There are certain people in your life that you just shouldn't insult. These are people that can make your life a living hell if they so choose (or if you choose for them). Sure, there are some easy ones: your parents, your teachers, your neighbours, your boss. But there are a few which may not be so obvious:
- Your mechanic ("Yup, I'm gonna have to rebuild your whole engine.")
- The guy who makes your fast food burger (yes, they DO spit in them)
- Your children (they will choose your nursing home eventually, after all)
Surprisingly though, some people don't have any problem insulting their doctors - you know, the people who are trying to help them. I've heard stories from colleagues that were almost too ridiculous to believe, but I've never experienced it myself.
Until now.
An older gentleman was brought to me after he fell down an embankment and struck his head on a brick wall. Fortunately his brain was just fine, but after an extensive workup, I discovered only two things were broken: a bone in his neck was one of them.
His wife's sense of decency was the other.
As soon as I walked into his room to explain the situation to her, she immediately launched a full-scale attack against me, based not on my abilities, but rather on my looks. I unfortunately have one of those baby faces, and it makes me look much younger (and much less respectable, apparently) than I am.
"My god, how old are you?" she shrieked. "You look like you still belong in high school! Are you even old enough to be a doctor?"
Wh...what? Somehow restraining my desire to slap her, I ignored her age comment and calmly explained that I was not only fully trained, but also very good at what I do.
"Well I'm not gonna let my husband get killed by some baby doctor! My mother was killed by a baby doctor like you!"
Now up until that point I thought I had seen it all - I have been sworn at, spit at, cursed at, and threatened with violence and even death numerous times. But never have I been so insulted in my entire professional career.
I realised that trying to defend myself would get me nowhere, so I simply finished explaining the situation to them and walked out.
But wait, the title of this post is "Insults and happy endings", so what the hell is the happy ending? Here it is - I got the last laugh. The neurosurgeon who ended up taking care of his broken neck is even younger than I am.
Friday, 25 January 2013
Friday, 18 January 2013
Medical shows
I got another request from a reader named Mr. M (not his real name). I hadn't thought about a post like this, but his question piqued my interest in the subject.
The thing to remember about TV is that it's meant to be entertainment, not informative. I can guarantee that no one would actually watch a reality show based on my life. While my stories may seem mildly interesting or entertaining, they are few and far between (which explains why it's often a week or more between entries). The vast majority of what I do is mundane and boring. I hope that doesn't disappoint too many people, but that's reality, folks.
I watched a few episodes of "Grey's Anatomy", and it's nothing more than a glamourised soap opera. The social interactions that these people have are complete and utter bullshit (to put it mildly). Sure, there may be an odd affair here and there in real life, but the show makes it seem like everyone in the hospital is having sex with everyone else, and that just isn't the case. In reality, most of us have boring lives, and at the end of the day we go home in our boring cars to our boring families.
"ER" was interesting and fun to watch, but it's just as exaggerated. What drove me nuts was how almost every patient who was shocked by the defibrillator "came back" after the third shock. Um, no. Most of those people die in real life (real death?). And whenever anyone got intubated, the person putting the breathing tube in would triumphantly announce "I'M IN!" and the nurses swoon and ovulate. Sorry, but we don't do that. Ever. If anyone ever did that in real life, he'd probably get kicked in the crotch for being corny.
As far as "House" is concerned, I will shamefully admit that I watched almost every episode. But only because my wife made me! I swear! It wasn't because of the interesting cases! The biggest problem with that show is that drama and the pranks in the hospital just don't happen. At all. Worse yet, there's no such thing as a Department of Diagnostic Medicine at any hospital like they have on the show. The real diagnosticians are internists, surgeons, cardiologists, nephrologists, etc. We don't farm out our "interesting" cases to smarter doctors because we just can't figure it out.
