- Parks and Rec is about to get medically wrecked.
Pee-woo!
(gun shoots)
- [Ron] Ah! I've been shot!
- [Woman] Oh my God.
Oh my God. Oh my God.
Ron, I have you hat.
Ron I have your hat.
- Why is no one calling 9 1 1?
Why do they think they could solve this?
Like, this is an office issue.
- I was shot in the head with a shotgun.
- Ron. It's actually not that serious.
I just need you to stay calm, okay?
- Yeah.
I'm just gonna stay angry.
I find that relaxes me.
- Okay, here's your scotch.
- Okay, Jerry.
Jerry's here.
Here's your scotch, Ron. Here we go, Ron. Okay.
- Scotch can actually make you bleed more.
So that's not something that we want.
- The pain medication I gave you is pretty strong.
Donny uses it for menstrual cramps.
How many did you take?
- Seven, eight...but I washed them down
with plenty of fluids.
- But Ron, you cannot drink scotch with this.
You're gonna need to purge right now.
- Pain medications, especially ones that include
acetaminophen, AKA Tylenol, with alcohol,
can be quite disastrous.
In fact, one of the leading causes of
acute liver injury happens to be
Tylenol intoxication.
Whether on purpose or even by accident.
I see it quite often when patients are like,
oh I took some Tylenol,
and then I took some Coricidin or NyQuil,
these are all things that contain acetaminophen,
but because they have different brand names,
people don't realize it,
and they like get a toxic dose of Tylenol.
We recommend ideally maxing out
at 2000 milligrams of Tylenol a day.
But the max dose is 4,000.
- This is for your own good.
- I don't want you.
- Open your mouth?
- If that is Ipecac,
this would make it a lot easier.
- Hey Anne, are you still a nurse?
Or did they fire you because you slept with all the doctors?
- Whoa! Someone belongs on Grey's Anatomy.
- Andy's not feeling well.
- What's wrong Andy?
- Just got a headache and I'm seeing double.
And I got a song stuck on my head, and my teeth hurt.
Also, I'm hungry.
- Not gonna lie.
Most of my patient visits go exactly like this.
For us doctors, we want to address
one concern at a time in order to give it
adequate time and effort.
But patients don't work by check boxes.
So they tell you everything that's wrong with him.
Then we have to decide, is this all due to one cause,
or are we gonna take this apart in several visits?
- Did you hit your head?
- Yeah, he was hanging up his gold record.
(head bangs)
Oh my God.
Are you okay?
- Yeah. I'm good.
(Andy falls)
- Look to the left. The right.
Whatever.
(laughs loudly)
- The best fundoscopic exam I've ever seen.
You can't do a proper fundoscopic exam
when a patient looks so far to the left
and so far to the right,
'cause you gotta look through the pupil.
- Well, if it's a concussion, it's extremely mild.
So I wouldn't worry about it.
Anything else bothering you?
- The way that I like to do it, is say,
okay, based on reason, X, Y, and Z
is why I don't think this is
inherently dangerous right now.
Things you need to be on the lookup for are X, Y, and Z.
The patient can then understand why I'm making
the recommendation.
To understand that if something changes,
that now is outside of my initial recommendation,
they know when to come back.
- Got a weird rash in my knee pit.
Sometimes when I walk
my ankles make like a weird rattle snake sound.
Broke my thumb on the way over here.
- Whoa, that's a serious break.
There's a lot of bruising.
- We made like a hundred million doctor's appointments
for ourselves in one week.
After this, we won't have to go to the doctor
for like 10 years.
- That's not true.
But seeing a family medicine doctor is really ideal,
because a lot of these problems are really not
requiring the consultation with a subspecialist.
We can handle them in family medicine.
So Dr. Harris seems to be a-lackin'.
- Oh let's get you home and get me some ice cream.
- Here's your bill.
- Oh yeah.
We won't be needing that.
I've got the free medicine card.
- (chuckles) Free medicine card.
- (Indistinct) a deductible for dental procedures.
- Oh, I think you're wrong.
We have the insurance thing.
I believe we're covered.
- It's still $500.
- You know what?
Go! Dine and dash. Out of the way!
- Wait, he got a dentist appointment
and then he's in an ICU all of a sudden?
Where is he?
- Woo-hoo!
(head bangs)
- Oh, call an ambulance!
- I'm making the water fountain hygiene upgrade
our number one priority.
- Great! For some reason,
when people in Pawnee use the water fountain
they put their mouth completely open.
- Ew! Oh my God!
That's my worst fear!
Oh, that's a sure-fire way to get herpes.
