true story kiddos!

TSK: Ask your doctor if rat poison is right for you

90+ grumpy old man (who has been objecting to all medical advice I’ve given so far): Ok, doc, you seem like an honest guy, so tell me the truth – isn’t my blood thinner made out of rat poison?

Cranquis: Basically, yes. When you give warfarin to rats, their blood gets too thin, and then they bleed internally and die.

Man: I KNEW IT! And you’re the first doctor to admit it when I ask. So I guess I’ll do whatever you say now.

TSK: Nay, I say

Cranquis: So as my nurse already informed you, we need to transfer Lulu to the ER for evaluation of her belly pain from the accident. She could have internal bleeding.

Mother of teenaged Lulu: NO WE DON’T NEED NO ER, WE JUST NEED AN XRAY TO SEE IF ANYTHING IS BROKEN!

Cranquis: Lulu, did you throw up after the horse kicked you in the pelvis and then stepped on your stomach?

Lulu: Ye–

Mother: NO. SAY NO, OR THEY’LL SEND YOU TO THE ER.

Cranquis: LISTEN, LADY – IT. DOESN’T. WORK. THAT. WAY.

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: Xiphoid process metastasis

Patient with self-admitted anxiety: While you’re feeling my stomach, can you please check if the lump on my left side is still there?

Cranquis: *palpates left flank, finds deep hard pointed well-defined mass with slight mobility* This?

Patient: Oh no, yeah, that’s it, oh I’m scared to ask… what is…?

Cranquis: Well, I have bad news and good news. The bad news is that you probably have another one on your right side just like it. The good news is, they’re your 12th ribs and they’ve been there all your life.

TSK: As supportive as a cheap bra

Husband of patient with glass fragment in foot [excerpts of his constant teasing throughout entire visit and procedure]: “HEH THAT’LL TEACH YOU TO WALK AROUND BAREFOOT. HEY DON’T BLAME ME I DIDN’T DROP THAT CUP ON THE FLOOR. OOH THAT LOOKS LIKE A BIG NEEDLE I BET THIS IS GONNA HURT. YEAH THAT’S GONNA LEAVE A SCAR FOR SURE, YOUR FOOT MODELING DAYS ARE OVER.”

Cranquis throughout


Cranquis giving discharge instructions: “…now when you change the dressing, wash the wound carefully. Studies show that foot wounds heal faster if your husband kisses them regularly, but you could also apply bacitracin and…”

Husband: wait what

Cranquis + Patient:

TSK: Panic! At The Supermarket

(Scene: Cranquis stands innocently in the cold cereal aisle)

Some Lady (walking by): OH HI, DOC!

Cranquis: Hi…?

Some Lady: DO YOU REMEMBER ME?

Cranquis (trying to be polite but also trying not to HIPAA all over the place): Um, sorry…?

Some Lady: YOU DRAINED MY BUTT ABSCESS LAST WEEK!

Cranquis (very interested in the cereal boxes again): Oh, hi.

Some Lady: MY BUTT IS DOING A LOT BETTER!

Cranquis (throws random boxes in the cart, and ZOOM gettingtheheckouttadodge): That’s great. Sorry I didn’t recognize you, take care.

Some Lady (calling down the aisle at my fleeing back): HAHA NO PROBLEM YOU PROBABLY JUST DIDN’T RECOGNIZE ME WITHOUT MY NAKED BUTT HANGING OUT!

Cranquis: (considers pulling a reusable grocery bag over his head)

TSK: Chief Complaint “Yellow liquid coming out of belly button.”

60-something Patient: IT’S NOT EVEN MY ORIGINAL BELLY-BUTTON, IT’S A NEW BELLY-BUTTON THAT JUST SWELLED UP A FEW DAYS AGO!

Patient: NO, IT CAN’T BE AN INCARCERATED HERNIA ERODING THROUGH MY BELLY SKIN, HERNIAS ONLY HAPPEN IN YOUR PRIVATES!

Patient: I AIN’T GOING TO NO EMERGENCY ROOM FOR POSSIBLE EMERGENCY SURGERY, JUST GIVE ME A CREAM TO PUT ON IT!

Patient: FINE I’LL GO TO THE ER.

Patient: BUT AIN’T NOBODY DOING SURGERY ON ME TODAY!

3 HOURS LATER - Operating Room Board: “[Patient] Emergent Add-On, Incarcerated Ventral Hernia, Abd Wall Abscess”

TSK: Chief Complaint: “Stomach pain and rash after eating shrimp”

Cranquis, before entering the roomGI and derm symptoms after consuming a high-frequency food allergen! Better check that BP, hope this isn’t anaphylaxis or angioedema.

Reality: “My stomach was hurting last night, and last week I had a rash on my ankle after mowing the yard, and I was thinking about it and I did eat shrimp 3 weeks ago, so maybe I’m allergic, anyways all the symptoms are gone now, I need a note for missing work today.”

Cranquis, after leaving the room

TSK: Chief Complaint: “I took my stitches out too early”

Yes, you should’ve left those in for the 10-14 days as instructed, instead of believing your “healthcare friend who thought they looked ready to come out” on post-repair day 3.

No, I’m not putting in new stitches now, 2 weeks afterwards.

Yes, your scar is going to be more visible than it would have been.

No, our Urgent Care does not have a plastic surgeon on-call in-house for second opinions on super-delayed closure of superficial hand lacerations.

TSK: The most evasive historian in the world.

Cranquis: So does it hurt when you swallow?

50-something Patient: Well it doesn’t feel right.

Cranquis: So, painful, or more like tightness?

Patient: It’s just different.

Cranquis: Ok. Does it hurt to swallow?

Patient: Not really.

Cranquis: Does it feel like you’re choking when you swallow?

Patient: No, it just stings.

Cranquis: But… isn’t a “sting” painful?

Patient: I don’t know, I’ve never been stung in my throat.

Cranquis:

TSK: Go with the flow

30-something female patient with sinus infection: …”and then my ears started hurting and I got dizzy, I feel drunk and I haven’t even started drinking for St. Patrick’s Day yet!”

Cranquis: Well that sucks!

Patient: I KNOW! And the worst is, I started my period while I was in your waiting room, so… HAPPY ST. PADDY’S DAY TO ME.

Cranquis: Happy St. MAXI Paddy’s Day to you.

Both:

You’re the first doctor to actually touch me in 17 years. The rest of them just see a fat guy and write a prescription.
— 

480-pound man with intertrigo.

WTF, my colleagues? Just because a person weighs more than another person doesn’t mean that you get some kind of Physical Exam Not Required modifier. Since when does “patient is obese” = “patient’s self-description of their medical concern is enough for me, wouldn’t want to actually use my skills to make a proper diagnosis”?!

This rage isn’t just targeted at “the rest of them” – I’m upset when I recall the times that I’ve convinced myself that a physical exam of an obese [or smelly or wheel-chair-bound or hyperactive or or or] patient isn’t worth the hassle. Sure, some of those times it probably wasn’t necessary in order to manage the presenting complaint – but what unknown overlooked conditions did I miss by being lazy, by stereotyping my patient and offering 2nd-class medicine? SMH.

So let’s make this our guiding slogan when faced with internal pulling-back from providing the usual standard of care, my colleagues:

“Patients: Gotta Touch ‘Em All.”

TSK: July 5 Medical Mystery

Patient: I got a headache and dizziness at 2 o’clock this morning, but I feel fine now.

Cranquis: Yesterday was the Fourth of July, and it was hot and sunny all afternoon. Plus you’ve got a mild sunburn happening on your neck and ears. So I’m guessing that you spent a long time outdoors and that you consumed more alcohol than water, right?

Patient: Well kinda. We were at the beach for 8 hours that day, but I didn’t drink any alcohol.

Cranquis: Ok, that–

Patient: Or water. Or anything.

Cranquis:

TSK: The Derminator

Anxious teen with forehead laceration: ARE YOU GOING TO USE A NEEDLE TO NUMB IT UP?

Cranquis: What do you want me to say? (places drape over kid’s eyes)

Teen: I HATE NEEDLES

Cranquis: “I hate needles” (prepares to inject)

Teen: (laughs)

Cranquis: Or as Ah-nuld Schwarz-neggah would say, “GAHHHH AY ATE NEEEDOSE GET TO DA CHOPPAH!” (injecting the entire time)

Teen: (laughs more) WELL JUST TELL ME WHEN YOU’RE GOING TO START INJECTING

Cranquis: “OHH NAOW, IT’S TOO LAYYYT, I ALRADY FEENESH DAT!” yeah that part’s already done, so you’re all numb now.

Teen: ok that was awesome.

Thanks for calling to check up on her, doc – and one more thing. Thanks for examining her stuffed animal during the visit yesterday. She keeps telling everyone, ‘The doctor checked out Winnie the Pooh and said he doesn’t have an ear infection, but I have an ear infection.’
— 

Mother of a 3 year old kid with doctor-phobia – which eased up nicely after I gave poor long-suffering Winnie a full physical.

(It’s so awesome when that works…)

TSK: I’m not even joking, I checked and this is exactly what happened.

Cranquis: So your daughter has been vomiting?

Mom of toddler: YES, SHE VOMITED AT BREAKFAST!

Cranquis: Has she been able to eat or drink anything since then?

Mom: WELL SHE VOMITED BECAUSE SHE TRIED TO EAT HER BROTHER’S ENTIRE HARD BOILED EGG WITHOUT SWALLOWING BUT AFTER IT CAME BACK UP SHE CHEWED IT IN PIECES AND THAT STAYED DOWN JUST FINE.

Cranquis: