Things I Learn From My Patients

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There is a policy at my hospital that every trauma patient who has a +UDS must have a psych consult. After 2 weeks, you hear some interesting excuses as to how cocaine got in their urine.

"My boyfriend does coke and we had sex about 2 days ago"

"I cut myself with a razor I picked up off the ground, maybe there was coke on that"

"I think my kidneys must make cocaine on their own"
 
UTox +opiates with ~$200 of heroin in her purse: " I don't use drugs, I rub it on my gums to stop the pain when I have a toothache."
 
my favorite c/c last week.
we just got a guinea pig and I have a st and runny nose so I want to be screened for swine flu.....
(what, guinea swine flu?)
 
spacemummy said:
If you are a 500-pound female and want to have sex, you can have YOUR SISTER hold your folds of abdominal fat up out of the way while your husband does the job...

A 500 pound woman came into the ER and found out she was pregnant. When the doctor asked how she was able to even have sex, she casually replied, "Oh my sister holds up my belly for me." (Rural Arkansas).
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Or, if you aren't that close with your family, your man can just slip a slab of wood under your pannus to lift it out of the way.

You will be asked when presenting to the emergency department how you acquired so many cuts with splinters in them on your abdomen, to which you will reasonably reply, "Oh, that's from the board." Confused, the nurse will ask what board, and you can then explain how your lover uses a board to gain access.
 
I have been reading this thread for years now and I am very pleased to be able to add my own humble examples of what I have learned...

1. During your examination (when I am desperately trying not to lose my lunch due to your god-awful smell) it is appropriate to complain about the grandmother you were sitting next to in the waiting room who "smell like she piss in her f***in' clothes or somethin' " loudly enough for the whole department to hear you.

2. If you get drunk and decide to dance, don't fall over and fracture your tibia. If you do, don't wear expensive lingerie to the hospital. If you must, please wear something over it. If you can't manage that, don't be an overweight, sweating mountain of a middle-aged man.

3. Apparently if I ask you if there is any chance you could be pregnant, it is acceptable to answer 'no' even if you have had a LOT of unprotected sex and you skipped your last period.

4. If you drop a refrigerator on your hand (but it isn't badly injured) by all means use the same hand to punch the fridge to let out your frustration- and fracture your 4th and 5th metacarpals.

5. If you are my patient and I advise you of your normal radiograph, go ahead and yell that you "know" your arm is broken and demand drugs. When security arrives and you engage in a struggle with them, you may just prove me wrong.
 
If your seventy year old wife has been constipated for longer than you remember, do not use the garden hose on high pressure every morning for 5 years as an enema. When you bring her into hospital with a rectum wide enough to fit a basketball in, you will be asked some tough questions by attending medicos.😱
 
If you are a drunk patient who has been put in the isolation room and everyone ignores you banging on the door for an hour straight, just bang on it for another 3 hours. Alternatively, try banging on it with your shoes, head, or any other object you can find. This is sure to make the ED staff empathize with your situation, let you out, and make you a warm cup of cocoa.
 
when your wife leaves your 10 yr old parrot outside in the heat and it dies, don't throw "the empty bottle of tequila because i wanted to drink the full one" at her, have her run over your left ankle/foot with the car, then pop 25 valiums and drink said full bottle of tequila to get rid of the pain
 
Please don't tell me that your brother is the baby daddy.\

Just don't. The paperwork is horrendous.
 
"But Doc, I swear...I never use cocaine...it must be something I ate that made my urine positive for coke."

Top 5 things that makes urine drug screen false positive for cocaine:

1. Rocephin 1 g.....+ cocaine
2. MultiVitamins......+ cocaine
3. Vanilla ice cream+ cocaine
4. pretzels.....+ cocaine
5. starbucks coffee....+ cocaine:laugh:
 
Even if your expensive rocket style firework doesn't work it's not a good idea to lay down on your side and try to stick a propane torch up under it to set it off.
 