The way the doctors give IV medicines, do all their own procedures, surgeries, MRIs, ultrasounds, and biopsies, is completely fabricated. Radiology techs do all of the scans, surgeons do surgery, pathologists look at specimens, lab techs do the bloodwork. And though the names of the diseases presented on "House" may be real, the presentation and evolution of the disease process that is shown is exaggerated, embellished, accelerated, or some combination thereof. House's basic premise was to come up with a list of possible diagnoses for the patient's problem, narrow it down to one, and then treat it before confirming it. Inevitably that treatment wouldn't work ("Well, I guess it isn't lymphoma!"), and another symptom would emerge ("OH MY GOD, I CAN'T FEEL MY LEGS!"), prompting a change of diagnosis and a new treatment which also wouldn't work. And so on and so on, until House had his "House moment" and figured it all out. No, it isn't lupus. It's never lupus.
Social interactions are why people watched the show. It it were purely medical, it would flop after one episode. No one wants to see cordial people politely greeting each other as they walk down the hall, making idle conversation in the elevators, and silently watching TV while gobbling a sandwich in the lounge between cases. But that's reality. Every now and then I get an interesting case, but inevitably I solve it, fix it, and move on to the next patient with regular, ordinary, run-of-the-mill appendicitis.
But instead, people would rather see the surgeon having wild sex with the nurse in the broom closet. Now THAT is good television.
Hi DocBastard,
I have a wish for one of your interesting blog entries: could you give us your perspective as a real practising surgeon on medical tv shows like Grey's Anatomy, Dr. House or ER and tell us how they compare to real life in the hospital? I know they try to incorporate real but very rare medical cases, but what interests me more is how daily life in hospital is portrayed, with the relationships between doctors, the time they seem to have to discuss personal problems in the hospital, nine surgeons in one OR on one case, or all nine of them in a bar together, some living together in the same house...You'd do a great service to dispell these myths and perceptions about medicine created by these shows, because I personally know people who want to go to medical school to live the life portrayed in these shows...
The thing to remember about TV is that it's meant to be entertainment, not informative. I can guarantee that no one would actually watch a reality show based on my life. While my stories may seem mildly interesting or entertaining, they are few and far between (which explains why it's often a week or more between entries). The vast majority of what I do is mundane and boring. I hope that doesn't disappoint too many people, but that's reality, folks.
I watched a few episodes of "Grey's Anatomy", and it's nothing more than a glamourised soap opera. The social interactions that these people have are complete and utter bullshit (to put it mildly). Sure, there may be an odd affair here and there in real life, but the show makes it seem like everyone in the hospital is having sex with everyone else, and that just isn't the case. In reality, most of us have boring lives, and at the end of the day we go home in our boring cars to our boring families.
"ER" was interesting and fun to watch, but it's just as exaggerated. What drove me nuts was how almost every patient who was shocked by the defibrillator "came back" after the third shock. Um, no. Most of those people die in real life (real death?). And whenever anyone got intubated, the person putting the breathing tube in would triumphantly announce "I'M IN!" and the nurses swoon and ovulate. Sorry, but we don't do that. Ever. If anyone ever did that in real life, he'd probably get kicked in the crotch for being corny.
As far as "House" is concerned, I will shamefully admit that I watched almost every episode. But only because my wife made me! I swear! It wasn't because of the interesting cases! The biggest problem with that show is that drama and the pranks in the hospital just don't happen. At all. Worse yet, there's no such thing as a Department of Diagnostic Medicine at any hospital like they have on the show. The real diagnosticians are internists, surgeons, cardiologists, nephrologists, etc. We don't farm out our "interesting" cases to smarter doctors because we just can't figure it out.
