Tuesday, 30 January 2018

What's The Bleeding Time?


In my 35 year nursing career I must have worked with hundreds of doctors .
The majority have been a joy to work with, but some, like anyone else you have to rub along with in the workplace have been absolute shockers.
When I was a student nurse I withnessed a renowned neurosurgeon have a temper tantrum in theatre. He screamed into the face of a scrub nurse and actually threw a tray of surgical instruments onto the floor, behaviour that was not challenged at the time due to the pure shock and passive acceptance by the staff.
I would like to think that such godlike diva behaviour by such autocrats is a thing of the past, nurses generally are more assertive where medical bullying is concerned.

Yesterday I gave a villager some advice about how to get the best out of their family doctor, who they thought had rudely dismissed a problem they felt they had.
My advice ? Remember your doctor is not god. Write your questions and statements down- it makes it easier to get your points over. Take in a friend or relative with you to act as your advocate or
Speak to a practice nurse.

Years ago I was acting as a chaperone to a consultant psychiatrist who was physically examining a middle aged female patient who had a "full figure" .
The doctor was showing off to me, his audience and took it on himself to point out various physical signs of long term alcohol abuse on the patient's body.
I felt uncomfortable on behalf of the patient as the references seemed inappropriate bordering on cruel but the woman looked nonplussed by the examination and even winked at me when the consultant pointed out a " scar" on the woman's abdomen exclaiming " what a neat looking appendix scar that is!"  
Moments later , the patient leaned over and whispered to me with a grin " it's a line left by my tights!" 

111 comments:

  1. Hello John
    I always tell my students...
    Remember. Doctors are not gods, they are only licenced to practise

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    1. When I was a charge nurse I always told the junior medics to trust my senior nurses.." make a friend of them and they will make your experience a good one here"

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  2. It's good when senior doctors view people firstly as people and not as medical conditions.

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    1. Yes...that's mostly the case nowadays me thinks

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  3. What are the physical signs of alcohol abuse? Just asking for a friend...

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    1. Spider telangiectasia ( blood rash marks on skin) ascities ( swollen abdomen) that's off the top of my head

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    2. Thanks for that, John. Yesterday I met someone, in her official capacity and after a long interval, and I couldn't help wondering, as one does, at the amazing protrusion, her stomach. The sort of eight months pregnant type. The woman is well past her child bearing days. So, yes, who knows where she finds solace. On the other hand ... she could be dead ill.

      U

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    3. Do tell your friend, Tom, that one sign of alcohol abuse any doctor will look for, surreptitiously, are the palms of your hands. If they are an angry red (particularly the mount of that chicken drumstick, underneath your thumb) your liver is trying to tell you something.

      What I have observed about those who, for many decades have tried to find answers to life at the bottom of their glass, that, eventually, they are stick thin. As diets go it's not exactly a short cut but still ...

      Gweneth Paltrow greetings,
      U

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    4. PS, Tom. Nearly forgot. Please do tell your friend to supplement his "diet" with industrial strength Thiamine. Helps, neurologically, firing the synapses of grey cells; Vitamin B complex in general notoriously depleted by percent volume.

      U

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    5. You've just told him

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    6. She knows what she is talking about.

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    7. What does it signify when someone completely lacks a sense of humour? They make the worst alcoholics.

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    8. A happy drunk is easier to cope with than a grumpy or bland one!

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    9. Change the record, Tom. I work with those unfortunate enough to latch onto substances as, once upon a time, they latched onto their mother's nipple.

      Nurse your ills, Tom. I'd even be there for you to look further than your bottomless glass. But then that's what the imbibers are good at - keeping others, those genuinely interested in them, at arm's length.

      Best wishes, Tom. Be sure to toss them aside,

      Ursula

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    10. I thought this blog was mine ursula not yours!

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    11. John. I never allowed anyone to use my blog to slag off any third party, but maybe you need the comments more than I did. It's funny that the best writer here (Sarah) gets about two comments per post. Ursula has actually threatened to stalk me before now, saying that she knows my postcode. She is a very nasty woman and I am disappointed that you give her oxygen.

