Tuesday, 16 April 2013

Almost a patient

So far I've written about stupid doctors, stupid lawyers (oh, I thoroughly enjoyed that), stupid questions, and of course stupid patients.  But I haven't written about someone stupid who wasn't my patient.

Yet.

Some people I can just tell will end up either in my trauma bay or on a cold steel slab soon, some sooner than others.  For example, when motorcyclists pass me on the highway like I'm standing still, I usually yell after them "See you soon, idiot."  Not that they can hear me, of course.  But screaming at them somehow makes me feel better.

I got a call from the ER at midnight about a patient who was actively dying and needed immediate surgery (I'll leave out the details because they aren't relevant).  I apologised to my wife for waking her (as per Bastard household protocol), jumped in my car, and raced towards the hospital.  Fortunately in the middle of the night there's usually no pedestrian traffic to worry about.

Usually...

Got that sense of foreboding yet?

Halfway to the hospital I nearly ran over a woman who I can only describe as leisurely strolling across 3 lanes of traffic.  Bad enough?  Of course not, but I'm sure you knew it got worse.  She was also wearing all black in the middle of the night.  What, still not stupid enough?  Ok then, she was also looking down at her cell phone, not paying any attention at all to the world around her.

I have no idea (nor do I give a flying fuck) if she was updating her Facebook status, tweeting about what she was doing in the middle of the road at midnight, or flinging pissed-off birds at pigs.  Regardless, she didn't even bother to trouble herself to look up as I slammed on my brakes and swerved, barely missing her.  She did, however, pause long enough to yell "ASSHOLE!" and give me a nasty gesture.

I shrugged off this idiotic encounter and got to the hospital in time to take my patient to surgery, which she survived.  It was speed, not dumb luck, that allowed my patient to survive that night and make it out of the hospital in one piece.  It was the exact opposite that kept this imbecile OUT of the hospital and out of the morgue.

I imagine her latest tweet was "OMG just almost got run over lolol #yolo"

Monday, 8 April 2013

DocBastard FAQ

I always try to encourage questions from readers either by email or in the comments, but it seems people are very hesitant to post comments.  So most of the questions I get are via email.  But I've noticed that I continue to get variations of the same questions, so I've decided to create a one-stop answer repository for you.  This is not because I want everyone to know everything about me; rather, it's much more selfish than that - I just want a link where I can point people from now on instead of answering the same damned questions over and over and over.

DISCLAIMER: Not all answers herein will be truthful, useful, helpful, or any combination thereof.  Some answers may or may not be completely or partially fabricated, invented, or otherwise fictional.  Batteries not included.  Please allow 6-8 weeks for delivery.

Now that that's out of the way, let's begin, shall we?

1) Where are you from?
HA!  You really thought you'd try that first, eh?  Nice try, but I'm not falling for that one!  Did you really think I was going to answer that?


2) Fine, asshole.  Why won't you tell us where you're from?
Well that's a much simpler question to answer, so I'll answer it in as complex a fashion as possible.  My family is my first priority, and my patients come next.  Part of taking care of my patients is protecting their privacy.  All of the stories I tell are true (with certain details admittedly altered or embellished), so if you knew I was in London or Montreal or Sydney or Beijing or Moscow or Johannesburg, it might be easier to figure out who these people are.  I simply can not let that happen.

3) So I guess you won't tell me your name?
You guessed right.


4) Are you actually a doctor?
Seriously, I get this one all the time.  Yes, I am.

5) If you're actually a doctor, how do you have so much time to comment on FML and to update your blog?
What, are you some kind of time management expert now?  Trust me, I find the time.  I happen to be very efficient with my time, so when I can save a few seconds here and there, they add up.

6) Are you an ER doctor?
No.  NO.  NO!  Why don't you just slap me in the face, because that would hurt less.  In case you didn't catch that, no I'm not.  I'm a trauma surgeon.

7) Well excuuuuse me.  So what's the difference anyway? 
An emergency physician sees anyone who walks into the emergency department with a sniffle, a sprained ankle, pinkeye, chest pain, a hangnail, abdominal pain, anything.  A trauma surgeon sees only those people who are brought in having suffered a traumatic injury - falls, car accidents, stabbings, gunshot wounds, my-lawnmower-ran-over-my-foot wounds, etc.  We evaluate them and then perform surgery to repair any damage done, from simple things like lacerations to more complex things like shattered spleens.

