Quoted: Quoted: Any armchair radiologists wanna take a crack at this? The patients has a sent of keys and bunch of poop in the gizzard.

Odd, I hadn't noticed the keys, I was struck by the lateral displacement of L4...

I was going to mention boney findings but since this is so obvious and says KEYS in the description of the film, I gave you what you wanted.  There is also some degenerative changes in that film as well besides the L4-L5.

Quoted: Quoted: Ok-what's a Tubal Ligation? Is that what I was asking about? Dave you are talking about an ectopic pregnancy. A tubal ligation is when we tie off the tubes so she cannot have anymore children.

(slaps forhead)

So what makes the Egg attach there? Aren't there normally some sort of chemical/hormonal signals telling the Egg to set up camp on the wall of the Uteris?

Quoted: I was going to mention boney findings but since this is so obvious and says KEYS in the description of the film, I gave you what you wanted.  There is also some degenerative changes in that film as well besides the L4-L5.

OK, this time WITHOUT looking at the description, try this one on for size.

Quoted: Quoted: Second opinions are not always available. But I always encourage my patients to go to get another opinion. 9 out 10 they come back and bring more friends to my office with them.   +1 Any doc afraid of a second opinion is not your friend.

Absolutely.
The only times I have tired to persuade against was when it would postpone treatment of a problem that needed to be cared for ASAP!
But people are adults and can do what they want. I quit trying to buck that a long time ago.

As for radiologists they have helped me out and they have missed things. Clinical correlation required!

Quoted: Any armchair radiologists wanna take a crack at this?

Keys for a Schlage 7-pin tumbler lock.

Next?

Quoted: OK, this time WITHOUT looking at the description, try this one on for size.

2LT who told an E-8 to call him "Sir."

Next?

Quoted: Quoted: I was going to mention boney findings but since this is so obvious and says KEYS in the description of the film, I gave you what you wanted.  There is also some degenerative changes in that film as well besides the L4-L5. OK, this time WITHOUT looking at the description, try this one on for size.

I can tell you want happened though.  

I was loading my weapon naked when I slipped and fell on the round.  

Quoted: Quoted: Quoted: Second opinions are not always available. But I always encourage my patients to go to get another opinion. 9 out 10 they come back and bring more friends to my office with them.   +1 Any doc afraid of a second opinion is not your friend. Absolutely. The only times I have tired to persuade against was when it would postpone treatment of a problem that needed to be cared for ASAP! But people are adults and can do what they want. I quit trying to buck that a long time ago. As for radiologists they have helped me out and they have missed things. Clinical correlation required!

It never hurts to get a second or third opinion.  I am not above groveling for a second opinion.  If a patients life is at stake I really dont give a shit what the other docs think of me. I will steal, lie cheat, to keep my patient alive and well.  In this case I had 2 docs on the phone and 1 come to help me out.  I am not God and more hands is sometimes is all you need.

Quoted: Quoted: Quoted: Quoted: Second opinions are not always available. But I always encourage my patients to go to get another opinion. 9 out 10 they come back and bring more friends to my office with them.   +1 Any doc afraid of a second opinion is not your friend. Absolutely. The only times I have tired to persuade against was when it would postpone treatment of a problem that needed to be cared for ASAP! But people are adults and can do what they want. I quit trying to buck that a long time ago. As for radiologists they have helped me out and they have missed things. Clinical correlation required! It never hurts to get a second or third opinion.  I am not above groveling for a second opinion.  If a patients life is at stake I really dont give a shit what the other docs think of me. I will steal, lie cheat, to keep my patient alive and well.  In this case I had 2 docs on the phone and 1 come to help me out.  I am not God and more hands is sometimes is all you need.

Yeah. In my case anything serious always gets a second opinion in the hands of a specialist. I've had to get pushy a few times and even then had lackluster experiences. Most all with surgeons unfortunately. I just quit using one group(our own) and I would imagine Administration didn't like it much. Fuck 'em. Had one lady I sent back to the same surgeon twice over a breast mass that I was convinced was CA and he was not. Fell thru the cracks as he blew her off even the second time and I left my position for another. Didn't work out too well.
Surgeon got pissed at me for doing so and pt died because of his arrogance, after much suffering I might add. Her husband was a Marine(Korea) and is a friend of mine so I heard about it all later.

