Things I Learn From My Patients

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Tonight I learned yet another helpful life lesson from one of my patients. If you're on the street corner selling coke and you see the cops coming to bust you don't eat all your coke. Having been taught this valuable lesson I will now know better than to do this and wind up going to the ER in handcuffs, seizing uncontrollably, aspirating my vomit and doing all of this with a white powder moustache looking like and ad for "Got Coke?"

It's a recurring theme lol....we just had a guy swallow 16 grams worth of meth when a deputy pulled him over. An ambulance was called 3 minutes after the stop, and he died enroute----some pretty quick stuff. Some people.

Lemme add tip #3. Always pay your drug dealer! Bad things happen when you don't pay.

#4. Always be polite to strangers. No matter how tough one thinks he is, there is always someone bigger, badder, or more likely to use violence to accentuate his point.


Last but not least.... If I had a nickel for every time a patient looked at me and said, "Young man, I know my body, and this chest pain isn't from my heart." - as I'm looking at the huge ST segment elevation. I'd probably be able to put a sizable down payment on a nice car.

One thing I've learned from 3 EM rotations is:

#5: Stay away from people named "Some Guy" or "This One Dude", because they for whatever reason, just punch someone in the face or hit them with a crowbar and run off. If I see them on the street, I cross the street to get away from them.

Q

#6 Never, ever leave flashlights, shampoo bottles, beer bottles or any long, circular object on the floor because someday you will fall on it and it will somehow, work its way up your rectum.

1) Never run from the police especially if its a K9 unit.

2) Always wait until finishing your woodwork with the skillsaw prior to using your meth.

3) Don't swerve your Suzuki Samari to avoid hitting a squirrel in the middle of the road.

4) Don't road surf on the top of a moving stickshift car driven by your younger sibling with a learner's permit.

never leave your last refill of percocet in plain site after your docs office closes if one of these 3 friends is coming over for dinner:
1. some dude
2. my friend
3. that bitch

if the two dudes live in YOUR city, don't sit out on your front porch reading the bible and minding your own business at 2 AM unless you are praying to be shot

Originally posted by anonymousEM
if the two dudes live in YOUR city, don't sit out on your front porch reading the bible and minding your own business at 2 AM unless you are praying to be shot

Ah, that's the best one yet... thanks for the laugh!

If those two dudes broke your arm while you were walking home from Church on a Friday night, and the trauma surgeon fixed it via external fixation, DO NOT by any means use a wirecutter to remove it 4 days after discharge.

Q

Well another professor of life came through last night and bestowed some wisdom on me which I'll share. No matter how annoyed you are at being incarcerated dont slash open your scrotum and shove razor blades up your urethra. Now I know, who among us hasn't thought wistfully of doing that but it turns out that it's not a good idea.

Oh, I love these crazy ER stories! More!! I'm going into surgery and I just found out that my program doesn't put me in the ER for a month, so I'll never get to tell the stories of my month of crazy stuff from the ER.

Keep the stories running!

If you are prone to dystonic reactions and are stealing your roomates meds. Make sure you can tell valium from haldol.

Take a look at the two in the PDR. It is amazing how similar they are.

Latex paint, despite being thick and creamy, does not coat your stomach and provide the same relief as pepto bismol.

1. When cleaning a swimming pool with Muriatic acid, if you splash a large amount of it on your face and arms, vinegar is not a good neutralizing solution.

2. Never, Never, for the love of God, let someone with chest pain use the bathroom.

3. If you own a horse named thunder, flash, psycho, or reaper, do not get within 20 feet, and don't even think of just taking them for a quick ride.

If you get a cold, or have a runny nose, and don't feel like going to see your GP, just go to the ER and get yourself a Z-Pack!

2. Never, Never, for the love of God, let someone with chest pain use the bathroom.

Someone at my shop forgot this rule recently. Vfib is a bad thing right?

Latex paint, despite being thick and creamy, does not coat your stomach and provide the same relief as pepto bismol.