The way the doctors give IV medicines, do all their own procedures, surgeries, MRIs, ultrasounds, and biopsies, is completely fabricated. Radiology techs do all of the scans, surgeons do surgery, pathologists look at specimens, lab techs do the bloodwork. And though the names of the diseases presented on "House" may be real, the presentation and evolution of the disease process that is shown is exaggerated, embellished, accelerated, or some combination thereof. House's basic premise was to come up with a list of possible diagnoses for the patient's problem, narrow it down to one, and then treat it before confirming it. Inevitably that treatment wouldn't work ("Well, I guess it isn't lymphoma!"), and another symptom would emerge ("OH MY GOD, I CAN'T FEEL MY LEGS!"), prompting a change of diagnosis and a new treatment which also wouldn't work. And so on and so on, until House had his "House moment" and figured it all out. No, it isn't lupus. It's never lupus.
Social interactions are why people watched the show. It it were purely medical, it would flop after one episode. No one wants to see cordial people politely greeting each other as they walk down the hall, making idle conversation in the elevators, and silently watching TV while gobbling a sandwich in the lounge between cases. But that's reality. Every now and then I get an interesting case, but inevitably I solve it, fix it, and move on to the next patient with regular, ordinary, run-of-the-mill appendicitis.
But instead, people would rather see the surgeon having wild sex with the nurse in the broom closet. Now THAT is good television.
Thursday, 10 January 2013
Getting away with it
How many drunk idiots have been brought to me after crashing their cars? A hundred? Two hundred? Probably more than that. And how many of them have actually been arrested? I can probably count that on one hand. Most of these maniacs get away with it, something that makes me absolutely livid.
Now, how many of them have gotten simple citations for their besotted idiocy? I don't keep actual statistics, but based on my memory, it's likely less than 10%. Most of the time the police don't even show up, and when they do, they don't seem to feel like hanging around until our workup is done so they can issue the ticket. One police officer actually told me that "it just isn't worth it".
Isn't worth it?? I just stared at him, incredulous. It drives me batshit crazy when these people get away with crimes like this that put everyone, my wife and children included, at risk of serious injury or death. In fact, I get aggravated when someone gets away with something as simple as a traffic violation. Which seems to be a perfect segue into my first mini-rant of 2013.
I was sitting on the freeway in stop-and-go traffic on my way to the hospital this morning, a police car right in front of me, something I usually find to be very comforting. As we were passing an on-ramp, I noticed a taxi in the other lane swing into the on-ramp lane to get around a few cars. It pisses me off when I see people do this, because it's like they are telling me "I'm far too important and in far too much of a hurry to sit in traffic like the rest of you plebs. I'm making my own traffic rules!" I immediately yelled at the policeman in front of me to pull the taxi driver over, which I'm fairly certain he didn't hear through my windscreen and his back window. Traffic continued at a near-standstill while the taxi got ahead of 5 or 6 cars. Congratulations, asshole. Now you get to keep sitting in traffic with the rest of us underlings.
About a minute later, we started to pull even with the far-too-important cab who had again been caught in the slower lane. I noticed the policeman sidling over towards him and my mouth started to curl into a smile. It broadened into a huge grin as he flipped his lights on, swung quickly behind the taxi, and pulled him over.
Justice. Sweet, sweet justice.
Sunday, 30 December 2012
Zzzzzz
Texting and driving is stupid. But I've already ranted enough about that. Drunk driving is even more stupid. Sure, I could end this post here, but everyone knows all of this. I bet even the idiot drunk drivers are thinking, "My god, what the hell am I doing??" while they're doing it. So what the hell is my point? Unless you've been living under a rock (which is probably one of the safer places to be these days), driving under the influence of drugs or alcohol isn't the only stupid thing you can do at the wheel. You have also heard of drowsy driving.
What?! You haven't? Have you been living under a rock?
Put simply, drowsy driving is driving while you should be sleeping. About one in 6 fatal traffic accidents can be attributed to driver fatigue, which can impair judgment, delay reaction times, and impairs coordination. Sound like anything else? Exactly. It's been shown to be at least as dangerous as drunk driving, if not more so.
Yet another car accident victim was being brought to me at 2 AM on a night when I had already had 15 patients come in. I was tired, I was cranky, and I was in no mood for another fucking moron who had thoroughly earned a trip to my trauma bay. Unfortunately that's exactly what rolled through the door.
