Posts tagged: silly

Spud

By , June 2, 2010 7:05 am

I walk into the cubicle, with Ken in tow.  There I find an eight-year-old boy, hoeing into a packet of chips.

“Hey, Daniel.”

“Call me Spud,” he says, without looking up.

“Hey Spud.”

With that, he raises his head, and smiles from ear to ear.

“This is my Mum,” he says, gesturing across the cubicle.

“Hi Mum.”

Spud lets out a laugh.  “She’s not your Mum!  She’s my Mum!”

I look across at Mum.  She holds her head in her hand.  “He was sick when we brought him in here, I swear.”

“Hey, I believe you.  Kids turn around quickly,” I say.

I look around at the intern, who has been taking down everything I’ve said.  He looks confused.

“Kids turn around quickly?” he parrots.  I nod.  He scribbles some more.  It’s like owning a puppy that can write.

“These are admission notes, Ken.  You don’t have to write everything.  In fact, nothing that we’ve said yet should go in the notes.”  Ken looks deflated.  I look back at Daniel.  “In fact, just put the pen down, Ken.  I don’t even know that Spud is going to need admission.”

Spud lets out another little laugh, a delighted cry.   His Mum rests her head in her hand, shaking it some more.  Ken looks at me like I’ve scolded him.  It’s like the Charades Olympics.

“It’s okay, Ken,” I repeat.  “Let’s…just…listen.”  Reluctantly, he puts the pen on the bench.

I turn back to Daniel, just as he begins to pull the auroscope off the wall.

“So you weren’t crash hot this morning, Spud.”

“Nup.”

“What was going on?”

“Sore eyes.  Stiff neck.”  He fiddles with the expensive equipment, bouncing it up and down by the cord, oily finger marks trailing all over it.

“So I heard.  The emergency doctors were worried that you might have meningitis.”

“That’s what they said, yeah.”  He tires of the auroscope, letting it go by his side.  It springs back up like a bungy, hitting the wall, before bobbing up and down on its coil.  Its tip scratches the wall, making a sound out of a B-grade horror movie.  Ken looks frightened.

“Cool,” Daniel says.

I grab the auroscope, putting it back in its holder.  “Not that cool, mate.  Six hundred bucks cool if it’s broken.”

“I don’t care.”

“Sure you will.  Once mum pawns off your iPod, X-Box, Wii and PS3 to pay for it you will.”  He looks at me and frowns, stopping dead.  “That’s right.  All of them.  So let’s just settle down a bit, okay?”

I glance around the room.  Spud gives me his complete attention, his Mum has lifted her head out of her hand, and Ken now stands motionless.  We’ve gone from Charades to Statues.  Ken gives me one more pleading look.

“You can write if you need to, Ken.”  He smiles, picking up the pen, touching it quickly to the page.

“So Spud,” I continue, “the sore eyes and the stiff neck.  What happened?”

“Gone.”

“Headache?”

“Gone.”

“Problem with light in your eyes?”

“Nup.”

“Nausea?  Vomiting?  Lethargy?  Sore joints?”

“All gone,” says Mum.  Her head returns to its rightful place.

“So they all just kind of disappeared, hey?”

“Yup.”

“And no fever at any stage?”

“No.”

I shine a torch in Daniel’s eyes.  He doesn’t blink.  I stare at the back of his eyeball with the ophthalmoscope, the non-greasy companion-piece on the wall.   His eyes stay open.  I complete a neurological exam, testing his tone, power, reflexes and sensation.  Perfect.  I check his abdominal, respiratory and cardiovascular exam. Everything is completely normal.

Ken takes notes the whole time.

“There’s one more thing I want to do Spud.  I need to raise your leg while you lie still.”

“Yeah?  You really need to do that?”  He looks genuinely excited.

“I do, yes,” I say, a little confused.

“Then watch this.”

With that, Spud takes his leg, holding it at the ankle.  He takes it in a grip that looks odd, initially.  It begins to make more sense when he takes his leg and places it over his head.

“Is that what you wanted me to do?” he asks, a little breathless.

“Well, not exactly, Spud…”

“…What, you need it to go further?”

“No!” I yell, worried about what comes next.  “No, I was not going to take your leg and put it over your head.  I just wanted to lift it up off the bed a little bit.

“Oh,” he says, disappointedly.

“Did you know he could do that?” I ask Mum.  She shakes her head some more.

“Well it’s not meningitis,” I say.

“Are you sure?” asks his Mum.

“That last test is normally called the ‘Straight Leg Raise’, or – in Spud’s case – the ‘Over the Head Raise’.  It puts a stretch on the lining around your spine, the meninges.  With meningitis, raising the leg causes a lot of pain, as it puts pressure on the meninges.   The fact that Spud can stick his leg over his ear gives me a fair indication that he doesn’t have meningitis.  In fact, it gives me a fair indication that you’re somewhat of a freak, Spud.”

