cranquis

The Night Before Cranqmas
  • The Night Before Cranqmas
  • Dr. Cranquis
  • The Night Before Cranqmas
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THE NIGHT BEFORE CRANQMAS, BY DR. CRANQUIS ‘Twas the night before Cranqmas, and all through the Urgent Care Not a creature was stirring: no patients were there! We’d been very busy but now it was Q-word. (That’s “Quiet”, but we don’t dare announce it, ya’ heard?) The staff were slumped over, worn out, in their chairs; While visions of leaving on time danced through the air; And Nurse in her smock, and I in my scrubs, Had just called the pizza place to order some grub, When out in the waiting room there arose such a clatter, I sprang from my chair to see what was the matter. Away to the window I flew, lickety-split, Just in time to see some guy throw up through it. The emesis on the breast of the still-heaving guy Was black and smelled like something had died. I glanced to the parking lot to see how he got here: Just as I thought: he’d ridden a John Deere. He slurred out his name in an accent so thick, I didn’t quite catch it, so I nicknamed him Old Nick.  More rapid than eagles his retches they came, And he wheezed, and he shouted, and he called us bad names: “Now, ****er! You *****er! I’ll *** your ****! Give me some Dilaudid, you **********! Whaddaya mean, "Do I drink alcohol?” I had a fifth of vodka today, maybe 2, that’s all.“ Now quick for an emesis basin my skillful nurse flew, As the barf hit the floor, and Old Nicholas too. And then in a twinkling, the emesis turned bright red – Esophageal rupture: this dude was half dead! As I reached for the phone and called 911, He slumped to the floor – (oh joy, here comes the fun). His eyes were so jaundiced! His breathing so shallow! His cheeks and his nose pale as a marshmallow! He had palmar erythema and a distended belly That shook when he retched, like a bowl full of jelly. Classic alcoholic cirrhosis, with Hep C probably, So I pulled on some gloves to hopefully protect me. A feel of his pulse, which felt thin as a thread, Soon gave me to know I had plenty to dread; He spoke not a word, just continued to hurk, As we placed 2 IV’s and tried to make his heart work, His blood pressure dropped as mine steadily rose, But hark! Ambulance sirens! So glad to hear those! The EMTs snatched him, slick as a whistle, And away they all flew like the down of a thistle. But then I heard him exclaim, as they drove out of sight— “Hey it’s Cranqmas, y'all – can I have a Bud Light?”
for those of us on our last spoon.

it’s waking up from a restless night of sleep, bracing yourself to face the day.
it’s willing your body to make it two more steps, so you can brush your teeth.
it’s compromising looking decent for having a bit more energy.
it’s realizing how tired you are…and it’s only nine in the morning.

it’s trying desperately to focus on your professor’s words.
it’s constant shifting to try and get a bit more comfortable.
it’s holding back the tears as you remember that meeting.
it’s nap time, because without it you would collapse.

it’s telling people no, not because you don’t want to but because you can’t.
it’s always feeling like you’ve let someone down.
it’s nagging pressure to try and act normal.
it’s your body shutting down when you do that.

it’s a phone book’s worth of doctor’s office numbers.
it’s lab work every month.
it’s eight, ten, twelve pills a day (or more).
it’s hoping and praying that this new treatment is effective.

it’s looking normal but knowing you’re not.
it’s judgmental glares from strangers when you take the elevator, not the stairs.
it’s misunderstanding from friends who truly do care.
it’s not fair, but you deal.

it’s giving up the life you thought you’d have because you can’t physically do it.
it’s seeing other people happy and healthy and wanting it for yourself.
it’s emotional and physical pain, twenty-four seven.
it’s wishing it would all go away.

it’s hearing you’ll never be able to have children.
it’s feeling inadequate and invisible.
it’s wanting what you’ll never have.
it’s the worry that something else will pop up. 

it’s fibro and lupus and hashimoto’s and crohn’s.
it’s CFS and PCOS and CAH and RA. 
it’s endometriosis and celiac and cushing’s and MS.
it’s chronic illness, and it’s your life.

***

i promise i’m not depressed; well, at least not in the sense that i’m gonna go and do something cray. no, i have a strong support system and for that i am eternally grateful. but it’s been a rough week. i feel as if i went from the mountain top last week to the darkest valley this week - and it is all because of my stupid immune system.

invisible, chronic, autoimmune illness has plagued my life. there are some days when i say that everything is going to be alright, that i’m alright, that it’s just another thing, that there is medicine for that. then there are some days, like today, when i’m so spent i can’t even make it out of the apartment. i use up the little energy i have on homework and have nothing left for friends.

one thing that i’m learning - and that my mom reiterated to me earlier today - is that i have to stop worrying so much about what other people think, because it’s not their body that pays the price for me pushing myself too hard. and she’s right. as whiny as it may sound, any person with chronic illness can tell you that if you push yourself just a bit too much, you pay for it the next day. and it takes a while to pay for it, because it creates this snowball effect of trying to catch up on the stuff you miss while you’re paying for pushing yourself too hard, and the vicious cycle continues.

i just want so desperately to lead a normal life, but that is an impossibility. the only thing i can do is make the most of what i have, and learn to love myself, to take care of myself, and to be all i can be. 

this all happened for a reason, i’m sure of it.
one day i’ll know. 

for now, while i try and conserve the spoons i have left, i thank God for specialists who seem to know what they are doing (even though i had to go through some crummy ones first) and for my support system, those loved ones who never fail to make me smile, even on the dark days. 

MRSA...eww

It amazes me how people can take one small thing a doctor says and hold onto it so tight. For example, my brother has had MRSA infections in the past and about once or twice a year he gets really bad knots usually on his arms(armpits) . The most recent one he had to go to a surgeon to cut open the infection on his bicep. Well my family physician told my mom during a visit that sometimes a person can get a staph infection from spider bites. So, unfortunately my brother has no health insurance and developed a knot on his forearm. My mom says to me, “how does he always get bit by these spiders that cause this MRSA?” -_-

Does anyone have any info on MRSA in general and if you can ever get rid of it and what he should do.. He’s thinking about going to the er, but with no insurance, I don’t know what most er docs will do?

anonymous asked:

I'm so confused like you and Cranquis seems really close. Are you 2 friends or are you shadowing him in real life or his your whoever In real life? The discussion and chemistry felt between both of you on here .... Is hella strong. Just saying cause that's what I observed? Have a great day lovely! Xx

Just gonna post this one without further comment…

…and let all of the medblrs speculate. 

anonymous asked:

what did you write in your personal statement for your medical school application :) love your blog whooop whooooop :D

Plus a follow-up question from the same reader:

sorry it is me again XD sorry to ask, who did you ask to get your references as well :P !!!!! happy easter!!! 

——

Well, Whooping Crayon, I had to dig around in my paper files for a while before I finally found it, but here it is: my med-school application personal statement. Despite containing some rather naive viewpoints on child psychology and parenting, I think it also conveys a little of the Ol’ Cranquis Attitude, even way back then! (Obviously, I ended up going into family medicine and urgent care, instead of child psychiatry – but that’s because my 3rd-year child psychiatry rotation quickly convinced me that, should I go on to become a child psychiatrist myself, I would rapidly end up in prison for using a 3-ring binder to assault stupid parents. This just goes to show that your imagined “future specialty” can shift wildly as you go through your medical training.) Anyways, enjoy – and don’t forget to spell my name correctly if you decide to quote me in YOUR personal statement. It’s “Cranquis” with a “Q”, no accent marks.

————-

Dr. Cranquis’ Med-School Application Personal Statement (yes, I got accepted with this)

The last day of summer camp was always the hardest for me. Parents would come to pick up their kids after a week of fun outdoors adventures, and I, as a camp counselor, would watch “my” kids reunite with their parents. I would cringe as I watched young boys who had been happy and outgoing all week suddenly withdraw into themselves as their moms and dads approached. “My” campers always introduced me to their folks, and I always dreaded the frequent question: “So, just how naughty did Johnny (or Paul or Ben) behave this week?” I would try to expound on how wonderful these boys, “my” boys, had been all week, but the parents never heard me. They’d apologize profusely for how “terrible” and “sneaky” their sons must have been, and then drag their cowed children away.

I grew up in a home where children were valuable members of the family. I naturally assumed that all homes were this way, until I started making friends with other kids around me. As I discovered the abundance of “bad” homes and families around me, I also noted that many of these dysfunctional families blamed their children as the cause of the family’s problems! Titles like “troublemaker,” “ADHD,” and “delinquent” were tossed around to explain how a family’s problems were the child’s fault. However, from my viewpoint, I saw that the actions of my “bad” friends, while sometimes ill-thought-out and poorly-planned, were often caused by poor parenting and disciplining. Furthermore, as I began to study children with behavioral problems during my psychology training in college, I realized that many psychologists and psychiatrists have been relying on similar labels plus quick medication remedies to diagnose and “fix” these troubled children.

I believe that the very practice of labeling children with a “disorder” or “syndrome” allows them to feel that they are not in control of their lives, and therefore not responsible for their behavior either. Also, I think that parents are too quick to treat their children as victims, as “patients” who just need the right combination of drugs in order for them to finally obey. This is very detrimental to the child-parent relationship; parents become mere “zookeepers” over their kids, and expect their children to mess up often and spectacularly – and the children are happy to meet those low expectations. This obviously does not provide the children with the emotional and moral support which they so desperately need during their formative years at home.

My goal has become to reach out to children and parents in a way which will help them to solve the behavioral problems of the children while also addressing the relational problems of the parents. Through conversations with my father, a psychotherapist, along with other people in the psychological field, I have discovered that there are many professionals who wish they could implement programs and counseling structures through which they could reach out to the many children who are being treated simply with psychotropic medications, instead of with parental care and loving discipline; unfortunately, these professionals’ desire for change is hindered by the pecking order which places psychiatrists above psychologists. So, I have decided that I will be most capable of carrying out my goal by first obtaining as much technical and practical knowledge as I can through proper psychiatric training in medical school, then utilizing the expertise and status which accompanies that training in order to design a program to help “mislabeled” children like my childhood friends.

I must warn you, readers of this statement, that my true goal is not to get into medical school. Medical school, its trials, challenges, and rewards carry no inherent attraction to me; rather, they have all become a means to an end. I intend to use the training I receive, whether in medical school or elsewhere, to increase and enhance the assistance which is made available to children and their parents. “My” kids, the campers I have cared for and the millions of mislabeled children like them, are the focal point of my scholastic and professional efforts.

———-

As for my application references, I think I listed my psychology advisor/professor, the director of my summer camp, and the chairman of my college’s pre-med club.

***Pending Cranquis-Mails: 27***

cranquis replied to your post: Instead of Veteran’s Day,…

You ARE going to start a collaborative list on “inappropriate songs to sing on the day of OB/GYN orientation”, aren’t you? Shall I go first? “Back That Thing Up”. Ok, now you go.

My turn? :D

  • Baby Got Back by Sir Mixalot
  • Bad Touch by the Bloodhound Gang
  • Double Team by Tenacious D
  • Highway to Hell by AC/DC
  • Welcome to the Jungle by Guns n’ Roses

Come on, people, I know we can keep this going!

Laws of the House of God

I. Gomers don’t die. 

II. Gomers go to ground. 

III. At a cardiac arrest, the first procedure is to take your own pulse. 

IV. The patient is the one with the disease. 

V. Placement comes first. 

VI. There is no body cavity that cannot be reached with a #14 needle and a good strong arm. 

VII. Age + BUN = Lasix dose. 

VIII. They can always hurt you more. 

IX. The only good admission is a dead admission. 

X. If you don’t take a temperature, you can’t find a fever. 

XI. Show me a medical student who only triples my work and I will kiss his feet. 

XII. If the radiology resident and the medical student both see a lesion on the chest x-ray, there can be no lesion there. 

XIII. The delivery of medical care is to do as much nothing as possible. 

A set of hospital rules/truths from Samuel Shem’s book, “The House of God”.

anonymous asked:

Adding on to the "pseudo" name post.

How did you think of Cranquis to be your 'stage name'? :]
Or, why did you choose it?

Well, Mystery Meatus, I wanted to write an anonymous blog that would allow me to be snarky about my patients. As I started thinking about the persona who would be portrayed in this blog, I realized he needed a good name to convey his sense of righteous sarcasm. Initial ideas included “Dr. Grumpy” and “Dr. Misanthrope”, but then the French-ish mishmash of “Cranky” and “Marquis” came together… and thus, history was made. :)

Somewhere on this Tumblr, I previously wrote a post describing what the fictitious Dr. Cranquis would look like and behave like – but I can’t seem to find it now. Grr. Stupid Tumblr. (4 months later: EDIT: I found it!)

I told the health insurance person that I went to the ER because the Urgent Care doctor AND my husband said I had to go, but she said, ‘You could have refused to go, so it’s an elective visit and we won’t pay for it.’
— 

50-something patient, requesting that I fill out a Certificate of Medical Necessity form after her insurance company denied the claim for her ER visit.

Why did I direct her to the ER? Oh, no reason… EXCEPT SHE HAD A BP OF 70/40, HEART RATE OF 130, AND HAD BEEN VOMITING SO HARD THAT SHE PASSED OUT TWICE.

Definitely an elective visit. Right.

Behind the Medic: They grow up so fast.

Scene: Cranquis Jr. and Cranquis 2.0 are tucked into bed, and as is their custom, they ask me about any interesting cases I saw at work today.

Well, I saw a lady today who came in for “sinus infection” but when I asked her what symptoms were currently bothering her, she said “I’m feeling much better actually, since my doctor started me on an antibiotic 3 days ago.”

Cranquis Jr. (age 5): But then why did she come to see you?

Me:

So I asked her that, and she said, “I’m worried I need a stronger antibiotic because my snot is still green colored.”

Cranquis Jr.: What?! She doesn’t know what she’s talking about!

Me:

Cranquis Mail: Conflicting Emotions during first dissection

(name withheld by request) asked:

(please withhold my name!)
Hello Dr Cranquis, I’m not sure if this is the way to ask questions but hey, I’m doing it anyway.
We dissected a heart in Biology today - age group about 17ish (not sure how your USA system works). It was my first ever dissection and I was really looking forward to it. I’d like to go into forensic pathology, which is why I thought yeah, I got this, what could possibly go wrong, and I was wondering if really conflicted emotions are normal? Like on the one hand the whole seeing-how-everything-works jam is really interesting, but it’s a bit grim. Like, not even ethically-speaking. It’s childish, really, that the smell and the goo should be the thing that bothers me, but it was only when I was waiting around for my partner to do their thing that it bothered me - when I was doing stuff to it it was fine, because it was really interesting. Is this a normal reaction, or should I consider an alternate career path? Thank you in advance.

Hello there, Yin Yang Yo-Yo (your Cranquis-Nym to identify yourself for future communication re: this topic) – hey, thanks for telling me right away whether to conceal your identity when I publish this question/reply on my blog!

What you described is TOTALLY NORMAL for someone participating in their first dissection of an organ, especially if it was a human* organ. I mean, 110% completely-human response, Grade A classic pre-med experience. This is a psychological/emotional hurdle which almost every scientist and doctor/healthcare provider encounters along their journey.

