The Medical Bell Curve

 

As with most Ricochetti, one of @drbastiat ‘s posts, Strange Things Aren’t Getting Better, got me a-thinkin’.  Yeah, I know.  A-thinkin’ isn’t my best look.  The Lovely and Talented Mrs. Mongo probably echoes your thoughts.  She has told me numerous times, “Honey, go do something physical or dynamic or ballistic.  Go beat somebody up, or shoot up something, or blow something up, but in the interest of all that is good in this world, don’t set yourself to a-thinkin’.”

Too late.

Doc lays out the trials and tribulations of Karen, the treating of whom is a nightmare (even a layman like me can see that), and, per Doc and many of the comments, sets the predicate for being a problem child of epic dimensions by saying, “I know my body.”  Yeah.  I get it.  Anyone that would choose a crystal bracelet over ibuprofen for a sprained wrist is suspect.  Still…

I know my body.

I think that most docs (and I certainly encourage any medical subject matter expert to chime in) after years of treating different people with wildly different maladies, find that their patients’ response to and compliance with their doctors’ instructions fall into a bell curve.  I further posit that they get used to thinking that the 70-90% of their patients that make up that big ol’ swell in the bell curve are every patient that walks into their exam room.  Outliers are not taken into account.

I’m only going to use personal examples, not because I’m a self-involved egoist who thinks everything is, ultimately, about me (I am and I do), but because with The Lovely and Talented Mrs. Mongo (aka Supernurse) is a clinical risk manager.  Heaven forfend that anyone think, from my supplying hypothetical anecdotes that there were ever any pillow talk that violated HIPAA–or, as the Lovely and Talented Mrs. Mongo prefaces about every conversation with, “hippa, hippa, hippa.”

[Aside: Can you imagine the pain to the gluteus maximus when one half of a couple ensconced in marital bliss is in Special Operations, swaddled in OPSEC and NDAs and National Security stuff, and the other is a medical professional who takes HIPAA very, very seriously?

“Hey, honey,” I’d hear upon coming home, “how was your time x? (your time x = the day/week/month/year you were gone)”

“Fine.  How was yours?”

“Fine.”

My kids would start watching the ensuing exchange like they were at a tennis match.  One of my more perceptive daughters would holler, “Popcorn!” and hie away to the kitchen.  All the kids knew that the trauma on one, or the other, or both sides would leak out somehow, and it would be fun to watch.  Li’l heathens.  They got that from their mother.

Also, when hubby is on call for judiciously applying mayhem and (to the uninitiated) what appears to be wanton destruction, and wifey-poo (she will literally kill me if she ever reads this and sees that I said that) is a member of an open heart team that is on call, when both beepers went off–literally simultaneously, at the worst time imaginable, every time–playing “rock, paper, scissors” to see who got to go into work immediately and who got to bundle the kids up to take to their on-call, 24/7 emergency babysitter, well it was just fun.  Good times, good times.  And I know that was a run-on sentence, but you had to be there.  End aside]

Example 1:  Some years ago, I had to have a laparoscopic procedure on my knee.  I’d torn up the meniscus, and they went in and cleaned up all the flotsam and jetsam.  They also shaved the back of my patella, as apparently said meniscus detritus had scarred it up pretty bad.  Because US healthcare is freakin’ awesome, it was an out-patient procedure.  Before I checked out, the last visit was from the provider’s physical therapist.  He gave me some pretty generic tips, and then told me “you want to get off the crutches as soon as possible.

Okay.

The procedure was on a Thursday.  On Friday I gimped around on crutches.  On Saturday, I decided it was time to sac up and kick the crutches habit.  Done and done.

The next Monday, I had a follow-up appointment with the docs that had fixed my knee.  Part of that was seeing the physical therapist.  He walked in, looked around, and asked, “where are your crutches.”

“Got off ’em Saturday.  You said get off them ASAP.”

“I meant in a couple of weeks!  Not a couple of days!”

Well then, you should’ve said that.  Victim of the Medical Bell Curve.

Example 2:

Not too long after I retired from the military (like, a couple of weeks) I got my Type II diabetes diagnosis.  My primary care physician said, “take these pills (Metformin HCL), you can keep doing what you’re doing, and try to keep your blood sugars down.”

“Got it, Doc.”

