VOLUME XXVIII MEDICAL COLLEGE OF GEORGIA, OCTOBER 5, 1973 NUMBER4 A New Classification For Evaluating Trolls By JOEL AVERY and FRED SHEALY Some classic features of Trolls we have seen at Medical Centers through Old chart weighs more than 1 lb. ( 1 point); is more than 12 inches thick the years. (Since being a Troll is a relative thing there is no minimal (2 points). score needed to qualify.) However, points are included to confer some degree of trollism. The final diagnosis lies, as always, in the clinical Ataxia manifested by scratch marks on forehead secondary to impression of the examiner. The following suggest the patient is a Troll. attempted nose picking (7 points). (All points double after midnight.) 5 0-100 points - common run of the More than 3 green blow flies on patient at one time (10 points); Flies mill troll. 100-150. points - super troll. Over 150 points qualifies for refuse to light on patient ( 15 points). blue surgery service. Frequently overlooked on ward rounds (12 points). Patient's clothes are refused by the laundry and subsequently have to Patient answers all questions asked in an open ward: 4 bed ward· (2 be destroyed ( 13 points). points); 8 bed ward ( 4 points). Admitting orders include "bath, STAT" (2 points). Drinking from urinal (3 points). If the patient is referred to as "what's his name" for longer than 36 Feces under fingernails (2 points); If guaiac positive (3 points). hours (4 points). If patient has any two of the following: beard, lice, jaundice, confusion, Painless ulcerations great~.:r titan 1 em. deep: If only on buttocks (5 fecal impaction (4 points). points); if elsewhere ( 10 points). Presenting complain on ER sheet begins " . found unresponsive If patient has hip fracture older than 3 weeks at time of admission for in .. "(5 points). the fracture (6 points). If the concentr:o.tion of Airwick necessary in patient's room causes Sent back from X-ray without barium enema being completed ( 10 conjunctivitis among visiting personnel ( 12 points). points). Schlossman's sign: toenail curved down so it stimulates sole .to produce If catheter straight drainage tu hi ng is under more than 10 pounds continued Babinski ( 10 points). tension without any complaint fron1 the patient (5 points). Chews through Foley catheter (5 points). BUN greater than age (8 points). More than one pound of dirt washed off at first hath ( 5 points). Found to have lice when cast is windowed (4 points). Has more than 5 major diseases ( 10 points). Lice on patient survive 5 Kwellings (8 points). If patient has had more than 4 major surgical procedures (7 points). Patient is able to remove Foley catheter with inflated 30 cc bag (15 points); while in full restraints (20 points). ER nurse gags as she leaves patient's room in ER ( '5 points). Remove an I.V. (1 point); N-G tube (2 points). Only had two beers to drink before arrival in ER (S points). Patient seen in ER by 2 other services and refused admission before Remove a cut down (2 points); between midnight and 4 AM (4 points); if hypotensive (.8 points). blue surgery resident was called (3 points). If patient's toenails cannot be cut with clippers or a drill (3 points). If patient is a caucasian who is thought to be a negro on admission ( 4 Blood Is Thicker Than points). -- By ARMAND GLASSMAN, M.D. Urinating on roommate, physician or visitor ( 8 points); medical student (2 points); physician's assistant ( 4 points). Approximately &,000 units of States obtain a continuous. fresh blood are used at the Talmadge donor source from a variety of If semiformed, guaiac positive stool is found more than 10 feet from Hospital every year. Less than 15% sources. These includ! The the bed of the source (8 points). of these are collected .from within American Red Cross, their own the Central Savannah River area. At Donor Programs, purchase of a Patient goes into congestive failure and pulmonary edema when flowers present, less t han 300 people are on portion of their blood or blood in room are watered ( 5 points). the ETMH Active Donor List. Being components and combinations of Patient has gangrene of foot (5 points); both feet ( 10 points). a Major Medical Center and these. involved with procedures that use In order to obtain the 85% of Herniates after lumbar puncture when opening pressure was less than large quantities of blood and blood our blood supply from outside the 60 mm. (1 0 points). products results in a very tenuous CSRA, a delay time for collecting Femoral puncture required for daily pro time (12 points). situation regarding an adequate and shipping of 24 hours is supply for such things as support of necessary.. Difficulties are readily If abdomen is higher than