Monday, 6 June 2016

Fast food

I feel I must start by making a confession: I love fast food.  I know it's terrible for me, but I love fast food.  Hamburgers, hot dogs, chips/fries/frites, tacos, burritos, pizza, fried chicken.  I'm a total sucker for it - all of it.  If I have the choice of eating a very-good-for-me grilled chicken salad versus a very-not-so-good-for-me pizza, I will go for the pizza every single time.  I never feel particularly good about myself after eating it, but despite years of practice, I've still never quite perfected the art of avoiding it.

But there has been a serious emphasis put on nutrition and healthful foods these days (yes, "healthful", not "healthy"), and I've seriously cut back on my fast food intake.  I will still indulge from time to time, but it has become an anomaly in my life rather than a regular thing (and I still enjoy my Coke too).  But considering the GMO/organic/gluten-free discussions being bandied about, I decided it's high time I weighed in on the subject.

Weighed in.  Har dee fucking har.

Stupid (and obvious) puns aside, a recent interaction with Tim (not his real name™) illustrated just how dangerous fast food can be.  Sort of.

Tim was eating at a fast food restaurant (whose name does not start with M or S) when he suddenly became unresponsive and collapsed.  Instead of making sure he wasn't choking, his friends first took pictures of him on the ground, and then (after posting them to Facebook/Instagram/Twitter, presumably) called an ambulance.  (Before you ask, no I don't have any of the pictures, and even if I did I wouldn't put them here, you sick people.)  The crew found him completely unconscious, and they brought him to me as a high-level trauma.

Now those of you who know the world of trauma (you know who you are) may be thinking, "But Doc, choking is not classified as trauma!  Why did they bring him to you?"

Shush, you.  Don't ruin the story for everyone else.  There's a reason.  In my stories there is always a reason.

The first thing I do for most new trauma patients is lean over their faces to make a quick evaluation for any head trauma, as well as to make sure they have a patent airway and are breathing.  In trauma, Airway and Breathing are considered Very Important Things.  Tim had some minor abrasions to his scalp and was definitely breathing (and therefore not choking), but I believe his exhaust fumes were comprised mainly of ethanol rather than nitrogen, oxygen, and carbon dioxide.  

And there is the reason you've been waiting for.  The medics confirmed my suspicions.

"Good afternoon Doc, this is Tim.  Tim was drinking whiskey with his buddies at Fast Food Restaurant (not their real name™).  I guess he'd had enough, because he fell off his bench and hit his head.  He's just starting to come around now."

Uh huh.  In case you're wondering, no, that particular establishment does not serve whiskey.

The rest of my assessment was unremarkable, and all of his scans and x-rays were shockingly normal.  His bloodwork, on the other hand, was more revealing: though his chemistry and blood counts were totally normal, his blood alcohol level was just over five times the legal limit.  Even with aggressive IV fluids, it still took him nearly 12 hours to sober and wake up completely.  Once he did, I re-evaluated him.  Finding no serious injuries on him (other than wounded pride and a Facebook page full of rather crude comments), I sent him home.

The remainder of my day was filled with old ladies falling (4 of them), drunk drivers, drunk passengers, and one multiple gunshot victim who came in dead and stayed dead.  Fortunately everyone else survived.  To celebrate, I stopped at Fast Food Restaurant on my way home for a delicious and thoroughly-bad-for-me meal.  As usual I still felt terrible about myself for eating it, but for the 2,706th time in a row, I forgave myself.

Until next time, hamburger.  Until next time.

31 comments:

  1. What's the lesson to learn from this story?

    ReplyDelete
    Replies
    1. Do all of my stories need a moral? Can't I just tell one stupid story without some deeper meaning? GET OFF MY BACK!

      Delete
    2. Lessons I can think of:

      Don't get so drunk that you pass out in public.

      Your true best friends will call the ambulance first, take pictures second, and upload them third. Your good friends will take pictures first, call the ambulance second, and upload the pictures third. Those who take the pictures first, upload them second, and only call the ambulance after that, they are not your friends, even if they say they are.

      It's easy to forgive yourself if the food tastes good.

      Of course, the story was completely enjoyable without needing to learn a lesson.

      Delete
    3. I was more expecting a lesson about fast food, like maybe a patient who was trying to break a fast food restaurant's record or something and, well, I'm no medical guy but I can imagine several ways this could go wrong.

      That didn't happen.. But hey, Doc's reply is good enough for me!

      Delete
    4. Hi, NeatNik - IMHO, there *is* a lesson to be learned from this story...

      1. We've now learned that this isn't really the *worst* thing we could do for our health, because...

      2. Indulging in fast food, while *simultaneously* over-indulging in alcoholic beverages, to the point where we are rendered unconscious, is definitely worse!

      :)

      Delete
  2. Man, for a minute I was thinking this guy had that rare condition where his gut brews alcohol if he eats bread, but instead it was just a person who got too drunk in public. Oh well.

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  3. There is a lesson from this story.
    Tim is an alcoholic, by definition.
    Anyone naive to alcohol with an alcohol level five times the limit (so I'm guessing between 400 and 500mg%) should have profound respiratory depression, if not death. If Tim was breathing, he is an alcoholic.
    Tim's can tolerate, and his liver can metabolize, alcohol with powers and abilities far beyond those of mortal men.
    By definition, an alcoholic.
    (My record was 1200mg % - he was not breathing but he was still alive when he came. He was a repeater -he had had 950mg% once before.
    Cory F.

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    Replies
    1. 1200?? Holy hell. That's over twice my record (540).

      I clearly have work to do.

      Delete
    2. That's actually kind of impressive, in the horrific "survived nine gunshot wounds, three stab wounds, five broken bones, a concussion, an amputation, and one particularly viscious ferret, all sustained over the course of ten minutes" sirt of way.

      Delete
    3. "He was still alive when he came"...
      Was he still alive when he left?

      Delete
    4. When I read "my record" above, I thought that was your personal record and was about to ask you how you were not dead! Glad to hear it was an indirect record!

      I agree with Scottie - impressive in a "survived a fall from an aeroplane" type way.

      Give it a few years and we will have the google contact-lens - what a joy that will be! No tiny tedious detail of peoples lives will be safe from sharing on social media, but at least they won't have to stop to take photos before calling the emergency services!

      Ugi

      Delete
    5. @ anonymous:
      "He was still alive when he came"...
      Was he still alive when he left?

      Ironically no. Guy survives a 950 mg% alcohol level (after minor auto accident) and then gets a 1200 mg% alcohol level and comes in alive.
      But the ER staff had to intubate him because he was not breathing. They paralyzed him, something you should not have to do in someone who is not breathing, no obvious airway problem and is really out. I argued about that with them for years. In someone completely sedated who needs an airway there should be no reason to paralyze them - trust me he was completely sedated.
      They had trouble with the airway- I don't know why and they tried to do a quick surgical airway but since he was paralyzed they gave themselves no room for error, did not manually ventilate him long enough and he died - a preventable death.
      Guy was like a cat, he had nine lives - but what we used to say in the ICU about cats and people with nine lives - what happens is they usually use them all up.
      Also points to the sense of humor of the Medicine Gods, which you will learn if you do this long enough.

      I remember his name 20 years later (told his story in my book)
      Cory F.

      Delete
    6. I had a "customer" some unspecified time ago. had accidentally taken too many muscle relaxers. (I say accidentally because there is reason to believe the customer was not mentally competent)
      about a mile down the road, the ambulance stopped and flagged me down to manually ventilate while they prepped to intubate the customer. - because the customer was too relaxed to breathe on the customer's own.

      Delete
    7. Cory F,
      Thanks for the reply. The way you wrote that gave me pause.
      Nine is not an infinite number - some people manage to run through them pretty "efficiently". And some people remain in the eighth for a good long time.
      It's the luck of the draw. And some people draw stupidity.

      Delete
    8. @ Anonymous:
      It was a truism in my day, I don't know if it is anymore, that "God protects drunks and dummies".
      But even God has his limits.
      Cory F.

