Fun patients

[BoardingDoc]

In a departure from the typical "EM sucks" (it kinda does) and "here's how to make money to escape from EM" threads, I thought some levity was in order.

Feel free to chime in with any other entertaining stories.

Tonight:
75M sent in from the local s***hole nursing facility. His wife is a resident there too. Some other resident propositions the patient's wife for sex. Patient doesn't much care for this and a scuffle ensues. Patient says he's going to kick the horndog in the balls. Nursing facility says this means he's homicidal and sends him to the ER on a psych hold. This isn't the patient's version of events. This is literally the report EMS got from the NH, which the patient is corroborating.
Zero workup. Psych hold paperwork goes in the shredder. Discharge paperwork says something to the effect of "being angry that someone propositioned your wife for sex does not constitute a mental illness, nor does it meet criteria for involuntary psychiatric hospitalization. These instructions are for both your own benefit and the benefit of your nursing home staff."

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[alphaholic06]

Awesome!

 

[CoolDoc1729]

A patient asked me why she wasn’t peeing blood following her abortion.

How can I be the first person who has told her girls have two holes there? It was odd to have to explain this to a neurotypical adult.

 

[WilcoWorld]

In a departure from the typical "EM sucks" (it kinda does) and "here's how to make money to escape from EM" threads, I thought some levity was in order.

Feel free to chime in with any other entertaining stories.

Tonight:
75M sent in from the local s***hole nursing facility. His wife is a resident there too. Some other resident propositions the patient's wife for sex. Patient doesn't much care for this and a scuffle ensues. Patient says he's going to kick the horndog in the balls. Nursing facility says this means he's homicidal and sends him to the ER on a psych hold. This isn't the patient's version of events. This is literally the report EMS got from the NH, which the patient is corroborating.
Zero workup. Psych hold paperwork goes in the shredder. Discharge paperwork says something to the effect of "being angry that someone propositioned your wife for sex does not constitute a mental illness, nor does it meet criteria for involuntary psychiatric hospitalization. These instructions are for both your own benefit and the benefit of your nursing home staff."

20's year old with profound intellectual disability, but a good quality of life and a generally very pleasant demeanor brought in by mom for acute onset of agitation. He's a big kid and the staff is readying for a chemical takedown which will be followed by a 3+ day stay in the ED to await admission to our state's currently non-existent psych beds for treatment of aggressive behavior. I say that we should instead treat him like a baby with inconsolability and look for sources of pain. Give him a little haldol to help him cooperate with physical exam, and he chills out. Sure enough, he's obstipated. An enema is successful, VERY successful, and soon enough he's discharged to home with mom - both of them back to their happy lives together.

 

[RustedFox]

Fun patient last shift:

38 year old female. She's pretty. Also has the crazy eyes. No heterosexual man would fail to recognize this mark.
She's demanding to be tested for "chlorine poisoning", as she "read all about online" and is sure that her ex-boyfriend is poisoning her with chlorine, as evidenced by her "excessive sleepiness", which she shows absolutely no indication of.

In my mind: the old-timey, black-and-white WWI newsreels play.
Doughboys in those flat-and-broad helmets, wearing gas-masks that connect to hip canisters via those long tubes.

 

[GonnaBeADoc2222]

Past couple shifts I've done some lac repairs which typically the midlevels do.

I enjoy chatting up the patients while I sew.

I also enjoy getting in the zone and getting to avoid the nurses for awhile.

 

[thegenius]

Fun patient last shift:

38 year old female. She's pretty. Also has the crazy eyes. No heterosexual man would fail to recognize this mark.
She's demanding to be tested for "chlorine poisoning", as she "read all about online" and is sure that her ex-boyfriend is poisoning her with chlorine, as evidenced by her "excessive sleepiness", which she shows absolutely no indication of.

In my mind: the old-timey, black-and-white WWI newsreels play.
Doughboys in those flat-and-broad helmets, wearing gas-masks that connect to hip canisters via those long tubes.

So what did the chlorine level come back as?
Was it elevated? You are leaving us all in the dust with all these metaphors and we just want to know if she was chlorine toxic!

 

[The Knife & Gun Club]

My side job is working shifts as the on-call doctor at the local jail. Got called up to death row to see a patient in full shackles to be evaluated for shoulder pain after doing too many burpees in the yard. Went through 4 locked doors all with special keys while escorted by 2 armed guards. His shoulder was fine but he was probably the most pleasant patient I had all month - clear, direct answers to questions, wrote down my institutions for ice and conservative management on a little yellow note pad, said please and thank you, and made small talk about Hurricanes football this season.

Not necessarily a wild case, more just interesting that we as EM Docs get to see so many sides of society that are really hidden from public view.

He killed 3 people, chopped up their bodies, and hid them in the Everglades if you’re wondering.

