What’s up, you guys? Hey, it’s Dr. Buck. And in this video, I am going to watch and comment on New Amsterdam, a new medical show. So a lot of you guys have been asking me, “Can you watch Grey’s Anatomy? Is it real?”
Blah blah Blah. So this is a new medical show. New Amsterdam. Just a couple of episodes right now, so I’m gonna watch that, comment. And we’ll see if this is some real (bleep) here, or it’s a bunch of Hollywood fluff. All right, so here we go.
This is true. The nurses and the Environmental Services people always talk (bleep) about the doctors. This is very true.
He’s definitely firing him.
Blue, she’s having some wheezing…or sounds like Stridor. Possibly. I think what they’re trying to do is say the patient has Stridor. Stridor is an indication that the vocal chords are too close together, which means you can’t get enough air in. So Stridor is sometimes an airway emergency. In this case, you need to intubate the patient. Give them some kind of steroids. Racimic, Epi, intubate them, and possibly crike. This is where I come in. I had a couple of these where their vocal chords collapse for different reasons, and…Or it could get too swollen. And if you did a cricothyroidotomy, which is…You’ve seen in the movies where they stick a pen in someone’s neck. That’s a crike, but you do it in a better way in the hospital.
If somebody’s dead, leave them dead, okay? Don’t go and resuscitate them. You know why? Because their brain is dead. You can resuscitate the (bleep) out of the body all the time. You can bring the heart back. You can get circulation back. That’s not a problem. The problem is the brain has been dead. So if the brain hasn’t been getting any oxygen for a little while, then the brain’s dead. You bring the patient back, and now they’re a (bleep)ing vegetable, okay? The term Waterfeed is what we say, so you put them by the window. You give them water, and you give them food. But they’re not gonna do anything.
He can’t be the new medical director of this huge hospital. It’s…He has no gray hair. It’s a requirement. You have to have gray hair to be a medical director because that shows that you’ve done some (bleep).
Hot shot doctor who thinks she’s a (bleep)ing movie star. I don’t know any of those. It’s coded. It only says his name and M.D. I’d be offended. Well, I’d want to know what department I’m in. Specifically surgery because that way, they know I’m better than them.
This is typical. You’re trying to have a conversation with somebody and get interrupted. It’s what happens every (bleep)ing conversation. All day long.
Butt in the face!
Early morning lecture. Butt in the face. People sleeping. Classic.
Oh, this is the introduction of this dude.
He does look a little tire, so that I will give him.
That’s a good line. Remember that. How can I help? You’re gonna use that a lot.
Get some real (bleep)ing doctor shoes!
Oh my God!
Healthy food. This is my pet peeve about hospitals. You’re in a healthcare system, and you’re feeding people fried chicken and (bleep)ing jello. The patients and everybody else obviously, and nobody…hardly any hospital systems have actually healthy food. It just drives me absolutely insane. I don’t know why, and I can never…When I go to the hospital…I eat well at home. And then when I go to the hospital…(Bleep). I have a bunch of junk.
Look at all the surgeons. All the cardiothoracic surgeons.
Who’s gonna have a (bleep)ing swagger in the hospital? You gotta have some swagger in the hospital.
Oh, this kid is bringing something to the hospital that’s gonna be disastrous. Fevers from Africa.
Doctors are the worst patients. We don’t ever…We never wanna go in and see anybody because we see bad (bleep) happen all the time, and so we think…You can get sucked into the medical industrial complex is what I call it, right? So it’s just…A lot of people will show up, and they’ll say, “Oh, well, I have a cough or cold.”
Then they come in and find out they have cancer, and they’re like, “I was fine at home.”
That’s what I call getting sucked in, but it’s really not getting sucked in. It’s just a lot of people have…don’t have the understanding that they weren’t healthy before, and now that they get actually somebody to look at them, someone’s like, “Oh my God, there’s a lot of problems here.”
You start digging, and then lots of problems become (bleep) problems. So doctors never wanna get sucked into that, so we’re just like, “I think I’m just gonna ignore it instead.”
I hurt my back one time. One of the neurosurgeons I talk to, I’m like, “Dude, I hurt my back. It’s really bad. It’s been going on for a really long time.”
He goes, “Well, there’s a couple things we can do.”
He’s like, “If you’re somebody that wants to know what’s going on, then we can get you an MRI. Or we can just get you a steroid pack.”
I was like, “I am not somebody that wants to know what’s going on. Just help my symptoms.”
He’s like, “All right, we’ll get you a steroid pack.”
Then it went away after a while, so I talk about that every once in a while.
Basically that would never happen. You cannot fire all of the cardiac surgeons in a hospital. That is stupid. They make a lot of money for the hospital, which is why they often walk around with a lot of swagger. The hospitals have to be able to take care of certain emergencies. And if they’re designated as cardiac center and stuff or – especially for, say, cardiac casts. Patients will get stints and stuff like that. And if they get a stint or if they go get an entogram and they’re found out to have three dozen Z’s and they have to have cardiac surgery and it’s an emergent kind of thing, then you can’t really just not have a bunch of surgeons around.
