Consider this:

• Alcohol abuse reduces life expectancy by 10 years.
• Half of all fatal accidents involve alcohol.
• You can die from alcohol withdrawal. Interestingly, unlike alcohol withdrawal, heroin withdrawal is not lethal. For heroin withdrawal, life sucks and you think you’re gonna die. But you get over it.

• Steroids and other immunosuppressants can contribute/cause delirium. What is the one exception in which you actually increase rather than decrease the dose of steroids when your patient is deliriouis? Lupus cerebritis.

Doctor Dictionary

Allexithymic – adj. Describes a patient who doesn’t know how they feel

Derealization – the perception that you are watching your life as if were a movie. It’s the feeling that you are seeing yourself from above and behind. Happens to people with migrane.

Psychotic – this word is an adjective. It is not a diagnosis!

Perseveration - n. Psychology. Uncontrollable repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of a stimulus, usually caused by brain injury or other organic disorder. The tendency to continue or repeat an act or activity after the cessation of the original stimulus

Tricks of the Trade - from LL, my resident
Q: How can you tell if a person is having a fake seizure?

A: Watch their pelvis carefully. If the pt is thrusting their pelvis to make their limbs shake, you’ve got a faker on your hands.

Q: How do you make adolescents talk to you? [Technique]

A: Take them to the exam room. Take your chair, slump back, slouch, act disinterested and tired. And then in a tired voice say, “so…. Why have you been …dadada?” ... and then slowly pull them in. I think the trick is to not pull any power plays over them; doing so only leaves you with a world-class rebellion.