Sunday, November 30, 2014

My reaction when discussing knee prosthesis designs with my attending, and he dropped "when you really think about it, there's kinematic conflict between PCL retaining prosthesis and the higher conforming polys..."


Saturday, November 15, 2014















“Time out for safety!” declares man about to cover himself in bodily fluids while playing with sharp things.

Lake Oswego, OR – Local area orthopedic surgeon Martin Smith declared loudly for the entire room to hear “TIME OUT FOR SAFETY” just prior to dousing himself in another person’s infectious bodily fluids while handling, using, and occasionally playing with, numerous sharp objects.

A visiting OSHA employee Christine Platt gave the following: “The weird thing is, the entire time during this so called ‘time out’, they never even discussed the elephant in the room that they were all about to be covered in blood while handling skin cutting objects. They just wanted to make sure they were stabbing the right person.”

A survey of the room revealed the back table had numerous instruments that, at any time, could pierce any one of the participating employees skin and transmit life ending diseases such as HIV, hepatitis C or ebola. Maybe not ebola. There were cutting things, skin piercing things, poking things, burning things, more pokey things, things that weren't meant for poking but could definitely poke through skin of anyone who handled it wrong, and literally tubs of disease spreading contaminated water.

Christine Platt went on to say: “It’s just crazy that the whole thing isn’t discussed in the DEAR GOD WHY IS THERE 6 SHARP WIRES STICKING OUT OF THE PATIENT?! SOMEONE IS GOING TO LOSE AN EYE!”

“So you’re telling me those guys expose themselves to multiple peoples bodily fluids every day with only a thin barrier of latex? And those thin latex barriers can have holes up to 3% of the time?! Taking that kind of risk is insane,” local prostitute Bambi Anderson explained. “At least their pay is good, they get like what, $300 per customer right?”

At time of press, the reimbursement rate for an excision of a polydactyly is $26.

Sunday, November 9, 2014

So in this scenario, the OITE is Yaya Toure, the soccer ball is the brachial plexus questions, and the little girl is me not having memorized the brachial plexus...


Saturday, November 8, 2014

We got sent a memo by our chief that the medicine service WANTED to be the primary service on ALL ortho admits...















I would definitely be the dude on the right in this scenario.
Me to the medical students after sign out: "So we've got a little bit of time before we have to go up to the OR, anyone want to talk about a specific subject?"
Med student: "Can we talk about the ober and duckwalk tests?"
Me: ...


Thursday, November 6, 2014

I was draping a patient when one of the circulating nurses who was putting drapes on inadvertently dragged her hand across my jibblies...
















I'm applying to fellowships, and waiting to hear back for interview offers...


Sunday, November 2, 2014

Attending rule of 2's:
When 2 attendings scrub in to a case with you:

1. Resident work gets halved.
2. Number of suggestions on how to do the remaining work you do gets doubled.
3. Amount of resident mockery increases by 2^2.

Sunday, October 26, 2014

Random ortho fact of the day:
Sir Robert Jones, of the "Jones fracture" namesake, developed an interest in fractures of the fifth metatarsal after sustaining that injury while, um...


(In the pre-op area)

Me (trying to be friendly with the patient): "Dude, you busted up your forearm pretty good. How'd you do it?"
Patient: "Just jumping off a ledge. It was stupid."
Me: "That sucks, were you doing parkour or something?"
Patient: "Trying to commit suicide."
Me:...


Thursday, October 23, 2014

I had a short TFN nail where the interlock screw that was placed THROUGH THE JIG missed the nail.  I asked the rep, and he said it was 'probably user error'...











Love you dave.

One of my co-residents had me mix a packet of honey and packet of tabasco sauce and put it on the chicken strips here at the hospital...


Monday, October 20, 2014

Sunday, October 19, 2014

The attending after drilling the distal interlock screw for a tibial nail, and having arterial blood shoot out of the depth gauge...

Saturday, October 18, 2014

We took a patient to the OR for a trauma, and when we rolled him over to put the sliding board underneath him, a baggie of cocaine fell out from between his buttcheeks...


When I haven't eaten anything all day, and the nurses are having a potluck for someone that's leaving...


Friday, October 17, 2014

I had a patient that felt like we were abusing him for not giving him oral dilaudid to go home on after a small surgery...


Sunday, October 12, 2014

Trying to get a hug from my wife after returning home from a rather bloody consult in the ED...


What I feel like after telling a patient they're going to get drug tested on the day of surgery for meth in a couple weeks, and cancelled if it's positive.
And then they show up for surgery 2 weeks later and test positive for meth...


My thoughts after putting on a splint with a female med student and accidentally calling her "sweetie"...




Thursday, October 9, 2014

What i feel like holding the scalpel before a case i haven't studied for...


Wednesday, October 8, 2014

My reaction after a patient said in the morning, "Doctor, so good to see you, I almost forgot what you looked like, I've been dreaming about you all night.."


Had a patient the other day who started by going: "You know what actually caused the ebola outbreak, right? It's the same people that caused the AIDS epidemic..."


Getting a page at 2330 when I'm not on call...


What I feel now whenever an attending scrubs into a case...

