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08-10-2020
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#1
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Holistic Medicine and the Western Medical Tradition
Sneha Mantri
The Western medical tradition spans millennia, extending from the prehistoric use of plants and herbs to heal wounds through the technological advances of the present day. Over that long history, the practice of medicine shifted from prescientific holistic approaches to modern, scientifically supported explanations of pathology. As the practice of medicine became more thoroughly grounded in science, which seeks unified explanations for diseases, many feared the loss of individuality, both for the patient and the physician [1, 2]. Thus it is relevant for modern practice to examine the social and historical forces behind medicine's paradigm shift and what that shift means for the 21st-century patient-physician encounter.
In the early days of medicine, physical manifestations of illness were almost always explained in spiritual terms. In a world where the deities were believed to affect mortals directly, seizures, for instance, were thought to be the result of having angered the gods [3]. In 400 BCE, Hippocrates, often lauded as the father of Western medicine, proposed a new schema in which natural—not supernatural—explana tions of illness were sought. (It should be noted that the Hippocratic writings were probably not the work of a single physician but of a group of like-minded practitioners now referred to as "the Hippocratic physicians.") The Hippocratic treatise On the Sacred Disease, opens with: "[epilepsy] appears to me to be nowise more divine nor more sacred than other diseases, but has a natural cause from which it originates like other affections" [4].
This radical approach to medicine was not immediately accepted by peers of the Hippocratic movement. According to medical historian Lawrence Conrad, the pluralism of ancient Greek medicine meant that "healers, both male and female, competed with root-cutters, exorcists, midwives, bone-setters, lithotomists, gymnasts, and surgeons for patients" [5]. Although Hippocratic medicine began as one of many approaches to human illness, the structure of medical education in medieval and early modern Europe encouraged its dominance.
Hippocratic physicians were unable to study anatomy and physiology directly in the human body because dissection of human cadavers was forbidden on religious grounds. Instead, they relied primarily on logic and philosophy to explain disease. The central tenet of the theory was the belief that illness resulted from imbalances among the humors—blood, black bile, yellow bile, and phlegm. The physician's role was to diagnose the problem and tell patients how to restore their humoral balance and thus heal themselves.
Centuries later, Galen, a Roman anatomist who studied pigs, associated each humor with a personality. Certain temperaments were considered to be predisposed to illnesses of their humoral type, especially if the illness seemed to be triggered by emotional shock. Hippocratic-Galenic medicine was integrative, proposing a synergistic and individual relationship between each patient's body, mind, and personality and the outside world. For hundreds of years, this doctrine stood as the basis of Western medicine.
The seeds of change were planted as early as the 1500s when Andreas Vesalius, a Belgian physician, began teaching his students via direct animal dissection rather than by study of Galen's work. In 1539, an Italian judge gave Vesalius dispensation to dissect executed criminals, which changed the study of anatomy forever. Suddenly, structures that were previously only imagined could be visualized, handled, and sliced open to reveal hints of their living function. With the development of scientific, empirical study of human anatomy, the body-mind-personality connection that was so fundamental to Hippocratic-Galenic medicine was rapidly abandoned. As early as 1628, with the publication of William Harvey's explanation for the circulation of blood through a closed system by the pumping of the heart [6], physicians were beginning to view human physiology as the mechanized interaction of organs.
Simultaneously, growth in medical technology spurred the development of pathologic or morbid anatomy. In 1664, Englishman Robert Hooke published Micrographia, which revolutionized biology by using the microscope to view cells, a term coined by Hooke himself. Microscopy spread across Europe as a tool to study not just simple organisms but also the disease process. Together, gross and microscopic anatomy changed the ideology of medical discourse from philosophical to scientific. The definitive transformation of clinical medicine into a science based on pathologic anatomy came with Giovanni Battista Morgagni's 1761 publication of a five-volume tome De Sedibus et causis morborum ("On the Seats and Causes of Disease"). This catalog of diseases connected etiology to specific anatomical "seats" or locations.
The impact of technology and pathologic anatomy on medical practice had two major foci. First, its scientifically grounded explanations sparked an era of experiment-based medical progress that continues today. Armed with specialized knowledge about human anatomy and pathophysiology, the physician could at last take an active role in treating disease. Second, and more problematically, the voice of the patient, which had been so central to the Hippocratic doctrine, was silenced by the growing medicoscientific dialogue in which the uninitiated patient was unable to take part. In essence, power over the body had been transferred from the patient to the physician.
French philosopher Michel Foucault argues that the dominance of pathologic anatomy "dates precisely from the moment clinical experience became the anatomo-clinical gaze" [7]. For Foucault, the objectification of the patient is ethically problematic, a view by no means universal until the mid-20th century, if then. In fact, physicians of the 19th century considered the newly scientific basis of medicine "the ethical high ground" [8] and a moral imperative to their patients. French physician Xavier Bichat, writing in 1812, asked "What is observation, if we are ignorant of the place where the evil is seated?" [9]. Only by understanding the science of medicine, early modern physicians argued, would physicians be of service to their patients.