 

[Apollyon]

My side job is working shifts as the on-call doctor at the local jail. Got called up to death row to see a patient in full shackles to be evaluated for shoulder pain after doing too many burpees in the yard. Went through 4 locked doors all with special keys while escorted by 2 armed guards. His shoulder was fine but he was probably the most pleasant patient I had all month - clear, direct answers to questions, wrote down my institutions for ice and conservative management on a little yellow note pad, said please and thank you, and made small talk about Hurricanes football this season.

Not necessarily a wild case, more just interesting that we as EM Docs get to see so many sides of society that are really hidden from public view.

He killed 3 people, chopped up their bodies, and hid them in the Everglades if you’re wondering.

Local jail? Usually, those are for people awaiting trial, and folks with misdemeanor convictions, with one year or less to serve.

 

[BoardingDoc]

Local jail? Usually, those are for people awaiting trial, and folks with misdemeanor convictions, with one year or less to serve.

I'm assuming he misspoke and meant local prison.

 

[RustedFox]

I had a patient like this. Nursing home sent over a guy and gal for aggressive behavior. Turns out the guy was a demented horndog who tried to flirt with the lady, she didn't like it, and she swore at him. Nursing home shipped them both over for psych evals. Immediately discharged both.

On a different note, I had a 30 year old come in middle of the night because her husband "wouldn't listen to her." It was a slow night, so I bit the bullet and listened to her bitch about her life for 20 minutes, ran some basic labs (her chief complaint was severe anxiety) and told her she'll be okay. The nurse told me later she was yelling at her husband on the phone who was apparently waiting for her in the parking lot of the ER, telling him that I did a better job of listening to her than he ever has. Turns out he was some big real estate developer in the region. Felt bad for the guy. She was decent looking; I'm guessing he was not lol.

I'll bet he was decent looking, at least at one time. Then, he had to tolerate her Axis-II disorder for too long. That kind of stuff ages a man fast.

 

[always.chillin]

I'll bet he was decent looking, at least at one time. Then, he had to tolerate her Axis-II disorder for too long. That kind of stuff ages a man fast.

Definitely seemed to happen to Johnny Depp haha.

 

[BoardingDoc]

Definitely seemed to happen to Johnny Depp haha.

Oh man, the tape recordings from that trial. She seems like pure, unadulterated crazy. And that's while literally being forced to use Johnny Depp as your measuring stick based on context.

 

[valianteffort]

Had a patient tonight at 4am come in for back pain. 34M, overweight. Seemed muscular in nature and offered him my norflex toradol combo which he gladly accepted. He came alone initially but on my reassessment he had his significant other in the room. As I discussed my reassessment and plan with him, he laid fully horizontal on the bed with a burger above his face eating it. A pickle fell onto his face at one point, fortunately close enough to his tongue he was able to macgyver it into his mouth without having to let go of his burger. Meanwhile his girlfriend continued to crinkle burger wrappers and slurp her drink while I spoke. All at 4am. Oh and when asked how his pain was? Unchanged. What a glorious job we have.

 

[Boatswain2PA]

Had a patient tonight at 4am come in for back pain. 34M, overweight. Seemed muscular in nature and offered him my norflex toradol combo which he gladly accepted. He came alone initially but on my reassessment he had his significant other in the room. As I discussed my reassessment and plan with him, he laid fully horizontal on the bed with a burger above his face eating it. A pickle fell onto his face at one point, fortunately close enough to his tongue he was able to macgyver it into his mouth without having to let go of his burger. Meanwhile his girlfriend continued to crinkle burger wrappers and slurp her drink while I spoke. All at 4am. Oh and when asked how his pain was? Unchanged. What a glorious job we have.

was he 5'3 and 300 pounds?

 

[RustedFox]

was he 5'3 and 300 pounds?

5'3'' by 5'3'' by 5'3''
He was a cube.

 

[Boatswain2PA]

5'3'' by 5'3'' by 5'3''
He was a cube.

Surprised he wasn't eating a "bag of fudge rounds"

 

[BJJVP]

I once had an elderly man brought in from a nursing home with difficulty speaking & unilateral weakness. After the medics dropped him off, he looked around the room, started moving everything, and told me in clear speech that this is the only way he could escape the facility.

 

[Goro]

Fun patient last shift:

38 year old female. She's pretty. Also has the crazy eyes. No heterosexual man would fail to recognize this mark.
She's demanding to be tested for "chlorine poisoning", as she "read all about online" and is sure that her ex-boyfriend is poisoning her with chlorine, as evidenced by her "excessive sleepiness", which she shows absolutely no indication of.

In my mind: the old-timey, black-and-white WWI newsreels play.
Doughboys in those flat-and-broad helmets, wearing gas-masks that connect to hip canisters via those long tubes.

