Water Pills

"It's pretty hot out, so you should make sure you're drinking enough water."

"I don't like to drink water."

"Well, it's important.  You need to."

"Can't I just take a water pill instead?"

"You mean a diuretic?"

"Sure, whatever."

"I think you're misunderstanding what those kinds of pills do.  They make your body get rid of water.  They're the opposite of what you need when I'm telling you that you might be dehydrated.  You need to drink water."

"I thought those pills were just water in pill form."

"Think about whether that makes sense."

"I don't know.  They make everything into pills these days."

"A pill is not a substitute for drinking water.  Please drink water."

"Can I drink ice water instead?"

"Yes, ice water is fine.  Ice is just water in another form."

"I thought you said water doesn't come in other forms."

"I said it doesn't come in pills.  Ice water is fine."

"The rules are very confusing."

"I'm sorry.  Stay hydrated."

You Can Take My Personal Information And Stick It Where The Sun Don't Shine

"Doc, your 2:30 clinic patient is here...."

"Great, I'll come get him in a second."

"Just one problem."

"Yeah?"

"He won't fill out the forms."

"Can he read?"

"He says he doesn't want to give us his personal information."

"Like, his name and address?"

"Yeah.  And his insurance information.  You can't see him unless we are able to put his information into the system."

"So you want me to talk to him?"

"If you don't mind."

****

"Mr. Jackson, I'm [Anon Doc].  You made a 2:30 appointment?"

"Yeah, I don't feel well."

"The woman at the desk is telling me you won't give her your insurance card."

"I don't want you people knowing all my information."

"We just need the insurance information so that we get paid."

"I don't believe you."

"I don't know what you think we're doing with your insurance information, but if we can't bill your insurance company then we have to bill you directly.  And for that we need your address."

"I'm not giving you that either."

"Then I don't think I'm allowed to see you as a patient here -- you'll have to go to the emergency room and let them take a look."

"The wait's too long."

"I don't have a great solution for you.  What is your medical problem, just so I know?"

"I'm not telling you that either."

"What was your reason for making an appointment?"

"That's none of your business."

"But I'm the doctor.  It's hard to help you if you won't tell me what's wrong."

"Forget it.  I'm leaving."

"Okay, well, if whatever it is gets worse, you should go to the emergency room and they can help you."

"Screw you."

"But I Really Want The Surgery"

"So, I took a look at your blood results, and unfortunately I'm going to need to talk to the surgeon who's planning to perform your procedure next week -- I don't know that it's going to make sense to have the surgery until we figure out why your numbers are so abnormal."

"But I really want the surgery."

"Of course, but it's a non-urgent procedure, and if it has to wait a week or two, just so we make sure it's safe, I think we should do that."

"It's already on my calendar."

"I would think it would be.  Since it's scheduled for next week.  But I don't want you to end up in a situation where the surgery doesn't go well or there's a complication that could have been avoided.  Your platelets are really low, and I'm not sure why."

"But I want the surgery."

"I know.  And I want you to have the surgery.  But I want you to have it safely."

"Why are you telling me I can't get the surgery?"

"I'm trying to explain.  Your lab values were abnormal.  I want to repeat the labs and see if maybe there was an error, or something wrong with the sample.  But if these are the numbers, I think the risks of the surgery outweigh the benefits right now, and I'll want to talk to the surgeon and get his thoughts."

"He knows I want the surgery."

"Sure. But sometimes we need to push things back to be safe."

"Why can't someone else have their surgery pushed back if there isn't room on the schedule?"

"This isn't about the schedule.  I'm trying to explain why you may not be a good candidate for surgery right now, given the blood work.  But let's not get ahead of ourselves.  I'll take some more blood and see what the results show."

"Do you really think you should be taking so much blood from me right before I'm having surgery?"

"Okay, I'm going to have another doctor come in and explain this better."

Poop

"You mentioned fecal incontinence.  Describe what you mean."

"Every time I urinate, I also poop.  Even when I don't feel like I have to go."

"Every time you urinate, you poop?"

"Yes."

"Is it formed, or like diarrhea?"

"What do you mean formed?"

"Is it an actual solid piece of poop, or is it liquid?"

"I think I'd say solid."

"Like, how much are we talking about?"

"Like a small hot dog.  A pig in a blanket, without the blanket."

"Okay...."

"Like the size of a baby corn, I guess."

"Got it."

"Like maybe three jelly beans long."

"Okay, you can stop comparing it to food now."

"It's like the squiggle of toothpaste I put on the toothbrush."

"No more comparisons-- we're good."

"Like a cashew nut."

"Stop."

"Please Fill Your Antibiotic!"

I had a crazy week.  In which I meant to blog but I forgot.  So here I am.  Second-year fellow.  Which feels no different from first-year fellow, except for a tiny salary bump.

A patient comes in with a rash on his chest.  A fairly scary looking rash on his chest.

"How long has it looked like this?"

"Oh, it's definitely worse today than yesterday."

"And yesterday was the first day?"

"No, it's been about a week."

"And you're only coming in to see a doctor now?"

"No, I saw a doctor yesterday."

"Who did you see?"

"I went to the emergency room."

"The emergency room here?"

"No, a different emergency room."

"Which one?"

"I don't remember.  They gave me a prescription for an antibiotic.  They said it should make it better."

"How many doses have you taken."

"None.  I didn't fill the prescription yet."

"Why not?"

"I wanted to see if it would get better."

"You went to the hospital yesterday."

"Yes."

"They gave you an antibiotic and told you to take it."

"Yes."

"You did not take it.  The rash got worse.  You decided to come here and see another doctor."

"Yes."

"Why?"

"Because it did not get better."

"Take the antibiotic!"

"But I want to see if it gets better."

"Take the antibiotic and it will get better!  What did you think I would say?"

"I don't know."

"Take the antibiotic!  Go to the pharmacy.  Fill the prescription.  Take the antibiotic.  Then we'll see if it gets better.  It should get better."

"Maybe I wait one more day?"

"Why?  Take the antibiotic.  Can you not afford to fill the prescription?"

"No, I can."

"So why don't you want to?"

"I don't know."

"Will you promise me you'll fill the prescription and take the antibiotic?"

"Yes."

"Okay.  Feel better.  Goodbye."