January 8th, 2010 by Bongi in Better Health Network, True Stories
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Shaking hands is not really such a good idea, especially in a hospital where there are all sorts of nasty bugs floating around, seeking whom they may devour. So generally I do not shake hands unless the patient absolutely insists and I think the cultural slight may be more than he can bear. But one incident highlighted to me the reason you generally don’t want to shake hands so well it could just have well been written all over the hospital in bright neon lights.
I was on call that night so it fell to me to evaluate and treat the patient in casualties which the casualty officer said had a perianal abscess. I approached the bed and introduced myself, but I made a point of positioning myself in such a way that the patient wouldn’t be able to greet me with the traditional handshake. Experience had taught me that this was one case where this cultural idiosyncracy was patricularly ill-advised.
I asked what the problem was. without saying a word his hand moved to his gluteal cleft in one smooth motion. Moments later I found myself staring with morbid fascination as he pulled his butt cheeks apart and started prodding what was clearly an abscess with his finger. It had already broken open slightly so there was a thin stream of pus oozing out and following the natural pull of gravity. The patient’s grubby finger scratched, prodded and poked this poor stream of sepsis, completely disrupting its attempt to soil the bed linen. Read more »
*This blog post was originally published at other things amanzi*
December 8th, 2009 by Bongi in Better Health Network, True Stories
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I have already spoken about the hazards of doing favours, but recently I was reminded of another example when I was still a registrar where I only just escaped the proverbial falling anvil.
It was not an unusual case but still fairly challenging for a registrar like myself. The old man presented with an acutely tender abdomen and free air revealed on x-rays. If you ignore the outside horses for a while, this is either a perforated peptic ulcer or complicated diverticulitis (some people would throw complicated appendicitis into the mix, but I’m going to leave it in the stable with the outside horses if there are no objections). The patient needed an operation and soon. So with the sun shining happily over Australia somewhere, I took him to theater. Read more »
*This blog post was originally published at other things amanzi*
October 19th, 2009 by Happy Hospitalist in Better Health Network, True Stories
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I have a patient that comes in every so often that demands a PICC line (peripherally inserted central catheter). PICC lines are convenient for patients and nurses and doctors because they can be used to obtain blood without needing to stick the patient on a daily basis. They can be kept in for weeks and weeks and weeks with proper care. They can maintain adequate IV access when old ladies and drug addicts present with poor veins. Often they save the patient during acute decompensations of their critical illness. However, they come with frequent complications. I have had my share of patients return to the hospital with sepsis from their PICC line. Read more »
*This blog post was originally published at A Happy Hospitalist*
Shaking hands is not really such a good idea, especially in a hospital where there are all sorts of nasty bugs floating around, seeking whom they may devour. So generally I do not shake hands unless the patient absolutely insists and I think the cultural slight may be more than he can bear. But one incident highlighted to me the reason you generally don’t want to shake hands so well it could just have well been written all over the hospital in bright neon lights.
