Friday, September 16, 2011

Fulminant Supratentorial Diathesis

You heard it here first. This is my new name for fibro- chronic fatigue- chronic Lyme disease - systemic candidiasis - 'I know there's something wrong with me damnit' patients. You know, pussies. You know, the people you will be paying for under Obama care.... people that won't pay their doctor or ER bill but will pay for LONGINEXX penis enlarger pills or quote THIS SITE in an effort to convince me that their Axis 2 disorder is due to a tick bite thirty years ago.

Now most of us on the science / medicine side of things say, 'show me', when someone proposes an explanation for a syndrome of disease. But most of the lay public just says, 'blow me, I've got fibro.' So be it! So you do!  Yes! You have chronic Lyme disease and not poorly managed diabetes or thyroid disease or an undiagnosed Rheumatologic condition. Congratulations! Yes, you may apply for disability now.

But along the way, as science fails to back up the claims, it will become necessary to find the next "fibro".... and that's where I come in. It was tough between "Dense Cortical Slowing" and "Fulminant Supratentrorial Diathesis", but I pick the latter, sounds more Doctor-y. You heard it here first, and may I be the first to propose the diagnostic criteria for FSD....

Inability to work due to....

1. Being really tired all the time.
2. Having pain especially in the morning all over the place. 
3. Having been treated very poorly by family or strangers.
4. Being misunderstood and unappreciated.
5. Crying because of that person on Oprah yesterday.
6. You just need some time to yourself.
7. Having once been near a tick, a person with a virus, or mold.... especially black mold.
8. Having to go the the ER every other day for acute exacerbations of any or all of the above especially if accompanied by dizziness, mild nausea, and nearly throwing up thirty times.

Having any four of the above major criteria or any three of the above major criteria with a previous misdiagnosis or fibro, chronic fatigue syndrome, systemic candidiasis, or chronic Lyme disease shall be considered diagnostic of Fulminant Supratentorial Diathesis and shall be immediate grounds for giving the patient a handicapped parking placard, and a fast track to disability/ SSI

Or you can just give them two grams of Vagisil IV and be done with it.


  1. got an Aunt with the Fibro..
    and she used to bother me with her titers, her scans, her emgs, till I started botherin her with my $600/hr fee, billed down to the 10th of an hour just like a Shylock.
    And if they won't pay just slap em' with a 1099, and deduct it from your return...

  2. I think they are colonized by cooties (aka Morgellons). Only known cure is a 6 month course of hard physical labor in the afternoon sun, with 80% or more of skin exposed to direct sunlight.

    Alternate to hard work, dusting the body twice daily with DDT powder accompanied by 1,000 calorie per day diet. Symptoms will slowly resolve over several months.

  3. Fuck of Glen 'cuz Morgellon's is real because I HAVE IT (I think).... Gotta be.

    Besides, your "Cure" for FSD is Draconian (Drackmanian?) and should be dismissed out of hand as it would 1. Work, and, 2. Cut about a million jobs from the federal employee register as Welfare administrators would no longer be needed. Well, maybe three would be needed.

    Haters gonna hate.

  4. and whats with these Homos who need Sleepin Pills?!?!?!
    I haven't had trouble gettin to sleep since I was 11 or 12 and I learned how to...never mind.
    Gettin Mrs. Drackman to sleep...well thats another story.
    And ya gotta be careful with the rufies, damn Flunitazepam and its 120hr 1/2 life...
    and I know, CO2 has anesthetic qualities, just cant get her to go for the autoerotica asphyxiation thang...
    and then theres the whole Ritalin fraud, dont ya love the Soccer Moms who won't let Jordan/Jacob/Matthew/Dylan play Tee ball without a friggin Crash Helmet, but could care less about the little sissy takin enough methamphetamine to keep the entire "Sons of Anarchy" gang wired for a whole season?
    When I got "C"s I got a Basketball bounced off my haid'over and over, like in "The Great Santini".
    Baseball Season was worse, enduring hours of brushback pitches, Chin Music, and fastballs in the ribs.
    Yeah, Mom was pretty tough.
    and whats with these Names? "Cameron"? "Hunter"
    When I was a kid, we were named after REAL Men, Norman Kings, Nazis, Confederate Generals.
    Like my childhood buddy, William Irwin Rommell Nathan Bedford Forrest Rubenstein.
    Everyone called him "Billy"


  5. Wait...I thought all the crap I have been through was stuff I needed to just suck it up and deal with. You mean to tell me I was doing it all wrong? That I should be collecting disability??? I have been wasting a lot of time being productive and figuring out how to work around unfortunate things I guess. If only I had known!

  6. Radgirl,
    It's the new America... Ask not what you can do for your country etc...

  7. I'm an intern from India. Was handling a clinic with 150+ patients when this particular chap comes up with a past history of Typhoid, successfully treated & complains of inability to "taste" food well! I nearly blew a fuse! People just can't tolerate the slightest of problems off late..
    Can totally relate to your post, I used to hate typing in Fibromyalgia as a diagnosis while I was working at this other center, but the analytic guys said I wasn't diagnosing that condition enough!!