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Do not shoot bottle rockets at your friend's head, no matter how funny you think it might be.
 
Go ahead and light that m160 and crouch nearby with your butt facing the rocket. Your wife won't laugh at you on the way to and from the hospital.
 
If you steal your momma's car, get in a police chase, and then flip and wreck said car...you'd better be more afraid of your momma than you are of the police. :meanie:
 
That it is not a good idea to put several Black Cat fireworks into a beer bottle, light the wick, and then hold the bottle up to your face so you can get a closer look at what happens............
 
Just learned this one tonight: "I was receiving 100mg perscriptions of Methadone from my doctor until he lost his license" = I was getting drugs until my drug dealer got caught and went to jail.
 
If you happen to have a condition-dependent rash, it would help to know your condition for me to even have a shot at guessing the rash.

Like that third trimester pregnancy... you know, why you keep having weird "gas" pains. And no period for, like, 8 months.

(She was a nice enough gal, just didn't put two and two together. Once we figured out she was not only pregnant, but very pregnant, the pruritic and urticarial plaques and papules made a lot more sense.):laugh:
 
If you are a SI/HI psych patient that is drunk and high, with "PSYCHO" tattooed across your abdomen and have to be restrained due to being combative, you should definitely whistle ear-piercingly-loud to get somebodies attention. When we come to find out what you want, tell us that you want the f*#k out.

When we tell you that you can't be let out of the restraints, cuss us out some more and keep up this act of whistling and demanding to be let out so that we just draw your curtain, shut the door and ignore you. Because after a while you'll stop whistling because you want out and start whistling because you really need to crap.

Since we can't tell the difference we'll keep on ignoring you. You should then stick your butt out the back of your gown, between the rails of the gurney, and proceed to take the largest crap in history all over our floor while somehow managing to keep yourself strikingly clean.

Oh and be sure to be Hep C positive for all this, it will really brighten your nurses day!
 
If I may....

I've learned the following from what patients I've had in the prehospital setting some years ago. They're worth noting.

1. Don't use your foot to stop the moving heads of a stump grinder.

2. Don't dangle from a tree limb with one hand and try to use a chainsaw to, again one handed, cut the limb.
 
as a second year med student i australia, i have to laugh in the summer months when it comes time to do a little rotationing.

some important things i have learned so far from shadowing:

1. No matter how well it worked on Jackass, lubing up a toy truck and shoving it as far up your anus with a wooden spoon handle as can is not a good idea. Doctors were not impressed when they discovered the reason for the severe rectal bleeding and obvious swelling of the abdo and ragin feever from a ruptured large intestine.

2. It is never a great idea to train surf in Sydney where all the tunnels are designed to only just allow a train to pass, and the electrics for the trains is all over the tunnel front, no matter how much fun your friends tell you it is.

3. Do you really expect me to believe that puncture marks, multiple bilateral fx of the ulna / radius and lac to the head is because you "fell off the steps" at the front of your house, especially when I heard your husband coaching you through it in the triage room?

4. The police are not going to take the handcuff connecting you to the bed rail off because you want a smoke. No matter how much you tell them that you can be trusted.

Can't wait till they ;et me loose on the patients myself! Atleast as a shadow atthe moment I am able to hide behind the doc and have a very quiet giggle at the stupider accidents. Not sure what I will do when it is just me. Love EM though! Already know it is what I want to do with my degree!
 
just an ED volunteer but here are some things i've learned 🙂


if you are a 23 yo male who got into a drunken bar fight thurs night, by all means wait until sunday to come in for that nagging headache you have. then when you are told you have to be admitted due to your rather large intracranial brain bleed, go ahead and rip out your iv in front of the charge nurse and threaten to leave...you will buy yourself a stay in the psych room, some soft restraints and your very own safety officer while you wait for your ICU room to be ready.


