ndab Ah Yes, Medical School: Darwin, Reincarnated

Sunday, February 05, 2006

Darwin, Reincarnated

Out of the bubbling protoplasm that first yielded that vast, horrific taxonomic family (c'mon everyone...remember King Philip Came Over For Good Sex? Finally something I learned in high school that doesn't involve cursing in Farsi is paying off.) known as as Studentis Medicalannoythefuckus has arisen a new family, with a new set of genuses and specieseses under its proverbial tree. Yes, it has only taken me 6 months of intensive patient care to have already completed a preliminary survey of the vast array of species in the Patientannoythefuckus, and I can say without any hesitancy, fear, or regret that this family of creatures is undoubtedly more frightful, more terrifying, and more odiferous than anything previously known to my eyes, ears, nose, or probing finger. With that warning in mind, and with the caveat that I’m writing this the morning after downing 14 sake bombs meaning I cannot take any responsibility for incoherencies in this post, I invite you to take a tour through this symbolic zoo of creatures, and perhaps recognize some of your family members, friends, distant lovers, or even yourself in one of these species…

Fetor Assmaticus - Perhaps you have heard of Fetor Hepaticus, that distinct aroma emanated by the most chronic of liver failure patients. It tingles the senses, it frightens the mind, it challenges ones utmost abilities to suppress the frozen burrito you had for dinner last night. Now imagine taking a patient with that smell as a baseline, and then dumping a steaming pile of dog shit laced with yesterday's garbage, the urine you made after chowing down on all that asparagus, and a couple of rotting corpses, and you'll come close to experiencing the smell emanating from this species of patient. Overpopulating hospitals across the country and around the world, this species is known for the lowest standards in personal hygiene and the highest standards in personal lack of self-respect.

Entitlus Maximus - That noise you hear about every five to ten minutes is likely a loud shriek of complaint bursting out of the large mouths of these patients, who make up for their nonspecific and relatively benign conditions with enough whining about their care to make even the most generous of doctors and nurses want to slit their throats. This species is known for complaining about some of the more fundamental things in life, such as why the nurse won’t check on them every fifteen minutes or why the doctors actually change their management plan when they get new information about the disease. While this species has a predilection for being among the wealthier patients, they are also sometimes found in the essentially free county hospital system. Which of course makes this lowly medical student confused, because he is not only, as a student, paying a substantial amount of tuition money to pretend to be this asshole patient’s doctor, as a taxpayer, he is also paying a substantial amount of money to…be…umm…this asshole patient’s doctor. Excuse me while I throw up.

Buyus Aclueii – Beware this species, as its survival in spite of sheer idiocy of a magnitude not seen since, umm, I downed 14 sake bombs last night suggests a deep-rooted underlying cunning necessary for existence. Huh? Anyways, this species is known for showing up in clinic, any clinic, and then not having the slightest clue why they are there. ‘Sir, this is colorectal clinic, what brings you here today? Oh, that piece of paper told you to come? What about the massive hemorrhoid protruding from your anus?’ ‘Ma’am, what medications are you on? All of those? You realize that half of those bottles are of same drug, right? And you take one pill from each bottle?’ The truly fascinating aspect of this species is how its members are so resilient that their complete ignorance regarding their own health does not stop them from showing up to all sorts of appointments still clinging to life.

Denilus Aintjustariver – Unlike B. Aclueii, this species of patient is very aware of his or her disease state, cognizant of it’s potential complications, and appreciative of any care he or she would receive…should this patient ever get over the denial of having the disease in the first place and actually make it to the hospital. For that is the only explanation this taxonomist can come up with to describe this species of patient, after witnessing members of this species arrive at the hospital with a ten pound tumor in the testicle or a frightening full-body rash that has been there for, oh, say six months. Which makes one wonder, was it when the tumor got to ten pounds that triggered off the alarm in your head that it might be a good idea to check it out? 9 pounds not quite big enough for you? Was it when that rash successfully covered your entire body that you decided you were sick, and not the day before when that one speckle of your big toe was rash free?

Denilus Aintjustariverbutdontgiveafuckus – This is actually a subspecies of Denilus Aintjustariver, a group noted for not only being in denial about having a serious medical condition and avoiding the doctor at all cost, but then doing the complete opposite of what the doctor recommends to cure the disease. A noted example is the heart failure patient who shows up to the ER with a barely functioning heart (all secondary to heavy alcohol and tobacco abuse – no, one night of sake bombing does not heart failure make…I think), gets resuscitated, and is then found smoking and drinking in the hospital lobby still wearing his hospital gown and still under out care. I mean seriously, people, when you see shit like that it’s hard not to just throw in the towel and become the Las Vegas stripper I…umm, I mean you…were meant to be. Perhaps I’ve said too much.

Sickus Maximus – This species is sick. Very sick. So sick that their survival pretty much consists of being sick, going to the hospital, and dying. This is tragic enough, but it is compounded by the fact that these tend to be the nicest, most decent, most heartfelt people you’ll ever meet, which makes the situation all the more heart-breaking. I have no idea why this happens, but for whatever reason these sickest patients are also the least deserving of their fate, if one could in actuality deserve a disese. I guess this part isn’t very funny, but it plays out pretty consistently in the hospital so I thought I’d put it in here.

