An excerpt from my upcoming book due out May 2020

An excerpt from my upcoming book, 

Stream of Consciousness: A Tail of Male Infertility, Medicine, Life, & The New York Thruway (A Real Cock & Ball Story)

I find I have to remind myself to breath when looking under the microscope at glass slides that, in all probability, will contain very few, if any, sperm.  Each slide can take 20 minutes or more to look out and I have 24 of them in total get through.  For this reason, I like to schedule testicular mapping procedures late in the afternoon, after I have finished seeing patients.  I like--I need--to be 100% focused.
I go in a systematic fashion through each slide, left to right then down then right to left; kind of like a type writer without a functioning carriage return.  I hold my breath with each turn of the wrist to move the microscope stage, hoping, pleading, praying, that I'll see a sperm.  Just one will be sufficient.  I want it, I think, as much as Kathryn and Rhys do.  
I start to hallucinate:
Is that a sperm tail? 
I think I see a head.  
There, what is that?  No, that is nothing. Fuck.
With each completed slide that is devoid of a sperm, my heart sinks and my mood darkens.
My confidence withers.
Is it me?  Am I doing this correctly?  Can I trust the results?
Of course you can.  You know how to do this.  You have had successes in the past.  You got this, motherfucker.  You da man!
I argue with myself, self loathing and boasting simultaneously.
Maybe next time I do one of these friggin things I'll bring my shrink into the lab with me.
Minutes pass.  I lose track of time.  
Slide 1 then slide 2 then slide 3 and on and on and on.
The natural tendency is blow through the later slides if the earlier ones did not have sperm, sensing futility in the endeavor.
Resist that temptation. 
Sperm production is not uniform and can take place anywhere, even on slide 24.
Keep going.  One more slide.  Come on. . . 

You have just read an excerpt from my upcoming book, due out in May 2020.  If you have any questions or comments, please feel free to reach out to me.

The IU.

On Call Sanity

Let's face it: call blows.  Social science research has shown that on-call workers are prone to a variety of stress related afflictions such as exhaustion, irritation, sleep disorders, memory disorders, headaches, musculoskeletal pains, depressed mood, sleep deprivation, insomnia & sleepiness during the daytime, reduced cognitive function, and difficulty in concentrating.   There is also a relationship between on-call work and job dissatisfaction and also between on-call work and job-turnover.  On-call work negatively affects marriages, home life, and the so called work-life balance

The best way I know to get through call is as follows:

• stay busy
• exercise
• meditate
• yoga
• do CME

I also like to get outside and walk.



Good luck out there and stay positive.
The IU

Important legislation

https://drive.google.com/open?id=12W_KzMszwFOv4tcx5gq8HaMB3sThgj4f

Exploring: One of the Pluses of Locum Tenens Urology

Brownsville NY 

Cape Vincent Lighthouse: where Lake Ontario becomes the st Lawrence River

Lake Ontario from Sacket's Harbor, site of War 1812 Naval battles

Finger Lake

The Black River

Grand Hotel, Clayton NY

Lake Ontario

Black River Trail, Watertown NY

Black River rafting, Watertown NY

Black River State Park

Night Skiing, Watertown NY

Typical winter evening, Watertown NY

Samuel Clemens, resident Elmira NY

Mohawk River Bridge, part of Erie Canal-way

Watkins Glen State Park

Finger Lake

Elmira College, 2019 Women's NCAA Hockey playoff

Chemung River, Elmira NY

Elmira NY

Street Fair, Elmira NY

Tribute to vets of the Spanish American War, Elmira NY

An excerpt from my newest book

An excerpt from my newest book coming out soon

Stream of Consciousness: A Tail of Male Infertility, Medicine, Life, & The New York Thruway  (A Real Cock & Ball Story)

