Things I Learn From My Patients

[ISR]

I just found this forum and I can't stop laughing. It's too true...it's all too true!

I'm not a med student, but I am a COTA in a burn center...OK for me to share stories here, too?

On page 13, and they just keep getting better!

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[Apollyon]

IOK for me to share stories here, too?

Absolutely! The more, the better!

 

[ISR]

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.

Ok. That one got me. I made it through more than FORTY PAGES, laughing so hard I thought I was going to pee my pants...but you just squicked me out.

Wow. Just...wow.

 

[Dunce]

Ok. That one got me. I made it through more than FORTY PAGES, laughing so hard I thought I was going to pee my pants...but you just squicked me out.

Wow. Just...wow.

oh that was awful.

I have read through every page of this thread, but somehow I didn't recall seeing that one. Can somebody say "defense mechanism?"

 

[ISR]

and lastly understand that from this day forward you will be knowen as Ambien boy

Almost sounds like a bad comic book hero!

"The Adventures of Ambien Boy! Hold on to your seats as he snores more than TWELVE TIMES A MINUTE! Don't miss the excitement as his feet and hands twitch while he dreams of chasing a cat! Coming up in the next issue: Ambien Boy is faced with his biggest challenge yet...how will he cope without...his pillow!"

 

[ISR]

1. It is not a good idea to put out a grass fire with bare feet. It is a worse idea to blame the staff for causing your problems BEFORE you get your pain medicine.

2. Whatever it is you do to get unexplained full thickness burns INSIDE of your rectum is probably NOT A GOOD IDEA!

3. When I am removing a PCP k-wire from your finger with a hand drill, that is not a good time to cuss out my student, because I might decide that it would be a good "learning experience" to allow the student to remove the pin.

4. When your husband has just gotten back from Iraq, having been blown up by an IED and suffering > 80% TBSA burns, it is not benefical to wait until he has woken up from his pharmacologically induced coma, been extubated, and come to grips with his injuries to tell him that he's too ugly to deserve her, and that he should never have bothered crawling out of the building that was shelled. Do this when your husband's CSM is visiting to personally present the soldier with a Purple Heart for his injuries, and Silver Star for going back in THREE TIMES to pull out his battle-buddies.

 

[Wackie]

Only a premed, but have been volunteering for a while.


It's definatly okay to pay your ex-wife and four year old daughter a visit at the ED while completely inebreiated...then decide to pick a fight with her which elevates to you roaring at the top of your lungs, then opening and slamming the door shut to the exam room to scare her. The nurses will love it. Espeically the meanest, take-no-****-from-anyone nurse who will be crawling up your a**, shaking her finger in your face as she scolds you and you'll get to walk out of the ED like a kicked puppy with her following closely behind making sure that you damn well better understand that "this *will not* happen again".



Call 911 and have them transport you to the ED when they are extremely busy and use a sinus headache for your chief complaint. Then get upset when you don't get stickers and graham crackers.

 

[docB]

1. It is not a good idea to put out a grass fire with bare feet. It is a worse idea to blame the staff for causing your problems BEFORE you get your pain medicine.

Sage advice.

2. Whatever it is you do to get unexplained full thickness burns INSIDE of your rectum is probably NOT A GOOD IDEA!

More sage advice.

4. When your husband has just gotten back from Iraq, having been blown up by an IED and suffering > 80% TBSA burns, it is not benefical to wait until he has woken up from his pharmacologically induced coma, been extubated, and come to grips with his injuries to tell him that he's too ugly to deserve her, and that he should never have bothered crawling out of the building that was shelled. Do this when your husband's CSM is visiting to personally present the soldier with a Purple Heart for his injuries, and Silver Star for going back in THREE TIMES to pull out his battle-buddies.

What can you even say about a person like that?

 

[ISR]

1. If you really feel the need to get back at your girlfriend, the best way to do this is to light your pants on fire. It will certainately teach her a lesson.

2. Pulling a fresh skin graft (less than 6 hours old) off of the back of your neck after meticulously picking off the dressing will result in 2 points restraints. Having the nurse find your skin graft in your hamburger like a piece of cheese with ketchup and pickles placed ON TOP OF IT is a great way to earn yourself a psych consult.

Telling the psych that you had to hide your graft to protect it from the colony of alien ants living in your neck is not the best way to convince us that you're ok to go home.

