Sunday, May 29, 2011

Now...and Free

Me: "What are you here for today, Sir?"

Patient: " I am here to have my gallbladder removed."

Me: "Are you having any symptoms?"

Patient: "No, but I have in the past, and they told me I need to get scheduled to get it out."

Me: "Well you should definitely do that, then. But this is an emergency department. We can only consult a surgeon if you are having an emergency with your gall bladder. It sounds like you need to follow up with a surgeon."

Patient: "Look, I don't wanna do that. It costs money. Now get me a damn surgeon. I want the surgery NOW, and I want it for FREE."

He got kicked out shortly after. This is the country we live in. Imagine if I went into a mechanic shop with my car and demanded them to fix it for free and right away. Gese.

ER Doc

Sunday, May 22, 2011


A family of EIGHT came in for me to see. This isn't as many as my record (15), but it was definitely the 2nd most.

The family ranged from ages 7-79. They were in a Dodge Durango on the way to a graduation. They were rear ended at low speed. Everyone was wearing a seat belt. They all then went to the graduation and celebration.

Afterward, some 4 hours later, they decided to come in and "get checked out." And I discharged them ALL from the waiting room.

ER Doc

Wednesday, May 18, 2011

Weird Shift

Had a weird couple of nights this week....

1- A man was seen walking around the parking lot with a roll of toilet paper on a leash. He said he was looking for his mother's cat that took a cab to the hospital.

2- A 24 year old who came in for an ankle sprain...but was also grossly infected with scabies.

3- A 21 year old man called EMS for a toothache. I am not sure why they actually brought him...but they did. He walked in through the ambulance bay with the paramedics and his girlfriend, who had a bag of cheetos in her hands. I guess she needed a snack for the ride. When I directed them to go to triage, he got mad and walked out the hospital. Ooops.

4- A 37 year old man got released from drug rehab. He decided to celebrate by getting drunk and passing out on his porch and knocking out a couple of teeth.

5- A 22 year old female wanted a mammogram to see how far along in her pregnancy she was.

6- A 45 year old female came in intoxicated. She was afraid she was pregnant, so she decided to get drunk and do drugs to kill the fetus. But when she got the room, she decided she wanted to keep the kid (it would have been #9). Thankfully she wasn't actually pregnant.

7- A 37 year old male came in after getting "jumped" by 10 guys and 5 girls. Of course, he said they jumped him for no reason. On review of his past medical records, I learned he was seen a few years ago after being jumped. Somehow...his keys got stuck in his ass when he got jumped that time.

8- A 27 year old came in for a drippy dick. We counted on the electronic medical records that he had been seen TWENTY THREE TIMES in the past 2 years for a STD. Nice...

ER Doc

Sunday, May 15, 2011

Be Careful careful. Young people die too. Its one of the hardest things in medicine. The hardest thing I have to do is break the news on someone young that died. Children are the worse. These cases involved 20-30 year olds.

A few friends were celebrating a graduation. I suspect alcohol was involved. At 3 am, their car veered off the highway and ran into a tree. Only one was wearing a seat-belt. The other 2 were ejected through the windshield and landed about 30 yards away. They were pronounced dead shortly after making it to my ER. The guy wearing a injuries. Both victims left behind young wives and parents.

A 23 year old was helping his brother fix their car. The car wasn't on proper lifts. When he stuck his head under the car to take a look, it came crashing down on him crushing his skull. It was horrible. He left behind a brother, sister, and parents.

We are never too young to die. Be careful.

ER Doc

Tuesday, May 10, 2011

Ironman 3 - Poo Siege

Hollywood would have you believe that "Thor" is the first blockbuster of the summer. I have it on good authority, however, that there is a pirated version of Ironman 3. I am now going to tell you the plot. Warning: spoilers ahead!

For those who don't know, we have a patient in common we have dubbed Ironman. See posts here and here. I also gave a brief Easter update. Since that post, Ironman spent a few more weeks in the big-time psych hospital. Once they determined for about the 10th time that there's nothing that can help this guy, he was discharged. I'm not sure where he was discharged to. He didn't stay there long. Within 2 days, he was back in the hospital where my residency is.

Keep in mind:

1. These hospitals are 70 miles apart and would involve travel through 3 counties, at least.

2. He has no home and owns no means of transportation.

He is, however, apparently blessed with the ability to remember every phone number to every hospital within a hundred mile radius. Not just the main numbers. He can direct dial most of the inpatient units and some social workers.

The real question is why is he back in the hospital? He just spent a month and the grandaddy of psych hospitals (in this state anyway). He should be cured, right?

Ironman swallowed some sheet-metal screws. He didn't pretend to do this. There is radiologic evidence. He had to wait on the med-surg unit for the screws to pass. This requires the poor nursing staff to inspect his fecal matter. I guess it can't be that bad, he's a superhero, they could probably sell it on Ebay. Finally, a nurse noticed large, coarse particles and began to celebrate. She might have even shouted "Eureka!", thinking her fecal screw inspecting days were over.

But, alas, it was only some pieces of wood and bark that he had swallowed some other time.

And for the first time ever, a nurse wanted a patient to screw her, and he gave her good wood, but she was left wanting more. To be continued...

-Psych Doc

Sunday, May 8, 2011

Cage Em

A patient came in the ER with a severe ear laceration after being bitten by HIS BROTHER. One so bad I had to swallow my pride and call the on call plastic surgeon for help.

After explaining the case.....

Plastics: "Don't you think you can sew that up, give them a shot of antibiotics, and have them see me in clinic."

Me: "You mean like I do 98% of the time?? No. How about I take a pic and send it to your phone."

I sent him the following pic.....

And he called back shortly.....

Plastics: "I am on my way in. Please get me a plastics tray. And please get a cage to lock up these animals!"

-ER Doc

Thursday, May 5, 2011

Put It In Here

A 23 year old female (moderately attractive) came in for headache, fever, chills, and stiff neck. Obviously needed to rule out meningitis.

So when it was time for the spinal tap....there was an odd tattoo to her lower back.

It had a sign that said "Put It In Here" and an arrow pointing down. And it wasn't pointing to the area of the lumbar spine that the needle was supposed to go in!

-ER Doc

Sunday, May 1, 2011

Belly Fat Can Save You!

Forget about diabetes, hypertension, high cholesterol, metabolic syndrome, decreased libido, panniculitis, heart attacks, strokes, smelling bad, taking up too much space on an airplane, etc....being really fat can save your life!

A 22 year old male came in with a stab wound to the abdomen. But because he was 450 pounds and litterally had 20 inches of belly fat, the large knife only penetrated fatty tissue. The CT even read "penetration through 8 inches of subcutaneous fat, not in close proximity to the abdominal cavity." A couple of staples and out the door!

So at least there is one benefit to being a big boy.

-ER Doc