Friday 30 August 2013


1. a person whom one knows and with whom one has a bond of mutual affection, typically exclusive of sexual or family relations.

There are many different types of friends: the people you know and trust the most, the people you enjoy hanging out with, the people at work that you actually like with whom you talk about the people at work you don't like.  Perhaps you're friends because they are funny, maybe you share a common interest, or maybe it's just because you've been friends for so long and nothing else really matters.   Whatever the reason, there's a common thread running through all these different groups - they are all people you like.

All of which makes me wonder how this next guy chose his particular group of friends.

A man in his late 20's was brought to me completely unconscious.  He had suffered obvious head trauma - one side of his face had its skin scraped off, he had blood coming from his nose and ears, and he was completely unresponsive, but everything below his neck looked fine.  The report the medics gave us was more cryptic than their usual bullshit - he had supposedly been riding a motorcycle and crashed, but when the medics arrived, there was no motorcycle there, no broken helmet, nothing.  Just him, lying half-dead by the side of the road in front of a house.

Whenever I get a story like this that just doesn't make sense, it immediately raises red flags and I start to think about what else could have happened.  Had he been assaulted?  Had he fallen or been pushed out of a car?  Had he been abducted by aliens and unceremoniously deposited next to the roadway after they finished their anal probing?

His mother arrived later to tell us the whole story.   The answer was much more mundane and less interesting, though much more infuriating, than an alien anal probe.  He had been riding his motorcycle with a group of friends, and he had lost control and crashed.  Unfortunately for him he was not wearing a helmet whilst speeding along at three times the speed limit.

"So where was his motorcycle?" I hear you asking.  And more importantly, where the hell were his friends?  Well after watching him crash and nearly kill himself, they decided to take his motorcycle and leave him there, bleeding, to fend off death by himself.  They didn't even call emergency services before they fled.  The owner of the home in front of which he crashed happened to see him lying next to the road an hour or two later, and he called the ambulance.

The young man spent 3 weeks in hospital before I sent him to a nursing home.  He can barely speak, he can't eat, and he can't move the right side of his body.  I don't know if he will ever be able to walk again.

After this little episode, I propose my own definition of "friend" for DocBastard's Realistic English Dictionary:

1. A person you know and like well enough not to leave dying on the side of the road.

Monday 26 August 2013

Yet another way smoking can kill

Since I have never so much as taken a single puff on a cigarette (yes, really) I have a question for all you smokers out there: WHAT THE FUCK ARE YOU THINKING?  Wait, wait, wait.  No, that wasn't what I wanted to ask.  I got sidetracked for a second thinking about how stupid smoking is.  What I meant was, I've noticed that smokers tend to be very generous when someone, even a complete stranger, asks them for a cigarette.  I would never give a stranger a sip of my drink (whatever it may be) or a bite of my sandwich (especially if it had bacon on it), but I've always been impressed by smokers happily handing over one of their precious carcinogen sticks without hesitation.  But my question is this: what do you do when you ask to bum a cigarette and get turned down?  Is there some protocol you're supposed to follow?  Is there some set of rules?

This next guy must not have read that rule book.

I suppose cigarettes are just too expensive these days, so the guy simply ran out and needed a nicotine fix.  Normally bumming a cigarette wouldn't be a problem for him, since smokers are, as much as it boggles the mind, easy to find.  And it should have been a piece of cake to "borrow" a cigarette from a complete stranger.  But he just happened to pick the wrong stranger.  I am likely paraphrasing, but the conversation went something like this:

Patient: Hey, can I bum a cigarette?
Stranger: Um, no.
Patient: What?
Stranger: I said no.
Patient: Ok, I'm going to beat the shit out of you.

So the guy attacked the stingy smoker for not simply handing over a cigarette.  What he didn't count on was the other guy being much faster than he.  And having a knife.  Not only did he receive multiple lacerations all over his body, he didn't even end up getting his cigarette.

We sutured up his lacerations and sent him home, after suggesting that he either A) quit smoking or B) quit attacking ninjas.

