Wednesday 29 March 2017


I must apologise for the lack of a post this week, but unfortunately it seems that none of my patients have done anything particularly stupid lately.  Anyone who knows my patients' proclivity for gross stupidity may find this hard or even impossible to believe, but sadly it is true.  I got nothin'.

However, I feel somewhat guilty leaving all of my readers in the proverbial lurch, so in lieu of a stupid patient story this week, I'd like to share a few things that some of my readers and followers have made.

First, we have this little gem by Marc Draco (I assume that is his real name).  In case you aren't familiar with the Dunning-Kruger effect, it quite astutely (and accurately) describes people who are incapable of assessing their level of understanding of a subject and thus deem themselves more competent than actual experts.  Vani Hari (Food Babe), David Wolfe, and antivaxxers are prime examples.  Marc absolutely nailed it with this graphic:

Then there is this one, sent to me by @viva__lala (I'm pretty sure that is not her real name).  I don't know if there is an "emergency bracelet generator" out there, but if there is my 0.121 second Google search didn't turn it up.  
If anyone knows of a manufacturer that would be willing to make these, I bet I could sell at least 10 of these!  

The next one wasn't made by a reader or a Twitter follower.  Actually, it wasn't really "made" per se.  It's just a screenshot of a snippet of a conversation I had with a chiropractor I few months back, and somehow it got buried in my phone.  So I thought this would be the perfect place to deposit it.  I believe it speaks for itself:

And in case you're wondering, yes he meant that.  Whatever "that" is.

Finally, a personal bit of artwork presented without further introduction:

Surely everyone must be wondering what institution could possibly give me a doctorate in bullshit and why I would suffer through such an ordeal.  Well, I didn't.  A similar diploma can be yours all for the bargain basement price of zero, zip, zilch, nada.  Just go to, and earn a doctorate for yourself.

Now if you excuse me, I have to go back to hoping my patients start acting stupid again.

Monday 20 March 2017


Before anyone starts attacking me, yes I know it could be spelled "yutes" or "utes", but according to the official script, it is "yoots", so I went with Yoots.  Just like the original patent for toilet paper shows it going over the roll, I consider that orientation to be correct.  And if you have no idea what the hell I'm talking about, go watch "My Cousin Vinny".  Right now.  Go.  Do it.  And do not come back until Vinny and Mona Lisa are driving back to New York.

You're back?  Good.

I've often said that youth is wasted on the young, but then again so did George Bernard Shaw well before I first did (although his exact quote was “Youth is the most beautiful thing in this world—and what a pity that it has to be wasted on children!”).  In fact, I just told my children exactly that just a few days ago (the short version) when they were complaining about some movie not streaming fast enough.  At the time I decided not to delve into what it was like in the time before movie rentals when you just had to watch what as on TV, and then years later what it was like driving to a store to rent a movie, hoping they had the one you wanted, driving back to the store to return it, and paying late fees and fees for not rewinding (aka "The Good Old Days").  So instead I started boringly lecturing them on why they should be outside enjoying the weather, playing, frolicking, gamboling, and cavorting or whatever, rather than staring at a screen (which, ironically, is exactly what you are doing right now and also what I just instructed you to do). 

Regardless, kids should be outside playing, not inside playing, as long as they are reasonably safe about it.  But during their development most kids eventually go from "I'm not sure I can do this" to "I AM INDESTRUCTIBLE!  I CAN DO ANYTHING!  WHEEEEEEEEEE!"  It's the childhood equivalent of "Hey I saw some guy do this in a movie once.  Here, hold my beer".  At this crucial point in their development children lose the ability to judge their own 1) abilities, 2) carelessness, and 3) bravado.

And Travis (not his real name™) is a perfect example of all three.

The first thing that told me that Travis was a completely normal teenager was that he was actively texting as he rolled through the door of my trauma bay.  That prompted my first eye roll of the encounter.

"Hi everyone, this is Travis."  He barely had the decency to look up at the sound of his name as the medics gave their report, but he at least grunted, eyes (and thumbs) still glued to his mobile phone.  That prompted eye roll #2.  "Travis was riding his dirt bike, no helmet, and he lost control, and he fell onto his left side.  He was going about 60 kph (35 mph) when he crashed."

The second thing that told me that he was a normal teenager (and that caused eye roll #3) was his response to that bit of information:


I think all the people in the trauma bay, myself included, groaned audibly in addition to rolling our eyes.  Clearly, everything this guy was going to say was bullshit.

Travis then flashed the universal sign for "METAL", grinned, stuck out his tongue, and went right back to texting.  Once again, he wasn't even able to muster up the decency to look at us or speak to us.

I can imagine his text was something lucid, intelligent, and well-thought-out, like this:

Travis seemed completely uninterested and unimpressed by the fact that his left leg had an extra bend in the thigh where it did not belong.  He continued grinning intermittently and making strange grunting noises under his breath as we finished our workup (still texting furiously), which demonstrated only an isolated left femur fracture.  The only thing I could think as I looked at his X-ray was, "I guess the fucking thing is broken."

