Things I Learn From My Patients

[FoughtFyr]

Anyway, that's what I learned about emergency rooms: If possible, bring pizza.

Actually take-out Chinese works well too...



That is a GREAT story!

- H

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[Rahlala]

18 year old kids absolutely need new Audis-- especially the kind with the DVD player built into the dashboard so that they can watch "the fast and the furious" while driving along a windy road at say, 3am. the best thing to say (if you are an 18 year old driver of such a car) is "hey, watch my car handle this turn" as you careen into a tree. (unrestrained driver had not one but TWO spiral femur fractures in the same leg. his foot was pointed backwards). tree survived with minor scratches.

So true...I wonder if Mommy and Daddy bought him/her another vehicle?? And if the ***** learned anything from the experience...

 

[EctopicFetus]

Sad story.. A friend of mine since Kindergarten was unrestrained riding in the middle seat of a 3000GT, dude crashed, my friend was paralyzed.. Mommy and daddy got him a new car.. No remorse from this a-hole.. I guess being lower middle class had its advantages.

 

[corpsmanUP]

I don't give a flip what kind of money I make or how much natural gas I am growing on my farm, my kids will be driving some seriously embarassing vehicle that doesn't go over 60 mph. My first car was a 79' Mercury Capri, and it was Sunkist orange. It had no heat, no air, and was missing the passenger window because I had to break in to it one day when I locked my keys in it. It froze one day in Houston....literally like 10 degrees.......and the flywheel cracked. That was the end of "the pumpkin".

I think those type of experiences are character building and make kids glad to get a real car when they save up the money.

 

[sfbearcop]

I was turned on to this forum by a friend and had to check it out. I spent a good part of my police career assigned to SF General Hospital and as a psychiatric liaison officer and have seen quite a few interesting things.

In the area of "interesting things found in the rectum" I would like to add the half-dozen Barbie heads extracted from one pt. They were complete with their lovely synthetic locks. The pt. could give no real reason for this. I'm not sure there is one.

And then there was the older gentleman who presented with a stainless steel cock ring embedded at the base of his, well where they go. It had done its job very well and his erection was quite permanent. When all the medical personnel had run out of ideas, we summoned Rescue One and they arrived and set up their cutting tools. When they fired up the 10-inch carbide circular saw, the ring miraculously seemed to fall right off.

If I learned nothing else -- and that isn't even close to true -- I learned that one can never have seen it all. Just when you thought you'd seen everything, something new and very weird will come in. I've seen guys shot by one of the "Dude Brothers" - you know, Some Dude, That Dude, Some Other Dude -- with a .45 round transecting his skull just behind the eyes. The round popped one eye and partially severed the optic nerve on the other before coming to rest just under the skin in the right temporal region. The pt. was blind but still annoyed enough to keep getting off the gurney in the trauma room. When we 4-pointed him, he tried to get up and take the gurney with him, back out to the car he was driven up in -- now a crime scene. Finally he was put under with one of the cocktails always available and they could begin saving his life.

There were several instances of people under the influence of something try to walk away with a gurney to which they were restrained. No one made it further than the hallway. Imagine trying to deal with someone wearing a trauma gurney like it was a light sweater.

I've had a large young man brought in under the influence of an unknown substance -- which later turned out to be PCP -- who managed to lift my 250 lbs off the ground as I placed a carotid hold on him before he could tear up the entire ER and hurt someone. It is a strange feeling to feel your feet leave the ground while applying a hold that is supposed to incapacitate a person quickly.

I retired four years ago and although I don't miss the job -- politics, mostly -- I do miss the work and the excitement.

 

[RogerX]

This thread is absolutely frickin hilarious! I am just a pre-M, but I work in a small, yet busy ER.
...
Please, by all means bring your child into the ER in the middle of the night for a HIGH fever (which the triage RN record's as 99.0), stay for 30 minutes and then request a doctor's excuse because you have to be at work in 3 hours.

I'm thoroughly enjoying the stories here... I just wanted to give some of you folks the flipside of the coin. (Non-medical professional, son of physician.)

When it's 3am and your first-born, infant son (who has been running a fever for two days at 102.1) suddenly spikes to rectal temp of 104.1, you might panic. Although you know it's probably just something minor, you call your HMO's "Nurse on Call" to run down the list of symptoms just to be safe. They tell you that because they are not doctors, they cannot diagnose, and please take child to ER ASAP. This means you will be charged a 200 dollar co-pay that you really can't afford, but it's the only advice you are given. When you get to the hospital, are triaged at 101, and get to 99 by the five hours later it takes to be seen by peds, you feel kind of stupid. And now, broke, also.

When your wife is in the last month of her second pregnancy, with C-section planned for following Monday to prevent possible rupture, is experiencing afore-warned uterine rupture NOW with a liter of blood in abdominal cavity, is listless and unable to stand or speak, you should still have her wait at ER desk to be signed-in and triaged as ER nurse suggests, and NOT demand that she be taken to Maternity immediately. And you should also not be upset by this 5 minutes of bickering at the front desk when your needing-to-be-born daughter has ruptured out into said abdominal cavity, is inoxic and needs to be bagged back to life and life-flighted to NICU on other side of town.