Saturday 24 August 2013


It used to be that transactions were simple and made sense.  You had some grain that I wanted, I had some milk that you wanted, so we traded my milk for your grain.  And we were happy.  Somewhere along the line someone realised that gold was rare (and thus valuable) and could be traded for stuff instead of goods.  And then some other genius decided that substituting pieces of paper that represented this money would be simpler and safer. 

But ever since then, people have been figuring out ways to save money. Some people go out of their way to reuse things. Others rely on coupons and sales, whilst some do their best to reduce their usage and recycle what they have. And then there are some who completely lose their minds and make an incredibly stupid decision, all in the name of saving a little money. 

A man in his 60's was brought to me after he crashed his motor scooter on his way to work.  He broke 3 ribs and his wrist, but fortunately he was wearing his helmet so he had no serious brain injury. When the time came to discharge him a few days later, I was elated to hear him say "You know what Doc, I'm done with scooters.  They're too dangerous!  But that's what I get for trying to save a few pounds dollars euros rubles yuan kronas rupees yen." (You didn't really think I'd let that slip, did you?)

I suppose he saw my quizzical look, because he continued.  He informed me that he had bought the scooter because it was cheaper than a car and got great fuel economy.  He never once thought about his own safety.  Never mind the fact that he took this little thing on the freeway around maniacs driving way too fast while putting on makeup, updating Twitter, and drinking a cup of coffee. 

I saw him a few days ago in my office, and he's recovering well.  He's already sold the scooter, and he's looking for a used car.  One with seat belts and air bags and crumple zones, none of which you'll find on a motorcycle. 

You get what you pay for. I guarantee he'll be paying more now (in lost wages, etc) than he would have if he had just bought a car in the first place. 

Saturday 17 August 2013


A lot of people have written to share their stories with me.  Some have been inspiring, some are funny, some are tragic, and some are just plain sad.  This one falls into the latter category.

Jamie (not her real name) wanted me to share this story because of the senselessness of it, the avoidability.

Hey Doc. Thought I'd share my little brother's story.  Two weeks ago my brother got in a really bad car accident.  He was going down a seemingly straight road at around 110 mph (177 kph).  In the middle of the night.  He was driving while he was really angry after fighting with his girlfriend.  I guess he didn't see a slight turn in the road until it was too late.  He hit his emergency break and tried to drift around the corner.  I'm guessing that was a really stupid move.  He flew off the road sideways into a ditch and rolled his car at least three times.  His car landed about a hundred feet away from where he went into the ditch in some small trees at the edge of a pond.  Here comes the bad part: as I'm sure you guessed, he wasn't wearing his seatbelt.  He got thrown about 30 feet from his car and landed on a pond.  He broke several ribs, his collar bone, his scapula, crushed two vertebrae that were pressing on his spine, and had a collapsed lung.  He is now paralyzed from the waist down and got surgery on his back.  They rebuilt his vertebrae I guess.  He has to get a couple more surgeries.  He is only 22 years old.  He will probably never walk again because he decided to drive like an idiot, unrestrained.  I'm not a doctor, but by the looks of his car, he would have been MUCH better off had he been wearing his seatbelt.  Please share this story.  People need to realize there is a really good reason why we have seatbelt laws.  Twenty two and paralyzed.  No one should ever have to go through that.  Now I know for certain that seatbelts really do save lives.

Sad, right?  Oh just wait, it gets worse.  A few days later, she emailed me with an update:
So the other day we found out what caused my brother's crash.  An EXTREME case of idiocy.  His phone was finally found at his crash site.  He was going through it the other day and he found the reason he lost control in his camera roll.  My idiot brother was taking a picture of his speedometer.  He was going 110 mph.  You can see the two signs he barely avoided hitting in the picture.  He took the picture and looked up last second and saw the turn and tried to pull the emergency break and drift around it.  Thought you might like that little bit of information!  

This type of story makes me incredibly sad, and I see it with my own eyes on a regular basis.  For those who don't, it doesn't make it any less sad.  Fortunately he's not dead, but this young man will likely never walk again because of a combination of speed, brash youth, raw emotion, and careless stupidity.  He's lucky to be alive, but his spine injury will be a lifelong reminder of one simple mistake he made when he was young enough to think he was indestructible.

If anyone reading this knows someone (including that person you see in the mirror every day) who doesn't wear a seatbelt, remind them to put it on.