      Delete
  4. Speaking of food, had you gotten the memo that Dr. Heimlich had the opportunity to perform the Heimlich maneuver on a real choking patient, and was successful in dislodging the obstruction, and saving the life of the patient?

    ReplyDelete
    Replies
    1. I saw that. I'm still trying to figure out what will eventually be known as the Bastard Maneuver.

      Delete
    2. good luck. see if you can come up with something that leaves a signature scar.

      Delete
    3. Doc, I'm fairly sure that is just a kick in the family jewels. - L

      Delete
  5. Oh you are so not alone! We love fast food too. But we are smart enough not to make it an everyday affair. Hard to say what our favorite is, cause we love them all along with a Coke.

    ReplyDelete
  6. Hey Doc, are you familiar with the work of the late John Hinds?

    This talk he gave about resuscitative thoracotomy seems right up your alley. "Crack the Chest. Get Crucified."

    https://www.youtube.com/watch?v=GFX_tocJShA

    ReplyDelete
    Replies
    1. I am. Dr. Hinds had much to give and died way too early.

      Delete
  7. Doc if you love fast food you must/will love Taco Bell's crunchy burrito thing theyve got now. It has spicy fritos in it. Sounds weird, I know, but it is to die for.
    Connor

    ReplyDelete
    Replies
    1. some of us think artificial spicy flavoring is revolting.

      Delete
  8. I read this post while eating a sweet crispy red delicious apple. I was still hungry after my healthy lunch of salsa chicken with saute zucchini and a nectarine. Now I want to have tacos for dinner. Thanks Doc Bastard. You are a real role model.

    ReplyDelete
  9. Y'know Doc, you can have your burger & your health too. Find a local eatery that does burgers made from grassfed beef. Google it -- the nutritional profile for grassfed beef is So Much Better than crappy commercial corn-&-soy fed beef! (You get lots of CLA, less fat & it tastes better. And the cows are much happier & healthier being raised on open pasture the way cows should be, rather than in nasty commercial feedlots.)

    My ol' man is a fast food junkie too, but he was also getting a gut, which was not cute. So I established a New House Rule: If you want fast food, you have to cook it yourself. When he was jonesing for a cheeseburger & fries, I sent him to Whole Foods to get some grassfed beef, organic potatoes, organic burger rolls & onions. For the cheese, some of that amazing Jasper Hills Bayley Hazen blue. (LOVE that stuff!) I've been a hi-protein/low-carb eater for decades, so fries are a high holy days food, but I keep some duck fat in the fridge just for making french fries. He brings it all home, we cook it up & it scratches his fast food itch in the healthiest way -- For Weeks.

    Seriously, whether it's brownies or a burger, when you make your own junk food with top-quality ingredients, you appreciate the splurge more & end up up craving fast food less often. He lost 22 lbs. in less than 3 mos. after the New House Rule, which I take full credit for.

    ReplyDelete
    Replies
    1. that misses half the point of junk food.

      though I will admit, a burger made from good grass fed beef kinda runs circles around a fast food burger. you just have to make it bigger for optimal negative health impact.

      Delete
    2. RC - I agree that grass-fed beef is tastier than regular beef, but I'll have to politely disagree with the organic potatoes, bread, and onions. I haven't seen any evidence that "organic" is any better than "regular" food in any way other than price. Unlike with the beef, I also don't notice any difference in the flavour.

      "Organic" doesn't mean better nutrition, better flavour, or better ingredients. It just means more expensive.

      Delete
    3. really, the main difference between organic store produce and mass market produce is mass market produce often features varietals that are bred for durability and uniformity, while depending on the organic market, you can still get varietals that are bred for flavor. really, I prefer homemade produce. I actually prefer homemade beef as well, but I don't have the right facilities for that.

      Delete
  10. Hm. 'Best' I ever saw was an old drunk faceplanting into his chicken fingers and snore bubbling the gravy.

    I guess I should have called an ambulance?

    ReplyDelete
  11. Speaking of fast food, there is a Poutine Burrito available in Montreal. I have a hankering for one right now. Although it's poutine - maybe I'll hold off on trying it until it's winter.

    ReplyDelete

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