When your wife wakes up in middle of night suffering from swelling, respiratory distress and other telltale symptoms of acute allergic reaction (likely tree nuts or wasp sting), is without EpiPen (yes, her fault), and does not have med. history at local ER... PLEASE DO scream at the husband for trying to help fill out her history despite having had only 3 hours sleep in past two days and has just had to get kids taken care of, wife to ER, and fill out 5 pages of HIPAA waivers. I tell you what, both the triage nurse and the ER attending literally yelled at me for trying to alert them to her allergies and symptoms-- give her Epi!-- while they were trying to get her to talk to them directly. Considering her airway was blocked and she was in respiratory distress, I assumed they wouldn't get much useful info out of her. However having them misdiagnose, call EarNose&Throat guy out of surgery, and having him scream at ER attending in the hallway that it's a "textbook allergic reaction, give her Epi & Benadryl and send her home" gave me a smug sense of satisfaction.

Please do continue. It's a rough job and God knows I couldn't stomach it, but I did want to inject my two cents from the other side of the curtain!

 

[IronHelix]

I hope noone minds a non-doc butting in

In the commonwealth countries we have a pseudo-paramedic volunteer society called St. John Ambulance.

So, I was young, gung ho, wanted to be a med student, had just come out of my two day advanced training (including oxygen administration) and was one of those "waiting for someone to hurt his/her self" types.

I see this guy collapsed facedown in a pile of newspapers.

So I rush up. "Can I help you? Are you OK?"

No response, except some random vowel sounds.

I try to (gently) turn him over as taught.

He resists.

I try to see if there's some mechanism of injury....

He stands up, stops praying in Arabic, and tells me to stop interrupting his daily prayers. Apparently he was caught in traffic en route to the mosque and being devout decided to find an alleyway, set down a newspaper, and prostrate himself and praying, which I interpreted as collapsed and talking gibberish.

Christ was I embarassed.

Had another incident like that. Turned out to be an African refugee who decided to take a nap facedown on a grassy knoll, splayed out like she'd been coldcocked. Learned a few choice jailhouse swear words off her.

 

[beary]

After you drive yourself to the ED, besure to walk up to the Triage Nurse to tell her you are having a seizure. When she asks "have you ever had a seizure in the past?" Respond with "Yes, I have been diagnosed with pseudo seizures. It's real bad."

That's hilarious. Pseudo seizure pts are the worst.

 

[steatopygia]

If you are faking a seizure


After you drive yourself to the ED, besure to walk up to the Triage Nurse to tell her you are having a seizure. When she asks "have you ever had a seizure in the past?" Respond with "Yes, I have been diagnosed with pseudo seizures. It's real bad."

awesome!

that is a great story.

In the city hospital I work at people often have seizures to gain attention. Yesterday a particularly busy nurse walks by a patient who throws himself onto the floor convulsing. The nurse walks back and steps over the patient saying "you can do better than that." The patient gets back into their chair with their head hung low and says "you're right."
I guess the best part of the story is that in the drama of the collapse, the patient threw their prosthetic eye across the floor. It took us 20 minutes to find it.

 

[kcmknice]

I've been in a few hospitals and I"ve really enjoyed this list. I wish there was one for dental but here's one that happened to me in GD private practice:

Pt, who has only always received emergency dental care, demands to be seen TODAY and he's not waiting in the waiting room either, so DMD asks me to check him out. Pt c/o picking teeth with toothpick and lost it. In a 13+ mm perio pocket, Two weeks ago (but god forbid he take off work). And guess what lucky RDH got to fish it out, all 1 1/2 bloody, pus-coated inches of it? Told pt he should see someone about perio problem, preferably an OMS.

There was a post back in the 400s about a guy with a fish hook in his hand . . . I think that was my dad, on a family camping trip, hooked between thumb and forefinger, waited Sunday afternoon from 2 pm to 10 pm, got yanked at unsucessfully then waited for ER doc to get very unsterile pliers from maintence. Dad was pissed (I coulda done that!)

Maybe why at 46, it took my mother finding him crying in the bathroom to get him to go to ER. Hadn't peed in three days, severe UTI, with prostatitis. Was tx by URO PA, who tried to release him on the magic 3rd day, even though MRI was not read until the next day. In the meantime he develops bactermia from sloppy needling. Is released on 6th day, when the raging fever finally goes down. 3 months later they change their "all men your age have enlarged prostates" to "OMG it's cancer." Hilarity ensues. Including post surgical morphine IV, which produced severe itching and was treated with Benedryl. Is it just me, or do you change the med rather than treat side effect/adverse reaction/allergy?

Same hospital tells us G'Ma's gonna die tomorrow after 1 week of declining AM pulse-ox, y'all better come say goodbye. Everybody flies/drives in. Cousin spends night in hospital, replaces nasal O2 when G'ma pulls in out in the night and OMG she recovers in 2 days. Last time she was admitted after a long car trip, they said she was in renal failure and was too old and sick to put on transplant list or dialysis, come say goodbye, we all do. They wouldn't feed her for 3 days, but the fluids were enough to get her home in 6. No kidney problems by the way. I'm afraid that if they ever say she's alright, that'll be the day she croaks.

