Saturday, May 02, 2009

Douchebag of the Month

Dear OBGYN doctor who performed an abortion on one of my current patients four days ago. You are a douchebag. You have a post-operative complication and you send your patient to me? I practice 150 miles from where you performed the procedure. Your patient is scared. Your patient is sick. This is not the first time. Now some other OBGYN is going to have to clean up your mess. You are a douchebag. Admit it.


  1. This is one issue that seriously disturbs my calm.

    Had a patient with a post op wound that was draining pus from his abdominal incision one week post laparotomy. The patient called the surgeon, who told the patient to go to the ER and he would "clear the way". And, you guessed it. No phone call, no email, no note. Nothing, except an angry patient wondering why we weren't running out to the car with a stretcher and a freshly fluffed pillow.
    I walked into the room, blood pressure rising, to had a 5 inch by 3 inch piece of skin ripped off of my ass by the patient. He was a FOCEO - friend of the CEO) dammit, and was not going to be treated like this. After what seemed to be an hour of berating, I looked at the would and yup, infected and had a small dehiscence draining pure pus. Temp 101. And an awfully tender abdomen.
    Called the surgeon, who had a personality of #4 grit sandpaper. Told me to go in and just "open it up" to drain it and then put some packing in... that ought to do it. Send FECEO home. After spending 15 minutes explaining that he was being very brave with my malpractice policy, he relented and asked who the hospitalist was, He wasn't going to phone the hospitalist, I "could do that". Just wanted to make sure it was a good hospitalist.
    Of course, later, the surgeon said that "nobody told him" how serious the situation was when he took the FECEO back to the OR, and the FECEO "could have died". Guess I changed my name to "nobody", because I told him.

    There is an old rule in the ER ... never shoot the guys on the front line.

    So memo to this surgeon... I am no longer managing your complications. The unit secretary will be calling you personally, no matter what the hour, to advise you your patient is here and the ER doctor has requested you come in.

    (Of course the hospital admin put the kibosh on that plan, but an ER Doc can dream, can't he?)

    Now, I must bid farewell so I can finish up the administration's request for a written reply and apology to the patient's complaint letter.

  2. Igloodoc, that sounds absolutely infuriating. Did the patient tell you his doctor had 'cleared the way' for him? Could you then explain to him that no, he had not, and therefore you had to triage and examine him like anyone else?

    And to top it all, an apology letter to the entitlement idiot of a patient? I'd burn out in weeks if I had to practice in that kind of environment. No offense meant, I'm just disgusted at the thought that the one who did the right thing having to end up apologizing. Bleargh.

  3. You're lucky you had a name and number to call, 9-11, most of those Abortionists are as hard to find as Bin-Laden...Used to see a few post Abortion patients in the military, since Uncle Sam wouldn't pay for em, they'd get their pregnancy terminated on a weekend, then come in Monday to get their day off...

  4. Can you guys go back to moderating comments? That last rant was so long and useless that I gave up reading it well into the first sentence. Thanks.

  5. winner, winner, chicken dinner. anonymous, could you repost the main points please?

  6. If I had a dollar for every patient that said "My doctor told me to come in and he'd meet me here." I'd be a rich woman and retired by now. I usually tell them "what you doctor means is to go to the ER where the ER doc will do all my work for me."

  7. anon 5:49- you missed a very entertaining story complete with exact measurements of the size of skin the patient ripped of igloodoc's ass. . .igloodoc- as Nurse K might say-get a blog!

  8. Not just a douchebag---a murdering douchebag. This "doctor" is sucking tiny body parts down a sink and you exspect him to give a rat's ass about the OTHER patient (the one that left his procedure alive???)

    Pattie, RN

  9. Weenie, snarky "Anoymous" posts belong in th sink. Anybody that can't post a user name and register a real person behind it is a societal wound.

  10. That "douchebag" is 150 miles away because only 7% of texas counties have OB/gyns who do abortions. I get are against abortion. Sadly, overturning Roe V Wade will not make the problem go away, rather instead of that "douchebag" abortionist, it will be some back alley drug addict with a hanger. Then dear 911, you will really see complications. Be careful what you wish for.....

  11. ok anonymous,
    point taken, but it was not a point relevant to my post.

    in this particular case the surgeon abandoned the patient. i think this is universally considered illegal so get off your soap box... the surgeon was not available by phone, the surgeon was on vacation and had no one covering. in all probability the surgeon only does abortions and get's paid for each and every one.

    but since you have dragged the conversation into the abortion argument, which i was clearly trying to avoid, let me ask you this. what would you propose as a solution? i think there are two...

