I saw this sign on the sneeze guard today at lunch and laughed. My first thought was, is it really necessary to tell people not to pick up the pickles and onions with their fingers at a public restaurant. But of course it is.
I tried to get my friends to stick their hands in the pickles for my picture, but they wouldn't do it. Chickens.
I say it every time, but here is another one of my favorite medbloggers. One of the reasons I like Dr. Whitecoat's blog is because I never know what to expect. Sometimes I find a medical post, sometimes he writes about his family and his personal life, and sometimes he posts gross pictures. Right now, Dr. Whitecoat is writing about his malpractice trial, which I find fascinating.
Here is my interview with Dr. Whitecoat.
1. When did you start reading the medblogs? Do you remember the first medblog you read?
A few years ago I think I followed a link to GruntDoc's blog while researching an issue about tPA use. Never even heard of a blog before that. Followed a couple links to places like KevinMD, Nurse K and MonkeyGirl (RIP) [Just piss her off and she'll post. ~MA] and got hooked. Tried my own hand at it about 6 months later and never looked back.
2. Are doctors good patients? How about you? Are you a good patient?
Depends on your definition of a "good patient." I've found that some docs I treat tend to be skeptical of my thought processes and question me. To me, that's a good thing because it makes me think through my diagnosis. But if the treating doctor can't "sell" the recommended treatment and the "patient" doctor doesn't think it will work, then the patient probably won't do what he's told.
As for me, lets just say I try to be a good patient. The last time I was admitted, I turned off IVs when they were done, wrote my input and output on paper for the nurses, and would re-start the pump if it began beeping. I also slept with headphones in because there was so much noise. When one the night nurses shook me to wake me up, I woke up with my fist cocked and yelled. She screamed and jumped back. I try to help because I know the nurses have it tough. When I was discharged, I left a 3 pound bag of M&M's at the nurse's station to say "thanks."
The doctors have a little harder time with me because I ask a lot of questions and I buck the system if I don't like what's going on. My last hospital stay I drove the resident crazy because I kept asking her why I needed this test or that test and she couldn't answer me. Then I told her I refused to stay in the hospital just to receive IV antibiotics. Instead, she could give me the bags and I'd administer the antibiotics myself. She told me she wouldn't send me home with the IV materials and I told her not to bother - I already had everything I needed at home, including IVs. She was so exasperated that she called the fellow in from home. The fellow came in, we talked for a little while, and I got sent home with the antibiotics. Later I called the attending and gave the resident a little plug - even though she didn't feel comfortable with what I requested, she did what she needed to do to solve the problem.
3. How did you and your wife meet? Do y’all have a special “song”?
I was actually one of her tutors in medical school. She stalked me after the first class.
One of the first times we went out to a party together, we both were drinking and heard "Paradise by the Dashboard Light" by Meatloaf. We both started pointing at each other and singing the song in each other's faces until we had a crowd of people around us laughing. So aside from our wedding song ("Have I Told You Lately That I Love You" by Van Morrison), we always look at each other, smile, and start pointing when we hear Meatloaf.
4. You medical folks seem to be able to stomach just about everything [I’ve never read so many odes to pus since discovering the medblogs], but I’ve heard that everyone has one “gross-out” thing that can make them gag. Is there something that makes your skin crawl when you come across it at work?
Nope. I've got a pretty strong stomach and I've seen pretty much everything - maggots on the skin, gunshot wounds to the head, blood, pus, puke, bloody diarrhea, mucous. Doesn't bother me. Almost puked once as a resident when a drunk projectile vomited blood all over a nurse. The patient had liver failure and there was a nasty odor to his vomit that I'll never forget. But now I could be eating spaghetti and meat sauce while watching it happen, and it wouldn't bother me a bit.
5. What is the first thing you do when you get to work?
Clean off the desk, put all the books away, throw out all the miscellaneous papers that have gathered, and put everything in order. Have to start with a clean desk.
