Dr. Cranquis' Mumbled Gripes

If you really want to spend a long time at the Urgent Care, while the doctor does a “Fever of Unknown Origin” workup on your child, including urine test, strep test, flu test, and chest xray (which takes about an hour to get all the results)…

Don’t tell the doctor about your other child’s recent illness (even after the doc specifically asks you, “Is anyone else sick around this child lately?”)…

Instead, wait until this child’s influenza test comes back Positive, and the doctor starts to discuss prophylactic Tamiflu prescriptions for the other children in the home, then blurt out, “Oh that’s ok, the other child is already on that medicine after she was positive for influenza at the ER yesterday!”

When the first thing you say to the Urgent Care doctor is:

Doc I think I’m gonna die from all this puking and s—-ting!

But the last thing you say to the Urgent Care doctor is:

Naw, f—- that “bland diet” s—-, the medicine worked and I’m gonna go eat a burger!

The Urgent Care doctor will mock you online as fast as possible.

GUARANTEED.

(Hey, I think it’s about time for another episode of Bad and Worse!)

What’s Bad: The mom says that her 4-year-old girl has “had to use a nebulizer ever since she was born, whenever she gets sick, because she gets all wheezy and has trouble breathing.”

What’s Worse: “She’s been really wheezy all night, I was really worried.”

What’s WORST: “But I didn’t give her the nebulizer treatment, because I wanted to wait and see what you would recommend.”

Guess what I recommended? Ah-yup, a nebulizer treatment.

What’s WORST-EST: But of COURSE Mom smokes!

Ingredients:

1 20-something female with mildest case of acne ever

1 extremely-busy shift with wait-times averaging 45 minutes

Directions: 

1. Wake up with a single spot of acne on your face
2. Realize that you ran out of your acne medications a year ago
3. Call your dermatologist’s office, and find out that they won’t refill your meds anymore without a visit because you haven’t been there in 3 years, and the next appointment isn’t for 3 months
4. Decide you must have your acne meds today, or you will perish
5. Go to Urgent Care, see the massive line of sick people with coughs and sore throats, and decide this is the place for you, too
6. Wait an hour to see the doctor, simmering
7. Complain about the wait every 15 minutes, by opening the exam room door and sighing loudly into the hallway
8. Greet the doctor with your demand, “Look, just give me a refill on my acne meds, that’s all I need.”
9. Stare blankly at the doctor when he asks you for the names of those meds
10. Look suddenly excited as you start to describe the containers: “Well, one was in a white tube, with a green stripe… *blank stare from doctor* kind of a pale green, with yellow words?”
11. Resume looking like a powered-down android when doctor patiently asks you for the pharmacy you last used or the name of your dermatologist.
12. Discover a hidden reserve of anger when the doctor long-sufferingly asks you to go home, look up some (ANY!) information and call him with the details, and stomp out.
13. Call back the next day to complain to administration that the prescriptions were never sent to your pharmacy. You know, the prescriptions for the medications you never named, and the pharmacy you couldn’t remember.

Hey hey, Constant Readers! Now that you’ve been reading my blog for a while, you’ve probably started to develop a Stupidity Sixth-Sense for patient scenarios that are just about to “go for a trip to Stupid Town.”

So, let’s put your new ability to the test: read through this patient’s story line by line, and note which line first causes your SSS to start ringing (MINE started buzzing at line 2, and was howling by line 3).

Patient: 75-year-old male with “shoulder and neck aches”.

1. “Well, last weekend I was at a restaurant with my 15-year-old grandson, and we played one of those arcade games where you shoot basketballs.
2. “He kept making the baskets, and I could barely get the ball to hit the rim.
3. “So yesterday, I went to the gym and tried shooting some baskets, and I still couldn’t get the ball up to the rim.
4. “So I went over to the weight area, and lifted weights for 2 hours.
5. “Then I went back and tried shooting baskets for another hour.
6. “I never did make a basket, so I went home.
7. “This morning, I woke up and my neck was killing me, and my shoulders feel stiff.
8. “Do you think I got meningitis from someone at the gym?” (By this point, I was trying so hard to NOT laugh, that I was chewing the inside of my cheeks!)

