Dr Obvious: He knows more than you do

"The patient was born in Localtown, to her biological parents." 

Glad we cleared that up. Because sometimes, people are born to... wait, never mind. 

Department of Dental Redundancy Department

"ASSESSMENT: 1) Toothache. 2) Dental pain."

I'm not as think as you drunk I am

"The patient had ultrasound used to guide the placement of her wine." 

There might be a problem with this EEG

"The background consisted of 20 to 40 microvolts, to death." 

We're gonna need a bigger brace

This just in: Healthcare benefits extended to tall buildings!


"The patient wears elastic braces on his 28th floor."

(Dictated: "...braces on his knees for....")

The doctor will see you now, Mrs Bass

"This is a very pleasant 62-year-old widemouth female."

(Dictated: "...white female...")

Dr Obvious attends to detail

"The patient lives in Nearby County with his wife, who is still living, and is currently present in the room."

(It's good that she is still living, as zombies aren't yet included in the hospital's Infection Control plan.)  

Oh, speech wreck, you so silly

"FAMILY HISTORY: Gore."

Dictated: "Family history noncontributory." Perfectly clear dictation. Why did "gore" appear instead? We are not to know, my friend.

No bacon for you!

"The patient states he had no more hogs or problems since the early 80s."

(Dictated: "...no more heart problems...")

Don't be the problem, be the solution

"The patient is a normally dissolved female who is currently resting in the bed."

(Or is she the precipitate? Yes, Horse is still a science geek at heart.  Dictated was: ..."normally developed...)

You'll find it in the last place you look, you know

"MRI of the brain was performed to relocate this patient's brain."

(Dictate was "re-look at," which makes me grind my teeth, but never mind).

I think we're gonna need a bigger drill

"POSTOPERATIVE DIAGNOSIS: Dinosaurs caries."

(From a Peds. dentistry note--"early childhood caries").

If that's your chief complaint, geddouttahere

"She is widowed and is tired."

Gone fishin'

"The patient confirms some piscatory preoccupation and delusional thinking." 

(For fishermen, aren't those two the same thing? . . . Dictated was "persecutory preoccupation...")

Sunday Speech WRx

Latest batch of Speech WRx. They all appeared in draft medication lists, just as you see them below. See if you can guess 'em all. The last one is pretty obscure, so you should just give up.

1. Back to now

2. for a valid 

3. awoke again

4. clipped a real 

5. climbs up 

6. travels first  

7. Pus drained 

8. than the mouth pain 

ANSWERS

1. Actonel

2. chlorthalidone

3. amlodipine

4. clopidogrel

5. clonazepam

6. travoprost

7. Fosrenol

8. bendamustine

Ow. Ow. Ow. Ow.

"She has a burning IUD in place."

(Dictated: "... a Mirena IUD in place.")

Twittering

... Yeah, so I've caved . . . Never one to be hasty, I've given in after a mere year and a half of horsing around here and gone on Twitter. Why? I have no idea. The blue birdie button's over in the right-hand column somewhere. It's mostly going to be posts from this blog; not sure if I'll be adding anything more... you never know.  But feel free to, you know, retweet, or whatever people do. 

  

Taking 'sympathy pain' too far

"The patient and his wife were both resting comfortably following Dilaudid."

(Thanks to VR for this one. Finally got around to it).

I'd be uncomfortable too

"A very uncomfortable female. She looks like a kidney stone." 

(See, what happened was, while I was looking for a normal boring image of a kidney stone, I found this picture of a kidney stone with William Shatner's face. This is much better, don't you think? No, I'm not going to explain it; you'll have to google that yourself.)

Baron Munchausen, the doctor will see you now

"...the latter diagnosis is less likely, as the patient is not exhibiting the full consolation of symptoms." 

(Dictated: "...constellation of symptoms."

I'm feeling bad because I totally missed International Munchausen Day, but at least it provided us with this awesomely bizarre illustration).

Beer. It's what's for dinner.

"The patient underwent paracentesis with 2 beers taken off."

(... 2 liters taken off. Of course, the procedure was for alcohol-related cirrhosis, so we can squeeze a few more snickers out of it. We're pathetic). 

Teacher teacher I declare

"Eye movements are conjugate and full, with some psychotic intrusions on her student." 

(Dictated: "...with some saccadic intrusions in pursuit...")

Of Speech Wreck, Censorship and iPhones

There's a whole world of speech recognition software and hardware and apps and stuff going on out there, in case you weary delvers in the medical dungeons hadn't noticed. 


So I thought I'd share this delightful blog post with you; though not new, this matter of the Dragon iPhone app censoring its users was new to me, which is just as good. And the post is funny and well-written (and despite the subject matter, completely SFW, not that you'd be reading this at work, you scoundrel). 

Plumber, heal thyself

"He has worked as a plumber but is currently unable to void."

(Dictated: He has worked as a plumber but is currently unemployed.)


Thanks to the ever-helpful JP for both the wreck and the caption!.