Monday, October 6, 2014

So we had a patient come in with an ankle fracture that was a polytrauma, intubated in the ED. I went up to do the secondary exam, walked in the room and introduced myself to a teary eyed family. I explained that I was the bone doctor, and that I didn't know a lot about the other systems, but knew a lot about the bones and needed to do an exam to make sure nothing was dislocated or frankly broken. I examined the still intubated patient, ranging all the joints, etc. At the end, I told the family that the patient did have an ankle fracture, but that we would be managing it without surgery and that they had (and i quote verbatim) "other priorities that are higher on the list than their ankle." They nodded and I walked out.
And that's when the nurse informed me that the patient expired 30 minutes ago...


Sunday, September 28, 2014

The usual reaction that I get from patients when I say that a broken bone and a fracture mean the same thing...


 When a teenage girl asked if I was going to make her scar look good...



Saturday, September 20, 2014

I dont have a scenario for this. This is just here for your viewing pleasure.


Friday, September 19, 2014

(Random memory from 2nd year)

Husband: So what do you think?
Attending: Well, I believe your wife is suffering from pain originating in the coccyx.
Husband: So what's the next step, more imaging?
Attending: Not exactly. We're going to step out for a second, my resident will be back to manipulate her coccyx and see if that is the pain generator.
Me: ....















I sometimes wish I was making this crap up.

Tuesday, September 16, 2014

My attending told me that I had dainty hands. I laughed then, but later...


I was pinning a DRUJ, and I got an xray of my first wire, which completed missed the ulna. It was at that point in time that my attending decided to walk in the room...


Page from the ED at 1257 AM:
"Hey, we've got a guy that had some knee pain, no fracture or anything, probably not septic, but is there any way you can just, you know, drive in and give this guy a steroid injection?"


Monday, September 8, 2014


Bones.


Bones. I like bones. I like big bones. I like small bones. I like medium bones. I like long bones. I like short bones. I like old bones. I like young bones. I like misshapen bones. I really like broken bones. I like bones sticking out of skin. I like bones about to stick out of the skin. I like all sorts of bones. I like them. I like bones.

Sometimes bones are broken. I like to fix bones. Sometimes I break bones to fix bones. Sometimes I put screws in bones. Sometimes I put plates on bones. Sometimes I put wire around bones. Bones. I like to take broken bones and make them straight. Unless it is not a straight bone. Then I do not like to make it a straight bone. 

The lungs confuses me. The heart confuses me. Kidneys confuse me. The pancreas confuses me. Bones do not confuse me. Unless it is the skull. That confuses me. Teeth confuse me. They are bones. I do not like them as much. Ancef is good. I like when anesthesia gives it. Sometimes gentamycin is good too. Not as good as bones. I like bones. 

If you consult me about a deep cut, I will ask if there are broken bones. If you consult me about a crush injury, I will ask if there are broken bones. If you consult me about an infection, I will ask if there are broken bones. If you did not get xrays, I will get them to look at the bones. 

I like muscles too. Sometimes I cut muscles to get to bones. I do not like nerves. They are not bones. They get in the way of bones. 

After I finished my medical school, I was deeply intrigued by the pathophysiology of complex disease processes and the underlying pharmacokinetic advances of our current treatment strategies, but now,

Bones.
IM resident: "Hey, we've got a consult for you. It's a guy with shoulder pain. All imaging is negative, but you know, we're just not sure what to make of it."


Sunday, September 7, 2014

An attending handed me an opened snack bag in clinic and said: "Hey, would you like some hot jerky?"

Tuesday, July 29, 2014

Chiefing to an attending: "So the fingers kind of dusky, the 2nd year wasn't able to get a waveform on the pulse-ox, couldn't get a doppler, and it didn't bleed when he poked it with an 18 gauge needle."

Junior resident (aside): "Actually, it was a 27 gauge needle..."


After returning from the restroom in scrubs, a nurse said "you may want to take a little longer on the jiggle afterwards..."




Friday, July 25, 2014

I occasionally do workers comp exams.  My usually state of mind by the end of the day...


What usually happens when an attending calls me at home....

When I ask a junior a question during indications they didn't see coming and handn't prepared for...

Tuesday, June 24, 2014

Attending at indications: 'So you're saying the patient had symptoms of calf pain consistent with nerve impingement, what dermatome is that?'
Junior resident: 'S3.'



Monday, June 23, 2014

Seeing the US won their first world cup game....while in peds clinic...

Watching the incoming intern class greet each other, not knowing the evil that shall soon befall them....




Whenever a patient asks me: 'is the doctor going to be in soon?'


Talking with my co-residents about their OITE scores...



Sunday, June 15, 2014

We had a kid with a negative hip aspiration that was ambulating without much pain. The ED resident was POSITIVE the kid had a septic hip....

My attending after I was having a hard time getting the proximal interlock screw...


Attending #1: "Hey, so no one is covering the trauma room tomorrow, and you're on call tonight, so would you mind..."
Attending #2: "You want me to take care of my own junk. I do it most of the time anyways."

Monday, June 2, 2014

Attending: "I hope you're ready for the next case, it's a pretty destructive procedure..."




Saturday, May 31, 2014

Getting a page from general surgery saying that they're 'signing off' of a patient they're still the primary team on....