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    13. Of course it's your blog, John. A safe place. I wish there was anything for me to apologize for. As it is, there isn't. However, I do respect your sentiment, and thank you for being tolerant of a sorry saga being played out in your comment boxes.

      U

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    14. Oh yes, I forgot. You are. Solicitor, and now it seems you are a doctor's, dentist's and psychotherapist's assistant. I don't believe you. You are a twisted stalker who needs treatment before you get yourself into trouble.

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    16. I now feel ashamed. John is - right now - trying to help people with real crisis. Ursula, do me a favour. Leave me alone and I'll do the same for you.

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    17. I came to this argument late
      And Tom is right, perfectly right. I have told you before Ursula not to fight with people here and I am tired to do so yet again. I gave you the benefit of the doubt as your comments have been more constructive of late.
      Please don't do this again...I don't want to be deleting posts left right and centre. This post was a chat about medics
      NOTHING MORE and I certainly am not being tolerant of sagas! I am not a tolerant person!
      And Tom I don't need followers so please don't think I'm playing some sort of game here.

      Nuff said

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    18. Ursula9:29 pm

      You let Tom's comments slandering me stand, and delete mine trying to explain something?

      I'd like to say, soothingly, and because it's you, John, "it's ok". It isn't ok.

      U

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    19. I'm saying no more on this you've both had your say no more please

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  4. I was only saying this the other day that doctors only advise, they are not gods, they are not always right and they do not have to be obeyed. I agree about writing down what you want to say before you go to the GP. I do this on the rare occasions that I go and hand the note to the GP and say "it is probably easier for you to read the problem that hear me burbling it out". It makes for better use of the GP's time too. Straight to the point and straight to advice and possible diagnosis.

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    1. Agreed and a good idea....

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  5. I went away from a dentist I had been going to for over 20 years because he was horrible to his assistances, always making rude remarks and mumbling behind his mouth mask. It made me jittery because I couldn't make out if he was giving me instructions. The atmosphere in the room was terrible.
    Greetings Maria x

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    1. "Jittery"?. That's nothing, Maria. I once had a magnificent wizzard of a dentist (Chinese) - the atmosphere in the room was sizzling with adultery (him and his assistant). I was very happy for them (though, obviously not for his nine months pregnant wife) but did worry whether he'd keep his eyes on the "job" rather than gaze into hers. Talk about intuition. As it happens it turned out I was right.

      U

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    2. You are in such a vulnerable position at the dentists ..physically and emotionally....much scarier than the doctors me thinks

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    3. I’m not so sure.....you’re a man John.... we women spend so much of our time taking our knickers off at the doctors...the dentist and the doctor amount to pretty much the same...

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  6. I used to have a doctor who always asked me what I thought was wrong with me, followed up by what medicine did I think I needed. I might have well have stayed at home, other than I couldn't write my own prescription!

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  7. I love James Robertson Justice! Just saying...

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    1. Oh, me too! That voice was such a gift!

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    2. He was a bit of a dish in his early days

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  8. I read recently that the patient interview is one of the most powerful diagnostic tools, and one that we train doctors for so little.

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    1. I've worked with May types of medics anaestesiests seem to be the most human

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  9. I wish I had the patience and wit to get my own back like that woman was able to. She knew that doctor wasn’t worth bothering with and seemed to know you needed to understand she was fine. Power can make people ugly. Or maybe they were ugly but to begin with.

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    1. The neurologist I mentioned was a nasty diva plain and simple. Like I said before most doctors are wonderful with patients some less so with nurses

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  10. Apart from anything else, a surgeon's temper tantrum is surely going to make those around him nervous and more likely to make mistakes. Hopefully such behaviour is no longer tolerated, as you say.

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    1. I think the nurses reported him in the end and a disciplinary case brought

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  11. I've always felt that doctors are just people like us who have chosen to learn the things they learn, and specialise in their chosen specialities.