80+ y/o Woman in the next bed is moaning, for hours, but seems demented. We alerted nurses station, repeatedly and 30-45 min intervals. Pt daughter comes, apologies for noise. Turns out woman desperately needs to use bathroom and all that was needed was assistance to the bathroom. Took them 3 hours of ignoring her to clear that up. (same nurses that almost let my G-ma die of an itchy nose)

Other nutjobs (these are in my family) Aunt tells EMTs "She's old. Just let her die." In front of my grandmother, who's on the gurney being treated for MI.

My uncle got in a tussle with an ER doc and hospital security because they weren't treating G'ma quickly enough. Not did that not move her to the front of the line, but he didn't get to see her again until after his stay in county.

Mad props to ER docs, keep up the good work

PS on the subject of whacked out MedHx, 70+ vet pt in retirement community dental office "Kidney problems or dialysis? No." Very aware, chatty pt who answered yes to diabetes, HTN, heart disease and listed meds accurately. I treat (cleaning, etc) and then DDS comes in for exam and reviews MHx. "I had some kidney trouble, but Dr at VA says I'm cured" Confirmed with Dr by navigating Walter Reed phone labyrinth. "He's fine, no PreMed" Return to room. Pt stratches left arm, revealing dialysis stent under sleeve. I'm about to cry. Guy just came off dialysis and meds last week, so to prevent loss of license and lovely bacterial endocarditis, we (me) admin PostMed As was said before . . . pt's lie . . . or forget all about spending half their day hooked up to nifty blood cleaning machine.

 

[gRooviN']

I'm a nurse in peads, north of your border. This thread has been both horrifying and hilarious. I haven't laugh so hard and felt as morbid in some time. Here are my 3 cents.

Something I've learned from my patient:
If you'd like to see your anaphylactically-allergic-to-peanuts-but-otherwise-healthy 7 year-old son intubated for a couple days, please - go ahead and give him a Wunderbar! (very similar to an american Butterfinger) It'll earn you a nearly effective death-look from your wife, and do wonders for your marriage.

Regarding attempted suicides (story courtesy of a friend who works emerg):
Adult male comes in via ambulance after chugging about 4L of antifreeze. That oughtta do the job! Ended up calling 911 after a few hours because nothing was happening yet. Nobody in poison information, no toxicologist, no doc, no nurse, not ANYONE can figure out why this guy isn't dead. ...then the tox screen comes back. Turns out this hapless gentleman thought that he may as well numb the pain of death with beer, and lots of it.

A word of advice for those of you heading into peads:
Grandma is not the ideal candidate to hold and position her adorable three week-old grandson for an LP. That's just a mean thing to do to a very nice lady.
(I managed to find another nurse to help position very quickly when I told her what the original plan was. Grandma was left free to reassure and comfort the concerned parents of the baby outside, as grandparents should do.)

Good luck to all of you in the ED! Pobody's nerfect and all you can do is your best!!

 

[Kensey]

Another non-medico here (I think I got linked here from the fark.com thread on IT nightmares, IT being my own field), but this is one I learned from the pt. on the other side of the curtain in the ER while waiting to have my foot stitched up as a teenager:

If, on the Fourth of July, a firecracker fails to explode after you light its fuse, you should break it open to dump the powder out. Since powder is hazardous, you want to keep it all together in a pile in some sort of container or dish -- an ashtray is perfect for this, especially since powder is flammable and ashtrays are designed to hold flammable materials.

It is then a good idea, the next day, to put your cigarette out in that very same (unemptied) ashtray.

 

[khereva]

First, mad props to you guys. I was pointed to this thread by a friend, and all (so far) 39 pages are a stone hoot.

One more that I learned as a hapless hubby last night:

If it's your wife's birthday and you've baked a tray of brownies for her and the guests, by all means let her cut them up to serve to the guests herself. Let her use the sharp knife.

If you can get her to have some wine with dinner previously, that's even better.

I'll just say any ER I can get her out of in 2 hours (St. David's in Austin) is wonderful, and the guys there were tops.

 

[dchi_man]

Lessons learned as an EMT in a rural county in Missouri:
1. When a 1987 Chevy Cavalier takes on a John Deere, the tractor will win.
2. When you are 15 yo female and you attempt to kill yourself by OD on your foster-father's TCA's, and you are found in your room responsive to painful stimulus, wearing only a thong, you will have a resting heartrate of 185, and I will be left with a lot of questions from the authorities because you could not do this fully clothed and you had to use your foster-father's drugs.
3. Teenagers + ATV's + Alcohol = Ambulance crew stabilizing on scene until air ambulances (plural) arrive.
4. A shotgun to the head is not a guaranteed way to end one's life. However, when using a single shot 12 guage, and after the first shot, you have managed to blow out both eyes, but are still alive, by all means, be calm and collected while you unload the first shot, set it on the edge of the dresser, reload, and succeed with the second shot. While extremely messy, and hard for your family to deal with the site, you will give the ambulance crew a good laugh for years to come.
5. When your paramedic misses intubation 3 times, it is perfectly ok for him to blame you (EMT), and get angry when you suggest using an EOA to establish some sort of airway. Did I mention that you (EMT) received EMT training as a combat medic, so you are also trained in intubations, but you are not licensed to do so on a civilian?

