How it actually happened vs.  How I wish it could have happened

Me:  So what brings you to the ER today?

Supergenius:  I’m really short of breath.  I’ve had a cough and can’t breath fer 2 months.

Me:  Alrighty.  Well, it says here you have asthma, right?

Supergenius:  Yeah.  I dunno if its that though

Me:  Uh-huh.  Have you been taking your medications?

SG:  Uh, no (duh).  I can’t afford them, they’re too ‘spensive.

Me:  Oh, wow, that’s really crummy.  Especially since most of them are really cheap, like 4 dollars at Walmart, or some of the are free.

SG:  Yeah, well, I don’t like taking them either.

Me:  Ah.  Um, what?  Ok, nevermind.  Let me listen to your lungs here (wheeze… wheeze… wheeze… cough)

SG:  Maybe could be a little asthma

Me:  Yeah, this is asthma.   And those are cigarettes.  How much do you smoke?

SG:  I’ve been cutting down.

Me:  How much do you smoke?

SG:  Well, I haven’t been smoking as much as I used to

Me:  How much do you smoke?

SG:  About a half a

Me:  (glares at her…)

SG:  I mean, about a pack a day.

Me:  You know, you really shouldn’t smoke.  You really REALLY shouldn’t smoke if you are an asthmatic.  Also, smoking is very expensive.  If you stopped smoking for 1 week, you could afford most of your medications for the entire year. 

SG:  Yeah, well, I dunno if that’s causing this.

Me:  Your an asthmatic who is wheezing that smokes a pack of cigarettes every day…  Well, let’s do some tests…

HOW I WISH IT COULD HAVE HAPPENED.

Me:  So what brings you to the ER?

Supergenius:  I’m short of breath and I have this cough-

Me:  Stop right there.  According to my 2 second review of the chart, you smoke every day and don’t take any of your medications.  YOU ARE AN IDIOT.  WHY WHY WHY!  SERIOUSLY ARE YOU REALLY CONFUSED ABOUT BEING SHORT OF BREATH?  AAAAAAAH!!!  AAAAAH! (This is when my clothes start ripping and my skin changes green.  I start tearing down the monitors and ripping the medical equipment off the wall).
  HULK ANGRY AT UBER-DUMMY!  NO GET HOW YOU BE HERE !! GAAAAAH!

Then I calmly walk away and discharge her.

Every other female at my work is pregnant.

I don’t know how this is.  Well, actually I do, but it really amazes me.  Today I found out that yet another nurse is pregnant.  As a joke, I shouted over to another and said, “hey Em, aren’t you pregnant too?”  This was a joke, since she couldn’t be pregnant as well.

Wait, yes, yes she was. 
“When did you find out!?” she responded.

Sheesh.  My ER is like some sort of TV show where everyone gets everyone else pregnant… like Grey’s Anatomy only without the whole show sucking.

I try to be empathetic with my patients in the ER, but at times it is so very difficult when people create the problems that bring them in.  Often I have patients that smoke constantly, even though they are asthmatics, which irks me to no end.  However, alcohol is usually the cause of much of this difficulty. 

I have come up with a new formula.  The formula helps quantify stupidity, also taking drunkness into account.  Take a normal person.  Lets call that person Bork. 

Bork is a normal guy in every single way.  Bork has an IQ of exactly 100.  Perfectly average.  Let’s also make up a new term for the ability to make logical, good decisions, we’ll call that the NADA Quotient.
NADA = not a dumbass.  Bork, being average, has a NADA (not-a-dumbass) of 100 as well.

Now if Bork drinks one beer, according to the new formula I just made up, his NADA will drop by 7.  After 3 beers, it will drop by 21.  Thus, as Bork gets drunker and drunker, he progressively gets dumber and dumber.  This is for the average person.

Thus… A persons NADA normally = 100.  But with drinking, it goes to: 
NADA level = (Normal level) – (7 x number of drinks).

Now I realize there is a wide variance from person to person.  For some people, one beer will drop them 10, or even 15 NADA points, thus after 4 beers, they get amazingly stupid. 