Well, I didn’t keep doing what I was doing.  I read everything I could about Type II and how to survive and thrive with the condition.  I was knocking it out of the park.  I was getting those blood sugar levels down.

But…

I mentioned to The Lovely and Talented Mrs. Mongo, three/four months in, “Man, this is the second training session in a row that I couldn’t spar.  I was so exhausted, I was a safety hazard, to me or someone else.”

Herself said, “Well, you’re still keeping a journal of your blood sugar levels, right?”

“Affirmative.”

“Let me see your log.”

So, I have no idea whether the numbers are in parts per million, parts per billion, milliliters or centiliters.  Bunch of metric stuff involved with Type II Diabetes.  But, if you’re not fasting, a blood sugar count (again, no idea of the units) should be at/about 180.  If you are fasting, should be at/about 120.

But I’d been told to get my blood sugar levels down as much as possible, per the doctor’s guidance.  I was going for zero, baby.

The Lovely and Talented Mrs. Mongo reviewed my painstaking, day-by-day blood sugar log, and said, “Hey, dumbass, you know that any count below 70 is of medical concern, right?”

“Uh, no.  No one mentioned that.  So, I shouldn’t be proud of those entries that say 28?  32?  26?”

“No.  Now go drink some orange juice right now.”

“But orange juice has a lot of sugar in it…”

“Did I sound like I was asking you?”

“No, my love.  Getting orange juice on board time now, my love.”

***

I know my body.

I can tell, if I’m out in an austere environment, humping a heavy rucksack, the moment I go from burning fat to burning muscle, just by the smell.

I can tell, given the configuration of the shards of broken glass embedded in my shoulder, if this morning’s workout can have 20, 10, 5, or 1 pull-ups in it.

I can tell if some impingement or debility will just be a pain in the tuchus, or will hamper the odds of mission success.

I know my body.

Just saying.

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  1. Dr. Bastiat Member
    Dr. Bastiat
    @drbastiat

    Boss Mongo:

    eah.  I get it.  Anyone that would choose a crystal bracelet over ibuprofen for a sprained wrist is suspect.  Still…

    I know my body.

    No.  You don’t.

    • #1
  2. Boss Mongo Member
    Boss Mongo
    @BossMongo

    Dr. Bastiat (View Comment):

    Boss Mongo:

    eah. I get it. Anyone that would choose a crystal bracelet over ibuprofen for a sprained wrist is suspect. Still…

    I know my body.

    No. You don’t.

    Heh.  Ewwkay, Doc.  

    • #2
  3. Arahant Member
    Arahant
    @Arahant

    Does TLAT Mrs. Mongo keep a bat around to punctuate her points and get you moving?

    • #3
  4. Arahant Member
    Arahant
    @Arahant

    Part of Doc’s point might well be that the body is a very complex system, and it’s all connected in interesting ways. So, you might have certain symptoms, and they don’t start where you think they do. For instance, having a weird problem with your hand moving on its own, twitching and such, doesn’t sound like it would be caused by something one ate, but it can be. And even doctors have trouble remembering and knowing how all of the parts mesh together.

    • #4
  5. MarciN Member
    MarciN
    @MarciN

    Arahant (View Comment):

    Part of Doc’s point might well be that the body is a very complex system, and it’s all connected in interesting ways. So, you might have certain symptoms, and they don’t start where you think they do. For instance, having a weird problem with your hand moving on its own, twitching and such, doesn’t sound like it would be caused by something one ate, but it can be. And even doctors have trouble remembering and knowing how all of the parts mesh together.

    So true. I have a couple of compressed vertebrae in my neck. The pain is in my shoulders.

    I saw an orthopedic surgeon who asked me to go through range-of-motion sequence with my arms. “Wow,” he said. “For the amount of pain, you should not be able to do that.” I agreed. We laughed. He sent me for an MRI or three or four. The next time I saw him, he said, “The problem is in your neck.” There was some pain in my neck, but at that time, not so much that it was bothering me a lot.

    He sent me off to a neurosurgeon, and no, I did not have the standard surgery doctors do for scrunched vertebrae. I just don’t look at the lights on the ceiling at Home Depot. My husband has to describe them or take a picture for me. :-) :-)

    Referred pain is fascinating.

    • #5
  6. Boss Mongo Member
    Boss Mongo
    @BossMongo

    Arahant (View Comment):

    Does TLAT Mrs. Mongo keep a bat around to punctuate her points and get you moving?

