Ep. 43 - The Slack Doctors Episode 43 TJP( Tom Jones Pancreatitis)

No clips for you guys today. Just Dr. Bob reliving his recent hospital stay. Dr. Bob takes us from the E.R. to inpatient. Topics include pain management (lucky number 7), self-advocacy, hospital rules/guidelines, sowing dissent amongst patients, how hospitals really work, interns and hospitalists, and of course THE BEEPING. All these and more, a must watch for anyone who has a hospital visit in their future (all of us).

Transcript

SPEAKER_02 0:14

Hello, ladies and gentlemen. We are about to inflict another episode of the Slack Doctors upon you. I am Dr. Chip. I am Dr. Bob. And Dr.

SPEAKER_01 0:25

Bob has recently gotten out of the hospital. Dr. Bob almost didn't make it for this episode. I just got discharged from the hospital yesterday. I had a lovely three days in the hospital, courtesy of yet another attack of pancreatitis. It has been almost a year since my last one. And of course, it was the same hospital. And ironically, it was a year before that. April of 25, April of 24. Both of those months were the last two times that I had it. So interesting. The beginning of today's show is going to be a little diatribe about what it's like to go to the you know the hospital here and the idiocy that it included. In fact, I was so upset about some of the things that were going down that I actually called our slack line uh and left ourselves a message so that I'd be able to play it on the show and that that might inspire me and help me remember what it was like in the moment. So if you give me just a second here, we're gonna go ahead and share that. And then after we listen to it, then uh I'll give you the rest of the story.

SPEAKER_00 1:31

Alright, so this is the first time I've actually called this flat liner. It's kind of funny hearing my own voice talking about it. So I'm sitting here until I'm in the hospital with a fucking angry. And I had a tiffany, I guess. Uh after dealing with my third set of hospitalists or interns or whatever the fuck you want to call them, I come to the realization that a doctor in the hospital, i.e. a hospitalist and intern, is to the medical community what a public defender is to the legal profession. In the same sense that this doctor was appointed to me, he didn't choose me as a patient, I didn't choose him as a doctor, he didn't choose just whatever's wrong with me as his speciality, this is just something he has to do before he has on practice, just like a public defender. Uh also he has more patients than he can honestly take care of, just like a public defender has more cases than he can possibly take care of. Anyway, we should talk about all this on the show, as well as the other dumb shit that's gone on while I was here. Uh anyway, we'll talk about it.

SPEAKER_01 2:31

All right. So to be quite honest, uh I thought I would have sounded even angrier. I must have already been given some pain medication, which is gonna be a highlight of the story. We're gonna talk about that for sure. But I want to be pissed off. I want to touch on the point that I made up, the epiphany that I had. So the difference between, let's say you you you call your primary care or you go to see a doctor or even a specialist, whatever, and he says, You need to go to the hospital, right? So you ask him, where do you have admitting privileges, right? And which is something most patients don't even know to ask. I wouldn't. He'll tell you if he has admitting privileges at any hospital. If he doesn't, that's usually not a great sign in the first place. Yeah. But if he does, you go to that hospital, and then the treatment that you receive is coordinated through him. He already has your records, he knows you, he knows your medical history, all of that shit, right? So getting admitted to the hospital that way is very much like going to court with your own lawyer, right? That guy is already in on your all, so to speak, on retainer. You've already been giving him money, he's you're an established client, etc. Much better position to advocate for it without the admitting privileges of your doctor or uh, you know, any of your doctors, is the same as getting a public defender. You show up, whatever doctor is there, and all doctors have to do a residency uh at a major general hospital in order for them to fully complete their training and be able to, you know, join a practice, open their own office, open their own practice, etc. Uh, and this is the same thing that public defenders have to do. They have to serve a certain amount of time doing that before they can then move on to either being a defense attorney or specializing in something, or you know, or maybe even becoming a prosecutor and hopefully eventually a district prosecutor, whatever. So that was the point that I was trying to make is that there's a tremendous difference in the care that you receive, the promptness of things that are done, having somebody as an advocate for you who is in the medical profession, i.e. your doctor, is a tremendous benefit and a boon. Most people that go to the hospital and deal with these people do it on such an infrequent basis and they're so ill-educated about the process that they don't know the right questions to ask. They don't know what are, you know, what are guidelines and what are actual rules. And they think those people are there to help them. How many people that I because I'm in the hospital, you know, when it happens, and uh I've had brain surgery, I've had the abdominal bowel resection, six hernias. This is the seventh time with pancreatitis. I know my way around a fucking hospital. I know how the fucking game works, I know when shift changes, I know how to sweet talk the guys in nutrition if you want something better for breakfast, lunch, or I know all that shit.

SPEAKER_02 5:21

And you learned something about the number seven, I believe I was supposed to remind you of. Lucky number seven. Yeah, let's get into lucky number seven. So wait, wait, before you get into that, before you get into that, I have a couple of questions. First or and comments. First of all, do you think it's that I that's interesting you pointed out that it's every April. I was gonna say, do have you just been eating food with flavor? Is that the problem?

SPEAKER_01 5:43

I mean uh apparently, but you know, it's funny that you all right. So when the ER doctor, who is the basically your admitting doctor in this scenario, right, he was questioning me because I said he asked me, well, do you have a history of pancreatitis? I said, I have chronic pancreatitis. I've had it six or seven times. And he goes, When was the last time? I said, honestly, I don't remember, but it I came here. It was here and I'm in your your computer, so why don't you do me a favor and look that up? And so he looks at, he brings up my medical record, and he's the one who tells me, Oh, it was April of last year. And then he goes, and it was April the year before. And I said, Okay, well, then apparently I have seasonal pancreatitis, which I don't think is a thing, right? Yeah. But then he looks at me and he goes, What do you mean seasonal pancreatitis? All right, I'll rephrase it. I said, I'll rephrase it. I have Tom Jones pancreatitis. He goes, What does that mean? I said, it means it's not unusual.

SPEAKER_02 6:37

It's funny you should mention the the uh as if with the doctor as the uh as the public defendant. Um first of all, uh of my current uh, you know, what do they call primary doctor, I've been to this chick many times. I mean, I've probably been going to her three years now, maybe, even maybe more. She's seen me three, four times a year now, at least for three, four years. I ha I don't think she has any idea who I am. And every time they try to push the cholesterol medicine on me, and I just look at her like, really? Again? We're gonna have this conversation again? Don't you remember from last time?

SPEAKER_01 7:17

Yeah, just for you being an obstinate noncompliant. That's the word they use, is noncompliance.

SPEAKER_02 7:23

But not not only that, before that, when I used to go to that place FoundCare, which is a federally funded revolving door, I mean, literally shithole country level, you know, uh uh service and treatment, but all I needed was a script to get my damn syntheroid, so I didn't give a shit. But I would go there and literally every four to six months that I uh at that place be a new doctor. And they and none of them spoke very much English, any of them. So talk about your you know revolving door of uh uh public defenders just getting you know that reminds me of something I I need to make this comment before I forget it.

SPEAKER_01 8:02

So uh one of the many GI doctors, hospitalists that came to see me in my stay, several of them asked me, um, well, who is your GI doctor right now? To which I had to explain to them, that's a guy named Dr. Kramer, but unfortunately he's closed his practice. And one of them says to me, he goes, Well, what group was he in? I said, Oh, well, he was not in a group. He was a private practitioner. He had his own office. He was the only doctor in that office doesn't exist anyway. My eyebrows bugged, almost bugged out of his head. I said, Yeah, he's a dinosaur.

SPEAKER_02 8:31

Yeah, that's why he used Morris code.

SPEAKER_01 8:34

Yeah. The first time I met that doctor on my first appointment, he literally talked to me in his office for an hour and 20 minutes.

SPEAKER_02 8:42

Yeah. Yeah.

SPEAKER_01 8:43

An hour and 20 minutes.

SPEAKER_02 8:45

Yeah, that's old style doctrine right there. They don't do that shit anymore. You're lucky you get 20, 15, 20 minutes.

SPEAKER_01 8:51

He was so comprehensive about GI health that he asked me whether I had been born via cesarean section. Right. And he went on to explain why that mattered. He then he asked to inspect my teeth. Right, right. Yeah. He's not a dentist. I think we've had this deal. One of the first things he ordered me to do was go go to the dentist, buy a mechanical toothbrush, like start taking this probiotic. Like, he was extremely comprehensive. All right, let me let me get back to my my rant on my lucky number seven rant. All right. So I will say that the ER here at this hospital in Gainesville was pretty good. Like heads and shoulders above what happened once I actually got moved into the hospital proper. Within 30 minutes of my arrival, I had I was brought back within five minutes of walking in. And there were other people in the waiting room, so they must have taken me somewhat seriously. But within 30 minutes, I had received pain medication, I was hooked up to a saline bag, I'd had blood drawn to uh for diagnosis because they look for your lipase levels, is one of the things, and I'd had a CT scan performed. So the results come back, the CT scan shows inflammation, the lipase. Technically, to diagnose you with pancreatitis, your lipase is supposed to be three times what it's your normal. Mine was 2.7. But the 2.7 in conjunction with the imaging that showed the actual inflammation was more than enough for him to like, yeah, you're right. You have, you know. And I told him that when I went in. One of the first things I said to him was, Look, I know you hate when patients self-diagnose, but this is literally the seventh time that this has happened. Nothing else feels like this. Why would they hate when people know what the hell's wrong with them?

SPEAKER_02 10:30

That's what yeah, yeah. That's the thing.

SPEAKER_01 10:32

Because they feel like you're stepping on their toes. They feel like you're insulting, whatever. Trust me, they do they do not like it. For whatever reason, I can't explain it, but they don't like it. So he comes back into the room after the blood results come back in the CT scan, and he's like, Yeah, yeah, you've, you know, you definitely have it. Uh, we're gonna admit you. They sent me to another room. Now, the pain, this is really weird. I had what I can only describe as a schmorgasboard of pain medication while I was in the hospital this time, meaning that they hopped around a lot. So in the ER, the first thing they gave me was a four milligram shot of morphine. And they gave me something for nausea as well. And of course, it worked. You know what I mean? Pain went down. It was probably at an eight, it went down to like a two, whatever. I uh, you know, very manageable, quite nice, thank you. I appreciate it. The pain is gone. Let's get me on the saline. I know I'm not going to be allowed to eat or drink anything for a couple of days. The way you treat pancreatitis is you just starve the patient so that the pancreas ceases to produce any enzymes. Um, you hydrate them with saline because they're not allowed to have anything to eat or drink, and you give them pain meds because pancreatitis hurts. You're basically diet, it's organ failure. One of your organs is digesting itself. You know, that those digestive juices that are supposed to get squirted into your small intestine stay inside your pancreas and just start eating it. Now, obviously they gotta turn that off.

SPEAKER_02 11:57

Obviously, your pancreas has nerve endings. Yes. Interesting.

SPEAKER_01 12:02

I wonder why the only part of your body that doesn't have nerve endings is your brain. Like when you experience a headache or something like that, that's the cranium. The nerves in the cranium responding to the pressure. There's no actual nerves inside the brain that feel pain. That's why people can be conscious during brain surgery. Right. Uh which they they have to be because if they touch the wrong, they they they will ask you cognitive questions during the surgery to make sure that they're not slicing and dicing in an area that they're not supposed to, you know. They make a slip of the wrist and all of a sudden you you know you can't do long division anymore. It's it's kind of dangerous. So the first thing they gave me in the ER, like I said, was morphine. And uh after that, they send me to the he tells me I'm admitting you, right? But this is another sneaky trick that hospitals do. And this is important to know depending on what kind of insurance you have. I have Medicare. Uh so they tell you they're gonna admit you, but they the first room they send you to, you're not really admitted. You're under observation, right? And if you if your condition clears up or you demand to leave or you leave AMA against medical advice, or any of those scenarios occur, and if you do that while you're still under observation, you were never actually admitted to, you were never inpatient. You're never actually admitted to the hospital. And that is a completely different category for how much you're billed after the process, right? Right. Like by Medicare, once I'm admitted to the hospital, like I'm inpatient, right? It's covered, it's all covered. So that room that I'm in, eventually, you know, my pain comes, you know, creeps back up again after six hours, seven hours, I don't know, something like that. I ask my nurse uh for pain meds, he brings me something, and I assume he's about to give me morphine, but you always ask, don't ever let somebody in a hospital inject something into your IV port without confirming what it is they're giving you. So I said, Oh, he goes, I've got your pain medication. I'm like, Oh, well, what do we have? He goes, Oh, uh, he goes, You have fentanyl ordered. I'm like, Okay, well, I mean, if anybody knows how to dose it out, because again, it's micrograms, this is really strong stuff. I'm like, okay. So he gives me a shot of fentanyl in the IV port. 20 minutes go by, I'm asleep. You know, again, pain is gone. It works, you know. Um, and I'm in that that room for this. I started off as Tuesday night, and I spent all of Wednesday pretty much in that room until late Wednesday night. So another seven hours go by in this point, you know. So I I rang the bell or whatever, and we'll call him Don. That's not his name, but that was my I had a male nurse, black guy, really nice guy, but he turns out a really informative guy because he's the one who told me about lucky number seven. Right. Now I don't know if he did this unintentionally, but what happened was I called him back for pain meds. He goes, Well, what's your they always ask you, what's your pain on a scale of one to ten. Right. And I said, It's about a six, you know. I said, you know, it was a five an hour ago when I asked you to come in here, but it's about a six. And he looks at his at the chart or whatever, and he goes, I can't give you, he goes, you have fentanyl or delauded ordered for your pain management. And I goes, I can't administer either of those under anything under a seven. I'm like, I I thought the whole point of pain management while you're suffering like this in the hospital was to get ahead of it. To not let you reach the upper echelons of pain, right? So I say to him, I'm like, Well, all right, come check with me in an hour. I don't think it's gonna get you. Come back in five minutes. Right? So I wait 45 minutes, I call him back, he comes back, I'm like, yeah, yeah, it's a seven. In fact, I think I said seven and a half. Yeah, 7.5 or 7.2. He he comes back and he gives me a shot, and this time he gives me Dilatin, right? And now in the course of 15 to 20 hours, I've had uh morphine, which I must admit is a bit archaic. I mean, it's been around since 1403. Yeah, we used it in the Civil War, along with ether, right? Why don't you just give me some ether or something like Hunter Thompson and I can fucking huff it? So, yeah, so within you know 24 hours, I got all three of the big players. I don't think there's anything else in the hospital that they need. I know they used to use something called Demerol. I don't know if that's a thing anymore. So I think in that you know, I'm pretty sure I got all three of them.

SPEAKER_02 16:14

I don't know. I've had Demerol. Demerol is badass. That's the stuff from that my very first knee surgery after they gave me that. Well, they gave it to me because I was freaking out. And after they gave it to me, I was like, yeah, cut my leg off. I don't care. I didn't give a shit after they gave it a good mood.

SPEAKER_01 16:27

It does put you in a good mood. And that that raises another point, all right. So the whole reason that they ask you the pain, you know, like they know it's a painful situation, but they clearly don't want drug seekers, you know, they don't want people that are in there just asking for meds. Right, right. Like my mom, rest, bless her soul, rest in peace. My mom had a lot of medical issues, and she had a lot of legitimate pain. She was in the hospital a lot. And I learned most of my hospital techniques uh through being with her and interacting with doctors and stuff for decades. And she was, sadly to say, she was a drug seeker, but she also had legitimate pain, and that's a that's a hard line to walk, right? Oh, yeah. She was one of those people that would, you know, if if they say they can give you this pain med every four hours, four hours on the dot, she's hitting the button and asking for the meds, right? Right, right. Now, the problem with doing that is that if you you go by the books like that, whether it's true or not, whether you have legitimate pain or not, you're gonna get shit on your chart. You're gonna get labeled and they're gonna treat you differently. And the reason that I still am able to get proper pain management when I go to the hospital, because I have this chronic recurring condition, and I've had, like I said, I've had the bowel obstruction a couple two times before the hurt the pancreatitis shit even started, is that you have to be very clear and concise with them, and you have to cut yourself off when the pain goes away. And you can't hit the bell every four hours. You gotta wait. You know what I mean? And I never go, you know, I I don't do it based on when I'm allowed to have it. I know that I can't have it for another four hours, and then I wait after that until it hurts, right? But I'm not gonna wait until it creeps up to a fucking seven or an eight. Yeah, though. And this is another this is another reason why the whole scale in the thing is weird, is because most people are not accurate and they're not honest with them when they ask you what's your scale of pain on a scale of one to ten. I have been in the ER and overheard other patients talking to doctors because there's no privacy in the ER, obviously, right? And I've heard people say to the doctor, it's a 10. I'm sorry, but you should never be able to say 10. You should be fucking screaming. Yeah, right. It's a 10. Yeah, 10 is not I have a 10. I've never I've never had a 10. I've had nines, and I was crying.

SPEAKER_02 18:48

I think I've had a 10, but it was only like for a few instants, and then you are screaming.

SPEAKER_01 18:53

Yeah, well, I've never been shot or stabbed. Maybe that's you know what I mean. I've never birthed a child and I've never had a kidney stone, so maybe those are tens. But I've had nines and I've seen people screaming in pain and car accident situations and things like that, and to that's probably a 10. So when I, you know, to me, a seven is a pretty substantial uh amount of pain before I'm gonna admit to a seven. You know what I mean? So that's why when they for them to put a a code cutoff on a number like that for you to get your pain meds. So I could have bitched and raised a fuss, and I could have demanded that they give me something. Right. But having already admitted to being less than a seven, do you know what that would have required that nurse to do? That nurse would have had to then contact the doctor that was in charge of my case, i.e. the hospitalist, explain the situation to him, assuming he's not busy and has time to talk to him, get him to change my pain med orders for whatever the next level down is, maybe it was morphine, I don't know what they give people that only have levels up to five or six, then that would have had to go to the pharmacy, then they would have had to fill it, then the nurse would have had to go get it, come back, and then give it to me. That would have added another two hours to me receiving the medication, at which point I would have been over a seven again and fully able to qualify for the meds they had scheduled me to get in the first fucking place.

SPEAKER_02 20:12

That's crazy. I got a buddy of mine, it's a drummer too, that it's like he's he's an opioid addict, he knows it, I know it, everybody knows it. But he needs them, you know. He's got some lower back shit that you know, and it was crazy because you could tell when he showed up at a gig, oh shit, he hasn't had his meds. This is gonna be a crappy gig. He's not gonna he's not gonna be happy, or show up and he'd be happy as hell, like, all right, great, he's had his meds, thank God.

SPEAKER_01 20:38

You know, but and the other the other point I wanted to make about the whole drug seeking, you know, giving you, you know, look, I'm not gonna lie to you. The only time I any get these types of, especially in Venous, like Dilatin, yeah, things like that, is when I'm in extreme pain. Having said that, it kills the pain and it gets you high. Oh, yeah. There's no denying that. It feels good. You feel good, right? Here's my question. If you're in the hospital being treated for a condition that is known to literally cause extreme pain, that's what it does. You're burning up an organ inside you with chemicals. Why wouldn't they allow you to enjoy the fact that you know what I mean? Like, I'm gonna be a better patient and bitch at you less if you give me the fucking shot. Yeah. The only thing uh I can't eat anything, I can't drink anything. I'm in a room with another guy, stranger. I'm surrounded by fucking loud beeps and bright you know lights and codes being called and people running around. It's a nightmare scenario. Nobody wants to be there. Let me be high. They don't want to make you an addict. It's the only thing, it's the only thing that makes the whole thing it's slightly tolerable. And even having said that, you still want to get out as soon as you can. So the morning that I woke up Thursday morning and it didn't hurt anymore. And that's the way this shit goes. It's like almost like having a cracked rib, like it hurts and it hurts, and then One day you notice, oh, it doesn't hurt anymore. I mean, it's a much quicker process because it only takes a matter of days instead of weeks. But that is how pancreatitis goes, it just stops, stops hurting. My pancreas quit doing the thing, you know. Um, you still have to go real easy and only have like broth and water for days before you slowly reintroduce real solid foods and everything, but you don't need pain meds anymore. Like that that part is over. So on Thursday morning when the nurse came to me and she goes, How do you feel? She goes, What's your you know, what's your pain scale? I'm like, Oh, I don't have any pain in my pancreas, it's gone, you know, the abdominal pain is gone. She's like, Oh, and that also is key to like you don't, you know, every single interaction you have with these fuckers is written down. Oh, yeah. And that's key to ensuring that the next time this happens and I go back to the ER, they'll they won't treat me like like a drug seeker. You know what I mean? Because if you try to milk it out, you know, you know, wake up that on that next day, the pain is gone, but you, you know, I'm just gonna stay in the hospital for another day. Imagine it doesn't work. Imagine how tough. If you let them give you IV shots of Delaudid for more than three days, you're gonna have withdrawals. You're gonna have problems. But just imagine I mean, if you if you're in pain for more than three days and you need them, well then you just you let them happen and but but accept the fact that you're gonna have withdrawals. And if that's the case, what you need to do while you're still in the hospital at a certain point is ask them, can you guys start giving me uh percocets instead and orally? And then cut those in half, you know what I mean? So that by the time you actually get discharged, the last thing you want to do is ride the gravy train until the last minute and get fully hooked, and then get discharged cold turkey, and now you got to go home and suffer through opioid withdrawals for a medical condition. You have to know how these things work and you have to approach them in a scientific manner, or you're you're gonna do that.

SPEAKER_02 24:00

And just think how it's gonna be now that uh you know that all all medical stuff is gonna be done by robots and AI, and you're like, hey, listen, I really listen, computer, I really, really need a percocet today. I'm sorry, Hal. You've had your you've had your fill of percocets for the day.

SPEAKER_01 24:18

Yeah, yeah. Yeah, it's chilling.

SPEAKER_02 24:21

Yeah, that's what it's gonna be. Did you see did you see Melanie?

SPEAKER_01 24:24

Speaking of go ahead. Speaking of things that, you know, being in charge of your own destiny, so to speak, when you're in the hospital, I can't tell you how many people I've seen that are afraid to do anything that they think will get them in trouble, right? In trouble, air quotes there, or that it's gonna get them thrown out of the hospital, right? So on Thursday, like I said, after I had told them I I don't have any pain anymore, she said, Oh, well, then we'll probably discharge you today. She went ahead and disconnected me from my my IV. I still have the port, still got the IV in my arm, but I'm no longer connected to the saline bag on the pole. Right. So I can I can walk around, you know, whatever I so they bring me my my liquid breakfast. It's got a cup of coffee involved, and it's hospital cafeteria coffee. So I put my clothes on, I get up, I go downstairs, go to the cafe, go to the cafe, not the cafeteria, but the little coffee shop area where they have real coffee. Myself a latte, you know what I mean? Go back up to my room, drink half of my latte, ask my my roommate who looks at me like, what are you doing? I go, Oh, they got a coffee shop downstairs. You want a coffee? I'll get you one on me. And he's like, No, no, no, no. I don't, I don't want anything from the outside. I'm like, okay, whatever. So at this point, I had uh I'm feeling fine. I don't have pain anymore. I'm just waiting for them to process my discharge papers. There's no reason for me to be here anymore, you know. Uh I know what to do for the remainder of my my care when I get home. So I hadn't had a cigarette in two or three, you know, two and a half days, whatever. So at that point, I still got half my coffee. I go down. Well, I gave I made them give me a nicotine patch. I was gonna say, yeah. Yeah. Uh and you don't ever oh, by the way, if you do smoke and you you you've never experienced a nicotine patch before, and you have to go to the hospital and you end up receiving a nicotine patch, do not go to sleep with the nicotine patch on. It is not wise to sleep with a nicotine patch on. You will have the most vivid dreams that you've ever had in your life. And and while that may sound like a good thing, I can assure you that it can take a very dark turn. It will turn a nightmare into a religious experience. It's it's very, very bad. Just don't ever do it. And and the simple reason is that while you may be a smoker, you don't typically smoke in your sleep. Uh, and so it's really not a good idea to flood your system with nicotine while you're asleep. But anyway, so I go downstairs with my half a latte, walk out the main lobby, go outside, and it's it was cold as fuck in the hospital, too. The I walked by a thermostat and checked it. They had the whole wing, the whole floor was at 66 degrees. Oh, which I know they gotta like keep germs down and stuff, but my god, buddy! That's prison cold. It was in the vent was right by my my bed, too, like on my side. Like you had a hotel room, the air conditioner was on my side of the of the room. So it was so nice to go outside. It was warm, it was lovely. I walked over to my car, pop open the door, because I was parked in the the ER parking lot. I got lucky with the the night I came in, got great parking. Took out a cigarette, went and hid behind a pole where I knew no cameras were looking because it's not my first rodeo, and I've been there before. What are you not allowed to have a cigarette? Not allowed to smoke on hospital property. Oh, I see what you're saying. Not even in the parking lot. Gotcha. Now, if you want to be an asshole about it, I could have sat in my car and done it in a hotbox the car.

unknown 27:48

Right.

SPEAKER_01 27:48

But I literally did the only reason I didn't do that, A, because I didn't want to just completely coat myself and stink, but also because I didn't want to give somebody false hope that thought they were going to get my parking spot. I'm not that much of an asshole. There's not that many spots in this tiny little lot. And if I saw somebody getting in their car and I was trying to go to the emergency room, I would sit there for a long time thinking, well, he's gonna pull out eventually. Just to see them get out of their car and a big cloud of smoke come out. I'd be mad as fuck. So didn't want to do that. So I have my sig and I go back into the hospital. And at this point, I'm in a good mood again because I'm I'm not in pain anymore. And I know I'm gonna be getting out probably within a couple of hours. This is like probably eight o'clock, eight o'clock in the morning, maybe eight thirty. And uh I get back to my floor where my room is, and I see this woman, older woman, tiny, frail little thing, probably four foot eleven, you know, maybe, maybe eighty-five pounds. And she's got a shawl on and she's pacing the halls. And I said, Oh, honey, uh, it's cold in here, isn't it? She goes, Yeah. I said, You should go outside for a few minutes. It's actually, it's like it's over 70, maybe 72 outside. It's really nice. And she goes, Oh, I'm not allowed to go outside. And I said, Well, you're walking around the hall. I said, Well, if you are fall risk, you'd have different colored socks on. I know the code socks different color codes for whether you're a fall risk or whether you're allowed to leave your floor. And based on her brown socks, grippy socks, I know that she has the same privileges that I do, which is you're not a fall risk and you're not confined to any, you're not in prison, for fuck's sake. So I tell her, yeah, go outside. She goes, Oh, I'm not allowed to. And I said, Why not? And she goes, Well, I have my IV instill. And she shows me her arm. And I'm wearing a bathrobe, so my sleeves are kind of long. Always bring your own bathrobe so you don't have to have your ass hanging out when you walk around in your gowns. I pop my arm out of my sleeve and show her my IV port, and I go, Yeah, I got one too. So what? And she goes, Oh, I don't want them to throw me out. I said, They're not gonna throw you out for going outside to get warm because it's so cold in here. I said, first of all, if they might give you a warning, right? They might tell you they don't want you to do this. I said, go back inside. I wish to God they would deny me medical treatment and throw me out because I went outside to get warm. So you own this. One of these buildings will have my name on it. It's gonna be a lot of fun. So, on the same vein of, you know, they're not the boss of you, Dr. Bob. You can kind of do what you want. Uh, I um I had to get an MRI while I was there, which oh, this is a fun. This goes back to the Schmorgas Board of Drugs. I forgot to mention this. Oh, yeah, they go pretty intense claustrophobia when it comes to an MRI. I don't know. There's something about being in in the middle of a I fall asleep, Durnham. I instantly not out of face, right? No problem. Smell my own breath bouncing back into my face. I don't know. I don't like it. Makes me feel like I'm buried alive. So every time I've had one, and I've had eh five or six of them. Um, and they're they used to always be of the brain and the neck. That's why I was that's the worst kind, too, because now your head is dead center. You can't see light on the tunnel at either end. You look down at your feet, you look up, you don't see the exit on either side. You're as far as your eyes can tell you, you're in a tube. You're in a you know completely closed cylinder. So they always give me something for anxiety. Now, typically, it's this is an outpatient procedure, which means that they they know they prescribe me almost always it was a one Xanax. Uh, one time it was one Valium. Uh, and it's really funny to go to the pharmacy and fill a script for one pill. They always look at you funny and it's like, yeah, I have a procedure coming up. That's what this is for. Now, because I'm in the hospital, sorry, I got a tickle in my throat, and I'm NPO, which means nothing oral, not allowed to have anything. No, no, nothing. I forget what the letters stand for. It's Latin or something, but it doesn't matter. What it means is you can't eat or drink anything. They won't even give you ice cubes to suck on. Like you're fucked. Pro tip, you can just go into the bathroom and drink out of the sink. Water tastes like shit, but if your mouth is that dry and you're thirsty, again, you're not in prison and they're not the boss of you. But they schedule me for this MRI, and this was at 4 o'clock PM, right? And uh, she tells me, she knows it's in my chart about the uh claustrophobia. She goes, We're gonna give you a shot of Valium, uh, five milligram shot of Valium. Now, here's another little math tip for people whatever pill you've had in your life, like let's say you've ever had a Valium, you've taken a Valium, if you took a 10 milligram Valium orally, a little pill with a little V in it, that's the equivalent of five milligrams if it's injected. Whatever the strength is that you took that you felt the effects of from an oral medication, if the IV version of that drug is literally twice as effective, so they're gonna give you half as much. So all of that is to say that a five milligram shot of Valium is equivalent to taking a 10 milligram Valium pill, which will definitely help reduce your anxiety and put you in a good mood. So she calls, she has to first of all, they fucked this up too. When she filled the prescription, she accidentally filled it for 10 milligrams instead of five. Now, because of that, she had to waste, she had to squirt half of that syringe out into a waste receptacle. But she's not allowed to do that by herself because there could be some issues with that, because oh, I accidentally drew too much, and then she gives herself a little a little bump of Valium and then gives me the rest. So she has to go get another nurse to come in and witness and sign off on the wasting of half of this syringe. Now, the the the guy in me that likes to have a good time was very tempted to say, Oh, come on, guys, just give me the tell anybody. But obviously, I can't do that, and then again, that's gonna go on your permanent record. So they go through the whole process of wasting it and filling out the forms, and should have said, I'll take one for the team. Go ahead, guys. Filling out the paperwork on the bench there, and I was there for two hours, three hours, four hours. I'm sorry, I started to go into Alice's restaurant. But uh, so at four o'clock, she calls down, she tells uh radiology, All right, I have the medication in my hand. When are you guys coming to get them? I can hear because the phone is loud. I can hear them say five minutes. We'll be there in five minutes. So she says, Well, should I give him the shot now? And thank God, this moron on the other end said, No, wait until we get there. This so that was four o'clock. At 552, they came to get me. Now, thankfully, she did wait until the last minute because it would have been an hour and 45 minutes after they were supposed to be there and it would have worn off fucking completely. So she gives me the shot of Valium. Now, this is like an hour and a half after I received a shot of Delaudded. So as I'm being wheeled down to radiology, to the MRI, I'm a little drowsy. I'm not only am I not in pain, but now I'm a little like, you know, a little dizzy, whatever. They get me down there as they're wheeling me up. There's like two or three people in gurneys that have already had their procedure done, and they're just laying there waiting to be taken back to their room. I'm they're still finishing up some guys, so they put me in front of the doors. The doors are cool, they're like something out of a Marvel super villain lair or something, because they have these at every corner, that four corners, there's these flashing lights, and they flash red or green depending on whether the magnet is in operation inside. So, like you know, when it's safe to go in or when you need to make sure you don't have any metal in you, blah, blah, blah. So they finish up with the person in there. I didn't get a good look at them. I don't know if it was a man or a woman. I guess in this days, I'd have to ask him anyway. But um, they finally pull them out of there. It's my turn to go in, and I'm I'm fucked up at this point. I'm you know, I'm high on Delauded and Valium. And uh, so the guy says to me, You don't have any, you know, necklaces, tattoos, you know, or piercings or any metal on your body. I said, No, no, no, not you know, no keys, nothing. I'm naked under this robe, like we're good to go. And then as we start to walk into the room where where I know where the point is, where if you did have metal in your problem, it's a it's a in you, it's about to be a problem. I jokingly say, Well, I ate about 15 ball bearings before I came here. That's not going to be an issue, right? And his eyes get big. I'm like, I'm just fucking with you. So they put me in the tube, they do the process. Now, this is the longest fucking MRI I've ever had in my life. It was a good 45 minutes, right? Wow. And it involves a lot of very incremental movements, and then take a deep breath, exhale, hold your breath. And then and then they'll move you another quarter of a millimeter and say, take a deep breath. And it's a recording, like a HAL 9000 voice telling you to do all these things. Wow. And then at the end, that's a long story. You have to just then he tells you to just breathe normally, and the you're gonna hear tones and try to match your breath to the tones. Some weird shit that made no sense to me. Um, they did play uh Grateful Dead and Fish and bought John Prime for me through my headphones, so that was cool. I was kind of jamming out to the phone. You have to wear headphones. They offer it was a nicer facility, they offer them to you. Well, you didn't have to loud them, they just give them to you. And MRI is a really loud thing, so at the very least, you want earplugs or noise canceling headphones. But the nicer places well, this guy was hooked up to Spotify. He's like, What kind of music do you like? I was like, jam bands, like you know, Grateful Dead, Fish, something like that. So he he picked a good station for me. So the final part of the procedure was was getting a bit too much for me. And I they give you a little bulb to squeeze if if you need to communicate with them. So I'm I fucking squeeze the bulb, and he's like, uh, Mr. Rimlin, you know, whatever. You know, I said, look, I said, I'm getting to the end of how long I can stay in here, man. I'm starting to freak out, you know. And uh he goes, You you only then he tells me he should have said we're almost done, just a few seconds or a few minutes. Instead, he says to me, We're we're almost done, only 24 more breaths to go. So now I'm counting each one. So like I'm hyperventilating in the thing because I'm trying to get done because I'm thinking once I get to 24, you let me out, but you have to breathe at a normal pace or it fucks up the thing. So every other breath that I made, it didn't go. So I knew that that wasn't registering. So now I'm saying longer. Now it's now 24 is gonna turn into 48. I don't know how the fuck I got through the end of it, right? But I finally did. They finally pulled me out. And uh again, 45 to 50 minutes, like it was a long time. So I get back in the wheelchair, they they wheel me out past the the double doors again of of Dr. Doom's lair with the flashing lights and whatnot. Two of the people in Gurney's that were waiting to go back to their room are still there, waiting to go back to their fucking room. So I'm like, well, this fucking sucks balls. That means I'm gonna be stuck sitting here in this chair for an hour and a half, maybe two fucking hours. Yeah. So they finally, when they were short staffed, of course, when aren't they? You know, they might as well be the fucking uh CSA guys. Yeah, but they they finally take one of the women back, and as soon as the guy disappears with her, I look around, nobody's looking at me. I just got up, got up out of the wheelchair, and I'm still a little groggy, but the Valium has mostly worn off at this point, and now it's been two and a half hours since I got the deloded shot. So, you know, mama didn't raise no bitch. I can handle most of my chemicals fairly well, and at this point, I'm fine. Shit, I probably could have driven home, thought about it the next day, but that's a different story we'll get into in a minute. Uh so uh I walk back to my hospital room. Now, radiology is on the very first floor, oftentimes it's even in a basement. The reason being that it requires a lot of cooling, uh, the machines are massive, and they they also don't want anybody fucking with them. So they're all hidden behind those double doors that require a nurse or doctor's key card, the little thing they wear on a lanyard or a little extendable cord, and they put it up to the thing, and then the doors will open and you can get through. So I'm I know I'm gonna be behind several of those. So I mill about near one until a nurse goes through, and then I piggyback on her, just like you do going into a gated community when you don't want to fucking deal with the code. You just wait until somebody uses their remote control and just follow them on in. I did that too through two sets of double doors before I found myself in the hospital proper, like in an area where I would technically was kind of kind of expected to be. But again, I'm still I've got my you know IV in one arm and my bracelet on the other, and I'm wearing a bathrobe and wearing sandals because I hate their socks. So always take your own shoes, slippers if you own them. Uh and finally a nurse or a orderly or something looks at me and he goes, Where are you going? And I was like, back to my room. And he goes, What room are you in? I'm like, 333B. He goes, Is that what tower is that in? I go, 3 north. He goes, Where where are you coming from? I said, I just had an MRI. And his eyes get real big, and he goes, You're just walking back from your MRI. And I'm like, Yeah, I didn't want to wait. And he goes, All right, well, go take elevator B right down there to your right. And that'll, you know, sure enough, that elevator popped out on the third floor, right around the corner from my room. I walk into my room. Uh, the next within five minutes, the nurse comes in. She's like, Where were you? And I'm like, What do you mean, where was I? I saved everybody time and effort. An hour and a half, I've saved. I would have sat there for an hour and a half, and one guy would have had to come get me. And you, you know, no, why would I do that? That's fucking stupid. Oh, so as far as like thinking about leaving, the next morning, like I said, Thursday, after they had taken the IV out and I had got my coffee, and I went out and I told the poor frail little woman that she could go out and enjoy the sun if she wanted to. Uh then I went out for another smoke. At this point, it's like 9.15, and the thought literally crossed my mind, and I wished I'd had done it because it would have been a hilarious addendum to the story. But I have sadly to say that much like the nicotine gum to the child, I didn't really do it, but I did think about it. And that was I could have driven home, taken a shower, changed clothes, and gone back and gone back to my hospital room. And I wonder if anybody would have noticed. For that matter, I could have smoked a joint while I was at home, too. But yeah, you know, yeah, didn't do any of those things. I was more afraid of losing my parking space than anything. Plus, I really thought that they were they were gonna get it done. Um, so this was again like 9 30. I finally got discharged at 12 30.

SPEAKER_02 42:08

Yeah, which is freaking ridiculous.

SPEAKER_01 42:10

How long I mean, for a hospital is when you tell them at seven o'clock in the morning that I'm fine, I don't need to be here anymore, and they tell you, okay, well, I'll talk to your doctor and we'll get your discharge worked up. 7 a.m. to 12 30 p.m. is about as good as you can hope for. Yeah. That's really about as fast as that's gonna move. Um, and so every night when you're trying to sleep there, by the way, here's a short list of things. If you have a loved one in the hospital that's been admitted, or if you plan on going and you know you're gonna be there for a little while, here's some things that you can take that will greatly improve your experience. Obviously, a phone charger and your phone, a back scratcher, right? Because opioids make you itch, even if they just do. Um, like I think I mentioned your own bathrobe if you have one. Uh, a universal remote, if you're somebody that actually likes to watch TV, because the remotes they use for the TV are attached to the bed by a cord and they're part of a complex system that either calls the nurse or it can do a lot of different things, but all it can do for the TV is turn it on, turn it off, turn the volume up or down, and move the channels up or down. You cannot enter a channel number on that. Right. So you gotta cycle all that. And oftentimes one of the up or downs will be broken, which means if you miss it, you got to go all the way through again and better not miss it again, or you're gonna go all the way through again. So a universal remote is a really, really good thing to give to people. Uh a pair of slippers, so you don't have to wear the socks. But the most important thing would be headphones. And I don't mean headphones for your device, I mean noise canceling headphones, earplugs, something along that. A sleep mask wouldn't be a bad idea either, now that I think about it. Oh, what? Because everything, a sleep mask. Oh, mask, okay. Mask. Everything in your hospital room and everything in the hallways around you and everything in everybody else's hospital room beeps, blinks, or buzzes all night long. Every time your IV runs out, it starts beeping. Now, the amount of time it takes for somebody to notice it and come do something about it, in my experience, has never been more less than 10 minutes. Oftentimes more than that. So you can hit a button on it to make it stop beeping, but only temporarily. And after a few minutes, it'll start beeping again. You can ring the uh nurse's station and tell them, hey, my IV is complete, uh, the transfusion is complete, somebody needs to come do whatever. Um, another thing that can make it beep incessantly is that if it gets unplugged once the battery runs low enough, so then you have to get out of bed yourself and plug it in. Um but the bigger issue that I want to ask the medical community is that if these things are allowed to beep uncontrollably for 10, 15, 20, 25 minutes, why the fuck do they beep at all? Why do they beep at all? It's 2026. There's an app that my niece uses where you can feed cats in Japan by donating money on your phone. A lever will drop treats into a cat's bowl with a fucking camera on it. You can watch it live. You're telling me you can't tell in the nurses station 30 yards away that the fucking IV in my room is done. For fuck's sake, what are we wasting our money on technology for? Why can't we do this?

SPEAKER_02 45:39

Oh, good lord.

SPEAKER_01 45:41

The beeping and the blinking is off the fucking charts. It's unnecessary, it's completely unnecessary. And I know this is gonna be one of our shorts. And Dean, I look forward to the things that you add to it. Uh forget the shorts.

SPEAKER_02 45:53

I believe this was I think we're just gonna wrap this whole episode up right here.

SPEAKER_01 45:57

And uh this was a powerful one. That's it. I feel like I've talked the entire fucking glorious clip. We didn't listen to any of your voicemails at all. I listen to your voicemail. Somebody learned something from this today. I hope that the next time you go to the hospital and they ask you what your pain is on a scale of one to ten, don't you dare say anything less than a seven. Because if so, you deserve whatever suffering you get. Oh, and if you haven't my opinion, that's their opinion.

SPEAKER_02 46:27

And if you need any more medical advice, nine oh four five four nine nine oh two four, like, subscribe, comment, and we will see you next episode. Thanks, guys. So that's it.