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Monthly Archives: December 2009

Yes, sir, I mean, m’am

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Ma’am or Sir?

Living in the south, I have learned to call patients “ma’am” or “sir.”  When I forget to use these titles I am sometimes gently reminded with the phrase, “You’re not from around here, are you?”
“No, I’m not.—I mean—No, sir, I’m not.”  But what if you are not sure which to call your patient? Recently I had a patient who is transgender, male to female.  And he is undergone some but not all of the steps toward physical gender re-assignment.  The patient preferred “ma’am” so I said “ma’am” the whole time.  The last set of physicians called the patient “ma’am.”  But the current set called the patient “sir” and the family called the patient, “him.”  My first thought was that if the patient considers herself female, we should respect those wishes and change the gender we have in the computer.  But I quickly realized that wouldn’t work.  Despite describing herself as female she was still, medically speaking, male—for example, she still needs to get her prostate screened for cancer.  It was quite an interesting experience to wonder how female someone has to become before we consider her a female.  Perhaps in medicine the answer is never.

What would you do in this situation?

Hazardous Vomit

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This weekend I had two students come to the floor and shadow me for an hour or so.  The first day, Lauren came, and we had a rather uneventful experience but she was able to get a tour and ask questions and understand how complex patient care can be.

The next day Mollie came and, unlike Laura, she got a very close look at nursing care.  Probably too close for comfort! One of my patients was vomiting from one end and … well, doing something else from the other end.  He was miserable.  To make matters worse, his vomit was hazardous.  The reason is that he is on a medication so poisonous pregnant women should not touch it.  Furthermore, once the pill has been crushed (or partially digested?) it should only be dealt with under a fume hood.  And unfortunately for me but probably fortunately for the lab techs, he didn’t vomit under a fume hood, he vomited all over himself.  While vomit is always gross, this situation was the first time the vomit was also hazardous to my health!  We got him all cleaned up but poor Mollie may never be the same!