Friday, November 21, 2008

The Mother Letters

Someone linked me to this great project called The Mother Letter Project

I think I might write a letter and submit it. Mine will be to a mother who wants to bring her child to the emergency room.

How honest shall I be?

Sunday, November 09, 2008

Running Commentary of a Random Day

My first patient of the day was a STEMI (heart attack). Busy beaver this AM. 37 years old. Yes, you heard me right. 37. No risk factors. NONE. No family history, not a smoker or drinker, eats well, exercises daily. Therefore, I shall use this as my excuse to never exercise, eat like shit, and drink to my heart's content.


THEN:

A gallbladder and 2 ear infections.

Do you ever find it weird that we refer to patients by their diagnosis and not their name? Even though I do it online for privacy reasons, we still do it in real life.

"Hey Lucy - can you medicate my gallbladder in Exam 2 please?"


NEXT:

Migraine (my own).

Trauma Chart Reviews for an hour.


TIME FOR LUNCH.

Another chest pain after lunch, another Migraine, a Peeing blood, and abdominal pain, and a r/o labor.

Then I got transferred to OB with my r/o labor and finished my shift there.

Rural Medicine is great.


Friday, November 07, 2008

You're Kidding Me, Right?

You have to be. You absolutely have to be, because no one in their God given right mind would think that you insert a chest tube into someone's SPLEEN - FOR SHITS SAKE!

Phew...... got that one off my chest. Chest. Huh, funny. That's where that damn tube belonged.

Dr Morris even said it! "5th intercostal space, mid-axillary line." That means 5 rib spaces down from your collar bone and along an invisible line that comes straight down from your armpit.

Um, yeah. Maybe the technical advisers should have listened to the dialog (that doesn't look right - shouldn't it be dialogue? Nope guess not. Spell check says I'm stupid as hell apparently. So anyway........). As Morris is telling Chaz where the tube belongs, he meanders south about 5 inches and puts it in his abdomen. Loser. It's not like they couldn't have faked him putting it in the right spot - they didn't need to pretend the abdomen was the lungs. Sheesh.

Oh! And! (How do you like that rule breaking sentence structure?) When the "blood" was pouring out of the chest tube area - it looked like red tinted water coming straight out of a faucet on high pressure. Whatever. Special effects on a tight budget all of a sudden? Blood does not spray out continuously like a water faucet. I know they can do this right as we've seen it before. Apparently, the special effects peeps have either forgotten the basics of blood spurting or have become so incredibly lazy they figure the general public will believe blood sprays out just like when you're running yourself a nice, cozy, hot bath with bubbles. Maybe they should supply us all with a glass of Chardonnay and a good book to read too.

Now let's talk about the MRI incident. Can I just call a bullshit on that one? Granted, it was funny as hell to see a patient screaming for morphine get their due, but honestly.... the MRI techs would have NEVER let that happen since in the REAL WORLD the techs do the scans and not the doctors/interns/med students.

Moving on to Sam and Gates. Sam gets an A+ for wanting to secure their patient's airway first. A-B-C's. Learn 'em. Know 'em. Follow 'em. Dr. Gates obviously is dyslexic since he follows algorithms backwards. "Naw, we don't need to worry about no stinkin' airway - let's scan his head first! Off to the scanner troops! Move out!" Oopsy-daisy...... airway needed.

And I will give a nickel to anyone who can tell me how exactly a 1% Non-Rebreather is supposed to work. Anyone? Anyone? Bueller? Mrs Bitchtastic, superheadchief of the ER, apparently has invented a new way of providing oxygen to a patient. For all my non medical peeps out there, a NRB (non-rebreather) is usually run on 10 to 15 Liters of oxygen. Therefore you will receive an order to "place the patient on an NRB at 15L." Ah well - dramatic license and all, eh?

Whatever will I do when this show is over? Thursday nights will be so dull and boring. No one yelling at the TV in my house. No one cussing about portrayals of medical care on TV. Maybe I'll just have to get drunk.


Wednesday, November 05, 2008

Paging Dr Greene.....Paging Dr Greene - STAT!

So, my prediction for the return of Dr Greene shall be as follows (and y'all know mine will be a hell of a lot more entertaining than anything they have planned anyway):


Dr Greene will come back as an evil twin of the original Dr Greene, who will carry out his evil plans to become a serial killer by offing ER patients via injections of a mysteriously blue colored substance or smothering them by holding the tip of his finger over the end of the ET tube. And then good Dr Carter will come back to save the day, all the while screwing some hot nurse in the janitor's closet. But then (oh no! dun dun dun.....) Dr Carter will be trapped in the dungeon of the hospital by Evil Dr Greene who will inject him with some new bio terrorism substance that will turn Dr Carter into a Stepford Wife. The Carter Stepford wife will then become the Evil Dr Greene's new partner between the sheets.

Suddenly - Sam will show up and kick the shit out of both of them before jumping out of the 5th story window and becoming a patient herself. But alas, the Evil Dr Greene will be able to sneak into her hospital room and will pull out the mysterious blue syringe. Just as he starts to inject the substance Neela will run in, throw her arms around Dr. Greene and say "I knew we could do it my love. I knew we could!!!"

Ack! It's all so shocking!