    We too can learn any subject we wish to but that doesn't make us always right or give us the right to act like know it alls. We are very lucky in our doctors practice in Llanrwst that the doctors are a cheery 'normal' bunch, but some I've met in the past have been complete tw*ts ;-)

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    1. With so many chronic conditions about many patients are also experts in their illness

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  12. Your post reminds me of the hospital serial "House" with that eccentric,wicked, diagnosis- expert Dr. House. Hard to believe this type of doctor is real, or even close to real.

    Anyway, now and then he uttered some thought-provoking phrase. In one of the episodes he said, in reaction to a patient's words: we don't matter, we're just cockroaches. I tend to agree with this.

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    1. I prefer the ER ( George Clooney's Dr Ross ) approach more

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  13. we just had a conversation about this subject the other day, as I feel our doctor never listens to what I have to say..........I need to write a post on my blog about this, as I have a lot to say.

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    1. Take notes in next time gill

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  14. sort of on topic:
    http://www.nzherald.co.nz/opinion/news/article.cfm?c_id=466&objectid=11980644&ref=NZH_FBpage

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  15. If my doctor looked like a young Leslie Phillips, I'd be there all the bleeding time!
    Ding Dong.
    Lisa x

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    1. Hello hello TREBLE hello!

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  16. Classic last one-liner John, loved it.
    I also think that at times we overlook the number of time-wasting hypochondriacs that might of been seen before us, some regular as clockwork. It can't always be easy to smile and be gracious.

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  17. My doctor listens. He's rare and wonderful.

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    1. I would like to think he's not rare

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  18. What's the difference between God and a surgeon?
    God doesn't think he's a surgeon, whereas the surgeon.........

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  19. My poor mother thought ever doctor she met was a god.
    They did her no good in the end.
    My brother in law was a doctor, in a family of doctors. He committed suicide.
    I see a doctor only when I must .. I have been blessed with fairly good/excellent health. But I still see them as people who went to school and got a degree to practice medicine, not God.

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    1. I think a " partnership" in healthcare is vital. The patient/ doctor relationship should be professional but honest

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  21. Ooops had to have a do over...
    They would be brought down a notch or two if they did a rotation in any New York City hospital Emergency Room. I worked 6 years as a Paramedic in the city and witnessed some amazing exchanges of Patients telling Dr's exactly where they could go and how to get there! Even I was called a "Blonde Headed Hell Bitch" by one EDP. And that just for asking her to confirm her name.

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    1. Now I sense you could write a book on these experiences. I'd read it quicksticks

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  22. I have been my friend's advocate/helper/not-take-any-shit-from-a-doctor-or-consultant/bulldog/pisstaker for many years. On several occasions have I had to say 'erm excuse me but...' or 'stop doing that, it hurts her, read her notes instead' (she has fibro amongst many other things). But often we have laughed - in the waiting room (whilst being given filthy looks) or indeed in the treatment/consulting room. And sometimes the doctor/consultant/therapist has laughed along with us. Often with the comment 'and this is your Best friend?'. Now she has a fiance and he goes to the appointments. (I am having a well earned break, from all the family ill health as well as hers). I really should go and get annual checkups but don't want to see the inside of another clinic! (Please don't nag me).

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    1. I am not medic bashing here as I think your approach is useful for seeing nurse practitioners or any other profession where clarification is required

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  23. Anonymous2:41 pm

    Our doctors surgery has a note in the waiting room saying" The doctor will only deal with one problem per appointment".I know many people who are nervous about going to the doctor and will go with one problem before gaining courage to blurt out the real reason for coming to the surgery.

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    1. Oh I wish when I was a nurse my patients only had ONE problem

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  24. My husband is facing surgery in a couple of weeks . His newly hired surgeon just called last night from his skiing vacation to introduce himself and assure my husband he was going to be well taken care of, even gave his personal cell number in case of questions. Hubby was impressed and reminded him not to break a leg!

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    1. Newly hired? Perhaps that s why he was courteous

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  25. What a super post. I am just this afternoon off to my new patient medical and have had to ask himself what to say to the doctor to be sure I get the particular brand of pills that I have had for years. In the past I have tried the generic ones which haven’t agreed with me. I am worried that I won’t put my request in the right way as I do seem to be known for saying it like it is, without a shade of subtlety. I will go with your words echoing in my ears. Thanks John. LX

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  26. I would have loved to hug that woman!!! I would have loved to kick that bastard.

