Thursday, September 6, 2012


You may or may not be familiar with warfarin, a drug that patients sometimes refer to as "rat poison" because it is used to poison rats.  Like most drugs, it was discovered when someone's cows died after eating mouldy clover, using a scientific process that is opaque to me, but undoubtedly involved much glassware.  The dose is often tweaked up or down each day depending on the results of that day's blood tests because otherwise the after hours cover intern would have nothing to do on the weekend.  Getting it wrong might mean that your patient bleeds to death internally or perhaps has a massive stroke.  No pressure.

So when I was called to the ward one day to clarify the daily dose of warfarin, I thought, yeah - fair enough - nobody wants to stuff this up, and doctors' handwriting is actually even worse than it is reputed to be.  But when I get there, the nurse points at the drug chart and asks, and I am not making this up, "Is that a '6' or a 'b'?"

I mean - like, totally, huh?  How could you prescribe someone 'b' milligrams of warfarin?

Not even I am nerdy enough to prescribe in hexadecimal.  Although if I was, I'd make sure that I did paediatric prescriptions in octal and neonates in binary...


Anonymous said...

Did you really mean to use the phrase "like totally - huh"?

That's a crime against English!

PTR said...

I certainly did, and I'm glad you noticed. As I wrote it, my fingers produced something more like this: "I was astonished and horrified in equal measure, for the question itself betrayed a fundamental misapprehension of the nature of medical prescription blah blah blah...", which may sound all clever and stuff, but wasn't really a fair representation of my brain at the time, which had basically been cudgelled into the pre-sentient state of a Gen-Y-er by the stupidity of the situation - hence the phrase "like totally, huh?" which made the final cut.