Also had a kid with CLL that came in with a small lump on his head. Very difficult to sort out early on and history I was given was BS. He ahd already seen 2 docs previously who told them it was nothing. Did a substantial W/U and wasn't finding anything, got several consults trying to get this biopside, second opinion, etc. I knew something was up but studies were neg and I wasn't coming up with an answer. One of those deals where the hair on the back of your neck is telling you something is wrong though. Pretty mcuh pissed everyone involved off as they were telling me to quit wasting their tiem(no shit-I was just out fo residency). I did eventually make the lymphoma  diagnosis but then family got pissed, wouldn't follow my advice nor that of the surgeon AND oncologist I sent him too instead listening to a shabby oncologist who told them what they wanted to hear instead of reality.  I told them they were approaching this from the wrong angle and never saw them again. He died.

It was an awful case to be involved in from a professional AND, very much so, a personal standpoint as it still disturbs me years later.

Tough job, even on a good day and there ain't many of those.

Quoted: Quoted: Quoted: I was going to mention boney findings but since this is so obvious and says KEYS in the description of the film, I gave you what you wanted.  There is also some degenerative changes in that film as well besides the L4-L5. OK, this time WITHOUT looking at the description, try this one on for size. I can tell you want happened though.   I was loading my weapon naked when I slipped and fell on the round.

Heck of a weapon, that's arty!

Must get some work done, but here is something to contemplate next time you pick up a pair of Wrigley's obstetric forceps

What? more tales? (or should that be "tails"?)

very well, A 54-year-old man presented with the complaint that two days earlier he had drunk whiskey and "did something"

Quoted: Any armchair radiologists wanna take a crack at this?

Hmmm...    looks like a couple of keys contained in a mass of poo.




Diagnosis: Kinky Butt Syndrome.

Quoted: Quoted: I was going to mention boney findings but since this is so obvious and says KEYS in the description of the film, I gave you what you wanted.  There is also some degenerative changes in that film as well besides the L4-L5. OK, this time WITHOUT looking at the description, try this one on for size.

Hmmmm....    looks like a cannon round inserted into his 'breech'.



Diagnosis: Butt Howitzer.

"In retrospect, lighting the match was my big mistake. But I was only trying to retrieve the gerbil." Eric Tomasewski told bemused doctors in the Severe Burns Unit of Salt Lake City Hospital. Tomaszewski, and his homosexual partner, Andrew "Kiki" Farnum, had been admitted for emergency treatment after a felching session had gone seriously wrong. "I pushed a cardboard tube up his rectum and slipped Raggot, our gerbil, in," he explained. "As usual, Kiki shouted out "Armageddon", my cue that he'd had enough. I tried to retrieve Raggot but he wouldn't come out again, so I peered into the tube and struck a match, thinking the light might attract him."

At a hushed press conference, a hospital spokesman described what happened next. "The match ignited a pocket of intestinal gas and a flame shot out the tube, igniting Mr. Tomaszewski's hair and severely burning his face. It also set fire to the gerbil's fur and whiskers which in turn ignited a larger pocket of gas further up the intestine, propelling the rodent out like a cannonball."

Tomaszewski suffered second degree burns and a broken nose from the impact of the gerbil, while Farnum suffered first and second degree burns to his anus and lower intestinal tract.

What kind of moron, even a drunk moron, would stick a fucking light-bulb up his ass?

"Is it in yet bro?"

"Dunno, lemme push a little further"

*POP*

"AHHHHHHHHHHHHG!!"

Quoted: Quoted: I was going to mention boney findings but since this is so obvious and says KEYS in the description of the film, I gave you what you wanted.  There is also some degenerative changes in that film as well besides the L4-L5. OK, this time WITHOUT looking at the description, try this one on for size.

U.S., 37mm, HE, Unfired.

Safe to move, but I think I'll leave that part to one of you docs.

Quoted: <snip> Yeah. In my case anything serious always gets a second opinion in the hands of a specialist. I've had to get pushy a few times and even then had lackluster experiences. Most all with surgeons unfortunately. I just quit using one group(our own) and I would imagine Administration didn't like it much. Fuck 'em. Had one lady I sent back to the same surgeon twice over a breast mass that I was convinced was CA and he was not. Fell thru the cracks as he blew her off even the second time and I left my position for another. Didn't work out too well. Surgeon got pissed at me for doing so and pt died because of his arrogance, after much suffering I might add. Her husband was a Marine(Korea) and is a friend of mine so I heard about it all later. Also had a kid with CLL that came in with a small lump on his head. Very difficult to sort out early on and history I was given was BS. He ahd already seen 2 docs previously who told them it was nothing. Did a substantial W/U and wasn't finding anything, got several consults trying to get this biopside, second opinion, etc. I knew something was up but studies were neg and I wasn't coming up with an answer. One of those deals where the hair on the back of your neck is telling you something is wrong though. Pretty mcuh pissed everyone involved off as they were telling me to quit wasting their tiem(no shit-I was just out fo residency). I did eventually make the lymphoma  diagnosis but then family got pissed, wouldn't follow my advice nor that of the surgeon AND oncologist I sent him too instead listening to a shabby oncologist who told them what they wanted to hear instead of reality.  I told them they were approaching this from the wrong angle and never saw them again. He died. It was an awful case to be involved in from a professional AND, very much so, a personal standpoint as it still disturbs me years later. Tough job, even on a good day and there ain't many of those.

