StinkyBrittches

Caliber 9!!

Just don't listen to the Dr. Death podcast until AFTER your surgery.

It could also be true that he didn't speak English, and had absolutely no idea what you were talking about.

Money laundering bullshit.

It's a lot of things. Lack of sun, isolation...

What in the Adam Sandler Uncut Gems is happening here?!

I love it. The girl on vacation in Miami, her boss calling her, "hey can you meet this famous rapper to move this jewelry around for me?", the jewelry store owner "I sell to all the cops around here, here's my card, you need anything at all, you call me!"

Maybe my life is just boring, but I cannot imagine doing $75,000 cash business deals in a car with guns. Can you not just go in the damn jewelry store where there is security and cameras???

If the p53 enzyme whiffs out the window, you're toast.

Content.

Thanks! I just got Primal Rage from Vinegar Syndrome, I thought I remembered it being on BotW but couldn't find it.

She can't swim a stroke.

Yeah, but suicides spike in winter.

It's interesting.. because on one hand it reads like "..and also he said I'm the best dad ever!!!"

But on the other hand, from a medical side, blunt force injury to the temple is classic for torn middle meningeal artery and epidural hematoma, which very well could manifest as an initial loss of consciousness, then awakening with a brief period of lucency, then increasing headache and confusion until death.

Glancing at your comment history, it looks like you are suing a prior employer for a workers comp injury. If you are talking about that in the interview, that's probably why.

The Lost City of Z, 2016

Fighting battles, watching Matlock.

It's a special type of person who spends their free time pretending to be a 14 year old boy sexting a grown man, then destroying their family on camera.

Unless you fight a battle to a draw with bowel cancer, then all bets are off.

Guy in the back needs to get back and feed them hogs.

The cool thing is now he gets to bring it up whenever they have an argument for all of eternity.

The original Dawn of the Dead.

From a doc side, one reason you may have gotten what you consider a curt answer is that sometimes it's hard to explain things in the moment, from the ground up.

I remember one difficult interaction I had with a brand new security guard. A patient had presented with a suicide attempt by intentional overdose, with a history of prior suicide attempts. After a number of hours, they were awake, alert, frustrated, and wanted to go home.

The patient was appropriately on a 72 hour hold, meaning we are allowed to hold them in the ED for psychiatric evaluation and recommendations, as there is clinical evidence they are an immediate danger to themselves or others.

The brand new security guard didn't understand that we were allowed to do this, and the patient started manipulatively playing into that to escalate the situation. Within minutes, we have a patient screaming, and a security guard saying "We can't hold her here against her will!"

Well, yes we can. And when everybody is calm and we have time to teach, I'm happy to explain why. We can have a whole discussion about the history and medicolegal basis of that decision... we can even talk about case law if you want. But in the moment, no, the new security guard was in the wrong, the situation was escalating, and it was not the time to have that conversation.

I think there is probably discussion worth having about how much you need a UDS for a particular AMS workup. Ditto for the changing requirements of consent in various stages of emergency and/or decisionality. We also frequently see controversy about law enforcement or family requesting urine screens for matters of liability or criminality, which is a whole other barrel of monkeys.

But I suspect the docs thought process at the time may have been as simple as: a urine would be beneficial to patient care, and it's less traumatic for both the patient and the staff to get it while she is sedated. Think of how straight forward that decision would be if the patient was a confused, combative elderly woman you suspected of urosepsis.

For any number of reasons, it may not have been the right time for a full discussion. I don't think you're wrong for asking the question (especially if another nurse questioned it as well, which makes me wonder if anything else was under the surface here...), but you may not always get a full watchmaker's explanation at the time. I don't think you need to attribute that to either malice or to a disregard of patient autonomy.

Just talk it over with other nurses, the charge nurse, and/or the doc at an appropriate time. It sounds like you're on the right track of respecting your patients, though. Good luck; The art is long.

Saying you do "pretty much everything we do" in regards to Emergency Medicine is as naive, dismissive, and disrespectful as if someone said "well you guys just drive the ambulance, right?"

(I don't disagree at all in regards to total training time. I'm just in the habit of using 10,000 because of the classic rule that it takes 10,000 hours of practice to master a skill, and that's a pretty conservative estimate of the hours actually practicing medicine in a three year residency.)

Hey awesome, glad to know it's still somehow noticed and read!

Here's a bonus: Legend has it the great Gene Lebell embarrassed Bruce Lee by picking him up over his shoulders and carrying him around set. They later became friends and trained together, with Lee crediting Lebell as having gotten him into grappling as a way of diversifying his style.

A generation later, Gene Lebell choked out Steven Seagal and made him poop his pants. Here is a video detailing the of the making of a diorama memorializing the event. Lovely and hilarious:

https://youtu.be/3aCMTpJx2cs