Friday, December 10, 2010


The trauma service amd its 100 hour weeks is even worse in the winter. You miss all the short day light hours and find yourself inside all day, in only the faded glow of the flourescent lights. depression descends quickly under these conditions, amongst the death and mayhem.

Friday, November 26, 2010

Interesting Shift

The most interesting shift Ive had in a while had its ups and downs. I had a homicidal maniac who the cops had to taze after he threatened to kill me and the cop and was screaming, shaking and flipped the bed over. It was also a night of nasty pelvics. Started with 210 kg pregnant lady with vag bleeding, then there was a girl who hid a pouch of tobacco in her vagina when going into jail and lost it for two weeks and I had to go digging. it was the second time she had done the same thing in a month. didnt she learn? The whole room stunk before she ever took her clothes off and pus was flowwing out. first case of fitz hugh curtis ive seen. whats worse this thanksgiving day was like a hospital frequent flyer all stars day. all of our frequent flying psych pts were in, some multiple times. I think they were lonely on the holidays and we are reallly like their family. the higghlight of the shift was the save i made in the nursery, the one day old who was dropped on her head and had an epidural. the pediatrician was sitting on his hands, wanting an mri, etc. what the kid needed was a peds neurosurgeon and i pushed until we got it...saved maybe my first life that shift

Wednesday, November 24, 2010

Friday, September 3, 2010

Saturday, May 1, 2010

A case in point

on the local news yesterday, an apartment used as a meth cooking house (in some brand new low income apartments which look very nice), in a nearby town caught fire. One man was burned on 60% of his body and another injured as well. luckily, the people's two kids were at a grandparent's. the two neighboring apartments suffered smoke damage and are considered contaminated and have to be totaly evacuated and cleaned. The newscaster said that police say there has been a dramatic resurgence of meth with the recent crack down on prescription drugs.

Tuesday, April 27, 2010

The Prescription Drug Problem

I have thought a lot about the prescription narcotic problem. I have experienced it every day I have worked in the er, and I have seen friends and family members consumed by it. I have hated it. every day I see the crimes and blights on society produced by it, my car was even stolen from my driveway. I am ashamed that educated "professionals" contribute to the drug problem. However, recently, I have been thinking a little different lately. There has always been a drug problem, throughout history, and will always be. The only thing that changes is the drug abused most commonly. Right now, in my region, and in most of America, the drug of choice is prescription opiates. Is this the worst drug that we could have as our drug of choice for users? Maybe not. Unlike cocaine, heroin, or the like, these drugs are not furnished by large cartels in other countries. Organized crime has less opportunity to become involved. The manufacturers of these drugs are legitamate companies that provide jobs for legitamate american workers, unlike the slaves in the fields of south america. Even the people who make money from dealing these drugs are middle and upper class Americans who likely pump this money back into the US economy. Maybe this system is not the worst possible way our drug abusers could get their drugs. At least this way provides more income to our country and even to some innocent people (such as those drug factory workers). This is probably the wrong way to think, and I am going to continue to fight against this thing every day in the ED, but at least it is a small way to look on the bright side of the problem. On a related note, do you know that the street price for oxycontin is a dollar a milligram? So the average monthly prescription of say, 90 pills, 80 milligram oxys, the street value is 7200 dollars! Wow! Think of the people who just drive around all day, obtaining prescriptions for these things! More on this next time.

Thursday, April 8, 2010

The wild wild south?

The town is in an uproar and the hospital has been on lockdown two nights this week. Killings and reprimands have shaken the city. It started with a guy who was stabbed, but survived, then somebody stabbed the first stabber and he came in as a full trauma code, with thoracotamy. the families spilled into the waiting room and fights broke out there and in the parking lot. this went on for an hour before we were able to get the police to even respond to our calls. The guy who was accused of killing this guy then had his house burned down the next day, then, three days later another man was shot in the stomach and killed in his yard. Online community message boards are filled with posts, supposedly from atlanta and houston gang members who threaten coming to town and carrying out revenge killings.

