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"Things I learn" & "Medicine Sucks" discussion thread
Started by spyderdoc
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Doctors make the worst patients as we disregard most things that are not life-threatening and justify everything to be benign.
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This would be why I have my own personal supply of dermabond in the kitchen junk drawer, along with a ridiculous number of steri-strips (the latter mostly used for repairing inorganic objects like my bike lights). Cheers,
M
😀
That's awful... Yes, many of us have dealt with such tragedies at work and/or in our personal lives, but it doesn't make it any less horrible.
Epic. Freaking. Win.
Veterinarian transitioning to human medicine here. What's so incredible about it? A lot of treatments that are used on humans have been pioneered on animals. Which, of course, is not the only reason to do those procedures on animals...who have a worth of their own quite independent of their existence as someone's pet.
You can't imagine spending that much money on a cat? Fine, that's your choice. But to make a blanket statement that it's probably better just to have them put down...not very compassionate.
$20K for a kidney transplant for a cat at UC-Davis? Millions of cats in shelters, where you can adopt for $50? And, as you are transitioning to human medicine, have you ever seen a human with cancer getting chemo? If you want compassion, that ain't it. MANY patients choose to just expire with their cancer, instead of suffering the indignity and torture of certain types of chemo - the "cure" is only differentially less horrible than the disease.
That's good to know. So far, Sammy is incredibly healthy. We're keeping our fingers crossed! 😎
To be honest, I think it is weird, and in a way, sick.
If it was up to me, I would put some sort of arbitrary limit on medical procedures for pets, call it 1000, and automatically adjust it for inflation.
Any major procedure over that wouldnt be illegal, but would be taxed at 100%, and the money given to local/state free clinics or childrens hospitals.
Sure, if you want to spend 10000 on a cat, go ahead, but you will be assessed a tax of another 10K, and that will go to a human.
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Our cats (and our beagle) are more than "pets" to us. They're our children, and we treat them accordingly. They're little lives that we're responsible for, and since we took on that responsibility, they deserve the best lives we can give them.
None of us can save everyone. There are so many sad things in this world, and no one can address all of them. I can't save every cat on the street, and you can't save every child. But we do what we can to make our little corner of the world a better place to be. 😳
I agree with Jbar. Can we please end the "medical care for cats" discussion and continue the initial focus of this thread. Those of you that want to argue about cats, dogs, rodents, and whatever else pets you have and their care can start their own thread.
I will not let this thread die as well.
I too agree.
I thought the moderators were going to move these kinds of topics to the "Things I learned from my patients DISCUSSION THREAD". The cat lady and her friends have nearly killed one of the funniest SDN threads.
Of course, I guess I am not helping with this post.
Sorry.
Thanks, HH
I don't think this thread is dying at all. For a great thread to last this long and have a few random off-topic tangents is part of the inevitability of something lasting this long. Then again, I don't know why kittenmommy brought up the cat things in the first place when it clearly had no purpose in this type of thread.
docB had 4 great recent posts, like the one below:
It's amazing about the myriad people responding to different situations with different responses. It must've been hard for the family to be caught in a bad situation, but I find the mother's proactiveness amazing.
At any rate, keep up the stories while I put off studying for immuno tomorrow 🙁
docB had 4 great recent posts, like the one below:
It's amazing about the myriad people responding to different situations with different responses. It must've been hard for the family to be caught in a bad situation, but I find the mother's proactiveness amazing.
At any rate, keep up the stories while I put off studying for immuno tomorrow 🙁
I know you guys wanted to steer off the animals... but I just wanted to say... animals actually cope really, really well with chemo compared to humans. We don't need as high doses to achieve remission - and realistically, you generally only need a max 5 year remission for them to live out the natural term of life and die of old age. The experience is completely different. I interned with a veterinary oncologist and at the start of the week I asked him "don't you find it so depressing that all your patients are so sick?" And he said, "i dont see them as sick - I just see them as animals with cancer." Less than 10% suffer from severe nausea, hairloss, weightloss etc after chemo - most have a flat day, but some have no negative effects at all. Really remarkable.
I'm just curious, how would you know if a cat or dog is suffering from severe nausea or is feeling dizzy or is in mild pain? It's not like they can come to you and tell you their chief complain or ROS. How do you know that the cat is having NO negative effects or he's just lying there. The cat can be having horrible nausea, dizziness, pain, dysphagia, etc. and just be lying there. But, that's why we have vets, as they know more than me.
Well, if they're throwing up all over the place, they probably have nausea. 😉
Seriously, though, if one knows one's pet well, it's not hard to tell if the pet is having discomfort. If the pet stops eating and isn't even tempted by favorite foods/treats, s/he probably has nausea or just isn't feeling very well.