Wow, sorry to hear it, drjarhead.  And sometimes ppl wonder why physicians are jaded......... [idea].

I am not a physician (nor do I play one on TV), but I am a certified asshole and I think I might have shoved a legal/medical looking form under the family's nose which basically stated "I understand that by doing x, y, z instead of l, m, n, I am essentially killing my own kid.

Quoted: Quoted: <snip> Yeah. In my case anything serious always gets a second opinion in the hands of a specialist. I've had to get pushy a few times and even then had lackluster experiences. Most all with surgeons unfortunately. I just quit using one group(our own) and I would imagine Administration didn't like it much. Fuck 'em. Had one lady I sent back to the same surgeon twice over a breast mass that I was convinced was CA and he was not. Fell thru the cracks as he blew her off even the second time and I left my position for another. Didn't work out too well. Surgeon got pissed at me for doing so and pt died because of his arrogance, after much suffering I might add. Her husband was a Marine(Korea) and is a friend of mine so I heard about it all later. Also had a kid with CLL that came in with a small lump on his head. Very difficult to sort out early on and history I was given was BS. He ahd already seen 2 docs previously who told them it was nothing. Did a substantial W/U and wasn't finding anything, got several consults trying to get this biopside, second opinion, etc. I knew something was up but studies were neg and I wasn't coming up with an answer. One of those deals where the hair on the back of your neck is telling you something is wrong though. Pretty mcuh pissed everyone involved off as they were telling me to quit wasting their tiem(no shit-I was just out fo residency). I did eventually make the lymphoma  diagnosis but then family got pissed, wouldn't follow my advice nor that of the surgeon AND oncologist I sent him too instead listening to a shabby oncologist who told them what they wanted to hear instead of reality.  I told them they were approaching this from the wrong angle and never saw them again. He died. It was an awful case to be involved in from a professional AND, very much so, a personal standpoint as it still disturbs me years later. Tough job, even on a good day and there ain't many of those. Wow, sorry to hear it, drjarhead.  And sometimes ppl wonder why physicians are jaded......... [idea]. I am not a physician (nor do I play one on TV), but I am a certified asshole and I think I might have shoved a legal/medical looking form under the family's nose which basically stated "I understand that by doing x, y, z instead of l, m, n, I am essentially killing my own kid.

Jake believe me a lot of that does take place.  LOTS of forms and waivers.  If you cut too much off you cant sue us.  But they do anyway.

Quoted: Quoted: Quoted: Tough job, even on a good day and there ain't many of those. Wow, sorry to hear it, drjarhead.  And sometimes ppl wonder why physicians are jaded......... [idea]. I am not a physician (nor do I play one on TV), but I am a certified asshole and I think I might have shoved a legal/medical looking form under the family's nose which basically stated "I understand that by doing x, y, z instead of l, m, n, I am essentially killing my own kid. Jake believe me a lot of that does take place.  LOTS of forms and waivers.  If you cut too much off you cant sue us.  But they do anyway.

Local neonatologist has the form he gives hippy moms who don't want their babies injected with Vit K that said basically "by refusing this injection I know I may be killing my baby, or worse, subjecting it to life as a vegetable."

He said that every single time  he's done that the new-ager no-shots-for-my-baby hippy mom realizes just how serious it is and relents.

Quoted: Fuckers missed a molar pregnancy. I had serious problems in the OR because the dudes are fucking blind and couldnt diagnose an easy finding that a med student would have been able to pick out.  I scanned her myself is the OR and easily saw it.  They couldnt see it with their fancy machine that cost 100 times more then mine.

ARDOC,
Incompetance runs AMUCK, regardless the occupation. I used to believe a former employer who stated that 95% of people are incompetant was an extreme pessimist, now, I think he may have been understating the problem.

So, I tend to demand competance, or there are consequences... if a waiter/waitress, lousy tip... if doc, I "fire" them, AND dis them on a regular basis... if other professional, I fire them, bitch to their  superiors +++. I realize this could be a tad "tricky" for you in the situation you describe... but don't you have those nmeetings (can't recall the exact term) where you figure out what went wrong, and how it might have been avoided? Can you "dis" them during that w/o appearing to be a perfectionistic A-H? (_I_ don't think you ARE being one, but THEY might think so ).