Classic. I've never seen it but I can sure see it happening.

If you are prone to dystonic reactions and are stealing your roomates meds. Make sure you can tell valium from haldol.

Priceless! Possibly the best yet!

If you are a 70 year old man with COPD, and you want to clean the toilet really well, go ahead and mix the ammonia and bleach. Most of us learned not to do this before the onset of pubescence, but give it a try regardless!

Later, after the paramedic has successfully conducted a RSI intubation in the ambulance, make sure your family speaks up for you in the ED. They are there to advocate for you on the most pressing and salient issues.

Have them go right up to the ED attending, and demand that, if they don't find the patient's missing dentures right now, the doc and paramedics are buying him a new set.

Hint: they should demand this while standing in front of the ventilator (the patient's only earthly connection with an oxygen satuaration >70%).

Don't cut off your own penis and testicles with a knife...no explaination necessary.

Some others.....

Patients with chronic (back, neck, head, abd, etc) pain come into the emergency department at 3am because the pain suddenly gets "worser".

If you are going to get into a fight, and have a prosthetic eye, make sure you take it out first.....and, for safe keeping, shove it up your vagina.....the, realize that you cannot get it out and go to the ED for removal (happened to one of the guys in my residency).

No matter how tough you are, don't cross the street when you are drunk because the moving vehicle always wins.

If you have taken 7 home pregnancy tests that are all positive, and you come into the emergency department...chances are that test too will come back positive.

For the guys . . .

Just because the knut fits around your penis when you are not erect, it doesn't mean it will fit when you are.

If you are going to get into a fight, and have a prosthetic eye, make sure you take it out first.....and, for safe keeping, shove it up your vagina.....the, realize that you cannot get it out and go to the ED for removal (happened to one of the guys in my residency).

I guess that does show some forethought. I had a woman who was tweaking on meth and handcuffed to the gurney pull a crack pipe out of her vagina AND EAT IT! She chewed it up and got glass in her mouth and esophagus. I'd never seen anyone eat a crack pipe before and I did med school in Philly (city motto: Crack. It's not just for breakfast.)

Originally posted by docB
I'd never seen anyone eat a crack pipe before and I did med school in Philly (city motto: Crack. It's not just for breakfast.)

So-oo true if you're in North Philly or University City!

My fave patient, by far, was this woman who came in for "kidney pain". She was convinced that she needed a CT or US (and asked for them repeatedly), but we all thought it was musculoskeletal. So she's sitting there with her 2 year old, and her baby's father**, as we try to figure out if she's done any heavy lifting or anything recently...

So finally she says, "Hey Doc, you think I coulda done dis masturbating? Cuz da other night, YOU (points to baby's dad) just wouldn't wake up! And I needed me some lovin'! So I gave myself like 29 orgasms while you be sleeping in da bed next to me! You think that could've done it, doc?"

**Noone in North Philly is actually dating or married to their children's other parent. This particular story was a rare case, and does not accurately represent the population seen at Temple. However, even though this woman was still sleeping with her 'baby's father', she did not refer to him as her boyfriend/husband.

another big no-no...
when the iv drug user with no veins comes in with cellulitis and gets a central line, tell the nurses to not let them "go out for a smoke". pt took off (obviously), brought back in to the E.D. 1 hr later in full arrest by girlfriend after shooting up on the street into central line with"the really good stuff".... survived "intact"

Originally posted by emedpa
brought back in to the E.D. 1 hr later in full arrest by girlfriend after shooting up on the street into central line with"the really good stuff".... survived "intact"

The Law of Inverse Value: the less you contribute to society, the greater the trauma you can sustain with minimal to no physical sequelae, including falls from 3 stories, stabbings (chest, neck, head, slashings to the face), gunshot wounds (chest, neck, pelvis, leg, traumatic arrest (only to be killed 7 years later in a separate GSW incident)), and high speed MVC's, unrestrained, where multiple people in the other vehicle are killed.

Don't swallow quarters. No, not a kid, a 45 y/o guy.

mike