if you are a 32 yr old male who has been t-boned in a MVC and tell the paramedics that your fingers/toes "feel funny" thereby activating the code yellow trauma, do not be surprised when you arrive that no less than 15 people are in your room while you move your fingers/feet while strapped to backboard then yell at us when we tell you that is not a good idea...nor should you decide that ripping off your c-collar is a good idea when it is discovered you have a c-3 fracture of your vertebrae...you will be given a free pass to hard restraints and a safety officer
 
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Don't arrange to play an evening game of soccer with your cousins and friends. They may all happen not show up (...so none of their names are important), and an unknown, curiously angry group of assailants may happen to arrive instead.
 
My profession is not connected to the medical field at all. I came to this site by way of a link from Coyote Blog. Once I started reading this thread I couldn't stop myself. I've laughed so hard that I almost blacked out and have actually learned quite a bit. I would like to share two stories that I think belong in this thread.

The first one concerns a man who was brought to the Emergency Room after wrapping his Cadillac around a telephone pole at 3 AM. After about 15 minutes of his ranting at the top of his lungs about how much better the City he came from was than the "hick town" he was in, he was finally examined by an extremely good looking triage nurse. After the examination was done, he explained in graphic terms, what he would like to do to the nurse, if only he wasn't handcuffed. That wasn't a smart move, considering that the cop on his left was the nurse's brother and the one on the right was her husband. When you add the fact that the only person close enough to be a witness (me) had dated the nurse in high school. Needless to say that not all of the bumps and bruises on that guy came from the wreck. Damn klutz kept falling off the gurney.

The second one concerns people who think that the helipad is their own private parking lot. I spent some time in a Navy helicopter squadron. One day we had a guy get his lower leg crushed in an accident on board ship. While ship's Medical was getting him stabilized to be transported, we flew one of the Doctors in to a local hospital with x-rays and other information needed to try to save his leg. When we got to the hospital, the helipad that was used by LifeFlight was too small for our helicopter. The other, larger pad was covered in parked cars, ignoring the No Parking signs posted all over the place. We finally lowered the doctor and myself down by hoist. While the doctor took care of his business, my job was to get the helipad cleared so that the helicopter coming in from the ship, in about 30 minutes, could land to unload. I found the person who ran the PA system and she made several announcements asking people to move their cars. Several people did come out and move their cars, but about a dozen didn't. That was about the time I found the big Hyster forklift, with the keys in it. I had the helipad cleared in about 5 minutes, directed the helicopter in, unloaded the doctors and the guy with the bad leg, then I jumped in the back of the helicopter and we flew back to the ship. I don't think that I even shut down the forklift. I felt that they were lucky that I only moved the cars on to the grass, I thought briefly about stacking them on top of one another. I never heard anything else about it.
 
- It's ALWAYS a good idea to listen to your friends and stick a Roman candle up your ass. It's even a better idea to light it to try to get it out.

- Yes, Drano does clear clogs. Only in your house plumbing. Not in your actual body plumbing.

- Calling me, your ER doctor, a "dirty chink" that came and "stole your jobs" is always a great start to the conversation.

- Burning your pubic hair usually results in fried testicles.
 
Kittenmommy said:
I... what is this, I don't even... 😕
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I'm Asian, but born in Canada and last week they wheeled this guy who had accomplished to nail gun himself to a board into the ER.

I go in to take a look at him and he goes "I don't want no dirty chink doctor that moved here from China! Them chinks, they steal our jobs! He doesn't even know how to speak English!"

I just smiled and went "I'll be back with your tetnus shot."

We ran his Alberta health card and he hadn't paid his premiums. He was pissed when he got the government bill. Made me feel better though.
 
Kittenmommy said:
So, not the brightest bulb on the Christmas tree. 🙄



Oh, niiiiice. Except, you know, not.