8) Why do you call yourself "Doc Bastard"?
Easy, because I'm a doctor and a bastard.  NEXT QUESTION!  What, not good enough?  Ok, well the "Doc" part should be easy enough to figure out if you read question 4.  As for the "Bastard", when I decided to start commenting on fmylife.com, I thought I would act like the biggest asshole in the history of assholes to the posters and the other commenters.  "DocAsshole" just didn't look right, so "DocBastard" was born.  I quickly abandoned that idea, but I'm just not creative enough to think of a new username, so it stuck.

9) When did you decide to become a doctor?
When I was five years old, I visited my grandfather's medical office.  I saw his ophthalmoscope, otoscope, and stethoscope and thought, "Cool, I want to use these toys someday!" and I never looked back.

10) What about surgery?
I didn't decide that until I was well into medical school.  Believe it or not, I entered medical school thinking I'd go into pediatrics or psychiatry.  Surgery was barely a consideration then.  But on the first day of my surgery clerkship, I scrubbed into surgery for the first time (it was a groin hernia repair), and the scrub technician dressed me in my sterile gown and gloves.  The moment I put my hands on the patient, I knew I belonged there.

11) What does it take to be a trauma surgeon?
Hard work, determination, and a bit of luck.  You have to be willing to spend considerable amounts of time away from home, and you have to have a family that is supportive.  It's nearly impossible to spend 24 hours at a time in the hospital and survive without someone who loves you unconditionally to come home to.

12) Have you ever considered publishing these stories?
Ha!  No.  Writing is merely a hobby for me, and to be honest I never thought anyone would read this crap.  Now if anyone happens to know an editor or publisher and wanted to point him or her in my direction, I certainly wouldn't object.  HINT HINT

13) Who is your biggest influence?
That would be my father, DadBastard.  He was a surgeon as well, and a damned good one at that.  I'm told my personality is very similar to his, even down to his mannerisms.  He has always been my role model, and I can't think of anyone to whom I'd rather be compared, except maybe his father, GrandpaBastard (who unfortunately passed away several years ago).  They both tried repeatedly to talk me out of going into medicine (and surgery), since they knew first-hand the sacrifices I'd have to make.  But I think they just wanted to make sure my heart was really in it.

14) What's this lump on my ass?
I have no idea, but it's hideous.

15) Can I ask you other questions?
Yes.  See the disclaimer above.

Wednesday, 3 April 2013

Inspiration

People can be inspired by the strangest things.  Artists can be inspired by a beautiful woman, a screenwriter may be inspired by war, a musician may be inspired by a particularly nice ass.  I know of many people in the medical profession who were inspired to go into the field because of something that happened in their own lives.  People with diabetes pursuing diabetes research or becoming an endocrinologist, people with severe allergies doing immunology research, people who had surgery at a young age going into surgery.  I was inspired to go into surgery by my father who was also a surgeon.

Little did I know that *I* could be an inspiration, even from afar.

Mr. R (not his real name) wrote me a few days ago, and after reading his letter, I asked if I could share it.  Fortunately he agreed.

Hi DocBastard.  I have been debating writing this post for quite some time. Let me start by introducing myself.  My name is [name redacted] and I'm 20 years old from [location also redacted] but born in raised in [damn it, stop making me redact things].  I have been beset by health care problems my whole life.  It started at 3 months old with tracheomalacia [a congenital weakness of the windpipe] and lived with a tracheostomy until the age of three.  In addition to this I suffered heart failure until roughly the age of six.  From approximately the age of 7 to 14 I broke eight bones and had at that point fourteen surgeries.  For a brief three years I had no issues to speak of.  Then on February 22, 2011 my world was turned upside down.  I had just finished working out and wasn't feeling too good, and I noticed that my arm had gone numb and I couldn't speak. Five hours later I was informed that, even though I was only 18 years old, I had suffered a transient ischemic attack [basically a mini-stroke] due to an atrial septal defect [a hole in the heart].  The news turned my world around - I had to turn down over $100,000 in scholarships.  I went through depression...and then I found your blog.  (Now I know what you're going to say - "Thank god, he's finally getting to the point!")   
I want to thank you for providing me a source of relief when I was stopping myself to pieces.  Thank you for reminding me that even though I've had it rough, it could always be worse.  Thank you DocBastard, for even though you didn't know it you convinced me to apply to medical school so I can help others like the wonderful doctors in my life have helped me.
I am profoundly honoured that my writing could inspire someone to pursue medicine, though I don't think I can claim full credit.  I have a distinct feeling that Mr. R's experiences had a lot to do with it too.