I decided to drive.  I like a good road trip but what began with the excitement of a road adventure and good audio book soon gave way to increasing stress and tension with each passing mile.  The first 3 hours was pleasant enough but as I turned onto I-90 heading west from Albany, melancholy overcame my cheery disposition.  Interstate 90, which is known as the New York Thruway, traverses the state and passes some of the most important yet forgotten historic locations of our nation.  This is the region of the eastern edge of the Erie Canal, built in the early 19^th century by Irish immigrants, at a tremendous cost in both dollars and lives.  The Erie Canal may well be one of the greatest construction achievements in US history and even world history, on par with the Panama Canal and maybe even the Pyramids at Giza yet as I was driving along the highway all I could see was economic despair.  I turned off the audio book, unable to concentrate.  The river was pretty but the towns along its banks looked destitute, slum-like.  I had to look up on the map to learn the name of the waterway; the Mohawk.   Old bridges and locks; a canal system.  I had to ask myself, “What is this canal?”  I don’t recall ever learning about it in school.  How is that possible?  I made a mental note to learn about the Erie Canal during any downtime I might have this upcoming weekend of locum tenens urology call, the mere thought of which making my throat dry.

The Erie Canal was built to connect the food production facilities of the Midwest via Chicago with New York City and then the world.  The Canal is what made New York City a world capital and had a great deal to do with our nation’s prosperity.  The canal’s slow death began with completion of the St Lawrence Seaway to the north with the final death blow occurring with completion of the Thruway in the 1970s.  The canal did make many of the cities along its path rich.  Towns like Amsterdam; Herkimer; Utica; Rome: these were once thriving industrial and manufacturing towns that to me, as I drove passed them, were in decay.  The recession of the early 1970s worsened things and the towns along this once prosperous corridor have withered on the vine.  Poverty in this region of NY is rampant with rates exceeding 30% in some cities.  

My mood worsened and dread crept into my head.  I no longer wanted to be here, on this depressing road, and when I got to Utica, a city with close to half its population living in or around poverty, I decided to get off the Thruway and take a local, rural highway, in search of some charm; some history.  I hopped onto NY12, a 220-or-so-mile rural highway that starts near Binghamton and ends along the St Lawrence River, skimming the western edge of Adirondack Park.   NY 12 skirts Adirondack Park but is not part of the preserve, with its pristine lakes, dense forests, remote wilderness and high peaks.  The Adirondack Mountains are old mountains, much older than the Appalachian Range or any other range for that matter, by 2 billion years or so.  In fact, the Adirondack Range is the oldest range in the world and was formed prior even to the period of Gondwana, the giant multi-continent land mass that preceded Pangea by more than a billion years.  Theodore Roosevelt successfully fought to preserve the Adirondacks from development, starting the conservation movement.  Adirondack Park is magnificent.  But NY 12 remains outside the park, a world away from magnificent, as it winds its way along the Black River passing town after town filled with decay, dilapidation, & despondency.  

I was going upriver into the heart of darkness.

---

Let's catch up

It has been a while since I wrote about independent practice.  What can I say?  I've been busy.  Very busy.  That is a good thing. 

It has been 13 years and a few months and I enjoy solo practice as much as I did on day one, even more so. 

The early years were tough.

Lean.

Now is good.

Phone rings non-stop.  I had added 13,000 plus patients to my practice and I am really appreciated.

I have built the practice I have always wanted but never thought I could have.

I have a solid sub-specialty practice in male infertility, have a vasectomy center, do vasectomy reversals in-office and I have client depositor sperm bank. 

How many other urologists have that in Suffolk County?  Zero.  Nassau County? Zero.  New York State?  Zero.

Am I proud of this?  Hell yeah!

I have a strong referral base of independent docs, like me, who have resisted acquisition for all these years.  They ain't going anywhere.

The majority of my patients come from professional referral, word of mouth referral & web.

I do advocacy work for https://nysurologicalsociety.org/  on their exec committee and I am the President of the http://www.scms-sam.org/index3.html

It is all good.

Lov'in it.

The IU.

The New SCMS President Speaking

Sperm Talk Radio with Dr Doug Stein

Medicine Unplugged

Listen to this episode of my podcast, Medicine Unplugged, Medicine Unplugged: An interview with Dr William Spencer MD, Suffolk County Legislator https://anchor.fm/saluspopuli/episodes/Medicine-Unplugged-An-interview-with-Dr-William-Spencer-MD--Suffolk-County-Legislator-e3l2ch