Health Medicine

Manch Medic’s post reminds me to ask: Any tips from EMers on transitioning to a week of night shifts? I’m incredibly excited to dive back into clinics with another ER month next week, beginning with a week of 10pm-6am shifts. Sleeping suggestions, napping suggestions, caffeine suggestions? Thanks in advance.

The disease-ifying of normal just took one leap forward today with this question from Ask Metafilter:

I get very moody if I don’t eat in the morning. If I don’t eat until 3-4pm I get headaches, drowsiness and feel nauseous.. I think I’ve always had this. Since I usually eat enough it doesn’t really bother me. I’m 21, male, and a vegetarian. What do I have?

I love the answers:

You have a condition known as hunger.

The good news: it is easily treatable

The bad news: there is no permanant cure

This condition can be treated at a specialized clinic, the one you want is known as a restaurant. This condition can also be treated at home, but you will need specialized supplies from a grocery store. Most sufferers find that several treatments per day are necessary.

This week’s Grey’s Anatomy featured the Candirú fish, native to the Amazon. It generally parasitizes other fish, drinking their blood, but has been known to swim up human urethras, attracted by urine, and lodge themselves in the urethra with its sharp backwards-pointing spines.

I know, I know, I’m supposed to enjoy the show for its drama, but the “penis fish” man somehow had grapefruit-sized testicles as a result of the urethral obstruction. This ain’t how it works. The testicles are not magically connected to the bladder or something. The guy would end up with postrenal renal failure, not scrotal edema (maybe anasarca or something, but not just in the scrotum, come on).

Oh, and these interns are pimping each other on what an actinic keratosis is? Okay, done ranting.

This just ain’t right. This guy must have some sort of malformation of his orbital ridge, or something, cause I have no idea how he’s getting his globe (eyeball) so far out. I think it’s real–you can see the lateral rectus muscle as the camera pans to the side…

Clutch quote from an OB resident 3 weeks ago that’s still been bothering me, in reference to a patient with metastatic cancer who was in pain and needed a CT scan but was refusing contrast:

“I am so sick of these patients. Just suck it up already and deal with it. God.”

If you’re ever working with me, and I ever say anything as remotely cruel and disgusting as that about a patient, especially one with metastatic cancer all over the place, please, please, sock me in the gut, or slap me, or something. There’s ranting, and there’s bitching, and then there’s just plain inability to have any sort of compassion or caring for your patients.

I feel guilty that I didn’t speak up and put the resident in her place. Granted it was 3 residents versus one med student, but I wish I would take the right path rather than the easy one a little more often. Sigh.