3. Smoking while on oxygen is not a good plan. It will earn you a trip to my burn unit. Having your family distract the nurses once you've been extubated so that you can sneak outside (still on oxygen via nasal cannula) to smoke will earn you a trip back to my ICU followed by a one-way trip to our morgue.

 

[stoic]

4. When your husband has just gotten back from Iraq, having been blown up by an IED and suffering > 80% TBSA burns, it is not benefical to wait until he has woken up from his pharmacologically induced coma, been extubated, and come to grips with his injuries to tell him that he's too ugly to deserve her, and that he should never have bothered crawling out of the building that was shelled. Do this when your husband's CSM is visiting to personally present the soldier with a Purple Heart for his injuries, and Silver Star for going back in THREE TIMES to pull out his battle-buddies.

holy crap. what an evil bitch. i hope someone does something truly aweful to her.

hopefully she spends a lot of time SOCMMOB in an area populated by roaming sets of two dudes who, for no reason, smash her in the head with a 2x4. i'm mean seriously, what she did breaks my heart. i'd like to write that soldier a letter thanking him for everything he's done.

oh, and here's a good one. this is the type of pt that is just sooo draining. 45 minutes spent on her felt like a full shift.

don't show up in the ER complaining that you can't afford your chronic pain meds and need IV pain control (she actually ask for a central line b/c she has bad veins) and also demand to the nurse that you get some food b/c you can't afford to eat and are starting to waste away - then especially don't pull out a receipt for a meal at a local casino from 3 days ago to prove that you haven't eaten since then. and then, when being discharged after your IM toradol and po lortab (and discharge rx for 30 tramadol), don't beg me - the med student who can't right scripts - for an rx for at least 100 percocet because the doctor here just doesn't understand and it will be a while before you can afford to see your pain management doc again...

 

[GoofyDoc]

4. When your husband has just gotten back from Iraq, having been blown up by an IED and suffering > 80% TBSA burns, it is not benefical to wait until he has woken up from his pharmacologically induced coma, been extubated, and come to grips with his injuries to tell him that he's too ugly to deserve her, and that he should never have bothered crawling out of the building that was shelled. Do this when your husband's CSM is visiting to personally present the soldier with a Purple Heart for his injuries, and Silver Star for going back in THREE TIMES to pull out his battle-buddies.

What can you say about such a filthy piece of human trash? Wish they could just ship her off to Iraq.

 

[Apollyon]

1. If you really feel the need to get back at your girlfriend, the best way to do this is to light your pants on fire. It will certainly teach her a lesson.

Liar, liar!

 

[ISR]

holy crap. what an evil bitch. i hope someone does something truly aweful to her.

hopefully she spends a lot of time SOCMMOB in an area populated by roaming sets of two dudes who, for no reason, smash her in the head with a 2x4. i'm mean seriously, what she did breaks my heart. i'd like to write that soldier a letter thanking him for everything he's done.

It would be poetic justice if she ended up in our unit. Maybe we can contract one of the Dudes Brothers to come pay her a visit. I'm sure they have nothing better to do. Haven't heard from 'em in awhile (at least a week).

 

[ISR]

What can you say about such a filthy piece of human trash? Wish they could just ship her off to Iraq.

Why would you want to inflict that on the good people over there? Aren't they going through enough?

 

[ISR]

When you're making a splint for your patient, please ensure that all fingers are held well away from the leather shears you are using to cut the thermoplastic. If you fail to do this, you will cut your finger.

If, after you've sliced through a finger, do not be shy about asking your patient's brother (the only other person in the room with two functional hands) to help you stop the bleeding (gotta love 4x4's and coban!). You cannot do this by yourself without making a huge mess.

Once your finger has stopped gushing, stubbornly refuse to hand your patient off to someone else so you can go consult with a doc. Instead, finish the splint and clean up your own mess while your coworker goes to get your NCOIC because he believes you are being stupid.

On the way down to the ER with your very own escort, be sure to protest that it's not a big deal and you will be fine. Make sure you do this while your bandaged digit is leaking blood and you are dripping on the floor.

Once in the ER, make sure you (by some stroke of Karma) run into your old Drill Sergeant. Who is now the ER NCOIC and is doing triage because it is busy. Ensure that said former Drill Sergeant recognizes you. He will love your story about how you attempted to amputate your own finger while working with thermoplastic. In fact, he will love it so much, he'll bring over all of -his- students.

