Christmas Patients

[The Knife & Gun Club]

Good morning, Mrs Smith? It’s Dr Knife calling from the ER at Community General. Is “John smith” your son? Yea? I’m sorry to tell you this, but John overdosed on heroine this morning. We put a breathing tube in to help him breath, but he threw up into his lungs and has a really bad infection. His brain was without oxygen for a long time, we don’t know how much damage was done.

I promise we’ll take good care of him.

This was officially my first year actually working Christmas Day.

Man, it was a special kind of grim. On the plus side leadership bought us some fantastic catered Chinese food.

Anyone else have any good Christmas/holiday stories? Both epic saves and depressing venting are welcome.

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[namethatsmell]

Thanks for working x-mas. This was the first year in awhile I haven't worked it. And I'm OK with it as I always feel like the grim reaper's messenger when I work the holidays....last x-mas I got to diagnose 2 extremely nice pts under the age of 50 with cancer and tell a 3rd pt in his early 60s that his cancer, thought to be in remission, was back and had metastasized everywhere. And I still vividly recall x-mas the year before where I had to tell a 30-something yo pt they had cancer...and being pulled out of the room in the middle of breaking that news to go code a pt who died in front of their entire extended family at x-mas dinner.

 

[Cinclus]

Worked Christmas night one year and found stage 4 colon cancer in a guy about my age (too young). Was losing weight, having progressive symptoms of mets impinging on his spinal cord, and came to see me with horrible back pain and acutely worse SC compression symptoms after the primary NP failed to realize the symptoms weren't due to "prostatitis" over the last several months (not that this would have led to much difference in ultimate outcome). Merry Christmas, guy. Just terrible. Will never forget this one.

 

[skougess]

Christmas is always bad because the truly sick still come in and you can’t push away how horrific it is like a “normal” day. You don’t forget your bad Christmas Day cases.

 

[deleted92121]

If you are going to gift your wife a nicely manscaped scrotum for Christmas, please, oh please, do not use a straight razor.

 

[EMhawkeye]

Fetal demise at 20 weeks. Falalalala

 

[lp430]

25 year old drunk dude brought in by police only wearing his underwear and cowboy boots after being tased at 4am. He wasn't the happiest about it being Christmas lol.

 

[The Knife & Gun Club]

Fetal demise at 20 weeks. Falalalala

Wife had an IUFD at 37 weeks on labor and delivery. Had to push with the lady to deliver her dead baby on Xmas. Broke her pelvis in the process.

 

[Rekt]

Was this a teen? I never call family for this.

 

[Apollyon]

Wife had an IUFD at 37 weeks on labor and delivery. Had to push with the lady to deliver her dead baby on Xmas. Broke her pelvis in the process.

***damn, I'm crying right now.

 

[Dr Mantis Toboggan]

If you are going to gift your wife a nicely manscaped scrotum for Christmas, please, oh please, do not use a straight razor.

There’s nothing quite like a shorn scrotum. It’s breathtaking, really. I suggest you try it.

 

[BAM!]

Wife had an IUFD at 37 weeks on labor and delivery. Had to push with the lady to deliver her dead baby on Xmas. Broke her pelvis in the process.

broke her pelvis? is that a thing?

 

[The Knife & Gun Club]

broke her pelvis? is that a thing?

Yea actually not unheard of in OB patients, especially if it’s a small lady and a big baby. In this case she had DM1, so the baby was huge >10lbs.

Went into DKA on the labor floor.

On a lighter note, watching a cadre of gynecologists attempt to manage DKA was very entertaining. The frantic 3am phone call went something like “hey this lady is in like um in like DKA or something. Is that bad? Should we call someone? Her pH is like, like REALLY low”

 

[VA Hopeful Dr]

Yea actually not at all uncommon in OB patients, especially if it’s a small lady and a big baby. In this case she had DM1, so the baby was huge >10lbs.

Went into DKA on the labor floor.

On a lighter note, watching a cadre of gynecologists attempt to manage DKA was very entertaining. The frantic 3am phone call went something like “hey this lady is in like um in like DKA or something. Is that bad? Should we call someone? Her pH is like, like REALLY low”

Source on that?

 

[The Knife & Gun Club]

Source on that?

Incidence and Risk Factors of Symptomatic Peripartum Diastasis of Pubic Symphysis

Yoo JJ, et al. J Korean Med Sci. 2014 Feb;29(2):281-286. https://doi.org/10.3346/jkms.2014.29.2.281

jkms.org

Looks like around 1/400, but not a ton of literature on the topic.

