"It costs more to provide less"

Just for grins I looked to see how much it would cost to get my family health insurance through one of the Obamacare exchanges.  Turns out that for about 40 percent more cost, I can get a higher deductible plan that covers less.  What a great deal! I hope the medical center doesn't decide to drop our coverage.

Dope Flu

20 y/o male in the ED brought in by his parents because he was nauseated, vomiting, tachycardic, sweating and gnawing abdominal pain. Parents are convinced that he has appendicitis.  They said that he got sick right after they pulled him out of college last week because of his bad grades.  I asked Mom and Dad to step out while I examined him.  Yep, its been a week since he had his last fix of Oxys.  Good ole dope flu.  We checked an US of the belly to be safe.  Gave him the numbers of AA.  HIPPA says we cant tell his folks.

Pop tops and blow holes for Dummies

I think I am going to have to call the publishers of those "Dummies" books to see if they would consider a series on medical issues.  There are already tons of books about caring for cancer, "what to expect when you are expecting", and dealing with grief but I think the post-trauma market is untapped.  Especially for the "I took Vodka and Molly and then drove my car into the overpass" crowd.  There could be Dummies books for "pop tops" (PEG tubes) which if you are going to shot gun beer into them let it go flat otherwise, the top pops and you spray all over.  "Blow holes for Dummies" (what little cigars fit into the trache tube), "Keg taps for dummies" (suprapubic catheters), and last but not least "Bung holes for Dummies" for the colostomy bags.  Hey, you know how they have those anti smoking commercials with the people who lost their voice box and legs and stuff on TV.  Maybe they could have some that say "I'm cool, I joined a gang and now I have a pop top, blow hole, a keg tap and this great bung hole!

Reconcile This!!

As part of yet another JACHO mess, we are supposed to reconcile all the patients medications when they leave the hospital.  This means that we are supposed to say what medicines they are to take and not take regardless of what we are threating them for. We are then responsible for those medications both medically and legally.   This is hard enough because they might be in the hospital for a hernia but all the meds are cardiac or psyche meds.  Now we have to reconcile all the herbals and all the other things that they take.  "Lets see they take gin sing, oral silver, and a powder from the flea market".   On the computer I cant find a way to check the button that says "call the person who told then to take this stuff", or the button that says "sue someone else" so I just click "do not continue". 

Action Hero

I was driving home from a trip and traffic on the Interstate started to slow down.  I saw the sign that said "right lane closed ahead, merge left".  I moved to the left lane and joined the other cars that were already there slowed down.  After several minutes of slowly moving ahead, car after car sped past on the right to see how far up they could get and then barge into the line.  Of course they slowed the whole thing up and made everyone have to slam on the breaks.  One almost caused and accident. Suddenly the pickup in front of me moved into the left lane.  He didn't speedup, he just stayed even with me. I made sure I left his space in front of me open.  Car after car flew up behind him, honking and honking.  He just stayed even with me.  The line moved steadily without incident.  When the right  lane closed he slipped back in front of me.  I gave him the best thumbs up and salute I could!  You sir are a true hero! By the way, his license plate was from Texas and had a combat wounded veteran symbol!

Achromatopsia

It was early morning rounds before surgery and one of the medical students was presenting a case that came in during the night.  She explained that it was a 24 y/o male with severe abdominal pain that was out of proportion to exam.  I stopped her right then and asked what his race was.  She said that they were told not to mention race as that is "prejudicial and stereotyping".  Before, I could saw anything else, one of the residents said, Asians don't get sicke cell crisis.  I cant wait until we cant mention sex in the evaluation of pelvic pain.