Also, one must take into account that some people are naturally dumber than others.  In our great country are people of all shapes and sizes.  People of all colors and creeds.  Also, there are people of all varying levels of stupidity.  Mostly, these people are in my ER.  Many of these people were born with a NADA level that peaks somewhere around 50.

Here’s where it get’s scary.  If someone has a NADA level that only starts at 50, and then that person drinks, AND if that person loses 10 or 15 points per beer, that person may even get into the negative numbers.  Thus, according to the formula.

NADA level = 50 – (15 x (number of drinks)) = SCARY RESULTS!

Meaning being a dumbass is not only possible, but likely.  Actual logical decisions become nearly impossible!  Thus, I get situations in the ER like the following:

-Hey, you guys want to take the safety off the nailgun and have a fight… SURE!  GREAT IDEA!

-I’ve had 8 beers tonight, but I think I can still drive just fine!

-I just broke my arm, and it needs surgery tonight but I really want to be discharged so I won’t miss watching the game on TV tomorrow

-I just cut myself with a beer bottle and I’m bleeding all over, but I don’t want you to stop the bleeding because it might hurt and I’m scared of needles.  I’m deathly scared of needles.  Oh, and my whole body is covered in tattoos.

I would like to say that those examples are made up.  I would like to say that all those people were not drunken idiots.  But, this being an honest blog, I must just say that I can hopefully just accept the fact that everyone is born with their own NADA level, and I hope mine doesn’t drop to negative numbers any time soon.

I’ll see this guy in the ER soon…

Have you ever wound up in an ER drunk?
How low has your NADA level gotten?  What is it now?

I already miss last decade.

The main reason is because I can’t say the zero anymore when I refer to the year.  Oh sure, you can do it when you are reminiscing and stuff, but then you sound like a super old-timie grandpa, though, if you are still young, I think this might just be retro-cool.

Them: “When did that movie about all the crazy blue people come out?”
Me:   “Weeeeeell, younguns, methinks that was in twenty Ought Niiineoutnsogw (teeth fell out)”

But, that’s ok.  I might just change to putting the ought behind the two so I can call 2010 “two-ought-ten.”  That way I can be both retro and confusing for no good reason, which is fun.  Oh, I think this was my favorite blog entry of 2009 if you want to check it out

I digest, Let me do my yearly review on my new years resolutions once again.  Here’s 2009′s and how I did

1.  Weigh less than 185 this year –> WIN! but not currently, I blame delicious pumpkin muffins.
2.  Find a Church home  –> Sortof.  We have a place we go, but not members… so… FAIL
3.  Run 500 miles this year –> ha!  Not even close!  I was doing ok till April 2nd… then baby… and no more
4.  Get a new car —   WIN!  Got a Subaru Forester, and it is sweet!
5 & 6.  Write a novel from scratch SUPERWIN!  I still have TONS of editing to do, but I finished my novel
7.  Become the best daddy ever –> WIN
8.  Read 20 books cover to cover –> WIN
9. Once a month do a thorough overview of some ER topic –> WIN
10.  At least 3 Bool hunts for Gwen, and 1 couples vacation this year. –> FAIL, didn’t have a couples vac

Not too bad, considering most people usually fail with all of them by January 10th.  I’m pretty happy that I actually finished a novel.  It would be about 430 pages now if published… I have lots of editing to do.  I’ll let you know when the movie deal comes through, by which I mean if I ever get the editing done.

Now for this year.

um.

Hmm.

Might have to trim it down to 5, since I had so many fails last year.

1.  Get under 183 pounds for at least 2 weeks striaght (a loftier and perhaps healthier goal)
2.  Edit and finish my book
3.  Read 20 books cover to cover (a good goal every year I think)
4.  Try to exercise twice a week (gonna have to keep track on this one)
5.  Try to have at least one date night with wife a month

Yeah, I think those’ll do. 

 So many things going on all at the same time…

Here’s the short list:

- I did a lecture all about inappropriate use of the Emergency Department.  Highlights included coming into the ER via ambulance, twice, for the same urinary tract infection (yes, those antibiotics ARE free, just go and pick them up!). 