 

[El Cheba]

If for some reason your girlfriend or you has some obsession with firearms and you use a pistol to sexually stimulate her, please remember to unload the hollow points. If you don't you will keep me up all night assisting a charming urologist that enjoys these kind of things instead of me getting some sleep.

 

[BobbyJ]

Unload the hollowpoints? Are you saying if it's loaded with semiwadcutters, it's ok to leave it loaded?

JESUS, but we shaved monkies are getting weird when it comes to our sexual "kinks"...isn't anyone satisfied with a couple silk scarves, a blindfold, and some animal training tools, anymore?

 

[PedsMD]

I just found this thread (and this site) and it has made my overnight ER shift bearable - Thanks! Here are a few things I've learned:

1. If you must crucify yourself to the wall, you will be stymied when you get to the other wrist.

2. If you carve 666 on your hand, it is OK to atone for your sin with a chain saw.

3. If you shoot your baby niece with a BB gun you should definitely pry the BB out of her forehead with a butter knife.

4. If you are going fishing in the morning, don't leave your fishing gear in your bedroom. If you have no other place to put it, don't walk around barefoot.
(Incidentally, I always get the ortho's pin cutter from the OR for these - works much better than whatever wire cutters maintenance can provide.)

 

[Emerson_Emerge]

So, I'm not a resident or anything, but an ed. student hoping to get into clinical psy. I have an interesting story about the epidemic of terrible rural doctors that Canada has though.

I was living in Burns Lake B.C., which is fairly isolated (north of Prince George), and I started having these horrible headaches, and fluid buildup, and basically toughed it out until things became unbearable, and everything coming out of my body was neon green. I didn't want to have to go see the residential doctor for a town of 2000, after being around much better quality urban doctors for most of my life.

So I go in because I think my head is about to explode, and this doctor gives me a fairly full examination, including a vitals check. He puts the stethescope on my chest, and listens. Pulls back and looks at me nervously for a moment, and listens again.

I of course think he's just found my heart murmur (bicuspid valve) and point this out immediately upon his continuing expressions of concern.

"No, no," the good doctor says, "I think your heart is actually in backwards! Did you not realize this? Have you ever been to a heart specialist before?"

Despite reassuring him that I had been going to the cardiology clinic at the U of A since birth and every two years since, and that surely they would have "figured that out by now", he was genuinely convinced that a grievous error in my diagnosis had been made, the horrifying part of this being that he was one out of three doctors to serve the town and surrounding area. To his credit, he did diagnose the Sinusitis (sp?) accurately.

I've really enjoyed this thread a Canadian tonne. Throughout reading this, and the things you are able to pull away from doing this work as anecdotes, it shows you all are of very good character and have major cojones. We need some of youse in rural Canada! LOL. Pay sucks, but the healthcare's free.

 

[irrka]

In the area of "interesting things found in the rectum" I would like to add the half-dozen Barbie heads extracted from one pt. They were complete with their lovely synthetic locks. The pt. could give no real reason for this. I'm not sure there is one.

I have to comment on this... I used to be an e-toc junkie (electronic table of contents for any number of journals) and for a while i was getting some radiology journal's --which mostly turned out to be boring and got nixed, but more to the point: at some point they had an article about this guy who presented with SBO as far as i remember, and on whatever study it was, they noticed that his gut was full of these circular things with what looked like noses. Turned out the guy was SWALLOWING the barbie heads so that they would come out the other end for pleasurable effects.... yuuup

 

[BKN]

So, I'm not a resident or anything, but an ed. student hoping to get into clinical psy. I have an interesting story about the epidemic of terrible rural doctors that Canada has though.

I was living in Burns Lake B.C., which is fairly isolated (north of Prince George), and I started having these horrible headaches, and fluid buildup, and basically toughed it out until things became unbearable, and everything coming out of my body was neon green. I didn't want to have to go see the residential doctor for a town of 2000, after being around much better quality urban doctors for most of my life.

So I go in because I think my head is about to explode, and this doctor gives me a fairly full examination, including a vitals check. He puts the stethescope on my chest, and listens. Pulls back and looks at me nervously for a moment, and listens again.

I of course think he's just found my heart murmur (bicuspid valve) and point this out immediately upon his continuing expressions of concern.

"No, no," the good doctor says, "I think your heart is actually in backwards! Did you not realize this? Have you ever been to a heart specialist before?"

Despite reassuring him that I had been going to the cardiology clinic at the U of A since birth and every two years since, and that surely they would have "figured that out by now", he was genuinely convinced that a grievous error in my diagnosis had been made, the horrifying part of this being that he was one out of three doctors to serve the town and surrounding area. To his credit, he did diagnose the Sinusitis (sp?) accurately.

