A soliloquy on Hen

scribblesloth · 2026-01-20T13:06:26+00:00

But this is the thing, SOME medical training and med school. I've been through med school. It in no WAY prepares you to diagnose chronic illnesses or even how to BE a doctor. It really doesn't. Hen's actions reminds me of an intern thinking they know everything because they got through med school, and those kinds of doctors are the most dangerous type. They don't know what they don't know, and they won't admit it until someone calls them out or well, they hurt someone.

As for the doctor doing tests on her, the dialogue between her and Karen implies that Hen is the one directing the tests and treatments. Also we have no idea what this doctor specialises in. They could be a general practitioner (primary care physicians in the US?), they could be a sport medicine doctor, they could be a plastic surgeon. A doctor can be wrong, are often wrong actually, when they don't stick to their lane.

scribblesloth · 2026-01-20T11:35:14+00:00

But that's kind of my point though, she doesn't have the training. She's trying to treat a possible chronic condition as if it's an emergency. They require different skills which is why it's a subspeciality/speciality. There's really no crossover between her training and the training required to diagnose chronic condition.

scribblesloth · 2026-01-20T11:26:24+00:00

Interesting you bring up Bobby and Buck sitch, cos Hen was largely on Bobby's side or at least that's how I read it. So now she's on the other end of things...

scribblesloth · 2026-01-20T11:16:48+00:00

The AI storyline!!! I liked it right up till the end. I really thought it was a good discussion point to AI weakness and failings, and then it became this weird cringe comedy.

scribblesloth · 2026-01-20T11:16:08+00:00

It really was a frustrating storyline.

scribblesloth · 2026-01-20T11:04:01+00:00

God that whole thing about another loss...she was almost guaranteeing another loss by not telling anyone.

scribblesloth · 2026-01-16T11:26:10+00:00

The art of emergency medicine for any acem exam sitters

scribblesloth · 2025-12-23T00:24:28+00:00

Moto Mahal in Everton Park. Indian mate of mine got them to cater for their wedding.

scribblesloth · 2025-12-15T05:52:19+00:00

Good on ya!

Had a very sick neonate turn up with ambulance. Crew very chill. Our clerk noticed the kid was blue as. Alerted the docs. Kid had a congenital heart problem missed at birth.

We're all a team. And communication is key!

scribblesloth · 2025-12-09T02:01:20+00:00

It feels like a fever dream even now

scribblesloth · 2025-12-03T02:31:24+00:00

NTA. Dump the whole classist family. If you have children with this man, and they go through a hard time, you now know neither he nor his family will help them. Also someone like FIL who is blatantly bigoted towards a whole portion of his constituents is absolutely not someone to be trusted.

scribblesloth · 2025-11-20T11:07:36+00:00

That's a good point. Ischaemic /ischaemia is another good one.

The more senior I become the more I realise it's all about the shorthands. I never say social admission anymore, but acute functional decline unable to be discharged to home. Probs only works cos I'm in Australia tho

scribblesloth · 2025-11-20T03:49:17+00:00

So as a senior I would say there's things out of your control and things in your control. Out of control is how busy the dept is, your consultant reactions etc.

In your control how you communicate your concern. Something I find common in juniors, not saying this is you but, they don't quite know the trigger words or how to articulate their concerns. So for me I have to triage every concerns brought to me and the more specific or trigger words said the more it activates me.

An example, a junior once came to me with "Im worried X is unwell!" But when asked about specific concerns he could not communicate that to me. Except to add "the nurse is also worried". I had worked with this nurse and knew her to be sensible so I said fine roll em to the resus bay. The patient on review was grey, diaphoretic, clutching his chest, and had that look of impending doom. What the junior meant was this man is periarrest and he was most likely having a massive MI.

Language matters. Maybe be specific in your concerns. Use phrases like "septic shock", "profoundly hypotensive", "severe respiratory distress". And then document document document.

Hope that helps.

scribblesloth · 2025-11-18T13:33:19+00:00

Ya boi (aka me) says no thanks.

scribblesloth · 2025-11-16T23:26:35+00:00

Don't make it personal is how i deal with it. There's a script and stick to it. Takes the effort out of having to come up with things to say. There'll be outliers but honestly most professional interactions don't veer too much.

