Here’s another installment of the Totally Inappropriate Comment (TIC).
30-something year old patient with heart failure, renal failure and HgbA1c > 15, with point-of-care blood glucose of 439 (fasting): “Yes, I’ve been taking my insulin. Yes, every day.” Actual comment: “Have you been missing some doses? Because you’re on a LOT of insulin, and it usually works better than this.” TIC: “You’re gonna die. Soon. Like, really soon.”
Patient requesting a pregnancy test: “Well, I finished my pills and I didn’t get my period, so I didn’t start the next pack.” Have you been having unprotected sex in the 3 weeks since you stopped your pills? Patient: “Well, yeah.” Actual comment: “Had you missed any pills in the pack last month?” TIC: “Well, if you weren’t pregnant before, you are now!”
Me, to ex-alcoholic patient who had been complaining of severe hip pain (and had been brushed off as drug-seeking over the past month): “So…the xray of your spine shows 2 compression fractures, and the xray of your hip shows something that we call ‘collapse of the femoral head.’ That’s a big deal. That’s why you can’t really bear weight on your hip.” Patient: “Does this mean I can get something stronger than naproxen for my pain?” Me: “Yes. I’ll give you something stronger for your pain today. And we’re sending you to see Orthopedics asap.” TIC: “Boy, were we wrong! You’re not faking it at all! I can’t believe you’ve been walking around on that non-existent hip joint! I’m sorry.” *Lest you think I am a jerk, I did actually apologize for our clinic not catching the severity of the hip problem sooner, even though it wasn’t me that brushed the patient off.
