Administration

Stupid doctors.  Stupid lawyers.  Stupid patients.  Stupid paramedics.  Stupid nurses.  Stupid me.  There aren't many people I haven't appropriately abused here, but unfortunately there is one group that has been badly overlooked.  That, however, is about to change.

I'm referring to stupid hospital administrators.

If you think doctors and nurses run hospitals, you'd be sadly mistaken; we have almost no input into the day-to-day workings of the hospital.  Those details are left up to businessmen and businesswomen who supposedly know how these massive undertakings are supposed to work so that the people who actually treat patients can do their jobs.  That said, having been in this business for several decades, I've seen exactly ZERO hospitals that I could say are well-run.  Well, I could say it, but I would be lying my ass off.

Why, you ask?  Well sit back and let me tell you a tale of woe.

Other than my family, one of my few pleasures in life is sitting down and enjoying an ice-cold Coca Cola.  Although I know there are better options (YES I FUCKING KNOW COKE IS BAD FOR ME), every now and then I still treat myself.  There's nothing quite so satisfying as the sharp, cold bubbles tickling my tongue as the phosphoric acid erodes my tooth enamel and guarantees me a retirement of dentures.  Yes, I've tried the lite/diet options, to no avail.  Sure there's less sugar, but the artificial sweeteners leave a noxious (almost metallic) aftertaste in my mouth that completely defeats the purpose.

As an aside, I can't stand purposeful misspellings like "lite".  And if "lite" isn't bad enough, "Xtreme" and "kwik" make me irritated enough to want to kick a hole in the wall.  I find these intentional misspellings as disagreeable as the aspartame aftertaste and almost as awful as Iggy Azalea's "music".

As I was saying, fortunately both of my hospitals have Coke in their respective doctors' lounges.  Every so often I will indulge, though somehow drinking an artificially-coloured carbonated drink makes me feel guilty, like I'm breaking the law.

Now I don't know exactly what's going on in my two hospital, but though they are miles/kilometers apart and share no hospital administrators in common, they seem to be engaged in a vast anti-soda (and thus an anti-Doc) conspiracy.

As I was enjoying a rare Coke between treating idiots trauma patients several months ago, one of my colleagues approached me and laughed, "You better enjoy that while you can, Doc (not your real name©)."

"Why?  Are they getting rid of it?" I asked jokingly.

"Oh, didn't you hear?", he replied.  "They are doing away with the sugary drinks and replacing them with flavoured water."

Wh . . . wh . . . wh . . . what?  Can they even do that?

I checked into it, and indeed, apparently in an effort to make the staff healthier, the hospital administrators thought it would be a wonderful idea to get rid of all the regular soda.  For all intents and purposes they are telling us doctors, who are all grown adults last I checked, what we can (and more to the point can't) drink.  And somehow they feel that flavoured water (with various artificial sweeteners like sucralose) would be a better option for us. 

I sat there silently fuming and mourning at the same time while finishing what likely would be one of my last Cokes ever at that hospital.  Then I realised I was acting like a spoiled brat, so I put on my big boy underpants and made my way to my other hospital to make rounds.  Still fuming.

Oh, and before anyone mentions it, yes I realise this falls directly under the category of "First World Problems", but I think working 100 hours a week entitles me to a free soda every now and then.  So shut it.

Anyway, where was I?  Oh right, on my way to Hospital #2.  When I got there, I decided to spite the first hospital's administrators by having a second soda.  Ha!  Two in one day!  Take that, assholes!

I went directly to the doctor's lounge and walked straight to the refrigerator, seeking my spoils.  And what greeted me was . . . this:

Wha . . . wha . . . 

It was a tiny can of Coke.  A tiny can!  What the fucking fuck?  And as small as it actually was (about 2/3 the size of a normal can), what my mind saw was this:

I didn't even know this crap existed!  It's just like Coke, only . . . less!  Who the hell buys this?  And why?  Who wants less of something?

My ire arose once again, but this time I didn't let it get the better of me.  I fumed again for a brief moment as I considered my worsening First World Problem, and then I came up with a perfect solution.

I drank two of them.

Fuck you, administrators.

Angelina Jolie

I must admit I've never really been a huge fan of Mrs. Jolie.  Sure she's attractive (anyone with functioning eyes can see that), but I've never thought she was the most beautiful woman in Hollywood (that would be Scarlett Johansson).  And I was never a huge fan of her movies.

After she published her op-ed piece in the New York Times a few days ago, however, I'm a fan now.  A big one.

