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Things that drive me crazy. - Nobody wears a white coat any more...
...a tribute to becoming a doctor.
ayradyss
ayradyss
Things that drive me crazy.
L is a very nice man whose wife I've been treating for about six months now. I inherited her from another resident who graduated. Last time I saw her in the office, she brought her husband. "Take a look at this lump and tell me if you need to see him." I looked at the lump. "make a new patient appointment. Yes." It was firm and solid and on the side of his neck and probably nothing good.
So before he could come back to see me he had a coughing near-syncopal spell and wound up in the ER where they did my workup for me.
Nothing good. He has a 3 centimeter spiculated lung mass on the right lung, and lymphadenopathy that could only be tumor everywhere else.

I put him in the hospital because he was fainting. He had a spell of this on monitor. His blood pressure dropped to 60 over nothing and his pulse went to 40 something. I discussed thid with my friendly neighborhood cardiothoracic surgeon. "Sounds like this man needs a pacemaker." I called the cardiologist who'd put a stent in his heart 3 years prior. He called his electrophysiologist. They came and looked at him.

For three days he sat in the hospital while the cardiologists demanded a tissue diagnosis to put in a pacemaker and the CT surgeon demanded a pacemaker to put him under for a tissue diagnosis. And both of them kept paging me to tell me that the other one was being unreasonable. Three wasted days before they put in the pacemaker, and then only under duress. And with it in, he stopped fainting. He got his biopsy and we called the oncologist for his stage 4 metastatic poorly-differentiated squamous cell lung cancer.

I hate it when specialists won't talk to each other, and I really hate it when they waste 3 days of the life of a man who doesn't have three days to waste. If he's alive to see my daughter (he loves my baby, who rounds with me some weekends and holidays) turn two, it will be a miracle.

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Comments
bradycardia From: bradycardia Date: January 8th, 2008 05:18 pm (UTC) (etched in stone)
Oh, so frustrating!
And the longer you work in a hospital - any hospital - the more often you see examples like this. The patient inevitably ends up sitting in the middle, losing out.
1 whisper echoes . o O ( ... ) O o . whisper a word