All my patients thanked me today.

[deschutes]

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I'm still waiting for the warm fuzzy cloud of joy and happiness to descend upon me...

~
One of the patients was a not-so-elderly Oregonian who came in 2 days ago on 15L of O2. He's going back today to the peripheral hospital from whence he came, and I stuck my head in to see him before he left.

I had accidentally left my personal patient-tracker sheet in his room and he figured it was me "because you're the most meticulous of all the doctors who come by".

Well, I said, I wasn't a doctor. < Insert spiel on roles of the team members. >

He repeated his statement, thanked me and told me he really enjoyed his 2-night single-bed stay in our 3-month-old Ward Of The 21st Century. (I disclaim all responsibility for that name.)

So these are the moments that clinicians live for??

If I had things my way, all inpatients would have 2-night single-bed stays. But since none of those things are under my control, I'm still puzzled as to why he is so grateful.

 

[b&ierstiefel]

I'm still waiting for the warm fuzzy cloud of joy and happiness to descend upon me...

~
One of the patients was a not-so-elderly Oregonian who came in 2 days ago on 15L of O2. He's going back today to the peripheral hospital from whence he came, and I stuck my head in to see him before he left.

I had accidentally left my personal patient-tracker sheet in his room and he figured it was me "because you're the most meticulous of all the doctors who come by".

Well, I said, I wasn't a doctor. < Insert spiel on roles of the team members. >

He repeated his statement, thanked me and told me he really enjoyed his 2-night single-bed stay in our 3-month-old Ward Of The 21st Century. (I disclaim all responsibility for that name.)

So these are the moments that clinicians live for??

If I had things my way, all inpatients would have 2-night single-bed stays. But since none of those things are under my control, I'm still puzzled as to why he is so grateful.

I discharged my only patient left on my census today (after running around the hospital to get crap together to facilitate his discharge). He was a non-compliant type 2 (?) diabetic who came in with (believe it or not) DEE-KAY-A!

We were of similar age and we spent some time every morning just chatting when I came to preround. I dunno why but for some reason, we seemed to strike up some interesting conversations and we got along pretty well ("establishing rapport" as they teach us in medical school). Anyways, he thanked me today in a similar tone as your patient thanked you. It did feel quite good I have to admit.

Now hopefully he listened to my advice to do all the good things diabetics can do to prevent all the bad sh1t that can happen. And yup...this was a long 30 minute conversation today.

 

[quant]

D

 

[quant]

sorry wrong post..

 

[yaah]

#1: I didn't think 15 L of O2 was possible. That's like taking an ax to the side of the oxygen canister and holding the breakpoint up to your face.

#2: Type II diabetics don't get DKA. They get hyperosmolar non-ketotic comas. Only Type I.........ah who cares. That's clinical medicine. They both get terrible ulcers which I have to deal with when someone cuts their legs off.

#3: One of the weird things about clinical medicine is you can take the 15 minutes to say hi to a patient, ask them how they are feeling (without doing it in a "medical" kind of way), introduce yourself, find out what is really bothering them without interrupting too much, and then not see them again for a day. And they will act as though you are a wonderful doctor who listens better than anyone. And those who do this "clinical medicine" for a living do not get such praise.

 

[deschutes]

#1: I didn't think 15 L of O2 was possible. That's like taking an ax to the side of the oxygen canister and holding the breakpoint up to your face.

And to top it all off he preferred the prongs.
But what do I know anyways... he was American. They have super-powers.

He was the one I got paged at 9pm for, asking if he could take Ricola for his dry throat.

#2: Type II diabetics get hyperosmolar non-ketotic comas.

HONK, in a word.

Maybe one day I will be able to make up my own acronym. HONKoma.

#3: One of the weird things about clinical medicine is you can take the 15 minutes to say hi to a patient, ask them how they are feeling (without doing it in a "medical" kind of way), introduce yourself, find out what is really bothering them without interrupting too much, and then not see them again for a day. And they will act as though you are a wonderful doctor who listens better than anyone. And those who do this "clinical medicine" for a living do not get such praise.

And yet they are the ones who put so much value on patient contact.

I don't get it. I don't suppose I ever will.

I wonder if we would save a whole bunch of healthcare dollars by simply having a patient see one nice friendly dedicated doctor instead of spending it on million-dollar workups. Everyone knows that it's not the clinicians with the great bedside manner who get sued.

 

[b&ierstiefel]

#2: Type II diabetics don't get DKA. They get hyperosmolar non-ketotic comas. Only Type I.........ah who cares. That's clinical medicine. They both get terrible ulcers which I have to deal with when someone cuts their legs off.

That was the weird thing. He was overweight but young. And he came in with an anion gap of 25, tachypneic, abdominal pain, N/V, ketonuria, the whole bit. And in addition he was on oral meds (noncompliant too) and not on insulin. And his blood sugars just plain sucked. Apparently, a very small percentage of type II diabetics can get DKA. Most, like you say, get HONK/coma. But those patients usually have blood sugars that are sky high (like 800 or more). This guy didn't have that.