Psych ward isn’t fun.
Okay, I have to say another thing about this dude. I don’t like that he has the coat open. I like to close the coat. Two buttons up top at least. Not three. Usually just two. I don’t like to keep…It just looks sloppy. Plus he’s a medical director. He has scrubs on all the time. Why is that? He should just have a suit and he’d look better shaven and stuff. People always give me (bleep) because I didn’t shave all the way when I was in residency, and now either I shave or I have a beard but not in between because it just looks sloppy and who the hell wants a sloppy person taking care of their body?
Here’s another issue here is that he’s like, “Oh, the highest mortality and infection rates in the city.”
That could or could not be related to the surgeons. You don’t know that. And, actually, I know…I met a guy who does that specific thing. He goes into hospitals and tries to find exactly where infections are coming from because certain hospitals will have…They’ll have breakouts of certain infections, and they sometimes can’t track it. For instance, I was talking to this guy. And he said that one time he found that the infection was coming from the laundry because somebody was trying to take a shortcut, and they were dumping the laundry out on the pavement outside of the hospital. And then it was coming back in for some reason, and it was some trash out there. And that trash picked up the specific bacteria brought into the laundry, and then the…It didn’t get killed in the laundry, and then it went around the entire hospital and gave everyone this infection. So just because patients have an infection doesn’t mean it’s actually the surgeon because there’s actually a lot of people taking care of the patient, but I will say that patients that have a longer operation – so if your operation time is longer, then you can have a higher infection rate. And then mortality in cardiothoracic operations are generally, most of the time, due to the surgeon. But you also have to compare your patients to the rest of the…of patients that you’re comparing to…You can’t just say, “Oh, our hospital has a higher mortality-”
Because our hospital may have more problem patients or very diseased patients, and so that’s…It’s not quite the draw like that.
This is something that we would get into a lot was that. This is professionalism. This is an interesting point because, as a surgeon, some people get paid to operate. And some people get paid just to be there per day and actually do both at the current time. How do you know somebody is just not operating because they want to get paid? And that is professionalism. You’re hoping that all of your surgeons, obviously, and all of your healthcare providers are professional enough to say, “I don’t…You don’t need surgery. Even though I’m a surgeon, and I get paid for it.”
Because that’s a little bit of a conflict of interest, which is interesting. I’ve gone to some meetings, some meeting. And they’d say, “Oh, well, you can’t be in this meeting or whatever because this is a conflict of interest.”
I’m like, “We have conflict of interest every single (bleep)ing day as a surgeon. What are you talking about?”
I actually said that at a meeting one time. I didn’t say the (bleep) part, but they were like, “Yeah, I guess we do.”
I’m like, “Yeah, we do. Duh.”
It can happen, and it’s certainly hard to determine. But if you…You can’t dig into the numbers, and that’s what it takes to find out which patients are getting surgeries and if they really need them based on their – in this case, it would be based on their entogram following.
The key to survival is to have more than one speed. You know you need to get this mother(bleep)er out of the hospital because his speed is slow and very slow, I’m gonna tell you right now. Not to offend anybody – and I probably will offend some people, but this is government workers, right? Don’t do too much work because then you’re gonna have to do more work later, and this is what happens in the PA system unfortunately.
Now, this is pretty interesting. He said the brain convinced the heart that she was dead even though she was very much alive, right? That’s what he said? That’s an interesting concept because a lot of patients that we see manifest physical signs and symptoms based on their psychological issues, and so anxiety is actually really common one. People get super anxious, and they get chest pain. And they hyperventilate, and they think they’re gonna have a heart attack because they actually have chest pain. But it’s not from a cardiac source. It’s from up here. This is what we call super intorial. A lot of times, you’ll see surgeons that say…The E.R. doctors, they’re like, “What do you think? What do you think about the blah blah blah?”
Surgeons will say, “I think this is supertintorial.”
Sorry. So the tentorium is the thing that separates the low brain from the high brain basically, okay? So super tentorial is…It’s all in the head.
Here’s this kid about to infect the entire hospital with Ebola.
I don’t really do a lot of infectious diseases.
Oh, ebola! Shit! I’m good! Not that good.
Personal protective equipment, also known as PPE, drives you nuts. Not with all people because, obviously, it’s dangerous. But there’s a lot of bacteria in the hospital, and it’s…Well, let me put it this way. There’s a lot of bacteria that are naturally on our skin, and we’re carriers of bacteria. And mercer is one of them. Resistant staphorias. And a lot of the hospitals make you put all this gown and gloves and mask on. For that, even though everybody’s carriers. But then the nurse…Most of the hospital staff are carriers of that, but we don’t have to have our PPE on with…when we interact. It’s stupid. Anyway, PPE is a tricky word for…
I’ve never dealt with any this bad in faculties. However, I will tell you that this chick just took a biopsy of his throat. And now she’s in doing infectious disease something, so that doesn’t really make any sense. If it was for real ebola and they were really concerned about that, probably this person would not be doing it. It would be a…That’s a disease position or specialized agent.
