Priorities

Me: Good morning Mr. here-every-three-days-for-dialysis-because-you-commited-medicaid-fraud-and-can't-get-a-chair-without-coming-through-the-emergency-department. How can I help you today?

Him: "I need some chocolate ice cream with a fork."

::pause::

"And dialysis."

Good morning!

I walked in to my first patient's room this morning, a schizophrenic alcoholic brought in by ambulance to sleep it off, and was greeted by a giant boozy hug. It was a good minute and a half before I could disentangle.

"How are you doing today?"

"Well, doctor," (another hug), "I peed myself. Also, can you look at my rash, I think I got some of them bugs on me again."


Lesson of the day: Bring a change of scrubs. Always.

Chief complaint of the day

"Bugs in vagina."


(She was right).

AAAAH!

First patient of the morning: R eye gouged out in bar fight.

And I was right in the middle of breakfast. This is the one circumstance where I am so so glad (for the patient's sake) that he's completely sloshy. He will not be happy when he sobers up.

Not an auspicious way to start the night

"So, patient in 43 was out with some friends when a car pulled over with two men in it who offered her 2 adderall. For unknown reasons, she accepted and took them. . .

overheard at morning changeover

"Patient 3, is well, literally a crack ho, I guess there's not a better way to say it. So she was out working last night and one of her clients brought her in for agitation. . . this is probably attributable to the crack."

Overheard

Staff physician nextdoor to a very very frequent flier:

"Hello sir! I've seen you here a few times before. What brings you back?"

Patient: Wasn't me, I've never been here before.

SP: Actually you were here two weeks ago, and one week before that, only you were wearing an eye patch last time.

Patient: Wasn't me.

SP: Sir, it was you. All your other features are exactly the same.

Emergency of the night

A for-real triage note:

"23 female Pt complains of lower abdominal pain, crampy in nature, for two days. Pain has been accompanied by vaginal bleeding. She has had similar symptoms frequently in the past and thought she should get it checked out."

Actual chief complaint of the week

Circa 4am:

"Okay, so I'm a dancer and I found an amazing new move on Asianpoledancing.com or something like that and I practiced it a bunch of times at home but I don't have a pole at home so I just practiced in my living room. When I got into work tonight I thought I'd try it out but I swung out too far and hit my knee on the pole and cracked it. I was going to keep working cause I only made $8 so far and only one free drink but my manager said I had to come to the ER because he needs my booty on duty."

Later that evening I overheard her repeating the story to a friend on her phone only the last line became ". . .he needs my hole on the pole."

(Her manager apparently speaks entirely in dirty rhymes).

Her knee was fine so I'm sure all her body parts are back hard at work tonight.

Class.

with friends like these

We got a strange overhead page mid-shift this evening requesting all available staff immediately to the front sidewalk. We get there and find a young woman lying unconscious on the ground with a note on her stomach that reads "took heroin, not breathing."

We just caught a glimpse of the car that dropped her off driving away.

Happy holidays us.

a far too typical patient encounter, Monday edition

Me: Do you use any illicit drugs?

Patient: No way doc, I gave all that stuff up. I'm totally clean now. A new man. No drugs for me.

Me: Okay. So when was the last time you used any drugs?

Patient: Saturday.