    Nah.  Just a scalpel.  Right there.  On the bedside table.  Whenever it’s referenced, I remind her, “You got one shot to get it right.”

    Might sound dysfunctional, but it works for us.

    • #6
  7. Boss Mongo Member
    Boss Mongo
    @BossMongo

    Dr. Bastiat (View Comment):

    Boss Mongo:

    eah. I get it. Anyone that would choose a crystal bracelet over ibuprofen for a sprained wrist is suspect. Still…

    I know my body.

    No. You don’t.

    Perhaps.  But if I go in to see my Doc, and say, “This is the problem…”  Then that’ the problem.  It could be because of spinal issues, it could be because of my diet, but if I walk in and say, “This is an issue,” then it’s an issue.

    One time, me and The Lovely and Talented Mrs. Mongo were leaving a friend’s house at Ft. Bragg.  I got zapped in the face, like someone who got acid thrown in his eye.  

    That made me grumpy, so I was less than as courteous as I should’ve been to Supernurse, and a fight sorta/kinda ensued.  I went to work the next morning, and had to wear (my very spiffy, cool-guy wrap around) shades the whole day, even though I worked in a basement with fluorescent lights.

    When I got home, Supernurse was still keyed up to continue the fight (look, whole thing was my fault, I’d been very discourteous the previous evening).   As we began to chat I took off my (very spiffy, cool-guy wrap around) shades and she looked at me and said, “We’re going to the ER, right now.”

    Apparently, my pupil was so expanded that it went through the iris and took up most of the sclera, too (impossible?  Maybe, but just about the whole eye was black with pupil).  

    On the way to the hospital, Supernurse said, “How could this happen?  Were you stung or something?”

    “No sting.  Maybe it was, like a stink-bug, and it was acid or something.”

    “That’s ridiculous, don’t you dare say anything like that to the doctor.”

    “Okay.” 

    When we got to the ER, the triage nurse asked, “On a scale of 1 to 10, where is your pain?”

    “Uh, maybe a two?”

    “Mmm-hmmm,” said the triage nurse, making a note.

    “Stop right there!” said my beautiful wife, aka (I might’ve mentioned) Supernurse.  “If I took a ten-penny nail, pounded it through your eyeball, then your brain, and it finally sank through the back of your skull, what number would that be?”

    “Uh, maybe a three?”

    She looked at the triage nurse and said, “See what I’m working with, here?”

    “Got it.”  

    [Aside: when the Doc did that “put your chin in a cup” thing while he swiveled a light around my eye, it turned out that my cornea was thoroughly shattered.  Which is not a big deal, except for you need to protect against infection while the cornea heals.

    As the doctor described what he was seeing, Supernurse asked “So, Doctor, what would cause that?”

    The Doc said,  “No idea.  Maybe it was, like a stink-bug, and it was acid or something?”

    Moral high ground achieved.

    • #7
  8. Dr. Bastiat Member
    Dr. Bastiat
    @drbastiat

    As you might imagine, there are a lot of retired doctors on Hilton Head Island.  They come here to spend their remaining days playing golf, eating out, and drinking too much.

    Apparently I did something horrible in a previous life, because all of them have joined my practice.  Every single one of them, it seems like.

    So I get to spend my days listening to burnt-out orthopedic surgeons telling me how to treat their heart disease.  

    Drives me crazy.  It really does.

    They don’t know their bodies.  Neither do you.

    And neither do I, by the way.  About 10 years ago I nearly died of a gall bladder attack that I had been treating for months with Nexium and Tums.  As they were wheeling me into surgery I was fading in and out of consciousness.  But I remember thinking, “The only reason it got this bad is that I have an incompetent physician…”

    I was in the hospital for over a week.  Multiple procedures.  A holy mess, that they somehow eventually fixed.  Pretty much.  I still have pain, every minute of every day, even 10 years later.

    Why?  Because I have an incompetent physician.

    • #8
  9. Doug Kimball Thatcher
    Doug Kimball
    @DougKimball

    I’m going in for a check-up on Monday.  It’s been, well, I don’t remember.  I may not have ever really had a check-up, at least as an adult.   I joined a Medicare advantage plan and it turns out, it’s an HMO and they require one.  OK.  I went in for bloodletting last week.  This week, I get the workover.