- I apparently won the costume contest at the Halloween party I went to.  Slicy is officially retired from Halloween, which is kinda sad, but it is time to move on.  I already have my idea for next years costume.

- Gwen got really sick and admitted to the hospital.  She’s getting an ERCP tomorrow, so that’s fun. 

- Samantha got her first haircut.  I feel sad, since I really kind of liked the 7 month old with a mullet look.

- I got yelled at in the ER by a patient when I would not give him narcotics for his sore back.  He is very young and appeared to be in zero pain.  Yet somehow he has chronic back pain.  Despite this he could jump around the room, walk all over the place without difficulty and spent the entirety of his time in the ER on the phone and pacing.  Sorry, I’m just not buying it, no narcs for you, go see your primary care doc.

- Poop

- 3 deer continue to run around my back yard and a flock of turkeys keeps running by, don’t they know Thanksgiving is right around the corner?

Yes, yet again I will list my main super-power for those of you who may have missed it.

Super-pooping (I know your jealous, but it has its downfalls, see here).  I can crap faster than any human I know.  I am not sure how long it takes you to pee, but I can poop in less time than that.  I know, it’s not as good as super-strength, or teleportation, but hey, I’ll take it.

However, I do unfortunately also have a weakness.  I know my weakness, yet I remain completely powerless against it.  Those who know me closely already know my weakness.  Like any good human, I have gone through my 12 steps and finally come to the last… acceptance.  Now by accepting my weakness, and embracing it as my own, I can hopefully use it to my benefit to make me a stronger person. 

Sigh.  Enough drama.

I am, <sniff> a cartoon junkie.  Perhaps you already knew this?

Yeah, I know.  I can hear your scoffs, snickers, jabs, and guffaws from here.  Here’s our conversation

SUCKHEAD (You):  But aren’t you a doctor?  I mean aren’t you mature than that?
ME:  Have you read my entries?  Seriously I talk about poop in over 60% of my entries.
SH: But shouldn’t you just, you know, stop watching them?
ME:  I’ve tried, it’s my addiction.  I enjoy pretty much anything animated. 
SH: How is that a weakness?
ME: If anything is animated, I’ll pretty much watch it.  Heck, I’ve made it through episodes of Captain Planet.  I have a somewhat encyclopedic knowledge of any 80′s cartoon, and I can’t get this info out!  I want to replace this knowledge with something useful, but all I see is Ma Beagle from Duck Tales!  It’s not my fault
SH: Well, how can you make this into a good thing?

Well, I’m glad you asked, Suckhead.  I have decided to enlighten you to a few of the best online cartoons that are currently rummaging around in this big wide internet of ours.  I realize there are THOUSANDS of fantastic internet cartoons out there.  I have sifted through thousands to find a few gems.  Be warned, all of these are worth their weight in solid animation gold… Here are a few of my favorites. 

Enjoy:

 
Possibly my #1 pick (There she is, by Sambakza)


The Waterlollies (Fantastic Animation)

(**NEW EDIT**)
I can’t believe I didn’t put Homestar on this entry
in the first place.  For those of you who have never
been to Homestarrunner.com, you’re welcome.

Charlie the Unicorn (So dumb it’s hilarious)


BadgersBadgersBadgersBadgers
(So catchy You’ll wish you hadn’t seen it)

The Ultimate Showdown (bad animation =OK in my book
as long as the song is fun)

So many more, it’s hard to stop here.  Maybe I’ll just go watch Magical Trevor.  Any great internet cartoons that were left out?

Don’t you hate it when you wake up, look at the clock, and realize that your alarm didn’t go off.  Not only that, but you were sure, extra sure in fact, that you set it the night before.  So then you rush through your morning routine knowing full well that there will surely be a white-hot corny-chunk containing shit-storm waiting for you once you get to work and their is nothing that you can do about it. 

