Monday, March 28, 2011

There is always more than one patient

I had just finished a case and went to talk to the family. When I got back, one of the residents asked what took so long. I paused and then thought a bit and tried to explain. I told him that the person that went to the recovery room was not the only patient. While we were operating and dictating, someone is sitting in the waiting room worrying. There the clock seems to stand still. They are worried about their loved one, worse, they are helpless to do anything. Every time the phone rings, they jump. When the surgery is over, they have to face the news of what was found and what happened. Is there cancer? Are they going to be OK? What happens next? The person that had the operation is still asleep. The family and friends have to face the news wide awake. They are your patients too. Time and answers to their questions are the medicine that they need. Surgery takes as long as it takes, so does meeting with the family and friends.

Friday, March 25, 2011

Medical Ductape

I think there ought to be a medical hall of fame somewhere for the people who have contributed the most to medical care but who have not had their name placed on their invention. One of the most awesome things is that Mefix tape. It is like medical duct tape. It will hold in chest tubes, NG tubes and hold pressure on wound until you can pigure out what to do. Another cool thing is that artificial snot stuff that is on the back of EKG pads. It sticks, but you can pull it off later and it is like the rubber cement you used to put on your hands and play with in grade school. I dont know who invented it but I like how you can cut the end of the tube that chest tubes come in, and then use it as a blow gun to shoot those oral care sponges on a stick. Pillow packs. These are cool, besides being a convient way to get saline to lavage a plugged ET tube, they are awesome one shot sniper squirt guns. Opsites (tegaderms) are cool too. See through self stick sterile saran wrap. I wish I would have though of it. I think there should be a special place in the Hall of Fame for the person who can come up with a way to open all the sterily packaged stuff with gloves on. I hate having to open some of that stuff with my teeth!

Air Traffic Controller Lapses

I just saw on the news that the air traffic controller at Reagan National Airport fell asleep and as a result two aircraft low on fuel had to make landings. The Air Traffic controller's union in perfect form blamed the issue on staffing and not on the fact that the gut was asleep on the job. It is a good thing no one was injured. I guess unions are a good thing. If we decide that we are going to take a nap and ingnore the emergencies coming in to the ED, we are going to get in huge trouble. I guess that is why docs cant form a union, its not like we are responsible for bunches of people who could be in danger.

Ball Park Amnesty

I just had the opportunity to go to a professional Spring training baseball game. On the ticket and also announced in the stadium was the statement that "Baseball is an inherently dangerous sport and baseball, bats and other objects may cause injury, the stadium, team or its employees are not responsible for any injuries that must occur." By entering, you assume all liability for any injury. So, in other words, if a highly trained professional accidentally slips and lets hits bat fly into the crowd, he is not held responsible. I kept thinking about this. Medicine is an inherently dangerous activity, perhaps we need Ball park Amnesty! If a surgeon has an accident, he is sued. Oh, wait a minute. We cant have accidents, only malpractice.

Saturday, March 5, 2011

Toll Free Calls?

I think the thing that takes the biggest toll on me while taking call is the constant barrage of phone calls. I understand the calls from the hospitals and the ERs and the patients who are recovering from surgery. It is the other types of calls which is the majority and the biggest pain in my side. We have an answering service that does their best to screen the calls and the phone system even says "if this is an emergency, hang up and dial 911." It doesn't make a difference, people lie to the answering service and you get calls like this. "text message: patient had surgery by Dr. (partner x) and now has severe nausea and vomiting." Of course it is 2 am. You call the patient, he is drunk. Turns out the surgery was a small office procedure 2 years ago. The patient is drunk and wants nausea medication called in because he doesn't want to still be puking in the morning. I give him the speech that we do not call in medications after hours and that we are on call for emergencies for which he calls me every name that would get my mouth washed out with soap as a kid. After he hung up and I dealt with other people calling for zpacks and antibiotics for their colds, I decided to look up the drunk guy on Google. Turns out he owns a bunch of car dealerships. I so wanted to call him back in the middle of the night and tell him that I had a headlight changed at one of his dealerships and want him to call in a new muffler for me at Autozone so I wouldn't have to have my car make so much noise in the morning.