I've really enjoyed this thread a Canadian tonne. Throughout reading this, and the things you are able to pull away from doing this work as anecdotes, it shows you all are of very good character and have major cojones. We need some of youse in rural Canada! LOL. Pay sucks, but the healthcare's free.

He doesn't sound that terrible to me. He was talking about Kartagener's syndrome, which consists of sinusitis, dextrocardia (heart reversed in postion) and bronchiectasis (inflammed, dilated bronchi). He may have been wrong but if your exam was a little strange and you had sinusitis it was worth thiniking about. Indeed, it may mark him as a good Doc since he thinks about unusual diseases.

 

[eddieberetta]

So, I'm not a resident or anything, but an ed. student hoping to get into clinical psy. I have an interesting story about the epidemic of terrible rural doctors that Canada has though.

I was living in Burns Lake B.C., which is fairly isolated (north of Prince George), and I started having these horrible headaches, and fluid buildup, and basically toughed it out until things became unbearable, and everything coming out of my body was neon green. I didn't want to have to go see the residential doctor for a town of 2000, after being around much better quality urban doctors for most of my life.

So I go in because I think my head is about to explode, and this doctor gives me a fairly full examination, including a vitals check. He puts the stethescope on my chest, and listens. Pulls back and looks at me nervously for a moment, and listens again.

I of course think he's just found my heart murmur (bicuspid valve) and point this out immediately upon his continuing expressions of concern.

"No, no," the good doctor says, "I think your heart is actually in backwards! Did you not realize this? Have you ever been to a heart specialist before?"

Despite reassuring him that I had been going to the cardiology clinic at the U of A since birth and every two years since, and that surely they would have "figured that out by now", he was genuinely convinced that a grievous error in my diagnosis had been made, the horrifying part of this being that he was one out of three doctors to serve the town and surrounding area. To his credit, he did diagnose the Sinusitis (sp?) accurately.

I've really enjoyed this thread a Canadian tonne. Throughout reading this, and the things you are able to pull away from doing this work as anecdotes, it shows you all are of very good character and have major cojones. We need some of youse in rural Canada! LOL. Pay sucks, but the healthcare's free.

Yup, that is a great example of physician incompetence

 

[docB]

When the ER doctor somberly approaches you and tells you that your loved one is dead it’s really more of a statement than an invitation to debate. You may feel compelled to retort with:
“But he just saw his doctor last week.”
“He had this before and didn’t die.”
“But he only quit breathing 45 minutes ago.”
“Yes we made him DNR but he wasn’t supposed to die like this.”
“Well call Dr. Primary to come see him and we’ll see what he thinks.”
“If you don’t know what caused his heart to stop how can he be dead?”
“But he has a pacemaker.”
“But the cop who was at the house (and didn’t come to the ER) said he’d be fine.”
“But the rest of the family isn’t here yet.”
“Just give him some of that one medicine that works for him.”

None of these will result in the ER doctor replying, “You know, you’re right. He’s alive.”

 

[jrb_75]

I, too, am someone with no medical training (although I'm Jewish, so I'm pretty much halfway to being a doctor anyway) who found this thread on Boing Boing weeks ago and have been enjoying it slowly during down times at work ever since. I think the number of winces slightly outpaced the number of laughs, thanks to all the uretha-related posts, but there have been many laughs, some of which required closing my office door.

So thank you thank you thank you. And I will never go to the ER again unless the bleeding will not stop.

I'm also scratching my head at much of the terminology (I've figured out what AMA means, thanks to context, but I have no idea what it stands for), but have to say that SOCMOB may be the greatest acronym of all time. So I went ahead and created this for your amusement, and hope that somewhere there will be an ER doctor wearing this under his or her scrubs chuckling quietly the next time someone begins a story, "I was standing on the corner..."

http://www.cafepress.com/socmob

 

[EctopicFetus]

AMA is against medical advice.. which is when someone leaves when a doc thinks they need to stay..

 

[JohnQCitizen]

So I went ahead and created this for your amusement, and hope that somewhere there will be an ER doctor wearing this under his or her scrubs chuckling quietly the next time someone begins a story, "I was standing on the corner..."

http://www.cafepress.com/socmob

What ... no SumDude or ThatDude line of T-shirts to go along with this thread.

And while your at it, I want one that says Babydaddy

 

[jrb_75]

What ... no SumDude or ThatDude line of T-shirts to go along with this thread.

And while your at it, I want one that says Babydaddy

Your wish is my command. Introducing the complete line of SDN Forum "What I Learned From My Patients" wear:

http://www.cafepress.com/socmob

http://www.cafepress.com/somedude_jrb

http://www.cafepress.com/babydaddy_jrb

 

[gree0411]

I learned the other night that it's not a good idea to refuse medical intervention because of your relegious beliefs and continue to labor for two days at home with a hand sticking out of your vagina. When you do finally show up at the ED they will take you to the OR where you will code, end up requiring 24 units of blood, lose your uterus, lose your ovaries and lose your baby.