She was taking Heraperodone, and this is actually what happened. She had a tardive disconesia, which is when you lock up. I think that’s what happened. She was taking too much Heradol.
This is what drives me absolutely mother(bleep)ing crazy is that when patients’ family or the patient is like, “Well, I’m in pain! You have to do something!”
(Bleep), we are doing (bleep). Just because you’re in pain doesn’t mean we’re not doing something. Secondly, we can’t take everyone’s pain completely away. If we did, you would be dead. You know what I’m saying? There’s lots of different types of pain.
“You’re being a pain in my (bleep) right now” is what I say.
Sometimes patients are just (bleep)ed up, and there ain’t nothing to do anymore.
That was a good one. She said patient…I think she said MVA spleen and aortic tear, so that is a aortic transection and probably a splenic injury. So this is an interesting topic because it used to be that these patients had to have an operation. And if they had to have an operation on the aorta, which is a big blood vessel, usually you have to give blood thinner. But because the patient has a splenic injury, then if you give them blood thinner, then the spleen is probably gonna bleed. And then you’re gonna have to take that spleen out, or they’re gonna hammer it to death. So this is a tricky situation. Except now, we have stents. And a lot of these aortic tears can be…A stent can be placed inside the blood vessel – because the blood vessel is big. The aorta is this big, so you put a stent in the blood vessel and cover that…basically, the tear. But the treatment for that would be, first, stabilize the patient. Take the spleen out if you need to take the spleen out, but also keep the blood pressure low because the higher the blood pressure goes, the more pressure on that tear and the more chance that the aorta will rupture. And those patients actually have…50% survive to the hospital. 50% of those patients actually die in the hospital, so…
Uh-oh! I think this is a little romance there between the surgeon and the – I’m not sure who she is right yet. She’s either an EMT or an infectious disease doctor.
Okay, here’s the other question I get a lot. Do you have relationships in the hospital? Of course you have relationships in the hospital. You’re around people a lot. The people you have relationships with are the people that you’re around a lot. Except now that we have Tinder and Instagram, it’s all (bleep)ed up. But in the olden days, you had relationships with people… “relationships” with people in the hospital, and that would be including nursing, environmental services, right? The medical staff, administrative staff. It’s a little bit of a jungle out there. Let’s put it that way.
Oh, not a good way to start the day. Fighting with students. So the medical director would not be dealing with the psych patient just because they had a little fight.
That just doesn’t really happen like that unless he’s a psychiatrist as well as a infectious disease doctor or surgeon.
I love that. I have actually done this before. Had to go to another attending when I was in residency and be like, “You have to stop Dr. So-and-so. They’re gonna kill him!”
Then the attending was in an operation. I run in there. I didn’t run in. I go in and I’m like, “Dr. So-and-so, you have got to listen to me.”
She was doing an operation. She was super awesome. She was one of the attendings I really loved, and I trusted her a lot. So I was like, “So-and-so is gonna kill this patient!”
She’s like, “Okay, I’ll be right there after I finish this operation.”
Went to the bedside to fix everything, and I was like, “Oh man.”
The look on his face like, “How more (bleep)ed can I get today?”
I was gonna have the secret service come, but…
Actually, I take that back. I had a patient who was a senator. Not a senator. Governor. Governor. And I guess they had secret service.
Oftentimes, you get immune as a physician. Especially a surgeon to death unfortunately. I get accused of not being very empathetic a lot, but the thing is…Here’s the deal. If you’re dealing with life and death situations on a daily basis, then you are not very empathetic to, say, a hangnail, right? So that’s where things get confused. Because when people, especially patients, think that they have a serious problem but you know they don’t, they want you to be like, “Oh my goodness, we have to…I’m so sorry! We’re gonna fix this.”
Rush to their side. And you’re like, “Listen, you’re not an emergency. You’re nothing. I have five other people about to die right here, so I am not impressed with you.”
That’s where it becomes a problem.
She’s talking about squamous cell carcinoma like it’s a death sentence, and it is not! It is a highly treatable disease, depending on where it is and how much it invades through the layers. It’s very treatable, so telling this guy…acting like the cancer is about to ruin his life, and he’s gonna die in two weeks is kind of…a little dramatic.
Uh-oh! He has a baby?
All right. That’s not bad. I’m gonna give it a solid six and a half out of ten. No. I think…It’s actually not too bad. There wasn’t a ton of emergency or surgery or anything like that in there where I could say what they’re doing wrong, but they’re all…All the shows are…You have to have one doctor do multiple things otherwise you have to have too many people and all that stuff. You have to have the character do cool stuff, so I understand that. So I’ll probably watch it again. I think I’ll watch episode two.
All right, you guys. Thanks for watching another video. You guys are awesome. Subscribe, share, like, and comment below if you think this is a good show as well.
All right. Take care.
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