Beautiful! 😀

And a tetanus shot is no picnic for some people; I feel run down and really crappy for days afterwards. Let's hope he's in that group too. 😉
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That was a great day. We had that wonderful fellow, a few guys who drank a bottle of hairspray, a kid who had his friend drive him to the hospital on his bike because they had been "cage raging" and didn't want their parents to find out.

The next day we had a kid come in really confused as to why his penis was sore. He had just had it pierced he told me.

Didn't tell me that it was self done...with a safety pin. And that was steralized with a cooler....and the "ring" he had in was a safety pin.

God, I love rig pigs.
 
Messier said:
- Burning your pubic hair usually results in fried testicles.
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...but not always...

Roommate first year in college (military school) would cut his pubic hair with a lighter. One day, he got a self-sustaining fire burning. We got a picture of it (he covered his junk with his hand). Unfortunately, the ******* that quit before he got drummed out took the pic with him (although he didn't take it originally) when he left.

Edit: the fellow with the burning pubic hair wasn't (and isn't) the *******. The guy with the "fire crotch" is actually a really, really cool guy.
 
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I'm a bit of a lurker here, and I'm not a doctor-- though I've worked in a pharmacy for years-- and I have a few conditions that require doctors every so often. Things ER nurses have learned from me:

- If your patient self-catheterises, by all means try and insert an in-dwelling catheter while the patient is lying down. It will fail.
- If, by some stroke of luck, your patient cannot insert it while lying down, it is best to let them insert it the way they self-catheterise.
- After patient gets the indwelling catheter in, have the good grace to look surprised and say that they've never had this sort of issue with catheter insertion before.
- The next time the patient comes in through the ER, their mother will let the staff know that her daughter [the patient] should be the one to insert catheter.
 
As a student on the Trauma rotation, I learned that at times a Foley will miraculously improve your GCS.

In the ED, I continually learn that you can have 10/10 pain while sitting comfortably and eating potato chips.

Some people have multiple but very specific allergies. Such as, being allergic to all of the less-potent painkillers.

And my favorite (as pointed out to me by my senior resident) I learned that patients that state that they have "Multiple Personality Disorder" more likely have multiple - Personality Disorders. 🙄
 
Do not buy unknown pills from a stranger on the streets that are 'motrin'. You might end up with priapism for 2 days.......
 
Things I've learned from my patients...

- syphilis is what happens when you're 17 and you "can't remember" how many partners you've had. When I ask my shining star of propriety if he thinks he can count the number of partners he's had on his fingers and toes, or if he's had more... the sheepish look will say it all. And so will the chancre.

- sending any pediatric patient home before the diff is back is a bad idea. Usually, when the diff is taking forever, THERE ARE BLASTS. I'm just sayin.
 
Something I learned from my husband:

If you are prone to staph and MRSA infections 2/ infections from last 2 deployments(the sandbox is very dirty) by all means ignore the pain and rash on your back that is suspiciously familiar and continue with WLC until you have an abscess the size of half an egg with a lovely fever to go with it. Points for being able to gross out the Airborne Medic who then insisted you be taken to base ER, extra points for having the 2nd largest abscess the asprating medic had ever seen. And yes, particapating in the ruck march the next day is the best course of action you can take.
 
If you've broken a heroin needle in your groin and managed to not need surgery, feel free to add a second one right along side it, wherever that first one may have gone.


A work note will not get you out of having to go to work tonight, if you're a "working girl" with a huge labial abscess

if you take enough "dilaudid, trazadone, tramadol, seroquel, and percocet for 'missing disc', " you won't care either that you're losing your eyesight because of nasty diabeticized eye infection or that you're not taking your antibiotics because you "don't have medicaid" or that you're sleeping throgh your optho appointments "because they are too early for you"
 
when trying to hang oneself: a vacuum hose around your neck that is duct taped to the ceiling is not effective. If it fails the first time, just try it again. When that doesnt work, and your friends bring you to the ED, just let the medical provider know that you have figured out the problem and as soon as you leave -- just plan on using more duct tape.

