| Features,Label | |
| "I was my hospital's go-to guy for cognitive assessment of possibly impaired docs and employees. I've heard several similar stories, but in each case other people--usually nurses-- intervened BEFORE the serious mistake was made. Granted, I've only had one job for the past 30 years, but it's been decades since I've been in or heard of an OR where hierarchy prevented anyone present from speaking up when they saw something amiss. There is something seriously wrong in the culture of that hospital.",yes | |
| "Has your gestalt been rigorously tested for validity and reliability? I feel like I want to hire some patient actors to check you out, because if medicine can replicate your gestalt nobody will ever have to wonder who is really in pain.",no | |
| "For something this unbelievably extreme, I am having so much trouble wrapping my head around the *why...* since it is so far beyond just incompetence... clearly I am intellectualizing as a coping technique since in the first post about this I figured there had to be more to the story that explained why certain anatomical anomalies could be present to make it more in the range of incompetent but not full on crazy. Outside of substance abuse, which makes sense, what else? Acute psychosis (maybe a manic episode with psychosis to explain the grandiosity of insisting the liver was a spleen to pathology), with but early enough in the psychosis to not appear frankly psychotic? Some other acute psychosis? Something neuropsychiatric like maybe early Huntington's or Lewy Body? I don't work in neuropsych, but the craziness of it reminded me of the case of Dr. Benjamin Gilmer (great This American Life podcast episode [Dr. Gilmer and Mr. Hyde](https://www.thisamericanlife.org/492/dr-gilmer-and-mr-hyde). | |
| The big clue here is that staff agreed to work with him that day so even if he was kinda sketchy at baseline, it couldn't have been anything close to this, AND it sounds like they were somewhat paralyzed in the moment by the complete shock and unbelievability of what was happening- so yeah, I all I can come up with is a lot of meth or some other drug(s), acute early psychosis, or an undiagnosed neuropsychiatric condition. I guess the horse in this scenario is probably a lot of meth/drugs. Just... wow.",yes | |
| "Great question! As it turns out, people tend to respond very well to a slightly science-y explanation of IBS. In lay terms, I talk about the concept of visceral hypersensitivity, and the interactions between the enteric nervous system and other parts of the autonomic nervous system. So for instance, I will describe nerves as having a volume knob that can make sensations louder or quieter in different people or different situations, and talk about changes in pain sensitivity or motility as being no different from other physical manifestations of stress (like heart rate, blood pressure, sweating, etc.). I include the point that physiologically, excitement (positive emotion) and stress (negative emotion) are virtually identical to each other, which is why their kid has terrible symptoms at birthday parties, sleepovers, etc. I talk about the microbiome and how that can impact their tolerance for certain foods (FODMAPs). | |
| So, IBS patients can be challenging to deal with in a lot of ways, but they really appreciate when you take them seriously and help them understand why they feel terrible so much of the time.",no | |
| yes I agree with stabilizing patient first if possible. I was disagreeing with your comment about always giving sedation for each intubation and hoping for the best,no | |
| "If it's 7:30 and you have 3 patients you still need to get report on, and you are having a whole tea spill sesh with the secretaries,don't throw a fit when you are called out on it by the very tired off going nurse. | |
| Thank you for coming to my TED talk. | |
| ",yes | |
| I'm a student midwife and I have been at hospitals where I could count on this and then I've been at hospitals where the horror stories are true. I'm glad that you take your patients' pain seriously.,yes | |
| "Ok, fair enough. Report to the OR for surgery. What's wrong? Oh, you can't. OK, fine, then I want you to independently read this radiological image and write it up appropriately. What do you mean you can't? Leave at 3? But there are still patients....",yes | |
| "Tangible data. Monthly revenue, billing vs total. Yearly same thing. You can track procedures. Number of patients. Make sure you have access to all of these.",no | |
| "I'm not sure. I haven't witnessed any as a nurse. Before I became a nurse, I was patient. And then, as a nurse, I had an adenomyosis. My doctor was not aware that I was a nurse. | |
| My experience with a female doctor was a nightmaremonths and months of being tormented with pain around my menstrual cycle. I wasn't sure why she was this way. She was my OBGYN who didn't want to prescribe me contraception but would instead order narcotic medication I didn't like. I explained to her I could not have this medication based on my experience with its side effects. I don't like being drowsy and would get stomach pain. I'm not too fond of the feeling of it. Anyway, she sent me for a vaginal ultrasound to find the source of my pelvic pain. It was normal. She stopped here. I asked for the pill. She declined to renew it after 12-month of supply. I felt a lot better with this, so I stuck with it. | |
| I found a male OBGYN. He diagnosed me with adenomyosis. It was a tiny part of my uterus that got affected. It hurt like hell. The doctor told me that if contraception didn't work, surgery would be the last choice if I wanted to get rid of the pain. My life has been great since I started taking pills regularly. I don't miss darn periods and certainly do not forget my pill. The pain was unbearable.",yes | |