 

[spyderdoc]

I learned the other night that it's not a good idea to refuse medical intervention because of your relegious beliefs and continue to labor for two days at home with a hand sticking out of your vagina. When you do finally show up at the ED they will take you to the OR where you will code, end up requiring 24 units of blood, lose your uterus, lose your ovaries and lose your baby.

Again, Darwin prevails.

 

[ERMudPhud]

I learned that if your patient is a bouncer on HGH and steroids who has just suffered a vFib arrest then watch out after you shock him. As the blood returns to his slightly anoxic noggin he will become unbelievably combative. We had >1000 pounds worth of security, nurses, techs, and docs hanging on him and he was still kicking our butts. As he used his left arm to fling my 200 pounds around the ED I kept thinking what bad form it would be if fighting with us induced a second arrest that he didn't come back from.

In the end it all turned out OK and I have to say it was a pretty good save.

 

[thebvp]

I'm not a doctor, but I work in the radiology department of a hospital, so please, bear with me.

1) If regular old sex just won't do it for you anymore, swallowing four metallic ball bearings, each an inch in diameter, and then using a large magnet to move them around, hoping that it will stimulate your bowel while you masturbate is generally a bad idea. And if that doesn't get you off, the addition of a flashlight in to your anus won't help, either. You only have so many hands and the unfettered flashlight will actually become impossible to retrieve without medical assistance. Not even that little string will help you from getting your flashlight back and the hospital will make you wait a day before intervening because 1) no one wants to dig a flashlight out of your butt at 2 in the morning and; 2) maybe enduring the condition will teach you the importance of keeping your flashlights tethered.



Or maybe he lost the flashlight whilst searching for the ball bearings?

 

[krazykarls]

Wonderful thread

From friend and fellow paramedic,

Keeping your fridge clean and fresh smelling with an open container of bleach may or may not be a good idea, however if you have a 4 year old child, you should really pick something other than an empty sprite can

 

[8744]

Oh I have just got to add this story:

Once, when I was a young Marine, one of my friends was dumped by his bar-girl (buy me drinkee) girlfriend. He was so overwrought that he got drunk and carved her name in his chest with his K-bar.

Our squad leader looked at him lying on the floor of the squad bay in a pool of his own blood and his only comment was that he had spelled her name wrong.

"Now put yer' ****ing shirt on and clean up this ****ing mess."

This was back in the day when you could do stupid things and not get office hours as long as you showed up for morning formation.

 

[notinmed]

I am not a student.I have read some of the posting on this web site.Some are great and funny others are plain out rude.The attitude of some doctors,students and nurses are why some people wait to go to the hospital. When I was 25 weeks pregnant I went to the ED due to spotting My doctor had told me since I had Placenta Previa to go to the ED if I had spotting. I got there and waited about 30min(That was a great time) he walked in and said. Why are you here? I have no idea why you came nothing is wrong it is just spotting and left told me to go home not to worry.That made me feel about as big as an ant.I went home the spotting continued I did not call due to our last visit. 1 week later I started losing alot of blood my boss said you need to go to Ed. I said no way my doctor said nothing was wrong. She called ambulance they took me to ED. My son was taken emergancy c-sec due to placenta tore. He weighed 2.1 and is now doing wonderful. We depend on doctors, students, and nurses to help and dignous us.Your bedside manner does factorin in on when and why we come into see you. People do stupid things and wait till ungodly hours to come in to see the ED. The point is it is an ED that is what the employees are paid to do. It might be an ungodly hour we come in, but if we knew what was going on we would not need you and your job would not exist. I have three family members in medicine two work in trama unit and one on life flight helicopter. I know the stories of stupidity I also know that the high and mighty attidue in the medical field has to go. Well thanks for all you do.

 

[EctopicFetus]

huh?

 

[Mitas]

When you and a friend are arguing over whos turn it is next in a video game, feel free to get into a 1-fingered mercy match. When your finger suddenly snaps and the top half is pointing sideways, it is always a good idea to reflexively snap it back into place.

Two hours later when you are in the emergency room, be sure to try and cover up your actions by informing the doctor in the ER that you broke your finger while 'flipping off a priest' , I'm sure his reaction will be well worth the visit.

 

[ERMudPhud]

If your whole family has been sprayed by a skunk coming to the ER won't help. Although I did think about initiating our Hazmat protocal and scrubbing them all down in the parking lot.

 

[blake2go]

Reminds me of a 16-year-old I took care of many years ago, admitted to the ICU with her THIRD self-inflicted GSW to the chest. Patient teaching--IMPROVE YOUR AIM so we don't have to deal with you!

Being that you are so heartless,why did you not just kill her yourself? Poor mixed up KID wanting to die,failed, and had to meet you,no doubt people like you,are the reason she wished to leave in the first place. Perhaps with your weapons no how,you might take yourself out and then We would not have to deal with you!

 

[DocCM]

Being that you are so heartless,why did you not just kill her yourself? Poor mixed up KID wanting to die,failed, and had to meet you,no doubt people like you,are the reason she wished to leave in the first place. Perhaps with your weapons no(sic) how,you might take yourself out and then We would not have to deal with you!

