Wednesday, December 07, 2011
Uh, Doc... Would you kindly accompany me to the parking lot so we can settle this?
It was late in the shift and I was swamped with trauma and sick medical patients. One of my sick medical patients was either an ENT problem or a GI problem. She had pills lodged either in the posterior oropharnyx of high esophagus. I called GI and they said they would scope after we proved the pills were not in the vallecula. Fair enough.
A visual exam was unreavealing. A person started coding. I asked for the clerk to page the on call ENT to help me out. I had called in this ENT doc exactly zero times in my four years at this institution.
He called me back. I explained my problem. He proceeded to talk to me like I was some schoolkid and had more excuses about why he would not help me out than a meth addict caught with a mobile lab.
I hung up on him and resolved to get the scope out and do my exam after I took care of the MI and the crushed in a roll-over trauma patient.I just knew that I wasn't good enough with the scope to check all the nooks and crannies.... could find the vocal cords easy enough.... but to say, 'no, the pills are in the esophagus'... Well, I could have got close.
Well who saunters in ten minutes later but my colleague from ENT.
I decide we can be friends and go to shake his hand and thank him. He, of course, refuses the hand-shake (and the thanks) and simply asks, 'Where is the patient?'. Evidently I had pulled him away from his weekly Bridge tourney at the club and boy was he in high-dudgeon!
Five minutes later he pulls me out of the MI room where I had just intubated and stabilized a patient for a trip to the cath-lab. "The scope was clear like I knew it would be. I have never been hung-up on in my life (no time like the present doc).... And I am going to speak with your director about you (poking finger in my chest)."
Well, that was that, I grabbed his finger and lowered his hand and told him that I didn't appreciate his talking to me like an intern and that I needed his help and that he was on call and if he wanted to discuss it further that we could take it out into the parking lot and finish the discussion. Boy that felt good.
He crumpled right there.... ''Uh... Don't you threaten me.... Uh.... you stay away from me."
"I'm not threatening you doc, I'm asking you outside as you are being an asshole right here and now and you go ahead and call my director because he's got my back."
At which point the charge nurse got between us and the kerfuffle was over.
Doctors versus doctors. The genius of EMTALA.