I Want to Be a Doctor

Dr. Robin: Welcome back to I Want to Be a Doctor or Something. I'm Dr. Robin, and I'm here with my friend Jill, a registered nurse.

Jill: Hi, friends.

Dr. Robin: We're two healthcare besties sharing the real, wild, and funny side of medicine for anyone who's thought about a career in healthcare. Ready? Let's go.

Jill: Okay, so, Dr. Robin, I'm guessing we've both been yelled at by patients in one form or another, or by their families or something like that. Do you have any good stories to tell me?

Dr. Robin: I mean, so many. In medical school, you're actually taught how to cope with difficult patients. You practice before you get standardized patients who pretend to be angry. First, you practice with your advisor or mentor—or whatever they call it, a preceptor. I was one of those. When I taught medical students, I worked with a small group on how to do an exam, take a history, write a note, and handle different situations.

Dr. Robin: But my preceptor when I was in medical school was a hoot. He was an older gentleman with almost no filter, and he was so funny. When he was pretending to be an angry patient, he kicked a trash can against the wall and smashed it. We were just like, 'What is he doing?' I'd never seen that in real life—not even once. He got really into it, so he was really funny. I was overprepared. When the real thing happened, I thought, 'Oh, they're not kicking trash cans against the wall.'

Jill: That's great. That's great. Well, I can't say I haven't seen that a time or two, because I worked in geriatrics for quite a while. I remember one of my patients. She just did not want to take her medications, especially the morning dose. She would be singing some really funny old-timey songs. I'd kind of slip up to her and ask, 'Do you want to take your morning medicine before breakfast?' Oh, man, I got told off a few times, and the medicine got spit out a few times. But after that, she'd just go right back to singing. She just didn't want to take her medicine.

Dr. Robin: I do not blame her at all. It sounds kind of like when my kids were little and didn't want to take their medicine. I remember one time Elion had a urinary tract infection and needed medication. I said, 'You have to take it.' They were probably two, which is a really difficult age. Finally, I said, 'What will you take? Tell me.' And Elion was just like... [laughs]

Dr. Robin: So I tried mixing it with chocolate, but they could still taste it. You know, all the tricks. Then I said, 'Let's try honey.' I didn't use the liquid; I mixed the powder from a pill into it. You couldn't taste it. I thought, 'Oh, that's really good.' After that, every prescription was mixed with honey until Elion was big enough to swallow pills. For years afterward, Elion was convinced that honey was medicine, because that's how they always got their medicine. They'd say, 'I don't feel good. I think I need some honey,' and people would be like, 'What?'

Jill: I love it. That's funny.

Dr. Robin: I taught Elion to swallow pills when they were about three or four because I was just so done with it at that point.

Jill: Yeah, because it is really hard. And no offense to the pharmacists out there, but whatever flavoring they put in the liquid doesn't help. I'm sorry, it's just terrible. Maybe orange is okay, but grape is horrible. And the weird piña colada or cherry flavor is so bad.

Dr. Robin: Oh, it is. It's terrible, but they try, so hats off to them. When I was in pediatric residency, doctors in their offices had these drug closets with samples of all different medications, usually from drug companies because they wanted you to prescribe them. But it's really handy because you can send someone home with a medication to try. If it doesn't sit well with them, they haven't paid for it. If it's a short course, you can dose them right there and then they're done, if it's just one dose or whatever. So it's nice.

Dr. Robin: When I was in my first pediatric rotation, which was outpatient, they made me go into the drug closet and taste kids' medicine. I tasted all these different medicines, which was weird, but it was pediatric dosing, so it was fine. Almost all of them tasted terrible—almost across the board. A couple of the orange ones were fine, and there was a watermelon one that was okay, but they were so bad. I still remember dexamethasone, which you give for croup. It was absolutely horrendous. I was like, 'Bleh!' It was horrible. No wonder kids won't take this stuff.

Dr. Robin: For kids under one, you have to use the liquid, because what else are you going to do? But for kids over one, I actually kept dexamethasone tablets—I think it was one milligram or whatever; I don't even remember, it's been a while—and a mortar and pestle and honey at my office. When a kid came in with croup, I'd get the parents' permission and grind it up. I'd show them how to do it with two spoons, and the kids would take that honey so happily. But you can only do it over the age of one.

Jill: Yeah, that's a really good solution. That's something that a lot of people wouldn't think of. And I'm also scared by the fact that you tried the different medicines like that. I think that's great. I think a lot of nurses would love to know that.

Jill: I've often said with different shots and things like that, that I've had to give patients, unless we try them, we can't know how bad some of that medication hurts. It's so thick, like syrup, going in, and it's like, 'Oh, there's no way you can give that shot gently.'

Dr. Robin: Yeah, no, some of them are just so... Some of them are great, but when I had my strokes and had to be on a blood thinner, I bruised so badly, and it burned so badly. Not everyone is as sensitive, but it burns. It really burns. The first—I don't know how many—I did totally fine by myself, but over time I developed this reaction where I couldn't get my hand in there. My hand was like—or actually, it was probably my survival brain saying, 'No, this is not happening.' So I'd have Tim give me my last week or two, because I couldn't get it in there. It hurt so much.

Jill: You've developed, like, an aversion to it, yeah.

Jill: I totally get that. I'm sure a lot of people could relate. But going back to the honey, I've had a lot of patients who we'd give medicines in pudding or applesauce or even ice cream, because that was the only way to get them to take it. And that's adults too.

Dr. Robin: Yeah, let's see. I'll show my kitty since I've got her right here. I have to give her her little medicine in some really good treats. My daughter calls her Rat, but we're not sure what her name is going to be. She's really sweet, and we might call her Petunia. She was just dropped off here and, you know, we're softies. So she's living her best life here.

Jill: She is a very lucky kitty.

Dr. Robin: Well, I think we're all out of time, so that's it for today. If you want to be a doctor or do something else healthcare-related, head over to docrobinschool.com/podcast for your goodies. That's D-O-C, Robin like the bird, school.com.

Jill: And don't forget to subscribe so you don't miss the next episode. Thanks so much for watching, friends.

Dr. Robin: Bye-bye.