20 September 2011

Only a couple of possible outcomes

When every shift ends, you think to yourself - Did I actually do something? Most of the time, the answer is... 'sorta'. I sorta helped. Of course the attendings did something, residents a bit less, but them too, so maybe it's not a discontinuity when you get to the med student - Maybe I did something too.

But this always happens. When you do a thorough H&P, plucking every flower from the crannied wall, a few things can happen
  1. Grunt - Patient grunts, you get along with your day and start thinking about the A&P. 
  2. "Ok thank you" - Get along with your day, start thinking about the A&P. 
  3. "Thanks doc" - Sometimes I let this slide, especially if it's a combative patient refusing blood draws; I may need to come back later with the nurse and throw down the short coat hammer.* But sometimes I correct them.
"Not a doctor, not yet." Some of them then say "ok." Others say "Oh.. nurse, then?" Haha. A few (and just a few) tell me "You're a doctor to me.."

Always important to end correctly and on a high note. 

Finally I recently had a patient with increased white count and vague abdominal pain (per nurse). When I went to go assess him, he didn't want to talk about his abdominal pain (non existent). The first thing he says is "My uterus is giving out."

In the back of the ER, were beds are 1ft from each other, about a dozen patients chuckled. I mostly held it in and looked to see if he had an adam's apple. He did. 

*In possibly the longest aside ever, on my last day of Transplant, there was a patient who didn't have morning labs. The assumption? Patient is leaving. A shitty way to draw conclusions but it happens. 

When I got around to his floor, he was still there. He had refused morning labs. And noon labs. I talked to him. He wanted two pillows and a blanket. I got him two pillows and a blanket (and is it just me or does everyone look at me funny when I ask where the linen cart is?). I made him compare his hand with mine (he was jaundiced like a diseased frog), asked him whether he thought that was off. "It's off." So can we get some blood to find out why? "Ok let's do it." Told the nurse to page the incoming student if there were more problems. Boom. Ending Transplant like a bawss

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