The focus of this web site is medicine. In this blog, you’ll read about patient stories. The situations have been changed to be HIPAA compliant. Factual statements may or may not be true. I may change ages, gender or presenting complaints about patients. I may even entirely make up complete patient encounters from my fertile imagination. Trust me, if you think I’m writing about you, I’m not. There are billions of people in this world and readers send me stories about patients all the time. It isn’t you.
You’ll also read a lot about health care policy. I may throw in posts about life lessons, computers, and will even throw in family stories once in a while. If you’re looking for articles about politics, sports, or celebrities, you’re in the wrong place – unless the topics have some relationship to medicine.
If you want to add a guest post or to cross-post something from your blog, or if you have a patient story you want me to write about, e-mail me. See more information in the “About Me” page.
In my medical career, there have been a handful of patients that I remember well. Like frames on a storyboard, when I think back upon the tens of thousands of patients I have treated, these patients always seem to come to mind. Perhaps as a precursor of things to come, I even wrote stories about some of them early in my career when I saw them. I remember the first time that I drew blood on an elderly patient and how it seemed like her room was a prison cell. I’m sure she passed away a long time ago, but I can still remember looking into her eyes and wondering what this poor woman had been through in her life. I remember one of the first surgeries that I was asked to scrub in on during my Ob/Gyn rotation. They called it a “TOP”. I was excited to be a part of it. Then I learned that “TOP” stood for “Termination of Pregnancy.” I remember feeling uneasy as the resident showed me how to use the currette. I remember almost passing out when I looked through the speculum and saw a tiny white hand laying across the red surface of the patient’s cervix. I remember almost vomiting as a resident as a nurse told me that an intoxicated patient with dizziness just needed to “sleep it off” … right before he vomited a liter of blood all over her and over the curtain a couple of feet behind her. And of course there was the lollipop lady. I wrote a post about her already. Recently another patient was added to the storyboard of my medical career. I’m not sure if there was anything so memorable about her, but perhaps it was her blase demeanor in the face of a rather messy problem. Well … you can decide. The patient was in her mid- to late-60s, was well spoken, pleasant, and well-kempt. She had changed into a gown and her clothes lay neatly folded on the chair across the room. Her problem was a regulation of her bowels. First, she had diarrhea for a couple of days. She took some Imodium and Pepto Bismol and the diarrhea stopped. But then she had no bowel movement for two days. That was to be expected since after diarrhea stops it often takes the body a day or two to create more stool. The patient became concerned after having no bowel movement on the second day and she took a laxative, thinking that she may have a bowel obstruction. Then she had black colored diarrhea. Her stool was hemoccult negative, meaning the black color was likely from the bismuth in the Pepto Bismol. Bismuth combines with small amounts of sulfur in your GI tract and can turn your tongue and your stool black. Examining her closer showed that there was dried black crust all of the way down the inside of both her legs. She had passed enough diarrhea that her buttocks had become inflamed and it hurt when she sat down, so she preferred to lay on her side. She got a liter of fluid, we got a CBC, chemistries, and a stool sample just to make sure there wasn’t an infectious etiology for her symptoms and that she didn’t have a metabolic acidosis. Everything was normal. Then the strangeness began. I went back into the room to see how the patient was feeling. I could hear the lid on the infectious waste container slamming shut as I entered the room. Then I got hit head-on by a foul smell. I pulled the curtain ...Read More »