Exaggerating

[deleted958798]

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My biggest pet peeve is when people in the ER will tell you a story and then say something just absurd like, “My doctor told me to turn off my tv, put my shoes on, drive 90 miles an hour and come straight to the ER without any hesitation or they were gonna drive here and pick me up themselves”. Like no sir, they literally called you and said “Go to the ER”. Or when people try to name drop other doctor’s names when they are in the ER and pause waiting for your over zealous response of “ah yes, I dine and vacation with them quite frequently”. In reality, I have no idea who that even is sir.

 

[RustedFox]

Patients only know one adjective when it comes to describing the degree of pain:

"EXCRUCIATING"

They use that word cooly and calmly, with no indication of even modest discomfort.

That's my biggest pet peeve.

Knock it off, people. If you're not on the brink of tears or already there, it's not *excruciating*.

 

[IllJustScanEm]

Have to go with the “I haven’t eaten or been able to drink anything in days.”

…Accompanied by completely normal labs and a benign exam.

 

[Apollyon]

Have to go with the “I haven’t eaten or been able to drink anything in days.”

…Accompanied by completely normal labs and a benign exam.

And a bag of Cheetos, or the telling "perioral Cheetosis"!

 

[DoctorJDO]

I can't keep ANYTHING down...So ho many times have you vomited?...None, it just feel like I'm going to vomit

 

[thegenius]

My biggest pet peeve is when people in the ER will tell you a story and then say something just absurd like, “My doctor told me to turn off my tv, put my shoes on, drive 90 miles an hour and come straight to the ER without any hesitation or they were gonna drive here and pick me up themselves”. Like no sir, they literally called you and said “Go to the ER”. Or when people try to name drop other doctor’s names when they are in the ER and pause waiting for your over zealous response of “ah yes, I dine and vacation with them quite frequently”. In reality, I have no idea who that even is sir.

LOL

One of these days I'm going to genuflect to the patient when they tell me "Dr. Top Notch Vascular Surgeon" sent me to the ER for my runny nose.

 

[watermanMD]

I was having this discussion with a coresident the other day. I’m pretty sure when they wrote our medical texts, people were more reasonable/reliable. “Pain out of proportion to exam” actually meant something and 10/10 pain was probably legit. If I went around to 100 people in the ER today and pressed on their abdomen, I’d bet >50% would say “ow” or report moderate pain 😂 . Kinda like that c-spine tenderness study <Prevalence of midline cervical spine tenderness in the non-trauma population - PubMed>

 

[thegenius]

Have to go with the “I haven’t eaten or been able to drink anything in days.”

…Accompanied by completely normal labs and a benign exam.

So I've recently said this:

Humans eat 3 times / day, and about 1000 times a year. The human body is not so poorly designed that we will suffer if we don't eat for 2 days. We are not designed to eat 3 times a day. Once a day or even less is just fine.

(they usually don't agree with me)

 

[alpinism]

I was having this discussion with a coresident the other day. I’m pretty sure when they wrote our medical texts, people were more reasonable. “Pain out of proportion to exam” actually meant something and 10/10 pain was probably legit. If I went around to 100 people in the ER today and pressed on their abdomen, I’d bet >50% would say “ow” 😂. Kinda like that c-spine tenderness study <Prevalence of midline cervical spine tenderness in the non-trauma population - PubMed>

Haha what a great study. Not even surprised by the results. I will say though I often see docs aggressively palpating the spine then asking the patient wether they're having any pain at the site. Not surprisingly patients say yes even without having any injuries. Technically speaking tenderness is an objective physical exam finding whereby lightly palpating the spine results in the patient having an outward pain response.

 

[thegenius]

I love that study.
I'm sending it to the ATLS folks, EMTALA folks, and every ER residency

 

[Apollyon]

I was having this discussion with a coresident the other day. I’m pretty sure when they wrote our medical texts, people were more reasonable/reliable. “Pain out of proportion to exam” actually meant something and 10/10 pain was probably legit. If I went around to 100 people in the ER today and pressed on their abdomen, I’d bet >50% would say “ow” or report moderate pain 😂 . Kinda like that c-spine tenderness study <Prevalence of midline cervical spine tenderness in the non-trauma population - PubMed>

For any pt in my career with a traumatic amputation, all of them - ALL of them - rated their pain as a 6 or 7. EVERY SINGLE ONE.

 

[bravotwozero]

So I've recently said this:

Humans eat 3 times / day, and about 1000 times a year. The human body is not so poorly designed that we will suffer if we don't eat for 2 days. We are not designed to eat 3 times a day. Once a day or even less is just fine.

(they usually don't agree with me)

So much this!

People won’t agree with because unfortunately that’s all they know (breakfast is the most important meal of the day!!! Not) and not realize that for millennia, 1-2 meals a day is all that humans got, and did quite well with it.

 

[thegenius]

So much this!

People won’t agree with because unfortunately that’s all they know (breakfast is the most important meal of the day!!! Not) and not realize that for millennia, 1-2 meals a day is all that humans got, and did quite well with it.

