Wednesday, August 31, 2016

Differential

Dr. Grumpy: "This is Dr. Grumpy, returning a call."

Dr. Hack: "Yeah, this is Mike Hack, I'm an internist on the east side, and I'm not happy about what you told my patient."

Dr. Grumpy: "The guy with Myasthenia Gravis?"

Dr. Hack: "Yeah. I'd told him he had a stroke, and you have the balls to tell him something else?"

Dr. Grumpy: "But... he didn't have a stroke. His MRI was normal."

Dr. Hack: "Look, he had slurred speech. Any idiot can look up slurred speech and find out that it can be caused be a stroke. Except, apparently, a neurologist."

Dr. Grumpy: "A lot of things besides stroke can cause slurred speech. His brain MRI was normal, his Myasthenia antibodies were elevated, and he responded to Mestinon."

Dr. Hack: "Yeah, whatever fancy bullshit testing you people use nowadays. I've never referred to you before, and I sure won't do it again."

Click


38 comments:

Andy Syms said...

Jeez! What an arsehole for a so-called healthcare professional.

Glad he's not my GP. I feel sorry for his other patients.

Heidi said...

This is kind of horrifying.

MSGMD said...

Get his medical training at Google University? Probably a climate change denier, too.

Anonymous said...

Well, I don't think Dr. Hack is necessarily wrong. I just looked up the symptoms on WebMD and it appears this guy is also pregnant and has an acute 404 error, connection not found.

Anonymous said...

Can you report another physician to the licensing board for that level of dumb?

Liz said...

The only balls causing a problem are his, which you apparently stepped on. Big egos make poor physicians. And that last sentence? "I'm butthurt about making a mistake and too immature to handle it"

Powers said...

At least now I know that brain MRIs are "bullshit testing". I'll be sure never to go in for one!

Anonymous said...

Wow...just wow.

Packer said...

I diagnosed the patient as a drunk because he slurred his words, he was happy because his regular doctor told him he had a stroke.

Anonymous said...

Diagnosis-schlomosis!

bobbie said...

I'll bet that last statement put a Huge grin on your face!!!

Mage said...

What an idiot./

Loren Pechtel said...

Things like this need to be reported.

animal lover said...

I guess Dr. Hack is not getting Dr. of the Year award.

Andy Syms said...

@Packer: Rimshot!!!

Anonymous said...

It sounds like Dr. Mike Hack might have missed a certifying board exam or two and some CME courses. Judging from his statement before hanging up on you, Dr. Hack must be quite a bit older than you and getting testy in his dotage. There is no excuse for the lack of professional courtesy he showed to you. Sooner of later, that attitude of his will catch up to him and bite him in the ass.

gardenqueen said...

Have you started your book on how not to doctor yet?

Anonymous said...

"Myasthenia Gravis is the biggest hoax of the 21st century. It's just a big scam being perpetrated by the neurologists who control the AMA and all the mainstream medical journals. There's a YouTube channel that's going to blow the lid off this scandal."

Yoko Drāno said...

"Look, pal, I told the patient he had a stroke, and now my credibility is on the line here. If you make me look bad, I'm never going to be able to recruit him into my Herbalife network. You're gonna have to make this right. Sign up as a sales rep under me, and we're square."

Anonymous said...

"It's the last day of the month, the contest to see who can sell the most TPA is down to me and one other guy, and if I have to go back to my wife and kids and tell them I didn't win the trip to Disney World, it's on you. Got it?"

Anonymous said...

"You and all your fancy machines and whatnot. If my great-grandfather's copy of Ye Medical Almanack was good enough for him, my grandfather, and my father, it's good enough for me."

Moose said...

I want to make a joke (although Anon 08:04 did make me spit my coffee across the room), but I'm too angry from all the Dr Hacks I've run into just as a patient.

"Your blood sugar isn't low; you're just a little dizzy." (blood sugar: 35)

"I don't care that you have low blood pressure and normal bloodwork, it's obvious you've had a stroke." (Go to neurologist: "no, you didn't have a stroke." SEE? Listen to the neurologist!)

"You don't have an infection. You're fat, and fat people always get blood clots." (If I had a time machine I would go back in time, find this doctor, and smack them straight into the sun.)

But I'm not bitter. OH, WAIT. YES, I AM.

*cough* sorry

Anonymous said...

"This is Mike Hack, and I am pissed off because I got the diagnosis wrong and you failed to cover my incompetent ass".

The awful thing is, there are many medical professionals out there who *will* close ranks and lie for each other.

clairesmum said...

He is very qualified to go work for one of those giant health insurance firms that so carefully manage your care and their bottom line by declining to pay for "all that fancy crap" for accurate diagnosis...we all know that kind of medical care leads to use of those fancy new expensive medicines that save someone's life!

Deborah Brett said...


Dr: "You are far to young for this pain to be biliary colic, you're just having some bad menstrual cramping."

Dr: "Of course it's not gallstones, no one your age has gallstones! Cramping around the time of your period, and when you ovulate, is perfectly normal."

Dr: "There are some gallstones showing on this ultrasound, but it's far more likely that this pain you're having is related to your menstrual cycle. When you hear hoofbeats, think horses not zebras."

Me: "We *already know* that I have gallstones, which is already unusual in a teenager. I am having *sevear* pain *every few days* that fits the description of biliary colic. We are effectively standing in the *zebra enclosure* at the zoo. Would you *please* refer me to for a surgical consult."

I got a consult, followed by surgery to remove my inflamed and enlarged gallbladder, along with over 40 gallstones. I also got a new GP.


Anonymous said...

Is Mike Hack related to Mike Hock?

Library-Gryffon said...

I actually had a doctor at Student Death whose name was Dr. Hacker. I remember thinking that if that was her married name (she had a ring) she should have stuck with her maiden name, and vice versa. Her medical skills and her bedside manner both lived down to her name.

I've had a doctor tell me that my PACs which were waking me up were a) benign (true) and b) "as you get older you just have to get used to these aches and pains so stop looking for them". I went to a naturopath while waiting for my intake appointment at the new practice, she reviewed my medical history, meds, etc., and among other things she put me on magnesium. Within two weeks the arrhythmia was gone. I've since found out that if you take a PPI it affects magnesium absorption by the GI tract. Neither my GP nor my cardiologist seemed to be aware of this. Medical Librarian for the win!

I had an MRI two years ago for some visual problems (lower outer quadrant of the visual field in both eyes goes weird for no particularly obvious reason, probably a migraine) and while my optic nerve is happy, I have no pituitary. OK, not quite true, but it's really small and squished. I have tons of issues which fit thyroid, adrenal, and growth hormone problems (I grew a quarter of an inch after my 30th birthday, early menopause, mental fog, exhaustion, loss of body hair and thinning scalp hair, inability to lose weight even with diet and exercise, etc., etc., etc. ), and when I asked my previous neurologist about it I was told "Most people don't have any symptoms with empty sella, so there's no point in checking it out." I had never known that "most" equals "all". My new neurologist seems to agree with him, but at least his office staff haven't lied to me about my prescriptions, so there is that. I'd still like someone to consider that a single zebra might be more likely than 8 or more unrelated and contradictory horses.

Thankfully no one had any issues with diagnosing my daughter with gall stones at 17, and when the surgeon came out afterwards, he said just by looking at it, it was obvious she'd been having issues for a long time. She'd had stomach aches for several years at that point. The surgeon said he's taken gall bladders out on kids as young as 12.

Terry Daugherty said...

Me " I feel like I can't breathe "

Dr " I don't hear anything, you just have a touch of the flu, rest, fluids and Tylenol "

Me " my temperature is over 103"

Dr. " Take some Motrin with the Tylenol, you'll be fine "

Dr at the ER to my Dad ( I was unconscious by then). She's got double pneumonia, a collapsed lung ( explains why he didn't hear anything) and is septic.

Anonymous said...

Then there were the four pregnancies when I fronted up to OBGYNs with my history of 32-day menstrual cycles and my temperature charts showing the I ovulated on Day 16, 17 or even 18, and they still calculated my due date from my lmp and then acted surprised when I went'overdue'.

Anonymous said...

(Wow, just wow, -as above) ... And by the way, Hack, pyridostigmine was discovered in June 2 1934 for treatment of myesthenia gravis two years after you finished your medical studies. It's spelled 'm' 'y' 'e' 's' 't' 'h' 'e' 'n' 'i' 'a' etc and you can look it up on page such and such of Cecil's Textbook and if you're missing that page, it's in your 1959 Merck's.

Liz said...

"For all you know, this man could be bilious AND phlegmatic!"

Anonymous said...

"We've got our own way of doing things on the east side of town, and don't you forget it."

Liz said...

OMG, me too. 33 day, super regular cycle, and seemed surprised every damn visit when I measured a week off with my first. And wondered why I chose to wait instead of scheduling an induction. I went with the guy across the hall with the next one.

Unknown said...

It makes me sad that such people are treating other people. :(
Arzt4Empfaenger

Anonymous said...

It makes me sad that such people are 'treating' other people and that said people (and the insurance company) are paying their exorbitant rates for them to go on fishing trips or whatever. I remember during residency in an 'affiliated' health profession attending lecture at the NDSU School of Medicine and hearing the announcement by the Chief of Cardiology that he and his wife were hosting some fancy wingding for the medical students, and "don't forget to sign up for the pheasant hunt the next weekend", and I thought to myself ... well, it is North Dakota and there are probably pheasants like there are prairie dogs in Wyoming, so what's one less pheasant on God's green earth, and maybe someone is going to eat the pheasant after they kill it, and yet, and yet, why is it that the medical students get to kill the pheasants indiscriminately and not offer the same opportunity for Hippocrtic Oath Alternatives to other medical professions?

NO jealousy. Maybe, the expression 'pheasant hunt' was incoming freshman CODE for 'extra credit autopsy for victims of bird flu'? Still.

Anonymous said...

My son has myasthenia gravis and epilepsy. He once fell on the sidewalk during a seizure and the police thought he was drunk. After he came out of the seizure his one eye was very droopy and his speech was slurred. He was asked to walk a straight line and could barely do so. So they hauled him off to the drunk tank. I got their phone call at 2 a.m. I explained that my son had medical conditions that created these symptoms and the cops had the nerve to laugh at me. I asked them to look at his medical alert bracelet. They called back within minutes and said I could pick him up. No apologies anywhere. I drove him to the hospital because he had a cut on his scalp that was bleeding a lot and needed stitches. Noone ever looks for these bracelets. Even paramedics have failed to do so.

Shash said...

Sounds like my former GP.

Lokiicat said...

Fourth comment: absolute magic!!

 
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