Friday, September 23, 2011

My DiCaprio Turn

"Catch me if You Can", right, the one with DiCarprio passing bad checks and faking being a pilot, doctor etc??

So it has been long enough since the actual incident to tell this story now, but being a doctor with a lot of in hospital experience DOES occasionally have it's unexpected benefits.

A patient of mine came in one day with pain.... Doesn't matter where.... suffice it to say that it concerned me very much because there was no injury and the pain was in a vascular distribution and I was very concerned about an aneurysm; but no one else was.... not a soul at the Military Treatment Facility could be bothered to see him in clinic and the ER, well, let's just not talk about them.

Fast forward one month. My patient, after some skillful maneuvering by moi, was transferred, based on MRI findings (which took three weeks to get), to one of the 'mini-meccas' down the road. It was a Friday. There was some concern that he needed an immediate neurosurgical procedure, but the neurosurgeon at the mini-mecca ran crying from the room after examining the patient (and the MRI and CT). And it was Friday, and Dr. Burned Hospitalist was in charge.

Scared neurosurgeon had requested transfer of the patient to the large mecca a mile and a half away... the one with residency programs in everything from pet psychiatry to psychic-gamma-knife-surgery. I call Burned Hospitalist on Saturday and explain that I am his patient's primary care physician and he tells me he is going to discharge him to follow up at the Mecca NS clinic on Monday because he 'can't transfer him on a weekend'. Fucking liar.

Well, he thought he had a weak sister on the phone but I asked Burned Hospitalist if my patient was,

1. Controlled on his pain medicine?
2. Set up with follow up with a particular physician?
3. Off all IV meds?

And the stuttering and stammering followed at which point he said he would just keep him there over the weekend until he could arrange a transfer on Monday (i.e. get someone else to do it).

Well, I don't live too far from the mini-mecca and I was in the area that night in pursuit of pleasure in the form of skillfully played live music, and after that bit of enjoyment I decided to drop by and see my patient. It was ten thirty in the PM.

The place was locked-down, but I called up to the floor and spoke with my patient's nurse and asked if they could bend the rules for me and she practically had me teleported up.

She was VERY happy to see me. "We have to get him transferred," she said, "He needs to be at the Mecca...." I agreed.

"Do you mind if I use your phone and do you mind if I, as his primary care physician (and with his consent and all) look at his chart?"

This I was allowed to do. And then I did this, I went to see my patient, I told him he was going to be transferred and I told him that when it happened he was not to answer too many questions. I extracted the same promise from the nursing staff. And I picked up the phone...

"Transfer center? Yes, hello, this is 911doc here and I am calling you from the mini-mecca... I have a patient that we would like to transfer to your Neurosurgical service.... No, tomorrow is fine... I just need to set it up.... yes, i will hold.... Oh hello Dr Superman, 911doc here.... yes.... yes... tomorrow is fine.... can I put you down as accepting? Thank you sir."

And it only took one more phone call the next day for me to affect the transfer of the patient on the weekend. Burned Hospitalist signed the papers and was none the smarter, but I'm still pissed he got paid for my skillful impersonation, but if you really think about it I didn't lie, I just Bill-Clinton'ed it... It's all in the parsing.

And by the way, the nurses high-fived me on the way out as they were not fond of Burned Hospitalist and could never get him to do jack shit. Imagine that...

10 comments:

  1. I'm so sick of people (burnedhospitalist) who just don't care.

    Fucking soul suckers.

    Ms1

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  2. You practice 1.5 miles from Mecca??
    and I think its still Ramadan, maybe thats the problem.
    Hmmm I saw "Catch me if you Can" too, and all I remember is him screwing Jennifer Garner,and the greatest Actor of all time...
    Christopher Walker.
    Umm Dicraprio didn't screw Christopher Walker, AFAIK, I meant he was in the movie too.
    Seriously, I can do that whole "I wore this watch up my ass" bit from "Pulp Fiction" from memory...but just a few questions.
    and you can answer with "A,B,C,D, or E" which is how I answered questions on rounds during the first of my two third years of Medical School.
    Some Internal Medicine Homo would say
    "SO DR. DRACKMAN, WHAT CAN CAUSE AN ELEVATED URINE CALCIUM?"
    and I'd answer "B!!"
    and everyone would laugh,
    actually I was the only one laughing, people don't get ironic humor.
    Soooo...
    WHAT "STAN" Country was your H-1 Hospitalist from?
    A: Pakistan
    B: India-stan
    C: Iran-istan
    D: Russia-stan
    E: Other

    Frank "Alabama-stan" Drackman

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  3. methinks 'a', but it was definitely a 'stan' country. funny how you knew that.

    ReplyDelete
  4. and Frank this club's restricted so don't tell them your Jewish alright?

    ReplyDelete
  5. Hahahaha, Frank, you're gonna get creamed again... ;-)

    You're a real sucker for punishment, eh ?

    Apparently all people from Alabama are stoooopid.

    Nahhhhhhh, could that just be a label ?

    Not according to your version of correalation / causation, eh ?

    Canuckie with a bigger prickie

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  6. Palliative Care Doc9:19 AM, September 25, 2011

    I feel your pain. Mine however seem to think they can present to the patient that his health conditions are all beer and roses, leaving me to explain about his terminal condition with no backup whatsoever. They also seem to think I am their triplicate bitches, and consult me the day of discharge to write C2's for medications they started. You'd think after a year of telling them to pack sand they would stop, but no.

    I am glad that your patient was taken care of. I hope he did well.

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  7. the story evolves... ultra-rare benign but locally destructive neoplasm up near the c spine... Mecca had to consult pathologist by name of "Allah" at ultra Mecca to get tissue diagnosis.

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  8. No comments from the Hindu-Gallery??
    watsa matter? No Internet?, did the Water Buffalo come unhitched?
    Or maybe he just decided to stop turnin the waterwheel, not like your gonna eat him or anything.
    And I understand your reservations about Nuclear Power, heck with India's overpopulation a foul Cricket ball takes out a few thousand...
    and 9-11, took in a Ga Tech game yesterday,
    and it was pretty nice, except for the flashbacks.
    Can you believe they run the OPTION?, thats even more ancient than UGAs offense...
    And howcome no one ever says that "What are you? Tigers/WarEagles/Plainsmen" with Tech?
    Lets see, there a YellowJacket or a "Rambling Wreck" which isn't even accurate, that Model A's gotta be worth 6 figures...

    Frank

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  9. @911, this patient was lucky to have you (still is). That awesome, life-sucking meeting I attend each Thursday afternoon continually harps on how 'this is military medicine. There could be an earthquake in Haiti tomorrow and that Soldier's gonna be expected to go, so we've got to jump to the next step sooner than most of our civilian counterparts would' but this case so clearly defines those ones where we (the over-ordering, pushy, un-knowledgeable primary care) use clinical intuition to say "you know, this just ain't right, let's get a closer look soonest," but face roadblocks at every turn because of others' 'protocols.' I keep wondering how to present this (all M&M like) to the big guy. Every time I think about this case, it makes me so irate I could spit nails. 3 weeks to get an effing MRI, while miss "my knee hurts, I don't want to go to Afghanistan, whoops, I slipped and fell on that penis and now I REALLY can't go" gets 2 MRIs, same day, 2 weeks apart. WTF?!?!

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  10. With power taken from the docs to make important decisions they are all setting up defensive positions with HESCOs and claymores. There will be (lots more) blood.

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