Tuesday, December 5, 2017

Who You Gonna Call?

I certainly hope for this young man's sake, that the  tattoo is prophetic, but who are we going to page to extricate that foreign body. Many decades ago, all it would have required was a quick page for my general surgeon hero, Dr. Slambow.  In the days before surgical protocols were  dreamed up by busy body office sitters,  limiting the scope of a surgeons intervention, general surgeons did it all. Amputations, setting bones, circulatory grafting, repairing lacerated livers, kidneys was their stock and trade. There were few "specialists" and no subspecialties.

Dr. Slambows treatment plan would be to anesthetize and "succ" the above patient and then simply yank that nasty blade out. "Standby...if there is bleeding we will have to go in and find the bleeder, lets hope for the best." Dr. Slambow always called the standing around and waiting routine, "masterful inactivity."

I can't imagine the number of specialties that might be consulted today for a case like this. Here is the conversation between two residents considering the various consults that might be indicated.

"We better get an occuloplastic surgeon to see this tattooed knife target. That wound is pretty near the eye."

"No..I'm calling the ENT man, that toad sticker is obviously impacting his maxillary sinus. Maybe an oral surgeon too."

"What about that hospital directive advising a neurosurgery consult for any wound to the head?....That's not his head, that's his face I' calling the chief plastic surgery resident on call."

The straightforward approach would be a call to Dr. Slambow to quickly resolve the problem while the others are pontificating and checking the patients insurance coverage.



  1. LOL! Yank the knife out, and if it doesn't bleed too freely, kick him to the curb. If it does bleed, send him home with a wad of 4 x 4s and wish him luck.
    No, not much...

  2. I note you DIDN'T say: "Call the cops." Thank you.

  3. Officer Cynical, I was always very appreciative of a police presence around trauma patients. One New Years Eve, Dr. Slambow was removing shotgun pellet from a misguided reveler while an officer from the Cook County Medical Examiner's office waited outside the door for the "evidence." As the circulator, I flipped the scrub nurse a specimen jar to contain the pellets. When it was time for me to hand them off to the officer, I swirled them around in the jar and toasted him "Happy New Year!" Those were the days. We both had a good chuckle.

  4. So many ER stories, but from a humor standpoint, this is my favorite:
    I had arrested a woman for DUI early one morning, and taken her to the nearest ER for the requisite blood draw. My partner and I took the woman to the assigned exam room while we waited for the nurse. The woman, despite being quite drunk, insisted on wandering around the room and out into the hallway. I finally said, "Elizabeth, will you please sit down?" Elizabeth replied, "I can't sit down." I asked why, and she said - I swear - "Because I have a turd in my pants." My partner and I laughed so hard that patients and staff in nearby exam rooms were poking their heads out of their exam room doors to see what was going on. Years later, whenever my partner and I were talking and the word "why" was spoken, the other dutifully replied, "I have a turd in my pants.", and we'd bust out laughing all over again. Indeed, those were the days.

  5. That was a great story, Officer Cynical, at least she did not attempt to remove it and throw it at you. As a nurse, I've had to duck winged turds on a couple of occasions.

  6. That right inferior EKG lead is about to come loose. Better put down that smart phone and reattach it before the alarm sounds.

  7. It is always preferable to just go in there and do what needs to be done. Especially in cases of LIAs (Lifestyle Induced Ailments)and it was always comforting to have an officer following close behind.