Will you be my 1000th visitor? If so, leave a message and congratulations to you and to Mr. Hassle!
RSS feed now available using RSSify at Wytheville community college.
I’ll add this link when I’m convinced it’s reliable.
RSSify at WCC
It’s a 3rd party hack to turn your blog feed into RSS. If you don’t know what I’m talking about, don’t worry about it. But using this technology, you can scan a page like Medblogs to get just the updated blogs. Likewise, in my BlogRoll sidebar, the sites with an asterix use a similar technology to indicate that they have been updated in the past 24 hours. The problem is that some sites (like mine), get updated without an RSS feed or something similar to indicate to other sites that there is new info.
SO you’ll all just have to visit everyday!
AMA stands for “Against Medical Advice”. Patients are labeled as having left AMA if they leave, well…against your advice. Our hospital does not have a formal AMA discharge sheet because they feel it sets up an adversarial relationship between doctor and patient. I usually try very hard not to use those words on dictations, but rather, explain the situation that occured, and the conversation had with the patients. Usually, patients have good reasons for wanting to leave, and I usually don’t blame them too much and just make sure they know what to do if they get into trouble. On the other hand, sometimes you can’t but help feel adversarial against your patient. Today, a young lady with documented disease (a DVT) left our emergency department because she and her husband:
a) had been waiting too long
b) didn’t get the answers they wanted from me
c) didn’t get the answers they wanted from me fast enough
d) were idiots
e) all of the above
When I returned to their room to advise them of the developments (that she would be admitted for treatment) her husband was irate, insisted that we “take that thing out” (her IV) and that he’d take her to another hospital (an hour or more away) in the morning. What was I missing? She was going get treated like, right NOW, not tomorrow, but he insisted on leaving??? I asked the wife what she watned to do, and naturally, it was what her husband wanted to do. I felt like strangling them. Why would they leave, when they were about to get the treatment she needed? Instead, they’ll see a different doctor at a different institution with even fewer records than we have (we had 2 blood tests for teh past 4 months, one of them from today…the husband couldn’t understand why we couldn’t tell them what her problem was). There was no point in trying to use logic on them. I should have shot her with a lovenox dart gun on her way out. but they would have none of it. Why are some patients so grateful to be seen, no matter what you do to them, and others are irate, no matter what you try to do? Idiots. I used the words “against medical advice” on that dictation.
Today was a double woohoo day!
First woohoo: My first scene call on the helicopter (finally!). It was a Motor vehicle crash (not accident) south of here. THe patient we took flipped his car over while turning left into a driveway to drop off a check. I got out of the helicopter, walked to the scene of the accidnet, and a friend of mine was hanging out at the scene of the accident. Wierd! (How many friends do I have in this neck of the woods? Answer: just one, apparently). It turns out that it was her house this guy was driving to, and he got whacked RIGHT IN FRONT of her house.
Second woohoo: Speaking Spanish. it was about 1AM, and I was trying to wrap up my patients, when the staff doc asked the clerk to call the operator for a spanish translater. Now my spanish is not great. In fact, it’s far from good. But I know enough to ask what hurts, and I usually get long, verbose answers that I can’t understand. But in front of non-spanish speakers, I sound pretty good! So I felt a little bit like I was back in Honduras for a little while, that was pretty cool.
Wait, I just remembered one more…my first documented IUP (Intrauterine pregnancy) on ultrasound. How cool is it to glop some gel on someone, put a little plasticky probe on their belly and find a living creature inside? I could see it’s heart beating. Three woohoos!
Many other firsts this month…my first metatarsal head frature, my first metacarpal dislocation, my first garden variety hip fracture, my first torus/greenstick fracture (then 3 or 4 more in succession), my first fractured patella (kneecap)…summer is a great time for ortho cases.
Today I saw a 19 year old who had whacked his head a week ago, and today was unable to bat well at the batting cages. His mother wanted a cat scan to make sure he didn’t have a concussion. (If you’re a doctor or a nurse, or just read a chapter from my doctoring book, you’ll realize how absurd this is.)
“Ma’am, I can tell you without a cat scan that he has a concussion. ”
“Oh, my, then…maybe we’re doing wrong test, she said nervously. He works for a surgeon who thinks he might have a concussion. ”
“He does have a concussion,” I said, pained that she hadn’t read my book.
“Oh, then what should we do?”
“Well, we can do the cat scan to make sure he doesn’t have any bleeding to account for his slowed reaction times. ” (which I’m sure is why the boss/surgeon wanted him to come to the ED, not to see if he had a concussion.)
“Well how long does a concussion last?”
“Let’s just take one step at a time, OK?”
This last line is quickly becoming my most frequently used phrase in the ED…in particular when patients ask me how soon their hospital bed will be ready immediately after I’ve just elicited their cheif compaint.
Thank goodness that somedays the woohoos out number the ohnos.
My friend Jim, that is. Congratulations for correctly naming the author of the title of one of my prevous posts, Raise High the Roof Beams, Carpenter.
J.D. Salinger is the answer, of course.
Who can name the character described by my last 2 titles? Leave a comment. Here’s how. Click in the grey stripe below this post, it will say, “Add your two cents”, “Got more to say”, or “Agree with these x visitors?” A box pops up, enter your name, email and /or website address or any combination of the three. Type your comments into the box below, the click OK at the bottom of the screen. Double check by clicking on the comment link in the grey stripe again, and you should see your comment.
Good luck, jellyfish!