Don't tase me, doc

"Critical care taser this patient...."


Well, that's one way to stabilize 'em. Oh, wait....

(Dictated: "Critical care time for this patient...")

The Annoying Habits of Dr Obvious

Why do they do this? 


"... patient John Smith:  S-M-I-T-H, J-O-H-N."


But if the patient's name is "Oryan Btfsplk" there'll be no spelling, no sirree.

Why? Why? Why?

--and he knows how to use it!

"He has a ventriculoperitoneal shotgun."

It's not in the DSM, though it probably should be

"Mental status: Married."

(Dictated:  "Marital status: Married")

We've all been there... some never leave

"A xx-year-old male who was transferred by helicopter from atypicality."

The pause that refreshes

"The patient still drinks about a liter of urine daily."

(Dictated: "...makes about a liter...")

Aw, shuddup, lady, it's all in your head

"The patient had been seen . . . with severe fatigue and a history of mental menorrhagia."

Yikes! I guess I'd lose weight too

"She has lost about 30 pounds, but blames it on monster cleanses."

(Dictated was "... Master Cleanse," one of the current diet/detox fads)

Speech WRx Quiz, Rednecks Edition!

Why? Because it's Monday, and Monday sucks.


Here we go. I left the dosages if they appeared in the draft, by way of clues. Bwahahaha. Answers below.


1. Rednecks 500 mg daily
2. Esther--see you
3. Was rolled 10 mg p.o. daily
4. Floor sallow down 
5. Climbs up and down
6. stair well

(Those last two look like they should go together..but they appeared independently, in different reports, oddly enough).

ANSWERS

1. Ranexa

2. Ester-C

3. lisinopril

4. chlorthalidone

5. clonazepam

6. Seroquel

Sunday is Fun-Day! (Fun With Names, that is)

Summer is coming and Speech Wreck has produced a bumper crop of fine names. So let's get to it, shall we? 


Dr Colace Sonata 
Dr Pregnant male (my current favorite)
Dr Recurred bulk
Dr. Trolls gross 
Dr. Elaborate 
Dr. Cine obstipation 
Dr Worry
Dr Sure blob

And now. . . a word from Dr. Obvious!

". . . the patient is an adult, and is only going to get older."




(A little context, to be fair: He was referring a 20 YO to adult neurology and felt a need to justify this; but knowing that doesn't spoil the stunning obviousness of the final clause).

Syllables, schmyllables

And then there's the unfortunate patient who underwent "dilation and cutterage."


Um, ouch?

Go ask Alice

"Lortab elixir 15 Alice q.4 h. p.r.n."


Why yes, if you take enough of it, you too can fall down the rabbit hole!

SmokeSmokeSmoke that cigarette!

"She says that she usually smokes 203 cigarettes."

...Not easy, but, well, it can be done. If you really want to.

(Dictated: ".... two or three cigarettes." A tip of the hat to Annie Nemous).

Speech Wreck chokes on this

Dictated:  "...[class X] Mallampati airway."


Wreck 1:
"... mild potty airway."


Wreck 2:
"... melancholy airway. "

She presented with crimped hair, in a Duran Duran T-shirt

"Past medical history: The patient is back in the 80s." 

--but when he leaves town, he falls on his ass

"He walks without assistance, and is noted to have normal muscular strength in town."


(Dictated: "... strength and tone...") 

I love it when you talk dirty, Doc

"She knows to call or return earlier should a problem screw with her feet."

...and this is how Dr Vague dictates:

"Vitamin B6 or something."

"Nondescript eye surgery."

Yes, I do believe he's going to get his own label.

A trifecta of names

From one report, no less!



Attending physician: Dr. Joe Arthritis 
Requesting physician: Dr. Chris Vague
Referring physician: Dr. Spacer, emergency room


Can't you just hear it? "Paging Dr Vague, Paging Dr Vague...."

Colin called. He wants the piece of him back.

"It sounds like [the patient] had a piece of Colin removed."