This view persisted through the 19th century. George Weisz, a historian of Victorian medicine, attributes the rise of specialties to "a new conception of disease; it was precisely the influence of localist pathologist thinking, based on pathological anatomy and subsequently on new technologies...that created 'foci of interest' in organ systems around which specialties could develop" [10]. Although it allowed for a deeper exploration of individual pathologies, the resultant division of the human body into disconnected pieces further eroded the integrative fundamental tenet that had sustained Western medicine for more than 2 millennia. The explosion of specialization was by no means unopposed; several 19 th- century physicians called for a return to Hippocratic integration, arguing that the new trend would "fragment medical science" [11] and ultimately hinder medical progress. Despite such opposition, specialization became an integral part of the modern, scientific practice of medicine. By 1905, 35 percent of Parisian doctors were specialists [12]. Pathologic anatomy would seem to have won its quest to universalize disease processes and divide the body into separate, barely connected domains.
In recent years Western medicine has consciously tried to integrate its ancient, patient-centered roots with modern scientific validity. In the late 20th century, with the rise of illness narratives by authors such as Susan Sontag, Reynolds Price, and Audre Lorde, patients began to reclaim their voices and therefore power over their bodies. The patient rights movement, borrowing from the concurrent civil rights and feminist movements, argued that the patient should be an equal partner with the physician in medical care. In response to these and other pressures to restore patient-centered medicine, medical schools began to revisit holistic medicine. Although evidence-based medicine remains an important part of medical education—123 of the 125 Association of American Medical Colleges schools required students to take at least one such course in the 2004-2005 academic year [13]—most medical students now also study complementary or alternative medicine (111 schools), medical ethics (124 schools), and population-based medicine (113 schools). Medical students of the 21st century therefore inherit from both the Hippocratic and the pathologic schools of thought.
The history of Western medicine chronicles a struggle between two opposing ideologies of patient care. On one hand, the integrative Hippocratic view; on the other, the specialization view, with an ethically problematic depersonalization of the patient that coincides with the rise of pathologic anatomy and medical technology in the early modern era. Although the modern dominance of pathologic anatomy has yielded centuries of medical progress, at times it threatens to divide and reduce the patient to a silent sum of mechanistic parts. Recent changes in medical education have begun to address the need for holistic medical care. Only with careful attention to both the individuality of illness and the universality of disease etiology can physicians most effectively care for their patients
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04-18-2021
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#2
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The Squeaky Needle Gets The Sweets
MASSACHUSETTS, MEDICAL OFFICE, NURSES, PATIENTS, SILLY, USA | HEALTHY | MARCH 25, 2020
(My immunization records for college are incomplete, so I need to get a couple of shots. I hate needles, but I can distract myself from the pain by chatting with the nurse. However, some shots are just more painful than others, and for this particular one I swear and go pale.)
Nurse: “All right, you’re all set! Are you feeling okay?”
Me: *sigh* “Yeah, I’m fine.”
(I pause.)
Me: “I mean…” *fake childish voice* “Wah! It hurts! I want a lolly!”
(I laugh. The nurse arches a brow.)
Nurse: “Do you actually want a lollipop? We’ve got some.”
Me: “What?! YES!”
(The nurse left and came back a minute later with a small bucket of lollipops. I picked a blue raspberry pop and proceeded to text several friends to brag about it.)
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04-18-2021
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#3
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Fluffy’s More High-Maintenance Than Most Pets Of His Kind
AWESOME, CALIFORNIA, GOLDEN YEARS, PETS & ANIMALS, USA, VET | HEALTHY | MARCH 23, 2020
(I work at the front desk at an animal clinic that is located on a street with many assisted living facilities. Most of them are not pet-friendly — they may have an office cat but residents can’t have personal pets — except for the largest of them which is right next door and pet-friendly.
We have a deal with the management of this facility where, whenever a new resident moves in with an animal, we set them up as a patient with us, the facility handles all their billing, we send care instructions to them to make sure the residents don’t forget the doses, and when making appointments we contact both the owner and the facility so they can make sure the owner doesn’t have something else scheduled that day and doesn’t forget their appointment.
For the humans who think they are more self-sufficient than they really are, we make sure someone from the facility is available and needs to take “important paperwork” over to the clinic at the same time the owner needs to leave, to make sure they get there and back safely. Sometimes they slip through alone, though, or decide they have an appointment when we don’t have them on the books, so we are used to having random elderly people coming in.
A clearly distraught elderly woman carrying a small dog carrier comes in one day.)
Woman: “Please, you have to help me!”
Me: “What can we do?”
Woman: “It’s Fluffy! He’s not acting right and I think I need to put him to sleep.” *sobs*
Me: “Oh, dear, we’ll get you and Fluffy in to see the doctor and take a look at him to decide if that is the best thing to do, okay? Now, what is your name so I can pull your chart?”
Woman: “It’s [Name I don’t have in my system].”
Me: “I can’t find you on the computer; have you been in before?”
Woman: “Oh, no, Fluffy and I just moved into our new apartment today and you are so much closer than his old doctor.”
(I figure she is so new the facility hasn’t had time to bring us her paperwork, so I get Fluffy’s age and breed and go about making a chart. We’ll get the rest of her information from the facility when we contact them. Thankfully, we’ve had a cancelation so I can get her into an exam room right away.
A while later, she comes out of the exam room with the doctor, with one of our techs carrying the carrier for her, much happier than when she came in.)
Woman: “And you really think it will cure him, Doctor?”
Doc: “If it doesn’t, you just have your doorman give me a call and we’ll get you back in, no charge. Now, I’m going to have my son carry Fluffy home for you. You have a good day.”
