why are doctors so arrogant?

[Web MD]

In my n=1 experience, most people aren't educating themselves with peer reviewed journals, but instead with websites that generally have some sort of agenda. I've heard one too many elaborate explanations about how you can watch the autism germs leap from vaccines onto children

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[seattlejunkie]

WE ARE GODS!!!!
- or going to be, if we're still pre-meds

hahahahahahahahaha i seriously just laughed out loud

 

[kpcrew]

In my n=1 experience, most people aren't educating themselves with peer reviewed journals, but instead with websites that generally have some sort of agenda. I've heard one too many elaborate explanations about how you can watch the autism germs leap from vaccines onto children

lmao wat

 

[ManBroDude]

In my experience working in the ED, the docs (especially the seasoned ones) see thousands of belly pains and chest pains each year. Your typical textbook presentation of left-sided chest pain plus vomiting, which you've worked up literally thousands of times, turns out to be Boerhaave Syndrome, which if you don't catch within the first 24 hours, mortality/morbidity shoots through the roof.

A good doc will always keep an open mind when working up a patient. You just never know. Just last night, we had a 15-year-old with textbook sudden-onset RLQ pain, and a 19-year-old on her menses with diffuse belly pain coming on in waves. Both turned out to be appy's. A flustered doc will get defensive (their knowledge, which is their power and meal ticket, is being questioned), but a good physician won't have this problem.

 

[wlee43]

You ask me if I have a god complex. Well let me tell you something...I AM GOD

 

[Morsetlis]

In my experience working in the ED, the docs (especially the seasoned ones) see thousands of belly pains and chest pains each year. Your typical textbook presentation of left-sided chest pain plus vomiting, which you've worked up literally thousands of times, turns out to be Boerhaave Syndrome, which if you don't catch within the first 24 hours, mortality/morbidity shoots through the roof.

A good doc will always keep an open mind when working up a patient. You just never know. Just last night, we had a 15-year-old with textbook sudden-onset RLQ pain, and a 19-year-old on her menses with diffuse belly pain coming on in waves. Both turned out to be appy's. A flustered doc will get defensive (their knowledge, which is their power and meal ticket, is being questioned), but a good physician won't have this problem.

How do you tell if it's Boerhaave (vs GERD, angina, panic attack)? History of vomitting and CXR?

What happens if you just don't know? Call in a radiologist?

 

[ManBroDude]

How do you tell if it's Boerhaave (vs GERD, angina, panic attack)? History of vomitting and CXR?

What happens if you just don't know? Call in a radiologist?

It was an interesting case. The guy developed gastroenteritis from his daughter and was vomiting for a few days. He was 78, and he must have vomited so hard it perforated his esophagus. No prior history of intubations or dilations. A protocol PA chest xray showed a bunch of effusion around his mediastinum which looked just plain weird. A CT was ordered, and radiologist called back so fast it was scary. Rushed him to the OR. The surgeon who opened him up reported he had bits and pieces of noodles and rice in his chest cavity. It was crazy, but he lived because it was caught so fast. Docs with 25+ years of experience have never seen one before, so I was super priviledged to have seen one!

 

[45408]

Boerhaave Syndrome, which if you don't catch within the first 24 hours, mortality/morbidity shoots through the roof.

These things have a way of fairly rapidly declaring themselves, and someone with pneumomediastinum (and any 78-year old with chest pain and vomiting is getting a CXR) is getting explored or further imaging in short order.