A very large woman rolled in on the gurney, and the medics were having a very difficult time stifling their laughter as they told me why she was here. She had just been prescribed a new medicine, one that notoriously causes drowsiness. She had taken her first dose that evening and had supposedly discovered another side effect - a severe case of the stupids. So in the middle of the night, already drowsy from sleep deprivation and her new medicine, she thought it would be a fantastic idea to go out for nachos. And much to the surprise of NO ONE, she fell asleep and ran off the road into a tree.
Fortunately she was not seriously injured, and after a negative workup I sent her on her way. I have no idea if she stopped for a snack on the way home.
What?! You haven't? Have you been living under a rock?
Put simply, drowsy driving is driving while you should be sleeping. About one in 6 fatal traffic accidents can be attributed to driver fatigue, which can impair judgment, delay reaction times, and impairs coordination. Sound like anything else? Exactly. It's been shown to be at least as dangerous as drunk driving, if not more so.
Yet another car accident victim was being brought to me at 2 AM on a night when I had already had 15 patients come in. I was tired, I was cranky, and I was in no mood for another fucking moron who had thoroughly earned a trip to my trauma bay. Unfortunately that's exactly what rolled through the door.
A very large woman rolled in on the gurney, and the medics were having a very difficult time stifling their laughter as they told me why she was here. She had just been prescribed a new medicine, one that notoriously causes drowsiness. She had taken her first dose that evening and had supposedly discovered another side effect - a severe case of the stupids. So in the middle of the night, already drowsy from sleep deprivation and her new medicine, she thought it would be a fantastic idea to go out for nachos. And much to the surprise of NO ONE, she fell asleep and ran off the road into a tree.
Fortunately she was not seriously injured, and after a negative workup I sent her on her way. I have no idea if she stopped for a snack on the way home.
Stupid doctor
It's that time again: time for another post about stupid doctors! This time, you may be surprised that the stupid doctor is a trauma surgeon. You may be even more surprised to learn who the stupid trauma surgeon is:
Me.
Ok, granted, I wasn't a trauma surgeon at the time, I was still a doctor-in-training. So I can at least use that as an excuse. But it was one of those moments in my professional life when I deserved a well-earned slap to the forehead.
I had only been a doctor for about a year and was rotating through the intensive care unit, trying to learn how to take care of the sickest patients. Heart transplants, sepsis, strokes, heart attacks, surgical catastrophes, you name it. These patients are the worst of the worst, the sickest of the sick, and many of them never make it out. The patients who can't breathe on their own need mechanical ventilation, and this can be very uncomfortable and disorienting for them. Many of these unfortunate patients can become severely agitated, and sedation often isn't enough.
One such patient was an elderly woman who was having an exacerbation of her emphysema. She was intubated, on the ventilator, and fighting it furiously. The nurses had to attend to her constantly in attempts to calm her, but she seemed to be inconsolable, banging on the bed rails, pulling at her IV lines, and generally being a pain in the ass. All of the nurses had had it with her. Around 10 PM as I was making my nighttime rounds, she seemed particularly disturbed. I looked at her chart and noticed that her name looked German. All of a sudden a light bulb turned on - perhaps the nurses were having trouble calming her because she didn't speak the language. I studied the German language for four years in school, so perhaps I could talk to her in her own language! I could be a hero!
I walked timidly into the room, and her fierce blue eyes immediately narrowed and locked onto mine. I took a deep breath, racked my brain for the right words, and started telling her that she was ok, everything was fine, and she needed to concentrate on her breathing. She immediately calmed down ever-so slightly, and her eyes opened wide. She understood! I continued talking to her in very soothing tones, explaining in very broken German that her lungs were sick, but we were giving her medicine to make her better. At least I was pretty sure that's what I said...either that or I said that her lamp cow is sad yesterday and need more painted Wednesday.