Wednesday, March 24, 2010


A pessary is a small device worn, often by elderly women who have had multiple children, to hold bladder or uterus in place. It is a small plastic disc placed in the vagina. As you can imagine these things can get very nasty. All it takes is a demented nursing home pt. to forget that she has one of these for a couple months and.....zang! But nothing could prepare you for a chief complaint of "leaves from virginia". A friend of mine saw a lady, brought in by her daughter, with just this complaint. When he looked it was true. She had a vine, with leaves, protruding from her "Virginia". Turns out, the demented lady had secretly , for years, used slices of potatoes as pessaries! When she forgot that she had it in, the warm, moist environment was perfect for sprouting spuds!

Friday, March 19, 2010

Tuesday, March 16, 2010

New Format

Hi. Been a long time, I know. Anyway, the new format I was talking about is going to be too close this blog to public reading. I suspect people from my hospital spy on the blog, and I don't feel that I can write about what I want. So, for you people who are already followers, if you want to post or send me in some way your email address so I can add you after I go private, I would like that. If you don't follow already, sorry. I can't accept new email addresses now, because I won't be sure who it is. In short, I am going to turn this into a private space for me to write what I want, with no desire to publish publicly, but those of you few who have been loyal readers are welcome to come along. Let me know.

Monday, February 15, 2010

34 year old grandma

sewed up the arm of a 33 year old grandma tonight! How old was her grandchild? Well she has 6, but the oldest is 7!! How? That means she was a grandma at 26! if she was 13 when she had a child, who then had a child at 13, that is the only way this is possible (roughly).

Friday, February 12, 2010

New Post

It has been a while since I have made a new post, but working a lot in the ICU again. Also, I am thinking of going to a new concept on the blog in general. I will fill you many loyal readers in on this in the future. The world awaits with baited breath. As part of this new concept, I would ask all the people who casually follow the blog (if there are any) to add themselves to my official reader list, or whatever it is called. Being a follower will facilitate moving to the new style of blogging. You will understand when I unveil the new plan. Thanks for staying posted!

Tuesday, February 2, 2010

White Wedding

At a nearby doctor's office, where an internal med friend of mine was doing his "rural med" rotation, a wedding occured recently. The receptionist was married on her lunch break, with the doctors and office staff presiding. A minister showed up and everything. The cake was a dairy queen ice cream cake. Two Avatar action figures were placed on top, with their faces lit up. It was beautiful! After lunch, the groom went home, and the bride returned to work! They have no plans for a honeymoon. It is the third marriage for her, not sure about him.

Sunday, January 24, 2010

The Hiney Shot at Walmart

Went to walmart this morning and noticed a large sign out front. "Free H1N1 shots....Lawn and Garden! I had to chuckle.

Friday, January 22, 2010

First Case Post By Red

Hi everybody! My name is really Arthur, but some people call me "Red". Hope you like the case format. These cases are not complete and are not intended to really teach, but are just for fun.....A three month old girl presents with profound muscle weakness, and "Floppyness". On exam, hepatomegaly is noted. The chest X-ray is shown. Note Cardiomegaly. There has been no exposure to honey or home canned goods. .....The child has Pompe disease......An autosomal recessively inherited lysosomal storage disease. The deficient enzyme is alpha glucosidase, which is needed for glycogen breakdown.......The disease was first characterized by Johann Pompe in 1932. Pompe was danish, and was executed in 1945 by Nazi Germany for espionage.....The disease is also featured prominantly in the upcoming film Extraordinary Measures, which I believe is a statement against big pharama, and Bristol Myers Squib in particular. ......Besides Botulism (alluded to in the pertinent negatives of the case), a differential would include Werdig Hoffman disease. ...Stay tuned for more cases in the future. I hope to do atleast one every couple of weeks. Thanks!

Tuesday, January 19, 2010

And Speaking of Dogs...

A nurse in the ED recently saw her grandfather pass away. He was old and chronically ill, and he was admitted through our ED and died several days later on the floor. I told the nurse I was sorry. She said thanks, but the worst part was that she had to pay the money to have the old man's dog euthanized. That Bitch!