The Straight Leg Raise

Spud's Leg Over the Head Raise

Spud slaps his thigh like a good ol’ boy.  I just which he had a piece of wheat between his teeth.

“So I think you’re okay, partner.  You haven’t got meningitis, and you are free to join the circus.”  He laughs again.

“So why the headache?” Mum asks

I look at Ken.  He looks at me with fear, before returning to the safety of his page.

“Don’t know,” I say shaking my head.  “Headaches come and go.  Maybe it was a first-presentation migraine.  Maybe just a bad headache.  I’m not sure.  But what I am sure is that it’s not meningitis.  I’d suggest going home and having a good rest, Spud.  And try to keep your legs in front of your head, at least for today.”

“Sure,” he says, taking my hand in a shake.

“Thank you, Doctor,” says his Mum.

“Pleasure.”  I look down at the cheeky cowboy on the bed, the one who almost tore the equipment apart, until I threatened to confiscate his electronic pacifiers.  After that, he turned into a real character.  A real little lad.

“See you Spud.  It’s been a pleasure.”  He slaps me on the back, and winks at me.

“Pleasure was all mine, doc.”

I frown, looking at his mother.  She laughs.

“Just one more question for you Daniel.  Why do they call you Spud?”

“We live on a bit of property,” Mum says, interjecting, “and Daniel has always been interested in growing things.  So we got an empty wine barrel, cut it in half, and filled it with soil.  And Daniel grows potatoes in it.”

“I love potatoes,” he says shaking the chip wrapper like a talisman.

I pause for a second.

“What were you doing this morning?”

“Tending the spuds.”

“You do it every morning?”

“Most mornings,” he says.

“Do you use fertiliser?”

“Of course, man,” he says, “Dynamic Lifter.”

“And you used that this morning?”

“Yep.”

“How much?”  He looks back at me with confusion.  “How big is the packet?”

“Well, it was pretty big, I guess.”

“It was?” asks his Mum.

“You used the whole packet?”  He looks off to the side.  It’s the first time I’ve seen him look anything but confident.  “How long after you poured the whole pack of Dynamic Lifter over your barrel did you start to get sore eyes and a headache?”  He furrows his brow some more, before grinning sheepishly.   He raises his arms in a shrug.

“At least the spuds will grow though,” he says, finally.

Mum’s head returns to her hand.  Spud laughs.  I leave. Ken continues standing there, writing something.

Medical Records 101

By , May 25, 2010 3:25 pm

Problem:  INJURY – ARM (FOREARM AND WRIST)

Assess:  “Fell off couch & now limited movement, distressed with any attempt tomove (sic) arm.  Has croup like cough & black eye from cat.  PainStop @ triage.”


From this descriptive triage assessment, we can interpret:


1. That the child fell off the couch, and since that time is acting like a teacup.

2. Becomes distressed when no longer allowed to play that game.

3. Also has a cough.

4. And a black eye from the cat.  No need to try to make this funny.  That’s actually what they wrote.

5. Has given their contact details as painstop@triage.com

This triage assessment was initially confusing to me, until I read the doctor’s notes:

* * * * *

* * * * *

Then it all made sense.

Brevity is the key to clarity.

* * * * *

Plaster Master

By , May 20, 2010 6:29 pm

“Zeb?” I yell into the waiting room.

I stand and wait, while fifteen heads look at me, frozen.  This is my favourite part – being stared at.  The patient you call is never within sight, they’re always round a corner, taking years to get their things together.  While everybody else stares at you.  It’s the best bit.

“Zeb?”  I call again.  This time I hear a faint shuffle, and then movement.  And then the rattle of plastic bags.  Promising.  Very promising.

One of the staring people looks away, staring at something else.  Hopefully, staring at Zeb.

And with that, from around the corner, Zeb bounds.  All perky, and…green.  Fluoro green.

“How’s it going?” he asks in an Australian drawl.

“Good mate,” I return, and he giggles delightedly.  His mother rolls her eyes, and grandma tries the same thing.  “Nice colour, Zeb.”

“Yeah.  I like green.”

“This way,” I say.  “First door on the right.”

He walks off down the corridor ahead of us, and into the plaster room.  We follow him, waiting for grandma, who eventually places herself down on a stool.  The plastic bags fall to the ground in a heap.

“Can I get a different colour this time?  Sure, I like green, but this time I want red.  Or yellow.  Or, yeah, pink maybe?  Hang on, maybe not.”  It’s difficult to tell who he’s talking to.  Possibly no one.  “Yeah pink.  Can I, can I, can I?  Huh, huh, huh?”

