Monday 31 October 2011

Truth is stranger than fiction

I know that "The truth is stranger than fiction" is a cliché, but it's completely true.  I can't make this stuff up - I'm just not that creative.

Last time I was on call, I got a call at 3 AM (I HAAAAATE those) about a level 1 trauma (that's generally a person who is very close to dying), a woman who had fallen down the stairs and was unconscious.  Even at 3 AM, my heart starts beating a little faster when I hear the patient is "level 1".  However, my palpitations soon changed to amusement. 

The woman arrived a few minutes later without a scratch on her.  The second I laid eyes on her, I knew that something didn't exactly add up.  And then the paramedics launched into her history: she was drinking at home and passed out, so her husband (also drunk) decided to carry her upstairs to bed.  Halfway up the stairs, he dropped his cell phone.  Now what would you do:

A) Ignore the phone and continue carrying your bride towards her peaceful slumber
B) Bring her back downstairs, get the phone, go retrieve her, and start over
C) Grab the phone and risk dropping her

I think by now you've guessed he chose "C".  And he dropped her.  She landed in a jumbled mess of inebriated unconsciousness at the bottom of the stairs...still passed out drunk.  The paramedics didn't know if she was unconscious because of the alcohol, massive bleeding in her brain, or both.  Of course, it turns out that she was completely fine, except for her blood alcohol level of nearly 0.2. 

Don't drink and walk.


This one may be a few years old, but it makes me giggle every time I think about it.  A young guy covered with tattoos (in my neck of the woods this usually indicates a gang member) came in shot in the buttock.  Nothing is quite as amusing as a grown man crying like a schoolgirl because he was shot in the ass.  I usually ask these rock stars what happened, and here's this guy's explanation:

"I was gonna shoot this asshole, but he grabbed my gun before I could shoot him and that motherfucker shot me in the ass!"

Yes, yes he did.

Friday 28 October 2011

Drug seeking


I'm smarter than you. Have I said that before? I think so, but it bears repeating. You may think you're very clever and have it all figured out. You can try to claim you're allergic to ibuprofen, aspirin, naproxen, Toradol, Ultram, Tylenol/paracetamol, and everything except Dilaudid. But you can NOT fool me. I'm amazed that people are so arrogant that they think they can trick me into giving them narcotics.

Last night, two 22-year olds were in a car accident, and both claimed to have severe, crippling back pain. Red flag #1. I was suspicious, so I pulled up the driver's prescription record (didn't know I could do that, did you, smarty pants?). In the past few weeks, he had prescriptions for codeine, Vicodin, Percocet, 2 benzodiazepines, Ambien, and Viagra. Yes, VIAGRA. Red flag #2. Oh, and his arms were covered in track marks. Red flag #3.

After a CT of both their spines were normal (please, control your surprise), I watched as both were propping themselves up in bed and twisting and turning - all things that people with back injuries can not do. Red flag #264. I accused them of drug seeking, and the driver immediately threatened to sue me for malpractice (ha!!). I happily gave him my hospital ID and a pen and told him to write my name down and have his lawyer call me. Not the best idea, threatening to sue the guy who you're trying to con some narcotics from.

The driver's father, who is an oncologist, came and picked them up, and they amazingly were able to get up and walk out. It's a miracle!!!

You're both cretins. And you're busted.

Thursday 27 October 2011


There is a reason that many countries around the world (including mine, thankfully) have laws requiring seatbelts to be worn: China, Russia, Australia, EU, UK, United States (WHAT THE FUCK ARE YOU WAITING FOR, NEW HAMPSHIRE??!).  They save lives.  Unless I'm moving my car from one position in my driveway to another position in my driveway, I put it on (and even then I usually automatically reach for it).  I have to consciously try NOT to put it on.  It takes 4 seconds and it doesn't hurt, although it may hamper your ability to get your cell phone that you accidentally dropped while you were texting while driving.  That's a whole other rant I'll get into some other time.

Three friends were coming back from a party at 1 AM.  The driver was a bit tipsy, the other two were flat-out drunk.  The driver and the front seat passenger were wearing their seatbelts when the driver lost control and flipped the car several times.  The rear-seat passenger wasn't.  The driver walked away with scratches and the passenger had a few broken ribs and a broken sternum.  He went home in a few days.  The rear-seat passenger wasn't wearing his seatbelt.  For comparison, here is what a relatively normal cervical spine looks like:
And this is his.  That his 6th cervical vertebra completely impinging his spinal cord.  He's now paralyzed from the neck down, forever, because he didn't put on his seatbelt.