There are many great reasons to go into medicine - doctors are generally very well respected, we are among the most highly-educated people, and we get to cure diseases and help people get better.  There are even better reasons to go into surgery - mainly, I get to fix things instantly with no waiting, and I get to save lives, often in dramatic fashion.  So it always worries me that young people would look at a potential career in surgery and see only the bad things.  Sure it's a difficult lifestyle with long hours, a lot of time away from home and family, long and difficult operations, we are often underpaid...wait, why do I still do this to myself?

Thursday, 28 March 2013

Surgical secrets

After recently debunking some medical myths, I thought it only fair to spill some secrets that most surgeons don't want you to know. I have to tread lightly here, because what I'm about to tell you might get my licence revoked.

Ok, there's a remote chance that maybe that could possibly be a slight exaggeration.

1) We are not interested in your life story.  I'm here to fix whatever problem you came in for, so please tell me everything about that.  But I really don't care about how your Aunt Myrtle is doing or how many cats you have. Your primary doctor may care about what vaccinations you had as a child or how often you pee at night, but I just want to get the information I need and leave your room so I can get started fixing you, so please get to the point.

2) I have no idea when breakfast is actually served.

3) I hate seeing patients in my office.  I went into surgery to fix stuff, not to sit behind a desk and do tedious paperwork while wearing a suit.  I'd much rather be fixing something or banging my head against the wall or sticking hot pokers in my eye than doing office hours.

4) There are thousands of medical conditions, and sometimes we can't remember one or haven't heard of Whatever-You-Have Syndrome since medical school.  Dr. Gregory House doesn't actually exist, so sometimes we have to google it.

5) We see you completely naked during surgery, and we talk a lot while you are asleep.  If you have stupid tattoos, we will see them.  It isn't because we don't like you, but if you have "YOLO" in big letters across your chest or "The Pleasure Zone" with an arrow pointing to your vagina (yes, I've seen these), we will talk about them.

6) Whatever embarrassing problem you think you have, we've seen it (and much worse) before.

7) We really do treat everyone the same.  Whether you're a homeless guy off the street or a CEO in an Armani suit, Ferragamo shoes, and a Rolex watch, you will get the same surgery, the same pain medicine, the same postoperative treatment, the same everything.  I don't care who you are - you are NOT getting more narcotics or any special treatment compared to the poor guy next door with the same problem no matter who you threaten to call.

8) Obesity makes surgery much more difficult in every respect.  Your risk of every possible complication is higher, and we dread operating on you because of that.

9) I have no idea how often the curtains in your hospital room get washed, but they are probably dirtier than the toilets and the floors combined.  Don't touch them.  In fact, don't even go near them.

10) For people who demand certain narcotics or tell me that you need antibiotics when I know that you don't, I wish I could give you a shot of saline and tell you it's actually medicine just to get you to shut the hell up.  I've actually fantasised MANY times about doing just that, but I'm told it's an "ethical violation" to lie to a patient like that.

Can any of you other medical types (emergency personnel, nurses, internists, emergency physicians, pharmacists, medical students, etc) think of any others I missed?  Please email them to me at docbastard1@gmail.com and I'll do a followup.

This is top secret stuff I just divulged, so I hope you appreciate my taking this risk of revealing them..  If this update disappears and there are no more blog updates after this, that means "they" found me.

Sunday, 24 March 2013

Backup plans

I will confess that I had trouble deciding on a title for this post.  It was either going to be "Backup plans" or "WHAT ARE YOU, SOME KIND OF FUCKING MORON??!"  I thought the second one was a bit overly dramatic, so I chose the first.  The reason will become clear in just a second.  Backup plans are very simple concepts that most people have heard of, especially skydivers.  If you're going to jump out of a perfectly normal plane on purpose...

By the way, just as an aside, why the hell would you jump out of a plane??  ON PURPOSE!  What is WRONG with you people?

Ahem, as I was saying, if you're going to jump out of a plane, first make sure you have a parachute.  That's obvious, of course.  Second, in case that first parachute fails, you'd better be damned sure that you have a backup parachute.  Having a solid backup plan in place when your first plan is potentially deadly should be obvious, right?  Since I'm writing this, it obviously is not to some people.