Monday 12 August 2013


Let me start this post by saying that I get compensated very well for the work that I do.  I don't want anyone to get the false impression that I believe I'm underpaid.  I like to think that I deserve such compensation, however, because what I do is important.  Not to sound too self-congratulatory, but medicine is a pretty valuable profession.  But an email from reader Tom (not his real name) got me thinking: how does my salary compare to some other highly-paid people?

Robert Downey, Jr. (actor): $75,000,000
Tiger Woods (professional golfer): $80,100,000
Larry Ellison (CEO, Oracle Corp): $96,000,000
Michael Bay (movie producer/director): $160,000,000
Oprah Winfrey (you know): $165,000,000
Tim Cook (CEO, Apple Inc): $378,000,000
Me: Less than all the above.  Much less.  Much much MUCH less.  By a lot.

These make more while sitting on the toilet than I make in a week.  But as I told another reader who emailed me a few days ago, I am not in medicine to make money, and anyone who is needs to seriously examine his priorities.  

But regardless of the money, for all my long hours, for all the hours spent away from my family, hearing a patient say "Thank you" is worth more than gold.

With that in mind, if you've ever held a door for a complete stranger who simply walked through without even acknowledging your existence, then you too understand the value of "Thank you", and you also understand how NOT hearing it makes you feel worthless, like what you did wasn't worth your time.  Now imagine you've saved that person's life, and he simply walks out without a word. 

As I mentioned above, Tom emailed me with this story:
Doc, I have been reading your blog for about a 6 months now and you are the type of practitioner that I attempt to emulate as a medic.  During my last call we got called for a possible allergic reaction.  When we arrived the man in his late 20's was having one word dyspnea {he could only speak one word at a time in the midst of his gasping for breath} with all the other signs of an anaphylactic reaction.  He was close to needing to be intubated.  I got epinephrine on board then attempt to get an IV in his arm, but he was too obese, so I had to settle for a tiny IV in his finger.  Within 5 minutes he had returned to normal.  But did I get a thank you?  No!  After doing emergency services for this long I don't expect one, so the few times it does happen are special.  He decided to take it the other way and started moaning about how bad his finger hurt.  All the way to the hospital I can't get a word in edgewise because his damned finger was hurting.  Did he have any idea how close he was to dying?  I just wanted to hear one of your stories where you encountered something like this.  I know it happens to us all and I just wanted to hear your spin on it.  Thank you again for your great blog.

Unfortunately it happens to me all the time.  There was one particular fine young gentleman who had gotten shot in the abdomen.  After repairing multiple holes in multiple organs, I went to see him the following day.  "How are you feeling this morning?  Sore?" I asked him.


No "Good morning, doctor".  No "Thanks for saving my life, doctor".  His first inclination was to yell at me.  His second, third, and fourth inclinations were also to yell at me, because for the next several days, the only thing he ever said to me (aside from grunting "yeah" or "no") was "I want my pain medicine."  Even on the day I discharged him and was instructing him to follow up with me in a week, all he said was, "Where's my prescription for pain medicine?"  When he did come to see me a week later, he was dour, surly, and thoroughly obnoxious.  As I removed the staples from his incision, he kept acting like he was doing me a favour just by showing up for his appointment. 

Which brings us back to my list.  I figured that with the way he was acting, this guy must have been a spoilt rotten rich kid.  But after an exhaustive search, I couldn't find him on any list of the world's richest people.  So I had no choice but to conclude that he is just a loathsome twit with no appreciation for human life, most notably his own.

Monday 5 August 2013

Old wive's tales

Mothers are pretty smart people.  I don't know if they are all born with common sense or if they somehow download it directly into their brains through some kind of cosmic modem as soon as their first child is born.  Fathers, on the other hand, seem to have evolved without this ability.  Regardless, the knowledge that they have is invaluable and pervasive.  Old wives' tales exist in every country, language, and culture.  Some of them are completely ridiculous and make me laugh:

  • It's raining!  Put on a coat or else you'll catch pneumonia!
  • Don't swallow gum or else it will stay in your stomach for 7 years.
  • Don't make that silly face or it'll stay that way forever!
  • Feed a cold, starve a fever.
  • Don't go swimming for 30 minutes after eating.
But there are some others which are startlingly true:
  • Eat your vegetables.  They're good for you.
  • Chicken soup will help your cold.
  • Tea with honey can help your cough.
  • Clean your room, damn it!
Ok, I'll admit that last one isn't exactly an old wives' tale, but it's still something that every mother says to every child.  My mother said it to me approximately 48,302 times while I was growing up, and I say it constantly to my kids (my 2-year old tends not to listen to me, unfortunately, as he throws yet another wooden block across the room).  However, it happens to be very good advice.  

