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Things I Learn From My Patients

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

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  1. Apollyon

    Apollyon Screw the GST Physician Lifetime Donor Classifieds Approved 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.
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  3. Fox800

    Fox800 That drug that starts with "d"... Physician 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.
  4. BoardingDoc

    BoardingDoc Don't worry. I've got my towel. Physician 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.
  5. 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
    wholeheartedly and njac like this.
  6. Brutus Bluto!
  7. 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
  8. killerleaf

    killerleaf beware, beyond there be dragons 10+ Year Member

    Sep 6, 2006
    dazed and confused
    wait, SECOND-Worst??????
    MadScience101 likes this.
  9. 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.
  10. killerleaf

    killerleaf beware, beyond there be dragons 10+ Year Member

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

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

    Aug 2, 2006
    First worst
  12. 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
  13. 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.
  14. 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.
  15. 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:
  16. 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
  17. BoardingDoc

    BoardingDoc Don't worry. I've got my towel. Physician 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.
  18. DissocativFugue

    DissocativFugue 7+ Year Member

    Jul 26, 2010
    Changed it for ya. Everyone's favorite quantity of beer.
    bunchesonothing likes this.
  19. People already made these memes :D
    Last edited: Mar 12, 2017
    meep15 likes this.
  20. SpartanWolverine

    SpartanWolverine On the road to rads Bronze Donor Classifieds Approved 5+ 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.
  21. 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
  22. 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.
  23. MadScience101


    Dec 24, 2015
    Thanks! I've been having a pretty terrible day and that has cheered me up no end! :D
  24. 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:
  25. 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 spot 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.
    Last edited: Apr 29, 2017
    wholeheartedly likes this.
  26. 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...
  27. 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!
  28. 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
  29. 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
  30. SouthernGent

    SouthernGent 2+ Year Member

    Mar 28, 2013
    In a practice room
    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.
  31. bbpr120


    Nov 14, 2015
    With your dominant arm lying in the street (along with a leg) after having it removed via a street sign in car v motorcycle accident and medics furiously trying to stop you from bleeding out; make light of the situation by saying that the hardest challenge in front of you is learning how to masturbate with the wrong hand.

    A good friends younger brother was critically injured last week on his motorcycle when a truck pulled out in front of him and he clipped a street sign on his way down. He spent the entire trip to the trauma hospital cracking dirty jokes according to mutual connections and didn't stop till he was knocked out for surgery. Outside of 2 missing limbs, he's gonna "walk" away with only some road rash.
    MadScience101 likes this.
  32. MadScience101


    Dec 24, 2015
    I learned that tennagers shouldn't climb lampposts at 0200 on a Sunday morning.

    Apart from the obvious streetcred from hanging off a steel post 8m (26ft) in the air - you wont be able to get back down yourself.

    Your friends will fetch a ladder, set it to the wrong length, prop it up against the lamppost and send the largest guy in the group up to help you: this will cause the streetlight to suddenly bend, throwing you 8m (26ft) to the ground where your pelvis will pop like a party balloon.

    (Loudly) blame the guy they sent up the ladder for your current predicament. It's definitely his fault.

    Oh, and you'll also get charged for stealing that set of ladders, and for a new lamppost.

    Continue blaming your friends for this - especially the guy they sent up the ladder.

    It's totally their fault - but the streetcred was worth it.
  33. swoopyswoop

    swoopyswoop 2+ Year Member

    Dec 23, 2013
    Maybe I'm old and grumpy, but this thread is intended for medical professionals to post their stories, not for random people to post stories they think are amusing but which are not really relevant.

    The point is that we find things amusing from a different perspective than you recounting your night in the ER or your friend's trip in an ambulance.
  34. cubanlink

    cubanlink Apex Predator Gold Donor Classifieds Approved

    Aug 16, 2016
    Bronx, NY
    Wait why what happens if you do this?
    Aquar1us likes this.
  35. OH that thread
    Domperidone likes this.
  36. elcollins95


    Feb 23, 2016
    Saw a pt recently who non-traumatically dislocated their shoulder "washing dishes" (?!)
    The cocktail of drugs we ended up giving after NOx failed meant that our pt was more than a little stoned.

    The lesson?
    The appropriate response to 'how's your shoulder feeling now?' is not 'much better thank you' but:
    "I can't feel my shoulder, you must have stolen my shoulders! I can only feel my toes, don't steal my toes!" while sobbing hysterically.
    Other gems included (to the nurse) "You have no noooossse!" and "You have eleven eyes!"