In addition to this.  Don’t you hate it when your car is low on gas.  You remember thinking to yourself: “hey I have plenty of time now to fill it up, but I really just want to get home to relax, but I have to be sure to get up early to fill it up or I might be late for work, or even worse, run out of gas and be REALLY late.”   Unfortunately, you forgot about that and did not fill the car up so now you have to get gas anyways.  So you pull over and try to pump gas quickly as if the 7 seconds you save by quickly shoving the handle in your car will really make a difference.  But then as you try to do the same in removing it you forgot that a little leftover piss of gasoline is always waiting in the end of the handle which flies though the air and covers your pants, shirt, face, and hands with just enough of a misting to give you the aroma of Captain Wanker the Moron who can’t pump gas without getting it all freakin’ over himself.

And don’t you hate it as well when you are already rushing so you did not have any time to get a real breakfast.  You were smart enough to grab a can of Mt. Dew out of the fridge and a nutra-grain bar but that was about it.  You were OK with this being your breakfast until some douchebag slams on his brakes at a barely yellow light that you had already committed to going through so you had to either a) perform amazing evasive maneuvers using only your crotch since both your hands are already occupied with the aforementioned breakfast OR b) slam on your breaks.  But, after slamming on your breaks just after opening the Dew you spilled a healthy portion of the unhealthy yellow caffiene all over your shirt.  Then, maintaining your last ounce of sanity you look over to the side of the road only to see some random dead animal that makes you feel bad for getting so pissed about the little things that have happened to you.

You do?  You do hate it when that happens?

Bad days happen, get over it and get back to work.

Fortunately for me, I made all that crap up, today rocked.

Dale Carnegie taught a course on “How to Stop Worrying and Start Living.”  Must of this information is contained in his very small Golden Book.  I currently own the golden book which has many uplifting insights on how to live your life in a positive and optimistic way.

I do consider myself an optimist, despite many other peoples recommendations.

One of the nuggets of wisdom on how to reduce worrying is to try to keep everything in perspective.  Try to back up and take in the big picture and overcome worry.  He states: “What’s the worst that can happen.”  Out of all of the very excellent advice in this book, I think this one small part was not meant for ER doctors.

In the last 3 days, I have had to pronounce 5 people dead.  Nothing was done wrong.  People die.  It is still sad.

5 dead in 3 days…  That sucks.  Worse then that.  That crazy-kung-fu-mega blows!

Nothing makes that easier.  It is always hard.  Talking with the families and breaking terrible news always crushes me.  Doing it several times over and over just absolutely drains me.  In the ER I have to function extremely fast and react instantly to changing dynamics.  Emotions must be put on the back burner since I am caring for many patients at the same time; that being said, after everything is done for the day, sometimes it all catches up with me.  I feel terrible, even though I know I did everything I could and no one could have saved these patients. 

So, I sit and contemplate and hope the next day is better.  It is also tough to bounce back after that and be happy and energetic to see the cute 4 year old with the sniffles.

Sometimes it feels like I’m just putting a band-aid on everything and just trying to buy time. 

OK, enough whining, time to go back to work.

I peeked out into the hall to see that the line for the flu shot had grown to epic proportions.  I continued to diligently see patients in the fast track department with ailments ranging from: Cold with Fever, Fever with Cough, Cough with Chills, Cold with Runny nose… etc.  Excitement, thy name is fast track.

Then I went back to check on the line.  Some lady was handing out pamphlets to fill out while waiting in line.  I asked if I could have one so I could fill it out while I worked.  She looked at me in my scrubs and said:

“You work in the ER?”

“Uh-huh” I responded,

“Come with me,” she said.

She then took me past about 30 other people to the front of the line where a nice lady asked me if I had asthma or was allergic to anything (no and no).  Then I snorted down a vial of anti-H1N1-goo.  Mmm, bacony. 

Now I am an unstoppable force to be reckoned with.  Live attenuated virus down my snout makes me immune, Boo-yah!  Just to prove my immunity I licked the snot off of the next 10 kids I saw.  Take THAT, immune system!

Considering the fact that I’m a provider in an ER, I figure I’ll likely see more flu than pretty much anyone else I can think of.  So far, no side effects from the vaccine, I’ll keep you up to date, but I’m really not concerned.