Fortunately Travis' stay was short and uneventful, so I was not treated to very much of his teenage antics.  I heard about him flirting with several of the nurses, but they were just as unimpressed as I was.  And while he was with us his mother told me of several other not-quite-as-severe crashes he had recently had on his motorbike. 

Once it was time for Travis to leave, I knew I had one more job to do: make sure this didn't happen again.  I had already told him in the trauma bay and the following day that he was lucky he hadn't sustained a serious head injury yet, and he had to wear a helmet whenever riding a dirt bike.  But I decided to drill it into his fortunately thick skull one more time.  With his mother in the room, I told them both that if Travis was going to continue riding his death machine, he at least had to protect his head.  Travis looked at me as if hearing this strange information for the first time, his expression clearly saying this:

Yes. I was serious about that.

Friday 10 March 2017


This isn't a personal success story (though I have had several recently), nor is it a professional success story (though I have had several of them too recently).  No, this is a Twitter success story.

A what??

As many of you know, I hate Twitter despite my activity there.  Trying to communicate in 140 characters or less is downright madness, and whoever thought of it should be dragged through a muddy street strewn with horse manure by his toenails, then flayed, tattooed, hanged, and then killed.  To those of you who don't know about my exploits on Twitter, why the hell not?  Go to Twitter and follow me, god damn it.  There's even a little button on the side right over there that makes it easy.  Seriously, go do it now.

Anyway, my Twitter account has metamorphosed of late to become a "Calling Out Bullshit" account.  The bullshit can be anything that I'm not particularly fond of at that moment - homeopathy bullshit, antivax bullshit, naturopathic bullshit, chiropractic bullshit, nutrition bullshit, "cancer is a fungus" bullshit, etc.  You get the idea.

But many people have asked me (in 140 characters or less, of course) why I bother.  Why do I spend (read: waste) my precious time calling out these frauds on their bullshit?  What possible benefit could it have?
Well, I'm about to tell you why.

My focus lately has been chiropractors.  I am stunned that chiropractic has managed to survive for as long as it has, considering A) its extremely poor evidence base (it has only been shown to be mildly effective for low back pain), and B) its vitalistic origins.  If you don't know, DD Palmer, the founder of chiropractor, first invented it in the late 19th century purely out of his ass after he supposedly "cured" a janitor of deafness by manipulating his neck.  A stupid light bulb apparently clicked on over his head, because he then hypothesised that "subluxations" (mystical misalignments of the spine) are responsible for blocking the flow of vital energy (whatever the hell that is) and thus are the cause of disease.  To modern chiropractors, it apparently makes no difference that a chiropractic subluxation is not visible on any X-ray, CT scan, or MRI, and indeed has never been shown to exist, nor has vital energy.  It also apparently makes no difference that chiropractic manipulation has never been shown to cure, improve, or otherwise treat anything whatsoever.

That does not stop them, however, from advertising their bogus "adjustments" for everything from pain to asthma to GERD to headaches to paediatrics.

Yes, chiropractors claim they can help children.

I came across Kristen Simpson from Leavenworth, Kansas, USA, who is a chiropractor in the Life Family Chiropractic practice.  She posted this bit of bullshit on Twitter:
Now let's break this down, shall we?  Starting with the array of hashtags: what the hell is a "crunchy kid"?  What is a "well adjusted" baby?  Moving on to the little girl's top - yes, children need to eat.  Children need sleep (a lot of it!).  But "get adjusted"?  For what exactly?  What the hell was this chiropractor claiming her adjustments could do for this child?  Babies need chiropractors in exactly the same way that Olympic athletes need cupping.

Trying to get some answers, I tweeted this at her:
I wasn't expecting a reply, since these charlatans people rarely do.  Would you want to be exposed as a fraud on international social media?  I would be mortified, embarrassed, and ashamed.  So instead of responding to the charges, instead of facing her accuser, she did what any reasonable fraud would do in that situation:

She blocked me.

I can't say I was remotely surprised, and I was actually somewhat pleased.  I saw it as a major win, because it can only mean two things:
  1. She read my tweet.
  2. She had no response.
Since I was blocked, I couldn't continue the conversation with her and ask any follow up questions (SAD).  My followers, on the other hand, were not blocked (at least not initially), and they were not exactly kind, and for good reason:

Why am I telling you this?  What the hell is the significance?  Well if you search for Ms. Simpson on Twitter now, you get this:
That's right, she deleted her account.  Rather than face the music, support her stupid claim, or provide evidence, she bravely turned her tail and fled and is now unable to propagate her ridiculous bullshit on Twitter.