    I, too, know my body.  I’m 5′ 9″ and weigh some 240.  OK, I’m obese, though I doubt my body fat exceeds 15%.   That should be an interesting conversation.  I take no prescription meds.  I take vitamins, including vitamin I (ibuprofen – 2 each morning before I hike.) That’s it.  I hike 3-6 miles up and down rugged AZ mountains 5-6 times a week.  I do my own lawn, pool and other maintenance.  (I spent two hours fixing a sink that was leaking just last night.  My leg muscles are sore for all that crouching)   My standing heart rate is in the mid-fifties.  I have the usual prostate issues and joint, neck and back issues associated with someone who used to stick his face in other men’s chests at full speed, spun too many high eighties sliders and never met a contact sport he couldn’t love.  It’s something of a miracle that I’m still here and in one piece.  

    In the meantime, my doc is determined to find something.  I’ve not had a colonoscopy in a decade, so there is that.

    I come with an expiration, I know, but I’m not going gentle into that good night.

    • #9
  10. Susan Quinn Contributor
    Susan Quinn
    @SusanQuinn

    Sometimes I can trust my body, sometimes not. That’s why I get regular mammograms. When they discovered two small tumors on one breast, the doctor assured me I would not have found them through self-examination; they were too small. Off came the breast followed by chemo. 

    Cancers can be in our bodies in many forms and several of them can spread undetected. So, yes, how we feel is one indicator. But it’s not enough. 

    • #10
  11. Jim Beck Member
    Jim Beck
    @JimBeck

    Like you said you know your body. Anyway you are not the mechanic, you are just reporting what the gauges of the machine are saying.

    • #11
  12. Boss Mongo Member
    Boss Mongo
    @BossMongo

    Dr. Bastiat (View Comment):
    I still have pain, every minute of every day, even 10 years later.

    Y yo también.  Isn’t that just life?

    • #12
  13. She Reagan
    She
    @She

    I think I know my own body pretty well.  By which I mean I know its limitations (I don’t believe it has any) and I know when it’s telling me to slow down. (I always appreciate this second piece of information, because it gives me the chance to ignore it.)  I think both those things explain why almost all my encounters with doctors to this point are for acute conditions caused by something, usually something stupid, that I did to myself.  (Full disclosure: I’m grateful for my generally good health, and in spite of what I said above, I think I take pretty good care of myself.  Still, accidents do happen, and all.)

    I’m very fond of my doctor.  I’ve known him for over 30 years, and he’s currently director of the Family Practice Residency Program at the hospital where I worked for 20 years.  He calls me his “favorite patient.”  LOL.

    I think, if you asked him why he says that (partly in jest, I’m sure), he’d say that it’s mostly because he can always trust what I tell him, whether I’m simply listing mysterious symptoms, or if I go in and deliver my own diagnosis (which is usually correct) right off the bat.  As in “I’ve got shingles.”  Or, “obviously this is plantar fasciitis.”  Sometimes, he doesn’t like what I say.  When he says, “you probably need to go to the ER for observation and get some IV antibiotics,” and I say, “sorry, that ain’t happening right now,” he knows that–absent the prospect of imminent death–there’s no point in arguing; I’m not going. So we come up with another course of action, and I have to promise that, should things start to go south, I will go to the ER. He knows I’ll most likely be fine with the medication (doxycycline) and that I’m smart enough to pay attention and see if the infection is getting worse or galloping past its safe zone, and I know that if he really thought I was like unto dying, he’d put his foot down and insist I comply.

    I feel very fortunate to live in a fairly rural area, close to Pittsburgh, which has several world class hospitals and healthcare networks, and to have had, for the most part, the same doctors, whether generalists or specialists, for over three decades.   When I see stories of people having to switch networks, or change doctors, because of insurance changes or because the doctors in the region are themselves hopping from one network to another, I always think it must be very difficult, not only for the patients, but also for the physicians, to establish a level of real trust with each other.

    • #13
  14. Boss Mongo Member
    Boss Mongo
    @BossMongo

    She (View Comment):
    I think I know my own body pretty well.  By which I mean I know its limitations

    I think that’s what I mean.  If I come hard up against something I can’t do, I might not know the ins and each’s why I can’t do it, but I’ll know what my capability is.  And report that status up the chain if I can’t physically do what I’ve been tasked with. 