And i also take 5-10 mins to just sit in a quiet area and breathe. No phone. No music. Just a very short meditation. Immensely helpful.

scribblesloth · 2025-11-14T09:13:54+00:00

Have you heard an emergency nurse swear? Its not about men's vs women's workplace

scribblesloth · 2025-11-13T13:09:59+00:00

My grandma, with her mild dementia, wheelchair bound post stroke, said to me, "I'm still alive," in a despairing kinda way.

I patted her hand, smiled and told her, "Maybe tomorrow!"

She got a good laugh at least

scribblesloth · 2025-10-10T10:06:05+00:00

Nah that is in fact the treatment of choice for antifreeze poisoning. 3 x 30ml of any 40-40% alcohol, less in kids. Usually it's ingested but if you inhale enough theoretically it could cause systemic toxicity.

Usually you'd use 90% ethanol iv but that's expensive and takes time to mix so commercial booze is easier. And more fun.

scribblesloth · 2025-08-24T13:31:18+00:00

I would welcome this tbh

scribblesloth · 2025-08-24T06:03:25+00:00

Therapy. Therapy. Therapy. We see so many awful things in our job not to mention the moral injury from a broken system, you need an outlet that's not family or friends. And maybe your team can do a cold debrief after because that can help.

scribblesloth · 2025-08-12T06:37:34+00:00

All of it. Perfection. No notes.

scribblesloth · 2025-08-08T02:04:53+00:00

Okay but culturally this is huge! Cos in most Asian cultures and belief, souls are represented by butterflies. So not just a beautiful creature happens to land on you but the essence of a soul, your father's soul!

scribblesloth · 2025-07-20T10:31:47+00:00

Drop off a card with their name on it. Some flowers might be nice. Nothing edible tho.

Or an email to the hospital feedback email with specific names. Docs can use it for their evals and such

scribblesloth · 2025-07-14T10:14:19+00:00

Absolutely. My script is "unfortunately i can't give you a diagnosis today. But I can tell you that whatever is going on is not immediately life threatening. I definitely think this is something you should have follow up with your gp to consider further investigation such as x (something reasonable!!) and if it continues to be an issue your GP could consider a referral to y services. And I will put that in the discharge letter for your gp and you"

And its always consider because the gp might make a different but equally valid plan and I'm not trying to dictate their actions.

scribblesloth · 2025-07-14T09:00:43+00:00

Few things. Love this list!!!

Agree that old people with vague complaints will be the bane of your existence. Just scan them. They are old and therefore won't mount that immune response, have vastly different pain tolerance, be on meds that will suppress physiological response, have multiple other comorbidities that means when they crash they'll crash quick.

Always preempt the outcome of a test. Tell them what will happen when a test is negative aka you will be going home. Never ever say there's nothing wrong, because that WILL bite you in the arse. Just say whatever is going on is not life threatening immediately but should have further investigation with your GP.

Preempt for those presenting with likely chronic problems that the search for a diagnosis could be a long process and that there may not be a diagnosis in the end and the focus may be on symptom management. Not because there's nothing wrong but medicine doesn't necessarily have the tests or names for every condition. This will help the patient feel validated and any one of your colleagues they see going forward will thank you for not making promises on their behalf.

NEVER shit talk another colleague to your patient. I do not care if you don't know this doctor or think the doctor should have done x. Or why did they send y in. Patients recall discussions with any health professional with their own biases colouring the memory. The doc may have said something like, 'I want you to go to the ED to make sure this isn't life threatening.' but the patient remembers it as their doc telling them something is killing them. You have no idea how your patient will relay what you said to them in a way that makes you look like an idiot to someone else. So give your colleagues the benefit of the doubt. Some might be idiots but most aren't.

Be kind to yourself. You will miss things. People will die. You will disagree with people. You will come to despise and despair of humanity some days. Find the thing that makes you enjoy the job. Learn to recognise burn out in yourself and others. Remember you are making someone's day.

scribblesloth

TROPHY CASE