Friday, 25 January 2013

Insults and happy endings

There are certain people in your life that you just shouldn't insult. These are people that can make your life a living hell if they so choose (or if you choose for them).  Sure, there are some easy ones: your parents, your teachers, your neighbours, your boss. But there are a few which may not be so obvious:

- Your mechanic ("Yup, I'm gonna have to rebuild your whole engine.")
- The guy who makes your fast food burger (yes, they DO spit in them)
- Your children (they will choose your nursing home eventually, after all)

Surprisingly though, some people don't have any problem insulting their doctors - you know, the people who are trying to help them.  I've heard stories from colleagues that were almost too ridiculous to believe, but I've never experienced it myself.

Until now.

An older gentleman was brought to me after he fell down an embankment and struck his head on a brick wall.  Fortunately his brain was just fine, but after an extensive workup, I discovered only two things were broken: a bone in his neck was one of them.

His wife's sense of decency was the other.

As soon as I walked into his room to explain the situation to her, she immediately launched a full-scale attack against me, based not on my abilities, but rather on my looks.  I unfortunately have one of those baby faces, and it makes me look much younger (and much less respectable, apparently) than I am.

"My god, how old are you?" she shrieked.  "You look like you still belong in high school! Are you even old enough to be a doctor?"

Wh...what?  Somehow restraining my desire to slap her, I ignored her age comment and calmly explained that I was not only fully trained, but also very good at what I do.

"Well I'm not gonna let my husband get killed by some baby doctor! My mother was killed by a baby doctor like you!"

Now up until that point I thought I had seen it all - I have been sworn at, spit at, cursed at, and threatened with violence and even death numerous times. But never have I been so insulted in my entire professional career.

I realised that trying to defend myself would get me nowhere, so I simply finished explaining the situation to them and walked out.

But wait, the title of this post is "Insults and happy endings", so what the hell is the happy ending?  Here it is - I got the last laugh. The neurosurgeon who ended up taking care of his broken neck is even younger than I am.

Friday, 18 January 2013

Medical shows

I got another request from a reader named Mr. M (not his real name).  I hadn't thought about a post like this, but his question piqued my interest in the subject.

Hi DocBastard,

I have a wish for one of your interesting blog entries: could you give us your perspective as a real practising surgeon on medical tv shows like Grey's Anatomy, Dr. House or ER and tell us how they compare to real life in the hospital? I know they try to incorporate real but very rare medical cases, but what interests me more is how daily life in hospital is portrayed, with the relationships between doctors, the time they seem to have to discuss personal problems in the hospital, nine surgeons in one OR on one case, or all nine of them in a bar together, some living together in the same house...

You'd do a great service to dispell these myths and perceptions about medicine created by these shows, because I personally know people who want to go to medical school to live the life portrayed in these shows...

The thing to remember about TV is that it's meant to be entertainment, not informative.  I can guarantee that no one would actually watch a reality show based on my life.  While my stories may seem mildly interesting or entertaining, they are few and far between (which explains why it's often a week or more between entries).  The vast majority of what I do is mundane and boring.  I hope that doesn't disappoint too many people, but that's reality, folks.

I watched a few episodes of "Grey's Anatomy", and it's nothing more than a glamourised soap opera.  The social interactions that these people have are complete and utter bullshit (to put it mildly).  Sure, there may be an odd affair here and there in real life, but the show makes it seem like everyone in the hospital is having sex with everyone else, and that just isn't the case.  In reality, most of us have boring lives, and at the end of the day we go home in our boring cars to our boring families.

"ER" was interesting and fun to watch, but it's just as exaggerated.  What drove me nuts was how almost every patient who was shocked by the defibrillator "came back" after the third shock.  Um, no.  Most of those people die in real life (real death?).  And whenever anyone got intubated, the person putting the breathing tube in would triumphantly announce "I'M IN!" and the nurses swoon and ovulate.  Sorry, but we don't do that.  Ever.  If anyone ever did that in real life, he'd probably get kicked in the crotch for being corny.

