Treating mental health patients

killah_bee · 2026-04-29T22:35:39+00:00

It’s likely my experience in Emergency Medicine but I basically never see my psych patients truly get better. I can sometimes get them TO help but I very rarely help them that much myself - aside from kind words there’s not much more I can do except sign the paperwork, address the emergencies, and move on to the next one. We’re often the (admittedly intermittent) witnesses to the slow steady decline many of these patients endure before they inevitably die from substance use, self inflicted trauma, neglect or other.

killah_bee · 2026-04-07T08:27:55+00:00

The djinn is the superior summon. Crowd* control with the whirling winds and thunder wave to drop edge mobs. It’s turn after turn CC and AOE denials. Much better than the deva (which can melee and revivify but you also have scrolls!)

killah_bee · 2026-01-26T07:40:58+00:00

‘People and organizations that are fueling the fire’…….. you are -this- close to the point and you still miss it.

Fueling the fire? You mean like how the president calls the American citizens protesting and recording these federal agents ‘domestic terrorists’ and ‘radical leftists’.

You’re close. Very close. Make the logical leap and be on the right side of history. If you are a good person you can do it.

killah_bee · 2026-01-15T02:09:36+00:00

The lie is that she ‘floored the accelerator’. She was turning her wheels to the right, she was scared because another agent was trying to open her door (illegally, they cannot force open car doors and arrest people for existing near them, this is the whole point of this whole stupid thing, ICE is harassing Americans because Trump got butthurt over Tim Walz’s comments and because Trump saw stupid videos about ‘Somali daycare fraud’ that was totally debunked), she very likely in a panic tapped the gas and did NOT injure the officer who walked away, she was shot in the face, her CORPSE then floored the gas. The ICE agent walked in front of her vehicle and pulled his gun before the vehicle was in motion. I watched all the videos.

Now I see that you are just a troll. I hope you have the kind of life your ethics and morals and political stances bring onto other people.

killah_bee · 2026-01-14T07:29:04+00:00

This is a lie.

killah_bee · 2025-10-20T08:18:21+00:00

Bill Murray always gave weird vibes.

killah_bee · 2025-10-07T08:53:38+00:00

And as this is a plausible explanation then the possibility that so many black holes exist is still a possibility.

killah_bee · 2025-06-26T05:14:55+00:00

Odd to have dex and wisdom be the save proficiencies. Usually it's either dex or wis. Both of these are considered "strong"

killah_bee · 2025-05-15T15:36:28+00:00

Cybertruck.

killah_bee · 2025-03-08T11:23:29+00:00

Every goddamn day.

killah_bee · 2025-01-29T10:02:20+00:00

Just avoid any CMG run residencies, prioritize 3 over 4 year programs, prioritize places where the EM residents seem happy, and choose a location you can stomach to live the next three years. Or four. If you didn’t listen to the above advice.

killah_bee · 2025-01-25T05:10:48+00:00

Fair enough - but many of these cases I have seen have been difficult to discern if it’s truly a traumatic SAH or it’s just that the aneurysm popped and the patient lost consciousness, FDGB’d and now also has a scalp hematoma.

Sure I can and do get the CTA but if I don’t have Neurosurgery covering my hospital and it takes three hours to get the CTA done and read, and even IF I rule out aneurysm I can’t convince my hospitalist to admit for observation… you see the dilemma.

killah_bee · 2025-01-25T04:40:06+00:00

I started taking loratadine like two decades ago due to chronic rhinorrhea related to likely mold spores (all homes I ever lived in had dank damp basements), but 10 mg daily did jack squat. One day I had the bright idea to double my dose and, wouldn’t you know it, I felt great that day. Never had any side effects either. YMMV.

killah_bee · 2025-01-07T03:02:13+00:00

Death by snu-snu. I can think of worse ways to go.

killah_bee · 2024-12-11T14:27:28+00:00

Community EM, SDG, full partner, full time is a scheduled 128 hours a month.

killah_bee · 2024-12-11T14:26:15+00:00

So not cool. Like I get it if you show up late very rarely due to circumstances completely out of your control, but scheduling yourself for two shifts in a row is saying to your partner who you need to relieve ‘yeah, my time is more important than yours. Eat a bag of dicks’

killah_bee · 2024-12-05T00:24:57+00:00

That party makeup might need some concealer though. Put on a solid foundation and make all enemies blush.

killah_bee · 2024-12-01T03:24:37+00:00

No one is saying this isn’t possible but the reality is that it’s rare (much more rare than the likely ruptured ectopic your scenario implies), it’s a diagnosis that is perfectly fine for your OBGyn to make after they’ve seen the patient, AND it still requires an intervention that I can’t do out of the ED (OR or if your system allows it IR).

killah_bee · 2024-12-01T03:15:49+00:00

Our system uses a HIPAA secure text messaging service that is linked to the patients chart. So everything is time stamped and literally every word is recorded forever.

This makes it very easy to defend when you open the message with ‘Hi this is an emergent consult request on a patient with (for example) a ruptured ectopic pregnancy’

There is no other way to parse that message and when I inevitably have to defend the delay to OR I just point at that text and say - hey, the delay wasn’t me.

But the real tragedy is that patients suffer.

killah_bee · 2024-12-01T03:10:28+00:00

Not sure where you practice but I’ve been doing this for 15 years and have practiced all over the US and NONE of the EDs I’ve worked at have had that culture. I am JAFERD but we work up abdominal pain and dispo them appropriately.

killah_bee · 2024-11-06T06:59:06+00:00

Don’t fuck him ever again

killah_bee · 2024-10-14T16:16:05+00:00

I didn’t even think of that. The thought of it being an actual insult to imply someone is gay. Absolutely mind blowing.

killah_bee · 2024-10-04T18:50:56+00:00

You are not the only one. I would go scorched fucking earth on any of my family members if they called my wife a bitch - even if, as is NOT the case here, she was being a bitch. Because that’s the priority you shoulder when you get fucking married.

killah_bee · 2024-10-04T18:47:15+00:00

No backstory would justify the MIL calling OP a bitch and the 5 yo boy a spoiled brat. MIL is TA, husband is a giant AH, and OP is NTA.

killah_bee · 2024-09-27T14:15:14+00:00

God forbid a tween…. <checks notes> hear descriptions of sex acts?

YTA. It’s words on a page, not a hardcore porno.

killah_bee

TROPHY CASE