You can read more about her heroism (in my most humblest of opinions, of course) in The Daily Beast by clicking here.

Incidentally, my story was on their front page today (lower right corner of the picture).  I'm not sure if that means something significant or that I'm simply using my imagination and reading too much into it.

What your doctor won't tell you about surgery

So a few interesting things have happened since this was published in the Daily Beast this past Saturday.  In case you missed it:

I didn't get called an idiot (or anything else equally disparaging) in the comments this time, though I admit I didn't read the comments to my last two TDB articles, so who knows what insults were flung my way.  I thought I was making some real progress with this piece.

And then today one of my twitter followers hit me with this:

@DocBastard did your article make Fox News? I swear I just heard a tease for it or a story just like it?
— commonsense (@commonsense258) March 23, 2015

Ha ha . . . nah, I thought.  And then . . .

@DocBastard the teaser was: a surgeon tells you what your doctor won't tell you. What they are most afraid of. Sounded like your article
— commonsense (@commonsense258) March 23, 2015

Hm, that does sound like what I wrote.  But still, nah.  Couldn't be.  AND THEN:

@DocBastard Yep it's your story. Called you Anonymous. Daily Beast article.
— commonsense (@commonsense258) March 23, 2015

Ok, I freely confess that at that point I was sort of freaking out a bit.  And by "sort of freaking out" I mean I nearly drooled on myself.  Then a few minutes later I got an email from a reader who confirmed that Shepard Smith and  Kennedy had recapped my article on Fox News.

I'm pretty sure I stopped breathing temporarily.  I decided to tweet to Kennedy and let her know (jokingly) that I had been available for an interview:

@DocBastard @ShepNewsTeam @dailybeast I loved your article! Is that your Coke bottle?!
— Kennedy (@KennedyNation) March 23, 2015

Yes indeed.  It just kept getting weirder and weirder.

But it wasn't over yet.

As I was reading that tweet, a new email popped up.  It was a request to do a phone interview for a radio station in San Francisco.

Seriously.

I had to politely decline the offer (and concurrently split an infinitive), of course.  I don't think I can fake an accent long enough to get through an entire interview, though I suppose they could have run my voice through a voice changer.  But who the hell wants to listen to a faked computerised voice on the radio.  I know I wouldn't.  And as I was writing the email response, this popped up on Twitter:

@DocBastard loved article. Figured u wanted to stay anon. But I like your blog.. if u want on in future, send info to mark.hiner@foxnews.com
— mark hiner (@Marknewsdeck) March 23, 2015

Yeah.  Now if I could only figure out a way to change my voice and face . . .

Honour among thieves

A plague upon it when thieves cannot be true to one another. - Shakespeare, Henry IV

Some of my most painful moments in my illustrious academic career (ha) were trudging endlessly through some of William Shakespeare's most famous works.  I'm sure this blog's readers include more than its fair share of Shakespeare fans, but I found Hamlet, Julius Caesar, Othello, and others to be nothing more than literary torture.  I was just never able to decipher his ridiculously flowery garrulousness, I never found his comedies funny, and the tragedies were merely meh.  Ok, I'll grudgingly admit the plot of Romeo and Juliet may have been original in 1594, but his "star-crossed lovers" routine hath since been rather flung out liketh a dead horse o'er the ensuing 400 years.  

I think I need to rinse my mouth out after writing that.  Blech.

Anyway, despite the fact that ol' Willy wrote the quote at the top of the page (which of course translates to "There's no honour among thieves" in modern non-stupidly-flamboyant English), I confess that I like it and find it to be true.  It's commonly demonstrated on TV and in movies when bad guys stab each other in the back (literally and/or figuratively), but I've never really witnessed it in real life.

And then Henry and Richard (not their real names©) came along and gave me a Shakespearian lesson I shall ne'er soon forget.

Henry and Richard were old buddies, but Henry moved away from their home town some years back.  After many years apart, Henry drove back home to catch up with his friend over a long weekend, and the two of them decided that the best way to reminisce was to revisit their old haunts and re-enact the prior activities of their youth.

In other words, they decided to go to a pub and get blind drunk.

Unfortunately in Henry's and Richard's alcohol-saturated brains, designated drivers and taxis are what other people use to get home.  Speed limits?  Psh, that's for other people, not them.  Seat belts?  Ha!  They never wore them before, so why start now.  And trees?  They're perfect for running into and getting ejected from the car.

Oops.