Anyway, by the time I was done, she was perfectly calm, she was breathing more easily, and she actually had a hint of a smile on her face. Three of the ICU nurses watched open-mouthed as I strode confidently out of the room. "WHAT DID YOU SAY TO HER?" one of them asked. I simply told them that I explained her situation to her in her own language, and I continued on my rounds.
When I came in the next day, she had clearly gotten better because she was no longer on the ventilator. She was breathing on her own and looked much more comfortable...and still calm. I walked into her room and re-introduced myself, and after I finished my examination, I asked if she had any recollection of our conversation. I wasn't surprised to learn that she didn't (the sedatives can often interfere with memory formation), so I filled her in on the details.
"But I'm not German."
What? What do you mean, I asked her.
"I'm Norwegian. My husband was German. I don't speak any German at all."
Um...well then I guess her lamp cow really was sad after all.
Me.
Ok, granted, I wasn't a trauma surgeon at the time, I was still a doctor-in-training. So I can at least use that as an excuse. But it was one of those moments in my professional life when I deserved a well-earned slap to the forehead.
I had only been a doctor for about a year and was rotating through the intensive care unit, trying to learn how to take care of the sickest patients. Heart transplants, sepsis, strokes, heart attacks, surgical catastrophes, you name it. These patients are the worst of the worst, the sickest of the sick, and many of them never make it out. The patients who can't breathe on their own need mechanical ventilation, and this can be very uncomfortable and disorienting for them. Many of these unfortunate patients can become severely agitated, and sedation often isn't enough.
One such patient was an elderly woman who was having an exacerbation of her emphysema. She was intubated, on the ventilator, and fighting it furiously. The nurses had to attend to her constantly in attempts to calm her, but she seemed to be inconsolable, banging on the bed rails, pulling at her IV lines, and generally being a pain in the ass. All of the nurses had had it with her. Around 10 PM as I was making my nighttime rounds, she seemed particularly disturbed. I looked at her chart and noticed that her name looked German. All of a sudden a light bulb turned on - perhaps the nurses were having trouble calming her because she didn't speak the language. I studied the German language for four years in school, so perhaps I could talk to her in her own language! I could be a hero!
I walked timidly into the room, and her fierce blue eyes immediately narrowed and locked onto mine. I took a deep breath, racked my brain for the right words, and started telling her that she was ok, everything was fine, and she needed to concentrate on her breathing. She immediately calmed down ever-so slightly, and her eyes opened wide. She understood! I continued talking to her in very soothing tones, explaining in very broken German that her lungs were sick, but we were giving her medicine to make her better. At least I was pretty sure that's what I said...either that or I said that her lamp cow is sad yesterday and need more painted Wednesday.
Anyway, by the time I was done, she was perfectly calm, she was breathing more easily, and she actually had a hint of a smile on her face. Three of the ICU nurses watched open-mouthed as I strode confidently out of the room. "WHAT DID YOU SAY TO HER?" one of them asked. I simply told them that I explained her situation to her in her own language, and I continued on my rounds.
When I came in the next day, she had clearly gotten better because she was no longer on the ventilator. She was breathing on her own and looked much more comfortable...and still calm. I walked into her room and re-introduced myself, and after I finished my examination, I asked if she had any recollection of our conversation. I wasn't surprised to learn that she didn't (the sedatives can often interfere with memory formation), so I filled her in on the details.
"But I'm not German."
What? What do you mean, I asked her.
"I'm Norwegian. My husband was German. I don't speak any German at all."
Um...well then I guess her lamp cow really was sad after all.
Thursday, 27 December 2012
Actions speak louder...
I'm sure you've heard the phrase "Actions speak louder than words." Truer words have seldom been spoken.
Or have they? Perhaps words are sometimes all you really need.