Just put some Ativan in his IV and give him an order of toast

"He was experiencing some chest pain associated with an anxious saline of impending jam." 




(Dictated: "... an anxious feeling of impending doom).

The family that limps together, stays together

"The patient is married; however, he does not limp with his wife."

(Hmm... I wonder if this patient is actually this guy. Dictated was "... live with," natch).

The medical history was provided by his mitochondria

"Mutation history: Up-to-date."

"Death, be not proud, though some have called thee" ... confused.

"CODE STATUS: ... DO NOT RESUSCITATE, DO NOT ANTICIPATE."




Oy. Just that: Oy. 


  

I dunno what this job is, but I know I don't want it

"She is an assistant depressible of stool."



(Dictated, "...principal of a school")
Tx again to Annie Nemous!

Dang it, Doc, I still can't see

"She is status post cataract with a rock year-old lens." 


("... intraocular lens.")

And this week's Sensitivity Award goes to...

...the doc who was dictating a death summary on a patient when this one rolled off his tongue:


"Date of death:  Anticipated." 




(Thanks to JW, who also commented, "I hope he wasn't dictating around family members.") 

We've all heard of loan sharks, but...

Lung sharks? WTF. 


"A high-resolution CT of the lungs showed . . .  central pulmonary arterial hypertension, sharks, and bronchiectasis." 

Harold! Get off that poor guy! Now!

"Harold was still present over his legs and feet and upper extremities." 


(Dictated: "Hair was still present...")

His mama forgot to have that Important Talk with him

"The etiology of conception is unclear."

(Dictated: "The etiology of intussusception is unclear." )

Good! I hate it when he blows that horn

". . . findings of decreased. . . labial bugle lingual coordination." 


(On swallowing evalution: "... decreased labial, buccal, lingual coordination")

Laiter, gaiter, when your spelling's straighter

Oh, dear . . . they really should never try to spell things, should they. I can't blame anyone for not knowing what a gaiter is; but still . . .


"...what appear to be marked chronic venous changes, with hemosiderin deposition in a gator, G-A-T-O-R, distribution..."

At least he gave me a chance to use illustrations! I love that. So:

This is a gator:

This is a gaiter:

And this is a gaiter-wearing gator:

Any questions?

Stop the presses! Rising medical costs due to redecorating!

"Leukocytosis . . . no evidence of an infection; perhaps sequela of recent new kitchen."

Name wrecks for your humpday

Nice day for some fun with names. Annie Nemous has sent in some awesome Name Wrecks:



"Dr. the brain"


"Dr. 1 foot" 


"Dr. P Dick" 
(rats; it seems what was dictated was "orthopedic service")

"Dr. prostate" 

(similarly, it's a pity he's with vascular surgery)

"Ms. sphincter is seen in our clinic today"

"Gentle colon, MD"

I'd appreciate that, thanks

"... the plan will be to leave his finger stuck in place." 




(dictated: "...to leave his Sengstaken-Blakemore tube..." )

It was, like, a really . . . mellow . . . operation, man

This one is courtesy of reader Annie Nemous. Thanks, Annie! It's not a Speech Wreck, but it's wonderful as is. I imagine this surgeon looking kinda like The Dude, but in scrubs:


""It appears that on the flexor side that the median nerve lost several of its muscular branches and there looks like to be a little area where there were some fibers that if you just flipped them cephalad or proximally, they looked like there has been a tear and part of this tear extended distally somewhat off of perhaps where one of the trunks of the motor nerves come out. "

"Like a Surgeon," woo-woo-woo....

ER report, middle-aged lady:


"She apparently has been set up to be a virgin, but not until next week."




I don't even know where to begin, so I'll just tell you that what he dictated was "...to see a surgeon." Ow. My diaphragm hurts. Good thing I don't need it to do my work.  

It's good to be compliant with your BP med, but this is ridiculous

"The patient is married to clonidine."

An endemic complaint

"He currently lives by himself and wanes old."