When all is said and done, and you are the proud owner of a numb hand and 7 sutures, by all means, try to get one of the ER techs to let you go quietly by signing your paperwork and trying to sneak out the back entrance. Your former Drill Sergeant will absolutely love it when you run into him in the back hallway on your way back up to work with your 3 day no work profile quietly hidden in your wallet. He'll love it so much, that he will personally escort you back upstairs to your NCOIC's office where you will feel like a private again while they kindly remind you that it's ok to take some time off for yourself.

Moral of the story? If you're going to try to cut your finger off while making a splint, make sure no one is watching.

 

[EM2BE]

It would be poetic justice if she ended up in our unit. Maybe we can contract one of the Dudes Brothers to come pay her a visit. I'm sure they have nothing better to do. Haven't heard from 'em in awhile (at least a week).

Next time you see them, you can give them advice on who they should visit that week.

 

[medic15]

Almost sounds like a bad comic book hero!

"The Adventures of Ambien Boy! Hold on to your seats as he snores more than TWELVE TIMES A MINUTE! Don't miss the excitement as his feet and hands twitch while he dreams of chasing a cat! Coming up in the next issue: Ambien Boy is faced with his biggest challenge yet...how will he cope without...his pillow!"

hmmmm I think i have found a way to make my millions. Now if only i could draw

 

[DropkickMurphy]

When you're making a splint for your patient, please ensure that all fingers are held well away from the leather shears you are using to cut the thermoplastic. If you fail to do this, you will cut your finger.

If, after you've sliced through a finger, do not be shy about asking your patient's brother (the only other person in the room with two functional hands) to help you stop the bleeding (gotta love 4x4's and coban!). You cannot do this by yourself without making a huge mess.

Once your finger has stopped gushing, stubbornly refuse to hand your patient off to someone else so you can go consult with a doc. Instead, finish the splint and clean up your own mess while your coworker goes to get your NCOIC because he believes you are being stupid.

On the way down to the ER with your very own escort, be sure to protest that it's not a big deal and you will be fine. Make sure you do this while your bandaged digit is leaking blood and you are dripping on the floor.

Once in the ER, make sure you (by some stroke of Karma) run into your old Drill Sergeant. Who is now the ER NCOIC and is doing triage because it is busy. Ensure that said former Drill Sergeant recognizes you. He will love your story about how you attempted to amputate your own finger while working with thermoplastic. In fact, he will love it so much, he'll bring over all of -his- students.

When all is said and done, and you are the proud owner of a numb hand and 7 sutures, by all means, try to get one of the ER techs to let you go quietly by signing your paperwork and trying to sneak out the back entrance. Your former Drill Sergeant will absolutely love it when you run into him in the back hallway on your way back up to work with your 3 day no work profile quietly hidden in your wallet. He'll love it so much, that he will personally escort you back upstairs to your NCOIC's office where you will feel like a private again while they kindly remind you that it's ok to take some time off for yourself.

Moral of the story? If you're going to try to cut your finger off while making a splint, make sure no one is watching.

Ah......remind me again why I am glad I'm no longer in the Air Force.

 

[Taliesyn]

4. When your husband has just gotten back from Iraq, having been blown up by an IED and suffering > 80% TBSA burns, it is not benefical to wait until he has woken up from his pharmacologically induced coma, been extubated, and come to grips with his injuries to tell him that he's too ugly to deserve her, and that he should never have bothered crawling out of the building that was shelled. Do this when your husband's CSM is visiting to personally present the soldier with a Purple Heart for his injuries, and Silver Star for going back in THREE TIMES to pull out his battle-buddies.

Holy hell,that is one serious bitch on wheels. I think it's more accurate to say she didn't deserve HIM.

This simply reinforces my belief that most people are inherently evil.

 

[imnotadoc]

as my name implies i'm not a doc. love this thread tho

 

[NKMU]

If you:

-are 19 years old
-took narcotics and muscle relaxants today
-drank a six pack
-have no driver's license
-are on probation

Then some poor choices you could make include:
-stealing your mother's car from her place of employment
-going joy riding and side-swiping a car on the highway in view of an officer
of the law
-rolling your car a couple times
-having your car land right-side-up somehow and then TAKING OFF AGAIN!
-misjudging a curve and driving off the highway
-driving through the front and out the back of a pizza shop that is being
constructed
-explaining all of this in great detail to the nice officer in the room without
your lawyer (as if you have one!) present
-crying excessively and calling everyone "sir" or ma'am" so much that they
want to punch you and are openly laughing at your situation

 

[ISR]

If you burn yourself with hot cooking oil and don't go to the ER for your third degree burns, the best way to get rid of the infection that set it is to burn it out with...

wait for it...

hot cooking oil.

