Things I Learn From My Patients

Discussion in 'Emergency Medicine' started by docB, May 2, 2003.

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  1. Spectre of Ockham

    Spectre of Ockham

    Jun 17, 2016
    If you are a 32 year old man with pharyngitis the best way to treat it is to show up at the ER at 2:40 in the morning . When asked what have you done to treat it say without batting an eye "nothing" and rate your pain 6/10. This will cause the attending to come over and ask you how did you make it to age 32.

    After the end of the shift I will be able to laugh for hours thinking about your monolithic stupidity.
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  3. Apollyon

    Apollyon Screw the GST Lifetime Donor 10+ Year Member

    Nov 24, 2002
    Dude - in a word -" 'murica".

    You find singular something that is legion and quotidian he in the ol' US of A.
    Spectre of Ockham likes this.
  4. Fox800

    Fox800 That drug that starts with "d"... 10+ Year Member

    Repeat x20 times daily during cold/flu season.

    Don't try Advil then get indignant when I send you home with Advil for pain.
    Last edited: Mar 5, 2017
    Spectre of Ockham and shoal007 like this.
  5. BoardingDoc

    BoardingDoc Don't worry. I've got my towel. 7+ Year Member

    Feb 23, 2010
    While I understand that they derive from different sources, I enjoy the use of both " 'murica" and "quotidian" in the same response.
    njac, meep15 and Apollyon like this.
  6. Birdstrike

    Birdstrike 5+ Year Member

    Dec 19, 2010
    Only one country on Earth where you can do both.


    Sent from my iPhone using SDN mobile
    njac likes this.
  7. Brutus Bluto!
  8. MadScience101


    Dec 24, 2015
    Don't attend a flat-warming party, get drunk and somehow partially sever your pinky finger while climbing like a spider on the underside of a dinner table to impress the ladies.

    When the paramedics arrive, offer them beer too, but don't accept their advice that you should go to hospital...

    Instead, down your beer, tear off your pinky (severing what little tissue was still holding it on), wipe your bloody stump-hand on your shoulder, throw what's left of the finger at them and demand more beer.

    Apologise by offering them more beer too.

    ...second-worst party ever.
    Last edited: Mar 7, 2017
  9. killerleaf

    killerleaf beware, beyond there be dragons 10+ Year Member

    Sep 6, 2006
    dazed and confused
    wait, SECOND-Worst??????
    MadScience101 likes this.
  10. MadScience101


    Dec 24, 2015
    Lol - definately second-worst ;) Just to clarify - I was a bystander during the whole proceedings of hte second-worst-party-ever: I was pretty drunk and offered some very minor assistance...


    But as for the worst party ever...?

    In my third-year Fresher's week (by which point I had gotten bored of the whole idea of "Fresher's Week") I decided to remain sober - and was enjoying some quiet time with a girl I'd met (no, literal quiet-time - get your mind out the gutter - we were reading papers and discussing them!) when I was rudely interrupted by a frantic knocking upon my door.

    My new flatmate, aware that I had attended a 12-hour first aid course the week prior, needed me to help - come quick - it's an emergency!!!

    Lo' and behold - there's a classic heroin-OD right there in my kitchen - needle sticking out the arm, refusing to breathe and turning a magical shade of blue... me, a freshly-trained first-aider? Match made in heaven.

    I can't actually remember if he was having a heart attack as well? I mercifully blanked most of the particulars... I do remember being peeved that I didn't have my cpr face-mask though...

    There was also chille con carne all over one of the sofas... I never did find out what was all about... and the OD-guy? Didn't even say "thank you"! The nerve!

    ...worst-party ever.
  11. killerleaf

    killerleaf beware, beyond there be dragons 10+ Year Member

    Sep 6, 2006
    dazed and confused
    ***makes note to never party with MadScience***
  12. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner SDN Moderator 10+ Year Member

    Aug 2, 2006
    First worst
  13. MadScience101


    Dec 24, 2015
    Lol, it's alright - all my parties are fine - it's always other people's parties that you need to watch out for.

    I have seen people do things like that before... I used to hang out with White-Water kayakers who were all a bit... affected... I fit right in. Obviously we had the introverted folks who were pretty quiet and sensible (I was part of that lot)... and then you had the extroverted people who... well they done daft and stupid stuff - often while drunk. It was one of them who nearly lost his finger table-climbing last weekend incidentally xD

    [edit] - correction: he has lost his pinky finger because the surgeon didn't think it was worth attempting to reattach it - just tidied up the base (he severed it just below the knuckle - youch). I look forward to hearing the "alternative" stories of how he lost the digit!

