The Things Patients Say...

Quit drinking that sissy beer...

2013-06-17T09:54:00.001-07:00

The heat has made it to the South, which means that we have the first wave of heat exhaustion/stroke arriving at the hospital like robins in the springtime. One of the side-effects of becoming dehydrated and overheated is that many of the proteins in your muscles begin to breakdown. These proteins can quickly overwhelm the kidneys, causing them to fail and exacerbating the problem in a condition known as rhabdomyolysis. A few days ago, I admitted one such gentleman with the above problem.

Patient: "I'm not sure how I got dehydrated. I was drinking plenty of beer."

Friend: "If you'd quit drinking that uppity, sissy beer and stick with Busch Light like I did, you would have been fine."

#ugh

Gimme...

2013-06-15T08:00:00.000-07:00

The problem with entitlement is that it can quickly become addicting. When someone becomes accustomed to something, no matter how undeserved, they suddenly become angry when it is taken away.

I recently had a patient in the hospital who was very worried about the cost of her stay throughout her entire admission. Conscious of this, I attempted to minimize tests and relied mainly on physical exam and common sense to move her toward discharge. By the end of it, however, the patient began to be rather demanding...

Me: "We're going to work hard with you over the next few days so I can hopefully get you out of here without having to be on oxygen at home."

Patient: "Well, I want oxygen at home."

Me: "I'm not certain that you need it and it would be hard to arrange since you don't have any insurance."

Patient: "Well, just have them give it to me for free, then. If you write the order they have to do it."

#nothowthisworks

Siri, wtf?

2013-06-14T12:51:00.002-07:00

What I was trying to say was "Can a 26 year old with a DVT ever take birth control pills again?"

Marriage wars...

2013-06-12T08:19:00.000-07:00

My wife and I have been playing pranks on each other lately. She changed the backdrop of my phone to a guy in boxers with a semi-erect (covered) penis. In retaliation, I did this:

I was really hoping she would quickly hit send to someone random, but she caught it in time. Oh well...

#soclose

Maturity...

2013-06-11T08:38:00.000-07:00

There is a pervasive school of belief out there that doctors are mature adults. This is FAR from the truth.

#grownups

Keeping your figure...

2013-06-10T08:07:00.001-07:00

I recently had a conversation with a frustrated daughter of a patient. She was the most upset about the fact that her mother was not eating as much as she thought she should. This is despite the fact that the woman was 98 years old with terminal cancer. Classic case of missing the forest for the trees.

Daughter: "Mom, you have to eat more. Doctor, can't you give her something to make her eat."

Me: "Well, I can, but she's lucid enough to tell me that she doesn't want it, so I'm not going to force it down her."

At this point, the daughter stormed out of the room, clearly angry at both of us. The mother, who had been feigning sleep at this time, then opened up her eyes and looked at me.

Patient: "She can die fat if she wants to, but I'll be damned if I do."

#girlishfigure

In case of zombie attack...

2013-06-06T09:29:00.000-07:00

We often have problems getting people out of the hospital because they have this misguided notion that the hospital is the safest place for them. In reality, we harbor a veritable buffet of microscopic organisms, all uniquely evolved to survive in an area with excellent antibiotic coverage. I can't tell you how many times I have tried to D/C someone and been met with resistance. Many of those patients eventually developed a hospital-acquired infection and some of them died as a result.

Me: "I think it's time for you to go today."

Patient: "Oh, I think I should stay here a bit longer, so I'm safe."

Me: "If you stay here, you'll get a worse infection."

Patient: "I don't believe that."

Me: "Let me put it like this: if there were a zombie virus outbreak, would you run to a hospital first?"

Patient: "No way! It would probably have more zombies than anywhere else."

Me: "Same deal with bacteria at the hospital."

This line of reasoning somehow persuaded them to go home, presumably cowering under their covers with a shotgun and a katana.

#livingdead

That makes sense...

2013-06-04T07:26:00.000-07:00

Psychiatrist: "Yeah, we're not going to be able to take that patient."

Me: "Why not?"

Psych: "Because she can't move."

Me: "She's in a catatonic schizophrenic state. That is precisely the reason I need you to take her."

Psych: "Let us know if you get her moving."

#Ihateyou

Yeah, that's science...

2013-06-03T08:22:00.000-07:00

Me: "So, he's going to need to avoid alcohol or this will happen all over again (patient admitted for alcohol withdrawal)."

Daughter: "And we'll need to avoid sugar, too, right?"

Me: "Um, why would you need to avoid sugar? He's not diabetic or anything."

Daughter: "Sugar is converted to alcohol in the body. Didn't you learn that in medical school?"

#hummingbirdsaretheworld'sbiggestalcoholics

That would make life difficult...

2013-05-30T08:00:00.000-07:00

Me: "Have you had any surgeries before?"

Patient: "Yes, I had four vertebrae removed."

#slinkyman

Very careful...

2013-05-28T11:08:00.001-07:00

Me: "Did you take that medicine we gave you when we discharged you?"

Patient: "No, I was scared of it. I'm very careful about what I put in my body."

Me: "Sir, you came in drunk on Listerine and Scope."

#thoseareantisepticthough

Well...

2013-05-27T16:08:00.001-07:00

If you share nothing else off this blog, share this article.

I'm betting that's true...

2013-05-25T08:00:00.000-07:00

Patient: "The doctors told me that if I hadn't continued eating I wouldn't have survived."

#youdon'tsay?

Selfish consults...