(I say “almost” because there are the rare few who don’t feel a single twinge of remorse or empathy or concern when fiddling around with the inner workings of Life and Humanity – and those people are scary, to be honest.)

So, I’m reassured to know you have a working Empathy gland and fully functional Dichotomy Detecting sensors. Don’t let this be the sole thing that diverts you from pursuing forensic pathology, or any other “potentially gruesome” career (well, except “serial killer,” I guess).

Good luck to you! For more tips on “overcoming the gross-out factor,” try this old post of mine.

*Was it a HUMAN heart? Because that’s a really heavy experience to drop on a group of teens in their first dissection experience! I started with cow and pig organs in undergrad, and didn’t actually get to dissect my first human cadaver until med school.

Behind the Medic: Must be a nasal bone.

Cranquis: It was the worst calcaneus fracture I’ve ever seen.

Nurse (sarcastic): Har har, doc, there’s no such bone.

Cranquis: Um… yes there is? The calcaneus is the heel bone.

Nurse: OH! The CALCANEUS. Right.

Cranquis: Dare I ask what you thought I said?

Nurse (whispering through a face-palm): …um… the cocaineus…?

Behind the Medic: I don't usually get updates from my urgent care patients if everything went well...
  • Cranquis Boys (running amok in the grocery store): I want this kind of pasta! Can we get some applesauce?
  • Woman (walks past, then double-takes): Oh, you're Dr. Cranquis! You don't remember me, but 3 years ago... [insert story here]... and I just wanted to thank you for how you figured out I was having atrial fibrillation, my cardiologist said I'm doing great now!
  • Cranquis (awkwardly humble): Oh well, sure, my pleasure, thanks for the update!
  • Cranquis Boys: Dad why did that lady want to talk to you?
  • Cranquis: Well, I helped her a while ago and --
  • Woman #2 (walks past, double-take): Oh hello, aren't you Dr. Cranquis?
  • Cranquis: Y-yes?
  • Woman #2: It's so nice to see you! Do you remember, you stitched up my finger after I cut myself cooking the Thanksgiving meal last year?
  • Cranquis (no I don't): Oh sure! No accidents this year?
  • Woman #2: Nope, I'm doing fine, thank you again!
  • Cranquis: Oh well, sure, my pleasure.
  • Cranquis Boys: Dad how come everybody knows you in the store today?
  • Cranquis: I have no idea, but I'll be wearing this paper bag over my head for the duration. Go find the applesauce.
Cranquis Mail: The MCAT keeps defeating me

(name withheld) asked:

Hello Dr C
I really enjoy your blog. I am hoping to someday be a doctor but getting in has proven quite challenging. I did very well in school, have hospital/ER experience, volunteer at retirement home playing music and did independent biochemistry research. However, I feel I have been defeated by the MCATs. I have taken them twice now and the best I can do is a pathetic 26. I have no idea how to study for them. I tried notes and note cards. I took a class and I did practice questions, but being a full time worker at the hospital has made studying hard. Do you have any advice? How can I get all that information to stick? I am great at problem solving and diagnostics ( or at least the rudimentary diagnostics we did in physiology) but its the shear volium of information I am finding so defeating. Sorry to assault you with this wall of Text. Thanks for taking the time


Greetings, Gargling Gluestick (your CranquisNym™) –

First off, my standard disclaimer re: MCAT-related advice: It has now been… 18 (18?!) years since I took the MCAT. Plus, my preparation for the MCAT was rather, um, atypical.  So please realize, I am in no way an expert on anything MCAT related. Seriously, you’d be better off asking Kim Kardashian for her tips on memorizing the Krebs Cycle Cycle.

But for lots of tips on how to study, you should wade through (more information for you to absorb, sorry) my #study tips tag. Or here, this particular post summarizes a lot of my usual “studying under a deluge of info” advice.

Now, in case you wanted some feedback on your efforts so far: 

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