"I'm an ER registered nurse.
Young adult male presents with multiple abscesses on various parts of his body. States he injected his boyfriend's 'baby batter' into himself trying to get pregnant.
He tells one of the nurses that he should have gone with his original plan and tried on his dog first. Psych clears him. He's admitted to the floor and gets IV antibiotics.
"I'm a radiation therapist. We treat cancer patients and I've got quite a few who stand out.
1) Had a patient with rectal cancer demand a certain timing for his treatment. When we couldn't accommodate his request, he threatened to not come for his treatment at all. I don't know how that's supposed to be a threat to us, when you refuse to come for treatment for your own cancer.
2) Had a head and neck patient who presented with a very small, treatable lump. We use thermoplastic shells to immobilise head and neck patients. Because of all the critical structures in that area, it's important to make sure that the shell is tight and they can't move very much. This patient refused treatment because the shell was uncomfortable. We cut holes in the shell, made it slightly looser but he still refused. We have other methods of helping them to tolerate the shell such as sedation. This patient refused any help. Kept saying treatment wouldn't help him. Came back 2 months later, the lump had grown bigger and was causing him severe pain. Did a new shell for him. Started treatment. He came for two sessions out of 30 and refused the rest. Came back one month later- the mass had eroded out of his skin, you could see bone and pulsating vessels. Again, we did a shell and he came for one treatment and refused to come back. He eventually died. Had 2 young sons.
3) Had a patient who stopped treatment halfway. This is unadvisable because the dose we give is supposed to be the most effective against the cancer. Any less and you risk recurrence. When asked why she stopped, she insisted that God would take care of the rest and prayer would be enough from here on.
I've also seen a number of patients who refuse treatment and insist on alternative medicine. They almost always end up coming back with the cancer metastasizing."
"So many to choose from. The common ones are:
-People who regularly drink, smoke, and worse not wanting to be a 'pill taker' or put 'unnatural' things in their bodies when I try to prescribe them medicine.
-Opioid addicts who come up with every reason in the book why any pain medicine that is not an opioid is too dangerous to take. This is like saying you're going to swim across shark-infested waters because the well-constructed bridge to walk over them may collapse.
However possibly my most favorite one was this idiot who came in because he thought he had appendicitis. Turns out he was actually right in that he did - and it had a micro perforation and abscess already on CT because he'd sat on it a couple of days. So Mr. Idiot had googled it and decided that since in some places they treat appendicitis with antibiotics he was going to do so for his appendicitis. I explained very patiently for way too freaking long that the research into that only applies to simple early non-abscessed appendicitis and was not appropriately applied to his situation. (And I am bitter that I will never get that half hour of my life back.) His main reason for wanting to avoid surgery? He didn't want scars on his six-pack. (If you haven't already gotten the picture here, think of The Situation from The Jersey Shore.) I refused to participate in his stupidity and prescribe antibiotics, so he left against medical advice. Fast forward 2 days. He had purchased fish antibiotics and was taking that to treat his abscessed appendicitis. He now is septic with a fever of 103, a Lactate of 6, and systolic BP in the 80s (which is really sick).
Fortunately for him, he was young/healthy and it's actually really hard to kill young healthy people. I'm not saying it's impossible, but you have to work really hard. So Mr. Idiot pulls through but ends up with a full laparotomy (zipped right down the middle of his six-pack) instead of the nice little laparoscopy scars he'd have had if he'd come in the first day."
"I'm a dental nurse and was helping a patient to fill out her medical history form (not that intrusive, just medical stuff we as dentists/nurses need to know). As she stated she was pregnant, I ticked the nonsmoker and nondrinker box for her. Plus her previous forms all said she had never smoked or drank. No lie this woman literally flipped, telling me I had no right to do this. Ok, whatever, I just get her a new form and she ticks that she drinks roughly 10 units a day and smokes a full pack a day.
I asked her if she does this while pregnant and she said that she has smoked and drank through all her pregnancies (3 kids under 5, pregnant with another) and they were all healthy. She stated there was NO scientific/medical information on the dangers of it. I literally didn't know what to say, as a dental nurse all I was able to say was it's really bad for your gums and teeth and general mouth health. Not the fact you're freaking damaging your children.