    We all had to take it in turns stepping out to giggle at the poor patients 'stolen shoulders'. The best part was they work within the hospital so they will never forget about their antics!
  37. theseeker4

    theseeker4 PGY 1 Physician 5+ Year Member

    Apr 20, 2011
    Suburban Detroit, MI
    If you have BPH and are suffering from urinary retention, and you have failed to void all day, the reasonable solution is right there in your kitchen. Don't waste time by going to an actual doctor, just grab a drinking straw and thread that baby up your urethra. True, you might have some issues with the 90 degree turn a few inches in, but don't let that keep you from trying. The pain and bleeding is also perfectly normal.
  38. CajunMedic

    CajunMedic 7+ Year Member

    Mar 23, 2009
    Ethel, LA
    If you are a diabetic washing off after a long day in the oilfield, it's perfectly OK to use the industrial pressure washer to wash the mud, drill fluid, etc. off of your boots, be sure to leave them on. And when you accidentally spray the leg point blank with said pressure washer, wait almost 24 hours until the leg swells up and starts oozing to drive yourself to the ED. The gas pattern from the necrotizing fasciitis looks real pretty on X-ray and will buy you a high-speed trip to the OR. They hung antibiotics I'd never heard of today and are pondering a second trip to the OR in the AM.
    njac, evilbooyaa, AlgernonMed and 5 others like this.
  39. PDXErik


    Nov 3, 2017
    This thread just got $90 worth of pizza delivered to my nearest ER/ICU

    Just a head's up, Godfathers discounted it by %50 just for you folk.

    <3 you all

    Also, I did try to send it from "that guy" just SOCMOB, don't know if that will make it to the end, tho
  40. PDXErik


    Nov 3, 2017
    This is pt taking it in humor the same way you guys do. Gotta have some props for that.
  41. PDXErik


    Nov 3, 2017
    Just a head's up, I blew $50 on $90 worth of pizza that is sitting on a cart in triage just getting cold. Drop shipped from Godfathers. The staff was uncooperative in trying to get these pizzas to where they should be.

    So, Providence Medical, BVTN, yall didn't get pizza, but that's not my fault for trying.
  42. SpartanWolverine

    SpartanWolverine On the road to rads Bronze Donor Classifieds Approved 5+ Year Member

    Jun 28, 2012
    Thanks for thinking of your local hospital staff. It's super nice when people make gestures that show appreciation for the hard work that gets done. Sorry it sounds like it didn't end up working out exactly like you hoped, but hopefully it ultimately made it back to the staff room. Cold pizza is still good pizza!
  43. CajunMedic

    CajunMedic 7+ Year Member

    Mar 23, 2009
    Ethel, LA
    That apparently you can have pertussis, even as a vaccinated adult (apparently he got sick while in the Army). But more important this visit is the barking seal cough and stridor. Do a soft tissue neck X-Ray, classic steeple sign. So not only has my middle-aged patient had pertussis as an adult, he now has croup as an adult. Got some nebulized Lidocaine for that one.
  44. Lovelace09


    Nov 22, 2017
    Non-medical person here, but grew up with my mother in a medicine-adjacent field and got to hear a few good ones. I enjoyed reading this thread so much that I thought I'd pass on one of hers and one from the patient's end of things.

    From my mother, who did her PhD in medical applications of educational technology and spent most of her degree dealing with the faculty of medicine: No, Google Translate is not a massive leap forward in patient-doctor communication. Thankfully, the genius PhD student who came up with that breakthrough decided to ask my mum to help him test it before he brought it to the ER where he works.

    "Hey, do you speak any languages other than English?"
    "A bit of French, why?"
    "I had this idea. Can you help me test it? I'll be using it in the ER, so..."
    Input: <I'm sorry, you are dying.>
    "Alright, does the French look right?"
    Output: <Je m'excuse, tu es mort.>
    "It says 'excuse me, you're dead'."

    And one from the patient's perspective: If you had emergency surgery due to a lodged kidney stone, and were informed that there was one still in there that the surgeon didn't manage to get, here is what not to do. Wake up noticing that you're experiencing the exact same symptoms as last time, and since your cousin told you he passed a kidney stone at work once you should just start taking the leftover heavy-duty painkillers from the first surgery and keep going about your business as usual. Don't tell anyone this is happening. After all, it's only a few weeks before Christmas, your mother-in-law is in town for the holidays, you hate hospitals and your wife and daughter are both worriers. Schedule an appointment with your family physician in a few days to make sure it isn't anything really serious and go about your business. Walk to work when it's 30 degrees below freezing because you know not to drive with the painkillers.

    Then act completely shocked when your GP freaks out, gets you on the phone with the surgeon from the last time you had this problem (who happens to be the only person in the city at the time qualified to do that particular surgery), and instructs you to show up to the ER where that specific surgeon works first thing the next day with a note from your GP, the surgeon will try to fit you into his schedule. He goes on Christmas vacation the next day, so if you don't get surgery that day you will need to be airlifted to Vancouver. All because you don't like hospitals and put off a visit for two weeks for an issue you knew could need emergency surgery because you've already needed emergency surgery once for that exact issue.

    My dad is a really smart guy most of the time, but he can be a colossal idiot sometimes.
    Last edited: Nov 27, 2017

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