Blah, blah, blah... (yawn), blah... wait, WTF?

"Hypokalemia may be mediated by her hydrochlorothiazide. I would expect her lisinopril to kill her."

(Dictated was "expect her lisinopril to counter...")

Dr Obvious is in the house

... or maybe it was just too soon after watching Hitchcock's "Psycho":

"Social history: The patient takes care of his mother.

*  *  *  

Family history: The patient's mother is still living."

 

Not a speech wreck. Just to keep you on your toes. 

Yeah, we've got an outbreak of that here, too

"Patient also has a diagnosis of ringed nose phenomenon."

(Approaching pandemic? ... Thanks to V.R. for this one!) 

Doc has a gift for understatement

"The arm and wrist were removed and there was noted to be stability of the joint."

In Soviet Russia, speech wrecks you!

"Mr. Xxxxovich is a pleasant elderly male from unbearable Russia."

It could be worse. I think.

"He lives with his wife, who is still living, but who also has some health problems." 

Fun With Names, It's Been Too Long edition

Yeah, it has been a long time, hasn't it? 



Dr Bronco Rhonchi 


Dr. Rub Steroid 


Dr. Scatterbrain


Dr. Is Not In 


CONSULTING PHYSICIANS: Dr. Are Not, Dr. Already Well 



 ...and we have found just the right facility for all these guys:


Failure Medical Center 

tough love

"The patient will be kicked in the chest pain observation unit overnight."

Umm... might want to try a different specialist

"He had no response of his wide-complex tachycardia to a dentist in the emergency department." 

(Dictated: "... to adenosine...")

It's probably not contagious

... Culture positive for gram-positive cockeye.

Mrs Gingrich, the lawyer will see you now

"Further care pending divorce in the hospital."




(Oh, dear, that was kind of political, wasn't it. How naughty.)  

And he wan't amused either. 

(Dictated: "...pending course in the hospital.")

Coming soon: The Skeletina diet

"CHIEF COMPLAINT

"I want to lose weight. I want to be faxed." 

(Dictated:  "... I want to be back [to my old self].") 

Thanks to SO for this one!

Docs versus Zombies!

"He is, of course, at risk of acute decomposition."

(Dictated: "...of acute decompensation")

Speech Wreck: Valentine's edition

Speech Wreck has a sentimental side, and what better day for a glimpse of it. 


"Plan: 
Check an echocardiogram. 
Sputum culture. 
A little tenderness."


Being the jaded old cynics we are, we happily observe that Speech doesn't neglect the, er... friskier side of things, either:


"Again, special note, I discussed this patient in bed with Dr. Attending."

(Dictated: "...I discussed this patient in depth with Dr. Attending." Thanks to the eagle eye of JW for this one.)

New diagnosis

The patient has a "history of chronic NERD."

Dunno about you, but I'm guilty as charged.

Hold the lox

"The patient is a pedestrian struck by a bagel tonight."

Happy New Year, everyone, and watch out for giant bagels in the streets.


("... struck by a vehicle..." And thanks to S.O. for this one!)

There's no surgery for that

"The patient reports a bulging desk."

And don't call me Shirley!

Speech Wreck inadvertently served up a timely little memorial to Leslie Nielsen today: 


"Shirley. The patient has had a prodrome of diarrhea for weeks, but more concerning is the onset of fever and epigastric pain..."




(Dictated was, "Surely, the patient has had...")

(R.I.P., Mr Nielsen, and thanks for so many laughs...)

Hurry, or you'll never catch them!

"She has IV fluid running at 125 miles an hour."

It sucks to be him

"He is allergic to diltiazem, oxygen, and prednisone."

Fun With Names, Thanksgiving Edition

--This actually has nothing to do with Thanksgiving, but it sounds cozy, doesn't it? 


Dr. Might Go Walls (orthopedic surgery)


Dr Brake Lining (nephrology)


Mr. Clinic Head 


Dr. Sputum Coming


Dr Serene

Okay, one CT, you want fries with that?

"We will have the CT scan from McDonald's sent to us for review."

Times are hard and funds are short

... so hospitals are exploring creative staffing options.


". . . .She suffered a fracture that was treated with closed reduction by the horse OPA in the emergency room."



We don't know what level of certification "OPA" represents, but we have full confidence in horses around here, so we're sure he did a pretty good job.




(Okay, okay, it was actually "...by the ortho PA." Spoilsport.)

No one can accuse this doc of not spending enough time with his patients

"Time spent preparing this patient for discharge has now been 41 months."

Caring, you know? It's all about the caring.

"He is critically ill. His prognosis is discarded."

Dangers of the passive voice and slippery articles

"The patient recently had a husband die."


This painfully passive-voice remark with it's odd use of "a" was thought about by me, and it was wanted by me to be finished in an interesting way, such as: 


"... but the patient still has two husbands who are not dead, so she is having her  garbage taken out by one and having her lawn mowed by the other." 


(In case it can't be noticed by you, the passive voice is much utilized by medical professionals but is detested here at Horse HQ.)