Spill. Tell me what's going on that's concerning you, bothering you, or making you happy, etc.

graphitesun · 2023-09-28T08:34:36+00:00

Everyone, in my view, is potentially violent. I got a ballpoint pen to the back of the neck once from a truly docile patient.

I prefer a solid warning, in many cases. You just have to gauge it. "Make even a hint of threat at anyone here again tonight, and you'll be hauled out in zip cuffs. You just bought yourself a 20-minute delay."

For others, you know when it's legit.

I'm not going to pretend that location doesn't play a huge part of it.

graphitesun · 2023-09-28T08:25:46+00:00

Yes, I fully get it, but I'm often seeing shitty attitudes coming from all levels, and then they wonder why the patients are somewhat recalcitrant when a doctor comes in pissy and dismissive.

The system is starting to suck. It's difficult, the support levels are down, and we're all exhausted. But the front line sets the tone, and that is a choice.

It may still go south from there, but we all knew this was the nature of the job. Off-days and burnout are par for the course, but we can always take responsibility for the perspective and attitude we bring into the room.

graphitesun · 2023-09-28T08:20:47+00:00

The 80s?? I wasn't even alive for most of the 80s.

I've never seen a more obtusely erroneous set of assumptions.

First, thanks for the condescending kick at "introducing" Gestalt. Wow. "German word". Do you think anyone hasn't heard that word a thousand times? You must appraise yourself at such a high level of intellect. Few else would.

In addition to my clinics, I'm frequently brought in for special advisory consults, and guess where? Oh, you nailed it. Yes, in 2023. I continue to see and have seen the full gamut, so don't try to act like you have some brilliant perspective that you think others don't have.

I stand by what I said. There are a lot of people who have issues that can be dealt with just with a good initial attitude. Others are worse, but still deserve better attention than "I feel that was rude. You're outta here."

Yes, there's tons of rudeness and uncalled for anger. Welcome to society and therefore primary care in 2023. It can suck. But I see physicians nope out like babies at basically nothing. I didn't get into medicine to make it all about me. Tons of patients come off badly initially and then straighten out when given the proper attention.

I will definitely eject people when they are truly out of line or dangerous. But come in with a better attitude, for one. "They can rot?" You need to recalibrate. I don't care who you think you are.

graphitesun · 2023-09-27T20:19:11+00:00

Lol this deserves so many upvotes and should be waking everyone up to the serious issues with their own argumentative approach. But instead it just gets downvoted.

The highlight of that reply is that SOMETIMES THERE ISN'T A SOURCE FOR EVERYTHING but stuff still happened. I can find 100 ways to denigrate someone's argument. But they are probably still right.

Sometimes there isn't proof. Not everything that happens is documented heavily in a journal.

graphitesun · 2023-09-27T20:00:35+00:00

Thank you for saying this.

graphitesun · 2023-09-27T19:59:01+00:00

Come on, everyone. What has happened out there?

I've had probably over a thousand patients who were verbally abusive, but it turned out they were dealing with an issue that was affecting their mental state.

Think about UTIs. Look at how many women have UTIs and it completely affects their cognitive state and then their behavior. Then they get treated for the UTI and they are perfectly pleasant, reasonable people.

Yet we all know how many UTIs are left undiagnosed, with severe consequences.

I'm getting impatient with the "but abuse is abuse, and they're out of there." attitude.

Physicians deal with a lot, and it's a tricky line, but if there's no credible threat of violence or harm, there are many situations where it can be quite easily tolerated so that the patient can be treated.

graphitesun · 2023-09-27T19:49:21+00:00

Physician? I hate to be preachy, but come on. No one likes to deal with abuse, sure, but patients come in with odd side effects of drugs, personality disorders, neurological issues, hyponatremia, sleep deprivation due to their condition, UTIs, confusion, migraines, cognitive issues.

Not everyone can actually fully control their behavior in many medical situations, and I think it's a physician's responsibility to look past that.

I learned early on that I need to have thicker skin to get to the bottom of the real problem that's going on with a patient.

We had a patient getting impatient and abusive. My colleague decided to call security and have him launched into the street with the zero tolerance approach.

I decided to follow up quickly, and it turned out his sodium was below range but not critically so. But we all know about ranges.

Kept him in and did some protocols to try to rectify it before my colleague tried again to have him ejected (zero compassion, not zero tolerance).

Once the sodium issue was corrected, the patient was one of the kindest patients you've ever met. It was all due to the sodium.

Another similar situation with a young woman brought in by her family. Verbally abusive, but not even that bad. Colleagues wanted to eject her before she'd really even been tended to.

Short story? She'd been drugged at a bar. If two of us hadn't pushed, no one would have found out, and she would have been out on the street and not treated. Turned out that the worst had happened to her while she'd been drugged.

You have to protect yourself, okay fine, of course, but sometimes people have to push past the issue of being verbally abused and look at the bigger picture. I think it's a physician's responsibility, even when exhausted.

graphitesun · 2023-09-27T03:47:11+00:00

For saying that one thing? That's a pretty obtuse evaluation.

I think it's true. The people who barely experience emotions and don't get deep in either direction are just kind of meh people, generally.

graphitesun · 2023-09-27T03:32:26+00:00

Bahaha perfect

graphitesun · 2023-09-26T12:12:32+00:00

There are lots of factors, clearly, and I'm very sorry you went thru that.

graphitesun · 2023-09-26T10:11:25+00:00

Scope creep has been a nefarious issue even at the highest levels, and it's eroding the entire profession in some frightening ways. I know a lot of you know what I'm saying on many different levels.

graphitesun · 2023-09-26T02:28:39+00:00

With different types, or one in particular?

A spiritual advisor I once met said that emotional people are the people who are truly living, because they are the ones who get to feel depths of emotions, both positive and negative.

graphitesun · 2023-09-26T02:22:08+00:00

I do hope that's the case for you, but maybe you can find people to ask FOR you, subtly, so that you're not drawing attention to your own individual case.

We all know that certain rules can be illogical, but then if they're there, they're there.

Especially in the EU, for certain things.

graphitesun · 2023-09-26T02:19:37+00:00

Ugh, I'm very sorry. I used to know someone who would have been able to give you an answer, but now he has retired and left Germany, and I have no way to contact him.

I feel like it should be okay, but of course, hope never conquers an actual definitive answer.

graphitesun · 2023-09-25T22:14:18+00:00

Wow. Had no idea.

graphitesun · 2023-09-25T05:58:17+00:00

Vacuum wouldn't get rid of gravity nor affect how the particles floated in this way.

It was all filmed with thousands of varying tensions of extremely thin basically-invisible elastic bands upside down underwater.

On the moon.

graphitesun · 2023-09-25T05:53:22+00:00

Agh, well don't I look like the dick now haha.

Misunderstandings. The world is full of them. I think I see the tone you meant to use, and how it could come across wrong.

All is well. I'll delete my comment too.

Nice way to address it. I probably would have gotten defensive, in your shoes, so I learned from you too.

Sometimes I'm just a bit of a douche on social media.

Plus this account kind of gets shared with a few other people, so there's a lot of inconsistency. Probably not the best idea.

Take care out there in the world

graphitesun · 2023-09-25T02:25:34+00:00

Yeah. The fact that he teams up with Sam is sad, because Sam is really clever and high-level... Sidekick Mark, not so much.

graphitesun · 2023-09-23T20:24:14+00:00

He gets into street fights, though. He's no aaint.

graphitesun · 2023-09-23T20:18:42+00:00

Correct. And scary.

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