I know this may seem incredibly insensitive to you, but you really have spend some time in an ICU or ER to see what her point is. Again, this thread has served as a venting forum for people in stressful and taxing jobs. It can be extremely frustrating to split time and resources between a patient with multiple suicide attempts and a mother of 4 who was critically injured by a drunk driver for example. Also, this "heartless" nurse I'm sure did everything within the scope of his/her power to help this patient and will do so again on the next suicide attempt. (I'm pretty sure I just wasted my time typing this as this was most likely a trolling expedition, but oh well, need to keep my mind off of countdown to match!).
CM

 

[colforbinMD]

I recently learned from a patient (who shall go nameless) that they need us to help and dignous them
Now if only they had taught me in med school how to go about doing that.

 

[Seonag]

Oh, I really needed this thread today. I haven't laughed so hard in a long time (I think the hush puppies remark was what finally broke me).

I'm not a medical professional, and won't ever be one (thanks to some neurotransmitter entertainment) but I've grown up in the medical field. Literally. I'm the spawn of 2 lab techs, one of whom went to med school and became an FP. I grew up hanging around in a hospital lab (I could do clotting times, spin UAs and assorted other useful tasks by the time I was 10, back in the dark ages of manual labwork) and helping my dad study for tests.

Spent my adolescence in wheelchair races, helping choose carpet for the shiny new private practice (first priority - it hid bloodstains) and answering the phone when suicidal cops called to thoughtfully request a sedative for the wife before they did the deed.

My 20s were spent learning the front end of said rural island family practice with its own mini-ER, which meant equal parts triage, receptionist, AR clerk, and insurance wrangler with the occasional nursing stand-in.

So I've ended up walking like a duck and quacking like a duck, but without ever actually becoming a duck. I do have the sense of humor, though, from years of "Tales of the ER" at the dinner table, reading scores of medical memoirs as a precocious kid (including the infamous-at-the-time "Intern", which I got fine except for the sex parts), and my own adventures including impromptu punk medic duty

And from the personal file: to compensate for all the Entitlement Bitches and so forth, the sweet little old lady who drove herself to the office one morning because she didn't feel quite right. Walked in white as a sheet with grossly obvious hemiparesis, but 'didn't want to bother anyone if they were busy'.

~Seonag~

 

[shiro1]

Here are ways to get to know your optho consult/residents well:

1. In a friendly family dispute, one way to bring the family together is to go around when everyone is sleeping and pour bleach over everyone's faces. Seven facial, eyelid and eye burn victims in the ED, optho clinic really makes our day...

2. When attempting to leave this mortal coil, and having procured a gun and thinking that putting it in the mouth is an acceptable way doing the deed, please try to aim back towards the brain/brainstem. Pointing it up towards the roof of your mouth will only blow out eyes, nose and mouth. The subsequent repair will leave you with a face that literally looks like an a-hole, with a lovely string from one of the tampons hanging out of the remainder of your face. Causing my senior resident to affectionaly call him "tampon face". Oh, and it also buys you a trach and a g-tube for the rest of your life. Congratulations.

3. Similarly, a gun to the temple too far forward will only shoot out your optic nerves. Blind, it is much more difficult to do yourself in.

4. Please do not tell me that it was "some dude" or "some dudes" that did this too your face. I neither care, nor is it going to change the way I treat your orbital fracture and hyphema.


BTW, I'm going to encourage similar posts in other areas. EM is great for stories, but there are plenty out there in other fields!

 

[NateatUC]

From a VERY rural ED:

Apparently driving your pickup and eating a Slim Jim don't mix. Guy shows up ~2 days later, c/o eye pain and blurry vision. Turns out the Slim Jim wrapper flipped up and hit him in the eye - now has a nice corneal abrasion.

You might be a redneck I guess.

 

[Lexems118]

Don't call the squad at 2:30am for a stubbed toe and then expect us to do anything about it, and then when we arrive at the ER..dont change your story to make it sound like you actually had a syncopal espisode and hit your toe on the side of the ambulance we will all laugh at you and send you packing.

 

[FoughtFyr]

Being that you are so heartless,why did you not just kill her yourself? Poor mixed up KID wanting to die,failed, and had to meet you,no doubt people like you,are the reason she wished to leave in the first place. Perhaps with your weapons no how,you might take yourself out and then We would not have to deal with you!

Just a few thoughts:

"...Look, without humor we would all have committed suicide. We made fun of everything. What I'm actually saying is that that helped us remain human, even under hard conditions..."
"...But don't think that it is possible for people in such situations not to have any humor and satire. This is impossible, it is a kind of defense mechanism..."
"...At the Ghetto we were looking under ground for things to laugh at, even when there weren't any..."
"...When I was interviewed for Spielberg and they asked me, what I thought was the reason I survived, they probably expected me to answer good fortune or other things I said that I thought it was laughter and humor, not to take things the way we were living but to dress them up as something different. That was what helped me I wasn't thinking about miracles and wasn't thinking anything, I only thought how not to take things seriously, as if I thought that this was the proportion that I was giving, and I guess it (this attitude) helped me. Because it was absurd all that time, it was unconceivable, that they could do those things to people..."

