent of the population. Bad news, you have a leaky heart and we need to get a follow up with a cardiologist. I told my doctor, I BEYOND exhausted. That raised a flag for my pulmo yet my family GP ignored me. It makes me wonder what could have happened had we not gone a step further on our own. I have many stories such as this one but I've been long winded enough. In short, this problem goes both ways. Both parties are responsible for finding solutions to the problems current or that may arise. But, I as the patient should not have to go to medical school to cure myself. I dont' mind be an active contributing partner but I don't want to be my own doctor. It is what I pay good money for. I want the doctor to stop lumping me into the “common ailments” based on demographics & take me seriously as an individual. Thank you for your time.

  • Pingback: Doctors oughta doctor. « She's a character, she has opinions.

  • Lorivickery

    I finally got the time to come here and review what some have written. Wow. I can see you’ve walked through the valley of the shadow of death. God bless you and keep marching on.

  • guest

    “5. I hate bad doctors” — don’t we all! But those of us who have seen a lot of them and for whom doctors really matter because of our chronic illness, please understand that we really really really love good doctors!!! Even when they can’t fix us, just to be understood, not blamed for our problems, and to know we are in the best hands possible is so very important to us. I only wish I had more time to say this to my good doctors, but it is hard when time is at such a premium and you want to focus on what you are there for.

  • Robert Lester

    Someone once said a man’s greatest strength is also his greatest weakness. I am a primary care physician, and I get grumpy when one of my patients is not doing well. At first I wondered if I should try to “leave it all at the office”, but soon came to terms with the fact that I am going to feel pain when my patients are not doing well because I care about them. The fact that I care is what makes me good at what I do. So, the pain is part of the cost of doing business in this field.

Previous post:

Next post: