Wayfaring: Follows patient for her entire pregnancy, gets to know her family, etc. Hopes to count her as a “continuity” delivery.
Patient: Asks family medicine attending friend, who has not followed her pregnancy, to deliver her.
Wayfaring: Is on call when patient is in labor. Is glad when attending says please assist in delivery.
Patient: Stalls out at 8cm, baby starts looking bad, needs a c-section.
FM Attending: Does not do C-sections.
Wayfaring: Stays 4 hours late after her night shift ends. Scrubs in with OB attending, cuts the belly, dissects the tissue layers, cuts the uterus, pulls the baby out, sews it all back up.
Patient: Oh thank you sooooo much, *Family Medicine Attending* for taking care of me today and being there for me through this pregnancy!
FM Attending: Actually, Wayfaring did your surgery.
OB attending: It’s true. Wayfaring did it. I helped.
Patient: Oh Wayfaring, I’m glad you got to see my baby get born. *Family Medicine attending*, thank you AGAIN for taking such good care of me!
Patient: my baby’s got white stuff coming out of her hoo-hah!
Nurse whose first language is not English: her whaaat? What is dat? What hoo-hah?
Patient: you know, like in her diaper?
Nurse: Oh! You mean va-yiiina? It is not a hoo-hah!
Nurse: Doctor Wayfaring, I think you need to teach these mamas some anatomy ok?
**The following story has been adapted from real life events. The names and some details have been changed for our dear friend HIPAA.
Baby boy G’s mama was on drugs. Thanks to the wonderful folks at Social Services, he was allowed to go home with her after he was born.
Scratch that. He was allowed to go with her, but not home. She was homeless. They sent him back to live with her on a friend’s couch, in the very same house where he had been born on a filthy kitchen floor.
We as a team hated seeing him go back to that environment. That adorable, mild mannered, teensy little baby went home to a crack den, despite his and his mom’s positive urine drug screens at birth. Social services gave them one caveat: mom was not allowed to be alone with the baby.
Fortunately for our consciences and for Baby boy, mom screwed up. She showed up to an appointment with him unsupervised. His pediatrician acted quickly and had him admitted to the hospital. “Possible drug withdrawal,” he said.
Once in the hospital, we took emergency protective custody. For two days, Baby boy was the peds floor mascot. His given name was not to be uttered, as the emergency protective custody arrangement afforded him an extra layer of privacy. We nicknamed him Peanut. Nurses bought him clothes and toys from the gift shop. Attendings, residents, and nurses, unable to resist the baby fever, drew straws for who would get to manage his next feeding. We became attached.
We knew that a foster family would be coming soon. We collectively decided that if they were unacceptable to the group, we would figure out a way to keep him in the hospital until another family could be found. Everyone knows foster care is terrible, someone said.
Wayfaring’s Patient: My daughter just found out she’s diabetic.
Wayfaring: Oh, I’m sorry.
Patient: She just got a new job too and has insurance so she needs a doctor. She asked me if I knew of any good ones, so I told her about one I know.
Wayfaring: That’s good.
Patient: So she’s putting in an application to be one of your patients.
Nurse: Can I help you?
Baby Daddy of lady with an epidural: Yeah, uh, she’s gotta take a s***.
Nurse: Okay, I’ll bring a bedpan for her.
Baby Daddy: I mean, can’t she poop through the catheter tho?
From a pregnant patient in labor: My vagina won’t close.
Just sayin, probably should have taken care of that problem 9 months ago.
Recently I delivered a baby.
And then I delivered the placenta.
And then, as I was looking for lacerations and clearing blood clots, I felt something with strings. I pulled on said strings, and found that I delivered the mom’s IUD.
That was a new one for me.
Later, when asking the mom what kind of birth control she wanted, she replied “probably not an IUD.”
Probably not. Probably not.
In nursing home rounds with 6 guys
K: Mr. H is bothered by his testicles again. He says they hurt and that they shrunk. He’s always concerned about his testicles. But I mean, who isn’t concerned with their testicles?
Me and the female intern:
Could you tell us about the first time you worked with a patient solo? -anon
A long time ago I posted a picture of my very first patient. I have since taken the picture down from the blog, but it hangs framed in my bedroom.
I was in South Asia working on a water testing project during the short summer between first and second years of medical school. Some of the people from the village I was staying in heard that there was an American doctor in the village. I quickly let them know that this was not the case, and that I was a student, and barely that.
One afternoon a teenaged girl came to our house asking to see the “doctor”.
I came out, and through a translator, she explained that she had an itchy white vaginal discharge that wouldn’t go away.
"Can you ask her about sexual activity?" I asked my translator, an American who lived full time in this village.
"She hasn’t had sex," the translator responded without asking her. "She’s only 15. In this people group, sex outside of marriage is completely unheard of and would get her disowned from her family."
Okay. Yeast infection then. I wrote down the name of the medication she needed so her family could get it the next time they made the 4 hour trek down the mountain to the city.
Through the translator, the girl went on to add that every few months she would get very weak and sick for days. She would be bed ridden during that time and would frequently pass out. Her family would have to force feed her water until she came to. What the heck could this be? Some weird GI bug? Nope, no diarrhea. Occasional vomiting though. And the belly pain…
Think, Wayfaring. The only diseases I know are weird genetic diseases and metabolic disorders. And diabetes.
"Ask her if she’s always thirsty. Does she drink tons of water? Does she have to urinate frequently through the day?"
"She says yes. She has to stop her work and gets in trouble because she has to take so many breaks."
Diabetes! It toootally could be diabetes. She’s in the right age range to get Type 1. And the yeast infection! Is she going into DKA during these episodes? Yikes, this is serious!
"I think I know what’s wrong with her, but unfortunately I can’t help her. I only have over the counter meds with me, and they’re definitely not going to help."
"What is it?" my translator asked.
"I think she’s diabetic." The translator explained to the girl that there was a problem with the sugar in her blood. She would have to go to the city and see a doctor and have some tests. This is bad. How will she ever be able to control this if it really is diabetes? There’s no refrigeration here for insulin. I suppose the stream water will keep it cold enough. But how can she control her diet when any food besides rice is scarce? And here she is guzzling this nasty infected stream water. What good is my diagnosis? I am completely useless to her.
80-something year old patient makes an inadvertent pun about her marijuana usage.
Resident: Do you smoke?
Patient: I smoked for a short time because my friend told me it would help toothaches.
Resident: Mmmmkay… how long did you smoke exactly?
Patient: Bout 8 years.
Ms. F****** in 416 presented a meth bowl to the charge nurse. Security has been called.
Follow up page from my attending:
Ms. F******* is tweaking. Give her some downers. Anything will do.
Resident: Did you take any drugs or medications before you started having chest pain?
Patient: I smoked some weed about an hour before.
Resident: Anything else?
Patient’s spouse: No, we called the weed man on the way up here just to be sure there wasn’t anything else in there!
Nurse K, working up a patient before a procedure: Have you had any surgeries before?
Patient: Yeah, I had surgery on my stomach.
Nurse K: what was it for, do you remember?
Patient: I had a Biblical hernia.
Nurse K: An umbilical hernia?
Patient: Yeah, a Biblical hernia.
I bite my tongue and go home and when I get home,
Actually, once or twice I have had a really hard time holding back a laugh, or a smile in the very least, but I hope I played it off well.