Estimated reading time: 7 minutes
Last night, Karie crossed a finish line that took years of work, sacrifice, and an inhuman tolerance for academic committee feedback. She defended her dissertation. My wife passed and got her doctorate! She is, as of approximately 5:43 PM on a Thursday, Dr. Karie.
I could not be more proud.
I also could not be more prepared.
I had been waiting for this moment. I had a list. I had a binder.
The Consultation
“Okay,” I said, pulling out the binder. It had tabs. “I’ve been thinking about the conversion.”
Karie looked up from her celebratory glass of wine. “What conversion?”
“The house. To a practice.”
A pause. “A… what?”
“A medical practice. Your practice.” I gestured broadly at the living room. “Obviously, these couchy things have to go. That’s where the waiting room goes. I was thinking maybe some of those bolted-together chairs? And one of those little tables with magazines from 2014. A Highlights with the ‘Goofus and Gallant torn out?’ Very professional. Very ‘we validate parking.'” I flipped to Tab 2. “I also think we move the pig.”
“You think we move Trouble.”
“Patients don’t want to see a pig when they come in, Karie. It raises questions. It undermines confidence in the practice.” I made a note. “She can have the garage.”
Karie set down her wine. This is never a good sign. If you’ve been following this blog, you already know that Trouble McFussbucket has a long history of undermining confidence in things, including fences, routines, and my general authority in this household.
“I’m a doctor of education,” she said, slowly, in the same voice she uses when explaining things to Señor Hector Queso Suarez DDS, our chihuahua, who once ate a battery and seemed genuinely improved by the experience. “Also, we don’t have a garage.”
“Right,” I said. “So. General practice? Or are you going specialty? Because I looked it up and dermatology has great hours. Four days a week. Closed Fridays. We could do a lot with Fridays.”
“I’m not going to see skin patients on any day.”
“Allergist?”
“No.”
“Pediatrician?”
“Brian.”
“Podiatrist? Because I have a thing on my foot that I’ve been meaning to–“
“Brian.“
The Support Staff Question
I had also prepared for this part of the conversation. This was Tab 4.
“I want to be your PA,” I told her. “Your physician’s assistant. I’ve been watching a lot of medical YouTube. I know what a stethoscope is for, and I’m pretty sure I could learn the other one. The arm thing. The cuff.”
“Sphygmomanometer,” Karie said.
“I could learn to say that.”
“You cannot.”
“I could learn to stand near it in a way that implies familiarity.”
She picked her wine back up. I took this as progress.
“I’m serious,” I said. “I can greet patients. I’ve been working on a greeting. Do you want to hear it?”
“I do not.”
“‘Good morning, and welcome to Karie M.D.’. That’s the temporary name of the practice; I’m still workshopping it. ‘Please have a seat, a nurse will be with you shortly, and if the pig is in here, ignore the pig, she’s not contagious, we think.'”
“There is no pig in the waiting room.”
“She keeps getting back in.”
“We haven’t built a waiting room.”
“She’s VERY motivated.”
Karie stared at me. I pressed on.
“I can also do triage. I’ve been reading about triage. It’s basically just asking people how bad it is on a scale of one to ten, and then quietly adjusting for the fact that everyone says eight when they mean four. I’m good at that. I’m very calibrated. Ask anyone.”
“Ask anyone what?”
“That I’m calibrated.”
She looked around the room for someone to ask. There was only Trouble, who hadn’t returned from the garage and was standing in the doorway like a small, pink consultant. This is, honestly, not the first time she has inserted herself into a situation that did not require her.
The Liability Portion of the Evening
“Also,” I said, turning to Tab 6, “we need to talk about biohazard storage.”
“Brian, I promise you–“
“There are regulations. Red bags. Sharps containers. You can’t just put a needle in the recycling bin, Karie, I don’t care how good your intentions are, the county will come, and they will LOOK at you, and it will be a whole thing.” I tapped the binder. “I’ve already sourced a medical-grade disposal unit. It mounts under the sink. It’s a little bigger than I expected.”
“How big?”
“It’s fine.”
“How big is it?”
“It’s the size of a dishwasher.”
“We have a dishwasher.”
“We had a dishwasher. Now we have regulatory compliance.” I moved to the next page. “I also want to discuss the defibrillator.”
Karie put her face in her hands.
“I found one on Facebook Marketplace. Guy in Waynesboro. He said it’s ‘lightly used’ which is either very reassuring or deeply alarming depending on your perspective. I chose reassuring. I put a deposit down.”
