Thursday, 31 May 2012


As you may have read, there is a very strict protocol to which we adhere for every trauma patient who hits the door.  After assessing the airway and making sure that the patient is breathing and has a heartbeat, we completely disrobe every patient and examine everything, front and back.  Things usually go very smoothly, but every now and then something happens that breaks the protocol and sends things into a tailspin.  Sometimes I'm the cause of that.

A 79 year old woman was just brought to me having tripped and fallen.  She landed on her face, but on arrival she was alert and breathing normally, so we continued the protocol and disrobed her down to her underwear.  The nurses turned her to the side so I could assess her back, and after I had done so the head nurse asked me if I could unhook her bra while she was still lying on her side.  Without thinking, I reached over and deftly unhooked it with one hand in a single smooth motion, not even realising how it might look.

Of course, the nurses noticed immediately.

The nurses, ER techs, and even the radiology techs all immediately started hooting and hollering at my ability to undo a bra so easily.  They started laughing about what that might mean.

If you ever wondered if I am capable of blushing, the answer is a resounding "yes".

Wednesday, 30 May 2012


I've done stories about stupid patients, stupid doctors, and stupid family members.  Now it's finally time to do a story about STUPID LAWYERS.  Well, one stupid solicitor at least.  

I received a witness summons (also known as a subpoena) in the mail a few days ago cordially inviting me to testify at a criminal trial in July.  Ok, actually it was informing me that if I didn't show up, I'd be arrested.  I took a long look at the name on the summons and quickly realised I hadn't the foggiest notion who the person was or how I was associated with him.  I receive these summons periodically, and I figured he was probably a guy who had shot or stabbed someone I had taken care of.  I called the lawyer and got his assistant who informed me that I was close - it was a drunk driving charge.  I tried telling her that I had no idea who this fellow was, though I was glad to see someone getting properly prosecuted for the offence, and I nearly hung up the phone, smugly satisfied that I had gotten out of court.  Before I had a chance to hang up, she told me the names of the two gentlemen who had been in the car that this guy had hit.  Both of them had been my patients.


I figured I could still get out of it - I've never met the drunk driver, I wasn't at the scene of the crime, I didn't take care of him, and I have no idea about the circumstances of the accident.  So why would they possibly need me to testify, right?  Do they need me to stand up and say under penalty of perjury that these men were, in fact, injured, as clearly evidenced by the medical record?  Do they need me to admit that I have no knowledge of anything whatsoever having to do with the crime?  I told the lawyer's assistant that I was absolutely certain that I would have nothing to add to the case and that it would be a waste of everyone's time to have me there.

I got a call back from the lawyer's assistant today informing me that I do have to show up to testify.  I still have no idea why, because the scumbag lawyer hasn't returned any of my messages.  I have to give up a day of either operating or seeing patients in my office for this bullshit.

Fucking soulless assholes, almost every single one of them.

Friday, 25 May 2012

Love hurts

Passion is an extremely powerful emotion. It's also potentially dangerous. I'm not talking about spending twice as much on that Valentine's Day gift as you intended, just to impress that special someone. No, I'm saying it can light a fuse that explodes as rage, sort of like this next guy who found out the hard way just how much love can hurt.

A young man wanted to see his young child, but the child's mother didn't want him to. Sounds simple enough...until rage takes over. Overcome with emotion, he tried to barge his way into her house. Unfortunately he wasn't fast enough to avoid her new boyfriend's fist, nor was he strong enough not to pass out.

He woke up in my trauma bay last night with a nasty concussion and a split lip. As I was repairing his lip laceration, I noticed some ugly linear scars on his right arm. The pattern looked familiar, so I asked him the obvious question:

"Did you punch a window?"

"Yeah, Doc. I still got some glass stuck in there too."

"And why did you do that?" I heard myself asking him before I could stop myself. Why why why? Why would I ask that?

"That was the last time she wouldn't let me see my kid. I know, I know. I was stupid."

My father taught me to listen to the patient, because 80% of the time they will tell you their diagnosis. This guy had his right on the money: stupid.

Friday, 18 May 2012


I'm not that garrulous a guy, but it still takes a lot to render me speechless.  I typically have an answer for anything a patient may ask or say, but sometimes I still get stupefied by someone, and I solemnly promise to post each and every instance of that here.

