Ask a Surgical Intern, Part 1

GomerBlog is introducing a new section titled, “Ask a Doctor Anything.”  This is where to find all the great advice you’ve been looking for, but been afraid to ask.  Thank you all for your questions and we know you’ll love the answers.  We will start by asking a surgical intern.  Let’s begin!

Dear Surgical Intern,

I’m kind of embarrassed about this, but I’ve been having this tugging sensation down in my groin.  It started after I was lifting something heavy, and I kind of heard a pop.  Do you think I have a hernia?

– Bulging in Buffalo

Dear Bulging,

Listen, Bulging, I have to speak with my 3rd year medical students for a second.  Guys, look.  I know you’re 3rd year students and all, but there are like 2 things for you to do. One, don’t kill anyone.  Two, update the list.  There’s no diagnosis on half these people. You’ve got this patient listed as in room 7402.  There is no unit 7400.  Brad, I swear if you put ‘hypocreatinemia – replace creatinine’ under the assessment and plan again I’m going to slap you.  Kevin, parathyroid hormone doesn’t come from the posterior hypothalamus.  It comes from the parathyroid.  Jen, abdomens are not ‘clear to auscultation bilaterally.’ When you present it like that to an attending, after I TOLD you not to, you kill me.  On the inside.

Dear Surgical Intern,

I have this stomach pain that kind of comes and goes.  It like starts on my right side, but then it moved to the left.  And I got all hot the other day, could that mean something?  It’s weird, like, when I stand on the left foot, it makes the pain worse.  Do I need an MRI?

– Concerned in Kansas

Dear Concerned,

Yeah, this is acute care surgery, I was paged?  Thanks.  Consult?  Okay, name?  Medical record number?  Okay.  Yeah.  Okay.  How long?  What’s the CT show?  What’d the labs show?  You’re joking me right now, right?  You’re getting a surgery consult, because you pressed on his belly, and he was in pain?  You have no CT, no labs, no NOTHING, and you’re getting a surgery consult because his belly hurt and you want to rule out acute abdomen that’s been going on for 3 months?  Do you at least have the results from a KUB? No?  Of course not.  Hold on, let me pull up the CT and look at it.  This isn’t really showing anythin….wait, did you order a non-contrast CT?  You ordered a NON-CONTRAST CT on a patient with NORMAL CREATININE?!  What you’re saying sounds like you’re joking, but your tone says you’re serious.  Maybe we should do a non-CT contrast study for further evaluation.  Please don’t order that, I can’t tell if you’re going to.  Fine, yeah, I’ll come see him.  I hate you.

Dear Surgical Intern,

I’ve had this bump on the outside of my arm that keeps getting a little bigger in size.  I was reading online that it could be a lipoma?  Can you guys take it out?

– Lumpy in LA

Dear Lumpy,

Hey, Humpty Lumpty.  Oh one second.  Is this 7200?  Yeah, nurse for room 3, please.  Yeah, hi, it’s Mark with general surgery.  Yes, I’m aware she says she’s in horrible pain.  What’s she doing?  Eating pudding and watching tv, huh?  Is that her laughing at the TV in the background?  Nice.  Yes, I’m aware she says that Dilaudid is the only thing that takes her pain away.  She’s on a PCA already.  No, I’m not going to give more.  Because.  Sure, whatever, Robaxin 750 milligrams q8.  No, I don’t need to come evaluate her because she has pain all over.
No.
No.
No.
No.  Ahhhhhhhhhhhhhhhh.  Fine.  I’ll come see her.

Be sure to send in more of your sensitive medical questions and surgical interns will take care of you!

Need some more advice?
– Ask a 4th-Year Med Student (Who’s Checked out for the Year)
– Ask a Hospitalist
– Ask a July 1st Medicine Intern
– Ask a Surgical Intern, Part 2