(The doctor is referring to our tech who isn’t actually his son, but that’s the code we use to let the front desk know the resident is not paying us directly and to just smile and say goodbye rather than following the normal checkout process. As soon as she and the tech are out of the building I turn to the doctor.)
Me: “So, we’re charging an exam and what else?”
Doctor: “Nothing.”
Me: “So, just the exam?”
Doctor: “No, Fluffy isn’t real.”
Me: “What?!”
Doctor: “He’s a stuffed toy; he’s just been laying around all day for weeks now. So, I told her we were going to try an experimental treatment, and if it works, that’s great, and if not, she can bring him in to be put to sleep later. Then, I drew up some air from an empty vial and injected it. She said he already looks perkier. Poor thing; she is really far gone.”
(Tech returned almost an hour later. The woman wasn’t from the facility next door, or even the one on the other side of them. She was from the one almost all the way down the block, and they had to check into all of them because she couldn’t recall which apartment building she lived in.
To their staff’s credit, they thought she had gone to get lunch with her daughter and her daughter thought her mom was taking a nap after an exhausting morning of moving in. Nobody knew Fluffy had been feeling bad, or that he was capable of feeling bad.
The experimental treatment worked great for a month, and then Fluffy relapsed and had to come in for another treatment. We gave him his shot once a month for three years, and then one day he just stopped coming in.
Six months later, the daughter brought him in; her mom had become too ill to take Fluffy for his shots so she had just taken him out of the building for a bit and then come back and told her mom he’d had his shot, and now her mom said she couldn’t take care of Fluffy anymore so could we find him a new home. We found him a nice place in the doctor’s office; he’s our supervisor.)
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04-18-2021
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#4
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What A Doll
DOCTOR/PHYSICIAN, JERK, NON-DIALOGUE, USA | HEALTHY | MARCH 22, 2020
I was born prematurely and at low birth weight. I was four pounds, five ounces at birth. I had none of the typical newborn baby fat; my cheeks were flat and my head was bulging, while the rest of me was skinny and angular. To be blunt, I looked like an alien. Other than that, however, I was perfectly healthy and was discharged a day later. My mother took me for my first doctor’s appointment to a well-known, established pediatrician in town, who was known for being rather coarse in mannerisms but otherwise knowledgeable.
He went through all the usual tasks of a newborn check-up including checking normal infant reflexes. One of them was the step reflex, in which a newborn appears to walk or step when they are held upright and their feet touch a flat surface. The doctor, for some reason, used his hand as the flat surface, and this procedure ended with him supporting my neck and back with one hand and my feet with the other. He looked at me, looked at my mother, and then mimed — with me — a jaunty little dance through the air. To my mother, he remarked, “Look, it’s E.T. riding a bike!”
He honestly couldn’t understand why my mother didn’t find that nearly as amusing as he did. Or why my mother found a new pediatrician.
And she gets annoyed when I point out that, in his defense, I did look like a tiny, baby alien dressed in doll’s clothes.
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04-18-2021
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#5
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There’s No Need To Behave Like An Animal About It
IMPOSSIBLE DEMANDS, PHARMACY, USA, VET | HEALTHY | MARCH 19, 2020
(I work as a receptionist for a veterinary hospital. Earlier today, I gave a prescription to a client for a drug that is classified as Schedule II, which means it is considered as having high potential for abuse, so our facility is not licensed to carry it on-site. It can only be picked up from a human pharmacy. Thus, we write prescriptions instead of filling them ourselves at our on-site pharmacy. My first interaction with the client ends like this
Client: “So… what do I do with this?” *holds up prescription*
Me: “You take it to a pharmacy, just as you would with a prescription from your doctor. I would recommend calling around to see which places have it first before going anywhere because not all pharmacies can or do carry it.”
Client: “Can you call the pharmacies for me?” *stares expectantly*
Me: “I’m sorry, but I can’t. There are dozens of pharmacies in the area, and I have no idea which places have this drug. And unfortunately, I have other clients waiting so I’m not able to set aside that kind of time.”
(She’s not happy with my answer, but she takes the prescription and leaves. Maybe an hour later, I get a call from her.)
Client: “So, can I use my insurance card to pick up the medication?”
Me: “I’m sorry, but I don’t believe that’s legal.”
Client: “But I’m getting the medication from a human pharmacy. Why can’t I use my insurance?”
Me: “Because the medication is for your dog, and the prescription is filled out to reflect that. The pharmacy will be aware it is for a dog, and your insurance only covers you. If you have pet insurance, that may or may not help cover it, but that depends on your plan.”
Client: “Well, I should be able to use it. It’s a pharmacy, not a vet. Why can’t I use it?”
Me: “I’m very sorry, but I’m not sure what else I can do for you. If you have further questions, I can ask the vet to speak with you.”
Client: “No. Never mind!” *hangs up*
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04-18-2021
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#6
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A Wheelie Cool Therapist
AWESOME, EDITORS' CHOICE, HOSPITAL, INSPIRATIONAL, PATIENTS, THERAPIST, USA | HEALTHY | MARCH 16, 2020
(I’m a physical therapist. My next patient is reportedly frail; she’s wheelchair-bound and doesn’t leave her bed.)
Patient: “Can you teach me to do a wheelie?”
(I couldn’t help but laugh. She ended up being a fairly healthy girl, albeit with less muscle tone due to her condition. The reason she hadn’t left her bed? The nurses had put a bed alarm on her — standard procedure for someone like her — and she hated moving with an IV.
I wasn’t allowed to teach her how to do a wheelie, but I was able to teach the basic concept. Get a friend to pull you back, practice balancing for a while, and then try it on your own. Shove the wheels, hard, and have someone catch you when you fly backward. I think she’ll be just fine.)
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04-18-2021
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#7
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Enough Of This Song And Dance!
AUSTRIA, DOCTOR/PHYSICIAN, HOSPITAL, JERK, NON-DIALOGUE, PATIENTS | HEALTHY | MARCH 14, 2020
CONTENT WARNING: This story contains content of a medical nature. It is not intended as medical advice.
I am a musical theatre major, meaning that I spend the better part of my day in a ballet studio dancing or working out, and during what’s left of that day I’m either singing, acting, or both. After having an inherent heart condition fixed as a young teenager, I am proud to say that I am mostly healthy, a couple of minor-ish issues — as well as notorious unresponsiveness to most kinds of medication — aside.
About fifteen months ago, though, I get sick with something that is labelled “minor, superficial pneumonia” at first, and after sitting in my body for about two weeks turns into “asthmatic-spastic bronchitis.” Later, it becomes full-blown asthma bronchiale which, thanks to hyperreactive bronchia, I am very used to catching around twice a year. Usually, after a couple of weeks, it’s gone again, and my asthma falls asleep into insignificance once more.
Not this time.
The weeks come and go, and nothing happens. I’m fully incapable of doing anything at the conservatoire — but thankfully most of my professors are amazing and give me all the support they can possibly give me — and I’m getting more and more frustrated. My pulmonologist, after failing to succeed with several more antibiotics and cortisone therapies, is unwilling to give up on me and refers me to all possible colleagues. I get tested for pertussis, even for tuberculosis — and pretty much everything else — but they can’t find anything.
After just barely passing my semester with the worst possible acceptable grades, I go home for my semester break. By that time, this has gone on nearly two and a half months already. My pulmonologist tells me to continue my treatment, or rather, the search for a concrete diagnosis, as she is at her wit’s end.
I do, and they actually get the idea to do a bronchoscopy where, at last, they find not only a virus, but also bacteria that seem to cause all the trouble, sending me into a spiral of a constant asthma attack, which expresses itself with the symptoms of a chronic, constant bronchitis. They send me home with more antibiotics, telling me I can’t do much more but “sit it out and hope it’ll be gone in four to six months,” and put me on sick leave for my upcoming semester, since I can neither sing, dance, nor do anything on the acting front. I move back in at home with my most amazing, most supportive parents, and I begin my journey of doing not much of anything at all.
All throughout the time, I’m feeling flu-ish sick, with often insufferable headaches and horrible sore throats, short- as well as flat-breathed, and I obviously also cannot get rid of that cough. I have better days and worse, but the worse days definitely outweigh the good ones. Basically, I’m knocked out of my life entirely, and I often even have to think twice if I want to take a brief trip to town.
The months pass and nothing happens. There’s no improvement that lasts longer than two weeks and doesn’t follow a massive breach again. I lose another semester, as well as a fair share of friends. And, due to lack of movement, unsuccessful medication treatment, and, as I only just recently found out, my hypothyroidism acting up again, as well, I gain quite some weight; I’m not obese and still fit into most of my clothes, but you wouldn’t believe me the dance student, either.
I haven’t been idle over that time; I’ve been looking into common and alternative medicine and am in the middle of a doctor marathon, to not much avail except for the revelation of several more issues to work on, and about a month ago — as this has been going on for longer than a year already, and I’m beyond frustrated and only very desperately trying to scratch the final pieces of my patience together — I am referred to the pulmonologist department of my local hospital to finally treat my set-in-stone asthma diagnosis, as many doctors seem to purposefully ignore the bacterial aspect of my issues.
I have so many hopes for this appointment. But when I walk in, I see that, instead of [Doctor #2 ], who I am supposed to have the appointment with, I am met by a super young, and super overwhelmed-looking [Doctor #1 ].
I present him with all kinds of older to recent-ish but not super recent bloodwork and diagnoses and some very real proof that there are indeed physical issues to be resolved.
I explain, “…and this is why your colleague from the immunology department referred me over to you. It’s a rather pressing issue because my new semester is about to start, and I’d hate to miss the third one in a row. I really can’t do any dancing, singing, or much of anything at all, so I’m quite desperate about making progress. But unfortunately, I have issues with medication showing proper effect; it’s been like that since my heart issues way back as a child and starts with super simple things like common painkillers needing super high doses to start working.”
The doctor doesn’t even seem to listen properly. “Well, we couldn’t find anything physical in your test results…”
All they did was a basic lung function test, the results of which often fluctuate depending on my day.
I respond with confusion, “Um… But… I am officially diagnosed with asthma bronchiale already. Also, my lung function results fluctuate really badly, from unacceptable to–”
The doctor cuts me off. “There are no physical issues, and your lung function seems to be low but not concerningly so.”
“Well, as I explained before, it really fluctuates and–”
He interrupts again. “Well, this is definitely not a physical issue, and your lung function is–”
I cut him off this time. “But I really just said…”
[Doctor #1 ] ignores me and gets up to get [Doctor #2 ], who doesn’t even bother to sit down, and very clearly looks like she has no interest whatsoever in being here or helping me.
“Well, as my colleague already informed you, we cannot find any physical issues to work with, and clearly, you are not asthmatic.”
I sigh inwardly. “I really just explained to your colleague before that I have my official asthma diagnosis; I just need treatment for it, which is difficult because most kinds of medications have a really hard time to show any kind of effect besides the side effects, if they even work at all–“
[Doctor #2 ] says, interrupting me harshly, “If you were asthmatic, we would be able to treat you with cortisone inhalers, and those never showed any effect, so all you really have is a hyperresponsive larynx.”
I’m absolutely stunned at how they both have so successfully ignored anything I’ve said in the past couple of minutes. “But… as I said… and my lung function… I know it looks better now but it really, really depends on the day and… It’s really not only the cough; there are so many other issues that–”
Cut off again! “And your lung function isn’t that bad. I’ll just give you [super intense nervous system medication that is usually prescribed to epilepsy and severe anxiety patients, neither of which I even remotely suffer from] for your hyperreactive larynx. As for the fatigue, here’s a referral to outpatient rehab.”
[Doctor #2 ] gets up and leaves again without giving me the chance to say anything at all.
“It’s really not just the cough; it’s–“
[Doctor #1 ] proceeds to explain the effects of the just-prescribed medication without listening.
My mum, who had accompanied me, hasn’t had much of a word, either, so we just decide to give up on that lost cause and leave, both of us boiling inside. Not for one second do I consider having that prescription filled and taking this stuff, no matter how desperate I may be. Looking on the piece of paper, I was handed, I also find out that [Doctor #2 ] put “fatigue,” “chronic cough,” and “obesity” on my rehab prescription, which I am still livid about.
Later that day, I have a routine follow-up appointment with a new cardiologist, who not only is as appalled by this behaviour as we are, but also draws blood and reveals several very physical indeed issues, among them high inflammation signs, my hypothyroidism being at a not-dangerous-but-alarmingly-low level again, and the bacteria still being very, very present within my body. I’m referred to another pulmonologist immediately.
While I am, indeed, missing my third semester in a row, quite unsurprisingly, that new pulmonologist has not only found out that my lung function is currently at a new low point, but confirmed a “clearly asthmatic reaction and movement,” put that into the diagnosis, and promised to investigate if there is anything else behind it that I need to be treated for.
Fascinatingly enough, he has also listened to my medication issues and prescribed me two new inhalers that he’s hoping will help me as one of the 5% who actually do not react to common cortisone treatments.
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04-18-2021
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#8
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Anti-Antibiotics
AUSTRALIA, DOCTOR/PHYSICIAN, LAZY/UNHELPFUL, MEDICAL OFFICE | HEALTHY | MARCH 13, 2020
(I am twelve weeks pregnant. I have already seen one doctor who left the medical practice and I am seeing a new doctor. He goes through my test results, which the previous doctor had already spoken to me about.)
Doctor: “It says here that these numbers are fine, but the other doctor had you on an iron supplement. You don’t need that.”
Me: “Are you sure? The other doctor was quite worried about my numbers.”
Doctor: “I’m sure. And you are taking antibiotics for a UTI, but you don’t have one.”
Me: “The other doctor said I had proteins in my urine which indicated a UTI.”
Doctor: “No, definitely not.”
Me: “Okay, I need a referral for a twelve-week scan.”
Doctor: “You don’t need that.”
Me: “My daughter had a congenital heart defect; I’d prefer to get all scans.”
Doctor: “The only reason they want to diagnose in the womb is to do surgery in the womb.”
My Husband: “They needed us at a bigger hospital when she was born, in order to give her surgery.”
Me: “Can you just write the referral, please?”
Doctor: “You don’t need it, but if you insist.”
(We left the office and quickly realised he had written a referral for a twenty-week scan which the ultrasound place can’t take. I organised an appointment with another doctor who also checked my blood. She immediately pointed out that I had a UTI and should be taking antibiotics, and that I had low iron and should take a supplement.)
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04-18-2021
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#9
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Being A Pill About The Pills
CALIFORNIA, PATIENTS, PHARMACY, STUPID, USA | HEALTHY | MARCH 12, 2020
(I work in a community pharmacy. I cannot tell you how many times I have heard this story in some variation, as have my staff and coworkers in this field.)
Patient: *comes up to the counter* “Hi, I need to fill my medication.”
Clerk: “Oh, of course. Which medication did you need today?”
Patient: “I don’t know; it’s on my profile.”
(The clerk reviews the patient’s profile, which has more than 25 prescriptions dating back years.)
Clerk: “Do you know which one? There’s a bit of a list on your profile.”
(At this point, they will usually say one of two things
Patient: “I don’t know. Just fill all of them.”
(Or…)
Patient: “It’s the white pill.”
(This is where the clerk will grab one of the pharmacists.)
Pharmacist: “I’m sorry, sir, but we can’t just fill everything on your profile, as we don’t know which of these medications you take or have stopped taking.”
(Also, the staff hate having to fill a dozen or more prescriptions, only for the patient to say they need one or two of them; the rest we have to put back, wasting all the time and effort we needed to fill.)
Pharmacist: “Do you know what you take it for? Diabetes? Blood pressure?”
Patient: “I don’t know. It’s the white pill.”
Pharmacist: “Most of the pills on your profile are white. Do you know how many times you take it? Was it big or small? The first letter of the name or the doctor who wrote it?”
Patient: “How am I supposed to know?! You’re the pharmacist! You should know this! IT’S A WHITE PILL! I KNOW IT’S ON THE COMPUTER!”
Pharmacist: “Sir, I need a little more information to go on than just the color. Here’s our card; you can go home, find it, and then call it in. Or bring the bottle with you next time and we can help you more.”
(The patient stomped off. Seriously, if you come to the pharmacy, please know something about what you want to pick up. The vast majority of all the pills on the shelf are white. Bring the bottle, take a picture of the bottle, write down the name. Something!)
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04-18-2021
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#10
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R11 Độc Cô Cầu Bại
Join Date: Aug 2007
Posts: 113,688
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This Doctor’s Stubbornness Runs Deep
DOCTOR/PHYSICIAN, HOSPITAL, IGNORING & INATTENTIVE, LAZY/UNHELPFUL, MILITARY, USA | HEALTHY | MARCH 11, 2020
(Whenever I start coming down with any sort of respiratory infection, my voice gets deeper. The deeper the voice, the worse the illness is. I am stationed overseas in the nineties when a couple of coworkers notice that my voice is getting deeper. I go to Sick Call the next morning, and the corpsman, familiar with my history of pneumonia, sends me to the nearest US military hospital about 100 kilometers south to get seen by actual doctors.)
Doctor: “What brings you in today?”
Me: “I’m coming down with some sort of chest bug. Every time my voice gets deep, I get sick a few days later.”
Doctor: “What sort of symptoms are you having?”
Me: “At the moment, just the deep voice.”
Doctor: “That could mean anything. It’s probably acid reflux.”
(So far, the doctor has not examined me in any way.)
Me: “Whiskey Tango Foxtrot? Sir?”
Doctor: “I’ll prescribe you an antacid for a week or so. You should also prop up the head of your bed just a bit, to help control the reflux.”
Me: “First, I’m not here for acid reflux. I’m coming down with some sort of twitching awfuls, because my voice is getting deep. When I start sounding like James Earl Jones, I always get pneumonia or bronchitis or some other chest ailment within a couple of days. Every time. Since the deep voice just started being noticeable, I’m trying to get ahead of the disease. Second, I have a waterbed. Propping up the head of the bed will have no effect.”
Doctor: *frowning* “Sure, it will work. Just put a boot under the corners of your headboard. This will raise your upper body slightly and help prevent acid reflux from irritating your larynx.”
Me: *sighing internally* “With all due respect, sir, you cannot tilt water. It always stays level.”
Doctor: “Just raise your headboard a couple of inches. You’ll see.”
Me: *sighing out loud this time* “Sir, it’s a waterbed. Here’s a demonstration: run a little bit of water into that portable basin next to the sink.” *pointing at the small metal basin*
Doctor: “Okay.” *runs water into the basin*
Me: “Now, tilt the basin up on one end.”
Doctor: *lifts one end of the basin slightly*
Me: “Notice that the water stays level, no matter how high you raise either end of the basin? That’s why raising the head of my waterbed will be less than useless.”
Doctor: “Oh. I guess you’re right. I suppose we’ll have to get you an appointment with the gastroenterology clinic to cure your reflux.”
Me: *facepalm* “Sir, I don’t have reflux. Could you please listen to my chest?”
(I was given a prescription for antacid and told to go back to work, all without the doctor conducting an examination. Three days later, I was back in the hospital as an inpatient… with pneumonia.)
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04-18-2021
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#11
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R11 Độc Cô Cầu Bại
Join Date: Aug 2007
Posts: 113,688
Thanks: 7,428
Thanked 46,715 Times in 13,091 Posts
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Rep Power: 161
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Green With Envy Over Your Ability To See Color
ART/DESIGN, COWORKERS, HEALTH & BODY, RETAIL, USA | HEALTHY | MARCH 10, 2020
(I know my coworker and his wife pretty well — I went to their wedding — and they’re often in the store either helping with or participating in events when they aren’t working. They’ve finished both of their events this day and are going past the counter to leave, and they walk by me. I overhear their discussion, and they rope me in.)
Coworker: “It’s brown!”
Coworker’s Wife: “It is not! [My Name], what’s the color of my shirt?”
(Because she is wearing a BRIGHT RED JACKET, it’s pretty obvious what color the shirt is; however, if you just glanced at it, it might be misconstrued as brown.)
Me: “Uh, it’s green?”
Coworker: “Is it? But it’s brown!”
Me: *peering at it* “No, it’s green; it’s a dark green.”
Coworker’s Wife: “It’s emerald green.”
Coworker: “Well, it had better not be olive green, because that’s a color that doesn’t exist.”
Me: “But… What?”
Coworker’s Wife: “What color are [My Name]’s bracelets?”
(On my wrists are a paracord bracelet and a FitBit band, respectively.)
Coworker: “Well, I know that one is bright green and purple, and that one is… well, I dunno.”
Me: “[Coworker], it’s green. You’re colorblind.”
(I guess you learn something new every day — and this came as a bit of a shock to him, too!)
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04-18-2021
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#12
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R11 Độc Cô Cầu Bại
Join Date: Aug 2007
Posts: 113,688
Thanks: 7,428
Thanked 46,715 Times in 13,091 Posts
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Rep Power: 161
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Paging Doctor Cymbeline
AUSTRALIA, FUNNY NAMES, HOSPITAL, WORDPLAY | HEALTHY | MARCH 9, 2020
(I work on the switchboard for a major hospital. We take a lot of calls, have a lot of options to put callers to, and are, unfortunately, very used to callers giving us very little information so we have to guess the rest.)