"Fine, but how does this relate to trauma, or even to medicine at all?  I'm going back to watching my Ancient Aliens marathon!" I hear you scream.

Relax.  There is always method to my madness.

Lucy (not her real name) emailed me with the following story:
My name is {redacted} and I really enjoy your blog. I saw your post with random pictures and thought I'd send a couple of my own.

On {redacted} I was in my first car accident ever.  I still don't remember what happened because I was blacked out when the medics arrived, but according to the police it was my fault.  The other car left before anyone got there, so I don't know if that person was hurt.  Hopefully they weren't.  I was so disappointed because I pride myself on being a good and cautious driver.  Anyway, they say the car I hit was going 65 mph and my trusty Chevrolet Trail Blazer and its seatbelt kept me very safe.  Both air bags went off, and the only injuries I had were some bruises, a sprained ankle, a minor concussion, and a hole in my head the size of my pinky finger.  That hole came from something flying around in my car.  I always kept so much junk in my car!  However, I learned my lesson and my new car doesn't have any extra crap rolling around in it!

I know these photos aren't as exciting as some of the others you've posted, but maybe some other people need to learn the lesson I learned about keeping your car clean without having to learn it the hard way! 

So there you go.  NOW you understand why your mother always told you to keep your room clean, and the same goes for your car.  Because if you don't, you'll get into an accident and some piece of debris will fly out and knock you out and cut a hole in your head!  At least, that's the logic my mother would have used.  But then again, this is the same woman who tried to get me to eat mushrooms and broccoli because they were good for me.  Blech.

Thursday 1 August 2013

My favourite things

I've decided that it's time to divulge some more information about myself.  And what better way to do that than by revealing some of my favourite things.  I've even decided to narrow it down for you and make it that much more specific by listing my all-time top 1000 favourite things to do at 1AM (if it seems I'm being a bit obtuse, I have a reason.  Trust me, I always have a reason).  So without further ado, my top three:

1) Sleep
2) Sleep
3) Sleep

Sense a trend there?  Having sex very nearly made it to the top three, but as you can see it came up short (no pun intended, I assure you).  In the interest of time I'm going to skip several hundred entries to show you the bottom three entries on the list:

998) Stick hot pokers in my eye
999) Clean my garbage cans
1000) Home renovations

Clearly I would much rather be in bed (doing something or other) at 1 in the morning than anything else, but other people's priorities seem...different. 

At 1:30 AM a short while ago (see, I told you there was a reason!) I found out that the next patient coming in would be a fall.  I figured it was going to be yet another elderly patient who got up to pee but ended up losing the never-ending fight against gravity (since I already had gotten three such patients earlier that day). 

But if it were something that mundane, I wouldn't be telling you about it, would I?

The patient who rolled in was a 39-year old woman who had fallen off a scaffolding.  Now before you start thinking that the accident had been earlier that afternoon, think back to my list.  

In fact, she had fallen off the scaffolding and landed flat on her back at 1 AM.  What was she doing up there at that ridiculous hour, you ask?  Well she was replacing the siding on her house with her husband, of course!  What the hell else do you do at 1 AM?!  Her husband explained that they both had day jobs, so the only time they had to do their home renovations was the middle of the night when normal people are sleeping.  "But don't worry", he continued.  "We had a few spot lights set up out there."

I did not ask what their day jobs were. 

Fortunately she had no serious injuries so I sent her home.  But not before advising her to finish the job during the day. 

Now be quiet and leave me alone.  I'm going back to sleep. 

Not dead

I'll start this post by answering a few questions that may or may not be burning in your mind: No, I'm not dead.  No, I didn't g...