My co-intern, Clay: Ma'am, if you'll just step out and wait a little while in the family room, we'll put in this central line so that we can give your husband the I.V. fluids he needs.
Elderly lady: Are you going to be putting in this line? How many of these have you done before???
Helpful yet dishonest nurse: Sometimes the younger doctors are better at this sort of thing, since they're more recently out of training.
Elderly lady: Young!?! Of course he's young! I have shoes older than him! Shoes!
Me, after seeing a patient who was high on cocaine which contributed in no small way to his general spirit of uncooperativity, and thus necessitating my relying on some of the other doctors' notes: Wow, my History and Physical is short! I have so little information. It's so short, it's like a surgeon's H&P!
My resident: Um, that is the surgeon's H&P. You copied it.
And, have you ever wondered what a politically-correct name would be for the nurse who spends all day reviewing medical charts with the intention of prodding doctors to boot their patients out of the hospital sooner, thus maximizing the hospital's income? Utilization Management Coordinator
Saturday, February 11, 2006
Friday, February 10, 2006
From the Associated Press
Message in a bottle gets trashy reply from Britain
NAPEGUE, N.Y. -- A boat captain who sent a message out to sea in a bottle says he received a reply from Britain--accusing him of littering.
"I kind of felt like no good deed goes unpunished," Harvey Bennett, 55, told the East Hampton Star.
The plastic bottle was one of five that Mr. Bennett placed in the ocean off New York's Long Island in August. Last month, he excitedly opened a letter from England, and was stunned by the reply:
"I recently found your bottle while taking a scenic walk on the beach by Poole Harbour. While you may consider this some profound experiment on the path and speed of oceanic currents, I have another name for it, litter.
"You Americans don't seem to be happy unless you are mucking about somewhere," says the letter, signed by Henry Biggelsworth of Bournemouth, in Dorset County.
- - - - - - - - -
Jonathan's comment: Could you have a better name here than Henry Biggelsworth???
NAPEGUE, N.Y. -- A boat captain who sent a message out to sea in a bottle says he received a reply from Britain--accusing him of littering.
"I kind of felt like no good deed goes unpunished," Harvey Bennett, 55, told the East Hampton Star.
The plastic bottle was one of five that Mr. Bennett placed in the ocean off New York's Long Island in August. Last month, he excitedly opened a letter from England, and was stunned by the reply:
"I recently found your bottle while taking a scenic walk on the beach by Poole Harbour. While you may consider this some profound experiment on the path and speed of oceanic currents, I have another name for it, litter.
"You Americans don't seem to be happy unless you are mucking about somewhere," says the letter, signed by Henry Biggelsworth of Bournemouth, in Dorset County.
- - - - - - - - -
Jonathan's comment: Could you have a better name here than Henry Biggelsworth???
Saturday, January 28, 2006
Prostate Cancer Screening Clinic
Denial is a powerful force. I learned this, in a new and special way, after volunteering for the free Prostate Cancer Screening Clinic at the hospital this Saturday. I'm a sucker for desparate pleas for help.
Somehow, I imagined that I would be seeing patients with clip-board in hand, seated pleasantly across from a patient who, dressed with full dignity, detailed to me their past medical history, urinary problems, and pertinent medication use. After this time of information gathering, I would direct the patient to the back, where the urologist would be waiting with a gloved and lubricated finger, ready to detect any concerning anomaly in this spongy, golfball-sized gland.
When I arrived early at ten of nine, however, a sense of panic slowly but steadfastly took prominence in my now frail psyche. The nurses and volunteers seemed relieved to see me. "Okay, there's a doctor here! We can get started!" Fifty aging men milled about in the waiting area. I convinced them to wait to send the patients back until one of the urologists came (around nine o'clock), but it was soon clear to me that the urologist was here in a collegial and only occasionally consultative role. If there was something I was unsure about, I could ask for his finger's expert advice.
So there I was on my Saturday morning, doing prostate exam after prostate exam. I think I did about forty. My typical patient interaction started with a brief pleasantry, "Hello, Mr Smith, I'm Dr. _____; how are you this morning?" And continued with my reviewing the survey they'd already filled out: "I see you have some trouble getting up at night to urinate, and often have difficulty starting your stream of urine. Let's see, your last prostate exam was three years ago? And it was normal at the time?" And then came the meat of the encounter: "I'm going to have you lower your pants, and simply lean over this gurney. Do your best to relax...and...a little pressure...okay, done. You can get dressed."
Sometimes there were amusing variations in the conversation. Such as when several patients asked, "Do I need to lower my underwear too?" Or another patient who looked at the cart with gauze, lubricant, gloves, etc, and asked, "So is that all the free stuff?" I said, "I'm sorry sir?" "Are those things free?" he replied, "How 'bout those socks?" indicating the brown socks that were handed out to the G.I. inpatients, as the clinic was held in G.I. endoscopy lab prep/recovery area. "I'm sorry, this isn't an airplane. Go ahead and lower your pants," was my reply.
I guess it was nice to do a community service, and I think there may be a $50 honorarium involved! I definitely feel more comfortable with my prostate exam. But most significant was the experience of finding a nodule, as I found on three patients. Even though it's bad news to tell a patient, referring them for biopsy means they have a chance of catching a potential cancer while it's easily treatable with surgery. It was a chance to make a big difference in those patients' lives!
