Friday 29 November 2013

Call Gods

It seemed my last post spurred a rather interesting theological debate, so I thought I would expound on the subject just a bit.  If you've been wondering if I believe in god, yes I do - I firmly believe in the existence of the Call Gods.  The Call Gods watch over all doctors on call all over the world.  They decide what patients will come in, when, and for what reason.  You do not mess with the Call Gods.  If you ever decide you'd like to mess with the Call Gods, you DO NOT MESS WITH THE CALL GODS.  

So if any doctor on call is ever stupid enough to say, "Gee, it sure is quiet around here," the Call Gods take it upon themselves to ensure that a shitstorm of Gomorrah-like proportions will rain down on this foolish half-wit exactly 14 seconds later, only relenting when the call shift is over or the ignoramus quits his job to sell costume jewelry and counterfeit handbags on the street.  This is not the beneficent God you may think you know - the Call Gods are evil and vengeful, and they have a very twisted sense of humour.  Hmm, now that I think about it, they sound just like me.

The Call Gods do not reserve their torture for unsuspecting pinheaded nincompoops who disavow all knowledge of their existence.  No, they seem to enjoy paying particular attention to me whenever I am on call, though they are terribly uninspired when it comes to choosing patients to drop in my lap.  It seems whenever I'm on call they choose a theme for the day for me - Drunk Day, Broken Hip Day, Seizure Day, Tattooed-Nipple And Pierced-Clit Biker Day - and nearly every patient will fit this narrow profile.  For whatever reason, the Call Gods decided that one fine recent day would be Fall Day.  Everyone was falling - falling down stairs, falling off ladders, falling out of attics, falling after getting hit with a bat.  Ok, maybe that last one technically doesn't count.  Anyway, when I found out I was getting my sixth fall victim of the day already, my first thought was, "Bring it on, Call Gods!  Hit me with your best shot!"

Yes, I taunt the Call Gods.  YOU CAN'T HURT ME!  I AM INVINCIBLE!!

And hit me they did - the smell of alcohol hit me before the patient actually reached the door.  The medics told us the patient was found on the ground outside a movie theater, and it was unclear if he had fallen after being assaulted or had just fallen down from being piss drunk.  Regardless of the reason, he happily vomited on my shoes as we transferred him from their gurney to our stretcher.

Though he was too drunk to talk, I thought I would go through the motions and ask his name.  As I was opening my mouth the nurse said, "Wait . . . is that John {not his real name}?"

John?  Who the hell is John?  And did he really just say "not his real name"?

"Oh yeah I forgot," the medic said.  "He had this hospital ID on when we found him."

I looked at the ID card, and the nurse was absolutely right - John was one of our emergency nursing assistants.  "I just gave him an assignment last night," the nurse continued, looking from John to me and back again.  "He just got off at 8 this morning!  And he was supposed to be back at 3:30 today for another shift."

I looked at the clock - it was 3:25.

"He made it," I said dryly.  "Just in time."

Sunday 24 November 2013



In case you haven't guessed by now, I love to think.  Using my brain is very satisfying, and unlike most of the people about whom I write, I do it often.  The best part about my brain is that it doesn't take much to get it buzzing.  I overheard a discussion between two radiology technologists a few days ago that got my brain gears spinning.  I'm paraphrasing a bit here, but this is the gist of the conversation:

Tech #1: You know, I just read a theory that Eve wasn't created from Adam's rib.  No really, some people think he was actually created from her.
Tech #2: Nah man, Adam was created from dust, and she was made from his rib.  It says so in the Book.
Tech #1: I know exactly what it says, but that's what I just heard.

After a few seconds of this clearly sarcastic debate, I smiled and said, "I thought we evolved from monkeys", knowing full well that monkeys and humans evolved from a common ancestor and thinking I was making a mildly-amusing joke to go along with theirs.

They looked at me like I had two heads.  My smile faded.  They weren't kidding.

"You actually believe that crap?" tech #2 asked me.