     

    • #14
  15. navyjag Lincoln
    navyjag
    @navyjag

    Dr. Bastiat (View Comment):

    As you might imagine, there are a lot of retired doctors on Hilton Head Island. They come here to spend their remaining days playing golf, eating out, and drinking too much.

    Apparently I did something horrible in a previous life, because all of them have joined my practice. Every single one of them, it seems like.

    So I get to spend my days listening to burnt-out orthopedic surgeons telling me how to treat their heart disease.

    Drives me crazy. It really does.

    They don’t know their bodies. Neither do you.

    And neither do I, by the way. About 10 years ago I nearly died of a gall bladder attack that I had been treating for months with Nexium and Tums. As they were wheeling me into surgery I was fading in and out of consciousness. But I remember thinking, “The only reason it got this bad is that I have an incompetent physician…”

    I was in the hospital for over a week. Multiple procedures. A holy mess, that they somehow eventually fixed. Pretty much. I still have pain, every minute of every day, even 10 years later.

    Why? Because I have an incompetent physician.

    Only surgery my wife and I have had, with almost 150 years between us, was her gall bladder surgery. Serious stuff. She got through in about 4 days with no after effects.  Guess everyone’s carcass is different. 

    • #15
  16. Doctor Robert Member
    Doctor Robert
    @DoctorRobert

    No matter how well you know your body, you don’t know your body. Boss Mongo, despite his self-satisfaction at having been hit by a stinkbug, would have lost vision in that eye had the cornea scarred.  He didn’t know his body well enough to get help for a day.  Sorry Boss, that’s not the moral high ground; that’s stupid.

    When a patient says, “I know my body, something is wrong”, I pay attention. A lot of attention.  She lives in that body 24/7/52 and I don’t.

    None of us really know our bodies.  We can’t.  We don’t have warning lights like a jumbo jet.  We may know when something is amiss, but that’s all we can know. To distinguish simple heartburn, stomach cancer and biliary colic (gallbladder pain) can be a challenge, one that is best given to a professional.  When a patient says “I have a pain in my side and I’m sure it’s ovarian cancer”, it won’t be, it will be something else.  So I will evaluate the usual causes of side pain, but I will always be certain to get a CA125 level or an ultrasound to reassure her.  Reassurance is good medicine.

    The patients who Dr Bastiat described in his last posting on the subject, whose last five Docs were idiots, who object to everything you do for them in good faith,who think they know more than you do, are the hardest people to work with.  This includes burnt-out orthopedists with heart disease.  For these patients, a goodly dose of listening, a goodly dose of active reassurance and a larger dose of standing your ground makes for the best outcomes.  Dismissing such patients as cranks means that you will miss something someday.  Maybe you will miss an ovarian cancer.

    When simple measures don’t work, Doctor Robert’s Second Law of Practicing Medicine (“Don’t change what’s working”, with its corollary “Change what’s not working”) should be invoked and professional help obtained.  The more fraught the symptoms, the sooner it should be invoked.  If you have a breast or testicular mass, crushing chest pain or are “zapped in the face, like someone who got acid thrown in his eye”, invoke it now.  Your eyes and heirs will thank you.

    Despite one’s affection for Dr Bastiat, one notes that he has constant pain because of an easy diagnosis missed by an incompetent physician.  Does he mean himself?  He writes of his “gall bladder attack that I had been treating for months with Nexium and Tums. ”  Perhaps the physician would have been more competent if a consult had been obtained when the Nexium and Tums had failed for a month, before the gallbladder went surgical.  See Doctor Robert’s Second Law. I wasn’t there, so I don’t know.

    I’ll bet you $100 that Dr Bastiat will never, ever miss another case of biliary colic.

    • #16
  17. OmegaPaladin Moderator
    OmegaPaladin
    @OmegaPaladin

    Funny story.

    I had a wound that was taking it’s sweet time to heal on my left calf.  I have edema in that leg, so a bit of this was expected.  I put some antibiotic ointment on it, stuck a dressing on it, and got back to life.  It keeps draining, but it is not painful and the drainage is clear, nothing nasty, so I just invest in more dressings and antiseptic.

    This continues for a while.  Eventually, I figure something is wrong here.  I go the university urgent care, and they tell me I have an infection.  I am a bit in disbelief – there was no pain, heat, or pus, just drainage like a leaky faucet.  The doctor is rather emphatic on this, and is concerned this is a resistant bug.  So he breaks out the big guns – mupirocin ointment, sulfa/trimethoprim, and cephalexin.  I dutifully take my meds, since I know all about antibiotic resistance.