    1. force OBGYN surgeons to perform abortions. the result of this would be that most medical students who would otherwise choose the specialty would not and then everyone would suffer.

    2. force abortionists to follow up on their 'care'. of the two i think this is more workable.

    and yes, i am against abortion and find it hilarious that you think it's 'sad' that there aren't more abortionists out there as each abortion ends a human life. to get the impact your statement has on those of us who oppose abortion let me put it this way, 'i think it's sad that there aren't more executioners in our prison systems and 'sad' that there aren't more hanging judges'. the difference being, of course, that folks who are on death row have done something to deserve death. have fun at the PETA rally.

  12. yeah, igloodoc, get a blog. we will link you immediately and ride your coattails from then on like we do with drackman.

  13. "point taken, but it was not a point relevant to my post."
    Actually the point is totally relevant. You have NOW elaborated that you were unable to get a hold of the doctor or partner for transfer. I am a doc (who takes call Q3-4 for my patients by the way not a shift worker), I am not going to say that behavior is right, it's not. Good surgeon's own what they do. Did you file a complaint with the Texas medical board instead of just whining on your website? The fact is a 150 mile transfer may or may not be workable for a multitude of reasons including asshole docs and up to and including patient stability.
    The simple fact that I pointed out (without saying I was "for" abortion) is that 93% of Texas counties don't have OB/Gyns that do abortions. Therefore, for those woman who want an abortion for whatever reason, a 150 mile (or more) trek is going to happen.
    Try re-reading my statement. I didn't think it was "sad" there aren't more abortionists. I think (actually know since I was doctoring in that era unlike you) that overturning Roe V Wade will push abortion underground in those states such as Texas that promptly outlaw abortion. You will see very sick patients repeatedly come into your ER because of botched abortions by non-medical providers. I guarantee it, because I saw it...firsthand. This is not a statement "for or "against" abortion. It is what you will see 911. Been there done that...have you?

  14. dear anonymnous,

    are you a libleral? seems to me 'whining about it on my website' would be preferable, to the particuar sugeon in question, than a complaint filed with the TX medical board. that to me is a usually cowardly tactic resereved for those with an inability to confront folks about their issues in a man to man fashion. no i didn't file a complaint! i'm not in TX.

    thanks for the explanation of the 150 mile transfer rule, but we routinely do it because, as a result of EMTALA and attorneys, there are no specialists who will practice in small towns anymore so our ambulances consider 150 miles a milk run. and yes, i understand about the 'patient stability' issue as it's kind of what i do all the time being an emergency physician and all.

    then you make an interesting appeal to authority, something you are not allowed to do anymore unless you are a leftist. an appeal to authority is an argument such as the following... "you should not inject succinycholine into a patient without being prepared to intubate because SCIENCE has proven that this will kill the patient" the authority cited being 'science', and i agree.

    however, you appeal to a different authority in your argument, namely, well, yourself. 'don't outlaw abortion because i've seen the results'. okay grandpa, you must be well over sixty years old if you are not lying. but why are you the authority?

    you then seem to indicate that if i have never experienced something first hand that i have no right to offer an opinion on it. okay, i have never seen a murder so i guess they don't happen, or, if they do, i can not comment on how murderers should be prosecuted. the end.

    but let me ask you which of the following you prefer...
    1. in 1968 there were 5 states with legalized abortion. total number of abortions, 18000.
    2. after roe v wade the total number of abortions in 2003 were... 1.3 million

    now assuming an exception for rape and incest and emergent conditions which necessitate therapeutic abortion (placental abruption, amnionitis/sepsis, IUFD sepsis, preeccplamsia, and a few i'm probably forgetting) which would you prefer? millions of babies killed per year under with the blessing of our government and without the lessons of making bad choices being learned, or a few medically necessary abortions per year with the others who would be 'forced' to be pregnant (after being 'forced to have sex of course') then giving their child up for adoption or raising the child themselves?

    Yes, there would be back alley abortions, they exist right now and always will and have since the dawn of recorded history. to argue this way is to argue that since we are a capitalist nation and some will not succeed that the government should take from the ones who succeed and give to those who don't. oh wait, that's what obama's doing!

    no i have not seen the results of back alley abortions 'first hand' but i have not seen a polar bear either, i have never stepped foot on the moon or the sun (and therefore don't believe in them) and i have not seen a unicorn. have you?