If the pet is lying in one spot and shows a reluctance to get up, there's obviously something wrong. Pain? Maybe. Coax the animal to his/her feet and get him/her to walk. If the pet cries out, there's probably pain. If the pet is wobbly and unsteady, s/he is probably dizzy.
I'm no vet, and this is just off the top of my head. Hopefully a vet will show up and elaborate on this.
Its all in the game.
I'm beginning to think that those of you who talk about how a patient's survival chances are inversely proportional to their value to society are dead on.
I'm a retired radiographer, who spent many years doing ER work in England. I joined just so I could post a True Version(tm) of this tale, which I was a witness to.
One dank and dreary November evening in oh, 1975 or so, a young man (late 20s early 30s -- I don't remember exactly) was brought into the A&S department of $LargeTeachingHospital on the south bank of the Thames in London. He was suffering from hypothermia, concussion, a broken wrist, and a lacerated penis.
Fortunately for him, the lacerations were pretty superficial.
He worked nights. His roommates worked days. Their flat had a long hallway with a step down about 2/3 of the way along (he lived near my gran -- I knew the exact layout of the flat). His room was up, the phone was down -- at the far end of the hallway, past the step. Not long after he'd gone to bed, the phone rang. He jumped up to answer it, and ran naked down the hallway. The cat was sitting on a chair near the step and made a swipe at the dangly bits as they went by. He jumped, hit his head on the ceiling and as he fell onto his oustretched arm (Colles #), he hit his head a second time on the corner of a book case. He then lay on the floor in the unheated hallway for several hours unconscious and concussed until his roommates came home. They called 999 and the ambulance brought him to us.
He made a complete recovery, and when I saw him a couple of weeks later at the fracture clinic, he told me he'd even forgiven the cat, so she survived as well.
So, while the version originally posted might be of urban legend quality, it is indeed founded in truth -- I was there.
This goes along with approaching a male patient with a 24F foley in order to get a urine sample. Works like a charm
^awesome!
I got another one:
When the peds ER is so busy that there is a 17 person waitlist, please make sure to get in with your daughter who is having severe lower right quadrant pain and make sure to call the doctor a nurse. When the doctor tells you she is not a nurse and is, in fact, a doctor, tell her that you meant ME, because "that one there is in training, so he must be a nurse". I completely forgot that med students have to be nurses before they are doctors...my fault.
Once the doctor corrects you again, definitely get all huffy and start yelling loudly about how you are being disrespected and insult the doctor at every turn ("if you dont get the IV right on the first try, we're leaving!"). Threaten us with going to another hospital every time we pass your room....not with a white count of 17 you're not!
Your forgetting something important! You, the doctor, sees the patient, puts in orders. Fast foward 3 hours later, labs are back, pt is back from CT and has recieved meds and fluids, the mom will stand up and loudly exclaim that she has been here 3 hours and her daughter hasn't seen a doctor yet!
Yeah, because I typically order CT scans with the triage protocols 🙄
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Well everyone knows that every doctor should have all the labs done in 30 minutes while handling 20 patients, giving a perfect diagnosis, serving them coffee, and juggling chainsaws...
I mean, don't they wonder how all of these meds or tests happened? on top of your 30 pts u are a "bad" doc because u didn't order a tray of food for them and all the visitors.
Yep.
Also? When your psych patient pharmacy delivery customer says things to you that would cause most people to make a face like this one: 😱 ? As in, "With hair that red, your husband must be a happy man....aren't all redheads firecrackers in bed? That's what I've heard."
The best response? Is not to make that face. Nor does it do you any good to say, "That's none of your damn business." They don't even hear it. I swear to you, our resident nutcase sure as hell didn't hear, "That's none of your business," when I said it to her.
*sigh*
These days? I just keep a straight face. And ignore, ignore, ignore.
Well, DUH! I mean, what kind of aliens/conspirators would they be if they used technology that could be easily found by one's local vet? 😛
That's what I do. (Honest.)
No hypoglycemia, and gaining weight (which I wouldn't do if I wasn't taking enough).
Iron overdose can be a nasty way to go...
Or even better, make sure they're not homeopathic pills like Billy Joel's daughter tried to use. The biggest risk from taking too many homeopathic remedies is drowning.
No one ever went to prison for being good at thinking things through...
*snicker*
Yeah, they get 'em around here like that.....and when they make those ineffective threats (most of 'em don't get farther than threats)? They're stripped, put in a taco suit, and put in suicide watch seg. Period.
They all really hate that, too!
Not even just the homeless - apparently we're required all the patients AND their families.