A few days ago two brothers were involved in a car accident.  The younger brother was egging on his older brother, encouraging him to drive faster.  Not to be taunted by his little brother, he pushed the car to the limit and then lost control.  The car flipped several times, and the driver was ejected because he wasn't wearing his seatbelt.  The younger brother, who had put his seatbelt on just prior to the accident, did not even have a scratch on him.  The older brother suffered hemorrhaging in his brain and is currently on life support, barely clinging to life, in the intensive care unit.

I was talking to his mother in her son's room in the ICU the next day, lamenting the fact that he had chosen not to wear his seatbelt.  "Well I never wear mine either," his mother almost proudly announced.

"You do now," I replied and smiled sadly, thinking she had learned her lesson.

"No I will not!" she flatly stated.

I simply stared at her with my mouth probably agape.  I glanced over at her critically-injured son, and then looked back at her, hoping she would make the connection.

"I've just heard of too many people getting hurt from those things, so I will NOT wear one."

I wanted to reach over, grab her face, and point it at her son, much like you would do to a puppy that pees on the rug.  "Just look at him!  He might die because he wasn't wearing his!  Your other son who had his on literally walked away from the accident!" I almost shouted at her.  She just looked at me almost defiantly, and I realised this was a battle not worth fighting, at least at that moment.  I know she was grieving, but this was ridiculous.

Don't you think for one second that I'm planning on letting this go, however.  I will revisit this issue with her once things settle down, but I have a bad feeling that she is a lost cause.

Monday, 14 May 2012


I'm going to take a quick detour from my usual stories to post something that I hope will make you smile as much as it did for me.  I don't come across stories like this very often, so when I do, I feel the need to share.

Oh, stop gagging you big baby.  Just read.

I was consulted on an elderly gentleman in his 80's about 2 months ago due to anemia and rectal bleeding.  In a man of this age, this is considered to be colon cancer until proven otherwise.  A gastroenterologist performed a colonoscopy and found a mass in his colon, and biopsies confirmed colon cancer a few days later.

Mr. X (not his real name) took the news very well.  He and his wife, who passed away a few years ago, were Holocaust survivors, and he dealt with the bad news just like he dealt with everything else - with an amazing sense of humour.  I've never heard so many cancer jokes in my life - I never knew so many cancer jokes even existed!

I removed about half of his colon laparoscopically (with a few very tiny incisions), and he recovered very well, going home about five days after surgery.  I saw him in my office about two weeks later, and everything was going very well, though he had elected not to undertake chemotherapy.  He still cracked jokes at every possible opportunity.

Hold your horses, the heartwarming part of the story is coming now - I just got an email from his daughter that the local municipality will be naming a school after his late wife after an exhaustive search for a new name.

There isn't very much out there, besides my wife and children, that makes me feel all warm and fuzzy inside.  This did.

Sunday, 13 May 2012


Very little makes me sadder than trying to take care of someone who has just tried and failed to commit suicide.  This person has chosen this day to die, and it's my job to make sure that they fail in their endeavor.

This past Thursday I had two attempted suicide patients in a row.  I won't focus on the second patient who tried to commit seppuku (according to his suicide note).  His case was sad, and fortunately his injuries were minor and he was admitted to our psychiatric unit the next day.

No, I'm going to focus on the next idiot.  "OH MY GOD, DOC!  HOW CAN YOU CALL THIS POOR GUY AN IDIOT?"  Oh, just you wait.  I guarantee you'll agree with me by the end.

A 19-year old kid was brought to me from jail having tried to hang himself.  You may be thinking about the character Brooks from The Shawshank Redemption hanging himself with a rope tied to a rafter and  kicking his chair out from under him.  Oh no, no, no, nothing that dramatic or effective.  This genius thought he'd try to kill himself by wrapping a bed sheet over a hook in the wall, sitting on a small trashcan, and leaning backwards to get some kind of tension on the sheet.  Needless to say, it didn't work.  He didn't even pass out.

What, that story isn't good enough?  Would it be any better if he had tried the exact same thing a month ago?  Well, he did.  And it didn't work that time either.