2013-05-24T08:00:00.000-07:00

We have a real problem at our hospital with consults. You see, the way our specialists interpret the rules is that they have 24 hours from the time a consult is put in to see the patient. However, when the shoe is on the other foot, they assume we will drop everything that we are doing and come see their patient. Our group has a rule regarding emergent consults. If we really need you quickly, we will call you in person. I have yet to receive a phone call for an "urgent" consult.

Nurse: "The surgeon wants you to come clear 513 for surgery."

Me: "When are they scheduled to go to surgery?"

Nurse: "In an hour. He said to tell you to hurry." (this is verbatim)

Me: "Here's what I'd like you to tell them: 'I'm not going to hurry up and come spend 30 minutes of my time to make $50 on a consult in order to help you make $5000 on a 30 minute operation'."

Nurse: "I'm not going to tell him that!"

Me: "Then tell him I technically have 24 hours starting from now."

#turnaboutisfairplay

So, last Friday, this happened...

2013-05-22T08:00:00.000-07:00

The other day, I posted this article:

http://www.thethingspatientssay.com/2013/03/go-into-light.html

It had to do with a room in the CCU where we had something akin to a ghostly phenomenon occur. Well, last Friday at about six p.m., I was in the same room, talking to one of the nurses about the patient in the room. We had just run a code on her and I was tweaking her pressors and fluids to try and get her a bit more stable when I felt something like a woman press up against my back, effectively spooning me. It was so realistic that I thought it was another nurse and that they were about to wrap their arms around my waist. Being married, I naturally turned around to try and stop what felt like a fairly sensual embrace only to find....absolutely nothing. I turned back around to the nurse probably fairly wide-eyed as she was already staring at me with some trepidation.

Me: "Did...did someone just run into the room and hug me from behind?"

Nurse: "You're really starting to freak me out."

Me: "Seriously, did someone just run in and hug me?"

She adamantly stated that no one had come into the room and was now staring at me like my head would start to spin around.

We finished our conversation out of the room.

#weirdness

Drinking habit...

2013-05-21T08:00:00.000-07:00

Me: "Do you drink alcohol?"

Patient: "Yeah."

Me: "Every day?"

Patient: "Pretty much."

Me: "How many beers you drink in a day, you think?"

Patient: "Don't drink beer."

Me: "How many hard liquor drinks then?"

Patient: "Don't drink those, either."

Me: "What do you drink?"

Patient: "Listerine."

#wellthat'safirst

Not quite getting how this works...

2013-05-17T07:55:00.000-07:00

Nurse: "You need to lay back down or we're going to have to restrain you."

Delirious patient: "No! Don't put me in restraints! I refuse! You can't put me in restraints if I refuse!"

#fourpointleatherscomingup

Everything should be free...

2013-05-16T09:14:00.000-07:00

I think one of the reasons that most doctors are conservative in their voting habits is that we see an unfair representation of the entitlement culture. We know in the back of our minds that these people do not make up the majority, but yet they take up most of our time and energy. They are the most infuriating to work with and I'm not convinced that even universal health care would stem that tide. They'd still want more and more for their (non) buck.

Patient: "These prescriptions will cost me. I need them for free. I don't have any money."

Me: "They're all generic prescriptions. At most you'll be paying like $4 with Medicaid."

Patient: "I don't have any money. I need them for free."

Me: "Well, you could just stop smoking for a few days."

Patient: *pausing a moment* "Or...you could just give me the money."

Me: *sigh*

#nothingiseverfree

Ain't nobody got time for dat...

2013-05-15T07:15:00.002-07:00

Nurse: "The patient in 451 is bleeding rectally. All over the place!"

Me: "What are his vitals?"

Nurse: "We don't have time for that! We've got to get him cleaned up!"

#priorities

Izzo Sunday...

2013-05-12T08:00:00.000-07:00

The last time I heard this song was when I was driving around in a jeep following college with a girl who is now very high up in government. Bizarre memory of someone so now well-connected. The remainder of that day (she told me) was a day she had to recount to the federal government when she was applying for her job. So, somewhere in a government file is a story about the bad things I did 12+ years ago. Great. Just great.

Welcome to Sunday...

Put a little Campho on it...

2013-05-09T08:00:00.000-07:00

Me: "Your mother has a stage four decubitus ulcer on her bottom. Given her nutritional status, I don't think she's ever going to heal it."

Family: "Oh, don't worry about it. We'll put some Campho-Phenique on it, have it fixed up in no time."

#notquitegettingit

Guess you could live there...

2013-05-06T08:00:00.000-07:00

Me: "I think we're going to be able to let you go home tomorrow."

Patient: "But where will I go? I have to have some place to live."

Me: "You don't have a house?"

Patient: "I guess I could go to the house I've lived in the past 37 years. That might work." (this was verbatim what she said to me).

#thatisprobablyavalidoption

About Sunday...

2013-05-05T08:00:00.000-07:00

Taking a three-hour driving tour of Rome today. Hope all is well, state-side.

Welcome to Sunday...

Out of town...

2013-05-03T10:18:00.001-07:00

Headed to Rome today. Will be back in about ten days. I have scheduled a few sporadic posts, but don't expect comments to show up until I approve them upon my return.

Physical therapist: "What are your goals for therapy after your hip replacement?"

Patient: "I just want to be able to drop it like it's hot like I used to."

#geriatrictwerkteam

That's not supposed to be there...

2013-04-30T13:17:00.001-07:00

Seen in dictation: "Patient is noted to have feces in her toenails."

#nailpoli