  8. Hey Jug-Dish, I mean Sculptor
    Smooth Move Schweizer, missing an obvious case of Pancreatic Cancer, Lou Gehrig's Disease, or Kuru. And FYI,"Inability to taste food well" is called "Anosmia" would have saved you 4 or 5 seconds typing time you could have used to swat those Tsetse Flys or whatever it is that causes your country to have a life expectency of 17...
    And whats with the "Chap" business?? The English didn't screw us nearly as long as you guys, but you don't see Americans driving on the left, sipping tea, and calling perfectly good French Fries "Chips". Have some pride in your 3rd World Nuclear Power dot-head.

    PS Whats an "Analytic" guy?


  9. dear sculptor,
    please excuse Frank. He's off the lithium again and has somehow obtained Internet access from the solitary confinement section of Folsom prison where time keeps marching on.

  10. Can we add a minor diagnostic criteria?
    Multiple fired primary care and/or specialty physicians. ;P

  11. dear anon.,
    I have checked with the committe of fairness in disease creation and they mislike the wording... they suggest that instead of " multiple fired primary care physicians" you substitute "multiple failed primary care physicians" or "multiple incompetent primary care physicians"... So I had them all killed... I accept your addition of the minor criteria mentioned.

  12. @anonymous person off lithium who decided he wants to be called 'frank':
    Inability to taste is called ageusia NOT anosmia.
    also you should have known that kuru is confined to the cannibalistic tribes of papua new guinea, however your geography may be too screwed up to know that this is no where near India ( I am not blaming this on your non compliance to lithium.)
    How does lou gehrig's even come in picture? Unless you think taste is now a motor function.
    See I can very well go about giving out pejorative comments, but your medical knowledge (,lack of) does the trick fine.
    FYI: No one calls french fries as 'chips'.

  13. @mkk,
    So did Dr. Ghandi take a complete travel/dietary history? Maybe his malingering Untouchable had a taste for cerebellums? Immigrated from a land even lower on the Cast system than India? And I checked my Rand McNally, its 3 times farther from India to America than from Cannibal land to "We're starving but won't eat Cows-ville" and theres no shortage of Patels/Joshis/Singhs running every QT/Dialysis Clinic...
    And its the "Fore" tribe with the highest prevelence of Kuru, saw that on "Scrubs"...
    and FYI not every disease reads the friggin book, I mean, when I caught the Clap, I lost my sense of taste...bout 10 minutes before I...never mind.
    and we all know our Indian Intern just wants that H-1 Visa so he can make millions peddlin that back-alley Botox...


    PS. Closest I've been to real Fish & Chips was eatin at an Arthur Treachers in Kankakee, Illinois when I was 9 or 10...
    Some people can't handle the truth...

  14. We love this post, 911DOC. We see a lot of Indians everyday who till date must have been undiagnosed cases of FSD, but now, after this post, that will all change.

    We also love the minor criterion you added and appreciate that you killed so many people for the cause.

    You quoted "Scrubs" as a veritable source for your medical knowledge. Just saying.
    No Indian even remembers the 'Untouchables' anymore, but thank you very much for reminding us.

    Signing off,
    A great fan of your blog, an Indian intern, and a person who vows never to get an H-1 Visa.

  15. This comment has been removed by the author.

  16. @frank:
    As if it wasn't enough that you got everyone questioning your knowledge of medicine, now, we've got no damn option but to question your history, spelling, english yada yada yada..
    First things first, our clinics are damn busy and you need to sift through patients & prioritize. A lot of patients truly come as described above in the post, without organic disorders, mostly in need of some counselling, which we duly provide, only after having obtained an adequate history & gone through the examination & investigations. FYI, The guys at Analysis are those responsible for the daily stats at our hospitals.

    Dumbass, what you're referring to is "Caste", NOT "Cast", which by the way we use in orthopedics, just for your info, which seems to lacking on all fronts. Thanks for reminding me of something that I learned in my history texts, since forgotten!
    Indians may not be as fat as the rest of the world, but, hell we don't usually die of heart disease or cancer either.
    "Scrubs"? Really? Oh my god! I totally saw "Dr.Ghandi" on Grey's Anat the other day... Does that make me his biographer? It's Gandhi, dipshit!
    And you forgot that Fluoroquinolones (used for Enteric Fever, again FYI) can cause dysguesia & aguesia

    PS. The closest I've come to someone this ignorant & snobbish is a delusional "chap" in my psych rotation. At least he seemed to be lucid at times. I'm just thinking u're one of those old, obese, med students who keeps flunking cause he thinks he can cheat off Scrubs right before the exam!
    Some people don't know the truth..

    @911doc: Diagnosing FSD totally make work awesome today!

