Medical charts

The following are actual, unedited, notes written by doctors on
patients’ medical charts:

1. Patient has chest pain if she lies on her left side for over a
year.

2. On the second day the knee was better,
and on the third day it disappeared completely.

3. She has had no rigors or shaking chills, but her husband states
she was very hot in bed last night.

4. The patient has been depressed ever since she began seeing me in
1993.

5. The patient is tearful and crying constantly. She also appears to
be depressed.

6. Discharge status: Alive but without permission.

7. Healthy appearing, decrepit 69 year-old male, mentally alert but
forgetful.

8. The patient refused an autopsy.

9. The patient has no past history of suicides.

10. Patient has left his white blood cells at another hospital.

11. Patient’s past medical history has been remarkably insignificant
with only a forty pound weight gain in the past three days.

12. Patient had waffles for breakfast and anorexia for lunch.

13. Between you and me, we ought to be able to get this lady
pregnant.

14. Since she can’t get pregnant with her husband, I thought you
might like to work her up.

15. She is numb from her toes down.

16. While in the ER, she was examined, X-rated, and sent home.

17. The skin was moist and dry.

18. Occasional, constant, infrequent headaches.

19. Patient was alert and unresponsive.

20. Rectal exam revealed a normal size thyroid.

21. She stated that she had been constipated for most of her life
until she got a divorce.

22. I saw your patient today, who is still under our car for physical
therapy.

23. Both breasts are equal and reactive to light and accommodation.

24. Exam of genitalia reveals that he is circus sized.

25. The lab test indicated abnormal lover function.

26. The patient was to have a bowel resection. However, he took a
job as a stockbroker instead.

27. Skin: Somewhat pale but present.

28. The pelvic examination will be done later on the floor.

29. Patient was seen in consultation by Dr. Blank, who felt we should
sit on the abdomen, and I agree.

30. Large brown stool ambulating in the hall.

31. Patient has two teenage children, but no other abnormalities.

32.  By the time he was admitted, his rapid heart had stopped, and he was feeling better.

33.  Patient was released to outpatient department without dressing.

34. I have suggested that he loosen his pants before standing, and then, when he stands with the help of his wife, they should fall to the floor.

35.  The patient will need disposition, and therefore we will get Dr. Blank to dispose of him.

36.   The patient expired on the floor uneventfully.

37.  She slipped on the ice and apparently her legs went in separate directions in early December.

38.  The patient experienced sudden onset of severe shortness of breath with a picture of acute pulmonary edema at home while having sex which gradually deteriorated in the emergency room.

39.  The patient was in his usual state of good health until his airplane ran out of gas and crashed.

40.  Coming from Detroit, this man has no children.

Medical school, round 2

Uni has started and I am once again up to my pits in work. Seriously, there's literally no space to move. But even so, I went to medcamp last night. Good drunken times were had. 

Also, Med tends to suck inspiration, time, and life dry. Who would have thought things could get worse than first year. In light of this, I'm not even going to promise that I'll post again anytime soon. Way too far behind in everything, especially sleep. 

$50 to anyone who invents a consumable form of sleep. 

Interesting Medical Cases: Unusual Foreign Body In Boys Bladder

(From ISPUB) Click here for the full text.
Below is the unTL;DR, slightly less medical version.

So basically, a 14 year old boy complains of pain, difficulty in passing urine with dribbling and subsequent urinary retention that is 24 hours in duration. On further questioning he told the doctor that while he was cleaning the fish tank in his house, he was holding a fish in his hand when he went to the toilet. When passing urine, the fish slipped from his hand and entered his urethra and he developed the subsequent symptoms.

An X ray and abdominal ultrasound were done, with the ultrasound showing a 1.5cm echogenic object found inside his bladder. 

For management a cystourethroscopy was done (i.e. sticking a flexible scope up his penis). A 2cm long dead fish was found inside the bladder. The medical team tried to remove the fish with forceps but was unable to due to its slippery surface. Instead, a rigid ureteroscope with stone graspers was used to remove the fish whole. 

Afterwards, the child was asymptomatic and was sent for psychiatric counseling.

This story begs the question, what the fuck was the kid doing with a fish in his hand whilst in the toilet in the first place.

The article itself then goes on about the Candirú or Canero fish, found in the Amazon river. Below is the extract. 

"One of the strangest stories from the Amazon was a fish that was urinophilic and could swim up the urethra or into the vagina who urinated while bathing in the Amazon. It was said that this fish, known as candirú [in Brazil; as carnero. Once inside it would eat away the mucous membranes and tissues until hemorrhage would kill it or the host. It was also said that even if one caught the fish by the tail, once in the urethra it could not be pulled out because it would spread itself like an umbrella. in Spanish-speaking countries], was long, thin, and capable of forcing its way into the body's passageways following the trail of urine."

 

Charming.