Richard was brought to me first, so drunk he could hardly keep his eyes open.  The medics reported that he was the passenger in the car, and they had found him outside the vehicle in the rain leaning against a concrete roadside barrier.  He managed to dribble out that his shoulder hurt, and he had lacerated one of his toes (apparently shoes were also optional during their little reunion soirée).  He also had scrapes and bruises everywhere but no other obvious life-threatening injuries.  I needed more information.

"Were you driving the car, Richard?"

"Noisrajg," he replied, which I believe is Drunkenese for "No, sir."  The medics shook their heads.

Seeing that Richard would be no useful fount of information and finding no major injuries, I went to examine Henry, who had arrived just a few minutes later in a separate ambulance.  Like his friend, he also smelled as if he had been freshly dipped in a vat of old liquor, stale beer, and cigarette butts.  "He was the passenger in a motor vehicle crash versus a tree, Doc," the medics reported.  "He was ejected out of the vehicle."

At this point you are probably thinking the same thing I was at the time - Wait wait wait, how could they both be passengers?  Were there more people in the car?  My Spidey Sense was tingling.

"Who was in the car with you, Henry?" I asked him.  Fortunately Henry was just slightly less drunk and slightly more coherent than Richard.  Slightly.

"Just me and my gooooooooooooood buddy Richard.  RICHAAAAAAAAAAAAAAARD!!!  I'm just *burp* visiting from out of town and we went out to have some *urgh* fun."

Right.  Running your car into a tree and getting thrown from the vehicle sounds like a total blast.  Fucking whee.

"Were you driving the car, Henry?" I asked him.  He vehemently shook his head no and then vomited on the floor.

"Ok, so Richard was driving?" I pressed.

Pause.

I waited.

As I stood there watching his face, I could almost see the hamster running in the wheel in his head, turning the gears in Henry's brain.  

After several seconds his glassy eyes lit up as he obviously thought he had come up with a brilliant, infallible response.  My anticipation was at its peak.  Henry opened his mouth:

"Uh, no comment."

I had to control myself, realising that he had really thought that would clear up everything.  I took a deep breath and tried again, this time a bit more slowly.  

"Was Richard driving, Henry?"

He audibly sighed, realising that his unassailable ruse had been assailed.  

"Uh . . . well, yeah.  I just don't want him to get into trouble.  But yeah.  Yeah he was."

It was clearly my robust interrogation technique which had broken him, and I was instantly glad I had watched all those James Bond movies.  I was, however, surprised he had thrown his buddy (his supposedly gooooooooooood buddy) under the proverbial bus so easily.  

The police had some choice words and a veritable stack of citations for Richard (once he sobered up a bit), who seemed none too pleased, though obviously astounded, that his stupendous trickery had failed.

Fortunately between the two of them, all they suffered was a fractured scapula, various bumps, bruises, abrasions, and lacerations, a totaled car, and a ruined reunion weekend.

I guess Henry never read All's Well That Ends Well:

Love all, trust a few, do wrong to none.

And now I need to rinse my mouth out twice.

Dead wrong

I've spent several decades compiling my lexicon, and I must admit I'm quite proud of it.  Along with all my fancy-schmancy medical terminology that I also sling around, it allows me to sound as arrogant and haughty as possible (or so the readers at the Daily Beast would have you believe).  I may not quite be a master of language, but I'm fairly proficient, regularly adding to my repertoire when new words and phrases arise.  For example, I just recently (and extremely grudgingly) added "selfie" to my personal dictionary, though I had to take several showers afterwards and continue to feel guilty about it.  There just isn't any other appropriate good word for it.  Yet.

Anyway, while I do occasionally add words and phrases, I very rarely remove anything since I seldom find that to be helpful or useful in any way.

After meeting Teresa (not her real name©), however, that philosophy was thrown all to hell.

So what word or phrase was removed?  Stay tuned.  You know I'll get there.

In medicine just like in the rest of the world, common things happen commonly.  In the trauma arena car accidents are common, falls are common, assaults are common.  Gunshot wounds and stabbings are common.  Hangings, on the other hand, are rare.  I've only seen a few, and they tend to be prisoners who "pretend" to hang themselves just to get out of jail for a few hours.  Real hangings don't typically make it to the hospital, but sadly Teresa fell into that rare category of those who do.

Teresa had a long history of depression and had taken several different anti-depressant medications over the years with little improvement.  She had been texting with her daughter early one afternoon, and nothing seemed awry at the time.  When her husband got home later that day, he was shocked to find her half dead, hanging by a bed sheet slung over the balcony in their front foyer.  He immediately lifted her up and let her down, but she was unresponsive, barely breathing.  He called emergency services immediately, and when they arrived she remained completely unresponsive.

