Black Widow Spider Bite

        When I first started practice, I had a lady in the Emergency Room with a  black widow spider bite.  It was my first case of that.

        I checked her out, got her out of pain first, then found an Emergency Medicine text.  I opened the book to the page on black widow bites, flopped it open on the foot of the bed and commenced to follow a written protocol.

        The lady was groggy from the pain medicine but said, “You reading that book makes me nervous.”

        I replied, “Well, I tell you what ma’am.  I believe you’d be more nervous if I wasn’t reading the book.  This is my first one of these.”

        I think if she hadn’t been loaded up on Morphine she mighta bolted, but she stayed and got better, though I can’t say for sure it was my treatment.  Mostly it was morphine and time.  Half of what I did that day is no longer in evidence based medicine vogue.  (Not that what is in fashion today will be twenty years from now either.)

        She didn’t much want to hear it, but I think patients and Docs both are better off for us to admit up front what we don’t know and do the best we can.

Dr. B

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17 Comments on “Black Widow Spider Bite”

  1. Cindy Carter Says:

    My grandmother swore by turpentine. She said you could turn the bottle up over the bite and watch the poison be pulled up in to the bottle.

    We weren’t allowed to use the outhouse because of fear of black widdow spider bites on our butts.

  2. drtombibey Says:

    Cindy,

    I never had to treat one on the rear end- folks musta listened to grandma.

    Dr. B

  3. mrschili Says:

    I am the FIRST person to admit when I don’t know something. I think it’s the responsible thing to do. Besides – as I tell my kids (both biological AND academic), the point of being smart isn’t to know EVERYTHING; it’s knowing where to look to find the answers to the stuff that you DON’T know that makes you smart.

  4. drtombibey Says:

    Ain’t it the truth chili. If a Doc says he/she knows everything better run!

    Dr. B

  5. pandemonic Says:

    Can’t you die from those? It would have been reassuring for me to see you with that book open.

  6. drtombibey Says:

    pande,

    They can be fatal, so a trip to the ER is indicated if you get one. Even if it doesn’t kill you it can make you wish you were dead- very painful sometimes. Prompt treatment makes a diference though- one of those things worth going to the ER over.

    Dr. B

  7. amberfireinus Says:

    You know, I would rather have a doctor tell me that they don’t know rather than try and BS me.

    I realise Im a hard patient – because I question everything. But that is because so many won’t admit that they don’t have all of the answers.

    7 weeks ago, when my mother was admitted into the hospital and they told me that the diagnosis was ITP, the first thing out of my mouth (and my specialty is not oncology or hemotology) is to do a bone marrow test. The doctor actually argued with me and made me feel like I was dumb for even suggesting such a rediculous thing.

    Well guess what? 5 1/2 weeks later when she was stumped by the ITP and I pulled my consent to remove the spleen, she finally did the Bone Marrow test and found the A Plastic Anemia. Now, more than likely it would not have saved my mother’s life or prolonged it to have a diagnosis before this. But what if I had let her remove the spleen? My mother would definately be dead by now.

    Id rather the doctor be looking at a book, computer, whatever tools to find the answer. Medicine is a HUGE field. No one person can know all that is involved. I think you were working smart.

  8. drtombibey Says:

    ms amber,

    You are right on. Every time you post a comment it makes me think of two or three stories.

    One thing you say deserves special note. EVERY time a patient makes a suggestion or has an idea I take it seriously until proven otherwise. It has saved me (and them)over and over.

    Dr. B

  9. bobleckridge Says:

    GREAT story Dr B.
    I remember a leading article in the British Medical Journal years ago which was about medical education and it concluded that the ONE thing we could do to improve medical education (if meant post-grad ie for qualified, working docs), was to encourage doctors to say “I don’t know”
    It argued that if we never say “I don’t know” then we never bother to find out!
    I’m happy to say “I don’t know, but let’s find out!” – oh, and the WEB is SUCH a great tool for doing that right there and then with a patient….

  10. bobleckridge Says:

    oh, and by the way, amberfireinus, a patient who asks loads of questions is not a “hard patient” – patients who ask lots of questions are my FAVOURITE patients!

  11. drtombibey Says:

    Dr. Bob,

    As usual, Wisdom from Across the Pond is great to hear from. “I don’t know but we’ll find” out is right!

    As Docs we should consider ourselves perpetual students. Tis always good to hear perspective from my Scotland Med School Professor friend.

    Dr. B

  12. amberfireinus Says:

    Dr. Bob, Brit doctors usually HATE ME!!! LOL. I have spent plenty of time lecuring NHS doctors. Poor things. Somehow consultants don’t like it when we mere mortals have opinions.

    Im glad I have ONE Brit doctor who appreciates me!!! :D

  13. drtombibey Says:

    amberfireinus,

    If there ever was a lady with an appropriate name you’re the one! You’re house a fire, but that is a good thing. Spunk’ll take you a long way.

    Dr. B

  14. amberfireinus Says:

    Actually Doc., there is a funny story behind my name. When I first became sick and I was not able to do much, I turned my attention to the internet for two reasons. 1 research, and 2 it was a way to be social and still be a “normal woman”. I also taught myself webdesign too whilst in intensive care. (I am not someone who sits and can do nothing).

    I had my own chat room. I used the internet to focus away from the pain and suffering and indignity I faced each day. The horrors of 7 months stuck in the hospital.

    Anyway, it took me quite a long time to come up with a nickname. At the time, the only people on the internet were geeks and executives. All of the women used really trashy nicknames and that just wasn’t what I wanted to say about myself. One day, I exchanged pictures with someone. Their response was…. You have the most Amber colored eyes I have ever seen! They are so full of fire too! So, it just fit! Amberfire!

    After people got to know me via the internet… the more people knew me by Amber. Plus I was having to change my entire life due to my disease. So Amber just stuck. I changed my name officially. Amber I have been ever since. I think Amberfire does suit me and my personality.

    Thank you :)

  15. drtombibey Says:

    Ms. Amber,

    Amber eyes. There is a song in there somewhere. There are a million songs about blue eyed girls. I wrote about a brown eyed girl for my wife. Someone needs to do one on amber eyes, ’cause I don’t recall one out there.

    D. B

  16. keepbreathing Says:

    There’s a lot to be said for knowing when to admit that you don’t know. I’ve found that life is a lot easier when I am willing to admit that I don’t know; and I’ve also found that if you admit that you don’t know something, most people who do know something will gladly take five minutes and teach you.

  17. drtombibey Says:

    K.B.,

    Ain’t it the truth? Best to keep looking for all the help and good advice one can come by.

    Dr. B


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