Oh, and I've also learned that the homeless may lack a place to live, but they almost always seem to have a lawyer ("I'm going to call my lawyer, you aren't doing anything for me in this ****ty hospital!") 🙄
1st of all im not a doctor or in the medical field, but i must say thanks a lot for the many laughs i have had over the last few days reading this thread in my spare time.
I have a couple of tales to tell as well.
when a 10 year old boy has broken both his ulna and radius, its not a good idea to try and move his arm to the position you want it in post xray, with out giving any pain meds cause you will end up with a broken arm from bracing your landing from when he has pushed you off him.
Its not a good idea to fix your broken 5th metacarpal yourself, so you can keep drinking for the night, then wait for a week cause the swelling has not gone down and go to your local doctor, who will confirm its busted and out of place via xray, he will then send you to the hospital to get it fixed. Who will agree that it is stuffed and send you to see a specialist who has a 3 week wait. And he will re-break it and put it in place with out any meds. yes it does hurt.
Also when your patient has cut his thumb open also cut his tendon not to mention chipping the bone, take his word that he done it with his blunt knife and is lucky it wasnt his sharp knife, cause when you test how sharp, the sharp knife is you will cut your thumb to the bone.
I have a couple of tales to tell as well.
when a 10 year old boy has broken both his ulna and radius, its not a good idea to try and move his arm to the position you want it in post xray, with out giving any pain meds cause you will end up with a broken arm from bracing your landing from when he has pushed you off him.
Its not a good idea to fix your broken 5th metacarpal yourself, so you can keep drinking for the night, then wait for a week cause the swelling has not gone down and go to your local doctor, who will confirm its busted and out of place via xray, he will then send you to the hospital to get it fixed. Who will agree that it is stuffed and send you to see a specialist who has a 3 week wait. And he will re-break it and put it in place with out any meds. yes it does hurt.
Also when your patient has cut his thumb open also cut his tendon not to mention chipping the bone, take his word that he done it with his blunt knife and is lucky it wasnt his sharp knife, cause when you test how sharp, the sharp knife is you will cut your thumb to the bone.
As a part 2 to this one, you can also add a second dose because you "just didn't feel right" after the first one. You don't remember this, of course, but your friends do.
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He wouldn't just connect a set of shackles to the patient and the bed to avoid (medically) unnecessary radiation exposure?
This isn't in the ED (though I doubt the cath lab is, either): I've had a corrections officer agree to leave the room for the history/physical after I asked him to. (The patient was already shackled to the bed before I got there, it had nothing to do with me.) How else could I do a HEADSSS (...SSSSSSSS...) exam and expect my patient to answer honestly? Not to mention, it's an issue of respecting confidentiality. I don't implicitly know whether any given corrections officer is HIPAA trained. At the time, I guess I was thinking it was better to have the corrections officer out of the room if it wasn't necessary for them to be there.
Anyway, good story Katydid!
Cath lab doctor insisted he be uncuffed.
The state rules are that an inmate is either cuffed, or a corrections officer is with the inmate. No exceptions.
I have no idea how this works with regards to HIPAA, but them's the rules, and believe me when I tell you that the corrections officers do NOT like it any more than the inmates or doctors do.
Not to mention? Do you guys really want to be left alone with an uncuffed inmate? Someone who is already in jail for beating on someone? I know I wouldn't.
Of course, I hate being at the jail anyway. Both my husband AND my brother are corrections officers at the county jail, and I have had to go there twice. The last time? I had to enter through booking, where they buzz you in the door. Into a little metal closet-looking room, with thick glass. I'm claustrophobic. Seriously. And I had to wait for DH to get to booking, so he could get the crap he left at home that I had to bring to him. *twitch* And then I didn't realize that they have to buzz you OUT. *twitch* I was having a huge internal freak out over that!
That being said? I do not like being at the jail. I do not like being around the inmates, mostly because I know who they are (it's a small county, and I grew up here), and exactly what they're in for. And I would never leave some unsuspecting doctor alone with any of them.
How is that even possible?! I sprained my ankle about three weeks ago, not even that bad, and it's STILL sore sometimes when I'm walking...I can't fathom walking on a broken one.
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The vast majority of our "psych" patients are as they are due to addiction and homelessness. They come in intoxicated and make up symptoms like suicidal ideation or hallucinations to get housing. The actual psychs, the schizos and bipolars off their meds are in the minority.
[YOUTUBE]http://www.youtube.com/watch?v=HcIk2G9_dDU[/YOUTUBE]
(That's actually a cool little video; I've never seen that scene without Jabba's dialogue being subtitled. Hmm.)
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