She stayed in that state until she was brought to me about 20 minutes later.  On my initial assessment her skin had a grey tinge to it, her eyes were closed, and her only movements were decerebrate posturing, an extraordinarily bad sign indicating very severe brain damage.  She didn't have any other injuries, so after putting in a breathing tube and starting mechanical ventilation I got a CT scan of her brain and cervical spine.  As expected I didn't find any acute injuries.  Anoxic injuries (ie those cause by lack of oxygen) typically take several hours to show up on a CT scan.

After reviewing the scans, I took a deep breath and went out to speak with her family.  Her husband, children, parents, and at least 20 other family members were there - I've never seen the family meeting room that full.  Clearly this was a woman who was very much loved.  Regardless, I was blunt, direct, and thorough as I always am.  I told them very carefully that though I didn't know how bad her brain injury was, it looked bad.  Really bad.  REALLY BAD.  As in, I-don't-expect-her-to-last-through-the-night bad.

I went to check on her the next morning before leaving the hospital, and nothing had changed.  Though her vital signs were stable, she was still comatose.

So I went home, awaiting the inevitable.  And exactly as I was anticipating, I got the expected phone call later that afternoon from the intensive care unit.  "Hi Doc, I'm calling about Teresa."

"She passed?  What time?" I asked.

"Oh no, she's doing really well, she's extubated, she's talking, she's awake and alert, and she's following commands appropriately.  We want to transfer her out of the ICU to the trauma ward."

It takes a lot to render me speechless, but I must have sat there in stunned silence for what seemed like an hour (but was probably closer to 2 seconds) before I managed to stammer my excellent, eloquent response:

"Wh . . . wait, she's what?"

When I walked into her room to see her the next morning, she looked right at me with a big smile on her face.  The only one in the room smiling bigger was her husband.  She was completely awake and alert, though she had no recollection of any of the events from the previous two days.  There was not a single sign that she had nearly died less than 24 hours prior, save for a few minor abrasions on her neck.

After consulting with a psychiatrist (obviously), I transferred her to the psychiatric ward the following day.  She clearly needed some major help, though not of the physical type, and much more specific aid than I am capable of offering.

While I thoroughly enjoy being right, sometimes I don't mind being wrong.  This was obviously one of those times.  But just how wrong was I?  Flat wrong?  Completely wrong?  100% wrong?  Categorically wrong?

Maybe.  But thanks to Teresa, I'll never again claim to be dead wrong.

Head transplants

Please allow me to introduce the opening scene of a science fiction film to you.  If you don’t like science fiction, just pretend it’s another a formulaic Kate Hudson or Katherine Heigl rom-com or a Daniel Craig 007 action flick.  Whatever floats your boat, just stay with me here.  This is important.

We fade in on a top-secret laboratory, beakers bubbling, computers beeping, screens displaying complex mathematical formulae.  A mysterious set of feet walk across the screen toward what must be a refrigeration unit.  The door opens, and dry ice fog quickly streams out and dissipates eerily.  Our mystery man picks up a small box and walks to a waiting table.  He opens the box to reveal . . . Cue dramatic music . . . a human head.  The camera zooms in on the box, where a sticker says “LIVE HUMAN—FOR EXPERIMENTATION ONLY.” 

Live human head? What? 

The mystery man picks up the head and turns to reveal an awaiting headless body covered in medical gadgets lying on an operating table.  The head is placed on the body.  A team of white-robed doctors descends with scalpels.  The music peaks . . .

It sounds completely ridiculous, something straight out of Hollywood, right?  Well, not exactly.  If a doctor from Italy is to believed, science fiction may soon become science fact.

Want to read the rest?  Well then unfortunately you need to head over (har dee har har) to The Daily Beast because they own me now or something.

I'm not sure if I should be shamelessly promoting my TDB articles here or not.  I still have yet to decide if I'll continue doing it.  I'd appreciate your thoughts, not only on the head transplant (that phrase just looks weirder and weirder every time I type it), but on putting teasers for my TDB articles here.

UPDATE: Just to clarify, I have no intention of giving up this blog, or reducing or otherwise diluting the content in any way.  My first responsibility (after my family and my job, of course) is maintaining a repository for my stories, which was the whole reason I started this stupid blog in the first place.  I never expected anyone to actually read it, I just wanted to be able to remember this stuff.  I have no doubt that the idiocy around me will continue, so the weekly updates should as well.