Speaking of it.
- I have a hernia this morning.
I made the mistake of sneezing.
(sneezes)
- Oh, that looks like he has an inguinal hernia
where intestinal contents actually
go through the inguinal canal into your scrotum.
That's right.
You can end up with intestines in your scrotum.
- But as long as I sit still and don't move, I'm good.
I got this.
- The most dangerous part
about having a hernia is if it becomes strangulated,
which means that within the opening that was created
and that it went through, some kind of inflammation happens
or stress happens where it starts getting choked out.
And this choking out actually cuts off the blood supply
to that part of the intestine, thereby causing it
to necrose and die, which leads it to develop an infection.
So a strangulate hernia is a surgical emergency.
(bread thumps)
(laughs)
- That was actually really funny.
- But the best part about being an MRI technician
is I can see inside of everything.
Look inside this steak or this butter or this bread.
- Well if you look inside this bread
all you're gonna find is more bread.
- I don't know.
I'd have to do an MRI.
(laughs loudly)
- I mean, I've never even had an MRI before.
- What?
- Is he taking her to get an MRI,
in a claustrophobic loud little space that you have to sit
for long periods of time?
Ugh.
- I don't know about this.
- I'm offering you a free scan.
Usually cost up to $2,000.
- Free scans are not necessarily good scans.
In our bodies, we have all sorts
of little growths and differentiating markers.
Some of these things go away.
Some of these things, aren't actually a problem.
If we find them on imaging
when we're looking something else
we actually have a name for them called Incidentalomas.
And these things are not usually meant to be found.
Finding them just results in more scans,
more radiation, more healthcare related anxiety,
more testing that you don't need,
and the reality of us actually trying to save your life
by finding this thing,
are almost zero.
- How's that feel?
- Ah, weird.
- Perfect.
- How about asking her
if she has any metallic objects on her?
Oh, so much can go wrong.
- You never had any kids, right Leslie?
- No.
- You got a great oven.
- Okay. Time to go.
- Got ample room in there.
- What is this even an image of?
- You got a big industrial sized oven.
- Ah, I'm feeling sweaty.
Do I look sweaty?
I feel, you know, I need to use the bathroom one more time.
- That's like five times in an hour.
- Well, somebody's nervous about the ceremony.
- Or he could have a UTI causing him to have a fever,
which is causing him to sweat,
which is causing him to urinate quite often.
(Ben groans)
- Ben? Oh my God!
- Kidney stone?
- Are you okay?
I think I'm giving birth.
- Kidney stone?
- Yep. Big sucker too.
- Big sucker. Size is one of the most important factors
when we're looking at kidney stones
to decide what to do moving forward.
You know, Lithotripsy is a really unique option
where we can actually break up the stone
while its inside of you.
But we could also go in and physically retrieve them.
- I want candy.
- What is he on?
- Morphine.
That's good stuff.
- We could also give medications like Flomax
which can help in the passage of smaller stones.
- Ron, you've been sweating in here all day.
- My God, why is everyone sick?
- Yes. Plenty.
- No, you need to drink water.
- Usually I take it neat
but I will make an exception in the name of health.
Last night, I watched a movie with Diane and the girls
in which an orange fish is separated from his father.
The children were sniffling, which I believe to be
due to the sad nature of the film.
I was wrong.
- Kids are Petri dishes.
They touch everything.
They bring it right up to their noses, mouths,
eat it, then get sick and then pass it along to us.
- I am a grown man.
I've had a cold before I need no help.
So if you don't mind...
(Ron falls)
- Oh no. He fainted.
- Make sure that he has a pulse.
Otherwise start chest compressions.
- Before you begin a few ground rules.
I need you to explain everything you do before you do it,
so I can determine whether I will allow you...uh!
- It's funny.
That's what I usually do with my patients.
But the other day I had a patient
who I was draining an abscess off of his back,
which means that there was like a pocket of pus,
tennis ball size.
Almost like what you would see on Pimple Popper.
And as I was doing it, because it was on his back
I wanted to narrate what I was doing before I did it,
so he would feel comfortable.
He actually got mad at me multiple times.
The first time he said
please stop telling me everything you're doing,
'cause it makes me feel worse.
I apologized.
And then, when I realized it was taking a little long,
I reassured him and said, everything's going well,
and he reminded me,
please stop telling me what you're doing.
And I made the mistake and I apologized again.
- Yuck! Balsa wood?
You could at least use mahogany.
- There's something occluding your ear.
- It's sawdust.
Just blow.
(blows)
- Why is there sawdust in his ear,
not earwax?
