I have never told a single patient "I am smarter than you." I freely admit to having thought it perhaps once or twice or five thousand times, but I've never said it aloud. While I'm not the smartest guy in the world, I'm certainly well above average. Additionally, physicians tend to be among the most educated people in the world.
Yeah yeah yeah, hey look at that, it's another Doc Pats Himself On The Back Event!
Oh, shut up! I'm trying to make a point here and you're just being rude and interruptive.
Well then get to the damned point!
Fine!! Where was I? Oh, right. The fact is, whether they like it or not, unless they happen to be doctors themselves (which they rarely are), my patients know less about medicine than I. That may sound obvious, but hear me out. I'm very thoughtful, conscientious, and careful, so when I give advice and make a plan of care, I fully expect my patients to abide by it. And the vast majority of the time, they do.
Sometimes, however, people have other more pressing needs than some crackpot doctor trying to do something stupid like, oh I don't know, take care of you and your stupid, unappreciative, know-it-all ass!
Wow...sorry about that. Anyway, a 50ish year old guy was brought to me after he had the shit beaten out of him, er, I mean after he was assaulted by multiple people. Probably because he fucking deserved it!
Ahem, let me take a second to gather myself here. You can probably tell I'm still a bit miffed by this guy, and you'll see why in a minute. This previously-healthy gentleman was brought to me having been beaten. He had bruises all over his body, especially his face and torso, and he complained mostly of rib pain. What was most obvious was the exquisite tenderness over his ribs and his bloody, crooked nose. He was worked up fairly quickly with multiple X-rays and CT scans, and in addition to his 2 broken ribs and his broken nose, both his lungs were punctured, he had a broken bone in his back, and there was a small amount of bleeding in his brain. One of these injuries is bad. Two is worse. Add them all up, and he's in REALLY bad shape. Fortunately for him none of the injuries was bad enough to need surgery, but he at least needed very close observation in the intensive care unit for both the bleeding in the brain and the punctured lungs. I admitted him and ordered repeat scans for the morning to make sure nothing was getting worse.
After I finished explaining this to him, he looked at me with frantic eyes and asked me how long he would be in the hospital. At least three days or so, I told him.
"OH NO! I got shit to do, Doc! I can't stay that long! I gotta get out of here!"
I resisted the urge to slap the stupid out of him, and I again explained the severity of his many injuries and how several of them could be potentially fatal if they get worse. He seemed to understand, but he just kept telling me how he had "more important things" to attend to.
The next morning I headed straight to the ICU to make my rounds as I always do, but when I got to his room there was an old lady in his bed. Thinking they had moved him elsewhere, I checked the computer census, but the computer had no record of him being in the hospital. Suspicious of the answer, I asked the nurse where he was. "Oh, he left last night against medical advice. He said he had something he needed to take care of and refused to stay."
SOMETHING TO TAKE CARE OF?? ARE YOU ACTUALLY SERIOUS? WHAT COULD POSSIBLY BE MORE IMPORTANT TO TAKE CARE OF THAN YOUR HEALTH?