ndab Ah Yes, Medical School: ERrrrrrrrrrrr

Thursday, November 09, 2006


A Pirates Guide To The Emergency Room

Editor’s Note: Two posts in one day? He must be mad! Not really, but I got so depressed writing the first post of the day I had to cheer myself up, and since I’m all out of alcohol and I’ve seen Erotic Survivor 2 about 46 times already (thanks Patty!), I thought I’d put this together. I hope you don’t mind. But if you do, please send me some new porn so I have something else to watch. And I hope you appreciate the irony of me putting in an Editor’s Note here, as if to signify that there are two separate people working on this. I’m losing my mind.

Ahoy pirates, welcome to the grimiest ship in all the sea, the emergency room. OK I’m done (for now). Rather than change the slogan of every ER (or every medical school, for that matter) to “Abandon all hope, ye who enter here”, I thought it’d be fun to recap some of the things I’ve learned about the ER from the pirate perspective because…well…umm…pirates are fun. I feel like that needs no further justification. So please enjoy the guide that follows, and if not, it’s off to Davy Jones’ locker for ye, arrrrrrr! (See how much fun this is? There’s no way I’m not starting a patient interview tomorrow by saying “How arrrrrrrr’ ye doin’ mate?”)

Most of ye patients, they not be chum free. Aarrr.
I’m sure the rules of personal hygiene apply to most people in this world, rules such as “Clean oneself once every two to three weeks at the absolute minimum”, but it seems to me like people who go to the ER actually know they are going about 4 months beforehand and choose to stop showering, shaving, brushing teeth, or doing anything that might resemble cleanliness before entering, almost out of spite for having to wait so damn long before we see them. I mean, we get trauma patients (who, presumably, had no plans of coming to the ER before being hit by a car or something) come in who are homeless who smell a hell of a lot more fresh than other housed people with less urgent problems who have no excuse. So, please, unless you’re being brought in by an ambulance, throw on a little deodorant before coming in. Or at least try wiping the urine off your pants.

Avast, ye silly tricks be too strong for a lubber. Aye!
People do the strangest things. In the ER, that means taking us by surprise and showing us things we never thought the human body was capable of doing. Whether that be discovering that a Johnny Walker bottle can indeed fit up ones rectum or that it is possible for one to squeeze skin near ones thigh and express a milky white discharge through a hole created by a botched hip replacement surgery 12 years ago, these tricks are simply disgusting. Next time, just say you can do it and not actually feel the need to show us, we promise to believe you.

Scraping barnacles off me rudder be worse than dropping anchor in a storm.
You haven’t lived until you’ve scraped a live cockroach out of someone’s ear. I have nothing further to add here.

Shiver me timbers, swabbie be bleeding more than a scurvy dog!
It never ceases to amaze me how many people show up to the ER teetering on the edge of death, bleeding out of all sorts of orifices most people don’t even know exist (except for those of you into the really cutting edge art-house porn – that’s two porn references in one post, I’m on fire!), and not having any clue how sick they are. No, ma’am, you shouldn’t be bleeding like that, the blood is supposed to stay…inside of you. But thanks for asking, and I’m really glad you are enjoying your fifteen hour wait. Please enjoy our complementary reading material, a 1985 Time magazine.

Everthin’ be faster than a wench on me jiggers.
I never really appreciated how fast one needs to work until I started my rotation in an ER. Everything has to be done at breakneck speed, from interviewing the patient, doing procedures, and shipping him or her off to somewhere else, because there’s another 50 people in the waiting room, two gun shot wounds coming in from ambulance, and one of the patients just crapped her pants all over the floor. In other words, it’s total chaos. It’s great that some people thrive in this sort of working environment, but me, I don’t think I function all that well after 7 straight hours of chaos, which is probably a big reason why I plan on staying as far away from the ER as possible in my future (assuming I haven’t managed to extract myself from the hospital in the near future – c’mon, someone has to want to give me some money for this crap?!). It also should be noted that I like my poop to remain in the toilet. But hey, that’s just me.

Not even the scallywag can see the end of a bilge rat.
Highlighting what I find to be the most frustrating part about emergency medicine, this bit of pirate wisdom points out to a key characteristic of the ER: no patient continuity. This means that the vast majority of the time you evaluate the patient, initiate a work-up of the problem, and then transfer the patient to home, clinic, or the inpatient ward for further investigation, often never really knowing what happens to the patient. Now, for people in ER this serves as one of the perks of the field, but personally it drives me nuts. It’s like only being allowed to watch the first twenty minutes of every movie you watch. Sometimes, as in the case of just about every piece of crap movie that came out this summer, this strategy works in your favor, as by minute twenty you are about ready to kill yourself anyways. However, every once in a while The Godfather comes on, and it would be a crime, a travesty, an affront to Al Pacino’s glorious overacting to turn it off after only 20 minutes. And that’s why I cannot be an ER physician. Aye, ‘tis true.