patient's head despite 30 gatch of bed, or if cardiopulmonary bypass operative apparent in those instances when patient diureses more than 75 lbs. (2 points each). procedures or of platelets to scheduled surgery is .cancelled or Found in bed with another patient (3 points for each patient). support patients undergoing chemo­ projected use of blood "is. not or radiotherapy. Other .large followed through with actual If patient is unable to talk (3 points). teaching institutions in the United (See BLOOD, Page 5) Page2 TH~1J).I.JER October 5,1973 A. Review Of Current Films By LARRY DAVIS Before you prepare yourself for another one of Davis' attacks on 4 Stars - Excellent entertainment and/or technically superior. entertainment, perhaps I should warn you that this article is a real live Example: French Connection. attempt at a serious critique of the current movie menu. Notice, I did not specify that these movies are now or will ever play in the Augusta 3 Stars - Entertaining movie but lacking in subtelties of technique. area. Nevertheless, I have eyeballed them all during one of my flic-ins (a Example: Poseidon Adventure. flic-in is defined as se.eing 2 or 3 movies in one day. This concept was 2 Stars - Flop in all attempts at being a better movie. May be introduced to me by· Dr. Benton Bridges; world famous Orthopedist slightly entertaining. Example: Topaz. and holder of the international award for blood shot eyes and popcorn bezoars). The rating system is relatively simple: · 1 Star- Dog. Save your money. Example: "X, Y, and Z." 5 Stars - Fantastic entertainment value and exceptionally well done. 4 Stars- Day of the Jackal - Sl<>w but absorbing adaptation of the Should be nominated for New York Film Critics A wiud and Academy current best seller by Frederick Forsyth (also author of current be.st Award as best picture. Example: Cabaret. seller - Odessa File). Director Fred Zinneman displays the technical excellence he previously utilized in such movies as "A Man For All Seas.ons" and "High Noon". Mr. Zinneman also directed "From Here to Senior Editorial Eternity," "Oklahoma," and "The Member of the Wedding." Do you get the same feeling I do about his movies; i.e. they are very good but The words of welcome our new students heard a few weeks ago, not greats. Something is lacking - maybe it's a certain tingle you get forgotten now, have gone to the great down your spine during scenes from other movies. I don't love good-intention-graveyard-in-the-sky, welcoming words subdivision and Zinneman movies but they are damn good. Edward Fox gives me the are even now preparing a suitable welcome for this also. However, the impression he will never get another role of this magnitude. What ever thought that to be forgotten, words must first be heard or read, sustains happened to his brother - James Fox ("Magnificent Men and Their the effort to .present them. Thusly, I would like to add my welcome to Flying Machines," "Thoroughly Modern Millie," "The Chase")? all new students at the Medical College of Georgia, starry-eyed fools 2 Stars - Class of 44 - Any sequel is usually the studio's attempt to that you may be. Your dreams will be destroyed here, not made. No cash in on a previous success, and it usually flops like a lead tit. matter if your role is a member of the health services team, you will see "Summer of 42" was, in my opinion, the best nostalgia piece to date. incompetance, waste, arrogance, selfishness and nonsense beyond Now we follow the adventures of Benjy and Oscie as they go off to imagination. You will see sickness, suffering, death and grief over and college. What emerges is reminiscent of all the previous movies about over. You will see those in training for the highest responsibility life as we thought it was yesterday; (connotation of nostalgia) - diminish themselves through cynicism, disappointment and greed. Your faithful in detail but entirely lacking in love. Thts love is the misty, training will teach you things you don't want to know, things you memory evoking feelings produced by "Summer of 42" WQn't ever use, and things that aren't even true. Not exactly the stuff dreams are made of. 1Y2 Stars - Last Tango in Paris - I think everyone should see Marlon The point, though, is that you aren't in training to make your dreams Branda get a rectal exam from his girlfriend using Imperial margarine as come true. As confused, as redundant as your experience here may be, a lubricant. I hope you don't have to pay $4.00 for your seat as I did. Bertolucci (the Director) is recognized as an international giant as you live through it, you will learn the basics required to allow you to although I am not familiar with his work.