The first time I heard about using empty whipped cream dispensers to get “high” was a long time ago. I was living at my parents’ house after I had finished medical school in France. I had done my thesis as quickly as possible, in the fall. My residency was projected to start July first. I promised my parents I would do what I could to earn my keep. I sold kitchen cabinet fronts over the telephone, got involved in a chorus production of “Pirates of Penzance,” and substitute taught for awhile.
As a substitute teacher in suburban Boston I was taught everything from senior hygiene to 9th grade algebra. A principal saw me teach 9th grade algebra and told me the heck with the credentials — the way I put across factoring quadratics was good enough for him to take me on permanently. I was leading the class in yelling, singing, and dancing “everybody factor.” And they were.
I told him I was going Cincinnati to start a surgical residency. He stared at me in disbelief. I told him I had more important news for him. Read more on Teens and Inhalant Addiction and — K2 Spice?…
Whitney Houston’s death might be “old news” already, but I still think her death may not have been in vain.
Because Whitney was a star, we were treated to hearsay before facts. She drank in the morning, in a public place, and according to some observers may have been behaving a bit strangely.
There is an old screener for alcoholism called the “CAGE” questionnaire. It’s named after the four questions that presumably even a primary care physician — who has little room left in an overtaxed memory — could remember. Read more on Whitney Houston’s Death May Not Have Been in Vain…
“Old Marley was as dead as a doornail.”
– A Christmas Carol (1843)
Thank you, Charles Dickens, for creating such a wonderful, enduring story, and such an apt simile. If you hadn’t heard it before, that’s probably because it is usually omitted from the children’s versions of the oft-told (and filmed and broadcast) tale. With everyone from Michael Caine to (my favorite) Mr. Magoo starring as the wickedest man who ever snorted “Bah Humbug!” and was converted to the most ardent celebrant of Christmas by the end of the story.
A wonderful, happy story — and it deserves to live forever. But death is not terribly suitable material with which to start a children’s story.
Young women (and men) — some no older than children and many who could be termed “recent children” — were ardent fans of singer Amy Winehouse — who is now “dead as a doornail.” Read more on Amy Winehouse Proved Drugs Aren’t Glamorous…
A Minneapolis nurse was accused of stealing pain medicine from a patient. She had a fentanyl habit to feed, and didn’t seem to mind that it left her patient in substantial pain. Unfortunately for her, the patient was a Dakota County Sheriff’s Deputy.
Some women just make bad choices.
The reason I bring this up is not to wonder about if this woman is guilty or not. I can tell you that I share one opinion with the judge — that people who ask for a lot of continuances may be getting everyone angry. Read more on Addiction And Nurses…
Here are some phrases that you might not expect to hear sweet, friendly Dr. G use very often:
“No, there is no way in hell I am going to renew that prescription as written.”
“Read my lips. No more oxycodone. We gotta get you into a rehab, sweetie.”
“Sure, you can see another doctor. I don’t know how long it will take to get an appointment. If I am your doctor, you go on a tapering schedule. Today.”
“If I did what you want, I could kiss my license goodbye. I am not prescribing outside my specialty and certainly not this crap. Yes it is crap. I am sorry you don’t like how I talk, but it is crap. I can start getting you off it.”
These are all things I have actually said. Usually loud, yelling over the patient. Read more on Pill Mills Are Death Traps — Marginally Legal…
Recent research by the Centers for Disease Control and Prevention’s National Center for Health Statistics has confirmed a longstanding trend — namely that whites live longer than blacks pretty much consistently, and have for a long time. People have attributed this to the increased difficulty of containing blood pressure in black people — probably a genetic difficulty– which leads to increased rates of both stroke and of heart disease. Both have long been established as being deadly. Plenty of well meaning people have at least tried to deal with this. One of the well-meaning people is me. Many times I have seen people of color for other reasons, checked their blood pressure, been concerned, and referred them to appropriate blood pressure followup by general medical personnel. Of course, I have no way of knowing how many (if any) went where I told them, but I tried.
I mean, I would tell them, “If there is something extra that can be done to make sure you are around for a few more years, to see the grandchildren grow a bit or whatever is precious, then it should be done.” I usually have no problem getting the person to agree, at least in my presence. Menthol cigarettes are a different kind of issue, and therefore a little tougher to be unequivocal about. Read more on Ban Menthols? Our Government To The Rescue!…
97 million Americans with chronic pain and I got a 57 year old screamer in a wheelchair. Back pain, leg pain, pain in places she was not sure of. No, psychiatrists are not supposed to give out morphine. Yes, I know I have a prescription pad. But I keep it close to my heart, locked in my file cabinet, or in my purse, because I actually enjoy practicing medicine and do not enjoy the vision of my license certificate on wings on its way out the window. Even if I could have done it fearlessly, I would not have increased her pain medicine. The more you give, the more they hurt, the more they need. This is written in a lot of places but you only have to look at the patients who have been created into addicts, and there are plenty of them.
Alternative recommended approach nobody will listen to: A Bryn Mawr college student, apparently not loaded down with clinical cynicism or even clinical experience, came up with this one.
The way it is said is brilliant. We all act as if we had a pool of attention, and the more of it we place on something that is not pain, the less pain we feel. Experiments cited go from virtual reality to guided imagery to music. Read more on Down With Pain…
I thought this person should be fired from the county clinic, but most counties don’t let me do that sort of thing. The state of California has a nice service, where I ask to see who else is prescribing this person the same abusable drugs that I am. I try to work with people who abuse drugs, I really do. In one sense, it is the purest of pharmacologies, in that things I usually think are parts of a physician-patient encounter, like conversation and logic, play little or no role. House said that patients lie. House is a Vicodin (opiate) addict. Some of my more intelligent substance abusers are House fans. The same way that “Cops” was the most watched TV show in prison, when I was a jailhouse doc.
This person, was getting weaned off amphetamines. After a lot of years, I am not very sure I believe in ADHD, or “Attention deficit disorder.” We all have problems of differential maturity. These are just people who learn to concentrate later. They may have other skills like class clowning that are way ahead. My book learning was ahead of my social skills for a lot of my life. Besides, most anybody brightens up when you give them amphetamines. Not that the effect lasts very long, mind you. Even kids who take Ritalin in a quest to do better on the Scholastic Aptitude Test seem to revert pretty quickly to their previous state of dullness. Read more on Getting Amphetamines In Other Places…
He looked more like the romantic hero from the era of Lord Byron than a psychiatric patient – he wore his hair longer than today’s style and he obviously pumped iron. Indeed, I found out that working out was an important part of his life.
He was 28, and he had just been released from a two day stay at hospital and his medication was standard fare — Zoloft (sertraline) antidepressant.
I had no clue why he had to be seen by me on an emergency basis. It turned out he had been admitted to the hospital because he was uncomfortable about his roommate’s anger. He had been concerned he might get “attacked.” I had no way of telling whether the roommate had an actual history of this sort of behavior or if this was delusional. But the roommate was not the patient before me. “Just give me klonopin,” Lord Byron said. “Everybody else does.” Read more on Fixing The Problem Is Much Better Than Taking Addictive Drugs…
Tinkerbell has come a long way from the light reflected with a mirror in the original J.M. Barrie play of Peter Pan, back in 1904 — l argely through being part of the Disney stable of ideals for young girls. I remember, even though I have always been a lover of personal expression through the visual arts, being asked, as early as the second or third grade, to draw a princess.