That be the last, me hope ye liked ye trip. If not, it’s the plank for ye. Aarrrr!

Seriously this is too much fun. And can you believe I made it through an entire post about pirates and didn't make attempt to combine the word "pirate" with the word "butt"? Me neither.

(I would like to thank the folks at talklikeapirate.com for enhancing my linguistic abilities in all things pirate. FYI, Talk Like A Pirate Day is September 19th.)


Blogger Bob said...

I celebrated that day! It was so much fun...got some odd looks from people, but what the heck!

5:36 AM  
Anonymous Anonymous said...

2 post in one day!!! Hope you continue on this basis! Love your blog!


6:21 AM  
Blogger gabbiana said...

Tee-hee. "No, that blood is supposed to stay... inside of you." Comedy gold!

7:44 AM  
Anonymous Anonymous said...

Hilarious as usual. The pirate link is busted, though.

9:02 AM  
Blogger Sarah Bellham said...

Wow, great post! I have been a silent lurker of your blog and just wanted to let you know that I enjoy it.

10:51 AM  
Anonymous Anonymous said...

I'm down in ER a lot...that thing about the poop staying in the toilet...with you on that one. Ever notice how the entire place smells?

1:38 PM  
Blogger Sarah said...

hehe, ur so silly....

5:00 PM  
Blogger The Angry Medic said...

2 posts in a day, matey? ye know yer readers arrrrrrr lovin' it!

seriously, though. why the sudden extra efficiency? you must be blogging to skive your ER hours.

and ignore anonymous up there. the pirate link works fine.

5:33 PM  
Anonymous Anonymous said...


"Argggg, I just gave her an Angry Pirate"

10:47 PM  
Blogger Gregory House, PA-C said...

Hahaha. I too enjoy talking like a pirate from time to time.

And I completely agree with about the ER. I'm interning in one now and you're right on. IM is where it's at.

12:14 PM  
Blogger genderist said...

Be still my heart... Pirates make me weak in the knees.

12:31 PM  
Blogger Febrifuge said...

Arrr, sorry our little tea party is rufflin' your petticoats, Sally. Never fear, you'll be back on dry land soon enough, and back in your mommy's lap.

Seriously, though. Good for you for recognizing the two most important things about the ER: one, it's totally messed up and needs attention from thoughtful people, and two, it's not for everybody in medicine. Both these posts are tremendous.

I work in a county ED, and yeah. It's totally like that.

10:52 PM  
Blogger B said...

Yeah... I got out of ER as fast as possible... Mostly because of not being able to watch all the good movies. It's poetry diagnosing Gilbert's in someone who has taken ecstasy.

6:48 AM  
Blogger L.Bo Marie said...

other than waiting for you to add to your site...
eats my time :)

8:10 AM  
Blogger Couz said...

Clearly, your attention span isn't NEARLY short enough to thrive in the ER. Get back to internal medicine, matey!

9:59 AM  
Blogger dog food sugar said...

OMG. 2 posts in one day. You tease us!


1:56 PM  
Anonymous Anonymous said...

I would never have thought about the ER that way. It would suck to witness many interesting problems but not being able to see the after math. And the speed you operate at is incredable. talking like a pirate huh? I like your usage of time.

1:25 PM  
Anonymous Anonymous said...

I can't believe you didn't include a "shiver me timbers" reference!

10:34 AM  
Blogger Elisheva Roshani said...

You make me laugh so much. :)

I had a short stint as a pre-med intern at a cardiology pratice several years ago. It was ... interesting. That solidified my intent to not go into medicine.

I can relate to the madness. Please don't stop blogging.

Elisheva אֱלִישֶׁבַע

2:16 PM  
Anonymous Anonymous said...

EM is where it's at, man. That's where I'm going. The real reason I'm commenting is because I found your blog the other day and I read the entire thing from beginning to end. Great stuff. You swear a lot, or at least used to, but sometimes things just aren't as funny without a swearword. Keep up the good writing. And post more often. Ya got a knack for things of the literary persuasion.

1:47 PM  
Anonymous Anonymous said...

I love your site. I am myself a medical student (in Germany though) but it seems to be the same all over the world.


6:26 AM  
Blogger Forsoothsayer said...

good blog...and i thought law school was bloggable :)

4:33 AM  
Anonymous Anonymous said...

