Archive for October, 2008

Ignorant Feckers.

Posted on October 28, 2008. Filed under: Journal from behind the desk... |

As I get a tiny bit older (not old, just older), I realise my perception of time isn’t quite right.  I see the patients date of birth and think…oooh they were born in 1994, and I look down the corridor expected some little kid with bunches and a cute smile.  Instead I am grunted at by a spotty, 6ft teenager…

My heart sinks…I like seeing cute kids, they are easier to communicate with than teenagers.  I realise the teenager is without parent….my heart sinks further…  I realise the teenager has bought one or more friends with her, there is a dull thud as my heart sinks so far it falls out of my shoe.

This happens on a regular basis, these “kids” are sexually active… and they want to see me to talk about “it“…kill me, kill me now…

Actually that gives the wrong impression.  I like educating people about safe sex etc. but sometimes I say things they don’t want to hear. I like to think I am “down with the kids” and have “my finger on the pulse”….

…but I think they probably think I some old guy who hasn’t heard about sex.  The opposite is true and this is part of the problem, I am wise to the ways of young teenage boys (I even confess to having been one once).  More concernedly I am aware of the ways of some older teenage boys towards younger teenage girls… (but no I was never “like that”…I was attracted to slightly older women when I was younger…and not preying on younger girls who had a ton of make- up on, but that’s another story).

Where am I going with this? It’s one of the subject I have so much to say on I don’t know what to say…and that’s a bit how my consultations with these patients go.

The more I talk to these ignorant (and I mean that literally rather than rudely) teenagers, the more I find things I need to tell them, some is in the realms of the consultation and some probably isn’t… like “I don’t care if your boyfriend does like condoms…HE isn’t going to get pregnant!!”

So I do my best not to sound fatherly…

 and I TRY to get across to the girls about safe sex, not just pregnancy avoidance but HIV/Chlamydia/Crabs/Syphilis/Gonorrhoea/Genital Warts/NSU/Herpes/TV/Scabies/Hep B/Syphilis avoidance.  Yes girlies there are that many…probably more, and then I think I may have got through to them…it’s doubtful but I might just have got through.

Then I realise I have wasted my time, not because they aren’t intelligent enough to understand, but the fact I’m talking to the wrong people… it’s those dumb ass pricks that are the problem.

A young lad came to my room this week and the yoof said…

“I fink I’ve got chlamydia again”.

So I kindly ask : “Why didn’t you learn to use a condom after your last “bout”?”

Yoof replies: “Well we’ve been together for a few monfs, so we stopped using it”.

Max… “BUT WHY????” I think they think that a few month into a relationship when “love” develops all sexually transmitted nasties die off…  They seem to think that love is like some kind of antibiotic to sexually transmitted infections….

Yoof retorts: ” It’s not my fault it’s the girls in this town, their all scanky”

Max retorts rhetorically: “…and where do you think they caught their infections from????”

Perhaps this is the big problem, we are talking to the girls, when we should be talking to the boys and perhaps we are assuming they, as sexually active individuals, are adults and aiming our advice at too higher level.  OK so from now on I will talk to them as children and make reference to popular children’s characters…

…”if you Dipsy your Tinky Winky into her La La and have UPSI daisy, you’ll likely to get Spot the Dog on Tinky Winky”…

That’s it…I’ve been threatening long enough to do it….I’m off to the school and going to do an assembly….to the BOYS!!!  I’m sure they will stop laughing and vandalising my car after a few months!

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How to irritate your clinician

Posted on October 20, 2008. Filed under: Benign |

I recently posted a singular rant about a patient that wound me up…I thought perhaps I should expand on other things that really get my goat.

Somethings patients do really make me mad.  I’m going to tell you what you can do to wind your clinician up into a frenzied urge to prescribe you a large suppository and offer to apply it with their boot!

Disclaimer the following information is NOT recommended if you want to receive a pleasant consultation and appropriate assessment and management.

