stupidiot

TSK: She just came in for “eye infection”

Cranquis: So did anything happen to your eye before it turned red and itchy?

40-something female patient: NO IT’S NOT INJURED, IT’S JUST INFECTED.

Cranquis: Ok. Have you been around anyone with pink eye lately?

Patient: NO BUT WHEN I WOKE UP YESTERDAY MY CAT WAS LICKING MY EYE.

Cranquis glances at the chart – ‘ALLERGY: Cats’

Patient: SO I KNEW MY CAT WAS GOING TO INFECT MY EYE, AND I TOOK SOME OF MY BOYFRIEND’S ANTIBIOTIC PILLS BUT THOSE WEREN’T STRONG ENOUGH BECAUSE THE INFECTION IS SPREADING, LOOK! 

Patient lifts shirt to reveal hives on torso

Cranquis glances at the chart – ‘ALLERGY: Bactrim’

Cranquis: Were the antibiotics called Bactrim?

Patient: HOW DID YOU KNOW THAT?

TSK: Now remember, children -- Motrin and Ibuprofen are the same drug.

Cranquis: So what meds have you tried for your knee pain?

50-something Patient w/ knee arthritis: MOTRIN.

Cranquis: How many pills and how often?

Patient: ONE. JUST ONE.

Cranquis: Well I can tell you that 1 dose of 200mg of Motrin is nowhere near enough anti-inflammatory to make a difference in an adult patient.

Patient: EXACTLY. SO PRESCRIBE ME SOMETHING STRONGER.

Cranquis: Well, I could, but the prescription meds have greater side effects; why don’t you try taking a higher dose of Motrin for a few days? Or switching to Aleve?

Patient: NO I WANT A PRESCRIPTION, I’M NOT WASTING TIME ON THOSE PUNY DRUGS.

Cranquis *wishing Pt had used a Schwarzenegger accent just then*: Ok then, I’ll prescribe you Diclofenac, but it could be harder on your stom–

Patient: HOW MANY MG IS THAT?

Cranquis: 75.

Patient: DON’T TRY TO BE SNEAKY WITH ME DOC, YOU JUST SAID 200MG WASN’T ENOUGH AND NOW YOU WANT TO GIVE ME ONLY 75MG!

Cranquis: No, see, it’s a different drug, and th–

Patient: I NEED A STRONGER MEDICATION, SO GIVE ME SOMETHING WITH A BIGGER MG!

Cranquis *a pause*: …Oh, I know! How about a short-term prescription for ibuprofen, 800mg tablets?

Patient: NOW THAT IS MORE LIKE IT. GEEZ.

Cranquis

deadspin.com
What Did We Get Stuck In Our Rectums This Year?

AKA: “The Year in Foreign Bodies: a 2013 Rec-trospective” – for good laughs, try reading this list to the family around the holiday table tonight!

As in past years, the U.S. Consumer Product Safety Commission has created a searchable database of emergency room visits around the country. And as in past years, we have trolled the data for the finest examples of insertions showcasing extraordinarily bad luck and/or ingenuity.

Sorted by orifice, working south:

Ear:
SEED
PAINTBRUSH
“SOME BALLS”
SLAG
MAKEUP BRUSH
PATIENT TOLD PARENTS THAT THE CATS STUCK SOMETHING IN HER EAR
GASOLINE
BUTTERFLY
HERSHEY KISS
“CLASSMATE PUT A ROCK IN EAR, HAS PIECE OF PAPER IN OTHER EAR”

Nose:
EAR PLUG
CRAYON
PLASTIC EYEBALL
HEART-SHAPED GEM
DIME
PENNY
NICKEL
AA BATTERIES
SPONGE
SMALL DECORATIVE ROCK
2 ERASERS
MULCH
“PLACED A BEAD IN HER NOSTRIL, PATIENT HAS NO COMPLAINTS”

Throat:
DETERGENT PACK
WHISTLE
ENGAGEMENT RING
“SWALLOWED A QUARTER WHILE TAKING A SHOWER”
DOING MAGIC TRICK AT SCHOOL & SWALLOWED A QUARTER”
SCHOOL LOGO MAGNET
CONFETTI
SCREW
A TACO
BALL OF STRING
A BEE

Penis:
PENIS PLUG
20-30 MAGNETIC BUCKY BALLS
DICE
FISHTANK AIRHOSE
ANTENNA
SEWING NEEDLE
BB PELLET
“WIDE WOODEN DOWEL”
NAIL
PLASTIC PIPE, DENTAL FLOSS WITH BEADS
WIRE
MARBLE
EMBEDDED DOMINO IN PENIS “TO PLEASE THE LADIES”

Vagina:
GLUE STICK
BARRETTE
SMALL FINGER VIBRATOR–"IT’S STILL ON"
TOILET PAPER
“LONG BLACK OBJECT”
PENIS RING
RIVET
“WORMS COMING OUT OF PEE-PEE"—PINWORMS
SPOON
PENCIL ERASER
PLASTIC BOTTLE OF CREAM (LID STILL ON)
NAPKINS IN VAGINA TO HAVE SEX DURING PERIOD

Rectum:
PENCIL
PENCILS
SHAMPOO BOTTLE
COLOGNE BOTTLE
LOTION JAR
SODA CAN
SODA BOTTLE
FLASHLIGHT
BATHTUB STOPPER
SHOT GLASS (BROKEN)
SOCK
ICE PACK
END OF CURTAIN ROD
"PATIENT STATES HE WAS EXPERIENCING AN ITCHY RECTUM AND INSERTED A REMOTE CONTROL TO SCRATCH”
VIBRATOR
VIBRATOR BATTERY
COVER OF VIBRATOR
TIP OF VIBRATOR
“BIG PURPLE DILDO”
“PATIENT STATES HE GOT DRUNK AND PASSED OUT AT GIRLFRIENDS HOUSE, AWOKE WITH SPOONS AND DILDOS IN RECTUM”
LIGHTER
TOY SUBMARINE
TOOTHBRUSH HOLDER
2 HALVES OF BAR OF SOAP
POOL BALL
LIT BOTTLE ROCKET; “IT DIDN’T GO WELL”

TSK: 50-something male with a 15-something grasp of science

4-inch-long full-thickness laceration of the shin, from an old soda can kicked up by a lawn mower blade.

Tibia is visible through parts of the wound, which is contaminated with dirt and grass and who knows what.

Last tetanus shot “probably 20 years ago or more”; declines tetanus booster shot today – reason?

“My immune system is strong enough, those vaccines just weaken you." 

Behind the Medic: Never be sexist to a biologist, even when she's on vacation.
  • Mrs. Cranquis:Did you hear what the jerk in the condo downstairs said to me this morning?
  • Cranquis:No.
  • Mrs. Cranquis:I was headed to the beach with the boys, and he was standing on his balcony and goes, 'Oh, you have two boys! That's cool. My *WIFE* won't give me anything but girls.'
  • Cranquis:Oh boy. And what did YOU say?
  • Mrs. Cranquis:Nothing, I just smiled and kept walking. But I *WANTED* to say, 'Actually, sir, the production of male offspring requires that the male's sperm carry a Y chromosome to the female's egg. The female is only able to provide X chromosomes. So really, the only person you can blame for your lack of sons is YOU."
  • Cranquis:Whew! So I'm not going to get jumped by an idiot when I go to the pool later?
TSK: I have the utmost respect for your idiocy.

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.

TSK: There's a-hole in your theory

Dear father of the “boy with wheezing for past 6 weeks”:

I’m not upset that you waited that long before bringing him in to the Urgent Care for “coughing all the time and wheezing at night, but only when he is in the house.”

I’m not upset that you caused his breathing problems in the first place,  by “throwing handfuls of mothballs into the walls and the heating vents 6 weeks ago, to get rid of the mice in the house” – so many mothballs, in fact, that people who visit your house tell you that “it smells like mothballs in here.”

No. What has me ticked off is that you went home from our visit, and told your wife that “the mothballs have nothing to do with the boy’s breathing problems” and “we don’t need to try to get them out” – which was the EXACT OPPOSITE OF WHAT I TOLD YOU.

How did I find out about your blatant lie? Happy coincidence – since I’m the same doctor who saw your wife the following week, when she came in for (wait for it…): “wheezing and short of breath whenever I am in my house for past 7 weeks.”

Behind the Medic: Zpak Alternatives

Been working on a Cranquis Mail reply about antibiotic overuse. Just had a great idea for some alternatives to the Zpak (azithromycin, an antibiotic often demanded by patients) – I need to patent these ASAP:

  • See?Pak – 6 combo tabs of azithromycin + a powerful laxative, designed to emphasize my warning that “antibiotics can have many side effects, including diarrhea.”
  • Zpak 90x – A homeopathic 90x dilution of azithromycin, for people who actually NEED an antibiotic but refuse to take anything that “isn’t natural.” (Note: dosing requires 180 tabs the first day, 90 tabs each day after, for a total of 90 days.)
  • Zpatch – Adhesive patch impregnated with topical azithromycin, to apply directly over the chest of people with viral chest colds. (“Studies proved Zpatch has equal efficacy as oral Zpak for people with your illness!”)
  • PlaZbo – Sugar pills packaged in old Zpak containers.
TSK: Not sure what you want from me, lady...
  • 50-something female patient (here for "painful urination for 8 days"):What took you so long to come back?
  • Cranquis:Um, the urine test takes 3 minutes to run, sorry about that. The result definitely shows a bladder infection.
  • Patient:Well DUH, I told you I had a bladder infection when I came in here, like FOREVER ago.
  • Cranquis (glancing at computer, which shows she has been in our clinic for a grand total of 15 minutes so far):Well let me just send off the antibiotic prescription for you and...
  • Patient:I don't want any antibiotics! I just wanted to confirm I had an infection.
  • Cranquis (glancing at computer, which shows that it only FEELS like I've been in this room for FOREVER):...
TSK: Holy Guac-Oh-NO-le! (Also: "A Recipe for Dis-ASS-ter")

Ingredients:

  • 1 can of warm Pepsi
  • 3 packets of salt from McDonald’s Drive-Through
  • 2 indiscriminate splashes of olive oil (any purity level)
  • 1 squish of lemon juice
  • 1 4-year-old child with sudden onset of vomiting and diarrhea the day after getting back from visiting family in Mexico.

Mix all ingredients (except child) together into a McDonald’s coffee cup. Proceed to force child to drink sips of this warm mixture (and ONLY this mixture) every 30 minutes for a day. When diarrhea and vomiting persist, and your lethargic child has not urinated for over 12 hours, bring child and mixture to the urgent care, and proceed to be baffled when I rush your child to the ER for IV fluids and observation.

Note: If you have a functioning brain, you may substitute oral rehydration solution, such as Pedialyte, for everything in this recipe. (Except child).

Serves: to make me pissed off.

Behind the Medic: "Shut up and tell Dr. Cranquis to prescribe me some pain pills!"

Ma'am, I cannot emphasize this enough: regardless of how much you yell at my nurse, the infection on your hand will not get better if you still haven’t taken the antibiotics I prescribed you… 2 weeks ago.

(I know this because I called the pharmacy, and they told me you didn’t pick up the antibiotics, only the pain medicine.)

(Congratulations: you’re now on my official Unofficial List of people who get no pain medicine prescriptions from me. Ever.)

TSK: Stupid-sense, tingling!

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. :)