Anyways, I'm on call and our team is already getting slammed. Goddamn I hate this.

 

[quant]

I thought of the same thing when i saw the post...but then i checked it up and saw that apparently a small percentage of people who are NIDDM do get DKA...
well 2+2 is never equal to 4 in Medicine i guess...

 

[b&ierstiefel]

I thought of the same thing when i saw the post...but then i checked it up and saw that apparently a small percentage of people who are NIDDM do get DKA...
well 2+2 is never equal to 4 in Medicine i guess...

Word up man! Now close this window and go watch Austin Powers!

 

[quant]

I will andy i will.....but i need to get this stupid step 1 out of my way (which is why i thought HONK is in NIDDM 2 and not DKA..... )....what the hell ....i ll probably go watch the movie anyway, i guess it is playing on TNT (?)

How did you like kill bill?

 

[b&ierstiefel]

I will andy i will.....but i need to get this stupid step 1 out of my way (which is why i thought HONK is in NIDDM 2 and not DKA..... )....what the hell ....i ll probably go watch the movie anyway, i guess it is playing on TNT (?)

How did you like kill bill?

ok man, you're gonna need to put the books down for a moment and run to the video store.

i loved kill bill...both of them. i don't think austin powers is playing on tnt. but you can get all those videos at once.

 

[bente]

Apologies if this is duplicate post...it vanished.
Dka/niddm mixed presentation...have seen it 3 times, even in bro in law. Wacky.
Quant, give Austin a second chance...and while you are at it, pick up SO I MARRIED AN AXE MURDERER. It is one of his first (with Wayne's World), and I think it has some very funny bits (scene 1: 'Excuse me, I ordered the LARGE capuccino!)
While at video store, peruse the Coen bros...and join the fan club. They have some of the best writing around. FARGO, BROTHER WHERE ART THOU?, BARTON FINK, RAISING ARIZONA...We had a Coen bros film festival one wkend at our house, some 8 films. Very intelligent folks...subliminally, it will help you on Step 1!

 

[quant]

Apologies if this is duplicate post...it vanished.
Dka/niddm mixed presentation...have seen it 3 times, even in bro in law. Wacky.
Quant, give Austin a second chance...and while you are at it, pick up SO I MARRIED AN AXE MURDERER. It is one of his first (with Wayne's World), and I think it has some very funny bits (scene 1: 'Excuse me, I ordered the LARGE capuccino!)
While at video store, peruse the Coen bros...and join the fan club. They have some of the best writing around. FARGO, BROTHER WHERE ART THOU?, BARTON FINK, RAISING ARIZONA...We had a Coen bros film festival one wkend at our house, some 8 films. Very intelligent folks...subliminally, it will help you on Step 1!

Bente....
I did give Austin a second chance..i wouldnt say im an unabashed Austin fan, but i did find his pictures quite funny...I saw Fargo and Brother.... I loved Fargo...absolutely loved it! Frances Mc Dormand did a great job in it , i especially loved the "Yaah" in it and the various meanings a single word "Yaah" can mean in midwest. Is that where you get your name from Yaah?
Brother was quite funny too,except i think you had to be familiar with American rural interior on a day to day basis to appreciate the humor. A few parts of the Southern accent flew over my head but i think it was a wonderfully done film. Barton Fink and Raising Arizona are films that i now have on my list. The next time i go to the video store i shall definitely get them....And sure as hell hope it ll help on step 1....

Thanks Bente....
You never told me how did you find the tour de France?....

Regards
Quant

 

[yaah]

Actually, Yaah is also a northeastern term. My mother and other people in the area with heavy new england accents say yaah all the time (instead of yes or yeah). My mother, in fact, can virtually have an entire conversation with someone using only the word "yaah" and varying the inflection of her voice. It is quite impressive. I know exactly what she means. The Minnesota yaah is a bit different. It is usually used in the context of, "Oh yaah?" or "Oh yaah!" or "Yaah you betcha."

I like Coen brothers movies also. I saw Fargo in Minnesota in a small town, many of the locals I think were somewhat insulted and thought that the accent was a bit overblown. I, however, did not. It was dead on. William H Macy's character is a perfect Minnesotan. I also like Raising Arizona. Some great scenes in that movie..."Okay, then." The first few minutes of that movie is a revelation. The prison scenes, "I'm walkin' in here on my knees Ed, a man proposin'."

and when there was no meat, we ate fowl and when there was no fowl, we ate crawdad and when there was no crawdad to be found, we ate sand.
You ate what?
We ate sand.
You ate SAND?

Mighty fine cereal flakes, Ms McDonough.

Okay, so this Polack walks into a bar, carrying a pile of dog **** in his hand, and he says "Look what I almost stepped in."