I'm going to deviate from my usual posts (obnoxious, angry ranting and raving), shut my big, fat, stupid mouth, and let someone else do most of the talking for this update. I get emails from readers with some frequency, many of them asking medically-related questions. Most of them have nothing to do with trauma - they come from people who are simply desperate for help or answers and don't know where else to turn. I received this email from Kira (not her real name) about three weeks ago:
Well I think anyone with more than 7 brain cells can tell that this certainly doesn't sound good. The only thing I told her was that coughing up blood is not normal, and that she needed medical attention. NOW. She responded immediately:
I sat next to the computer wringing my hands the entire time, wondering, hoping, worrying...ok, that's a complete lie, but I was mildly concerned. And then three weeks later, I got this:
Now don't get me wrong, I'm not taking credit for anything here other than trying to alert some oblivious parents to take their child's complaint seriously. My daughter makes mountains out of molehills all the time (Daddy, it's bleeding!! It's just a papercut, dear. YEAH, BUT IT'S BLEEDING!!!). But as a parent you have to be able to detect the difference between exaggeration and reality. That can be very difficult to do sometimes, especially when you have no medical training. But when it comes to your children and their health, I feel it's better to err on the side of caution. It's much easier to bring your child to the doctor and be reassured than the alternative. Fortunately my email caused Kira's parents to reconsider and spurred them to do the right thing.
See what I mean? Sometimes words really do speak louder than actions.
Or have they? Perhaps words are sometimes all you really need.
I'm going to deviate from my usual posts (obnoxious, angry ranting and raving), shut my big, fat, stupid mouth, and let someone else do most of the talking for this update. I get emails from readers with some frequency, many of them asking medically-related questions. Most of them have nothing to do with trauma - they come from people who are simply desperate for help or answers and don't know where else to turn. I received this email from Kira (not her real name) about three weeks ago:
I've been told by my doc I have bronchitis but lately I've been coughing up blood and hacking my brains out. I've also been very sore in my entire stomach and lung area. I can't hardly breath and my parents won't listen. They just make fun of how I sound or when I'm in pain. Please help me.
Well I think anyone with more than 7 brain cells can tell that this certainly doesn't sound good. The only thing I told her was that coughing up blood is not normal, and that she needed medical attention. NOW. She responded immediately:
I can't get to the hospital they won't take me.Shit. Won't take her? What?!? At that point I advised her that if she really is having trouble breathing, she needed to either A) call a taxi or emergency services or somehow get to her doctor without her parents, or B) somehow convince her parents that this is actually something serious. Coughing up blood (aka haemoptysis) can be a sign of bronchitis, lung cancer, or more serious lung infections like tuberculosis, but it is never, ever normal.
I'll try, doc. Thanks. Ill let you know how I'm doing tomorrow.And then I got nothing for three weeks. Was I simply blowing it out of proportion? Was it not as bad as it sounded? Was she dead?
I sat next to the computer wringing my hands the entire time, wondering, hoping, worrying...ok, that's a complete lie, but I was mildly concerned. And then three weeks later, I got this:
Hey doc, I just wanted to let you know I'm finally feeling normal again. It turns out I had a severe case of pertussis (whooping cough). If I had not gone in when you sent me that message back that convinced my parents to take me in, I probably would not be writing this. In fact I would probably be in the ICU. But thanks to you I am now well and happy (if a little short of breath occasionally). I just want to share I also found out because of you I have damaged lungs from where I grew up as a child. If you hadn't convinced me to go in I would have never found this out and been able to learn more about it. If you can please tell your readers don't take second hand smoke lightly. I grew up in a place that was constantly filled with smoke and because of that I'm way more susceptible to bronchitis, pneumonia and all other respiratory issues. Anyway I just wanted to thank you for giving me the best gift of all. My life back.
Thanks doc!