So then I asked for the children's medical history... all 3 had birth defects from her drinking, and one had a birth defect which is related to smoking during pregnancy. She was adamant this was untrue and the doctors lied about this.
At this point, I was really concerned. We're not really allowed to 'go behind the patients back,' but I found the loophole that says we can contact their doctors for advice. Phoned her doctor and explained the situation and said we won't be providing her dental care and we feel the children are in serious danger and what advice do they have. The doctor took our statement and reported it on our behalf.
On assessment the one-year-old had serious bottle caries (tooth decay caused by going to bed with a bottle), the 3-year-old had holes in all his teeth and the 4-year-old was missing teeth as they were that rotted he had lost them and already damaged his underlying adult teeth. Luckily they're booked in this week so I'm hoping they're doing good."
"Oh! So many...
1) A guy brings his wife to the ER, her leg has a 3 in x 3 in wound (diabetic ulcer) with greenish yellow pus and what looked like a few maggots. Now I took one look at her and referred her to the Surgery department for admission. But the hubby is adamant on his wife's kidney disease.
'But doc, it's just a wound, you gotta fix her kidney first doc, I read online that diabetes can cause kidney failure, and you gotta do something for that.'
I spent an hour convincing him that his wife would probably die before the kidney damage set in by sepsis from the clearly infected wound.
2) During my pediatric internship period, I was in charge of the general ward. The basic things were to look after the kids, solve small complaints (cough, breathlessness etc...), and evaluate new admissions. Now where I work, interns are supposed to draw blood from children for tests. So I went about my job and there's one little tyke who's a bit too active and jumps around when he sees the needle.
The mother gives me a vile look and says,
'You are just puncturing my child for your education.'
At which point the kid just screams even harder. Yes, I'm studying drawing blood at 2 in the morning by waking up a kid instead of trying to help heal him - that's what she thought.
It took a fair amount of convincing that wasn't my motive.
3) I took care of a child that got measles. The mother and father were strongly anti-vax but was yelling at me 'how can modern medicine not have a treatment for measles!' At which point I told her there was a preventive method but they didn't use it. She asked me what it was to which I replied vaccinate your child.
She said, 'You're just one of them pharma lobbyists, aren't you?'
4) A lady comes screaming into the ER, Now she's all dressed up, so are her 2 grown daughters. All of them screaming hysterically that their mother is going to die. I go by them and nearly get tackled by the sister-in-law and the husband of one of the daughters.
'Save her, she's having an embolism!'
Shaken, I examine the lady, asked her where she was coming from (a wedding, that explained the dress). She apparently had a bit too much of potatoes. A shot of pantoprazole later, her embolism is gone. She had a bad case of 'fart embolisms.'
One thing I will never forget is how I learned never to be mad at a patient.
Now, this was when I began as an intern. A patient had an intestinal obstruction. We inserted a nasal feeding tube as the patient could not have anything per orally before the surgery. Problem was that they would always come and complain to me about how I didn't stick it properly (you have to stick the end protruding out of the nose to the nasal bridge.) After 2-3 such episodes where I reluctantly dressed it, they complain that the tube is out of the nose, and lo and behold it is out. It's very uncomfortable, most patients try and pull the nasal tube out. I replaced it 4 times. Poor guy was fed up by then.
On the morning of the surgery, his wife comes and asks me,
'Doc, can you just remove that tube so that I can give him some coffee?'
Now I got totally mad. I was working a 72-hour shift, so I scolded her by saying that if she or he didn't want the surgery then I couldn't do anything and it would be nice if they gave me some peace.
She didn't say anything.
The patient, 50-years-old with no other complications, died on the table.
I couldn't face her.
The moral being, doctors know more things than patients. But it's not always wise to bite their heads off. I could have convinced her it was impossible to remove the tube before surgery in a calm way.
Since then I've tried to be a better speaker to patients."
We had a patient who refused to let us use the tonometer, a machine for checking ocular internal pressure to diagnose glaucoma. He said that puff machine gives you glaucoma and we weren't going to pull that on him.