In a fun side note, cutie-pants Samantha got her 6 month vaccines yesterday as well.  I felt so bad.  Mostly because right before she got the vaccine she was giggling and looking up at me with a huge smile on her face.  Then *POW POW POW POW* four shots in the thighs.  Poor thing.  But shes back to her happy as a clam personality today, and she seems to still love daddy cause she’s giggling like crazy (normal for her).  Not only that, but I can still bring home the bacon without bringing home the swine.

First of all, I really did not plan to destroy her day.  It was neither my intention nor my desire to have another human to suffer so horrendously due to my inadequacies.  However, we all sometimes fall short of the mark.  I digress…

It started as a typical day at work.  Drove in, had my Coke for breakfast as I drove in.  Also, on the way in, I snacked on a couple Fiber One bars.  Don’t get me wrong, these things are actually quite tasty.  Not only that, but I think they have something like 281548% of your daily requirement of Fiber.  Perhaps I back up a little here.

I am a very regular guy.  I don’t mean that in the “I’m Mr. average Joe and I fit in well in the crowd.”  No.  Not at all.  I don’t go for the fit in average.  By regular, I mean that I poop regularly.  Heck, I’m extra regular.  In fact, I think I crap on average about 2.7 times a day.  Everyday.  Not little wimpy micro-spurts either, we’re talking king sized Baby Ruth’s 3 times a day.  Mmm, Baby Ruth (actually more of a Snickers man myself… but I digress a second time)

So, I had my 2 fiber one bars.  Most people should have more fiber in their diet.  I am not most people.  I should eat more of Cap’n Brickos Mega-Constipating Cheezie flavored Hummus… if it existed.  But yes, I had 2 fiber one bars.  It took about 3 hours, but then I felt it.  You know it.  You’ve felt it.  Try and deny… you have had The Urge at work.  To go.  Oh yeah.

Fortunately my primary super power (as previously mentioned multiple times) is incredible bowel control.  So, I could overcome the power of The Urge by sheer mental and sphincter power alone.  That being said, I could still feel the fiber bars brewing inside for several hours.  I knew I had a massive amount of gas forming, but I kept busy with work, and I won the battle.  I made it out of work.  This is where the fun starts.

I walked to the parking garage.  For some crazy, horrible, and semi-hillarious reason, I could not get the 4 gallons of gas in my colon to pass while I walked outside towards the parking garage.  Then, I pressed the elevator button to take it to the 4th floor, since every morning I feel capable to walk down the 4 flights but I’ll kick someone in the crotch before I’ll walk back up them.

I get on the elevator.  My dark nemesis, The Urge, returns.  Fortunately, I am going UP on the elevator and there is ab-so-lutely no chance anyone else will be getting on since who would want to go up from a floor above the ground floor?  Seriously?  What are the chances?

I release.  No, that does not do it justice.  I produced a level of atrocious Anus-Swamp Vapor that could melt steel.  It came out as a vapor but I am sure was more caustic than pepper spray.  Even my eyes started watering a bit.  The sheer volume of it even surprised me.  It literally filled the entire elevatore with its presence.  I think if it would have been any larger I think the fart would have had it’s own conciousness and may even have willed itself into existance as a sentient supervillian, it was that amazingly bad.  Yeah, just vicious.

I then went up one level, suffering in my self made stink-coffin, but finally relieved to be rid of the monster that had been lurking in my colon for hours.

Then the unthinkable happened.  The elevator stopped at the first floor.

A nice looking lady in a business suit got on the elevator.  In a split second I had to make a decision.  And, using all the fast paced skills of a trained ER physician, I pounced on the best decision in that milisecond.

I left the elevator.

I watched the door close.  I sat outside the elevator for a second, slightly worried that I may have just killed an innocent woman, but relieved that I did not have to ride up in an elevator and try to pretend that the whole area did not just reek to all hell from my disemboweled evil I had just created. 

I then walked up the 3 flights to my car and went home.

Please, random lady in elevator in the parking garage, if you are reading this, you have my sincerest apologies.  I meant no harm.  I blame fiber one.

Sigh, the older I get, the more sure I am that fart jokes are the only thing that will keep us all sane…