Me: “Good afternoon, switchboard.”
Internal Caller: “Yeah, can I speak to Imogen?”
Me: “Imogen who?”
Internal Caller: “I don’t know.”
Me: “Uh, okay. Do you know what Imogen does or what department she works in?”
Internal Caller: “I don’t know; the doctor just wants a copy of an X-ray.”
Me: *light-bulb moment* “OH! You want to speak to imaging!”
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04-18-2021
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#13
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R11 Độc Cô Cầu Bại
Join Date: Aug 2007
Posts: 113,688
Thanks: 7,428
Thanked 46,715 Times in 13,091 Posts
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The Most Relatable Toddler
ADORABLE CHILDREN, DOCTOR/PHYSICIAN, MEDICAL OFFICE, USA | HEALTHY | MARCH 8, 2020
(On the morning of my son’s two-year-old “well-child” checkup, he wakes up unusually grumpy. Shockingly, the news that he has to go to see the pediatrician does not improve his mood, so in an effort to get him to stop whining in the back of the car, I make an absolute rookie mistake. I promise him that after his appointment, I will take him on a trip to his favorite place. I then discover that I have the kind of two-year-old who neither understands nor accepts the concept of “after,” and as such, the following interaction happens at least six times in the next 45 minutes
Son: *wordlessly bawling at the top of his lungs*
Nurse: “Oh, no, what’s the matter?”
Son: “I WANT TO GO TO TARGET.”
Nurse: “Me, too, honey. Me, too.”
(At least he did not scream at the doctor. Instead, he gently wept and whispered, “Please. Target.”)
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04-18-2021
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#14
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R11 Độc Cô Cầu Bại
Join Date: Aug 2007
Posts: 113,688
Thanks: 7,428
Thanked 46,715 Times in 13,091 Posts
Mentioned: 1 Post(s)
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Rep Power: 161
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A Would-Be Thief Has His Eyes Opened
CRIMINAL & ILLEGAL, MEDICAL OFFICE, OPTOMETRIST/OPTICIAN, SOUTH CAROLINA, USA | HEALTHY | MARCH 7, 2020
(I work with patients at an eye specialist, checking vision and administering eye drops. One day, one of my newer coworkers comes to me about a patient.)
Coworker: “He’s complaining about his eye being sore, but he’s asking way too many questions about [expensive temporary numbing agent for office use only].”
(I trust his judgment, so I ask another technician to casually restock something in the exam room where the patient is waiting for the doctor and take the numbing drop with him when he’s done. Not ten minutes later, when the doctor goes to see him…)
Patient: “Hey, Doc, why can’t you give me some more of those numbing drops?”
Doctor: “Because too much is toxic for your eyes. A patient stole a bottle years ago and used it non-stop for days; it really damaged their eye.”
Patient: “Good thing you said that, Doc, because I was planning on stealing that bottle!”
(He said this without any embarrassment whatsoever! I only hope he learned not to mess around with that sort of thing.)
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04-18-2021
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#15
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R11 Độc Cô Cầu Bại
Join Date: Aug 2007
Posts: 113,688
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A Very Expensive Taxi
EMERGENCY SERVICES, LIARS/SCAMMERS, NEW JERSEY, PARTY, USA, WEATHER | HEALTHY | MARCH 6, 2020
(I worked in volunteer emergency medical services for years. Without charge to anyone, a person would call 911, which would then send me and a crew with an ambulance to provide emergency medical care and transportation to the hospital. Unfortunately, our experience was that during a blizzard, some people would call 911 with a fake medical emergency and then decline transportation to the hospital. This was done because they had learned that a snowplow would be dispatched in front of our ambulance to make sure we had a clear route to the house in question. This way, the person would have their street plowed before others. The request of the woman in this story, however, blows my mind. We arrive at the location following the snowplow that is clearing 18 inches of snow on the road. I trudge up to the door and ring the bell. A young woman with an alcoholic drink in her hand answers. There is loud music playing. This is obviously a “blizzard party.”)
Me: “[Town] EMS, who is having the emergency?”
Woman: “Yes, that’s me. Um, I have diabetes.”
(I know that anyone with diabetes should not be drinking an alcoholic beverage.)
Me: “Okay, let’s sit down and check your blood sugar. Are you feeling badly?”
Woman: “Oh, no, I don’t need anything like that. I already checked my blood sugar. It’s [number that’s a bit high, but not an emergency]. I need my insulin from my house in [Next Town Over]. I was wondering if you’d drive me to get it?”
Me: “Ma’am, we are an ambulance for medical emergencies. We cannot transport you from one house to another. The policeman over here, however, most likely will.”
Woman: “Oh, that’s great. But, um, after I get my insulin, could he bring me back here to the party? I’m having such a great time!”
(I just facepalmed. The policeman did give her a ride home to her insulin… but not back to the party.)
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04-18-2021
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#16
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R11 Độc Cô Cầu Bại
Join Date: Aug 2007
Posts: 113,688
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Science Flu Right Over Their Head
HOSPITAL, ILLINOIS, MATH & SCIENCE, PATIENTS, STUPID, USA | HEALTHY | MARCH 6, 2020
Nurse: *to a patient* “Do you want a flu shot while you’re here?”
