Here's another tip for my fellow physicians and anyone else who cares:
No good will EVER come from getting consulted to see a patient who's been in the ICU for 2 weeks before they call you, and who's initial chart note starts with: "Patient is an 81 year old male who attempted to rectally disimpact himself with his toothbrush."
And I'll leave the rest of this sad story to your imagination.
Highlight was a 20-something guy I saw for a head injury. Get this, Grumpy fans:
He had a fight with his girlfriend outside a restaurant and said he was going to teach her a lesson.
So he began repeatedly banging HIS head against the concrete sidewalk until he was covered with blood. At that point the police and paramedics pulled up, and so he began banging his head repeatedly on the police car's windshield until he shattered it
He then went back to beating his head on the sidewalk, which continued until the cops tasered him and the paramedics gave him a dose of Valium.
The admitting diagnosis was "Self Assault"
Exactly what lesson his girlfriend learned from this is unclear, but I suspect it had something to do with getting a better boyfriend.
One of my afternoon patients today had this humongous booger hanging out of his right nostril, and as he talked, inhaling and exhaling, it kept blowing in and out of his nose. It was like watching a flag wave on a windy day.
It was pretty hard to maintain eye contact, or even pay attention to his story about his back pain, while watching this thing go. It was like trying not to look while driving by a car wreck.
How come they don't teach you how to handle situations like this in medical school?
Alright, I'm sure you're wondering where I was the last few days (or maybe you weren't) .
I was in LA, folks. A company I'm doing consulting work for sent me there for a meeting. This was one of those deals where they arrange every detail of my existence for 36 hours.
So I flew there on Friday night. I asked for an aisle seat, and got one. The window and center seat were occupied by 2 gay men who'd just gotten married and were on their way to Disneyland for their honeymoon. They were both wearing mouse-ear hats and spent the flight singing along with Disney songs on an iPod.
When I got off the plane there wass a teenybopper with a sign waiting for me. She had a name tag, and under that a green button that says "At our company, we're committed to the environment." She took me to the curb, where there were 2 other docs going to the same meeting, with their green-buttoned teenyboppers.
A big limo puled up, and all 3 of us started to get in it. Our teenyboppers stopped me and one other doc, and said "that car is for Dr. X only". So he drove off.
I turned to my teenybopper and had this exchange:
Dr. Grumpy: "Aren't we all going to the same place?"
Ms. Teenybopper: "Yes, sir!"
Dr. Grumpy: "Wouldn't one limo be big enough to hold all of us?"
Ms. Teenybopper: "Yes, sir, but each of you get your own limo."
Dr. Grumpy: (looking at the button again) "Just how strong is your company's environmental commitment, anyway?".
Ms. Teenybopper: "Very strong, Sir! Why?"
Dr. Grumpy: "Never mind."
It's been years since I've been in downtown LA. Hookers, bail bond stores, porn shops, and that's while you're still inside the airport terminal.
The hotel was a monstrosity. Apparently used in several movies, so there are plaques all over that say things like "On this spot Sylvester Stallone fought Arnold Schwarzenegger in 'Rocky vs. Terminator'." I was wondering if it would have a plaque over my bed that said "This bed was used in the filming of 'Linda Loves in LA'.
The hotel gym (which I didn't even consider using) is this glass-walled thing that's easily seen from any point of the lobby several floors below, with balconies hanging outside it with exercise equipment. So anyone eating at the buffet can look up and watch someone else trying to get buff, while someone working out can look down and see someone else trying to get fat.
The meeting was the usual stuff with Powerpoint slides, a darkened conference room, and a sleeping audience. The other docs (about 150) were all in suits and ties, but (since the advance materials didn't mention a dress code) I'd only packed shorts, a T-shirt, and old sneakers. Most of the other attendees thought I was a vagrant. So at every meeting, meal, snack, discussion group, whatever, I was constantly being stopped by conference organizers who asked to see my name tag. I think I was the only person who got asked this.
So if you were at a meeting in LA this weekend, and were wondering why there was an unshaven homeless person in your sessions, that was me. You got a look at Dr. Grumpy. Lucky you.
When they aren't talking at these meetings they're feeding you. At one point, during a session on data as to whether the drug being discussed caused weight gain, a waiter came in and began serving cookies.
My pet gripe for the meeting is, oddly enough, the same one I had in high school, college, medical school, and residency: "Why don't you other people in the audience SHUT UP!" These sessions always run over because there's always some doofus (or plural doofi) who keep asking questions, arguing about the data, nitpicking points, etc. (Yes, you, in the white shirt, you know who you are). For heaven's sake, Dr. Doofus. You're getting paid to sit there and shut up. So why don't you just join the rest of us in doing so?
I was very happy to get home. Craig greeted me with a Valentine showing a volcano erupting with hearts he had made himself. I'm glad he explained it. I thought the large brown thing on the card was a potato, or worse.
My first consult at the hospital this morning was an elderly gentleman who passed out while watching the Super Bowl yesterday. I quote directly from the note of the admitting internist:
"He was in his usual state of good health when he awoke this morning at around 10. He normally has eggs and toast for breakfast, but this morning he decided to skip this and went straight to cocktails. He had 7-8 Manhattans over the course of the day while waiting for the game to start."
This blog is entirely for entertainment purposes. All posts about patients may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate.
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Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.