"You don't?" I replied, my eyebrows raised so high that they were threatening to burst through the top of my forehead.

I won't bore you with the remainder of the conversation, because, well, there wasn't one.  They looked at each other, wordlessly deciding that I was a lunatic and not worth talking to, and promptly changed the subject to football or something else equally uninteresting.

Perhaps not coincidentally, I got an email from Aaron (not his real name) some time back that I've been holding on to.  It went a little something like this:

Hi DocBastard,

Love reading your blog and all the comments on FML. You definitely sound like a pretty interesting person!  In your last blog you mentioned evolution.  Now even though I know it isn't related to medicine a whole lot, I would love to hear you give us your opinions on evolution in general.  I've always been fascinated that people can dispute evolution despite all the evidence (and basic logic) pointing toward it and I bet you'd be able to write an awesome article on it.  If that's too tough a subject to write about maybe how the human body could have evolved over the last couple thousand years.  Or even if you could talk about how the field of medicine has changed too.  I'm sure you'd have a lot of insight on all those topics!  Keep the blog coming!
I will admit that I am no expert in the field of evolution, nor do I have an advanced degree in theology.  However, I have done a fair bit of reading on the subject of Young Earth Creationism, mainly because I find it fascinating that there are people (ie batshit-crazy crackpot nutcase fruitcakes) who believe in it.  Now if there are any creationists who failed to heed my initial warning and have actually read this far, I WARNED YOU, YOU IDIOT!  Now please don't misunderstand me.  I don't think you're stupid, just misguided.  And maybe a little bit stupid too.

There are creationists who think that evolution is stupid, and they go to great lengths to explain just how stupid they think it is.  Allow me to introduce Dr. Kent Hovind.  (He fancies himself a "doctor" because of his three degrees in Christian education, all from non-accredited institutions - his opening line in his most recent "doctoral" thesis was "Hello, my name is Kent Hovind."  Seriously.)

In case you aren't familiar with the difference, I am not referring to so-called theistic evolutionists who believe that evolution is real, but that it was started and subsequently guided by a Supreme Being.  Intelligent design is a similar concept.  I'm talking here about died-in-the-wool, real-world, actual Young Earth Creationists like Dr. Hovind who believe that the world was created by God some 6,000 years ago.  Some, Dr. Hovind included, even believe dinosaurs co-existed with man a few thousand years ago:
I'm not sure where they think all those dinosaurs went or why they vanished, but they have several absurd theories that explain everything.  For example, "The oldest tree is 4,300 years old and the oldest reef is 4,200 years old; therefore, everything on earth must be younger than that."  If you're in the mood for more laughs, here are some direct quotes from Dr. Hovind:
  • Communism is a direct offshoot of evolution.
  • The stars would have to evolve.  There's an awful lot of stars out there folks, but nobody's ever seen one form . . . I think it is scientifically impossible.
  • Macroevolution . . . is when an animal changes into a different kind of animal.  Nobody has ever seen a dog produce a non-dog.  But the evolutionist believes that a dog came from a rock.
Uh . . . ok, Kent.  Whatever you say.  If you're still in the mood for a laugh and have two hours to spare, I'd strongly encourage you to watch this video of Kent's "100 Reasons Why Evolution Is Stupid".  Needless to say, all of his 100 reasons are . . . well, stupid.  The volume of evidence for evolution is massive and incontrovertible, so I see no reason to present it here.  There are thousands upon thousands of articles to read showing how animals, plants, continents, planets, solar systems, and galaxies form and evolve.  None of them, I'm quite certain, explain how a rock turns into a dog.  Sorry to disappoint you, Kent. 

While we're on the subject of human evolution, however, I did find something that some people may find interesting.  Dr. Alan Kwan, who has a PhD in computational genomics (whatever that is) predicted how humans will continue to evolve over the next 100,000 years, including developing larger heads, larger eyes, darker skin, and thicker eyelids:
Admittedly the end result is a bit freaky, but I'm sure Neanderthals 100,000 years ago would have thought the same if they saw a picture of a modern human, especially if that human was Dennis Rodman or Sandra Bernhard.