    As I am finishing up my medications, I notice a rash.  It promptly becomes impossible to ignore, feeling like I had rolled around in poison ivy.  I felt running a belt sander over my body.  I call urgent care, and the kindly, sympathetic nurse suggests a one-two punch.  Not only did I buy an antihistamine spray, I took non-drowsy antihistamine pills.  Ahh, modern medicine to the rescue.  My leg is better, and I no long crave “an ocean of calamine lotion”

    I and nearly everyone I talk to think this was an allergic reaction to the medication.  I’m interested in figuring out which I am allergic to.  So  I see an immunologist.  Hilariously, his clinic is in the children’s hospital.  Round one is Cephalexin.  No reaction.  Round two is Sulfa/trimethoprim.  Again, no reaction.  Despite the apparent evidence, I had not experience a drug reaction.

    Two conclusions I had, based on evidence and experience, both wrong.

    Postscript: Almost a  year to the day when I first visited urgent care, I got another similar wound on my leg, in nearly the same location.  This time I hit urgent care immediately.

    • #17
  18. Living High and Wide Member
    Living High and Wide
    @OldDanRhody

    Boss Mongo (View Comment):

    Dr. Bastiat (View Comment):
    I still have pain, every minute of every day, even 10 years later.

    Y yo también. Isn’t that just life?

    Long Gust ____son, a Wisconsin logger of the premechanized era (and extraordinary teller of tall tales), once said;
    “Pain?  Pah!  I’ve had so much pain it doesn’t bother me any more, by Yimini.”

    • #18
  19. Flicker Member
    Flicker
    @Flicker

    Doctor Robert (View Comment):

    Perfectly written.

    And just as an aside, I do know my body, because I have WebMD!!!   LOL.

     

    • #19
  20. Boss Mongo Member
    Boss Mongo
    @BossMongo

    Doctor Robert (View Comment):

    He didn’t know his body well enough to get help for a day.  Sorry Boss, that’s not the moral high ground; that’s stupid.

     

    Ouch.  Righteous, but ouch.

    I shall have a rejoinder to this once I get some sleep.

     

    • #20
  21. Doctor Robert Member
    Doctor Robert
    @DoctorRobert

    Boss Mongo (View Comment):

    Doctor Robert (View Comment):

    He didn’t know his body well enough to get help for a day. Sorry Boss, that’s not the moral high ground; that’s stupid.

     

    Ouch. Righteous, but ouch.

    I shall have a rejoinder to this once I get some sleep.

     

    No need for a rejoinder.  I wrote that because I know you’re a tough guy and I care about you.  That’s just tough love.

    • #21
  22. Gazpacho Grande' Coolidge
    Gazpacho Grande'
    @ChrisCampion

    Doctor Robert (View Comment):

    Boss Mongo (View Comment):

    Doctor Robert (View Comment):

    He didn’t know his body well enough to get help for a day. Sorry Boss, that’s not the moral high ground; that’s stupid.

     

    Ouch. Righteous, but ouch.

    I shall have a rejoinder to this once I get some sleep.

     

    No need for a rejoinder. I wrote that because I know you’re a tough guy and I care about you. That’s just tough love.

    Good things hugs don’t hurt.  I sense a big one coming up.

    • #22
  23. Old Bathos Moderator
    Old Bathos
    @OldBathos

    Here is a story about learning your body.

    I was on night duty at the ER when MPs brought in a young hero who got really drunk, fell and punctured the side of his face on a fence post or something similar. The bleeding had largely stopped by the time he joined us and there was a visible, nearly quarter-sized hole in his cheek.

    After a quick once over, a medic told him to have a seat in the waiting room while the surgeon was summoned. Our hero then took out a pack of cigarettes, lit one and for some reason it did not seem to work. A small group of us gathered to watch something that really needed a Stan Laurel or Charley Chaplin for the full effect. He inspected the cigarette, found no holes but discarded it anyway. He took out another. Same issue.  Then as if a cartoon lightbulb went off overhead, his eyes brightened, he stuck a thumb in the wound and, suction restored, he was able to smoke.

     Medicine continues to gain ground on pain, disease and death but Stupid will always be with us.

