
True Surprise - dmit
http://www.docbastard.net/2019/05/true-surprise.html
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killjoywashere
One of my favorite ER patients was a guy who got stabbed in the chest by his
girlfriend with a 10" serrated bread knife. Came in with the knife still in
him, buried to the handle. Bellowing that this proved ... something about him.
He was clearly pumped. But not really bleeding. After a chest CT and removing
the foreign object from his chest, there was still no real bleeding. The knife
had gone in at a bit of an angle, but what really saved him was the fat. 10"
of steel and it never made it to the pleural cavity.

First case report I'm aware of where fat was cardioprotective.

~~~
classichasclass
In the bad surprise category was the 50-ish guy I admitted as an intern for
uncomplicated chest pain. He got married that day but left the ceremony in an
ambulance instead of a limousine. The plan was cardiac enzymes and put him on
a stress test in the morning. First set was negative and the anginal pain had
abated. All the right things were done. Seemed straightforward.

Three hours later while I was trying to sleep I get a frantic call from the ED
that he was coding. He was sitting up watching TV, suddenly turned grey and
clutched his chest, and fell back in ventricular fibrillation. We shocked him
into pulseless electrical activity and then did a three hour futile code
because his new wife couldn't grasp the fact her new husband had died right in
front of her. And really, who can?

Surprise.

~~~
insulanian
What does "coding" mean in this context?

~~~
Insanity
Yeah because this is HN, I first read it as "the patient started programming
in the middle of the night".

~~~
ak39
The irony of surprise is misunderstanding in the HN context too. I too
pictured the poor bloke got up, cracked open his laptop to do some coding in a
hospital bed. LOL. Thought: poor guy can't even get a break from devops on his
wedding day and even after a fucking heart attack.

No surprises!

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inflatableDodo
I met a soldier who had been shot in the head in Iraq. He had a scar all the
way round his head from near the temple right to the back of his head where
the bullet had gone under the skin and travelled round the surface of his
skull before exiting. He was a very lucky bastard.

~~~
noobiemcfoob
Luck seems relative. He did get shot after all

~~~
inflatableDodo
True. Amend it to, 'much luckier than most other people who have been shot in
the head'.

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FearNotDaniel
Is it normal in medicine to refer to a baby's physical sex as its "gender"?
I'm not looking to start a debate on whether that is right or wrong, just
curious to know if that's the common usage or just this particular writer's
preference.

~~~
LostJourneyman
In medicine, at least in my experience, the terms are used fairly
interchangeably.

~~~
noobiemcfoob
Similar with scientists in my experience. Though it's more easily explained as
the older generation sees the terms as interchangeable or not worth arguing
about. The younger generation tends to use sex specifically and might call out
improper use of gender.

// "MICE DON'T HAVE GENDER!!!!" <\- something I've heard at high volume too
many times

~~~
FearNotDaniel
Interesting the way it changes within a couple of generations, the "older
generation" in my day, i.e. my dad - a linguist - would call out the then-
modern interchangeable usage, by insisting " _nouns_ have a gender, _people_
have a sex!"

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obituary_latte
Great blog. Lots of cool and interesting tales. Thanks for sharing.

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jypepin
That is interesting. I don't know if I'd ever feel 100% sure that the bullet
actually bounced out until the bullet is actually found.

~~~
kijin
The bullet would have to be made of something really exotic in order to hide
from a head-to-toe CT.

~~~
Cthulhu_
Didn't Mythbusters do an episode of that? IIRC they tried an ice bullet and
one made out of frozen meat, neither really worked.

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stared
-log(probability_of_our_prediction)

There are no "true" and "false" surprises, it's continuous. And it is
additive.