Regardless of my obvious disdain, I believe that everyone has the right to believe in whatever they want, regardless of how preposterous it is, as long as those beliefs aren't foisted on me.  In the words of W.C. Fields, "Everybody's got to believe in something.  I believe I'll have another beer."

Wednesday 20 November 2013

Ruining the ending

We're going to go on a little detour today, away from the usual stupid patients, stupid doctors, and all the usual stupidity.  No, today I'm going to take you, my intrepid readers, on a trip.  Close your eyes.  Go ahead, close them and imagine with me.  Ok, now open them up and remember that you're reading a blog and can't read with your eyes closed, dummy.

Now imagine, if you will, that you're reading a great novel.  One with werewolves and sparkly vampires, perhaps.  Wait . . . forget that.  Imagine instead that you're watching a great movie with wonderful acting, a riveting plot line, great heroes, and a mysterious villain, and just as you're about to discover the identity of Kaiser Söze . . .

The movie shuts off.

NOOOOOOOOOOOOOOO!!!!  God damn it, now I'll never find out that Bruce Willis was riding Rosebud while eating Soylent Green with Norman Bates' mother and Tyler Durden, who is actually Luke Skywalker's father!

"Ugh, here we go again.  What's the damned point, Doc?"

Ah, the point, right.  I'll get there.  I just can't guarantee there won't be any plot twists in the meantime.

I was on my morning rounds recently ("Finally!  Something medical!"  Alright hush, you.), and I entered the room of my latest stabbing victim (who was stabbed in the liver and nearly bled to death), only to find her surrounded by a room full of visitors.  I introduced myself as her trauma surgeon, to which the patient announced, "He's the one who saved my life."  I was just about to say "Thank you" when one of her visitors said, "Hey, you also took out my appendix!"  I take out a lot of appendices, so he didn't look immediately familiar to me.  I asked his name, and as soon as he said it, I remembered him.

"Right, now I remember you," I said as I pointed an accusing finger at him.  "I also remember that you never showed up for your follow-up appointment."

"'re right," he laughed as he pointed to his abdomen.  "But I'm doing fine.  Everything went really well, so I didn't think I needed to come back."

So how the hell does this relate to ruined endings, you may be wondering.  For a surgeon, the gratification is all in the follow-up - that is our happy ending, our satisfying outcome, our denouement as the hero rides off into the sunset.  I like to know how my patients do, especially the ones who go home immediately after surgery.  How long their pain lasted, if they had any complications, if they found my watch that mysteriously disappeared during their surgery and probably didn't fall into their abdomen.  You know, the usual.  If a patient never follows up, I don't know if he developed a wound infection, if his pain got better, how his experience was, or if he died.

This particular guy chose not to come back to see me because he figured a follow-up appointment would be a waste of his time.  But the purpose of even a simple two minute appointment is that I get to look at the wounds, poke on the belly, and make sure all questions are answered.  And look for my damned watch.

So on behalf of surgeons everywhere, please don't ruin our endings.  We want to know that Leonardo DiCaprio is not investigating Shutter Island, he's a patient.  We need to know that the Planet of the Apes is Earth.  We have to know what's in the box at the end of "Se7en".  But we don't give a shit what happens at the end of Twilight.  Not one little shit.

Fuck you, Twilight.

Friday 15 November 2013

Getting personal

I'm a very private person.  Anyone who has read any significant portion of this blog knows that I rabidly defend my patients' and family's privacy.  But what I don't generally talk about is my own privacy (though despite my attempts to quash you, several of you continue to enjoy trying to unravel the mystery of where I live).  I also tend not to divulge specific details about myself, because MIND YOUR OWN DAMNED BUSINESS, NOSEY. 

But I've given it a lot of careful thought, and after my ruminations I've decided that I'm not completely opposed to revealing certain things about me.  So in the spirit of transparency, I will now truthfully and completely disclose all of my various tattoos, identifying birthmarks, distinguishing features, and piercings.  

