Dec
17
Prince of Denmark
December 17, 2009 | 1 Comment
Empty Suit How’s that Hope and Change working for you? Had enough? Still grimly resisting that urge to scrape off the bumper sticker? It’s all right. Nobody likes to admit they were fooled even though it’s now painfully obvious that, like many of us warned you, The Sun King Ra-Obama is nothing more than an [...]
Nov
21
Money for Nothing, Healthcare for Free
November 21, 2009 | Leave a Comment
Jumping the Shark “My arm was numb after I slept on it funny and my mom says I’m having a stroke,” says my essentially healthy 34-year-old patient to the nodding approval of his indulgent mother sitting by the bed. “How long did the numbness last?” “A couple of minutes…it went away after I straightened my [...]
Oct
12
State of Fear
October 12, 2009 | Leave a Comment
Struggling for Rationality “This patient,” I said to myself, “is going home.” I know. She’s 85 with the dreaded complaint of “Altered Mental Status” described by the family as a brief period of “staring.” No generalized seizure activity, you understand, and no syncope (fainting), slurring of speech, facial droop, drooling, weakness, confusion, sweating, fever, nausea, [...]
Sep
5
Yer’ Stinking Tax Dollars at Work
September 5, 2009 | Leave a Comment
(More questions from real readers. -PB) What’s the Emergency Department Really Like? The American College of Emergency Physicians and their bogus statistics notwithstanding, the majority of cases we see are not emergencies. As I have mentioned before, most of the cases we see probably don’t need to be seen at all by anybody in the medical profession [...]
Aug
30
Life or Something Sorta’ Like It
August 30, 2009 | Leave a Comment
(Just a few random questions from real readers-PB) What is your job really like? As you know, I am an Emergency Physician working in a medium-sized community Emergency Department in a medium-sized hospital in a medium-sized city in a medium-sized state. A “community” Emergency Department is not a major trauma center and generally sees mostly [...]
Aug
15
Pandamorama
August 15, 2009 | Leave a Comment
Quick Learner So I had a drug seeker come in the other day with her usual back pain. Lately I have been very stingy with narcotics and after refusing to give her a shot of anything stronger than Toradol I explained that I only give narcotics for patients with fractures or obvious acute injuries and never to patients [...]
Jul
13
Poker and Other Things
July 13, 2009 | Leave a Comment
Michael Jackson is Dead and I Don’t Care Michael Jackson is dead and, God forgive me, I don’t care. I wasn’t a fan and I didn’t like his music. Sure, I listened to it; it would have been impossible not to but I never bought an album, stopped turning the dial at the sound of [...]
Jun
14
Bread and Circuses, Water and Sewage
June 14, 2009 | 1 Comment
Customer Disservice There are days when I explain to the family of a 98-year-old customer, in terror of the the inevitable end, that today is not that day and while the odds of their mother living another month are close to zero, she’s alert, reasonably comfortable, and they have some time to say what they [...]
Jun
2
Anabasis
June 2, 2009 | Leave a Comment
Marching Up Country (With Apologies to Xenophon) The campaign draws to a close and will end like many such expeditions do; in a victory of sorts for I have certainly marched into and through the Empire of Medicine with my fellow mercenaries, outwitting the enemy on many occasions, laying waste to his crops and orchards [...]
May
9
Panda-emic
May 9, 2009 | Leave a Comment
“I got the Swine” I’m hoarse from explaining influenza to my patients, the numbers of whom showed a small but significant increase over the last two weeks as Swine Flu hysteria grew, peaked, and then receded. Everybody wanted a pill for “The Swine” for which, unfortunately, there is none except an essentially useless anti-viral that [...]