I am sure that is all it will take to work that third time.
 
when you come to the ER...
please be very, very surprised that the cops and health care professionals don't look like they believe you when you say that the 25lb infant in a large carseat "flew" out the backseat window while you were going "10 miles an hour" has a bruised, partially collapsed lung. really. your shock will cause us to reconsider our opinions. humbly.

ALSO!
when you find out that your brother has drowned, please run into the room praying, then proceed to swear, talk dirty, and fondle his penis... talking about the children you're supposed to have together. furthermore, please also look at everyone else like they're the crazy ones at this point, pointing out to us the extremely agonal PEA on the monitor as "look, he's responding!".

i know everybody greives differently... but... your brothers penis!??!!

p.s. it's also my fault, as the nurse who spent over an hour trying to revive him, that he decided to swim in a dangerous river with a BAC of .382.
 
When your loved one is a known user that really enjoys free-basing, by all means, if you find him unconscious yet again, just leave him there. He will wake up, right?

But of course, finally act like the concerned family member when 36 hours later he doesn't wake up, and bring him into the ER. When in the ER yell and scream at the staff complaining that they are doing nothing to treat your beloved family member, and ask about those funky sores (pressure sores from being left down), that bump on his head (hematoma), and why is he making is arms move like that (posturing)??

Oh, and don't forget that Jack Daniels makes for one hell of a good perfume....
 
When getting a mammogram please don't bother to turn off your phone. Be sure to answer it while the mammographer (me) is in the middle of taking your medical history. When the mammographer asks you to turn off your phone, ignore her and start chatting about your dinner plans.

When the mammographer insists that you turn off your phone, have a hissy fit and tell the tech how rude she is to interrupt you.

During the actual mammogram be sure to be as uncooperative as possible to show your displeasure. After all, if the tech doesn't get good pictures that's her problem right?

When the mammo tech goes to check your films for quality, refuse to wait to see if she needs repeats. Insist on getting dressed and going out to the lobby to finish "The very important phone call that you so rudely interrupted."

What's weird about this story is that when I went to the lobby to tell the patient that she could go, she then said "Thank you for being so good with me - even when I wasn't". :wow:
My son's theory is that when she called her friend back to complain about my 'rudeness' she probably got told off by her.
 
As you come to the ICU to visit your loved one who crashed head first into a brick wall with a blood alcohol level of 0.387, make sure you blatently ignore the rules of the ICU. Bring along several 3 and 4 year old children, the ICU staff won't mind babysitting, right?

And, of course, allow your child to run into a room on the far side of the ICU, as I am running a code. Apparently, it is OK to allow your child to have a great view of a code from within a room, just like the ER show, right (exact quote from the parent)?

Then...refuse to leave the ICU as I remove your other child from a MDR acinetobacter, MDR pseudomonas, and C diff room. And finally, scream and curse at the top of your lungs and threaten to sue the entire hospital as security removes you from the property.
 
I have been an attending for 10 years and I just learned addict CPR. If your boyfriend has had an extra large dose of heroin and has been lying on the floor, unmoving, cyanotic and cold for 3 hours, he can be revived by taking his pants off and kicking him in the junk a few times. Call 911 later, after the stash has run out.
 
Sleepngprincess said:
I have been an attending for 10 years and I just learned addict CPR. If your boyfriend has had an extra large dose of heroin and has been lying on the floor, unmoving, cyanotic and cold for 3 hours, he can be revived by taking his pants off and kicking him in the junk a few times. Call 911 later, after the stash has run out.
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That makes me think of "Dead Man on Campus" - Cliff: "Kick me in the junk!"
 
Gotta love a pre-med acting all offended that people get frustrated by the idiots they have to deal with.

Here's a good story.