I have none.  HA!  I WIN!

I got an email from some random jackass (seriously, that was his email address) who decided to get personal with me.  He was curious to know more about what I was like as a child.  Wait, you really want to know, jackass?  You really want to delve into this fucked up head?  You really want to know what makes me tick?  Fine, you asked for it.  Here goes: I was small and quiet and generally tried to stay invisible.  Happy?

No??  What, that's not good enough?  Well here's exactly what the jackass had to say in his email:

Hey Doc, you should post a story about your school life, as in like elementary, high school, middle school.  Such as were you popular, were you picked on, were you the bully, did you enjoy it?  Obviously you had really good grades, but what did your graduation feel like and such.  Thanks for reading, keep up the awesome posts. 

Ok there's a very small possibility that wasn't necessarily my childhood.  My shrink would say I'm deflecting.  I'm kidding, of course . . . I don't need a shrink, I'm fine, dammit.  What I said before was true: I was the small, quiet, shy kid.  I made up for my insecurities by being the funny one.  I learned very early that other kids tease the short kid less when they are amused.  So I became the class clown, sometimes getting in trouble for my antics.

As I got older, the kids started to give exactly zero fucks if I was funny.  They saw my height as a liability, a weakness, something they could exploit.  For a few years I took the abuse, hoping that the bullying would stop as the kids got older - they should grow more mature as they grew taller, right?  Mature they did, but all that meant was deeper voices taunting me and bigger muscles hitting and pushing me. 

It finally came to a head when I was 12.  One of the popular boys was doing his usual ritualistic teasing, and he pushed me and said something relatively insignificant that I can't specifically remember, but whatever it was, I thought to myself "ENOUGH IS ENOUGH".  I made a fist, spun around, and slugged him right in the gut.  HARD.  As he doubled over and slowly crumpled to the ground, the entire gymnasium went silent, all eyes on the short, quiet kid who they thought would always just take it, would always be a prime target, would never fight back.  I looked around silently from person to person, the look on my face clearly saying, "WHO. THE. FUCK. IS. NEXT."

Though I generally do not condone violence in any way, no one laid a hand on me or bullied me from that day through my graduation. 

Secondary school was not terribly challenging at all, academically or socially.  I had a small group of close friends, all of whom I still am in contact with today.  I was that guy that never really studied but aced all his classes anyway.  You know, the kind of kid that most other students hate.  But because of that one incident (and perhaps because my body finally decided to hit puberty at age 15), the bullying was over.  Eventually I graduated near the top of my class which helped me get into a good university, though the memories of being mercilessly bullied for years, and the constant fear that it would resume, never went away.  The support of my family and friends were the main things that got me through.   

Now I think that's enough pain for me today.  If you have any other personal questions for me, keep them to yourself.  Or if you really want to hurt me again, just give me a nice paper cut and pour lemon juice on it.  Now leave me the hell alone.  I have to go call my psychiatrist. 

Tuesday 12 November 2013


I have a confession to make: the title of this post is utter plagiarism.  I admit it.  I blatantly stole it from a reader named Emily (not her real name) who sent me an email with that same cryptic subject line.  If you feel the need, you may turn me into the Blog Plagiarism Police, even though Emily gave me permission to reprint her email, so actually you can't.  Ha!  So there!  And now that we have that little legal matter out of the way, Emily brought up a very good question, one that I previously hadn't really thought much about.  And as everyone (except my patients) knows, thinking is good.

