Sunday, March 18, 2007

I'm just sayin'....

If four of your cousins died from Huntington's disease, make sure somebody other than you in your family knows that when you come in with nonspecific neurological complaints.

If nobody in your family died from Huntington's, please don't leave the recitation of your medical history up to the one person in your family who will obsessively Google things until he thinks he's found something that matches what's going on.

If you're going to present with one-sided paralysis, please make sure it's consistent. Remember that if the left side of your brain is affected, the right side of your body will be, while the left side of your face will be.

If you're going to yell at a nurse for setting up suction wrong--and I can't believe we're going over this again, Doctor--please make sure you know how to set suction up yourself. Next time you holler at me for something that's actually right, I'll bite a chunk out of your skull.

Speaking of biting chunks out of your skull, it's probably not a good idea to rough-house with a pit-bull/Rottweiler cross with whom you're not really well acquainted.

Don't go swimming in stagnant water in Nigeria. Just don't. And if you do, don't come staggering to me six months later when things start to go badly for you.

Take your malaria pills. Please.

Scrubbing at your lumbar incision in the shower with a hairbrush is not the best way to keep it clean.

Shooting yourself or others in the head is actually a tricky operation. Please research the best angles and ammunition caliber to use to accomplish your goals prior to doing so. Otherwise, you'll end up missing a frontal lobe and I will want to strangle you.

Demonic posession does not cause seizures. Really and truly. Ativan will help seizures, but only if you let go of the patient long enough that I can reach his IV line.

Pica is nothing to be ashamed of. Plenty of people have it; in fact, there are whole families around here in which the women make weekly trips to their favorite sources of soil. Just let me know if you have it, and if your particular type of pica leads you to crave paint chips.

Wear a fucking helmet. I don't know how many times I'll have to say this. Especially wear a helmet if you're going to pull a wheelie while you're going 120 mph on a rough road.

Doctor, Doctor, please: write the orders for tests prior to doing the lumbar puncture. CSF doesn't stay good forever. I don't want to have to pull you away from whatever fascinating thing you're doing three blocks away to get you to come back and write cytology orders.

Know your facility's policy for chemotherapy administration. This is especially important if you're an oncology attending who's worked here for twenty years. If I can't hang it, I can't write it.

In slightly funnier news, a patient's wife told me this story the other day:

It was the late 1940's, and she had just learned to fly a plane. On a trip back from her in-laws' house, she was pulled over for speeding. The cop said, "Lady, the only way you can go that fast around here is if you have a pilot's license."

She pulled out her spandy-new pilot's license and showed it to him.

She did not get a ticket.


Anonymous said...

Do whole families really get pica and have favorite dirts to eat? Really?

Jo said...

Magpie, they really do. It's actually fairly common here in the South among African-American women, although most don't know it themselves and think they're crazy.

And yep, there are particular outcroppings of soil here and there that are *very* popular. Personally, I think it has something to do with iron deficiency, as the soil I've heard of the most people liking is high in iron.

But I could be wrong.

anne said...

"Don't go swimming in stagnant water in Nigeria."

But...but... I'd heard guinea worms make nice pets!

Ahem. No, that's not funny at all.

Anyhow... thank you for this. Reading you helps nursing school go by a little easier.