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Orthopedics can be complicated. Thankfully, Dr. Hal Dole, after passing his IM boards also completed a Fellowship in: Optimization, Restoration, Transition and Hyperalimentation of Organ Malfunction Emanating from Surgical Sequelae and Surprises: ORTHO-MESSS. There, he learned to use the word “fracture” instead of “broken” and bench-pressed 250lb.

hospitalist
Thankfully completed a fellowship in ORTHO-MESSS

Here’s his take on Intratrochanteric Hip Fracture:

“There are bones in the leg, you see. One above the knee and two below. Strange I know. Lower down, it’s all bones. Like maybe 80 of them. I think there is a special school where you can learn all their names. There are muscles and tendons too.”

“Usually bones are not broken. But sometimes, they are. You can tell if a bone is broken when it sticks out of the body. But bones can be tricky and be totally broken inside the leg. We have X-rays for that.”

“When I have a patient with a broken bone, you see: I get a detailed history, EKG, Echo, Labs. Social History, Family History, check lipids, Thyroid… gotta check thyroid. I found an insulinoma once. Do a full neuro exam. Make sure you get a full Review of Systems. Cortisol level… that never hurts. Iron studies? I never regretted getting those. Get an ultrasound of something… Kidneys maybe. I get X-rays too if I don’t forget. Then I call the orthopedic guy. The patient disappears from the floor for a while and comes back all fixed! EBL<50! Tricky stuff these bones…”

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Livin La Vida Locum MD
Livin La Vida Locum MD chose the most rewarding of all medical specialties and became a hospitalist. Wanting to contribute even more to the medical community, he trialed his hand at clinical research, but quickly realized that peer reviewed articles, R2,, and Odds Ratios will never top the impact of thorough healthcare reporting. So he dedicated his life to delivering the finest, deepest and broadest medical news from around the country. He accomplishes this monumental task by accepting locum assignments all over the country; in towns, villages and “hospitals” you never heard of and will never visit. May all fans of medical satire benefit from his wandering.
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