Have you ever noticed how people die immediately after getting shot or stabbed? Or they have their last few gasps before saying the name of their killer or "Avenge me!" or something equally dramatic and stupid. And have you ever noticed that the people who DON'T die immediately after getting shot just need to have the bullet removed so that everything is ok. They can go to a back-alley doctor or a veterinarian or anyone with a pair of pliers, and as soon as that nasty bullet is extracted, everyone sighs a big sigh of relief, because "He'll be ok!"
Well, I have some bad news for you - TV and movies are NOT reality. This shouldn't come as a shock to you, but it does to everyone else.
You see, I usually don't remove bullets from people who have been shot. Once they go through you, the damage is done. After it stops moving (if it's still inside you), it doesn't do anything. It just sits there. There is simply no reason to remove it, unless the police really need it to help find the shooter. Make sense? It seems to be common sense to me. However, whenever I tell this to someone, they look at me like I'm crazy.
"YOU AREN'T GOING TO REMOVE THE BULLET??"
No, I'm not.
"OH MY GOD! WHY NOT??!"
I try to explain what I just said above, but they still look at me like I have two green heads with antlers. Removing the bullet usually does more harm than good. Digging around for it can damage the surrounding tissues, and there's no benefit to removing it anyway.
Don't even get me started on the TV show "House" and all the mistakes they make.
Stories about general surgery, trauma surgery, dumb patients, dumb doctors, and dumb shit from the dumb world around us.
Thursday, 1 December 2011
Reality versus fantasy
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Can I request a post on some of the stupid mistakes house has made? I think it would be interesting?And I was wondering has a patient ever disputed what you have said with something like "but on house someone said this"ReplyDelete
Ugh...there are just way too many in every single episode. No one practices medicine the way he does - he thinks he's figured it out, so he treats the condition without confirming the diagnosis. Then when he's wrong, he treats something else. It's completely ludicrous.Delete
No patient has ever said anything like that to me, but as I said everyone is SHOCKED that I leave bullets in.
When left in, Isn't there a risk of lead poisoning or something like that? Just curious.ReplyDelete
Isnt there a risk of some kind of infection? I am absolutely not a doctor but i was just wonderingReplyDelete
I've never heard of a bullet getting infected. If anything, the bullet WOUND can potentially get infected, but that's about it.Delete
As for lead poisoning, it's very rare, though slightly more common in bullets that are left in joint spaces.
I guess the bullet is so hot when it goes in that it's sterile anyway. I can understand it being left in until the initial trauma has healed but the body has fantastic systems for detecting and attacking foreign objects. I would have thought (not being a doctor) that the site would have been constantly irritated by the bullet and you might need to go in in a controlled way later to remove it.Delete
Shows what I know!
Wait, wait, wait. What? If you leave a bullet in, and the patient has a MRI years later, can said bullet come ripping out into the magnetic-ness? This is the best blog ever. Now I have to stay up all night reading years of entries. I'll be tired and cranky tomorrow and I don't care. - DeniseReplyDelete
Nope. Bullets aren't magnetic, so they won't budge. It might possibly set off a metal detector, though.Delete
Now go to sleep! The blog will still be here when you wake up.
Steel shot is magnetic, though...Delete
Granted, but I see very few shotgun injuries. In fact, I think the last one I saw was about 15 years ago.Delete
What about steel cored bullets? Those are less common in anything small enough to not overpenetrate, but there's still a chance.Delete