Say that reminds me, how'd you get that kid so darn fast? Me and Dot went in to adopt on account a somethin' went wrong with my semen, and they said we had to wait five years for a healthy white baby. I said, "Healthy white baby? Five years? What else you got?" Said they got two Koreans and a negro born with his heart on the outside. It's a crazy world.

Sometimes it's a hard world for the little things.

 

[quant]

In Fargo, i especially liked the sequence where Frances Mc Dormand has a conversation with a couple of Minnesota girls and the whole sequence runs on the word 'yaah"...i mean a whole range of emotions using that single word!!!!....A slight inflection of tone here and the whole meaning changes.....it was just beautiful....but the sad part about the movie was it being an actual true story......mankind is really something!!...no wonder people like Einstein and Mark Twain had given up any hope for the human race as a whole towards the end of their lives....and they stated that in no unclear terms too!!!

You still dint say if that is where your screen name comes from...... 🙂

Regards
Quant

 

[b&ierstiefel]

You still dint say if that is where your screen name comes from...... 🙂

Uh yaah he did. 😀

Actually, Yaah is also a northeastern term. My mother and other people in the area with heavy new england accents say yaah all the time (instead of yes or yeah).

 

[bente]

Yes, I also had acquaintances who were offended by Fargo; I think they did protest too much!
Alaskans were so offended by NORTHERN EXPOSURE, which I loved. They were so pissed, 'It's not realistic!' I guess they believe everything else on TV is documentarial. They were so incensed, they would write letters to the editor, damning the show and all those associated to an eternity of hellfire and gnashing of the teeth. A few folks wrote back saying how much they liked it, and were told to 'leave Alaska if you don't like it".?? That is the standard Alaskan reply to any argument or discussion...if your debating opponent has not been won over by raising your voice, or swearing, they are told they should leave the state.

and when there was no meat, we ate fowl and when there was no fowl, we ate crawdad and when there was no crawdad to be found, we ate sand.
You ate what?
We ate sand.
You ate SAND?

I love that scene. I recently heard a Monty Python skit that reminded me of that scene (because people competing on who had it rougher in the olden days)...Monty Python's FOUR MEN OF YORKSHIRE.

Say that reminds me, how'd you get that kid so darn fast? Me and Dot went in to adopt on account a somethin' went wrong with my semen, and they said we had to wait five years for a healthy white baby. I said, "Healthy white baby? Five years? What else you got?" Said they got two Koreans and a negro born with his heart on the outside. It's a crazy world.

Sometimes it's a hard world for the little things.[/i]

HI! Our baby needs a dip tet. He ain't had his diptet!

And, one of my favorites:

Now I don't know how you come down on the incarceration question.
{Hi backpedals into frame with a shotgun and a bag of cash.}... whether it's for rehabilitation or revenge .... But I was beginning to think... that revenge is the only argument makes any sense.

 

[bente]

Thanks Bente....
You never told me how did you find the tour de France?....

It was incredible. The French were not as obnoxious as I'd dreaded. We were in the villages mostly...the French are incredibly bike-friendly and go out of their way to accomodate you (as opposed to Americans who go out of their way to KILL you).
Like most sporting events, the TV coverage is the best way to see the action, but the atmosphere makes it unforgettable. We'd bike the last 50miles or so of the course (with thousands and thousands of fans cheering for US and giving us wine..). The roads are closed so you can rocket down winding mtn roads, swinging wide to the left lane and cutting the corners. There are an average of 3/4 million along the route daily, in many costumes, stages of dress and undress...many fun things edited out for family TV. I'd go again. The Alps are awesome, the riding is unbeatable and I gained 5# despite riding...pastries and wine.

 

[yaah]

In Fargo, i especially liked the sequence where Frances Mc Dormand has a conversation with a couple of Minnesota girls and the whole sequence runs on the word 'yaah"...i mean a whole range of emotions using that single word!!!!....A slight inflection of tone here and the whole meaning changes.....it was just beautiful....but the sad part about the movie was it being an actual true story......mankind is really something!!...no wonder people like Einstein and Mark Twain had given up any hope for the human race as a whole towards the end of their lives....and they stated that in no unclear terms too!!!

Actually, the odd thing is that this wasn't really a true story. The filmmakers put that in in the beginning but it was stretching the truth a bit. I think they cobbled it together from some rumors and old stories. But it wasn't a true story. Alas, you can't believe things you see on screen, even when they are purported to be accurate.

That scene was funny though - He was kinda funny lookin...

 

[quant]

It is not a true story?.......that is really surprising....

 

[bente]

Quote:
and when there was no meat, we ate fowl and when there was no fowl, we ate crawdad and when there was no crawdad to be found, we ate sand.
You ate what?
We ate sand.
You ate SAND?

Most people have had some older relative who has walked 3 miles to school in driving snow, uphill both ways.
This grows on you:Four Men of Yorkshire