Dr. Charles kills me

He really does. He cracks me up. Take, for instance, this primer on How to Stand In for the Doctor (A brief primer for the layperson), although I'd be careful about this suggestion:
Use the instruments in the room. If there is a reflex hammer strike the patient where you think a reflex might lie. There are no good reflexes of the head, but the rest is fair game. The carotid arteries in the neck generally are not good ones for measuring blood pressure with a cuff, but if you are feeling confident consider going for it. The patient may need to take a deep breath before this risky inflation around the neck.
I might remove that last suggestion about using the carotid artery for taking blood pressures if I were you, Dr. C., even though it was clearly made in jest. You never know, someone might try it. It wouldn't do to have patients passing out with inflated blood pressure cuffs around their necks in your office or old patients stroking out from dislodged carotid artery plaques. It would be bad for your practice...

One other thing, your suggestion about wearing stethoscopes:
The stethoscope is worn around the neck, much as one might wear a scarf. Practice walking up and down the hall before entering the patient room. Learn how to bend and turn without the stethoscope falling off. By this time I will have finished covering the toilet seat with paper towels.
That'll work for internists and primary care doctors, but not if the lay person is trying to impersonate a surgeon. Surgeons usually don't even bother to carry a stethoscope, and when we do we never wear them draped around the neck like a scarf. Indeed, we have a term for wearing a stethoscope like that: a flea collar. (Note to non medical types: A "flea" is slang for an internist, a term most commonly used by surgeons.) Indeed, we usually make fun of medical students who sling their stethoscope around their necks like that while rotating on the surgical service.


  1. "The most crucial part of the visit has arrived - the pronouncement of the diagnosis. Look grave and serious, this will produce a moment of anxiety critical to success because you are actually going to give a survivable diagnosis. State in an unwavering voice: “You have a condition known as Todd.”"

    Isn't he supposed to say, "This is something or other ailment and this is an ailment I wil handle"?


    Autism Diva needs to know, because Prometheus just shared with her the perfect cure for autism... she'll soon be giving injections of the .9% solution....

    (shhhh) it's 0.9% sterile saline (not sure if it's special salt and Penta water, yet, we'll work that out), but the hypodermic needles need to be real hypodermic needles and for that she'll need a white coat and stethoscope, and some cotton balls and one of those brown containers of alcohol you smash the cotton balls down on to get them moist.

  2. I was often criticized for carrying the stethoscope around my neck, accused of being an internist, etc. I recall not caring too much.


  3. Surgeons always stuff their stethoscopes in their pockets. I could never get mine to stay in a pocket or hooked over my shoulder like the docs on ER so I guess that I was destined for flea-dom.

  4. The joke I learned in medical school went like this: "What's black and hangs from a perineum?"

    The surgeon's stethoscope.

    Seeing as I'm one step past a flea, I'm grateful to all my clinical colleagues

  5. Surgeons are periodically called "sturgeons" by fleas. Except, of course, neurosurgeons, who we generally try to avoid calling at all.


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