If you have a psychiatric disorder don't quit taking you meds and start taking PCP. You will go bat**** crazy, eat the eyeballs out of your five year old child's head, then attempt to amputate your own leg with a hacksaw. Granted, you might avoid jail time for it, but none of you health care providers will like you very much (especially the ones that had to take care of your kid who came in saying "daddy ate my eyes")
 
Actual, (sad) lessons from patients
-If the car in front of you stops mid-block and you can't see why don't swerve around it and keep going at full speed, you will probably hid the kid he stopped for.
-If children are near water, make them wear life jackets even if it is hot and uncomfortable and even if they are done playing in the water.
-Don't leave a crying toddler with your new boyfriend while you go out looking for drugs.
-Don't leave a 3-9 month old on a regular bed near a wall, they can roll over but they can't roll back.
-Always check behind your car before backing out if there is any chance children are near.
 
Depakote said:
If it is 445am and you are standing outside the ED in your hospital gown, go ahead and assume the coat and scrubs mean I'm not going to give you a cigarette as I walk into the hospital.
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Hahahahaha!! Reminds me of a drunk driver I picked up once: "Any chance I could finish my beer before we go?"
 
Point the nail gun away from your body......
 
Hey all. Im not part of the Medical field, nor do I plan to be, but I just wanted to stop by and thank all of you for the hard work and crap that you put up with from people, regardless of whether they are the best or the worst of what humanity has to offer.

This thread has given me a good week's worth of laughs during my downtime at work, and, even better, a good night's worth of conversation with my mom, who was an ER Nurse for the better part of my childhood. (She laughed especially at the Diabetic Glazed Foley Circuit guy.)

And now, for my personal experience (from just last week) to add to this thread.

If you are going to be performing Oral sex on your girlfriend, please make sure that all piercings are firmly attached to her body. Otherwise, you may end up swallowing said loose piercing.

It may require a trip to the ER, with you barely able to speak, so that your girlfriend has to try to explain everything to the visibly amused Doctor and Staff. Of course, when the doctor misunderstands, and your girlfriend has to clarify that it was HER piercing you swallowed, you can feel free to begin laughing as you realize that the Doctor is trying SO HARD (and failing) to keep a straight face.

This will cause said piercing, which is (not so comfortably) lodged somewhere in your esophagus, to move, which then will cause you to vomit and dislodge it, causing it to end up in the puke bucket they gave you, amongst the some blood and the rest of your stomach contents.

All I can say is that I am so glad that so many of you guys share the same sense of humor that I do. I'm also glad that that sense of humor helped with the laughter helped spare me some very uncomfortable procedures, should the piercing have remained stuck in my throat.

Thanks a ton, you guys!

Edit: Also, I gotta say, that GI Cocktail worked wonders for soothing the pain in my poor shredded esophagus
 
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NursesSon said:
If you are going to be performing Oral sex on your girlfriend, please make sure that all piercings are firmly attached to her body. Otherwise, you may end up swallowing said loose piercing.

It may require a trip to the ER, with you barely able to speak, so that your girlfriend has to try to explain everything to the visibly amused Doctor and Staff. Of course, when the doctor misunderstands, and your girlfriend has to clarify that it was HER piercing you swallowed, you can feel free to begin laughing as you realize that the Doctor is trying SO HARD (and failing) to keep a straight face.

This will cause said piercing, which is (not so comfortably) lodged somewhere in your esophagus, to move, which then will cause you to vomit and dislodge it, causing it to end up in the puke bucket they gave you, amongst the some blood and the rest of your stomach contents.

All I can say is that I am so glad that so many of you guys share the same sense of humor that I do. I'm also glad that that sense of humor helped with the laughter helped spare me some very uncomfortable procedures, should the piercing have remained stuck in my throat.

Thanks a ton, you guys!

Edit: Also, I gotta say, that GI Cocktail worked wonders for soothing the pain in my poor shredded esophagus
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That sounds like something that should've made it into Chasing Amy 🙂:laugh:
 
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