- You've got strep throat.
Running a prescription for penicillin.
- Why was he admitted into the hospital?
A, for strep throat?
And B, why in the world
are his eyes so red for strep throat?
Something doesn't add up.
- Hey, you look better.
I guess actual medicine can be effective.
Who would have thunk?
- Please leave me alone.
- A lot of people don't realize this,
but by taking antibiotics for strep throat,
you only decrease the time that you have symptoms
by about 16 hours.
That whole, oh, I'd like to get antibiotics
so I can get better for my trip thing,
doesn't quite work.
- The only problem I see is that your potassium is low.
So just eat a banana once in a while.
- Ladies, ladies.
- See now a gag reflect? What's happening?
- (indistinct).
- Oh! That's disgusting!
- Let's go wait outside the bathroom for Tom and scare him.
- Ready? And...boo!
(girls laugh)
(Jerry farts)
- Jerry! God, gross!
- Guys.
- Oh God.
I think he might be having a heart attack.
- And faring simultaneously?
- Medically speaking,
how would you describe what happened to Jerry?
- He had mild heart attack.
- Is there a term for having a heart attack
while releasing so much gas?
- Not really. Gastrointestinal distress
is common during a cardiac event.
- It's common during any stressful event, actually.
That's why the term,
butterflies in my stomach, exists.
- I just want to hear the doctors say
that Jerry had a fart attack.
Is that too much to ask?
- You could just have said it yourself, my man.
And if you're having a heart attack,
the most important thing you can do is call 9 1 1
because the time that we have to save your heart
that is not getting enough blood flow, is limited.
And if you're not getting there in time
we could actually lose parts of your heart
which then can lead
to rupture of valves or walls of the heart.
And obviously that could be lethal.
If you're having chest pain, you're dizzy,
it's radiating up, down, left, right,
call 9 1 1.
In fact, here's the recommended guidance
from the American Heart Association.
- I'm just feeling really tired.
I think maybe my allergies are acting up.
I've already vomited like five times today.
- Vomiting can be a sign of anaphylaxis.
That's something we don't talk
about enough because people are saying,
oh, I'm vomiting, that has nothing to do with allergies.
It can be.
From a skin allergy?
Very unlikely.
Just like a mild skin allergy.
- Oh my God.
- Is she, is she sick?
Are you sick?
- No.
- Yeah! She's sick.
That's why I'm wearing this,
and misting myself with hand sanitizer.
- Yeah, that doesn't work.
And it kind of reminds me
of the new Dyson product that was just put out.
I have questions about that thing.
- I'm getting better..
- All right, you're burning up.
- You're burning up. What?
- The fact that she's having multiple systems involved,
watery eyes, runny nose, abdominal discomfort, vomiting,
all of that point to the fact
that it's a multi-system issue likely to be a virus.
- Leslie, I typed your symptoms
into the thing up here
and it says you could have cancer,
network connectivity problems.
(laughs)
- That's actually really funny.
- 104.1.
- That high.
- Leslie you're dehydrated,
and I'm admitting you.
- Well...temperature is not correlated to dehydration.
If she checked her skin turgor,
or evaluated her lips being very chapped,
or checked if she was tachycardic,
all those things can point to dehydration.
In fact, there's something we could note on the chart,
dry MM, which means dry mucus membranes.
- It's food poisoning.
I have it too.
I did not sleep for one second last night.
- Did they vomit?
- And I cracked the bottom of the toilet bowl.
- Oh God. Don't say that.
- It's important that if you have food poisoning
that you don't take motility slowing drugs
like Imodium because your body's trying
to get rid of the toxin.
And by slowing down the motility of the intestines
you could actually keep that toxin in longer
creating a bigger problem.
Warning signs in your stool
that you could have a really bad infection,
blood, mucus, changes in your stool caliber,
fever, worsening lower abdominal pain.
The blood is one of the main ones though.
- All right, moving on to recycling.
(Ron groans)
- You okay, Ron?
Just a little tooth pain.
I'm fine.
- Do you need to go to the dentist, Ron?
- I don't like dentists, just a second.
(blade opens)
- Hey no, no, no, no, no, no.
- Don't extract your own tooth now.
- Oh no!
- Dentist pulled the tooth out yesterday,
but it's always a good idea
to demonstrate to your coworkers
that you are capable of withstanding
a tremendous amount of pain.
- Why did you have to have a healthy tooth extracted?
Could he just get a root canal?
Check out what happens when a doctor lies.
Click here to check that out.
Crazy patient story.
As always stay happy and healthy.