As far as "House" is concerned, I will shamefully admit that I watched almost every episode.  But only because my wife made me!  I swear!  It wasn't because of the interesting cases!  The biggest problem with that show is that drama and the pranks in the hospital just don't happen.  At all.  Worse yet, there's no such thing as a Department of Diagnostic Medicine at any hospital like they have on the show.  The real diagnosticians are internists, surgeons, cardiologists, nephrologists, etc.  We don't farm out our "interesting" cases to smarter doctors because we just can't figure it out.

The way the doctors give IV medicines, do all their own procedures, surgeries, MRIs, ultrasounds, and biopsies, is completely fabricated.   Radiology techs do all of the scans, surgeons do surgery, pathologists look at specimens, lab techs do the bloodwork.  And though the names of the diseases presented on "House" may be real, the presentation and evolution of the disease process that is shown is exaggerated, embellished, accelerated, or some combination thereof.  House's basic premise was to come up with a list of possible diagnoses for the patient's problem, narrow it down to one, and then treat it before confirming it.  Inevitably that treatment wouldn't work ("Well, I guess it isn't lymphoma!"), and another symptom would emerge ("OH MY GOD, I CAN'T FEEL MY LEGS!"), prompting a change of diagnosis and a new treatment which also wouldn't work.  And so on and so on, until House had his "House moment" and figured it all out.  No, it isn't lupus.  It's never lupus.

Social interactions are why people watched the show.  It it were purely medical, it would flop after one episode.  No one wants to see cordial people politely greeting each other as they walk down the hall, making idle conversation in the elevators, and silently watching TV while gobbling a sandwich in the lounge between cases.  But that's reality.  Every now and then I get an interesting case, but inevitably I solve it, fix it, and move on to the next patient with regular, ordinary, run-of-the-mill appendicitis.

But instead, people would rather see the surgeon having wild sex with the nurse in the broom closet.  Now THAT is good television.

Thursday, 10 January 2013

Getting away with it

How many drunk idiots have been brought to me after crashing their cars?  A hundred?  Two hundred?  Probably more than that.  And how many of them have actually been arrested?  I can probably count that on one hand.  Most of these maniacs get away with it, something that makes me absolutely livid.

Now, how many of them have gotten simple citations for their besotted idiocy?  I don't keep actual statistics, but based on my memory, it's likely less than 10%.  Most of the time the police don't even show up, and when they do, they don't seem to feel like hanging around until our workup is done so they can issue the ticket.  One police officer actually told me that "it just isn't worth it".  

Isn't worth it??  I just stared at him, incredulous.  It drives me batshit crazy when these people get away with crimes like this that put everyone, my wife and children included, at risk of serious injury or death.  In fact, I get aggravated when someone gets away with something as simple as a traffic violation.  Which seems to be a perfect segue into my first mini-rant of 2013.  

I was sitting on the freeway in stop-and-go traffic on my way to the hospital this morning, a police car right in front of me, something I usually find to be very comforting.  As we were passing an on-ramp, I noticed a taxi in the other lane swing into the on-ramp lane to get around a few cars.  It pisses me off when I see people do this, because it's like they are telling me "I'm far too important and in far too much of a hurry to sit in traffic like the rest of you plebs.  I'm making my own traffic rules!"  I immediately yelled at the policeman in front of me to pull the taxi driver over, which I'm fairly certain he didn't hear through my windscreen and his back window.  Traffic continued at a near-standstill while the taxi got ahead of 5 or 6 cars.  Congratulations, asshole.  Now you get to keep sitting in traffic with the rest of us underlings.

About a minute later, we started to pull even with the far-too-important cab who had again been caught in the slower lane.  I noticed the policeman sidling over towards him and my mouth started to curl into a smile.  It broadened into a huge grin as he flipped his lights on, swung quickly behind the taxi, and pulled him over.

Justice.  Sweet, sweet justice.

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