Not even 2/daily. The need to eat regularly is really a figment of the last 100 years and food companies jamming food down our throats.

For 10'000s years humanoids would walk around and eat berries and roots
occasionally eat some carrion
and once in a while go on a hunt to kill a mastadon or a deer or something.

I've started intermittently fasting and I'll go 2-3 days eating not a single fleck of food. I drink plenty of water, tea, coffee, etc though.
FEELS GREAT.

So now I laugh when the fat 240 lb F comes in vomiting for 1 day "I can't keep anything down". and I just smile and say under my breath - that is a good thing. STOP EATING POPEYES.

 

[dchristismi]

I bring up the "desert island scenario" every single day when talking about dying loved ones. Because their dying loved one doesn't have any caloric expenditure. We feed people we love, so it's really all about that. Also, Bobby Sands' highly publicized hunger strike (IRA, 1981) lasted 66 days before he died. So... yeah. Hell, Nalveny lasted 24 days, and we all know that Putin <probably> wasn't sticking to the Geneva Convention...

You can go more than a few hours. You can go days. In fact, you can go months. So your loved one is not going to die of starvation.
Also, see intermittent fasting post above. I also invoke the euphoria of ketosis as a powerful reason their loved one isn't suffering from that particular affliction. But... 'Murica...

FWIW, I only eat twice a day. Unlearning what is ingrained is hard! Ok, sorry, back to rant. FWIW, I love the c-spine study too!

 

[BoardingDoc]

Have to go with the “I haven’t eaten or been able to drink anything in days.”

…Accompanied by completely normal labs and a benign exam.

I had a 24 yr old guy come in a few months ago with vomiting. His GF made him come in. He explained that he "hadn't drank ANY water in 3 days" because of the vomiting.

I roll my eyes and order the usual.

Had a Cr of 6. I was so strangely proud of him. Not for the marijuana induced hyperemesis that he had (idiot), but because he was the only person I can recall in recent memory who was actually being honest.

 

[VA Hopeful Dr]

I bring up the "desert island scenario" every single day when talking about dying loved ones. Because their dying loved one doesn't have any caloric expenditure. We feed people we love, so it's really all about that. Also, Bobby Sands' highly publicized hunger strike (IRA, 1981) lasted 66 days before he died. So... yeah. Hell, Nalveny lasted 24 days, and we all know that Putin <probably> wasn't sticking to the Geneva Convention...

You can go more than a few hours. You can go days. In fact, you can go months. So your loved one is not going to die of starvation.
Also, see intermittent fasting post above. I also invoke the euphoria of ketosis as a powerful reason their loved one isn't suffering from that particular affliction. But... 'Murica...

FWIW, I only eat twice a day. Unlearning what is ingrained is hard! Ok, sorry, back to rant. FWIW, I love the c-spine study too!

Angus Barbieri's fast - Wikipedia

en.wikipedia.org

 

[Fox800]

"My doctor said it was the worst case of ___________ they've ever seen!"

Inevitably it's a patient with chronic pain issues.

 

[RustedFox]

All reasons why "it's okay to hate the muggles".

God Forbid.

Ukrainian grandmas are laying claymore mines and shouldering automatic rifles while American Boomers need their Percocets (sic), valium, soma, and Ativan for their Fibromyalgia.

 

[Rekt]

It all comes down to the patients having completely backwards thinking. They want something to be wrong with them (You have something wrong alright, bad news it's supratentorial). They're all extremely disappointed when I find nothing wrong with them (and I now start most encounters saying I'm probably not going to find anything). We need a cultural change that will never happen.

 

[Dr Mantis Toboggan]

It all comes down to the patients having completely backwards thinking. They want something to be wrong with them (You have something wrong alright, bad news it's supratentorial). They're all extremely disappointed when I find nothing wrong with them (and I now start most encounters saying I'm probably not going to find anything). We need a cultural change that will never happen.

Everyone is the hero in their own story. So many people I see lead such lives of quiet desperation there is a real desire for the juice and attention which would come from a good medical story, operation etc.

“I went to the ER and they scanned me but couldn’t find anything wrong” just doesn’t provide that.

 

[Angry Birds]

My first day as an intern in the ER: I spoke to a patient who convinced me that their surgeon was "expecting" her in the ER and wanted a call right away to let him know that she was there.
I, the dummy, immediately called the surgeon... You could hear the surgeon yelling at me from across the room through the phone...

haha

 

[thegenius]

All reasons why "it's okay to hate the muggles".

God Forbid.

Ukrainian grandmas are laying claymore mines and shouldering automatic rifles while American Boomers need their Percocets (sic), valium, soma, and Ativan for their Fibromyalgia.

oh man. There was a sad tale of a Ukraninan man who got shot in the leg by a Russian bullet, and broke his leg. he was holed up in some basement somewhere as Russia was bombing the city. He was there with his family and they didn't have much. It was cold. Little food. Little water. Someone made a makeshift splint for him. He was finally rescued.

Spoiler: What was the first thing the guy and family asked for?

Blankets. God bless him and I hope he got medical attention too.