1: Take your young child to the practitioner, allow the practitioner to spend time gaining your childs trust, and then just as the practitioner goes to do something invasive (look in their ears, mouth or butt) say nice and clearly:

“Ooooh, she’s not going to like that!”

Thus filling your child with dread and impending doooooom, so they scream, kick and generally make the rest of the consultation and any following consultations absolutely impossible.  If however you decide to keep your mouth shut, the practitioner would be done and dusted before the co-operative child could say, “Can I have a sticker please?”

2: Open the consultation with a bold diagnostic statement and treatment “request” like: “I’ve got a chest infection and want antibiotics”.  This immediately make the clinician think: I don’t care if you’ve double pneumonia, I’m going to tell you it’s a mild cold and tell you to take paracetamol”

3:Just don’t wash for a week prior to consultation.

4: Dramatise your symptoms. “I’ve <cough cough cough> got a <cough cough cough> cough”, and then don’t cough for the rest of the consultation, or…  Limp in complaining of leg pain, get assessed and walk out without a limp.  This will make the clinician smile and say in earshot of the patient “God I’m good, I laid my hands on your leg and resolved your limp”.

5: Allow the consultation for your 16 week slight rash to meet it’s conclusion and then as you get up and leave say…”While I’m here I ought to mention this crushing chest pain that woke me this morning”

6: Sit in the waiting room not considering what you’ll say when your called through, and then spend the first 5 minutes of your appointment saying: “Well it sort of started…no.. that’s not right…yes probably…Monday last week, could have been Tuesday…with these odd feeling…well not so much a feeling as a sensation…well sort of….hmmm, well it’s not really pain so much as….ohh, actually it was probably Monday.  Yes that’s right because I’d played golf on the Sunday before and my cousin said it sounded a bit like what he has, but his is more sort of lower, whereas mine isn’t……” etc etc/

7: Save the most vital piece of information until the very end of the appointment…it’s like hiding the last few pieces of the jigsaw.  For example: “Did I mention I’d be hit by a lump hammer before the headaches started?”

8: Come in at least one week after all of your symptoms have resolved because…you want to know what you had.

9: Start the appointment with: “I didn’t want to see you, but I couldn’t get an appointment with my favourite doctor”

10: Have your opening statement as “It began early in the Great War..”

Well there’s plenty more I’m sure, but these are my top ten… feel free to add your own…

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Busman’s Holiday?

Posted on October 9, 2008. Filed under: Uncategorized |

You know it’s time to have a break from work when your 3 year old hurts her ankle and says she got a sore lateral malleolus…

So we decided to go away, I thought this week I’d stay away from any physiology and anatomy and tell you about my holiday instead…

We decided to go abroad, and with airport parking so expensive we decided to get to the airport by train.  My daughter was keen to go on the underground, so we went on the Eustachian Tube then somehow connected with the Fallopian Tube and finally Central Line to Standstill airport.

The London airports are named after the villages they have ruined, rather than other airport which are named after famous people like John Lennon airport in Liverpool, or the John F Kidney airport.  Airports make me nervous…it’s all to do with the use of the word “Terminal”…as in…not going to live.

The flight was smooth, with Wallace and Grommet as the in-flight film. We arrived on our Mediterranean island hopping holiday.  We were spending the first half on the larger island of Labium Majus, and then going on a Crus to Labium minus.  My wife was sure if we spent enough time on the island we were bound to find the right spot eventually.  We bought an atlas and a tourist guide that had an in- depth appendix

One day we took a day trip to the isle of langerhans and had a gland day out.  They had an activity centre there were we took a Artery course.

Whilst away we tried several of the local dishes, such that lovely filled pasta – alveoli and that lovely Spanish fish and rice dish – patella, and drank some lots of wine, including a superior vena cava, much better than the inferior cava in the supermarket! I orta try that again.

Mostly it was a lovely holiday, the only complaint was at the first hotel was noisy as there were some building works going on, and they started early every morning, I was told not to complain about it as the builders had a mental foramen in charge, and I didn’t want to get on the wrong side of him.

We had a nice relaxing holiday, perhaps next year we’ll go through the carpal tunnel to France.

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