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And he’s caring, gentle, honest, a good listener

  “And he’s caring, gentle, honest, a good listener…” 

“I’d do her”

Cartoon generously provided by Jason Love with permission.
You can find more cartoons by Jason at jasonlove.com

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I was going to tell you that I love you

“I was going to tell you that I love you, but diamonds are forever.”

Cartoon generously provided by Jason Love with permission.
You can find more cartoons by Jason at jasonlove.com

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Would you like a bag for this?

“Would you like a bag for this?”

Francis was about to say, “I’m already in one,” but then the clerk would laugh or joke back — a commitment Francis wasn’t ready for.

Cartoon generously provided by Jason Love with permission. You can find more cartoons by Jason at jasonlove.com

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Deer John Letter

The dreaded “Deer John Letter” …

Deer John – It’s over! Our relationship has turned into one big rut! and I can’t take it doe more! I’ll be staying at Aunt Liers house for right now.  May the headlights be away from you my deer! Love Doetty. P.S. There’s berries and nuts in the frig.

Cartoon generously provided by Anton Ballard with permission.

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It’s a Common Form of Cancer

“It’s a common form of cancer … Unfortunately, it’s no more curable than a rare one.”

Cartoon generously provided by Jason Love with permission.
You can find more cartoons by Jason at jasonlove.com

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It’s a good thing you switched cigarettes

“Well, it’s a good thing you switched cigarettes, Bob … You only have cancer light.

Cartoon generously provided by Jason Love with permission.
You can find more cartoons by Jason at jasonlove.com

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Hit him again

An old country doctor went way out to the boondocks to deliver a baby. It was so far out that there was no electricity. When the doctor arrived, no one was home except for the laboring mother and her 5 year old child. The doctor instructed the child to hold a lantern high so he could see while he helped the woman deliver the baby. The child did so, the mother pushed, and after a little while, the doctor lifted the new born baby by the feet and spanked him on the bottom to get him to take his first breath.

“Hit him again,” the child said. “He shouldn’t have crawled up there in the first place!!”

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How can you tell the psychiatrist from the patients on the ward?

How can you tell the psychiatrist from the patients on the ward?

The psychiatrist has keys to the door.

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I heard our HMO might not cover this

“I heard our HMO might not cover this.”

Cartoon generously provided by Chip Cooper. You can find more cartoons by Chip Cooper at Coopertoons

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Official Gomer Rating Scale

Admitting letter from local MD ends with “Sorry.” 10 points
Local MD.’s letter begins with “Than you for admitting…” 10 points
Has untreated fractured N.O.F. for over 3 weeks prior to presentation 7 points
Fractures hip

  • while in hospital
  • while restrained
  • while in traction for fracture to other hip
3 points
6 points
9 points
Spikes temperature night prior to discharge 4 points
Decides “doesn’t like” nursing home that Social Worker has taken 6 weeks to locate 5 points
Hemoccult positive stool night prior to discharge 5 points
Sent back from X-Ray Department without having requested Barium Enema performed 8 points
Removes own

  • IV line
  • NG tube
  • sump drain
  • peritoneal catheter
  • chest tube
  • ventriculo-peritoneal shunt
2 points
3 points
5 points
8 points
10 points
15 points
Removes own foley with 30mL balloon full

  • while restrained
5 points
10 points
Any one of the following

  • age < urea
  • hemoglobin < shoe size
  • years in N.H. > years not in N.H.
  • number of hospital presentations > age
5 points
5 points
5 points
5 points
Toenails cannot be cut with nail clippers 3 points
Urinates on

  • roommate
  • visitor
  • resident physician
  • consultant
  • medical student
2 points
4 points
5 points
7 points
1 point
Fluid balance chart OUTPUT column reads “voided in bed”

  • on more than 4 occasions
  • while catheterised
4 points
8 points
Stool specimen (unrequested) found 10 feet from bed 5 points
Aspirates dentures

  • requires tracheostomy for same
6 points
12 points
Femoral punture required for daily bloods 3 points
Problem list 1 page long 5 points
Falls out of bed despite bed rails and 4 point restraint 4 points
Old notes

  • 2 volumes
  • 2 Kg
  • 2 feet high
3 points
3 points
3 points
Admitted by same Intern to more than 3 different teams 6 points
Overlooked on attending rounds on three consecutive days 4 points
Requests cigarette during spirometry 5 points
Fecal impaction

  • despite ileostomy
  • if ileostomy originally for fecal impaction
  • under fingernails
6 points
12 points
20 points
Answers “yes” to all questions 4 points
Answers “yes” to all questions asked to other patients in the room 8 points
Found drinking from urine bottle (own) Found drinking from urine bottle (neighbor’s)

  • while on strict fluid balance chart
  • while NPO
3 points
6 points
9 points
12 points
Psychiatry consult suggests transfer but declines same 3 points
Admission begins “Found unresponsive…” 5 points
Patient breaks thermometer while in:

  • oral
  • rectal
3 points
6 points
Room disinfectant concentration causes conjunctivitis 2 points
Refused by VA Hospital despite service in two World Wars 8 points
Clings to resident physician.’s arm though grasp reflex is negative 5 points
Easier to understand without dentures 3 points
Welcomes Medical Students 7 points
Daughter rings Social Worker more than 3 times per day 6 points
Appreciates hospital food 10 points
Requests bedpan immediately on arrival in hospital 3 points
Sits in waiting room following discharge 5 points
Knows catering staff by name 5 points
File includes more than 3 Incident Report forms 5 points
Squamous metaplasia of tongue due to prolonged exposure to air (Q sign) 8 points
Successfully resuscitated by Paramedics 20 points
Relatives

  • request admission
  • demand admission
  • arrive with patient’s suitcase in hospital
3 points
6 points
9 points
M.R.S.A. discovered after admission

  • to ward
  • to theatre
  • to I.C.U.
2 points
3 points
4 points
Anointed by priest prior to presentation 6 points
Presenting complaint reads only “Social Admission” and/or management plan reads only “For Placement” 5 points
Bounces after turf to Neurosurgery 20 points

Notes: All points doubled 0000-0700; 25% loading for non-English speaking patients; 37.5% loading for recognised dysphasias
 


 

Score:

 

0-20 : Hardly a Gomer at all. Almost Human.
20-40 : Borderline Gomertose. Reassess frequently.
40-60 : A true Gomer. Avoid all contact. Placement a priority.
Over 60 : Apply for Special Leave immediately, or consider Psychiatry Training.
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