    Speaking of Kayaking... if it's the middle of winter and there's 2 inches of snow on the ground - don't climb a hill naked - you'll slip, land on your didgeridoo, and slide down the hill...

    When you go to hospital (having slipped and landed on your didgeridoo) - I don't care how sore it is - at least have the decency to wear more than just a coat!

    ...and of course, somebody will have filmed the entire incident on their phone - but you won't find that out until they show the footage at the annual film night.
    Last edited: Mar 10, 2017
  14. netsuke


    Jan 2, 2016
    If you're bothered by arthritis in your knees, call your doctor to request a prescription for the glycerine and Cogentin your friend recommended.
  15. evangeline1313


    Mar 11, 2017
    If your high blood pressure is controlled by medication, that doesn't mean you don't have high blood pressure.
    I've only talked to maybe 20 patients so far and it already happened 5 times.
  16. Why did the surgeon not reattach it? One's fingers are kind of important I'd think. If it was completely destroyed, that'd be one thing...
    Also, landed on his didgeridoo?? I shudder to think exactly what you mean by that :whoa:
  17. meep15

    meep15 2+ Year Member

    Jul 14, 2013
    Working as an EMT has reminded me that everyone lies (or have selective memory recall)

    For example:

    "I have no medical history" - yet has a cabinet full of pill bottles

    "I have no medical history" - No doctor ≠ No history

    "I always take my meds on schedule" - (BP295/130)

    "My back pain is 11/10" - Asks for "that drug that starts with D"

    "I've never taken drugs, EVER!!" - Insert Maury meme: The Narcan determined that to be a lie

    "I slipped and fell on it." - Mystery rectal trophy

    "I keep good control of my blood sugar" - "hI"

    "I only had two beers" - s/p MVA, reeking of alcohol
  18. BoardingDoc

    BoardingDoc Don't worry. I've got my towel. 7+ Year Member

    Feb 23, 2010
    There is a long list of things which make a replant not feasible. Replanting an amputated digit is far less common than simply doing a revision amp.
  19. DissocativFugue

    DissocativFugue 5+ Year Member

    Jul 26, 2010
    Changed it for ya. Everyone's favorite quantity of beer.
    bunchesonothing likes this.
  20. People already made these memes :D
    Last edited: Mar 12, 2017
  21. SpartanWolverine

    SpartanWolverine 2+ Year Member

    Jun 28, 2012
    Chewing on a fentanyl patch is a good way to earn yourself some Narcan. When you rapidly come back from the brink of death and get angry with us for giving it to you, we're not going to feel particularly bad.
  22. MadScience101


    Dec 24, 2015
    Im afraid I'm unaware of the details - I didn't accompany him to hospital. On the other hand, one of the ladies he was trying to impress did accompany him to hospital - so maybe it wasn't all bad.

    The break was pretty mangled looking (he had crushed it off with the table edge (assisted by having his full weight on the table at the time) - there's probably a fancy name for a traumatic amputation by crushing - but I'm unaware of it!) - but I don't know if that was the main reason why they didn't reattach.

    I'm personally quite attached to my pinky-finger - if I must lose a particular finger, take my ring finger - it's not useful for holding stuff... seriously, try using a hammer while lifting your pinky off the handle - it's really hard. Repeat with each of the other fingers for comparison.

    As for landing on his didgeridoo... I refuse to clarify on the grounds that I might incriminate myself... 'nuff said

    Any idea why patients lie so much? I've encountered it myself several times just from witnessing events - now to be fair, there are some times when I can imagine lying about - such as how that cucumber got stuck up there (I mean, who want's to admit that they were climbing a ladder naked when the accident happened? I'd much rather lie and say I wanted some rectal adventuring than admit to my stint in the naked fruit cirque de solei)

    Might be a subject for another thread actually, in fact it's probably been done already and I've just not bothered looking for it! xD
    Last edited: Mar 13, 2017
  23. So it is you! YOU are the Rectal FB Bandit! You sneak in under people when they're naked hanging from slopes or ladders, you move any nearby cucumbers or didgeridoos and then people land on them! And then you sneak away you scoundrel.
    Then people say mad sounding stuff like 'somedude moved the didgeridoo there so I landed on it'.
    MadScience101 likes this.
  24. MadScience101


    Dec 24, 2015
    Thanks! I've been having a pretty terrible day and that has cheered me up no end! :D
  25. Happy to be of service ;)
    Anyway, you've struck again haven't you? Lookit that satisfied grin. And removing the radiopaque tag, of all things :sendoff::cold:
  26. Spectre of Ockham

    Spectre of Ockham

    Jun 17, 2016
    If you are a 63 year old woman and you just had "the biggest diarrheic BM of my life" at 2:40 AM without any other symptoms the right thing to do is to rush to the ER , there triage will make you wait until 4 AM. After I do a basic exam and history (PT took two high strength Imodium pills) proceed I'll show you to my attending (I'm just a med student) who will promptly ask you if you ever had diarrhea before and how did you survived it in the past 60 years without rushing to the ER at 3 AM.
    When asked what you took in order to sound smarter tell the attending that you took two antidiarrheic edemas. I will then be forced to rush to a camera blind sport so I can laugh silently while the attending puts on the biggest poker face in the universe and questions Darwin for the 8th time during one week.
  27. MadScience101


    Dec 24, 2015
    Im not sure how to put this into a concise-lesson format...