Subject: WWDBD (What Would DocBastard Do)
Hello! My name is Emily {still not her real name} and I would love your input on my sticky situation since it sounds like you love your job just as much as I love my job.  I am 20-ish years old {not her real age} and I am a surgical tech.  I LOVE LOVE LOVE my job, and couldn't imagine doing anything else.  Part of why I went into the medical field is because I have spent A LOT of time in the hospital and I wanted to give back.  I was born with a congenital heart disease called Tetralogy of Fallot.  No big deal.  I had an open heart surgery when I was 7.  Haven't had any big problems other than needing a pacemaker, which I got a couple of years ago.  But just in the past 10 months, the shit hit the fan.  I was put on the transplant list 4 months ago, which I always knew would happen sometime in my life.  However, I did a complete 180 and was delisted and am just being followed in transplant clinic medically.  My transplant surgeon was VERY adamant that I find a new career because of the risk of getting a dirty needle stick and contracting HIV or hepatitis C.  I will eventually need a transplant, and I know that if I were to get HIV or hepatitis I would either A) not be able to accept a heart or B) die from the disease when I'm immunosupressed.  When my transplant surgeon told me this, I simply asked him what the overall goal of a transplant patient is.  His response was to get the patient back to their original normal life.  I just smiled and said, "But scrubbing is my normal life."  As of right now I'm still scrubbing.  I double glove, I'm cautious, but I can't predict when those damn surgeons decide to throw something. {N.b. We do NOT do this.  Much.}  So Doc, what would you do?  Scrub or find a new career?

Well isn't that an interesting question wrapped in a quandary surrounded by mystery engulfed in an enigma immersed in a puzzle deep fried in a predicament dipped in ranch dressing.  Yes, ranch dressing.  Everything is better dipped in ranch dressing. 

Anyway, after thinking carefully I gave her a long, well-thought out, elaborate (ie boring) reply.  I'll give you the short short version of what I told her: do what you love.  Unless you love robbing banks or smacking puppies.  No, "smacking puppies" is not a euphemism, you sick bastard.  

Finding a career you like is hard enough, but finding one you love is next to impossible. The theoretic risk of getting slashed in the jugular by a blood-soaked, scalpel-wielding surgeon is always there, but living in fear of that is useless, unless  of course you're working with Dr. NickDr. Hannibal Lecter, or Dr. Evil.  And if you're working with one of those guys, you have much bigger problems than getting pierced with an HIV-infected needle.  Come on, folks . . . They're fictional.

But think about it this way: do you want to live your life in fear of what may happen, or would you rather just live your life?  Don't misunderstand me here.  I am NOT in any way advocating this YOLO lifestyle that seems to be all the rage nowadays.  But if you're going to slave away for 8-12 hours a day, you may as fucking well enjoy it if you can. 

And for any YOLO morons out there thinking "He's right!  I only live once!  I should jump off a bridge because hey, it's there!" . . . yes.  Go jump off that bridge.  But don't bother with that pesky parachute or the annoying bungee cord.  They tend to be unreliable anyway. 

Thursday 7 November 2013

Another stupid number

One million five hundred thousand is a large number.  A very large number.  How large?  If you were to take 1,500,000 standard light bulbs and put them end to end, it would make it from the Tower of London to Stonehenge with a few hundred light bulbs to spare.  Why light bulbs?  Because it's my damned blog and I'll use whatever random measurement I want to make the number look more impressive.  And why London?  Because the distance just happened to match.  I could have used the Eiffel Tower to Rouen, The Leaning Tower of Pisa to Bologna, or the Temple Mount in Jerusalem to Haifa, so don't read too much into it.  Seriously, stop it.

Not that the number needs any assistance to look better.  It's pretty impressive on its own.  To put it in perspective, here are some statistics:

  • There are 1.5 million non-profit organisations in the United States.
  • 1.5 million years ago, modern humans (Homo ergaster) were skilled tool-makers and hunters and had just learned to control fire.
  • 1.5 million people are killed worldwide due to indoor pollution from cooking fires each year.
  • There are 1.5 million new Android devices registered each day.
And one final statistic - As of today, this blog has been read 1.5 million times.

I've said it before, but it bears repeating: THANK YOU.  Without my loyal readers (and random people who I'm sure have accidentally stumbled across my crazy little nook and run away screaming), I would have quit writing years ago after the first post.  If anyone missed the million mark and wants to leave a comment letting me know where you're from, this is your last opportunity.

Until we hit two million.

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...