    • #23
  24. Arahant Member
    Arahant
    @Arahant

    Old Bathos (View Comment):
    Medicine continues to gain ground on pain, disease and death but Stupid will always be with us.

    And well worth watching.

    • #24
  25. She Reagan
    She
    @She

    Old Bathos (View Comment):

    Here is a story about learning your body.

    I was on night duty at the ER when MPs brought in a young hero who got really drunk, fell and punctured the side of his face on a fence post or something similar. The bleeding had largely stopped by the time he joined us and there was a visible, nearly quarter-sized hole in his cheek.

    After a quick once over, a medic told him to have a seat in the waiting room while the surgeon was summoned. Our hero then took out a pack of cigarettes, lit one and for some reason it did not seem to work. A small group of us gathered to watch something that really needed a Stan Laurel or Charley Chaplin for the full effect. He inspected the cigarette, found no holes but discarded it anyway. He took out another. Same issue. Then as if a cartoon lightbulb went off overhead, his eyes brightened, he stuck a thumb in the wound and, suction restored, he was able to smoke.

    Medicine continues to gain ground on pain, disease and death but Stupid will always be with us.

    One would think a person with such a sound grasp of cause and effect (not to mention Science!) might have avoided the situation that got him into the ER in the first place…

    • #25
  26. Jim Beck Member
    Jim Beck
    @JimBeck

    Morning She,

    When you suggest that there is a paradox between knowledge of cause and effect and how young men with that knowledge interact with alcohol, I get a bit confused.  As a male who was frequently interested in experiencing the effects of various amounts alcohol on the human body (for scientific reasons and to get smashed), I do not see anything unusual in this males behavior.  Not only is this behavior not unusual, in my experience it is classic behavior for young males, and if young males behave differently one might view the change in male behavior as a sign of cultural decline.

    • #26
  27. Dr. Bastiat Member
    Dr. Bastiat
    @drbastiat

    Doctor Robert (View Comment):
    Despite one’s affection for Dr Bastiat, one notes that he has constant pain because of an easy diagnosis missed by an incompetent physician.  Does he mean himself?

    Yes, he does.

    I misdiagnosed myself.  A common problem among doctors.

    • #27
  28. Old Bathos Moderator
    Old Bathos
    @OldBathos

    Dr. Bastiat (View Comment):

    Doctor Robert (View Comment):
    Despite one’s affection for Dr Bastiat, one notes that he has constant pain because of an easy diagnosis missed by an incompetent physician. Does he mean himself?

    Yes, he does.

    I misdiagnosed myself. A common problem among doctors.

    Even worse is the lawyer who thinks he can defend himself before the bar committee or a judge when accused of violations of professional ethics and malpractice. 

    • #28
  29. Doctor Robert Member
    Doctor Robert
    @DoctorRobert

    Dr. Bastiat (View Comment):

    Doctor Robert (View Comment):
    Despite one’s affection for Dr Bastiat, one notes that he has constant pain because of an easy diagnosis missed by an incompetent physician. Does he mean himself?

    Yes, he does.

    I misdiagnosed myself. A common problem among doctors.

    We all do it and we all should know better. I have seen lethal results arising from Docs self-diagnosing or diagnosing their spouses and loved ones. It’s hard being human.

    • #29
  30. Kozak Member
    Kozak
    @Kozak

    Doctor Robert (View Comment):

    Dr. Bastiat (View Comment):

    Doctor Robert (View Comment):
    Despite one’s affection for Dr Bastiat, one notes that he has constant pain because of an easy diagnosis missed by an incompetent physician. Does he mean himself?

    Yes, he does.

    I misdiagnosed myself. A common problem among doctors.

    We all do it and we all should know better. I have seen lethal results arising from Docs self-diagnosing or diagnosing their spouses and loved ones. It’s hard being human.

    The worse thing that you can do is change your usual practice when dealing with another doctor.

    Had a case ( not mine )where a local internist was shoveling snow off of his roof and fell, breaking both wrists.

    The first words out of his mouth to the ER doc were ” Nobody touches me till I get  Demerol”.

    ER doc complied,  gave him the Demerol before the exam.  Patient then proceeded to drop his BP and go into shock 

    from the ruptured spleen  from landing on the shovel which was missed on the initial exam because of the demerol.

    Damn near killed him.

     

    • #30