Patient: “No, I don’t get flu shots.”
Nurse: “Oh. Have you had an adverse reaction to them?”
Patient: “No. Vaccines cause cancer. I know that because I’ve been to Japan. People there aren’t vaccinated, and no one gets cancer in Japan.
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04-18-2021
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#17
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R11 Độc Cô Cầu Bại
Join Date: Aug 2007
Posts: 113,688
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Thanked 46,715 Times in 13,091 Posts
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To Censor Or Not To Censor: The Editors’ Dilemma
DOCTOR/PHYSICIAN, NON-DIALOGUE, PENNSYLVANIA, PUNNY, SILLY, USA, VET | HEALTHY | MARCH 5, 2020
Our English Setter has had surgery to repair an ACL injury. She chews on her stitches and manages to pop one. We load her in the car to make the 45-minute drive to the vet, calling ahead to make sure they know we’re coming, as we know we’ll be pushing closing time for them.
We get there a few minutes before close and our vet comes into the waiting room to greet us. He picks up our girl and proclaims dramatically, “What did you do that for, you b****?!”
His vet tech (and we) totally lost it.
And he replaced the stitches with staples for us!
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04-18-2021
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#18
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R11 Độc Cô Cầu Bại
Join Date: Aug 2007
Posts: 113,688
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Nancy The Needler Strikes Again!
BLOOD DONATION, JERK, USA | HEALTHY | MARCH 4, 2020
(While I am very squeamish about needles, I like to give blood often because I am a universal donor. I have family that have needed transfusions, so I like to donate in honor of the people who have helped them. Volunteers are usually very nice and ease my needle anxiety throughout the process. Not this time, though.)
Volunteer: “Lay down here.”
Me: “Okay. Just so you know, I’m kind of scared of needles. It would really help if you could just count down before you prick me.”
Volunteer: “No. I’m not doing that. Lay down.”
Me: *getting nervous now* “Wait. Why can’t you just count down to let me know when you’re putting the needle in?”
Volunteer: “You’re a big girl; suck it up.”
(She grabs my arm and quickly uses a wipe to disinfect the area. I’m a wreck, so I jump when she does this, even though I’m not in pain. I’m just so anxious about this needle now.)
Volunteer: “You can’t jump like that when I put the needle in! I’ll have to do it over if you jump like that!”
Me: “I won’t jump if you just count down or let me know when you’re putting it in!”
(I’m shaking at this point and close to hyperventilating.)
Volunteer: “What’s the point of giving blood if you’re going to be so jumpy?!”
(Eventually, I calm down enough for her to prick my arm quickly. A few months later, I’m giving blood again and am relaying this story to another volunteer, who was kind enough to count down before putting the needle in.)
Nice Volunteer: “Was she skinny, tall, dark hair…?”
Me: “Yes! That was her!”
Nice Volunteer: “Oh, that was Nancy. We got a lot of complaints about her. She doesn’t come to blood drives anymore”
(Thankfully, I never saw her again.)
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04-18-2021
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#19
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R11 Độc Cô Cầu Bại
Join Date: Aug 2007
Posts: 113,688
Thanks: 7,428
Thanked 46,715 Times in 13,091 Posts
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We’ve Heard Of Child Soldiers, But That’s Ridiculous
BLOOD DONATION, COLLEGE & UNIVERSITY, STRANGERS, STUPID, USA | HEALTHY | MARCH 3, 2020
(It’s circa 2009 and there is a blood drive going on at our school. I am sitting with a worker, doing the health screening questionnaire to rule out anything that would disqualify my blood. There are some questions that definitely shouldn’t apply, such as whether or not I’ve been in various parts of the world a decade before I was born, but I understand they need to be asked. Then, we get here
Worker: “Between 1988 and 1995, were you in the military or the dependent of someone in the military?”
Me: “Yes.”
(There’s a long pause.)
Worker: “So… you were a dependent?”
Me: *pause* “Yes.”
(Granted, I could have been more specific. But given that this blood drive was being held at a college, primarily with young adults who had only reached the age of conscription in the last five years, AND given that she had my birthdate of 1990 right in front of her on my paperwork… I didn’t think I needed to!)
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04-18-2021
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#20
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R11 Độc Cô Cầu Bại
Join Date: Aug 2007
Posts: 113,688
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Thanked 46,715 Times in 13,091 Posts
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That’s The Spirit?
BIZARRE, RELIGION, USA, VET | HEALTHY | MARCH 2, 2020
(I work for a vet. The phone rings.)
Me: “[Clinic], this is [My Name]. How can I help you?”
Client: “Hi. I got a card in the mail that my cat is due for a checkup, so I’d like to schedule that.”
Me: “Certainly. May I have your last name?”
Client: “It’s [Last Name].”
Me: “Okay, and is this for [Cat]?”
Client: “Yes.”
Me: “Okay, according to our records, it looks like [Cat] is overdue for her upper respiratory and distemper vaccine. Would you like to have that boosted?”
Client: “Oh, I don’t know. I’ll have to talk to my husband about that. Can I let you know when I come in for the appointment?”
Me: “Of course.”
Client: “We’ll have to pray about it and dowse to decide.”
(As far as I know, dowsing refers to holding sticks to try and find groundwater. I have no idea how the client intends to use it to decide whether to vaccinate her cat.)
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