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    1. I don't remember his name, now having even a male chaperone would be innapropriate

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  27. Re your photograph - I used to love James Robertson Justice - and I always felt there was an element of exaggerated truth in the way he treated everyone. Sounds as though I was right.

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    1. I have seen doctors like Sir Percival Spratt ....

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    2. Sir Lancelot Spratt, surely?

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    3. Apologies you are so right

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  28. Why was a psychiatrist physically examining a patient?

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    1. Psychiatrists - as opposed to psychologists - are first and foremost doctors. They are medically trained before delving into the depths of their chosen speciality (psyche). It's why a psychiatrist's training is a particular long one.

      As soma (body) and psyche are interlinked, one triggering malfunction of the other, a psychiatrist will often rule out any "physical" cause for your malaise before putting their patient onto the couch.

      One example, and I didn't need to see a psychiatrist since the cause was so obvious to my GP, about twenty years ago I couldn't swallow anything any longer. Literally. Bad news. So my GP referred me for tests, urgently, to hospital where they took me apart, turned me upside down, before releasing me into the wild again. My GP told me, and he was an inspired and inspiring doctor: "There is nothing [physically] wrong with you, Ursula. You have had enough. That's all. You can't [metaphorically speaking] take/swallow any more." Indeed. I was in the throws of a complicated, if amicable, divorce. Problem solved. That first sip of water passing my lips was nectar.

      Psychosomatic greetings,
      U

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    2. Yes, all psychiatric patients require a full examination on admission. Blood work , basic observations etc is routine

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  29. The ending made me laugh. I have a really good doc who teaches family medicine. I know I am fortunate.

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  30. That last anecdote made me laugh out loud! Most of the doctors and specialists I've seen as a patient have been good and professional in their conduct, but I've had run ins with a couple of arrogant pricks over the years.

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  31. Having just retired from a large academic hospital I can tell you that there are still asshole prima dona doctors out there. Funny enough, one of the worst where I worked was also a neurosurgeon. Entirely inappropriate, explosive, foulmouthed, you name it. Too bad he is brilliant or they would let him go.

    In my experience the neurosurgeons are the worst, followed by orthopedic surgeons. It's all an improvement after those...

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    1. Yes neuro seems to attract divas

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    2. Ortho!!! Yes. So judgmental, and full of bad advice. I would just watch the nurse standing behind him and she'd either nod or shake her head while he was pontificating. He would come in and just look at my foot, never look me in the face or acknowledge I was attached to the foot. So one time I borrowed a marker from the nurse while I waited, and drew a smiley face on the bottom of my foot. He was not amused. The nurse was. That made it worthwhile.

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    3. Jan, that's hilarious! Good for you!

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  32. When I was confirmed as pregnant with the eldest daughter our then GP, A lay preacher and a pompous twat, Pointed at my boobs and said "God gave you those for a reason so you should breastfeed". Cheeky git.

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    1. I would have pointed to his crotch and said " a small dick perched on a big one"

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    2. Good retort! I shall use it wisely hehe x

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  33. As you might remember, my son is a theatre nurse and he's come across a few bolshy surgeons in his time.
    Briony
    x

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    1. I do remember and I think theatre tantrums remain quite common

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  34. I appreciate strong character in a doctor, but I don't appreciate fits.

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    1. I worked with such a woman recently . An assertive ballsy young woman doctor
      She will make an ideal consultant and i told her so

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  35. Oh man, can I relate! I worked in an orthopedics floor and had six patients. One day as I am almost but not quite running past the nursing station one of the docs was charting (after peeking into the rooms of his three patients for about 2 minute each), the doc, said, "Hey, can you get me a cup of coffee?"

    Later, when I started working at a public relations director for skilled nursing, I would have to visit medical offices. Veins would throb in my forehead when doctor's staff would refer to their boss as "Doctor". Not, the doctor, or Dr. So-and-so, but Doctor!
    "Doctor is not in!"
    "Doctor is with a patient!"
    "Doctor will be with you in a moment."
    "God will see you momentarily!"

