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

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    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

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    Dude - in a word -" 'murica".

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

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

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    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
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  5. BoardingDoc

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

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    While I understand that they derive from different sources, I enjoy the use of both " 'murica" and "quotidian" in the same response.
     
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  6. Birdstrike

    Birdstrike 5+ Year Member

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    Only one country on Earth where you can do both.

    Sincerely,
    Bluto


    Sent from my iPhone using SDN mobile
     
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  7. Aquar1us

    Aquar1us 2+ Year Member

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    Brutus Bluto!
     
  8. MadScience101

    MadScience101

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    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

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    wait, SECOND-Worst??????
     
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  10. MadScience101

    MadScience101

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    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

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    ***makes note to never party with MadScience***
     
  12. Dr.McNinja

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

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    First worst
     
  13. MadScience101

    MadScience101

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    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

    netsuke

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    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

    evangeline1313

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    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. Aquar1us

    Aquar1us 2+ Year Member

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    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

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    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

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    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

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    Changed it for ya. Everyone's favorite quantity of beer.
     
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  20. Aquar1us

    Aquar1us 2+ Year Member

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    People already made these memes :D
    [​IMG]
    [​IMG]
    [​IMG]
    [​IMG]
     
    Last edited: Mar 12, 2017
  21. SpartanWolverine

    SpartanWolverine 2+ Year Member

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    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

    MadScience101

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    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. Aquar1us

    Aquar1us 2+ Year Member

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    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'.
    :sour:
     
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  24. MadScience101

    MadScience101

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    Thanks! I've been having a pretty terrible day and that has cheered me up no end! :D
     
  25. Aquar1us

    Aquar1us 2+ Year Member

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    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

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    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

    MadScience101

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    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.
    +pity+


    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. Aquar1us

    Aquar1us 2+ Year Member

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    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. Aquar1us

    Aquar1us 2+ Year Member

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    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

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