Now don't get me wrong, I'm not taking credit for anything here other than trying to alert some oblivious parents to take their child's complaint seriously. My daughter makes mountains out of molehills all the time (Daddy, it's bleeding!! It's just a papercut, dear. YEAH, BUT IT'S BLEEDING!!!). But as a parent you have to be able to detect the difference between exaggeration and reality. That can be very difficult to do sometimes, especially when you have no medical training. But when it comes to your children and their health, I feel it's better to err on the side of caution. It's much easier to bring your child to the doctor and be reassured than the alternative. Fortunately my email caused Kira's parents to reconsider and spurred them to do the right thing.
See what I mean? Sometimes words really do speak louder than actions.
Thursday, 20 December 2012
Phrases
I'm sure this is true in all languages, but there are lots of phrases in the English language that don't make a whole lot of sense:
But other phrases make perfect sense:
So what the hell am I getting at? What exactly does this have to do with anything? Just wait. I promise it will make sense in a moment.
A very boisterous (my nice way of saying "obnoxiously loud") man was brought to my trauma bay having been allegedly assaulted by five other men. His main complaint was a headache due to a gash on his forehead.
"Oh, and my fists hurt too."
Your fists hurt? I hadn't heard that one before. "Yeah, Doc. I think I knocked one of them the fuck out."
Lovely.
My main complaint was that he smelled like a dirty diaper that had been dipped in booze. He and his "buddies" that he had been brawling with had drunk at least a dozen bottles of something, so he had done the only logical and gentlemanly thing he could think to do - he emptied his bladder all over himself during the ambulance ride. Yes, on purpose. We peeled his pants off his legs and tried to dispose of them (the pants, not the legs...though trust me, the temptation was there), but the stench wouldn't seem to go away.
We continued with our workup desperately trying to ignore the odor. In this midst of everything, it turned out that his only available form of identification was an armband with his name and date of birth on it...the armband from the prison from which he had been released the day before. So naturally he had decided to celebrate his release by drinking and fighting. Fortunately he hadn't done any major damage and had no major injuries, so he received a few stitches in his forehead for his trouble, and I sent him on his merry way. The police were only too happy to take him right back.
After this experience, I've added "piss drunk" to the second list.
It's a dog-eat-dog world. Ok maybe some dogs are viciously competitive, but have you ever seen a dog actually eat another dog?
I slept like a baby. No you didn't, you slept all night. Babies wake up screaming every two hours!
He wants to have his cake and eat it too. What is the point of having cake if you're not going to eat it?
It's the bee's knees! It's...wait, what? What the fuck does that even mean?
But other phrases make perfect sense:
I'm as happy as a pig in slop. Yup, pigs look very happy wallowing in mud.
That went like clockwork. Sure, fine clocks are incredibly intricate.
It's as smooth as silk. Self-explanatory.
So what the hell am I getting at? What exactly does this have to do with anything? Just wait. I promise it will make sense in a moment.
A very boisterous (my nice way of saying "obnoxiously loud") man was brought to my trauma bay having been allegedly assaulted by five other men. His main complaint was a headache due to a gash on his forehead.
"Oh, and my fists hurt too."
Your fists hurt? I hadn't heard that one before. "Yeah, Doc. I think I knocked one of them the fuck out."
Lovely.
My main complaint was that he smelled like a dirty diaper that had been dipped in booze. He and his "buddies" that he had been brawling with had drunk at least a dozen bottles of something, so he had done the only logical and gentlemanly thing he could think to do - he emptied his bladder all over himself during the ambulance ride. Yes, on purpose. We peeled his pants off his legs and tried to dispose of them (the pants, not the legs...though trust me, the temptation was there), but the stench wouldn't seem to go away.
We continued with our workup desperately trying to ignore the odor. In this midst of everything, it turned out that his only available form of identification was an armband with his name and date of birth on it...the armband from the prison from which he had been released the day before. So naturally he had decided to celebrate his release by drinking and fighting. Fortunately he hadn't done any major damage and had no major injuries, so he received a few stitches in his forehead for his trouble, and I sent him on his merry way. The police were only too happy to take him right back.
After this experience, I've added "piss drunk" to the second list.
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