“You put a deposit on a used defibrillator?”
“Non-refundable, unfortunately. But it has a carrying case.”
“Why would we need a carrying case?”
I looked at her. She looked at me.
“House calls,” I said, as if this were obvious, as if she had asked why water was wet or why Trouble keeps eating the mail.
She stared at me with the expression of a woman who has spent the last several years studying human development and is watching it fail in real time, right in front of her, wearing socks with a hole in the left toe, next to a pig, holding an empty wine glass.
“What exactly,” she said, very quietly, “do you think I’m going to be doing?”
I checked the binder.
“Healing people?”
The Waiting Room Revisited
We sat with that for a moment.
Trouble wandered through the room with the unhurried energy of someone who has already won. Mr. Pickles, our five-pound Scandinavian Lintbøøl, materialized next to Karie the way small dogs do — without apparent movement, as though assembled silently by the universe. I have written about Mr. Pickles’ uncanny ability to appear in rooms he was not previously in, and science has yet to offer a satisfying explanation.
“Here’s what I’m hearing,” I said, “and stop me if I’m wrong…”
“I will not stop you. I’ve entered a new phase. I’m simply going to watch.”
“…is that you want to start small. Home visits. Boutique practice. Word of mouth. Very concierge medicine. Very Hamptons.” I made a note. “I’ll set up a booking link. Very clean. Very minimal. Just your name, your credentials, your hours, and a little dropdown for specialty, which I’ve temporarily set to ‘General / Pig-Adjacent.'”
“Please remove Pig-Adjacent.”
“It was the most clicked option in beta testing.”
“Who was in your beta test?”
I looked at Trouble. I looked at Mr. Pickles.
Karie closed her eyes.
“The booking link,” I continued, “also has a symptom checker. I built it myself. It has three outcomes: ‘Probably Fine,’ ‘Ask Karie,’ and ‘Have You Tried Lying Down?’ I think it covers most scenarios.”
“Take down the booking link.”
“Forty-seven people have already used the symptom checker.”
Karie opened her eyes.
“Forty-seven.”
“It’s been up for three hours. ‘Have You Tried Lying Down?’ is very popular. People really respond to it. I think it fills a gap in the market.”
What I Actually Know
Here is what I actually know.
When my partner defended her thesis, she wasn’t just completing a degree. She started this process when most people would have decided they had enough on their plate. She read things I will never understand, wrote things I could never write, and argued her ideas in front of a room of people whose job it was to find the holes.
There were no holes.
I know she is the smartest person in any room she walks into, and that now she has the paperwork to prove it to rooms that require paperwork.
“Doctor” is a word that covers a lot of ground. A Doctor of Philosophy/Education isn’t getting fitted for a white coat . She’s reshaping how entire systems think about how people learn. When your spouse finishes her dissertation in education, she joins a field that does something quietly radical: it makes the world better at teaching itself. That’s not a small thing. That’s not even a medium thing. That is, quietly and without enough fanfare, one of the most important kinds of work there is. More important than the doctor with the parking spot, and I think we both know it.
I know I’m an idiot. I’ve written about this at length, and the evidence continues to mount.
But I’m an idiot with a binder, a lightly-used defibrillator, a booking link with forty-seven users and counting, a pig who keeps getting back inside, and a wife who became a doctor, the real kind, the kind that changes how the world learns.
Congratulations, Dr. Karie.
The chairs arrive Tuesday.
See my Amazon author page and buy my books.
His first manuscript was composed entirely of punctuation marks and confused sketches. He's since published "Not Bukowski" (poems that don't rhyme) and "Slop and Swell from a Festering Mind" (essays so concerning that bookstores check on his wellbeing). He once spent three hours photographing a rare bird that turned out to be a plastic bag, and he's the only person banned from church bake sales for "weaponized brownies." Inheriting absurdism from Vonnegut and Adams, sprawling narratives from Irving, and weaponized failure from Moore, he writes about conflicted everymen struggling through supernatural chaos.
He has two new, offbeat novels waiting foran agent or a publisher: "Truth Tastes Like Pennies" and "Elliot Nessie."
He remains unconvinced that birds aren't surveillance drones.
More biographic lies...err...info.
- Packing for Marrakech, Distracted by Fried Chicken Fashion - April 20, 2026
- I Am Not a Carwash Guy Either - April 17, 2026
- Scientists Confirm Sperm Whales Have Language. Gary is pleased. - April 16, 2026