Somehow, I imagined that I would be seeing patients with clip-board in hand, seated pleasantly across from a patient who, dressed with full dignity, detailed to me their past medical history, urinary problems, and pertinent medication use. After this time of information gathering, I would direct the patient to the back, where the urologist would be waiting with a gloved and lubricated finger, ready to detect any concerning anomaly in this spongy, golfball-sized gland.
When I arrived early at ten of nine, however, a sense of panic slowly but steadfastly took prominence in my now frail psyche. The nurses and volunteers seemed relieved to see me. "Okay, there's a doctor here! We can get started!" Fifty aging men milled about in the waiting area. I convinced them to wait to send the patients back until one of the urologists came (around nine o'clock), but it was soon clear to me that the urologist was here in a collegial and only occasionally consultative role. If there was something I was unsure about, I could ask for his finger's expert advice.
So there I was on my Saturday morning, doing prostate exam after prostate exam. I think I did about forty. My typical patient interaction started with a brief pleasantry, "Hello, Mr Smith, I'm Dr. _____; how are you this morning?" And continued with my reviewing the survey they'd already filled out: "I see you have some trouble getting up at night to urinate, and often have difficulty starting your stream of urine. Let's see, your last prostate exam was three years ago? And it was normal at the time?" And then came the meat of the encounter: "I'm going to have you lower your pants, and simply lean over this gurney. Do your best to relax...and...a little pressure...okay, done. You can get dressed."
Sometimes there were amusing variations in the conversation. Such as when several patients asked, "Do I need to lower my underwear too?" Or another patient who looked at the cart with gauze, lubricant, gloves, etc, and asked, "So is that all the free stuff?" I said, "I'm sorry sir?" "Are those things free?" he replied, "How 'bout those socks?" indicating the brown socks that were handed out to the G.I. inpatients, as the clinic was held in G.I. endoscopy lab prep/recovery area. "I'm sorry, this isn't an airplane. Go ahead and lower your pants," was my reply.
I guess it was nice to do a community service, and I think there may be a $50 honorarium involved! I definitely feel more comfortable with my prostate exam. But most significant was the experience of finding a nodule, as I found on three patients. Even though it's bad news to tell a patient, referring them for biopsy means they have a chance of catching a potential cancer while it's easily treatable with surgery. It was a chance to make a big difference in those patients' lives!
Thursday, January 26, 2006
Alito's nomination
From today's CNN.com:
Alito "will tip the balance of the scales of justice," said Sen. Dick Durbin of Illinois, the Senate's No. 2 Democrat. "He will tip the balance against protecting our basic privacy and personal freedoms. He will tip the balance in favor of presidential power even when it violates the law."
I typically don't offer much political commentary; there are many more comprehensive and informed sources for dialogue than good ol' Mulberry Street. I thought this comment was interesting, however. Sure it's rhetoric-al, and even practical as every high school student learns in government class that the highest court is to be a check on the executive and legislative powers.
However, I've never quite understood the Democrats' inherrent concern in swinging the "balance" of the court. The president, elected by the people, has the power to nominate Supreme Court justices. Hence the make-up of the court can shift slightly as different presidents are elected by the people. That, in fact, is the very check--and the only check--that the executive branch has on the judicial branch of government. Whatever one's politics are, I would think this would be taken as a good thing, rather than focusing on replacing one justice with another justice who most closely mimics the departing one.
Alito "will tip the balance of the scales of justice," said Sen. Dick Durbin of Illinois, the Senate's No. 2 Democrat. "He will tip the balance against protecting our basic privacy and personal freedoms. He will tip the balance in favor of presidential power even when it violates the law."
I typically don't offer much political commentary; there are many more comprehensive and informed sources for dialogue than good ol' Mulberry Street. I thought this comment was interesting, however. Sure it's rhetoric-al, and even practical as every high school student learns in government class that the highest court is to be a check on the executive and legislative powers.
However, I've never quite understood the Democrats' inherrent concern in swinging the "balance" of the court. The president, elected by the people, has the power to nominate Supreme Court justices. Hence the make-up of the court can shift slightly as different presidents are elected by the people. That, in fact, is the very check--and the only check--that the executive branch has on the judicial branch of government. Whatever one's politics are, I would think this would be taken as a good thing, rather than focusing on replacing one justice with another justice who most closely mimics the departing one.
Wednesday, January 25, 2006
Webster's dictionary defines...
Pregnant adj. carrying unborn young within the body; gravid.
Hence, when my attending cardiologist asks his young patient (with her husband standing in the room), "So, are we going to get pregnant any time soon?" I didn't know whether to cringe or laugh. It was wrong on so many levels!
Might I take this time to helpfully clarify that pregnancy is a physiological state, not a state of anticipating a baby. "We're expecting a baby!" is an acceptable phrase for a young father-to-be. "We're pregnant," most certainly, is not.
Hence, when my attending cardiologist asks his young patient (with her husband standing in the room), "So, are we going to get pregnant any time soon?" I didn't know whether to cringe or laugh. It was wrong on so many levels!
Might I take this time to helpfully clarify that pregnancy is a physiological state, not a state of anticipating a baby. "We're expecting a baby!" is an acceptable phrase for a young father-to-be. "We're pregnant," most certainly, is not.
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