Sunday, January 17, 2010

Rectal Foreign Bodies

The people who have worked around an emergency department for years have seen all sorts of rectal foreign bodies. everything from gerbels (often in weather men or local news anchors if you believe the urban legends) to coke bottle to vibrators, shampoo bottles, fruits and vegetables, and whatever else you can think of. I have only seen a vibrator, a condom half full of crack (crack in the crack), and most impressive, one of these long oil funnels that is big on one end and tappered on the other. The bad thing is, this guy (who was just changing the oil in his car naked and slipped and fell on top of this thing on accident), had it in his rectum big end first! HOW!? Good thing is, it was easy to remove. pass a foley through the hole, blow up the balloon and pull it out. Crazy guy! other news, arthur "Red" Heirin is working on his first case presentation for the blog, and it should be up soon. Stay tuned.

Wednesday, January 13, 2010


I am a dog person. I have grown up with dogs, all my life, and I have dogs now. Today, and not for the first time, (probably the third or fourth time) I had a person cry about a dog to me. A patient I mean. "I just want to get home to my puppy" The 87 year old man said. It almost brought me to tears as well. Should have, if I would have let it. I should have let it. I think I will take a rawhide or something to him to give to his dog when he does go home. If they let him go back to living alone.

Sunday, January 10, 2010

Bad Weather, and the razorbacks season in review

With a patch of bad weather coming through the area lately, the ER has been busy. Car accidents, of course, and slips and falls with broken hips, and broken everything else, and hypothermic bums, and hypothermic little old ladies. And of course fires, which are the worst, and even people getting killed trying to make fire, like the two different guys we have seen killed cutting firewood this winter. I am certainly not a global warming naysayer, but this is the coldest winter since at least 1977 in many parts of the world. It is the coldest it has been in Key West for 131 years! I like the cold sometimes, but this is causing a lot of anguish, and is having all kinds of unseen effects like driving up fuel prices, and may even contribute to another flu (swine or otherwise) outbreak by keeping everyone jammed together in doors. ... (By the way, sorry to use all these dots and wierd punctuations, but it seems you can't start a new paragraph and indent on here.)..... Anyway, I have been using some of my extra time inside to reflect on the razorbacks. I am happy with the bowl we got, and I think we beat a tough team, from a tougher than most think conference. I am not Happy with Mallett, though. He looks like Gumby trying to play football, and he thinks he could have even thought about going pro? I doubt it. But the thing I hate the most is here he is, after his "sophomore" year, wanting to go. We know he doesn't care about the team. We can see where his selfish thoughts lie, and we have to spend the whole next season knowing he is leaving us early, and wishing he could have done it sooner. Oh well, I do think we will have an awesome season next year, maybe we actually will be a contender in the west?

Tuesday, January 5, 2010


Ok, the bus driver, who may be my only reader except maybe a family member or friend or two would love to hear more views, so we are going to try to get my dissident friend Cade set up on here, and also my other friend who will provide the occasional medical factoid or case study or some such interesting thing. Will probably be a bit before they get set up and rolling, but that is coming.

Monday, January 4, 2010

New Year

New Year, same shit. Haven't had a day off since last year! I was thinking last night, well actually I woke up in a cold sweat last night, thinking about the guy that died, and was asystolic for about ten minutes, and we hade spoken to the family, and went back to work, when he suddenly sat straight up in bed, let out a blood curtling scream, and fell back, dead as ever! That shit will fuck with your head! ............Thinking about adding an author or two to the blog, like maybe my friend cade....I don't know/ Not that anybody actually reads this anyway, but if anybody does, what do you think about me adding an author, maybe two? It might create more posts, and add a different voice and viewpoint. Cade, I don't know what he would blog about....nonsense probably, but I am thinking about adding an author who is actually interested in medicine as well, who can provide some case scenarios and pictures and (cool?) stuff like that. I mean, I do put some cases on here, but just when it is gruesome or gory or sad or something, maybe he could come on and just do some medical teaching