Let me guess, she was negative for chlorine poisoning, but was positive for mustard gas, trench foot, and shell shock?

 

[DocEspana]

had a patient yesterday with a humeral neck fracture and an olecranon fracture whose mechanism of injury was he got attacked by ducks when he tried to feed them and while getting pecked at and fleeing the ducks, he tried not to step on the baby ducklings and fell onto the ground.

My nurse didn't read the note or really talk to the guy at all, so when she went to sign the patient out to the upstairs team for admission, she began laughing so hard she started crying while realizing his mechanism of injury. I *fully* enjoy when I can honestly document exactly what they told me and it is not mocking them at all - but is still a joy to read because the story is inherently funny.

 

[rokshana]

had a patient yesterday with a humeral neck fracture and an olecranon fracture whose mechanism of injury was he got attacked by ducks when he tried to feed them and while getting pecked at and fleeing the ducks, he tried not to step on the baby ducklings and fell onto the ground.

My nurse didn't read the note or really talk to the guy at all, so when she went to sign the patient out to the upstairs team for admission, she began laughing so hard she started crying while realizing his mechanism of injury. I *fully* enjoy when I can honestly document exactly what they told me and it is not mocking them at all - but is still a joy to read because the story is inherently funny.

awww...poor guy!

 

[Saddleshoes]

had a patient yesterday with a humeral neck fracture and an olecranon fracture whose mechanism of injury was he got attacked by ducks when he tried to feed them and while getting pecked at and fleeing the ducks, he tried not to step on the baby ducklings and fell onto the ground.

My nurse didn't read the note or really talk to the guy at all, so when she went to sign the patient out to the upstairs team for admission, she began laughing so hard she started crying while realizing his mechanism of injury. I *fully* enjoy when I can honestly document exactly what they told me and it is not mocking them at all - but is still a joy to read because the story is inherently funny.

In the words of that great Loony Tunes hero, Elmer Fudd...
..."Don't F**k with Ducks!"

 

[Janders]

had a patient yesterday with a humeral neck fracture and an olecranon fracture whose mechanism of injury was he got attacked by ducks when he tried to feed them and while getting pecked at and fleeing the ducks, he tried not to step on the baby ducklings and fell onto the ground.

My nurse didn't read the note or really talk to the guy at all, so when she went to sign the patient out to the upstairs team for admission, she began laughing so hard she started crying while realizing his mechanism of injury. I *fully* enjoy when I can honestly document exactly what they told me and it is not mocking them at all - but is still a joy to read because the story is inherently funny.

Back in residency I had an older lady who was a serious trauma after being attacked by Turkeys in a rather Urban area… tripped backwards off the curb if I remember? Facial frx, head bleed, limb fractures… them Turkeys…

 

[rokshana]

Back in residency I had an older lady who was a serious trauma after being attacked by Turkeys in a rather Urban area… tripped backwards off the curb if I remember? Facial frx, head bleed, limb fractures… them Turkeys…

Turkeys are mean AF…

 

[RustedFox]

Turkeys are mean AF…

Son of Pennsyltucky here. Can confirm.

 

[Apollyon]

So, when I was in college, I was at military school, and bordering on us was a much more liberal school. Well, I volunteered in the ED, and, one day, there was this dude from the other school volunteering, also. Good dude, even with his long hair. A pt came in after a fall. This pt was a professor at the liberal school, an Asian fellow with a name such as Dr Lin or Dr Su. Why did he fall, in Virginia? He stepped on a snake! You couldn't help but laugh listening to him tell this story.

 

[valianteffort]

Was sitting at my desk tonight and overheard the interaction between one of our nurses and a patient. The patient was a 50s Korean female awaiting EMS transfer for a colorectal reason. Southern nurse, with accent and all, went into the room, to inform the patient and family about transfer info. The husband of the patient stated ‘we don’t want shi*ty ambulance transfer’ . She replied multiple times, increasing in frustration, asking what they would like instead. The husband continually responded ‘no shi*ty ambulance.’

About 7-8 mins of interaction later the nurse realized they did not want ‘The City Ambulance Service’, a private group they had a bad experience with previously and any other company will do.


Like straight out of South Park. But made my night.

 

[DocEspana]

Was sitting at my desk tonight and overheard the interaction between one of our nurses and a patient. The patient was a 50s Korean female awaiting EMS transfer for a colorectal reason. Southern nurse, with accent and all, went into the room, to inform the patient and family about transfer info. The husband of the patient stated ‘we don’t want shi*ty ambulance transfer’ . She replied multiple times, increasing in frustration, asking what they would like instead. The husband continually responded ‘no shi*ty ambulance.’

About 7-8 mins of interaction later the nurse realized they did not want ‘The City Ambulance Service’, a private group they had a bad experience with previously and any other company will do.


Like straight out of South Park. But made my night.

Damn Mongolians