My pager woke me out of a very deep slumber at 3AM, which happens to be exactly that time of morning that makes me want to either throw the pager against the wall or pretend I didn't hear it and go back to sleep.  Instead, I acted like a nice boy and trudged down to the trauma bay to see what the cat dragged in.  The scent that greeted me at the door was reminiscent of a pub on a Saturday night - a combination of cigarettes, booze, and dreary desperation.  The 48-year old woman (whom I shall call "Boozy") that was emitting this odor greeted me with, "HEY YOU, GET THIS SHIT OFF ME!"

That sound you just heard was me groaning from all the way over here.

Boozy (not her real name, though it was her real scent) had been a passenger in a car that had gone off the road and had an unfortunate encounter with a tree.  (HINT: the tree always wins.)  Luckily she had no major injuries, though she was thoroughly intoxicated (please, try to control your surprise).  Remember, however, that she was a passenger in the car.  Have you noticed anything strange?

Right - where was the driver?  Why hadn't he been brought in for evaluation?  Had he refused treatment?  Had he been abducted by aliens?   Had he died in the wreck?

No, no, and no.  Boozy's friend had been the designated driver, and after hitting the tree he pulled his friend Boozy out of the car and took off running.  But why would he do such a thing?  Why leave your drunk friend literally lying bleeding on the side of the road?

Because he was drunk too.  Boozy's brilliant backup plan consisted of getting in a car with someone drunker than she was.  I'm not sure who is stupider - him for getting drunk while being the designated driver or her for getting in his car.

If you have no backup plan, then you have no plan.

P.S. To all those who took the time to either post a comment on the last update or send me an email (and to those of you who didn't but come here nonetheless), I give you my sincerest thanks.  I hope you continue to follow along this ridiculous, merry little journey with me.  - Doc

Thursday, 21 March 2013

How many zeroes?

My wife was the one who convinced me to write these stories down.  It seemed that every day when I came home, I would have yet another stupid story to tell her.  Finally one day she said, "Doc (not his real name), why don't you keep a journal or something so you don't forget these stories?"

Hm.  Interesting idea.  So I started this blog for myself and my kids, but other people (this means you) have caught wind of it and started reading it too.  A lot of you.  So many of you, in fact, that as of today this blog officially has over one million page views.

A million.  1,000,000.  ONE FUCKING MILLION.

Never in a million years (hardy har har) did I ever think that my blog would be viewed a million times.  I'd like to thank each and every one of my readers for keeping up with my teeny tiny little corner of the internet and spending a little bit of your valuable time with me sharing my experiences.  It is a true honour, one that I wish I could repay somehow.

To everyone bothering to read this, please leave a comment telling me where you're from.  As always I welcome any email (docbastard1@gmail.com), even if it's just a few lines to let me know you were here.  Stories are even more appreciated, and pictures with your stories are almost sure to be published at some point.

Once again, thank you.

Best,
Doc

Saturday, 16 March 2013

Leave him alone

I'll be blunt, a lot of the patients that I get in my trauma bay are bullshit. I don't mean the patients themselves are, but the "trauma" that they've suffered is often not enough to cause any significant injuries, and I end up sending them directly home. But I found out recently that some bullshit is even bullshittier than the rest.

I was informed that my first patient of the day was a fall from a standing position, and I groaned audibly. Unless you are elderly and fall on your hip, or unless you fall face first on pavement, it's difficult to do any real damage in a ground-level fall. But this guy apparently did fall flat on his face, so I was hopeful the Bullshit Factor would be low.

Wow, was I ever wrong.

He rolled in on the gurney looking less sick than I did that day. Other than a scratch on his forehead, he was absolutely fine. So why the hell was he there?

Brace yourself.

He tripped on the curb while waiting for his bus and fell forward, catching himself before any significant impact occurred. But some Good Samaritan bystander saw him fall and called emergency services, who (unluckily for him) showed up before his bus. He tried to tell them he was fine, but they insisted he come with them. So he ran away from them. He ran a whole kilometer away from them. So they did the only sensible thing - THEY CALLED THE POLICE. Once the police arrived, they convinced him to come to the hospital and get evaluated.

It took a trauma surgeon to clean up his scratch and put on a Band Aid, which any 5-year old playing doctor could do.

If any medics are reading this, for fuck's sake if a patient tells you he's fine and can run further than you can, unless he's bleeding from his eyes or has an arm missing, just leave him the hell alone and go find someone who really needs you. And who really needs me.

American public health is (almost) officially cooked

As if the US public health system wasn't fucked enough when RFK Jr. was somehow, inexplicably, I-fucking-hate-this-timeline confirmed as...