You’re right a better phrasing would be “not unheard of” rather than not uncommon. A big place doing few thousand annual births a would see a handful every year. Also a seems to be more “pelvic ring injury” where you separate your diaphysis or SI joints rather than true fracture.

Edited my original post.

 

[VA Hopeful Dr]

Incidence and Risk Factors of Symptomatic Peripartum Diastasis of Pubic Symphysis

Yoo JJ, et al. J Korean Med Sci. 2014 Feb;29(2):281-286. https://doi.org/10.3346/jkms.2014.29.2.281

jkms.org

Looks like around 1/400, but not a ton of literature on the topic.

You’re right a better phrasing would be “not unheard of” rather than not uncommon. A big place doing few thousand annual births a would see a handful every year. Also a seems to be more “pelvic ring injury” where you separate your diaphysis or SI joints rather than true fracture.

Edited my original post.

OK yeah I was thinking like "broken bone" type stuff. That is a known complication (and we c/s is done on big babies).

 

[The Knife & Gun Club]

OK yeah I was thinking like "broken bone" type stuff. That is a known complication (and we c/s is done on big babies).

Yea the colloquial “she broke her pelvis” doesn’t necessarily equate to actual broken bones.

 

[Angry Birds]

I worked this Christmas... all I saw were drunks and overdoses, along with the nursing home covid patients. Fun stuff.

 

[CajunMedic]

Been off service this month on an ICU rotation, mainly with COVID patients. Yesterday was my last day, thank GOD! Lost track of how many death certificates I filled out.

December of my OMS-3 year was also ICU. I'll never forget watching the monitor go from sinus, to brady, to sine wave, to asystole while hearing the family cry and "Rockin' Around the Christmas Tree" was playing, it was surreal.

But, on the bright side: Managed to get a couple extubated and on the way to discharge, got what I wanted for Christmas, had a good mid-year eval.

 

[Jabbed]

Yea the colloquial “she broke her pelvis” doesn’t necessarily equate to actual broken bones.

Unrelated, but I had a transfer pelvic diastasis injury that was read by the outside radiologist as a "sprung pelvis".

I have never heard that terminology before, but apparently it is accepted.

 

[WilcoWorld]

25 year old drunk dude brought in by police only wearing his underwear and cowboy boots after being tased at 4am. He wasn't the happiest about it being Christmas lol.

No Santa hat?

 

[WilcoWorld]

Been off service this month on an ICU rotation, mainly with COVID patients. Yesterday was my last day, thank GOD! Lost track of how many death certificates I filled out.

December of my OMS-3 year was also ICU. I'll never forget watching the monitor go from sinus, to brady, to sine wave, to asystole while hearing the family cry and "Rockin' Around the Christmas Tree" was playing, it was surreal.

But, on the bright side: Managed to get a couple extubated and on the way to discharge, got what I wanted for Christmas, had a good mid-year eval.

I really don't like playing XMas carols in the hospital. I mean, if someone requests music therapy that's cool, but keep that **** off the PA please.

 

[WilcoWorld]

Unrelated, but I had a transfer pelvic diastasis injury that was read by the outside radiologist as a "sprung pelvis".

I have never heard that terminology before, but apparently it is accepted.

In my understanding getting "sprung" precedes the pregnancy.

 

[The Knife & Gun Club]

In my understanding getting "sprung" precedes the pregnancy.

I was imagining the baby getting “sprung” from the pelvis like an inmate getting “sprung” from jail.

 

[RustedFox]

I really don't like playing XMas carols in the hospital. I mean, if someone requests music therapy that's cool, but keep that **** off the PA please.

 

[wareagle726]

I was imagining the baby getting “sprung” from the pelvis like an inmate getting “sprung” from jail.

Sir Mixalot narrowed the definition of sprung to mean only one thing

 

[RustedFox]

Sir Mixalot narrowed the definition of sprung to mean only one thing

Citation, please

 

[wareagle726]

Citation, please

Mixalot, Sir et all. "Baby Got Back." Album Mack Daddy. 1992. Track 3. Lines 13-15.

 

[RustedFox]

Mixalot, Sir et all. "Baby Got Back." Album Mack Daddy. 1992. Track 3. Lines 13-15.

EXACTLY the joke I was fishing for.

Strong, strong work.