Dang it, update!!!!

4:10 PM  
Anonymous Anonymous said...

Please put up a new post :(. I spend days on end ferociously clicking refresh every five minutes to see if you have updated. Seriously. Yes, 'tis true, I have no life, and I would rather reading your blog than slaving over my Last's trying to learn the lower limb as fun-tastic as that may be. Pretty pretty please with a cherry on the top? Please quench my thirst for your musings. Pleaasssseeeeeeeeeee....

6:10 AM  
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Blogger Bob said...

Not to feel left out or anything...

best site

5:09 AM  
Anonymous Anonymous said...

best site, arrrrgh!

3:46 PM  
Anonymous Anonymous said...

Unrelated to this post, but... Do we have "Ah Yes, Residency" to look forward to?

7:28 AM  
Anonymous Anonymous said...

hi fake doctor - just wanted to say hi..today's registration day at mba school - every time i get stressed about mba school i just read your blog and feel better - it gives me a perspective of things about whats really important (what you do) and whats not really important (what i do)- been watching scrubs lately its really funny - i hope you're sweet like the resident doctor dorian.. you guys sound similar.. and the blue of your page matches his blue scrubs too - anyway enough blabber - hope we have "ah yes residency" to look fwd to and you should sell your stuff to scrubs the tv show.. bye bye =) snoopy girl

12:38 PM  
Anonymous Anonymous said...

from snoopy girl - http://www.nytimes.com/2006/11/27/business/27richer.html?em&ex=1164862800&en=ba051e42a2c7b930&ei=5087%0A

maybe you can get an mba after you graduate =) Insead near Paris, France can give you one in 10 months, and you'd be a cinch to get in =) this article makes me wish i were a doctor - except for the touching people part - no touching! - joking =)

12:47 PM  
Anonymous Anonymous said...

nothing todo in the office today - so felt like just talking randomly to myself online..hey so can you clarify some scrubs myths:
1) are changing rooms coed?
2) do people steal supplies from the hospital like in scrubs? such as 45 packs of pudding/fruit cups, toilet paper?
3) do people go "moonlighting" aka take another person's shift for $300 a pop like in Scrubs?
4) do y'all do sarcastic banter/play video games in your spare time like in Scrubs?

more Scrub questions later

1:48 PM  
Anonymous Anonymous said...

who would you describe your audience as? I"m doing an English project and I consider your blog to be "well written" but I don't quite know who you are directing your posts to.

11:49 PM  
Blogger dog food sugar said...

ey eye matie! Update yar blag or its the plank for ya! ARRR.

I'm mean come on! Hasn't someone thrown up on your shoes or put something weird in an orifice or something that you can wax poetically on?

Give it up fake doctor!!!

9:10 PM  
Anonymous Anonymous said...

I agree. How about a blood promise or something that you'll continue the rant with and Ah Yes, Residency and possibly its sequel: Ah Yes, U.S. Presidency.

1:47 PM  
Anonymous Anonymous said...

post again!!! i need something to get me through finals week!

8:46 PM  
Anonymous Anonymous said...

hey i noticed you haven't posted about jewish girls lately - does that mean you found a gf?

11:05 AM  
Blogger Prof Scrub said...

Have you eve made a patient walk the plank?

One of my seniors through a patient out of the ED by the collars! I havent seen that senior since!


12:09 PM  
Blogger A. said...

yoo hoo...fake doctor...it's been nearly a month...please let us know you are still alive and funny. miss you.

7:18 PM  
Anonymous Anonymous said...

where are you fake doctor?

get real and post :)

6:24 PM  
Anonymous Anonymous said...

You still alive?

8:37 PM  
Anonymous Anonymous said...

Read this while you wait!

8:38 PM  
Anonymous Anonymous said...

Speaking of shande, the quote should read, "Abandon hope, all ye who enter here," NOT "Abandon all hope, ye who enter here."

tsk tsk tsk.

Other than that, great blog!

3:19 PM  
Anonymous Anonymous said...

Thanks a lot, my son is going to spend the rest of the day talking like a pirate now :)

1:24 PM  
Blogger Fabulous Divorcee said...

I'm in the medical field and I agree with your assessment of the typical emergency room.

Oh yes, and I am a single Jewish chick.

1:55 PM  
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8:37 AM  
Anonymous Buy Tamiflu said...

I don't know if you have managed to rise your mood writing this post but I had a lot of fun))). I have never thought that doctors in ERs face such problems.

1:38 AM  
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Blogger justagirl24 said...

I love your blog. This totally made my day. Thanks and keep it up! God knows med students need laughs! =)

4:01 PM  

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