    So I'll just tell the story. Had a cracker (and possibly a crack-head) on the bus on the way into work this morning.

    Bus driver gets out the cab and goes upstairs (double-decker bus), drags some stoner out for not paying his ticket.

    The stoner then claims "They took his ****ing keys so he cant ****ing get in the ****ing house to get his ****ing jacket or his ****ing money and I have to be at the ****ing court for my ****ing parole appeal" -- the bus driver tells him to GTF off his bus.

    After finally getting him off the bus, he comes back on shouting about how he "had to ****ing rob the clothes he's wearing off some ****ing washing line!"

    This raises several questions:
    1) What was he wearing before he stole the clothes?
    2) It's been pretty wet here the last three days - how long ago did he steal these particular clothes?
    3) Who are "they" [the people who "took" his keys/clothes]?
    4) If you had to steal clothes, did you steal underwear too or are you going commando?

    Now you may be wondering what exactly I learned from this patient, and how exactly he even became a patient?

    Well, after his outburst... he angrily turned around to go off in a huff... and stormed straight into a lamppost: fell on his backside, and sat there for a bit while the driver pondered what to do.

    The funny thing is that as soon as the driver called an ambulance to come pick him up the guy got up, shambled over to the bus again and asked for a ticket to the hospital - and even proffered money for it - WHY DIDN'T YOU DO THAT IN THE FIRST PLACE!?

    Also, apparently the bus services aren't allowed to transport obvious A&E patients to A&E (he had an imprint of a lamppost on his face - I didn't even know tissues could swell up so much in such a short period of time!) - just in case the patient passes out / dies / gets worse en route.

    They are under obligation to wait for the ambulance to arrive though - I learned many things from this experience!

    -Don't be stealing clothes from washing lines on rainy days/weeks because "they" took your keys so you can't get into your house to get the money to go to your parole hearing at the court at 0600, especially if you do actually have money anyway.
    -If you're going to dramatically turn around and storm off, make sure there isn't a lamppost in your way.
    -Busses aren't allowed to act as ambulances
    -Your face can swell up so much that you look like a cartoon character in only 15-20 minutes (wasn't keeping track)
    -You can be thoroughly annoyed at being made late to work - but at the same time be thoroughly amused as to why you're late to work...
  28. Smooth. Real ninja...
    Wondering what exactly I learned, by pondering whether he's wearing stolen underwear, or none at all..?
    Real Ninja don't need it!
  29. Today, in an NHS hospital setting, I witnessed a 'sectioned' man (what a psych hold is called in the UK) yelling at the staff: 'I've got superpowers and I'm not afraid to use them!' But in the end he didn't, and did not get what he was demanding (to be released) :(
    Lesson learned: if you've got superpowers, don't be afraid to use them!! Only then you may get what you want ;)
    Last edited: Mar 18, 2017
  30. MadScience101


    Dec 24, 2015
    If you get an inch-long shard of metal stuck under your skin while working at a fabrication plant and it's too sore to pull out with tweezers, just leave it in there - it'll come out itself, right? right? Im sure those abscesses will clear up on their own!

    Whoops! It's

    If you end up losing a carrot in your butt, try to blame it on the house search the police performed the week before - those always involve butt-carrotings!

    Whoops! It's Sore-bum-o'clock!

    No, I can honestly say that I would have stopped trying to use the hammer once the head of the hammer broke off the shaft. STOP - no more hammertime.

    Whoops! It's MC-Hammer-o'clock! NB: MC stands for "metacarpals" in this case.
    Last edited: Mar 28, 2017
  31. SouthernGent

    SouthernGent 2+ Year Member

    Mar 28, 2013
    The Neutral Ground
    Don't put your eye close to the drywall when your buddy is on the other side putting in 4in nails with a nailgun.

    Don't put both of your very full, and very hot crackpipes in your vagina and to try and hide them from the police.

    Selfimmolation is not the fastest and least painful suicide method, especially when you consider the near total 3rd degree burn coverage and (eventually) fatal infection you'll acquire in the burn unit.

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