January 30th, 2008

Kendo mouse


Z let me know that the DNR patient did finally die...this was accomplished by the expedient measure of arranging for her to go home with Hospice. It's a rule of residency: If you want someone to die in the hospital, arrange for them to go home with Home Hospice. They will die on the day before discharge, but after the equipment has been delivered. Usually, when their family have gone to get the first hour's sleep in the last week.

Other Rules of Residency:
- Really Nice People on Staff Medicine who have an unclear diagnosis have a Bad Thing wrong with them and will die.
- Cocaine saves heart cells. You can do cocaine when your heart is pumping at 1/5 its recommended capacity and stay alive for years. If you are a clean liver, you will require Home Hospice.
- The crazier you are, the less likely Psychiatry is to recommend you be admitted to their hospital when medically stable.
- All pill ingestions which result in survival could not possibly have been serious, so don't expect Psychiatry to tell you your patient is really suicidal.
- The code siren only goes off when you are on the extreme opposite end of the hospital from the trouble in question, unless you are not required to respond, in which case you are Right Next To The Room.
A side note: Our code siren sounds exactly like the 'sandwich is done!' bell on the panini maker at Starbucks on the second floor.
- Alcoholics come in two varieties: Very Nice People who are genuinely sorry for their problem and eager to accept any help you offer, just like the last 345346094534 times they were admitted, and Complete Jerkoffs who will require doses of benzodiazepines sufficient to anesthetize most of the San Francisco zoo just to satisfy their craving for a high. The latter will force your cross-covering resident to interrupt a night of unexpectedly blissful silence in order to explain at length that people die of alcohol withdrawal before leaving anyway against medical advice. See Cocaine entry.
- When you enter the Emergency Department, people who were ready to walk out and go home happy suddenly develop crushing chest pain or fall over screaming, Just For You.

Tonight, I am feeling cynical. It may be because I had a patient today tell me that she couldn't possibly go to her Psychiatry appointment (which we have arranged three months in advance) because her bangs were too long and she looked like "Fluffy the dog".
This, too, shall pass.
  • Current Mood
    cynical cynical