He told us his father got an exam and had glaucoma after using that machine. His uncle and brother also had no signs of glaucoma, and after getting the puff test, both people had been diagnosed with the disease.
Glaucoma doesn't have any outward symptoms before you start going blind. This idiot just told me he has a very strong familial disposition to glaucoma and refused to be tested for it."
"Back when the Ebola crisis was huge and the media was losing their mind over it, I had a very interesting call.
We were riding 3 deep, all female crew. Dispatched to a sketchy part of town in a bad apartment complex for 'unknown urine problems.' Um? Okay. I'm taking the backseat on this one, kinda just going to observe.
We're met at the ambulance by a late 50's, early 60's African-American male. Unkempt, yellow eyes, clothes that look like they've been slept in for a week, dirty nails, general uncleanliness.
He asked us in a very thick accent where the men were. 'There are no men, it's just us. We all have the same training. If you're more comfortable with a man, we can get a male crew here, but they won't do anything different than we will.'
'Women can't be in male positions. You should all be home taking care of your husbands and children.' Sigh. One of THESE people. I respect and get cultural differences, but sheesh... it gets old.
After going back and forth for a few minutes about our training and trying to explain to him in futility that none of us (at the time) were married or had kids, we finally tell him, 'Look. We aren't here to discuss us. We are here to help you. YOU called US. What made you hurt so bad to call 911? We have to assess you. We can't just get another crew over here not knowing what the problem is. What issue are you having?'
'My junk. I think I have Ebola.' Cue the eye rolls.
'You... have Ebola... in your junk.' I said. It wasn't a question.
'Yes. I just came back from Liberia last week and I haven't urinated in 4 days.' Cue him spewing all sorts of things about what his culture says about illness and Ebola. His cousin, who was a doctor in Africa, told him he had it and it could be cured by banging a pure young woman and he was eyeing all of us like we're meat. What the...?
We wound up ignoring him and continuing our assessment. He was SO adamant about it though! Cited obviously fake odds and 'facts' and bragged he had hooked up with several women in Liberia, and that's how he got Ebola.
'Um... okay. Are you in pain? Can we take a look?' He let us get a set of vitals, but then he pulled his pants down. (Conveniently forgetting his request for men and apparently the fact all of us 'knew nothing' and should be taking care of our husbands or whatever.) His balls were the size of grapefruits, his pecker was turtled to the point it was basically inverted. His bladder was palpable and swollen too. So the dude was legit, he definitely had some issues going on. He was CONVINCED he had Ebola. Only in his junk. Also I'm sure he was more shocked that we weren't fawning over his gross-looking genitalia, us being a crew of women. I should note, this dude very much so did not have Ebola at all.
We took him to the hospital and when we told the receiving nurse what the chief complaint was, she brought the doctor over and asked us to tell him to his face what the patient was complaining about. Junk Ebola.
When we went back dropping off another patient, we asked how Patient Zero was. They laughed and said he just had some prolapsed organs in his balls and his pelvic floor was trashed. Had to stick a catheter down his urethra to drain the pee. No Junk Ebola, but he definitely was riddled with STDs."
"I'm not a doctor, but I assist on a clinical trial and my main job is screening potential participants. I have to ask a list of questions about their medical history and current substance use. And I've heard the wildest stuff I've ever heard in my life at this job. Some people just want to feel smart.
One of my favorites was when I asked someone if he'd ever had an MRI, he responded, 'I NEVER enter hospitals because I don't agree with their practices. Did you know homeless people go into hospitals for warmth and because they feel bad for them, the doctors give them coke?' He withdrew his interest when I informed him the trial would take place in a hospital. He was also the one that called me 'Big Farmer.' Not pharma. Farmer.
Yesterday I interviewed this guy who, upon being asked if he had any existing medical diagnoses, told me that when he was born he was admitted to a study on 'infants of greatly superior cognitive intelligence.' When I told him he was ineligible for the study, he scoffed and said, 'It's not a problem. I was actually worried I'd corrupt your data since you probably don't have any other participants of my IQ. Wouldn't be fair to apply my results to them.'