And with that, all I have to say is this:

Monday 6 March 2017

Stupidly obviously stupid

Life on planet Earth is generally complicated.  There are way too many questions and very few definitive answers.  Why are we here?  What is our purpose?  Is there life on other planets?  If not, why not?  How can there possibly be a septillion (that's 1,000,000,000,000,000,000,000,000) stars (approximately) in the known universe with Sol being the only one to have evolved life?  But if there is other life out there, how is it possible that just one of them hasn't evolved to the point of interstellar travel and visited us?  Well, here is one possible explanation:

I didn't intend on going in this direction when I sat down to write this.  I should probably stop writing these when I'm post-call, sleep deprived, and caffeine deprived as well.  My brain starts doing strange things.  Let me try to get back on track.  Hm.

Anyway, with all the unknowns surrounding us, there are fortunately a few knowns, a few certainties, a few obviousnesses.  (Yes, I know that isn't a word.  It is now.  So there.)  For example: everyone reading this (and for that matter, everyone not reading this) will die.  Sorry if I just spoiled your day, but it's a natural part of every life (unless you are bitten by a zombie, then all bets are off).

There are a few more plainly obvious things that come to mind:
  • vaccines work (yeah, you knew I'd squeeze that in somehow)
  • homeopathy doesn't work (that too)
  • stupid people do stupid things
  • there are a lot more stupid people than smart people
Those last two might not have been too obvious to me as I grew up, but after doing what I do for as long as I have done it, they certainly are now.  One of the basic tenets of life, something that I consider to be obvious, clearly is not to far too many people: Don't be stupid.  I don't mean "Don't be unintelligent", because not everyone is born with a high IQ and can understand quantum physics and do calculus.  No, by "Don't be stupid" I mean "Don't do stupid things".  Even smart people do stupid things sometimes (myself included), but there are some things that you just don't do no matter how stupid you are.  Anyone with an intelligence above the level of "cabbage" or "chihuahua" or "antivaxxer" should know not to do things that put himself, his children, and everyone around him in immediate and extreme danger.

Howard (not his real name™) apparently didn't get that message.

It was a Saturday night much like any other, which is to say that it was full of stupid people doing stupid things.  Stupid people getting stupidly drunk at the pub and falling in the parking lot.  Stupid medics not realising that the 90-year-old woman they brought to me as a trauma who had crumpled to the ground 4 days ago was severely dehydrated and septic and not a trauma patient.  Stupid people who still haven't figured out how to call a cab instead of driving home drunk.  Howard fell into that last category of course, though I had a total of four similar patients that night, all after midnight.  Of course.

At first he seemed like any other drunk driver - just merely a guy who had drunk too much and run his car into a tree.  I'm always just a tad gratified when a drunk driver is in a single-vehicle accident, because at least he hadn't injured any innocent bystanders, bywalkers, bybicyclists, or bydrivers.  Yes, I just created "bywalkers", "bybicyclists", and "bydrivers" too.  This is a good day.

Moving on.

Howard admitted to having "Two drinks" at first, which changed to "A few drinks" several minutes afterwards, to "A lot" a bit later.  He was complaining of pain in his left thigh, which made me worried that he had fractured his femur.  But as we continued asking questions, the real Howard made himself known awfully quickly.  He started acting obnoxious and entitled, but when the police showed up, he stopped cooperating entirely.

Our workup was fortunately fairly benign - no femur fracture, just a few bumps and bruises and a minor pelvic fracture that would require nothing but pain medicine and time.  But just as quickly as my worry turned to relief, my relief turned to outrage when the police gave me the real story.

Howard had gone to a friend's house for a night of drunken carousing and debauchery (I assume), but he hadn't bothered to find a babysitter for his twin boys, so he had brought them along.  The boys, if you are curious, were all of 18 months old.  I don't know what possessed him to drive home drunk with his twin toddlers in the back of his car instead of calling a taxi.  And I definitely don't know what made him think that going close to 200 kph (around 120 mph) while drunk was a good idea.  WITH HIS TWIN TODDLERS IN THE BACK SEAT.

I was informed that the boys had been taken to the local children's hospital, but that by some stroke of good luck, both were ok.  I couldn't help but think that if Howard had been a victim of drunk driving (rather than a perpetrator), his boys probably wouldn't not have been so lucky.  Bad guys always seem to get away with it, for some stupid reason.  And if you're wondering where the boys' mother was, I didn't get that far in my questioning.  I had to go find a safe space to scream my fool head off.

If it hasn't become clear to you yet, this episode made me angry.  As a trauma surgeon, it made me livid.  But as a father, it made me so furious that it made me want to grab him by his ears, slap him repeatedly in the face, and scream in his face "WHAT THE EVER LOVING FUCK IS WRONG WITH YOU!??  Those aren't just helpless, defenseless children that you could have killed, those are YOUR helpless, defenseless children that you could have killed!!  It was luck, and ONLY luck that kept you and your entire family from dying tonight!  And not only that, but you put MY helpless, defenseless children at risk with your idiocy!  Moron!  Idiot!  Asshole!"

Excuse me, I need to go find that safe space again.  I'll be right back.