 

[Matt Laneland]

best story I've heard yet..from gyn friend.

see pt in ER c/o vibrator in rectum in 22 week pregnant gal.


goes to evuluate, does pelvic...it's still ON!!! betcha she's thinking damn that engerizer bunny!!

(that kid will have tinnitus rest of it's life)

finally they do 4 finger in rectum removal

pt did well afterwords.

matt
physicianliving

 

[Febrifuge]

Ahh, another satisfied customer.

 

[docB]

This simply reinforces my belief that most people are inherently evil.

I share your belief. I would only add "and stupid" and I think we'd have an excellent dogma for a new religion.

 

[deleted109597]

I thought it was
1. Evil
2. Stupid
3. Drunk

And most trauma patients are at least 2 of those 3.

 

[ISR]

1) If copper bracelets work so good to get rid of pain, then copper bracelets with electric current running through them work better!

2) The quickest way to get the medical staff to take you seriously is to push the nurse call button, start screaming that there is an emergency, then double over laughing when staff sprint to your room because hey! That's the funniest joke ever!

3) The best place for a bottlerocket to be launched is from your rectum. (note: I didn't believe this one until the surgeon fished a piece of the stick out of the kids arse-hole)

 

[MirrorTodd]

3) The best place for a bottlerocket to be launched is from your rectum. (note: I didn't believe this one until the surgeon fished a piece of the stick out of the kids arse-hole)

OW!!! Gives new meaning to phrase, "For every action there is an equal an opposite reaction."

 

[EM2BE]

OW!!! Gives new meaning to phrase, "For every action there is an equal an opposite reaction."

...oh wow...didn't think about that til you mentioned it, and the visual...

 

[Annette]

There was a home video that showed a man letting someone light a bottlerocket to be launched from his rectum. Where is Darwin when we need him?

 

[SoCuteMD]

There was a home video that showed a man letting someone light a bottlerocket to be launched from his rectum. Where is Darwin when we need him?

Wait, wasn't that on the Jack@$$ video.

Ummm...not that I watched it or anything.

 

[DropkickMurphy]

One of our patients learned there is a reason why we ask if you have ANY piercings prior to an MRI. This means ANY, and it really doesn't matter how much you don't think the ED staff needs to know about your Prince Albert.

 

[ERMudPhud]

Wait, wasn't that on the Jack@$$ video.

Ummm...not that I watched it or anything.

Yes it was and I'm not afraid to admit I watched and loved it.

 

[stoic]

One of our patients learned there is a reason why we ask if you have ANY piercings prior to an MRI. This means ANY, and it really doesn't matter how much you don't think the ED staff needs to know about your Prince Albert.

oh my....that can't have turned out well

 

[dhb]

oh my....that can't have turned out well

I'm pretty sure it did turn

 

[ISR]

I'm pretty sure it did turn

You are horrible.

I love it.

 

[ISR]

Do not pick up the pot of oil you've been using to fry that fish with your bare hands. If you do, dont' be suprised when it's hot, you burn your hands, and dump the oil on yourself.

When you come to the burn unit after you're tour of the ER, do not be suprised when you have to go through a debridement shower. When in the shower, of course you should:

-try to punch the nurse debriding your burns. This will earn you 2 point restraints
-when the Rehab Tech (I was in the wrong place, wrong time) attempts to apply the wrist restraints, you should definately kick her in the sternum. This will earn you 4 point restraints
-Screaming threats at the top of your lungs about how you're going to "sue all you mother f*****s, I will own this hospital!" and trying to bite the staff will earn you an ass full of Haldol.

 

[ISR]

I know I have made several posts in a row but...then I read our newest med student's note and had to share.

I know most of you are med students, and I love you guys (I really do), but sometimes the notes you write make me chuckle.

(NOTE: name not included to protect both the patient and the med student)

"Inspected wounds this am. Donor site on back too soup like to harvest, donor site on front crusty but ready to harvest. Almost all autograft placed on last trip to OR has fallen off. Will try again on Tuesday of this week. Will keep repeating this until grafts take or patient dies."

 

[Dunce]

I know I have made several posts in a row but...then I read our newest med student's note and had to share.

I know most of you are med students, and I love you guys (I really do), but sometimes the notes you write make me chuckle.

