Thursday, 1 December 2011

Reality versus fantasy

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. 
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11 comments:

  1. lbhrvxvb17 February 2012 at 01:37

    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
    Replies
    1. DocBastard17 February 2012 at 03:43

      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.

      No patient has ever said anything like that to me, but as I said everyone is SHOCKED that I leave bullets in.

      Delete
  2. Rob Wilson21 February 2012 at 17:54

    When left in, Isn't there a risk of lead poisoning or something like that? Just curious.

    ReplyDelete
  3. Dancin' Wonder17 March 2012 at 00:00

    Isnt there a risk of some kind of infection? I am absolutely not a doctor but i was just wondering

    ReplyDelete
    Replies
    1. DocBastard17 March 2012 at 01:24

      I've never heard of a bullet getting infected. If anything, the bullet WOUND can potentially get infected, but that's about it.

      As for lead poisoning, it's very rare, though slightly more common in bullets that are left in joint spaces.

      Delete
    2. Ugi19 April 2012 at 13:35

      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.

      Shows what I know!

      Delete
  4. Anonymous9 January 2014 at 05:20

    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. - Denise

    ReplyDelete
    Replies
    1. DocBastard9 January 2014 at 05:55

      Nope. Bullets aren't magnetic, so they won't budge. It might possibly set off a metal detector, though.

      Now go to sleep! The blog will still be here when you wake up.

      Delete
    2. Jon Hendry17 February 2015 at 04:02

      Steel shot is magnetic, though...

      http://www.cabelas.com/product/Shooting/Ammunition/Shotgun-Ammunition|/pc/104792580/c/104691780/sc/104567580/Winchesterreg-Xpert-Steel-Game-Target-Shotshells-Per-Case/706168.uts?destination=%2Fcategory%2FShotgun-Ammunition%2F104567580.uts&WTz_l=undefined%3Bcat104567580

      Delete
    3. DocBastard22 February 2015 at 04:27

      Granted, but I see very few shotgun injuries. In fact, I think the last one I saw was about 15 years ago.

      Delete
    4. JC Denton5 August 2017 at 20:56

      What about steel cored bullets? Those are less common in anything small enough to not overpenetrate, but there's still a chance.

      Delete

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