"...Humor was one of the integral ingredients of mental perseverance. This mental perseverance was the condition for a will to live, to put it in a nutshell. This I am telling you as a former prisoner. However little it was, however sporadic, however spontaneous, it was very important, very important. Humor and satire played a tremendous role, in my opinion. It was a cemetery all right and exactly for that reason, the mere fact that we wanted somehow to preserve our personality, they wanted to make robots out of us..."
"...This was the integral part of our inner, mental struggle for our human identity, the fact that we could still laugh at things like these..."
"...Look, the ghetto showed that people have great vitality, as soon as a moment's time passed separating one trauma from the other people were already laughing, they maybe, even laughed more..."

From: Humor as a defense mechanism in the Holocaust. Thesis confirmed by the Senate of Tel-Aviv University to conferred the Degree "Doctor of Philosophy" to:
Chaya Ostrower, supervision: Prof. Avner Ziv Date: January 2000 (http://web.macam98.ac.il/~ochayo/absractf.html)

So basically, come off your high horse...

- H

 

[camkiss]

Love this thread!

One from today:
When you are coked up and put your hand through a glass coffee table and sever your radial artery, don't let your drunk AND coked up friend act as your ambulance driver. He will roll over the SUV you are in leaving you with a severed radial artery along with a brain bleed and open ankle fracture.

 

[GoofyDoc]

If you were attacked in your hardware store during a robbery and attacker slammed a rake on your head, it's just a minor injury. So save your money and don't bother calling EMS and just walk to the ER with the rake imbedded in your skull.

If you have been stabbed in the abdomen one night and are lying on the CT table while everyone is trying to figure out the extent of the damage, do jump off and swing your arms like a madman while shouting vulgarities and threats. While doing this, your gown might slip off, leaving you stark naked. However, since it's summer, you can immediately walk out the ER like that.

 

[GoofyDoc]

Not from the ED, but amusing nonetheless.

If you are walking outside and see a fist-sized golden-colored spherical blob with small tentacles, immediately call the police department and report that you have an alien baby. Because this is such a monumentous discovery, the police will respond quickly. However, since the blob is not moving, it is feared to be dead, and the police will carefully bag it and bring it to the medical examiner's office for examination. Also do report finding the alien baby to the local paper so they can publish an article about it.

Note: It was just a toy.

 

[Level_II_Trauma]

May I please top all of your stories with one of my own?

Always, before you decide to end it all with a crossbow, swallow a whole bottle of Tylenol first. Please DO wait for your parents to leave first on an out-of-town trip so it's not possible that they might be back anytime soon to intervene with your decision. Please, also make sure that your father is a famous physician in your home town, so that once the ER knows your story, the whole TOWN knows your story. And please make sure, that after you shoot yourself twice in the head with a crossbow, that you actually live to tell about it, because obviously it wasn't your time to go.

and

We like to refer to him as "Old Arrowhead", a.k.a., Steve Martin in his old stand-up comedy acts!

 

[EctopicFetus]

May I please top all of your stories with one of my own?

Always, before you decide to end it all with a crossbow, swallow a whole bottle of Tylenol first. Please DO wait for your parents to leave first on an out-of-town trip so it's not possible that they might be back anytime soon to intervene with your decision. Please, also make sure that your father is a famous physician in your home town, so that once the ER knows your story, the whole TOWN knows your story. And please make sure, that after you shoot yourself twice in the head with a crossbow, that you actually live to tell about it, because obviously it wasn't your time to go.

and

We like to refer to him as "Old Arrowhead", a.k.a., Steve Martin in his old stand-up comedy acts!

Dude has bad aim hope he uses his bow for hunting with a little more skill!

 

[psychbender]

MS1 here, with a past life in EMS. This was one of my first calls as an ALS provider.

If you just came out of rehab for cocaine, restarted your habit, and decided you're hungery, opening several cans of beef stew (and dog food?) and pouring them all over yourself is a good idea. It's an even better idea to then rip open a large bag of sugar, pour it on yourself, and commence licking everything in the trailer (including yourself) that is covered in said sugar (oh, did I mention the pt was a diabetic?). When the cops and medics arrive, lick them too after they try to pick your 300 lb, half-naked, glazed self off the floor and toss you onto the cot with gloved hands stuck in a GI Joe kungfu grip. As they are putting you in the back of the truck, please, grab the door and try to pull yourself out while screaming your only intelligible words (and official chief complaint), "WANT MORE SUGAR!!!" Once in the back, throw around the 200lb EMT like a rag doll, while the other two try to get IV access and realize that the monitor doesn't read through glaze. Later in the ER, if you become thirsty after your afternoon's exertions, you should definitely pull your foley out from the bag, and make yourself a complete circuit as you siphon urine from your penis with your mouth.

The song "Pour Some Sugar on Me" will never be the same, again.