OB patient: Oh, could you refer me to a cardiologist before I’m discharged?
Me: umm… why?
OB Patient: because I saw on the monitor that my heart rate was really high while I was having the baby. That ain’t good. I want them to check out my heart and tell me what’s wrong with it.
Patient (who is fully capable of walking to the bathroom): Can you get me a bedpan or something? I don’t think I can hold it.
Me: Yeah, I’ll be right back.
(2 minutes later, going back in the room)
Patient has taken a giant dump in the guest chair in the room, cleaned himself, and is back in bed.
Me (going through long spiel about stroke prevention with medications): …So we’re going to start you on a new medicine to help lower your cholesterol.
Patient: Those pills are poison. They cause heart attacks and liver failure and bladder cancer and muscle damage. I’m not putting that in my body.
Me (thinking): yet you continue to smoke a pack a day…
Me: well, that’s up to you of course, but I wouldn’t prescribe it if I didn’t think the benefit was greater than the risk for you. You’ve already had 2 TIAs this week. Your risk of having a stroke in the near future is pretty high, and this can help lower your risk.
Patient: Well I don’t believe you. Your job is to try to sell me medicines. Your job is to push pills. My job is to be smart and know what I’m putting in my body. I don’t even know you!
Me: I totally agree that you should know what you’re putting in your body. I also believe you should understand the risks and potential benefits of your medicines so you can make a more informed decision.
Patient: Well whether I take your medicine or not is not up to you. It’s none of your business. That’s between me and my DOCTOR.
Patient’s daughter: Mama, she IS your doctor.
Patient: (quiet)… oh… umm…. well… I guess I owe you an apology? I thought you were a regular hospital worker. Are you sure you’re old enough to be a doctor? Let me see your nametag. Well I guess you know what you’re talking about then. I guess I’ll take the meds. Now let’s talk about my blood pressure pills…
Had a patient several days ago with a bit of hospital delirium (what old folks with a touch of dementia get when they’re put in a strange place and their days and nights get a little confused). When I went into his room at 6 AM, he was lying upside down in bed with his feet propped up on his pillow at the head (which was elevated). Somehow he had managed to turn himself around TWICE while still wearing his safety vest that kept him in the bed. When I found him he was grunting and trying his best to sit up and turn around again.
Me: Mr. D, what have you gotten yourself into?
Mr. D: looks confused, goes about his business.
Me (louder): Mr. D! What are you doing?
Mr. D (loudly): I’m tryin to turn this ship around!
Patient: my daughter (a 3 year old) has a UTI.
S: ok, well tell me what makes you concerned that she might have a urinary tract infection?
Patient: well a couple days ago my friend took some of my daughter’s pee out the toilet for her drug test for probation and they called her back and said she had an infection.
Me: any allergies?
Patient: yeah I can’t take ambien.
Me: what does it do to you?
Patient: it makes me real sleepy.
I admitted a patient recently who was in her 90s and had advanced dementia. She usually said about 10-15 words a day, most of them rude and accompanied by scrappy attempts to maim hospital employees. When I first tried to examine her, she kicked me. Over the course of a week she had spit on nearly every nurse on the floor. We were giving her meds to help control her combative behaviors, but there really had not been much evidence that our meds were working. Finally, on the day of her discharge (after her morning Depakote breakfast, of course), she looked up at me, smiled sweetly, and said, “you’re cute”.
Fellow Female Resident: TR bounced back.
Me: WHYYYY do these things always happen to me?
Resident: He missed you because you were such a great nurse.
and consistently gets the 100-7 question wrong on the Mini Mental Status Exam.
Dr. C, describing frequent flier patient to members of the team who had never met her: She’s like a big…how do I describe this? … She’s like a big…jellyfish…of anxiety. She is the very embodiment of anxiety. She even flaps her arms when she gets nervous.
Several Hours Later…
K: Ms. S is complaining of chest pain. Her first troponin is negative. Her EKG is normal except there’s a lot of artifact noise on it.
Dr. C: Probably from the tentacles flapping.
Patient: Hey doc, I lost 9 pounds yesterday!
Me (facetiously): Well that’s pretty good I guess, but our record in one day is 37 pounds.
Me: Hey, we still have tomorrow…
Me: Since her urine was really festive…
Dr. C: Wait, festive? That is not a term I’ve heard to describe urine before. What was festive, the Urinalysis or the drug screen?
Me: Well, I meant all the things lighting up in red on her UA like a Christmas tree, but now that you mention it, the UDS was pretty festive too.
Dr. C: I would say that cocaine and opiates is definitely festive.
Me: That’s probably why her urine was so dirty. The bacteria were all strung out on coke.
Me: Wait, who found Mr. J when he passed out?
Dr. C: His neighbor thought he saw his goat lying on the ground in a weird position. Upon closer look, he realized it was Mr. J.
Me: He thought he was a goat?
K: He doesn’t really look like a goat. Maybe the neighbor was far away. He’s too big to be a goat.
S: Yeah, definitely too big to be a goat. Maybe a cow though.