Wednesday 26 October 2011


Like many radio stations, I take requests.  Someone yesterday noticed that I have some stupid patient stories, but no stupid DOCTOR stories.  Well, you asked for it...

I was on general surgery call at one of my hospitals yesterday, and I got a call from an ER physician about a young lady with right lower quadrant abdominal pain.  The first thing general surgeons always think about in a young patient with pain in that location is appendicitis.  It's incredibly common, and very easy and rewarding to treat.  The ER doc had ordered a CT scan of her abdomen which failed to identify the appendix.  There wasn't any inflammation in the area of where the appendix should be, but there was a recently-ruptured right ovarian cyst which surely was causing her pain.

But why couldn't the CT scan identify her appendix?

She had an appendectomy 4 years ago.
On a completely unrelated note (and having nothing to do with medicine whatsoever), PETA (in the US) is asking a federal court to give constitutional rights to 5 employees of SeaWorld.  Doesn't sound like such a big deal, until you realize that these employees are WHALES.  Yes, PETA wants constitutional rights extended to orcas, and they are claiming that the whales' captivity violates their 13th amendment rights banning slavery.

"By any definition, these orcas are slaves — kidnapped from their homes, kept confined, denied everything that's natural to them and forced to perform tricks for SeaWorld's profit," some PETA whackjob said.

Animals in captivity aren't slaves, you moron.  They are animals in captivity.  I am offended on behalf of all those people who actually were in slavery.  Fuck you, PETA.  Fuck you.

Monday 24 October 2011

You can't fool me

I always find it fascinating when people think they can outsmart me.  I'm not claiming to be the smartest person in the world, but I'm pretty damned sharp.  Tonight a 22-year old schmuck who REEKED of alcohol drunkenly rolled his golf cart at the country club tonight and then tried to claim he only had 2 beers...nice try, stupid.  Even after I tell these idiots that I am NOT the police and that I WILL be checking his blood alcohol level, they all stick with their story.  It's almost always "2 beers".  Were these 60 ounce beers?

Friday 21 October 2011

Don't judge a book...

I always try to believe the best about my patients, but a few experiences have severely curtailed my faith in humanity.

I have a guy now who was shot in the abdomen multiple times, and he suffered injuries to his small intestine and colon.  That's nothing new - it happens regularly, and these patients tend to do quite well.  This guy seemed like a nice enough guy - very polite, courteous, etc.  When I was making my rounds yesterday, I noticed he had been moved to the ward upstairs...the corner room with the locked door that can only be unlocked from the inside.  I figured the guy was under police protection, and I was right...sort of.  After being buzzed in by the police guards, I noticed he was handcuffed to the bed.  Turns out the guy has an outstanding arrest warrant.  For murder.

How the hell can I trust any of these people?

Thursday 20 October 2011


Can I talk about motorcycles for a minute?  Wait, it's my blog.  I can talk about anything I damn well please!

Motorcycles suck.  They really suck.  On a scale of 1 to suck, they SUCK.

If I hit someone at 60 mph/100kph, there is something rather comforting about having 1.5 tonnes/3000 pounds of steel, aluminum, and fiberglas surrounding me, not to mention the crumple zone, seatbelt, and multiple airbags that are designed to protect me.  If you're on a motorcycle and you hit a car (or a concrete barrier) at 60 mph/100kph, no combination of helmet, leather jacket, and armored pants are going to save your sorry ass.  It's just you and the road.  The road ALWAYS WINS.

What pisses me off even more are the idiots who defend their murdercycles to the death.  Literally.  I've had several patients tell me that their horrific motorcycle accident was their last and they are giving up riding.  But I had one guy a few months ago who had his leg nearly amputated at the knee.  He adamantly told me that he would get right back on his bike as soon as he was able, because the accident wasn't his fault.

Wasn't your fault?  What the hell does that matter?  Whether it's your fault or not, you almost died, and you almost lost your leg.  Life is a series of lessons from experiences.  LEARN SOMETHING FROM THIS ONE.

Wednesday 19 October 2011


Surgery has its share of tragedies, but I seem to see more than my fair share.

I was scheduled to do a colectomy a few weeks ago on a guy with a large colon polyp which couldn't be removed without surgery. He showed up for surgery 2 hours before his procedure, right on time. So what's the problem?

His wife died last night.  And he still came for his surgery on time.

He told me he'd be willing to go through with surgery, but he'd have to go home right afterwards. This is NOT outpatient surgery - people have to stay in the hospital for about 4 or 5 days after a colectomy.  Poor guy - I told him to go home and take care of his affairs. I wish all of my patients could be compliant like this guy, even though he took it several steps too far.

Tuesday 18 October 2011


Ok, more stupid patient stories.  One of my favourites is a 33 year old woman who jumped out of a second story window.  Why?  Because the guy she was with told her she had to go.  So she went...out the window.  Of course she was high on cocaine, why even ask!

She broke several bones in her back, but that's not the best part.  I was doing a FAST (Focused Abdominal Sonogram for Trauma) to check for any signs of internal bleeding, and when I put the ultrasound probe over her pelvis, I saw something move.

"Any chance you could be pregnant?" I asked her.
"No, I just had my period 2 weeks ago," she replied.

The fetus was actually 24 weeks along and probably just as high on cocaine as she was.


Stupidity isn't limited to trauma - it carries over to general surgery, too.  I finished doing a hernia repair on a guy a few days ago, and as we all know, patients who undergo hernia surgery should avoid any heavy lifting for 3-4 weeks after the operation. I reminded him of this, and he looked at me askance and said, "But my leading lady weighs about 21 stone (300 pounds)."

I thought he must be kidding. But he wasn't smiling or laughing.

"Just don't pick her up," I replied, thinking he must be joking.

"I mean in bed."

He's 71 years old.  His wife is too.

Friday 14 October 2011

More stupidity

What the hell is going on with PCP?  There's a major revival going on in my area, and more and more idiots are coming in so screwed up that they can't see straight.  These are just stories from this week:

A 55 year old guy was doing something on his roof while high on PCP.  Who the hell knows what...probably trying to fly.  He fell off, hit his head on the concrete, and had a major bleed in his brain.  He's on a ventilator now and probably will be for the rest of his pathetic excuse for a life.

A 24 year old guy decided it would be a good idea to go car surfing while high on PCP.  Much to the surprise of NO ONE, he fell off, hit his head, and bled into his brain.  He'll probably be a vegetable forever.

I find it difficult to have sympathy for self-induced trauma.

Life is cruel sometimes

This happened a few months ago, and it's just a sign that the world can be a cruel bitch.

A man came in having been involved in a high-speed rollover car accident.  He was unresponsive in the field with no pulse.  CPR was started.  By the time he got to me, he was still pulseless.  Massive chest trauma, flail chest, etc.  We continued CPR for 20 minutes before I declared him dead.  I got the really bad news a few minutes after that -

It turns out he was on his way from out of state to attend his wife's funeral.  She had died a few days before, also at my hospital, having hit a deer with her car.  The impact with the deer didn't kill her - the deer went through the windscreen and kicked her repeatedly in the head.  That's what killed her.

They had a 1 month old child.

Thursday 13 October 2011

First post...again

Well goddammit, I started this blog 2 damn years ago, and I can't remember the password to access it. I didn't like the name of it anyway, so to hell with it. I'm starting over. I'll steal some of the stories from that one.

Anyway, I'm a surgeon. Specifically, I'm a trauma surgeon, and as the name suggests this is about my patients who do stupid things. Once or twice a week I stay in the hospital for a 24 hour shift to see the worst of the worst. One of my hospitals is in a rather poor suburb of a rather large metropolitan area, and the other is in a rather affluent suburb. No, I'm not going to divulge which city. The patients at the first hospital tend to be hopped up on PCP, drunk, shot, stabbed, or some combination. Those at the second hospital tend to be teenagers who crashed Daddy's Mercedes. Almost all of them are stupid, have done something stupid, or have made a really bad decision just before coming to me.

The first stupid story - a couple was involved in a car accident, and as they were wheeled into my trauma bay, she was wailing in pain and he was yelling "NO DON'T WORRY ABOUT ME! TEND TO MY GIRLFRIEND!" I asked him if anything hurt, and he yelled, "Yes, my heart! It breaks for my girlfriend!"

Ugh. She was still wailing uncontrollably.

I worked them both up and they were fine. No injuries, just bumps and bruises. I walked into their room in the ER to see his WIFE and her HUSBAND yelling at them, along with her 2 sisters who had no idea she was cheating. Shockingly, they were both drunk at 8 AM.

Not dead

I'll start this post by answering a few questions that may or may not be burning in your mind: No, I'm not dead.  No, I didn't g...