(NOTE: name not included to protect both the patient and the med student)

"Inspected wounds this am. Donor site on back too soup like to harvest, donor site on front crusty but ready to harvest. Almost all autograft placed on last trip to OR has fallen off. Will try again on Tuesday of this week. Will keep repeating this until grafts take or patient dies."

Way to go, Admissions Committee!
It looks like those cracks are getting bigger and bigger.

 

[doctawife]

Someone needs to teach the med student the fine art of writing 'repeat until dead' without actually using those exact words.

For example:
- pt will continue undergoing grafting procedure as long as feasible or until graft acceptable.
- pt will remain on therapy indefinitely
- given the risks and benefits of ***, which have been discussed extensively with the patient and his family, we will procede with *** knowing that the chance for cure is minimal.

I know other people have written similarly obtuse and circular phrases. Although the need for such phrases is one of the reasons I'm ditching primary pediatrics for PEM!

 

[Wackie]

Way to go, Admissions Committee!
It looks like those cracks are getting bigger and bigger.

*pumps fist in the air*

Yes! Maybe I can fall through!


From last night:

After admiting you have ADD through...*flaps hands* and are "mad at the world", summon security by throwing yourself into the triage door multiple times in an attempt to get ahead of the other panic attacks waiting to be seen.
Bonus points for making the volunteer (me) nervous.

 

[Taaki]

Love it Love it Love it. I love this thread.

It is a GREAT idea to go 4 wheeling at age 18 after consuming large amounts of alcohol, only to be found 30+ minutes later face down in ditch. Please lie to us and tell us that you HAVE NOT been drinking (we can smell it in your blood and pores) and to leave you the F*** alone. Then throw a fit while we try to load you into the helicopter transporting you to a level 1 to have your face rebuilt. All this only a year after pt's cousin died in similar ATV accident.

 

[SoCuteMD]

Can of black beans for your famous "ground turkey tacos": $0.89
Cutting your finger while cleaning up from dinner: free
Tetanus immunization: $10
Having the chief of emergency medicine put your bandaid on for you: priceless

 

[ISR]

Can of black beans for your famous "ground turkey tacos": $0.89
Cutting your finger while cleaning up from dinner: free
Tetanus immunization: $10
Having the chief of emergency medicine put your bandaid on for you: priceless

 

[Anuwolf]

3) The best place for a bottlerocket to be launched is from your rectum. (note: I didn't believe this one until the surgeon fished a piece of the stick out of the kids arse-hole)

http://www.youtube.com/watch?v=DvHZvUQox2o heres more proof that kids really do stick bottlerockets up their asses.

Do not pick up the pot of oil you've been using to fry that fish with your bare hands. If you do, dont' be suprised when it's hot, you burn your hands, and dump the oil on yourself.

When you come to the burn unit after you're tour of the ER, do not be suprised when you have to go through a debridement shower. When in the shower, of course you should:

-try to punch the nurse debriding your burns. This will earn you 2 point restraints
-when the Rehab Tech (I was in the wrong place, wrong time) attempts to apply the wrist restraints, you should definately kick her in the sternum. This will earn you 4 point restraints
-Screaming threats at the top of your lungs about how you're going to "sue all you mother f*****s, I will own this hospital!" and trying to bite the staff will earn you an ass full of Haldol.

good job to the burn victim! (sorry but i just LOVE theses kind of stories)

 

[BKN]

Can of black beans for your famous "ground turkey tacos": $0.89
Cutting your finger while cleaning up from dinner: free
Tetanus immunization: $10
Having the chief of emergency medicine put your bandaid on for you: priceless

So are you depending on your demonstrated technical abilities to get you into the program?

 

[doctawife]

http://www.youtube.com/watch?v=DvHZvUQox2o heres more proof that kids really do stick bottlerockets up their asses.

I particularly like the mega-slow 'OH MY GOD' in the video. Those are some stoopid kids... Oh yeah, they're teenage boys! Silly me.

 

[SoCuteMD]

So are you depending on your demonstrated technical abilities to get you into the program?

OUCH.

I actually offered to put it on myself, but I guess he doesn't have much trust in my ability to band-aid.

 

[deleted109597]

That won't be a good SLOR then.

 

[signomi]

If you want the nurse's attention, you WILL get it if you do the following:
Strip off all your clothes.
**** all over your room.
Sit in the midst of it in the lotus position.
Oh and doing it during shift change gets you bonus points.