Friday, September 14, 2007

Dumpling Toxicity

Somedays it's hard not to say what you think. It seems more and more people I see are disabled for one reason or another. When I ask them why they are disabled, I am often puzzled. You can't work, but you can drive and do other things but the government is paying for it? Usually, the diagnosis is fibromyalgia or low back pain but the ones that really get me are those that are disabled because of obesity. They will not say "I am disabed because I'm obese", rather they say that it is because of their knees, hips, back pain etc. They then get stickers that lets them park closer to the restraunts.

Then I see patients who are dying of cancer or on chemo who can't get disability. It just doesn't make sense.

Hanging Crepe'

Why can't the pathologists be the ones who have to tell people that they have cancer? I mean they could come in and tell them and then leave. After all, you really don't know that they have cancer until the pathologist tells you.

I think having to deliver bad news is the hardest part of the job. No matter how hard you hope and pray for better news, sometimes you have to tell people that they are going to die. Then it gets worse. You do everything that you can do to help ease their suffering and comfort their family as you watch them slowly die. As they die, a piece of you dies as well.

Today, I had to give someone bad news. The very next patient was irate because I took so long with the previous patient and that I would not sign disability papers for their non-existant injury. I smile and apologize for their wait and explain that I dont due disability forms but will be glad to help them with their medical problems.

Sunday, September 9, 2007

Pupillated eyes

Medical terms always seem to be a bit hard to explain and worse to remember. Not to mention that so many things are named after someone. (Throckmortons sign for example) Sometimes in the ER, patients will try to explain what surgeries they have had or medical problems and I just cant figure it out. Its not their fault, its ours with our big fancy doctor words.

Then, there is my daughter. She went to the eye doctor and when I asked her how it went, she looked at me and said it was ok, but she didn't like it when he pupillated her eyes! Pupillating, what a great term! It conveys exactly what he did! I think she in on to something, new medical terms that everyone can use and understand!

On a side note, it got me to looking for other medical terms that could be changed to make them easier to understand. I also found out that there are some terms that there are no medical glossary equivalents. So far I have not found the actual medical term for boogers. I then asked an opthalmologist friend of mine what the medical term is for the eye gunk that you get in the mornings and he stated that those are called "eye boogers". A gynecologist suggested that we rename "Hysterectomy" to "womb outofme". As you can imagine, the discussions that followed became enough for a new medical dictionary or at least a small phamphlet.

Thursday, September 6, 2007

CNS QNS (abbreviation)

(Central nervous system/quantity not sufficient) Recently, I have had several patients come in an ask about certain "studies" that they heard on the news and the conslusions that the news reporters have made from them. Generally they are about a certain vitamin or dietary substance and cancer rates. The problems with these studies are that they look at numerous variables and are designed to see if any of the variables group together. They do not say that one variable caused the other.

Unfortuantely, the results of these studies are presented in such a way as to make people think that the vaiables are causal, usually to sell a product or sway a jury. A classic study noted that the incidence of nasopharyngeal carcinoma was higher in patients who ate a lot of fish. Was eating fish the reason? No, the population who ate the fish was of central asian ancestry who had a higher incidence of the carcinoma due to other reasons.

Like most things, studies are all about the spin. Hopefully, we can increase our CNS quantity about statistics and scientific method to avoid the spin.

Saturday, September 1, 2007

Humble Pie

On my way home after going to the OR in the middle of the night, I was given a great big piece of humble pie. It was after three in the morning and driving home to get some sleep before the next days clinic I saw lots of red and blue lights on the interstate ahead of me. I slowed down and got in the farthest lane to avoid the accident. Out of the corner of my eye I saw an EMT laying on his belly trying to intubate a victim lying decorticate in the middle of the onramp. It was a horrible accident.

I pulled over and ran over to help. It was bad accident with the victim thrown from the vechicle and an obvious head injury. I identified myself as a physician to the police offer and felt for a pulse. There was none. The EMT was trying to suction lots of blood while another paramedic was holding in line traction. Lying on his belly in a pool of blood and mud in the middle of the night he was able to get a good tube, I listened for breath sounds and it was in. No pulse, we pumped chest, loaded him on a board, he was in the ambulance in minutes. The police moved in unison to clear the way and the ambulance sped off with victim to the trauma center with epi and atropine going down the et tube.

The speed, effiency and professionalism I saw was awe inspiring. This was the paramedics first accident out of training and he perfomed like it was another day in the park. The police and fireman work like a well experienced offensive line.

Somedays in the ER and OR with all the equipment and help we get to feel like heros because we saved a life. The life was saved well before we see them, by EMTs, paramedics, police and fireman, lying on their belly, covered in blood and muck in the middle of the night.