I look at Mum.  She looks tired, but not as tired as you might expect.  Grandma is the one who looks beat.

“I think you’ll be getting white, mate.  I don’t think we’ll be getting out the fresh colours here.”

“Oh,” he whines, “why not?”

“Because I’m only a doctor.  I only do plaster.  It’s the plaster techs who do fibreglass.  That’s where the colours come into it.”

“Yeah, right, I get it,” he starts.  “Well, there’s a plaster under here.  From the start.  From, like, when this all happened.”  He nods, and his mother and grandma do too.  “And then we went back to the GP, like – I don’t know – like two days later, and it was only up to my elbow, right?  So he, like, sent me to the Children’s Hospital, and there the guy was like, ‘Dude, I don’t think it’s quite right, but I don’t want to re-break it for like a third time…’ ”

“…Third time?” I interject.  I get that interjection is the only way with Zeb.

“When he broke it was once, and when it was straightened made a second time,” Mum manages to say.

“…And so, re-setting it would make a third time,” completes Zeb, “and he was like, ‘That would be no good, man’.  So we were all, like, ‘Yeah, cool,’ and he was like, ‘Do you like fluoro?” and I was like, ‘Uh, duh, who doesn’t like fluoro?’…”

“You like fluoro?”

“Uh, duh!” says Zeb predictably.  We, the adults, laugh.   “And then he was all, ‘You can have any fluoro you want, and we can, like, cover up the whole white mess, if you want, dude.’  And so I went all, ‘Sure.  Do you have green?’  So he’s like, ‘Yeah, we got green’, so we, like, totally got it.”

He stops.  We all take a breath.

“That is a really amazing story, Zeb.”  He nods his head vigorously.  “But why are you here?”

“Yeah right,” he says, taking a breath.  I sit down, readying myself for a story.  “I got a pen lid stuck down there.”

He stops dead.  I do a double take.

“Is that it?  No story to go with it?”

“Nah, it’s, like, pretty boring.”

“So there’s a pen lid down your cast?”

“Yep.”

“Where exactly?”  He taps at his elbow.   “So pretty much half way down.  The furthest distance from either end.”  He nods again, like it’s a bore.  “And how did it get there?”

“I was, like, scratching myself.”

“With a pen lid.”

“Well, yeah.”

“You do realise, that you’re a goose?”

“Yup.”  He looks at his mum, raising his eyes.  “I’m a goose.”  We all laugh.

“This is a good story, Zeb.  Tell me, how did it get down there?”

“What do you mean?”

“Like, dude, like, tell me how it, like, got down there?”

“Is he making fun of me?” Zeb asks mother.

“Yes, he is.”  Grandma laughs some more.

“Well,” he says, cocking his head, “I was scratching, and, it, like, came off.”

“Oh, so it was on the end of a pen?”

“Dude!  I wouldn’t just stick a pen lid down there.  It might get lost.”  We all look at him raising our eyebrows in unison.  He ignores it.

“So, anyway, it came off the end of a pen?”

“Yup.”

“So then what happened?”

“I got some chopsticks out.”  We all laugh some more.

“This is great,” I say.

“Nah, nah, nah, I was really close.  I had it up to here!”  He points to the top of the cast.  “But I didn’t have enough hands left to grab it.”

“Why didn’t you ask for help?” asks grandma.

“Because I was embarrassed,” he says quietly.  It’s the first time I’ve seen him contrite.

“Lucky you managed to avoid embarrassment, eh?”

He raises his eyebrows, knowingly.

“So what now?  Do I get a different colour?”

“Not so fast, buddy.  Firstly, we need to get the lid out, right?”  He nods.  “So we’ll have to cut it down to here, so that we can split the cast and grab it.  You think you know where it is?”

“Yeah, it’s right here,” he says, pointing.  “I can feel it.  Right here.”

“Are you ready then?”

“Yup.”

I turn and open a drawer, one dirtied by years of plaster, revealing a treasure chest of torture devices.  Splitters, cutters, shears, giant bolt cutters – a whole stack of big metal things, with smooth handles at one end, and sharp bits at the other.

“Cool!” says Zeb.

* * * * *

We start with the shears.  It chews the fibreglass ineffectively.  I get about five centimetres in, before I give up.

“This is more like a crusher than a cutter,” I say.  I feel sweat on my forehead.

“You’ve got a long way to go,” says Zeb.

“Thanks for the reminder.”

“I’m just saying’s all.”

I look him in the eye, and then put down the shears.

“I’ll be back.”

I walk next door and return, wheeling in a machine on a cart.  I plug it into the wall, and the machine revs up.  From its end emerges a snaking neck, a buzz cutter on its tip.  A circle of teeth sits on the end of a rotor, a dangerous circular saw.  Zeb’s eyes pop.