  17. Hey Skulptor, can we be friends? I mean its not like your a Country anyone fears, except maybe in Cricket...
    Oh yeah, those road games in Bhopal are tough...
    and I like "Bend it like Beckman", hot & spicy curry, old Bollywood movies, and Cholera Cots...
    and thats what I love about India, instead of years of expensive research, clinical trials, you just poke some holes in a cot...
    and I your right about reincarnation cause what could be better than coming back as the USS Missouri, 11 Battle stars, Surrendering Japs, and Cher sliding down your 16 inch guns wearing those sexy fishnets....
    and don't be hatin, some of my best friends don't believe in Jesus...
    and the only Indian I know is Principal Figggins on "Glee"..


  18. Holy crap! Dropped my grammar level just by replying to frank.. Or maybe it's just my FSD acting up :P

    Diagnosing FSD totally *made* work awesome today!

  19. So flattered to have fans over in India... Now how to turn it into a money maker so I don't have to do the FSD shuffle anymore... Mmm.... Yes....

  20. @911DOC,
    I am one of those guys these pussies drove away from the ER -- to neonate intensive care, and believe me, it's a lot saner there -- and I thank you for "FSD"...
    We called it the FOWACOP (Fuck Off With A Couple Of Paracetamol) at my hospital in India. (Yeah, another one of your Indian fans, although I am in Russia now.)
    @Frank, are you "one of those old, obese, med students who keeps flunking cause he thinks he can cheat off Scrubs right before the exam"? Whatever that is...
    Always enjoy your stuff, old chaps.
    Toodle-oo, and *Дракман для Президента!*

  21. @911doc: India may very well be the FSD capital of the world! And have you considered writing a paper on the same? I could point out some great research assistants off the top of my head.. (menacing grin)
    I kinda logged in today & thought the war in the comments section would still be on, but I wouldn't really let it get to me. For the past 2 days I've been in the afterglow of Auburn's loss to Clemson! Kinda proves that form is temporary, classless-ness permanent! But, then again I didn't really expect a bunch on inbreeding dimwitted almost-graduates who cheat their way through everything they can find, including online surveys, to do any better!

  22. I think you left off one very important diagnostic criteria. In fact, if it is not present then FSD diagnosis is in doubt and will need serial arterial porceline titers to dsx...


  23. Allright, Skuptor, I was WORKING yesterday, and we Americans have this quaint tradition where we actually WORK while we're WORKING, thats why they call it WORK, and not JERKING OFF.
    OK, the Internet was down..
    Ask one of your countries Untouchables about it, just don't get to close, don't wanta catch Plague or Dyptheria...
    and yeah, my team lost, firt time in almost 2 years, or about 300million people ago in your incredibly-prolific-despite-crushing-poverty-joke of a country...and it happens, even George Patton took a few "L"s every now and then. You'd know that if your country ever won a war...
    and sorry if I come across a tad rude, I'm still just jealous of my College buddy Kumar who makes 3 times as much as me reading MRIs from poolside of his $1.5 million House..
    Hmmm lets see if I can put that in terms you'll understand.
    He's got like 5 flush toilets.
    And he didnt have to cruise highschool dances like me, he had a nice ARRANGED Marriage all set up, word have worked out great if it was a guy...
    and maybe I'm bitter cause I spent 2+ Hours with EA Tech Support in Bangalore tryin to find out why the rear speakers don't work while I'm playin "Rock Band", and the guy has the nerve to say something must be blocking the transmitter thingie, which was totally wrong.
    The little wire doo-hickey came loose, probably made in India.

    Frank "Yay Pakistan!" Drackman

  24. wow Frank,
    a bit touchy. hey they way i see it is the tigers won. 'nuff said. strange how they seem to hate Auburn over in the sub-continent as well. as for me, well, my team kicked ass this weekend. wow, a zinger from across the ocean. hold that tiger!

  25. UGA played this weekend???
    If UGAVII takes a dump in the woods, does it still stink?
    Non-televised games don't count, Jeez-Us, GEORGIA STATE's game was on TV, COLGATE-HARVARD, OLE MISS/VANDY, heck even Southwest Dekalb/Marist was on PBS...


  26. @frank:
    That is what I thought, precisely. Your anger is a substitute emotion for your fear and jealousy towards Indians. Now that you have faced it, catharsis has ensued and you are now free to walk among sane men, supervised of course.
    Dont worry about coming off as rude, your ignorance shadowed that well enough.

  27. @ mkk...
    Way to hit after the whistle Hadji, if you were in America you'd get a flag thrown at you and have to go back 15 yards...
    And your all just still PO'd at Christopher Columbus for mistaking a bunch of Head Shrinking Savages for the "Real" Indians...
    Thats, right Grung-y Dinn, He got off the Santa Maria in the friggin Bahamas, and thought he was in Calcutta, probably cause of the smell...

    Frank "Cathart THIS" Drackman

  28. Yes, be proud of (?PO) Chris Columbus and your land, which was 'discovered' by him what millions knew about already.
    I was sure you could not take on more than one of us at a time, hence the silence from my part.

  29. Palliative Care Doc10:06 PM, September 19, 2011

    Holy Cow! I don't have many patients with this, but almost ALL of their family members do! I wonder if the trauma of having a family member die contributes to the development of this disorder, and if I can get a grant to try to eliminate death altogether.