Lets do this

Hyperkalaemia ECG changes in 15 seconds. 

High levels of potassium destabilise the cardiac membrane causing arrhythmia’s which lead to cardiac arrest. This can be a real life-saving opportunity if you can catch and treat it!

no seriously

Me: *explains that, due to the holidays, the office will only be open til 5pm on Wednesday this week and next week, instead of til 7, for patient to lick up her narc script* (keep in mind that we are only open past five once a week, and it’s resident clinic only)

Patient: *goes on rant about how doctor’s offices should be open 24 hours and patients should be able to directly call their personal doctor’s cell phone whenever they want*

Me: *gently attempts to explain that their is a primary care physician shortage and it just isn’t possible staffing-wise. Doesn’t even bother with the entitled bit about the personal cell phone access*

Patient: “You guys make enough money, you should have to work more. Besides there are plenty of med students.”

Me: “Ma’am, med students can’t work without supervision. Neither can residents. And I’m sorry, but I already work 80 hours per week regularly, and I don’t even get paid enough to do THAT.”

Patient: *stubbornly repeats that physicians should have to work more* “Gas stations and grocery stores are open 24/7, and isn’t my health more important than that?”

Me: “Ma’am, I paid more money than I’ll be able to make back in my first ten years practicing in order to do this job. You don’t need to pay for a college degree to work in a gas station or a supermarket. If you’re willing to accept that level of expertise for your healthcare, that’s a problem. And if you really need a physician 24/7, there are emergency rooms and urgent cares.”

Patient: *repeats bit about needing access to her personal physician’s direct line because an urgent care “doesn’t know her.”*

Me: “Ma’am, you’re talking about a narcotic script. The pharmacy won’t fill that at 2 in the morning, so it won’t help you if you can get your doctor to write your prescription then. Your Rx will be waiting at the front desk once I get the results of *lab test with recent abnormalities that caused the PCP to hold the med*”.

Patient: “Oh, since I’m here, I need Xanax so I can sleep at night. I’ve been using my daughter’s and it works.”

Me,completely fed up: “Ma’am, I will not prescribe you an opiate and a benzo simultaneously. You will stop breathing and die overnight, I’ll lose my license, and there will be one less overworked physician to staff your 24/7 Family Medicine office.”

Patients’ daughter: *starts cracking up*

Me:

I am hoping to become a

(wait for it)

And I have somehow fallen in love with the demon kidney.

And might want to devote my life to the demon kidney.

The cat is named Sämpy if anyone is interested, she is very famous in Finland. Amazing ball of fluff! The owner is also very talented at photography.

I really doubt that any normal-headed folks are ever going to read this, but on the off-chance that someone searches for ‘things you shouldn’t say to your schizophrenic friend/spouse/co-worker’, here you go.

1.  ‘Have you taken your meds?’ - Unless I am literally covering the windows in newspaper, turning off every wifi-enabled device in the house, or something equally blatantly insane, don’t fucking ask this question.  I’m allowed to have the entire spectrum of human emotions like anger, sadness, melancholy, excitement, or fear just like everyone else, and they aren’t reasons to immediately assume I’m off my meds or having an especially bad day.  I’m schizophrenic, not a child, and you aren’t my goddamn caretaker.

2.  ‘You’re delusional/crazy.’ - Not agreeing or not believing something I say is not the same as me being in a delusional state.  This isn’t something to say offhandedly or joke about, or use as a method of playing practical jokes to make me think I might actually be experiencing delusions.  This is also NOT the thing to say when trying to be dismissive over something we’re casually talking about.

3.  ‘You need to calm down.’ - This doesn’t work with your significant other, your sibling, or your parents, so why the fuck do you think it will work with me?  Especially if I’m actually in a state that suggests I actually might need to calm down?  At best, telling someone to ‘calm down’ is condescending, and at worst, saying ‘calm down’ is actively attempting to make a not-calm person even worse.  Which are you going to be?

4.  ‘You don’t need medication, you just need ________’ - Get fucked.  No seriously.  Unless you are literally that person’s psychiatrist, you have no business suggesting that a schizophrenic doesn’t need their meds.  Ever.  SCHIZOPHRENIA IS AN ORGANIC BRAIN DISORDER.  YOU CAN SEE IT ON A FUCKING MRI.  There is no alternative medicine, snake oil, exercise routine, prayer ritual, or bullshit meditation center that is going to suddenly cure an organic brain disorder, because if organic brain disorders could be cured with whatever bullshit you’re suggesting, nobody would have Alzheimer’s, MS, or Parkinson’s anymore either.

5.  ‘You don’t have schizophrenia, you have ________’ - Again, get fucked.  Schizophrenia is the last thing that any well-adjusted, normal human being actually wants to have.  If there were any other potential diagnosis, there’s a good chance we’ve already ruled it out.  Unless you went to medical school with a specialization in psychiatry, and are actually qualified to suggest a new or alternative diagnosis, shut the fuck up.

6.  ‘You really don’t seem that crazy/look sick.’ - This always feels like a compliment at first, but underneath it is a suggestion that because I don’t ‘look crazy’ I’m somehow either not schizophrenic or that my issues, when I have them, shouldn’t be taken seriously.  There’s a good chance that a schizophrenic that doesn’t ‘look crazy/look sick’ is either currently stable, properly medicated, or just very good at keeping their shit together in public.  We also aren’t fucking obligated to tell you when we are experiencing symptoms in our day-to-day lives.

7.  ‘What do you hear?/What do your voices say?’ - Not all of us have auditory hallucinations, and not every schizophrenic with auditory hallucinations actually has ‘voices’ they can single out or identify.  What’s more, the folks who do hear voices often experience them saying very negative, unpleasant, sometimes very hurtful things.  If you heard someone constantly calling you stupid, or useless, or fat, or worthless, or suggesting even worse things, would you feel like constantly repeating that shit to someone else because they feel like being a tourist?

8.  ‘This is my friend X, they’re schizophrenic.’ - If someone trusted you enough to actually tell you about their diagnosis, you keep that shit to yourself unless it is absolutely medically relevant that someone else be told.  That is not your goddamn information to share or even hint at with others, ever.