"The mother of a toddler came into the emergency room. The kid had cruddy green/bloody stuff coming out of his left nostril, and a lot of redness and swelling of only the left side of his nose and the adjacent cheek. Mom was sure he caught a sinus infection and just wanted some antibiotics.
Now, I know some kids like shoving whatever will fit into their body orifices, and that this was more than likely given the one-sided nature of his condition. But Mom was insistent that he NEVER puts things in his nose.
It took some convincing, but I finally got her to let me take a look. Gave a squirt of midazolam in the good nostril to settle him, then dug with some tweezers through the crud until I pulled out a big ole button battery. It would've been burning his nose for a couple days. Hopefully, he healed up well."
"I work for an optometrist and it was the month before school started and a woman brought in her son to have his eyes checked for the first time. Seems like a pretty reasonable thing for any parent, even if he was a little older than usual for a first eye exam. Better late than never I guess. The mom was well spoken and appeared fairly intelligent. Everything went as normal, the doctor examined the boy and ended up prescribing glasses. The doctor was explaining to the mom that her son had to wear his glasses all the time since he's nearsighted and basically can't see clearly past 5' in front of him and would definitely need glasses for school. For some reason this caused a switch to flip in the mom and she spazzed out on the doctor, saying that her son doesn't need glasses and that the doctor is only saying that he does because he wants to sell glasses. She says that she only brought her son in because there was some form for school that needed to be filled out and that doctors are all con artists trying to push unnecessary medications and interventions. The doctor tried to calm her down and explain that he's only trying to help them but that she was free to get a second opinion and gave her a copy of the kid's prescription and sent them on their way. About four months later the lady is back asking for another copy of her son's prescription. Apparently, the first semester midterm results were in, and her son failed them all because he couldn't see the board in his classes and needs glasses!"
"I had an 80+-year-old patient who was declining with multiple diagnoses and about 3 bad ulcers. The daughter was adamant that her father be kept on his strict 'paleo' diet because that would 'supercharge' his healing. She had a stack of diet books. He simply wasn't getting enough nutrition to heal the ulcers. He didn't like the diet at all, by the way.
At some point, you kind of have to stop being polite and just tell patients/family members bluntly that you don't have time for this nonsense and what you recommend and they can do what they want and just document everything.
It happens a lot but she sticks out the most."
"I had a patient come in with several pages he printed off the internet. He kinda slammed them down and said, 'This is what I have.'
He had bloating, nausea, vomiting, diarrhea, bloody stool, and fever among other things. He insisted he had Schistosomiasis. He was being a real jerk about it like we're wasting time since he already knew what he had.
So, I asked when did he get back from Africa. And he said, 'Africa? I've never been to Africa. What the heck would I be doing in Africa?'
I proceeded to tell him that Schistosomiasis is a parasitic disease one gets while swimming in the Nile River or other rivers in developing countries like in Southeast Asia.
He got ticked off at me because he thought I was being a smart aleck.
He got seen and diagnosed with gastroenteritis (the stomach flu). The bloody stool? He had hemorrhoids."
"I'm still just a medical student, but our hospital sees a lot of poor and poorly educated patients since we're a big tertiary hospital in a developing country. The worst I've seen so far are the old ladies who everyone in the family turns to for health advice, their only qualification being seniority. They usually have a bunch of superstitions that end up contributing to the patient's poor condition in the first place.
I once saw a child brought to the ER for a really bad mouth infection, and the mother clearly hadn't taken a bath since the delivery (it's a common superstition here that mothers shouldn't take a bath a week or so postpartum), so we figured that's the source of the infection. While we're assessing the patient, the doting grandmother in the background decides she has to comment on everything we're doing (remember she's probably the one who advised her daughter not to take a bath).
Eventually, I just had to shut her down because A) It was late and people were running out of patience in our understaffed, under-equipped ER; and B) They're more worried that pulse oximetry is hurting the baby's tiny widdle toes when there's freaking pus leaking out of the baby's very inflamed salivary glands. I mean, I get that infections like these are a disease of poverty, that their poor education is just indicative of a wider systemic problem that Philippine society fails to address time and again, but by golly does it get annoying."
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