Clearly, there are many more species to be described, patients to explore, and so on, but I thought I’d leave it at this for now, if nothing else than I can’t write anymore because I have this massive headache that won’t go away. Christ, 14 sake bombs? Terrible idea.


Anonymous Anonymous said...

I bet one day patients will have those categorizations put on their charts.

I love your blog. You should post more often.

9:52 PM  
Anonymous Anonymous said...

excuse me if this comment puts me in the category of dumbus maximus, but in my excuse i just started reading this blog and am not sure if you have mentioned which school you go to...but we used to live near a particular school where many students did sake bombs at a particular restaurant...i think their mascot is a tree and they are called stanford or something...anyway, we did many sake bombs at said restaurant...cheers

10:43 PM  
Blogger Kate Mc said...

14? Nicely done. I'd still be in bed (yup. lightweight. Right here).

1:04 AM  
Anonymous Anonymous said...

Another sweet post, Fake Doctor.

Are you aware Natalie Portman is hosting SNL soon? Thought you'd want to know.

4:06 AM  
Blogger Christopher Robin said...

I realy wonder at times how the human population has been able to survie. Your new classifications remind me that I still have no clue how it we've managed this long.

Great post, particularly concidering your prior activities.

6:20 AM  
Anonymous Anonymous said...

"Sickus Maximus"

oh so true... as an RN on an oncology floor I see this species every day. These are the people that make doing what we do worth while. To say I wish all my patients were like this would mean I wish all my patients were dying... how horrible of me. That's certainly not what I want. But I do wish those who think they're really suffering with their gout and low back pain could come on into my 26 year old patient's room who is dying of metastatic melanoma and see what life is really all about.

7:25 AM  
Blogger Kim said...

Thanks fake doc. I'm trying to psyche myself up for my shift tonight. (it ain't going well)

The two patients that always stick out in my memory were definate members of your categories.

Miss Ingrown Toenail (Entitlus Maximus) and her neighbor Miss Cancer Ridden Due to Die within months probably weeks (Sickus Maximus). That night is so far the only night I have TRULY lost my temper with a patient.

Miss Cancer Ridden was one of the gentlest, sweetest and inspiring patients I have ever had. I would have to ASK HER if she needed anything. It was well known among the staff that she wouldn't ask for ANYTHING because she didn't want to be a bother.
On the other hand, Miss Toenail screamed at me (after repeated visits) and threatened to call the supervisor and the nursing board. She accused me of stealing her pain meds instead of giving them to her. She was prescribe OTC Tylenol BTW. Called me a bitch and a slut. Said she paid my salary etc. That she was paying for my services and the customer was "always right". (When did the hospital turn into Burger King?) I calmly told her to feel free to call whomever she pleased, and gave her the sups number AND the nursing board's. And to make sure she had my name correct when she called. I also told her that she was the most onus individual I had ever had the displeasure to meet and god help her if she ever got really sick. (not the nicest was to handle the situation, I know)

THANKFULLY, patients like her haven't been the norm. If they were, I'd be looking for work elsewhere.

10:16 AM  
Anonymous Anonymous said...

Your "sickus maximus" patient reminds me of the "Law of Inverse Value" a poster has come up with on the Emergency Medicine board of the Student Doctor Network forums.

The Law of Inverse Value: the less you contribute to society, the greater the trauma you can sustain with minimal to no physical sequelae, including falls from 3 stories, stabbings (chest, neck, head, slashings to the face), gunshot wounds (chest, neck, pelvis, leg, traumatic arrest), and high speed MVC's, unrestrained, where multiple people in the other vehicle are killed.

Likewise, if you are a generally good person - gainfully employed, a parent, wears a seatbelt - the more you do for society, the less or more minor the trauma that will incapacitate or kill you.

[credit to Apollyon at SDN]

2:21 PM  
Blogger lee said...

stripper,eh?But then everyone would see that rash all over your body... ;).

4:33 PM  
Blogger hotpink said...

I've been reading this blog for six months. You're alternately brilliant and hilarious.
Just thought I'd let you know.

11:23 PM  
Blogger Couz said...

I dunno... I mean, I've seen examples of every patient you've described, but making fun of it still makes me feel a wee bit uncomfortable.

I guess I'm just not jaded enough yet.

7:48 AM  
Blogger HanktheDog said...

The blackest of humor. There's something about a hangover that does this to one.

8:00 AM  
Blogger Dave said...

I always learned Kings Play Chess On Fine Grained Sand, but i think I would have remembered your mnemonic better.

9:29 AM  
Blogger An Enlightened Fellow said...

I always just said "Kingdom Phylum Class Order Family Genus Species" but then I've never been one for mnemonic devices.

5:51 PM  
Anonymous Anonymous said...

Oh memories of Miyakis -- Too bad Baja Fresh doesn't have sake bombs...
The slow little green animal with a hard shell luvs you :)

6:37 PM  
Blogger Twanna A. Hines | FUNKYBROWNCHICK.com said...