You still aren't satisfied?  Ok, then how about this - when his attempt a month ago failed, he waited a week before trying to drown his jail cell toilet.  I suppose he thought that was a bit, ah, unsavory, so he went back to trying to hang himself.

I expect to see him again soon, and I expect him to fail just as spectacularly.

EDIT: Because of doc_caleb's comment below, I've decided to give a little more to the story to clear this all up.  This guy clearly did not actually want to die.  These were nothing more than excuses to get out of jail for a few hours, and trauma surgeons see this regularly.  I saw the police walking him back to their car shortly after I discharged him, and he was actually smiling as he got in the car.  Have you ever seen any suicidal people smiling as they head back to jail?  No.  And neither have I.  That is why I called him an idiot, not because he supposedly attempted suicide.  Psychology was one of my major interests in university, and I am keenly aware of the difficulties that suicidal people (such as the first patient I mentioned) face.  If I had any suspicion that this guy was really suicidal, I would not have sent him back to jail.  I would have sent him for a psychiatric evaluation.

Is that clear to everyone now?

Thursday, 10 May 2012

Bad things only happen to good people

Some people just have bad luck.  They're at the wrong place at the wrong time when they're hit by a bus.  But some people create their own bad luck and their own bad situation.  And sometimes just when it seems a patient's story can't get any worse, it does.

This past shift was another busy one, with 5 patients coming to me in the first 90 minutes of the day.  The first trauma alert came literally as I was walking in the door.  "Oh great," I said to myself.  "It's going to be one of those days."  Well it was one of those days for my next patient, too.

At one point I was told I would be getting three patients, all from the same car accident.  Two cars had impacted each other head on, and at least two of the patients had obvious fractures.  The driver of one car had a broken heel and a broken rib.  In the other car, the 23-year old woman who was driving had minor scrapes and lacerations.  Her passenger was a 29 year old guy who had just gotten out of the hospital after fracturing his right knee in a car accident.  As soon as he hit the door of the trauma room he was screaming in obvious agony.  Everything from the waist down hurt, and his right leg was bent very awkwardly.  We got X-rays of everything, and he had fractured his left femur, left knee, left tibia and fibula, and his right knee (just below his previous fracture) and his right tibia and fibula.


Bad, right?  Oh ho ho not so fast!  That's not even the bad part.  The difficult part was yet to come.  It turns out he's a former narcotics abuser and takes multiple medications for it.  He told me he had been clean for three years.  Unfortunately for him his tolerance to narcotics was at Elephant Level, so we had to give him megadoses that should have been enough to kill him.

Now it's bad, right?  What, not bad enough?  Yes, it gets worse.  His urine drug screen was positive for cocaine.  Clean for three years?  Hardly.

That has to be as bad as it gets!  No no, just wait.  It gets even worse.

The woman who was driving him was his girlfriend, who was also on medicine for narcotics abuse.  He failed to tell us about his wife, however, until she showed up at the hospital.  She was obviously worried sick about her beloved spouse...

...and 9 months pregnant.

They say bad things only happen to good people.  Trust me, they happen to bad people too.

Monday, 7 May 2012

Smart people doing stupid things

 "Think of how stupid the average person is, and realize half of them are stupider than that." - George Carlin 

Doing stupid things unfortunately isn't remotely restricted to stupid people.  Even reasonably intelligent people do stupid things.  But all these people doing stupid things is what keeps me in business.

A 30 year old police officer was traveling on his motorcycle at highway speeds today when his front tire gave out and he fell off, sliding about 30 feet on the pavement before finally coming to a stop.  Fortunately he was wearing his helmet, but his right shoulder and face took the brunt of the fall.  He had extensive road rash on his face, shoulder, legs...pretty much everywhere.  As I was going through his history (including prior surgeries), he started rattling off the 12 or 13 bones that he had broken in the past, including his ankle and 10 bones in his back.  And how did he break them?

Why, his last motorcycle accident, of course.

Of course.

I told him that perhaps, maybe, it was possibly time for him to give up the motorcycle, because he didn't seem to be very good at it.  "Oh no," said he.  "I've been riding since I was 8!"

Not very well, apparently.  As you can imagine, I consider riding a motorcycle a stupid thing.  I consider getting back on a motorcycle after a horrific accident a really stupid thing.