Tuesday, March 13, 2007

Butterfly Effect

The previous post got me thinking about a patient I saw recently who had a stinky abscess. He also had a defining tattoo on his neck. I say defining because the moment he decided that a dragon up the side of his neck would be a great idea, he essentially made many decisions. Like not to become a CEO, nanny, salesman, or really any other position in the public eye that would require trust and respect. Who knows, prior to this he may have been destined to become regional manager for UPS or even Vice President. But this decision sent him down another road.

All the patients we see have somehow been affected by the butterfly effect, where a series of unfortunate events or, more likely, decisions, leads them to the ED at that particular moment in time. If a child's grandparents hadn't smoked crack and ignored his mother, who at 14 was knocked up while out all night drinking, and now relies completely on Uncle Sam for food and housing, yet somehow has painted nails and a cell phone nicer than mine, maybe she would have filled the prescription for antibiotics prescribed at the previous ED visit, which was the 10th of the year since mom is usually too high to remember her child's clinic appointment. You see what I am talking about.

So back to compassion, which was the subject of a previous post. If a patient in the ED decided on their own not to study or pay attention in school and decided to be a slacker/thug/etc,. then I believe they can also find a way to pay for their medications and ED visits. I grew up in a relatively poor family of 7 kids, went to public school, and had to pay my entire way through college and med school. Never did I expect or feel that I deserved a handout. But had I not swatted that neck tattoo butterfly away and given into the temptation of dragon neck, I might be cutting the grass of the person who did study and took my place in Med School, thanks to that butterfly.

The FIXX said it best... One Thing Leads to Another


  1. Doc,
    How does one answer a sage who quotes The FIXX? We pale in the shadow of your majesty.

  2. I think the it depends on the person to make a choice. I wish someone could figure out what makes a person choose to go either way though so no one would end up with the dragon neck.

    If someone tells me I am wonderful, that is what I strive to be. If someone tells a person they are worthless, well, that can go either way. The person can choose to believe it and live what they are told they are, or they can choose to rise above to prove that person wrong. For me, growing up in a damaged/damaging home, I chose to not believe what I was told about myself, and because of that I turned out to be a productive member of society who has a pretty good life now. I could easily have been lazy and just gone with what I was told, but I am a fighter which serves me well. Apparently, I also write a lot of run on sentences...sorry! To condense this comment....great post, I totaly agree.

  3. swatted the butterfly...
    dodged the bullet...
    This is an interesting topic indeed and how the patterns of effect start. For me, my parents were largely alcoholics and dope smokers but I was bound and determined not to become them. Well, now I'm a second year med student.
    That said, at 18, I got a massive tattoo that covers most of my calf. Dad was a ex-biker it was a birthday present.(Thank god, I can cover it.) And for some crazy reason, I also decided that tongue or nipple piercing was not cool enough, so I got a prince albert. WTF was I thinking. Still have it though :)

  4. Wait, you mean medical professionals can't have tattoos? oh crap. I'm gonna have to quit my job as an ER nurse. I have 5--two of which are quite large and one of which is very visible. Oh, and my friend the NICU nurse? She has 14. Oh WAIT--what about the 3rd year ER resident who has seven tattoos?

    I guess we're all out of a job. It just never occurred to me that the ink in my skin affects my IQ or my ability to give my patients skillful, intelligent, compassionate care. Guess I better go give my Masters degree back.

    Go figure!

  5. RA, a 'prince albert'? Better you than me. I bet the ladies dig it.

    Guitar Girl. My colleague, if I read him correctly, makes a distinction between tattoos and a "defining tattoo"... a defining tattoo being one so monstrous as to jump out at and slap the onlooker in the face with attitude. I do not believe schrodinger's cat has anything else against tattoos as I know he has one in the perianal area that states "exit only" (in case he ever goes to prison".


  6. I was going to comment about focusing on the tattoo would be missing the point of the post. I see that 911doc already did, and did it in a very funny way.

  7. The point was missed by a couple of people, much to my chagrin. I have a small tatoo on my right shoulder blade. The late John Denver said it best, sunshine on my shoulder makes me happy. But only my wife or others at the beach ever see it. Don't get all defensive, tatoo people. And yes, some people can overcome "defining tatoos". But most can't, and like it or not, public perception is what it is, and a large neck tatoo limits what you can do, and doubles your work to try to prove people wrong.

  8. If you did have the "defining tatoo", at least you know you could still open that hot dog stand you've been dreaming about.


  9. OK, you guys are right. Granted, I dont' think I would tattoo my neck either...but only because I can't think of anything good to put there.

    Maybe "Schrodingers Cat 4-EVA"?

  10. I hope you don't think that I missed the point of your post, I agree that tattoos in places you can't hid can lead to unforseen problems (not getting the job, or into medical school) in the future.
    For myself, I am susprised that I made the right desisions (sort of) given the enviroment I had around me, and the examples I had to go off of.

  11. No, I got it for sure. Just never met anyone with a "Prince Albert". Concealable, sure, but OUCH!

  12. guitargirl- i like the idea of that on your neck, but with that many letters you would have to be very close to read the whole thing

    ra - congrats on overcoming your surroundings

  13. I have 5 tattoos (besides being a woman, homossexual, latin and quite short)

    But I have managed to get to Regional Director of a well-known Multinational Company, leading more than 100 men and women in a whole continent before I was 35 years old.

    All that to say that I almost agreed with the logic behind this post, but the example of the tattoo, specially in 2007, put everything to lose.

  14. Dear C,
    Congratulations on avoiding all the tattoo stereotypes.

  15. 1807 or 2007, I stand by my post.