I tried to figure out which the categories fits me, but I couldn't figure it out. I can be pretty bad at remembering to go in for my annual physical on time. I usually only make it in every 16 - 18 months. Other than that, I'm pretty good about going to the doctor when I need to and I'm not obnoxious when I go there.

4:23 AM  
Blogger James Lindsay said...

Always a pleasure, Doc!

Methinks I'll be thieving your idea and begin the taxonomic identification and classification of High School Students on my blog. Thanks loads!

10:30 AM  
Blogger Gabbie said...

The Sickus Maximus ARE the most heart breaking. I usually went with my mom to get her chemo, and we had to go thru the pediatric oncology... oh my heart went out to those little guys and gals!!

12:36 PM  
Anonymous Anonymous said...

FOURTEEN sake bombs? sweet crying baby jesus... physician heal thyself! because if I did so much as four you'd be meeting me in the ER. . . . and not because I'd been stalking you. For a change.

1:24 PM  
Blogger HHD said...

It is the Sickest Maximus that I deal with most frequently. These patients break my heart because we end up becoming family, and I lose them a good six months later. The work is rewarding but leaves me wondering if I am strong enough to keep up this profession.

2:25 PM  
Blogger Margie the Pickle Princess said...

Man alive. You are completely coherent and funny, even after 14 Sake bombs. I've never done one, but I think you deserve some kudos for that. Good job!

9:07 AM  
Blogger Margie the Pickle Princess said...

Oh P.S.-I guess I qualify as Denilus Aintjustariver, because I put off going to the doctor due to lack of money and insurance. My doctor will say, after viewing my horrifying sinus infection that's now turned into bronchitus, "Why didn't you come in sooner?" And I say, "Because I didn't have $75 for the visit plus up to hundreds of dollars for perscriptions, and I didn't want to waste money if it was just allergies." Plus, I think I may be devoloping diabetes, but I'm not getting tested because I don't want it to be a pre-exsisting condition when I do get insurance. So I guess I'm practical, but annoying. :)

9:13 AM  
Blogger Zosja said...

made myself a toast and sat down to peacefuly read your post. BIG mistake. went as far as the liver desease smell description...

you really should not ONLY eat frozen burritos

8:03 PM  
Anonymous Anonymous said...

i've done saki, but never a bomb.....it's funny because you TOTALLY speak of all of my ER patients. I'm a travel nurse and I see the same shit ALL across the country. Thanks for keeping it real!!!

10:53 PM  
Blogger elizabby said...

Oh yeah, that's right. When doing paediatric oncology it was the same cases all over. The obnoxious ones always got better the quickest, the lovely ones who were mature and considerate died. We had a 13 year old girl who loved oysters and red wine and talked to all the newly diagnosed kids about getting their ports put in - she died and I got out of oncology (still doing paediatrics though and that is the correct spelling, BTW).

10:50 PM  
Blogger Holy Mother Eph said...

I never have understood the social custom of congratulating people for being able to numb themselves into oblivion. So I just have to say, 14 sake bombs...please don't do that to yourself, doc. (Or maybe you are going for a certain patient classification for yourself.) I hope I don't get attacked for this. I'm just saying, LOVE YOUR LIVER.

9:59 AM  
Blogger nurse pica said...

heh how funny, i wrote a similar post some time ago:


its interesting to compare a student doc and a student nurse's perceptions of patients

3:01 PM  
Anonymous Anonymous said...

we still need to get together and drink. ahh, maybe after all my midterms are over and you stop being busy. oh, right, that never happens.

1:08 AM  
Blogger GB, RN said...

I deal with each and every one of these kinds of patients. You're descriptions are dead accurate. It's good to know that it's just not a Midwestern thing.

Great post!

3:20 PM  
Anonymous Anonymous said...

perfect the sake bomb: put the sake shot on chopsticks over the glass instead of dropping it in by hand...perform a ritual dance around the glass...and bang your hands on the table to drop the shot into the beer. then chug, chug, chug! something about making it an event makes it more fun!!!!

7:58 PM  
Anonymous Anonymous said...

oh golly 14 sake bombs? you should just ask if any of your loyal readers in your area wanna get together for drinks :) maybe a cute jewish girl will show up :) i wouldn't know though i'm in the ny area :)

-snoopy girl

7:26 AM  
Blogger CGI-angel said...

Get OFF your lazy @r$e and post something new already!!.....pshHH~

12:10 PM  
Blogger DCTwistedLife said...

Ever Heard of< C-Diff? http://en.wikipedia.org/wiki/Clostridium_difficile My sister is an RN, she used to work on Cardiac Stepdown and the Adult ICU at Georgetown University Hospital. She said the worst thing ever period end of story, was C-Diff. And she's had a lot of bad stories...and she also worked with tons of Liver patients...so I imagine she must have smelled both in all her years in the ICU. So is it C-Diff or Fetor Hepaticus that wins for nastiest shi* ever??

10:48 PM  
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i've been reading your blog lately - great work! makes me wish i were a cute jewish girl ;) anyway i just wanted to say i learned it as Kinky People Come Over For Group Sex. thought you might like that ;)

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