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    1. Our consultants in Spinal injuries used to bring the tea in for everyone ( sometimes)

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    2. I recently did a three month stint as a doctors receptionist and really had to bite my tongue when my colleagues (all lovely ladies) used 'Doctor' rather than 'the doctor'. Doctors are highly qualified and skilled but they do tend to forget that we mere mortals can also be highly qualified and skilled - just at different things.

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  36. The older male dermatologist who did the wide excision surgery on my arm for a melanoma was a real jerk. The nurse who was assisting him let the instruments clank onto the metal tray next to me and he lit into her about how distressing that might be for the patient, etc. He was really nasty about it. Since I was used to sounds like that in the dental practice, it didn't bother me nearly as much as his berating a subordinate in front of me. I wish I'd said something, but he was about to take a 5 mm in each direction chunk out of me, so I kept quiet. I did kind of get back at him, though. When he lifted the tissue out after completion of the surgery, I told him I'd felt that. He got a bit flustered and immediately re-injected to further numb the site. Really, it hadn't been all that bad, but it was satisfying to see him scramble. :)

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    1. The dentist scene from THREE BILLBOARDS IN EBBING comes to mind

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  37. I think arrogance is the worst sin, no matter what job a person does. But doctors in particular need to have empathy for the patient they are about to work on and the assistants they are about to rely on . . . and I've met more than a few who do not.

    A kind and caring doctor, dentist or nurse is a gift.

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  38. I must have told this story of the appendix scar at least three times here over the years....it was a good story so was worth repeating x

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  39. Yes we are Jenny. So treat us well (A kind nurse X)

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    1. We all need to treat each other well.....everyone remember that

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  40. We used to have a very arrogant doctor when I was a girl . One of my Grandma's old friends would shout at the top of her voice when she left his room "I will see you at YOUR SHOP next time" as she said he is just the same as the corner shop done the road, if you don't like it you go to another place/shop ! I live by that :)

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    1. I think everyone in health care needs a reminder from time time about the importance of personalised care

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  41. I don't have as much confidence in my doctor as I have in my dogs vets.When I was a teenager Dr had his hand inside his trousers throughout the consultation.Recent Dr seems always asking me to get on the scales.I ask for help with hospital diagnosis of hemiplegic migraine & he looks baffled x

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    1. Flils I misread this at first , I thought you wrote that the doctor had his hand in your trousers ! Bloody hell

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  42. No,thank goodness but I remember that his hand was down his own trouser waistband & I felt uneasy x

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  43. ha ha, brilliant last word!

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  44. Decades ago now, I was in hospital for investigation under anaesthetic (not ill, just something unusual). When I came round, a doctor with an appalling command of English came to see me, thankfully with the Ward Sister, who was the mother of one of my school friends. The doctor's insinuations of how this must be affecting me upset me tremendously. The Ward Sister was arguing with him, telling him he was wrong. I wouldn't eat anything, I was so upset. Late that evening the Consultant, a lovely man in his 60s, came to see me. He told me that the junior doctor was a ****, that I was fine as I was, and persuaded me to eat something - he said he would send a meal from the staff retaurant.
    I must be one of the few people to enjoy steak and chips, late at night, in my hospital bed, courtesy of the NHS!

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  45. Anonymous10:16 am

    Interesting range of comments. Seems finally that Doctors, and police for that matter, are now being seen for what they are, good or bad. This is a huge improvement on the we have the best health service or police in the world...we certainly won’t unless we question, hold to account and give praise where it’s due.

    Rather pompous but my dry January started on the 30th December so the world feels quite strange. Oddly I sleep much better but all the myths about the superhuman advantages of sobriety are myths I am afraid. I still cannot leap tall buildings with a single bound and I feel just as knackered, but I am held aloft by insufferable smugness.

    All the best

    Charles

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    1. Are you having a drink at midnight tonight Charles?

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    2. Tell us more about yourself

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