6. What is the first thing you do when you get home from work?
Give everyone in the family a hug and tell them how much I missed them while I was away. Unfortunately I've seen way too many people who leave home and never make it back. Life's too short not to let your family know how much they mean to you. The cool thing about it is that I can have a miserable day at work, and when my kids see me walk in the door, yell "Daddy," and come running up to hug me when I get home, it's like the bad day at work never happened.
7. When did you decide to become an ER doc (See question 18 if you have a problem with my use of the term ER). What other specialties did you consider? Why did you choose emergency medicine?
I briefly thought about orthopedics. That was the "hot" specialty back when I did my training. I actually did an internal medicine residency in addition to my emergency medicine residency, but I never got into the whole office practice thing.
I did my first ED rotation in an inner city hospital. My first patient was a guy that had a nasty bite wound on his chest ... a human bite wound. The woman who bit him was restrained on a stretcher down the hall and they kept yelling insults back and forth at each other. Everyone in the department was cracking up. I thought to myself - "people get paid to watch stuff like this?" After that, I was hooked on emergency medicine.
8. Name one peculiar habit that you have. Name one peculiar habit that your wife has. [hehehe, I’m a troublemaker. ~MA].
It took a while, but then I remembered something that the people at work tease me about. I don't back down from arguments and apparently when I'm getting into it with someone on the phone, I stand up, walk around, and bounce up and down on my toes when I walk. Everyone giggles at me when I do it and I don't even realize I'm doing it. Now when I get ticked off at someone on the phone, I can hear people whispering "Ooooh oooh here he goes!"
My honey picked up a habit from my mother. When talking on the phone and you say something to her, she'll sometimes say "Yeah, no, I don't know." It makes no sense, but she says it out of habit. Now I start laughing every time she says it, so she doesn't do it as much any more. Sometimes she'll catch herself doing it and stop mid-sentence. Then I laugh even harder.
9. If you were a superhero, who would you be?
Superman. Like the special powers, but also like the idea that he can help people out and then just turn back into an average Joe when he's done.
10. Do you speak any foreign languages?
Used to speak fluent German, but haven't used it in about 20 years, so jetzt kann ich nur ein bischen Deutsch sprechen. [Ich kann Deutschen nicht lesen oder sprechen, aber ich kann Google Babelfish. ~MA] I can also speak enough medical Spanish to get by when I need to.
11. This week, my friends and I engaged in a heated debate on healthcare. Maybe you can settle this. When you’ve eaten a bad burrito and you’re pooping and puking your guts out, is it better to take something to stop the outflow, or should you just let nature take its course and get it all out of your system?
A bunch of lawyers arguing about excrement? I could make a joke about stopping your life force from draining from your systems because you're all full of ... ah nevermind. I'd chug some Pepto Bismol, maybe a little Imodium, and drink lots of fluids. Dehydration makes you feel worse - especially if you've been drinking and have the trots.
12. If you could be reincarnated, what would you like to come back as?
A dog with a really cool owner whose back porch backed up to a beach.
13. Did you have a bachelor party? If yes, tell us everything that went on that night.
No bachelor party. Did have a great wedding night, though. After the wedding, Mrs. WhiteCoat and I rented a bus and took all the guests to a professional baseball game. That was a blast.
14. Do you dance?
15. If you could be a contestant on a game show, which one would it be?
I hardly watch TV, so I don't know many game shows. Not smart enough for Jeopardy. Price is Right is too hokey for me. Who Wants to Be a Millionaire would probably be up my alley, although I'd just take the money and not wait for them to open up all the cases with the big money.
16. What is the best piece of advice ever given to you, and by whom?
Hmmm. I can't post the exact quote here, but when I started moonlighting in a rural ED, one of the staff docs who lived there all his life basically told me not to date anyone in the town, not to go to bars in the town, and not to say anything bad about anyone in the town because everyone there knows everyone else. He was right.
There was also a statement I heard in a lecture that always stuck with me - "People will never remember how smart you are, but they will always remember how you made them feel." I keep a book on my desk of all the quotes I have collected. Too many to list, but I've posted several of the ones I like the most on my blog.
17. I like country music. Write me a short country western song about life in the ER. It’s got to have heartbreak, pickup trucks and mama to be a real country song. And maybe a train if you can fit it in.
You'll be glad to know that I thought this song up while driving to work and that I kept calling my cell phone and leaving myself messages so that I wouldn't forget the words. I'm no Kenny Chesney and Tex is the real pro of ED Sing-a-Longs, but here goes (and no, that's not my real voice - I'm trying to get a country "twang"): Whitecoat sings!!!
18. I have to admit that I find the whole ER/ED thing a little annoying. Does it really matter? I mean, everyone knows ER means Emergency Room and ED means erectile dysfunction. Why do you insist on having ED?
Hey - I have 4 kids. Trust me when I say that I work in the ED, but that I don't "have" the ED. I can get an affidavit from Mrs. WhiteCoat with specifics if you don't believe me.
Everyone has their idiosyncracies. Kojak had his lollipops. Monk has his germophobia. You have the hair thing. For me, it's the emergency department. Emergency medicine has evolved. It's not just some radiology resident treating sprained ankles to make his rent money. It's a specialty that sees more than 120 million patients per year. That "emergency place" is no longer just a "room" - it's a "department" that often has dedicated radiology suites, dedicated labs, trauma rooms, psych rooms, procedure rooms, and on and on and on. Our little specialty sees about 12% of all the outpatient visits in the entire country each year. While the TV show "ER" brought the whole concept of emergency medical care into our living rooms, the term "ER" is antiquated and I don't think it reflects the breadth of services available in an ED. Like calling a "lawyer" a "counsellor" - you guys do a heckuva lot more than just "counsel" clients (at least I think that's the case). So you ever try hair gel for those stray golden locks of yours?[They don't make a hair gel strong enough to control my wayward locks.~MA]
19. You wrote: “I appeared in one of the Discovery Channel TV shows about Emergency Departments. Learned about it when my brother called me from out of town and was screaming that he just saw me on TV and then yelled ‘Whoa! There you are again!’” You’ve also written: “For the record, I’m just under 6′ tall and have dark brown hair with genetically gray frosted highlights.” I’ve watched the ER shows on the Discover Health Channel and I think it’s safe to say that description probably applies to at least ¾ of the men on those programs (at least according to my television set). Can you give us some hints about which show you were on?
Just look for the incredibly handsome doctor on the show - that will be me. The show was called "The Real ER" and it was one of the first shows in the series. That's all you get.[Geez. That helps a lot.~ MA]
20. In every issue:
a. Question from guest Joanne: Did you ever have such a horrible day at med school or as an intern that made you feel that you couldn't go on? If so, what inspired you to keep going?
I woke up the night before my medical school pharmacology final exam in a full out panic attack. I dreamt that I had slept through the test. When I sat up in bed, I was in a full body sweat and hyperventilating. At that point I wondered why I was putting myself through all the torture. Then we went out for drinks after the test and had a blast. In medical school, you develop a lot of close friendships with your classmates because you're all going through hell together. In my class, everyone helped pick everyone else up by the bootstraps when they were down. That kept everyone going. Besides, the student loans put you so far in debt that many medical students can't afford to quit and not get their degree.
One time in my internship, a resident drew blood on an HIV patient, set the needle on the desk, and turned around to grab the tubes for the blood. The patient took the needle and jabbed the resident in the arm with it. Did a lot of soul searching after that incident. You have to weigh things like that against the great feeling that you get by helping so many people.
I've become a strong believer in fate since those years.
b. What color scrubs do you wear?
Whatever's in the drawer in the doctor's call room. Usually green or blue.
c. Do you have any tattoos or body piercings?
Not one. Thought about getting a shamrock on the leg once, but never had the guts to go through with it.