Sounds like the future

Reposted from a MedKids Journal - http://boards.medscape.com/forums?128@559.f7mYawOqGzD@.2a063f93!comment=1

I Am Only Human After All

Kendra Campbell, MD, Psychiatry/Mental Health, 12:41AM Jan 14, 2011

"We are human, after all. Flesh Uncovered, after all.
We are human, after all. Much in Common, after all.”
-Daft Punk

It's 1:00 a.m. I just got home from an 18-hour shift at the hospital. I should really be sleeping, not typing. But I need to put in my weekly post here at the Ink Blot. And I don’t know when I’ll ever get the time to write again.

I remember when I was a pre-med student and even a med student...looking around at some of the doctors and wondering how they could sometimes be so short with their patients. I saw docs who didn’t really seem to care much for anyone, especially their patients. And I wondered how they could be in medicine and have such little empathy.

And now I truly realize why, maybe for the first time in my life.

As I’ve said before, there is an inverse correlation between the hours worked and the level of empathy towards patients. And not only empathy, but compassion as well.

I started the day at full speed, diligently caring for my patients. I comforted a patient in excruciating pain. I took the time to talk extensively with my patient’s mother. I went the extra mile.

But after around 15 hours into my shift, my empathy and compassion started fading. I began viewing patients not as humans who needed my help, but rather as obstacles in my path towards gaining sustenance, rest, and sleep.

Why did my patient have to go into respiratory distress and require intubation? Didn’t he know how fatigued I was? Why couldn’t he have waited until I left the hospital to become such a time sink?

Why did my demented patient have to keep ripping out her IV lines and foley catheter? Didn’t she know how much I wanted to see my bed?

I feel like I’m really starting to understand the dark side of medicine. I now comprehend The House of God with a whole new appreciation.

I want to care. I want to have empathy. I want to have compassion.

I know it’s within me. I know I want to be the best doctor I can be to each and every one of my patients.

But the reality...the truth...

Is that I can not.

I simply do not have that innumerable capacity.

I am only human, after all.

Some fun

You know you’re in med school when…

Your highlighter runs out of ink.

Your hands always smell of cadaver fixative.

You hear someone say a drug name/structure/whatever, obviously mispronounce it, and you get annoyed.

You can remember the Krebs Cycle, but not your phone number.

The name Robbins is as familiar to you as your last name.

You're wife tells you you smell like a band-aid when you get home at night

You can discuss cadaver dissection while eating dinner.

you find yourself talking about which post office innervates your neighborhood and whether or not two highways anastomose.

You're sitting between two people who are mindlessly spinning their pens around their thumbs during lecture.

when you realize that you are an average student and that it's ok

You tell your girlfriend to look lateral to the cereal to find the salt

when you take notes while watching ER or Grey's Anatomy

and when something you saw on ER/Grey’s anatomy shows up on a quiz or test.

 You own a 4-color pen and it's not enough colors for you

You have used up more than 6 highlighters in the past 6 months

You have highlighted something you wrote

You skip class to study

You equate "morning stiffness" with Rhematoid Arthritis

You have made a medical joke and no one laughed

SOB means shortness of breath to you

You know how to calculate specificity, positive predictive value, and anion gap

Anatomy makes you hungry

Your eyesight has worsened by 10 points or more in the last 4 years

You have debated between giving up eating or sleeping in order to find more time to study

You start studying for the boards more than 2 months in advance

When you're lifting at the gym and are staring at your muscles, not because of their size, but because you're trying to see their attachments and origins through the skin.

you see an attractive girl in a bikini but the first thought that comes to your mind is palpating her liver border

When you insist that someone in a photo is on the right. "No no no, the other right, the patients right."

You look forward to weekends not because you can sit back and relax and hang out with friends but because it means you have more time to study and catch up and dare I say? get ahead??

You feel superior to the 10am kids in college when your first class is at the asscrack of dawn.

You tell your friends in high school to enjoy it because they just dont know.

Reading 200+ pages over the weekend? easy. Trying to figure out how to sit back and relax? impossible.

You lose touch with whats popular on the radio or on television. The second that something new has changed with insurance, politicians & their plans for insurance, any change to anything USLME or med school or residency? You're the first to know.

Your friend says casually, "Ooh, I think I'm getting a headache," and the first things that pop into your head are:


1) When did the pain start?
2) Does the pain radiate anywhere?
3) Does anything make it feel better or worse?

You have an acronym for everything.


You have a differential diagnosis for your own abdominal pain that includes names of pathogens.


You diagnose members of the general public with diseases

You think " *courtesy of wikipedia" should be somewhere on your diploma.


You think you have whatever disease you’re learning about… every week.

You think " *courtesy of wikipedia" should be somewhere on your diploma.


You think you have whatever disease you’re learning about… every week.

You come to realize how normal handwriting can evolve into chicken scratch as you witness yours make the transformation.