Important

Tweet I agree it sounds funnier but shortness of breath in asthma where your airway sounds are high pitched and almost musical are not referred to a “weaseling”.

Tragedy in Boston

Tweet Haven’t had much to blog about lately but the events in Boston yesterday have stirred me. Of course the first thing you think of when you see those horrifying images of people who lost limbs is the overwhelming sadness and disgust with the event itself. However, as an ER doctor, I immediately start thinking [...]

How to Piss off the ER Doc

Tweet Me: “Hi, is this the surgical resident on call?” Dr Snot:”Yeah” Me: “Well, I have a patient here who initially went to their PMD a few days ago for weakness and was found to have afib….” Dr Snot (interrupting me): “And HOW then can I help you?!” Me: “You can start by letting me [...]

Smashed

Tweet Two guys drink themselves to within 10 g/DL of 500 then drive themselves into a pole. Luckily their smash in the car was at low speed compared to how smashed they were. They spend the night in the ER making drunken jokes in Spanish to each other.

Honesty

Tweet Me: “Sir, have you been drinking?” Mr Bacchanal: “Yeeeessshhh. *burp* Damn right I been!” Me: “How much?” Mr B:” However much I can get my damn hands on!!”

Mr Opposite

Tweet Me: “So how much do you smoke Sir?” Mr Aveloar-Coalescence: “Two packs a day. I increased it from one pack because I find it makes my COPD better.”

The Spin

Tweet Reposted today from 2008. Always applies though! What is one of the most important skills a doc learns while working in the ER? The “spin”. This is in addition to the obvious (and boring) skills of multitasking and learning the actual medicine. This skill (or lack thereof) can make a good ER doc into [...]

How is it possible?

Tweet This is sort of like a Keith Richards post. Want I mean is how is it possible that someone could abuse their bodies as much as Keith Richards does and still remain alive? However, in this case I mean how could some people who are riddled with as much diseases they are still keep [...]

Things that Piss me off

Tweet A). I walk in the room and you greet me with “Yo, what-da fuck up cuz!?” B). You’re a drunken dope who cut his face and you keep telling me “Don’t fuck this shit up, I’m a model!” while I’m suturing you. C). You say “Fuck this shit don’t work!” and you throw the [...]

Eventually they Die

Tweet Of there’s one thing all ER docs have learned is that there is one thing you can be certain of. Eventually all the chronically ill, drug abusing, frequent fliers die. Sooner or later you’ll walk into work and everyone will be like, “Did you hear?! So and so finally died!!!”. For a second you [...]

Injecting for Dollars

Tweet So, we all love to refer chronic backpaineurs to ortho or neuro or pain management or whomever for epidural steroid injections for sciatica.  It offers people something besides pain meds and boring physical therapy but not so radical as surgery.  We’d love to believe that they work and help people – ideally keeping them [...]

Proper Positioning

Tweet Listen, of you’re going to suffer a penis injury while having sex, it’s best done while NOT in the “Woman on Top” position. You see, most penile fractures occur in this position because the full weight of the woman comes down on the penis as it bends. *Ouchies* Generally, if things bend the wrong [...]

Miracle

Tweet Incredibly a nurse recently took the bull by the horns a cathed a febrile, elderly nursing home patient for urine and urine culture WITHOUT ME HAVING TO ASK FOR IT! Seriously though, why are urines mostly sent on young heathy people with no urinary complaints? Simple. It’s the law of Emergency Room Urine which [...]

Finely Tuned Machine

Tweet Sometimes things work out like they are supposed to.  More often than not, things tend to go wrong and it begins to look like a comedy (or in some cases a tragedy) of errors.  In the ER I would say things go awry more often than they go smoothly.  Things get ordered but not [...]

Vet consult

Tweet Here’s a consult for all you vets out there. First let me tell you that I have an appointment to take my dog to the vet tomorrow but thought I’d get some opinions. History is a 9 y/o F spayed Tibetan with one day of biting and scratching at her posterior and dragging her [...]

Half Assed CPR

Tweet If there’s one thing that irritates the heck out of me now is when people do poor quality CPR. The new ACLS recommendations are that they be done at 100 bpm and to compress the chest adequately. You’re not supposed to pause to check for a pulse every 15 seconds. You not supposed to [...]

7-11 Fun

Tweet Popping into a 7-11 late at night to grab something while on the road is a great convenience. However, turning the corner of an isle to see a drunk guy passed out on the floor with his junk exposed having just relieved himself all over the place puts a damper on things. No, for [...]

Nice Try

Tweet Dear Patient, Telling me to write you another prescription for Percocet because the one you got last night from the ER down the road was “illegible” and that you are sure the pharmacist would not be able to decipher it is not going to work on me. I looked at this Rx in question [...]

IPhone Is The Most Versatile Medical Device

Tweet We all know that the newest iPhones can do pretty incredible things. From finding you a house to buy, calculating your mortgage, paying bills, playing games, socializing, you name it, can do a lot. But what amazes me is how much cool stuff you can use it for in the medical field. There’s an [...]

Wipe Out

Tweet Getting drunk and driving is a very bad thing. However getting drunk and riding your wife’s “girl bike” is not only dumb but also kinda funny. People may laugh at you cruising along on a bike you are way too big for but it might stop when you crash it into a mailbox and [...]

CT Hell

Tweet I remember back in residency- I remember back in the dark ages with the old generation CT scanners. These are the ones that took 1 billion years to do anything more than I head CT. CT’s of the C-spine or the abdomen were absolutely painful. Painful to the staff especially the residents. Also likely [...]

Make Up Your Mind

Tweet There are few things more irritating in emergency medicine then when a patient who clearly is vegetative, severely demented, and bedridden has family members who refuse to make him or her DNR. One thing that is more irritating though is when they keep reversing themselves! Okay let’s make her DNR. No, wait! Grandma said [...]

Crap in a Bucket

Tweet Sometimes heard as an utterance expressing exasperation, it sometimes carries a more literal meaning. Take this chief complaint: “disturbed man brought in by police for being witnessed defecating in a bucket in his front yard”

Doesn’t work that Way

Tweet Dear idiots of the world, once you’re discharged from the emergency room without a prescription for narcotics because you’re a known drug abuser (backed up by the state narcotics record), calling 911 first from the waiting room and then 20 minutes later calling them from the hospital lobby is not going to get you [...]

Assholes

Tweet It’s really pathetic when MD’s who see all the patients in a nursing home just blast them all with pain meds without bothering to even try to figure out what’s wrong. Now, if someone is end stage dementia, vegetative, etc, fine. That makes sense. But functional 90 year olds should be treated a little [...]