 

[RuralEDDoc]

It all comes down to the patients having completely backwards thinking. They want something to be wrong with them (You have something wrong alright, bad news it's supratentorial). They're all extremely disappointed when I find nothing wrong with them (and I now start most encounters saying I'm probably not going to find anything). We need a cultural change that will never happen.

That’s true for some. Many reasonable people also exaggerate symptoms as they fear they won’t be taken seriously for 4/10 pain, or intermittent vomiting, or whatever. People want testing and reassurance more than something to be wrong with them. Although some do really want to be sick so they can play that role for all its worth.

 

[DrSnips]

My biggest pet peeve is when people in the ER will tell you a story and then say something just absurd like, “My doctor told me to turn off my tv, put my shoes on, drive 90 miles an hour and come straight to the ER without any hesitation or they were gonna drive here and pick me up themselves”. Like no sir, they literally called you and said “Go to the ER”. Or when people try to name drop other doctor’s names when they are in the ER and pause waiting for your over zealous response of “ah yes, I dine and vacation with them quite frequently”. In reality, I have no idea who that even is sir.

Reminds me of a patient who told me he wouldn't accept treatment from me until his PCP "vouched for my credentials". I told him I sincerely doubted his PCP had ever heard of me because I certainly hadn't heard of him. It's almost like there's over a million doctors in this country who don't all know each other.

 

[VA Hopeful Dr]

Reminds me of a patient who told me he wouldn't accept treatment from me until his PCP "vouched for my credentials". I told him I sincerely doubted his PCP had ever heard of me because I certainly hadn't heard of him. It's almost like there's over a million doctors in this country who don't all know each other.

As a PCP I love when this happens.

It's rare from hospitalists but I have patients pretty regularly see a specialist, that specialist recommends some form of treatment, patient comes to see me to make sure I'm okay with that treatment.

 

[dadaddadaBATMAN]

Reminds me of a patient who told me he wouldn't accept treatment from me until his PCP "vouched for my credentials". I told him I sincerely doubted his PCP had ever heard of me because I certainly hadn't heard of him. It's almost like there's over a million doctors in this country who don't all know each other.

Variation of this is demanding I call their primary doctor at 2am on a Saturday to get their opinion.

While I am confident your primary doctor would agree with me that you have another episode of hot-Cheeto induced heart failure, I would not wake them up right now even in the doubtful event that I could reach them.

 

[Splenda88]

Our healthcare system is screwed. I have never seen so much waste in anything like that.

U.S. health expenditure as GDP share 1960-2023| Statista

Total healthcare spending as a share of GDP has nearly quadrupled in the U.S. between 1960 and 2022

www.statista.com

This is 1/5 of our economy. Where all that $$$ goes?

 

[thegenius]

 

[Siggy]

The human body is not so poorly designed that we will suffer if we don't eat for 2 days.

All of the evidence regarding early nutrition and critically ill patients states otherwise. Early feeding almost always does better than late feeding. I'll grant that the metabolic demands on a critically ill patient is different than the average patient.

 

[RustedFox]

All of the evidence regarding early nutrition and critically ill patients states otherwise. Early feeding almost always does better than late feeding. I'll grant that the metabolic demands on a critically ill patient is different than the average patient.

Yeah, we're not talking about ICU level patients here, amigo.

We're talking about this:

 

[3rdJob]

Folks,

You know that the data are truly terrifying when your knee-jerk response, is 'hey, that plot might need to be on a log scale...' :O

 

[RustedFox]

Folks,

You know that the data are truly terrifying when your knee-jerk response, is 'hey, that plot might need to be on a log scale...' :O

I've posted this chart on SDN so many times.

I have no respect for the "business types".

 

[emergentmd]

American's are the most spoiled, demanding population that is fed by the Mcdonald's mentality. It won't get better when our politicians all whine about how everyone deserves free education, free housing, UBI, work 40 hrs a week, 6 month family leave, blah blah blah.

 

[WilcoWorld]

American's are the most spoiled, demanding population that is fed by the Mcdonald's mentality. It won't get better when our politicians all whine about how everyone deserves free education, free housing, UBI, work 40 hrs a week, 6 month family leave, blah blah blah.

Yeah, if the US became more like Scandinavia the health outcomes could be truly alarming.

 

[emergentmd]

Not going to debate how other systems are better. I am just saying Americans are the most demanding nation b/c we have been spoiled by the "I want it now mentality" perpetuated by our politicians which lends to pts becoming more difficult

 

[WilcoWorld]

Not going to debate how other systems are better. I am just saying Americans are the most demanding nation b/c we have been spoiled by the "I want it now mentality" perpetuated by our politicians which lends to pts becoming more difficult

No argument that we, as a society, are worse off because of our insatiable desire for immediate gratification.

 

[CoolDoc1729]

Have to go with the “I haven’t eaten or been able to drink anything in days.”

…Accompanied by completely normal labs and a benign exam.

Or the exsanguinating vag bleeder for 2 weeks with hgb 14 … better than mine! 🤦🏻‍♀️