Monday 24 June 2013

A REAL bastard

After reading about how I talk bluntly (and sometimes appropriately harshly) to my patients, you might just think I talk to all of my patients that way and that I'm a right bastard.  But you'd be wrong - my bastardish ways are like Batman - tough, dark, gritty, and exactly when and where (and only where)  it needs to be.  But I can also be extremely kind, even when you might not expect it.  Even when the patient might not expect it. 

I was called to see a 28-year old idiot, er, man, who had an abscess in his antecubital fossa of his left arm. 

WOOOO!  WOOOO!  Red alert! Red alert!  IV drug abuser!  WOOOO!  WOOOO!

In case you didn't catch that (or don't have a damned clue what I'm talking about), an abscess is a pus-pocket and the antecubital fossa is the inside of the elbow where your arm bends and most people have big, fat veins that are perfect for injecting drugs into.  And most people are right handed, so they inject drugs into the big, fat vein in the bend of their left arm.  Make sense?  Yes?  Good.  Moving on then. 

When he first showed up, he told the ER doc that a bee had stung him.  Yeah.  Fortunately he realised quickly that no one bought his cockamamie story, and he copped to injecting cocaine into his arm.  He also claimed it was his first and only time, and that he had used a brand new insulin needle he got from a friend.  It's a classic bullshit story, but strangely enough, they believed him.  I'll get to why in a minute. 

Just as I arrived to his room, the wild-eyes nurse caught me outside and said, "I have never witnessed anything so unprofessional in my entire career!"  Seeing the quizzical look on my face, she explained: the infectious disease specialist (who had just left) had waltzed up to the man, tore his bandage off, and had started squeezing the hell out of his arm trying to see if pus would come out, all the while scolding him and telling him that this was his own stupid fault.  She then walked back out without another word. 

And you thought I was bad!  Sure I might tell someone that their actions were stupid, but doing it while inflicting needless pain is ridiculous.  This woman is the real Doc Bastard. 

When I walked in, I saw a nicely-groomed, polite, obviously well-educated young man in tears.  I instantly felt sorry for him, but there was something about him that made me too believe that this really was the first time he has used IV drugs.  The fact that he had no track marks definitely helped.  After explaining what was going on, I numbed his arm and drained the abscess.  As I was doing it I told him gently, "I'm not going to beat you up about what you did, because I can tell you know it was dumb, and I'm sure you're beating yourself up enough already." 

He looked up at me, tears running down his face.  He smiled and nodded silently, and I knew he'd never do this again. 

Sometimes I have to remind people not to be stupid.  Sometimes other bastards do it for me.  But sometimes a kind, reassuring word is all it takes. 


  1. Yep, she's a bitch alright and what comes around goes around. But unfortunately she isn't the only one out there. There is one particular hospitalist at the hospital they take me to for a congenital heart arrhythmia that when they admit me I tell them upfront Dr. Screamatyou does not come near me.

  2. We have a NP (nurse practitioner, for you non-medical folks.) In our ER that has horrible bedside manner. He not only has dismissed patient's concerns (he refused to lance a large abscess on this patient's leg (that clearly needed it), which later burst while she was at the pharmacy. He has also mistreated employee's and their families while they were there getting treatment. He told one of my co-worker's friends it was her own fault she got drugged at a club. He has been fired once, but like a bad infection he keeps coming back. -.-

  3. Hey SkyGuy32, did you get my email?

  4. I can't claim to know the whole story but is it possible there is more to it? I mean this sounds like a relatively common occurrence and if she did this all the time she would be fired. Is it possible the woman was trying to scare him off of trying drugs? Must people who do this I bet are completely lying, not truly remorseful, and would do it again without a second thought. Maybe the Doctor saw a glint of hope in this one? She saw that this was in fact his first time (probably anyways), and so she tried to scare him away from ever doing them again. Because from how you wrote this story I sure as heck would bet money that this man had one of, if the the worst night of his life. Is there any chance at all that IDS Doctor isn't such a bastard after all and actually was trying to help?

  5. That lady sounds about as bad as the emt who pulled me out of my wrecked car. I passed out from low blood sugar (no history) and he took his sweet time loading me while ranting that I was the bad guy. The ER had to bring the Chaplin in to calm me down before surgery.


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