Wednesday, December 31, 2008

Through the Prison Gates


Talking to some of my patients you'd think we're running a penitentiary at Wilford Hall. If I had a dollar for every patient begging me to let them go or who asked that I call the cops, FBI, OSA, CIA, etc I'd have, like, seven bucks. This is not because of particularly poor patient care -- I am inclined to believe we treat our patient's better on average than most hospitals -- but because our patients are out of their minds crazy. Delirious more specifically, but crazy nevertheless. Sometimes they try to bribe me, sometime they try to convince me through semi-coherent cookoo logic, and sometimes they just ask very nicely, but the universal statement always seems to be, "I shouldn't be here! Ahhhh!"

And how do I respond to these requests?

"Sir, would you like a BOOST?"

Actually we're instructed to talk them down which I am not sure has ever actually been scientifically shown to work, but it's what we do nonetheless. "Sir, why do you think the nurses are trying to kill you? They're sticking tubes in your penis, needles in your arm, and waking you up every few hours because they want to help you!" The restraints are good for you, ma'am.

In other news, this last week I won the lab lotto. Laboratory tests are ordered to confirm probable diagnoses and rule out improbable ones. Checking them every day is always a little like a scratch off ticket to see if we have just another case of pneumonia and diabetes or something much more exotic and rare, and a couple of days ago I won big. An insulinoma! Or at least I thought I did. The patient was hypoglycemic and with super high serum insulin and c-peptide levels but it turned out it was just a gnarly side effect of her floroquinolone antibiotic. Still pretty unusual and still quite a prize. I was excited. Now I am told I get to write up an ACP poster for it, whatever that means.

And here's our Christmas tree!


Happy New Year!

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