“It’s okay,” I say, “it can’t cut you.”  I turn it on, the circular blades vibrating.  I place it against my skin.  I feel its vibration.  Zeb’s mouth drops wide.  “See?  The blade zigs back and forth – it doesn’t spin right around.  So it won’t cut skin, because skin’s not fixed.  Your skin just wiggles against it.  See?”  I put it against my arm once more.

“Cool,” he says.

We start.  I work my way down, the satisfying squeal of an electric saw with each stroke.  Each time it makes it through, I check Zeb’s face.  He’s freaked out, in a boy kind of way.  He doesn’t know if he’s thrilled, or filling his pants.  Or both.

We get to near his elbow, when I ask for guidance.

“Where is it again?”

“Right here.”

“I don’t want to cut the pen lid in half, do I?”  I pause.  “In fact, why didn’t I just cut out a window at the start?”

“That’s what I thought,” says grandma.

“Me too,” says Mum.

“I wouldn’t have minded suggestions, guys,” I say.  “I guess I’m so used to taking plaster off from the top, that I didn’t even think of that.  It’s not like I go fishing for pen lids in casts every day.”  They all laugh again.  “Where is it, Zeb?”

“Right there.”

I cut a hole, 4cm by 3cm.  I peel back the plate of fibreglass, it’s final fibres cracking.  I feel like an archaeologist.  I stick my hand in and fish around, finally feeling my finger against something round.  My eyes widen.  Everyone else’s do too.  I pull, trying to free it.  And finally, out comes the lid.

“There you go,” I say.  Grandma claps.  “I didn’t know that I’d find it that easily.”

“Why not?”

“The story is just such I good one, Zeb, I guess I didn’t know what I’d find in there.”  I hand the lid to Mum.

“Can I have it?” he asks.

“I think Mum should keep it,” I say.  He rolls his eyes once more.  All this family does is laugh, raise their eyebrows and roll their eyes.  It’s like they’re all having seizures.

“So what about fixing it up?”

“This will do for now,” I say, wrapping a crepe bandage, and taping it up, “just for overnight.  “But come back to tomorrow morning when the plaster techs are in.  Then you’ll get to choose a colour.  If I did it now, you’d only get white.”

“White, like, sucks man.”

“Like, I know.”

He rolls his eyes at my poor attempt at teen speak.

“Later,” he says.

“Hopefully not,” I say.

“Right.”  He jumps off the bed.  “You’re all right, man, you know that?”

He walks out the door.

“He never says that to anyone,” whispers grandma as she passes, shuffling her plastic bags between shaky hands.  “Especially not to men.”

I nod, watching Zeb walk off ahead, his mother and grandma in tow.  I catch him, looking back occasionally, making sure he doesn’t get too far ahead of his mother or grandma.

* * * * *

Hospital Charts

By , May 14, 2010 12:41 pm

The following quotes are taken from actual patient hospital charts, mainly in the United States.  They have been reproduced before, but they never get old.  Enjoy.

“The patient has been depressed ever since she began seeing me in 1993.”

“Rectal exam revealed a normal size thyroid.”

“Bleeding started in the rectal area and continued all the way to Los Angeles.”

“She has no rigors or chills but her husband says she was very hot in bed last night.”

“Patient has two teenage children but no other abnormalities.”

“Patient had waffles for breakfast and anorexia for lunch.”

“The patient has no past history of suicides.”

“She can’t get pregnant with her husband, so I will work her up.”

“Healthy appearing decrepit 69 year-old male, mentally alert but forgetful.”

“A midsystolic ejaculation murmur heard over the mitral area.”

“Both breasts are equal and reactive to light and accommodation.”

“Occasional, constant, infrequent headaches.”

“The baby was delivered, the cord clamped and cut, and handed to the pediatrician, who breathed and cried immediately.”

“Between you and me, we ought to be able to get this woman pregnant.”


* * * * *

“The patient refused autopsy.”

“The lab test indicated abnormal lover function.”

“The pelvic exam will be done later on the floor.”

“Skin: somewhat pale but present.”

“Large brown stool ambulating in the hall.”

“Exam of genitalia was completely negative except for the right foot.”

“Examination reveals a well-developed male lying in bed with his family in no distress.”

“Patient’s past medical history has been remarkably insignificant with only a 40 pound weight gain in the past three days.”

“She stated that she had been constipated for most of her life, until she got a divorce.”

“While in the ER, she was examined, X-rated and sent home.”

“When she fainted, her eyes rolled around the room.”

“Patient has chest pain if she lies on her left side for over a year.”

“Exam of genitalia reveals that he is circus sized.”

“Discharge status: Alive but without permission.”

* * * * *

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