Scoring: If your SSS started tingling at…

• Line 1: maybe you are a bit too cynical.
• Line 2: you obviously have prior experience with real patients.
• Line 4: you are a rational human being.
• Line 7: you know the shortest way to the bus stop.
• Line 8: you need remedial work; please go read some other “stupidiot” patient stories.
• Just now: please don’t ever become a doctor. :)

beadoer submitted:

I work for an ophthalmologist.  This morning a patient phoned in requesting a conversation with the doctor.  I usually screen the calls but because he was in the rooms and we had hit a rather quiet lull I put the call straight through.

*Doctor walks out*

‘Do you know what that patient phoned in for?’

‘No?’

‘He said, when he takes his glasses off his vision gets really blurry’.

‘Haha…wow I could have taken that myself.’

Bwa-hahaha! XD

Ok, lady with the abscess on your nose, let us agree to disagree.

Your chart shows “multiple I&D (incision and drainage) of abscesses,” most of which have been “MRSA (a drug-resistant form of Staph) positive”, according to the multiple ER and Urgent Care docs who have been treating you for the past year. Those notes also show that you never follow-up with the dermatologist or general surgeon or infectious disease specialist or WHOEVER you are referred to see about this. And you yourself just admitted to me that “I don’t usually take the whole course of the antibiotics”, which is just making your situation worse.

But what’s your explanation for these recurrent abscesses? Oh, it’s a good one.

It all started after I was in the Philippines a year ago, and I stole this girl’s boyfriend away from her, and she put a boil curse on me.

I can understand your interpretation of these events. But the fact that the first boils of this “curse” showed up in your genital area within days of your “Man Thievery” just tell me that Mister Man had MRSA too. So technically, all 3 of you people in that love triangle were “boil cursed.”

Oh, and speaking of triangles: There’s a reason I’m getting all worried about your nasal abscess and calling a specialist today, and not just “putting you on more of those pills” (which you won’t finish taking anyway). That reason is called The Facial Triangle of Death.

*sigh* No, it’s not the same as the Bermuda Triangle, ma’am.

Ok, parents of the 3-month-old girl with a high fever and diarrhea — let me get this straight:

• You all just returned from 3 weeks visiting family in Mexico.
• While in Mexico, little Ayeli had “a cough and runny nose, no fever” and you took her to a doctor who gave her a shot of penicillin (yay, modern Mexican medicine!) plus 3 days of oral penicillin. She “got all better in 3 days” (wow, big surprise, a cold getting better in less than a week!).
• Now she’s had “black watery diarrhea” for 3 days, and a fever since last night (although, of course, you have no idea what temperature it was because you don’t own a thermometer). Here in my clinic, her temp is 101.5 degrees.
• Her flu and strep tests are negative here, her chest x-ray looks fine to me, her ears are fine, her lungs sound fine, her throat looks fine, there’s no rash.

Ok, all that being said: you absolutely refuse to let me get a catheterized urine specimen to check for a bladder infection. “Is that really necessary?” you ask. “The doctor in Mexico didn’t do that!” you exclaim. “We don’t want to cause her any pain!” you wail. “Would you do that to your own child?” you challenge. (To which I answered, “Yes, in this situation at this age, yes, I would.”)

Oops, you’re absolutely right! I was just gonna have my nurse stick a tube up your child’s urethra for the pure giggles of it!! You caught me — I’m a sadist! And obviously that doctor in Mexico is the world’s expert on diagnosing Fever of Unknown Origin, since he pre-emptively put her on antibiotics before a fever even BEGAN! I’m certain that the injected penicillin hurt much less than a 30-second catheterization, too! I quiver in the presence of your genius! Here, take this prescription pad and go get her something nice at the pharmacy!!!! It would also be really nice if you’d condescend to doing these stool tests I’m ordering to see if she’s bleeding internally from some yummy enteric pathogen — but if that’s too gross for you or something, don’t fret about it — seriously, who dies from diarrhea nowadays?! Oh and when her fever doesn’t go away by tomorrow, don’t come back to my clinic, because the first thing I’ll do it stick a catheter in your child’s urethra while praying that she doesn’t have a bladder infection headed for her kidneys and All Points West!

I walked out of that exam room and told my nurse: “My new motto is: You can lead a horse to water, but you can’t make it think.” I’m pretty proud of being able to come up with that from within my cloud of blinding rage at that moment.

If you are older than 12, and you show up with a marble in your nose, prepare to receive a bit of mocking from your doctor. Just sayin’.

(Today’s winner: 17 years old — “I was just pretending to stick it in there, and…”)