Wednesday, December 07, 2011

Speaking of Deputies....

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.

15 comments:

  1. GREAT STORY 9-11...
    and your a better man than I am Grungy Din, I'd have just written threatening letters to the Pope/President/Governor/Head of the GBI/Medical Board/Hospital Chief of Staff in your ENT's name, preferably with his Office Letterhead...
    and I'd do it Old School, cutting out and pasting the letters individually instead of writing it out, cause the Secret Service knows thats what really dangerous freaks do...
    and reminds me of the time I got into it with this Cardiac Surgery Resident, something about some lab value they needed to know before taking a patient off Bypass, and I kept talking to this cute little Honduran CRNA student instead, and finallly the Resident said I better run the lab if I knew "what was good for me"
    Boy was She a Bee-Otch.
    Nice feet though, especially when she was tired, and she'd slip em out of those sexy clogs and.. damn you internal monolog
    The Surgery Resident I mean, not the CRNA student.
    And did you know I was a Senior Resident before I realized "Vallecula" didn't mean "Mouth".
    Cause they'd always say "Put the Blade into the Vallecula" but then they'd just stick it in the patients mouth.

    Frank

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  2. Gee!! I never did anything like that!! OF

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  3. Hey OF,
    you know where I can get some POINSETTA BOWL tickets??
    HAHAHAHAHAHAHAHAHAHHAHAHAHAHA

    HA

    Frank

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  4. Just above the "chokin-my-chiken" bowl tix...

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  5. See, here's where I would have said, "What part of let's go outside and discuss, don't you understand?" (I would also add "little man/hon" dependent on if short male, or irritating female as my derogatory for females is always gonna be "hon" -- which is only derogatory between females -- and since I have a height advantage to some men, I always use that as an insult because it always works and really makes them spin out of control, which makes things amusing for all watchers). I also will say loudly, "Pleeeaaase stop whining and do your job" followed by dramatic eye-rolling and walking away. This also works well, because I can count on not having to talk to that person for weeks :)

    -SCRN

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  6. @ SCRN
    In Med School there was this really obnoxious Internist, and he was really fat, and black, and get this...
    His name was "Albert", and when he'd show up on the ward I'd go "Hey Hey Hey"...
    You know, like Fat Albert used to...
    problem is, that only works if there Black and Fat and remember a cartoon from the 70's.
    anyways that "eye rolling" thang is sort of a turn on, except when my daughters do it, cause that would be creepy.But seriously, I only go to Starbucks for the eye rolling when I ask for extra grounds...
    your spot on about the height thang.
    Most of the really evil men in history have had little-Man syndrome, Napoleon, Hitler, Nick Saban...
    And do you consider my 5-8 short? My Dad does, cause he's 6-2, even with his dessicated disks. And that was part of how I chose Mrs. Drackman, we fit, if you get my insinuation.
    And she was the only woman who would have sex with me without paying first.
    Well there were those "Mentally Challenged" girls, but they don't count...

    Frank

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  7. Frank, I am territorial for those I love, xoxo. And, I would NEVER do that thing to you, where I hold that syringe you need high up over my head and tell you to "try" and get it...

    -SCRN

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  8. @Frank, amazing!!

    My family ENT had a thing about being called a what-do-u-call-'em-ologist! I always thought ENT was short & sweet, much like her qualifications!
    But, I quite like that specialty, heavy drinkers. Cheers

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  9. @ SCRN..
    Askin a man to try and "Get it" can be risky, listen to the REAL hardest workin Rock n Roll Band of all time DEF LEPARD's "Armageddin It" sometime.
    and Ya gotta watch it with that holding-the-syringe-over-your-head thing. First of all, it leaves you open to a kick in the nads, oh yeah, your a chick, and we can't punch you in the stomach, cause your a XX, and we'd be better off getting you drunk and leaving you to asphxiate(NOT drown, theres a difference)like Ted Kennedy did with Mary Joe Kopeckney.
    I used to flirt by untieing Nurses shoes, which was great, cause they couldn't complain cause sayin "Dr. Drackman untied my Shoes" just sounds rediculous, and probably played a roll in the horrible sucess of "Crocs"
    You can't untie them.

    Frank

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  10. Frank, I can imagine you on the floor crawling around under the drapes. Just that creeps me out a bit because I've never worn crocs. I'd be taking a few more side glances to make sure you were still in your chair... there'd be one more safety count added, 30 minutes in.

    -SCRN

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  11. Threatening to take a discussion "outside" in this setting is about as professional as sticking his finger in your chest. Sorry, you may have gotten your rocks off threatening a bully but two wrongs don't make a right.

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  12. Guess I shouldn't have expected professionalism from somebody who couldn't hack it fulltime in the er and ran off to "govmit " medicine, the thing he has been railing on for years. Stay in the VAspa or where ever you crawled off to for your 9-5 job. Leave the ER to those of us who can hack it with professionalism without being a blabbering baby. Now flame away Elmo... Goodbye.

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  13. Not sure that was an EMTALA-related event - probably more due to the fact that the ENT in question is a pansy-ass narcissist who has no clue what the world is like outside of his little snotty office (no pun intended)! I'm so glad you told him off - and I am even more glad for you that you felt confident that your director had your back. I have worked with several directors that I didn't feel that way about, even if my "interaction" with a difficult consultant wasn't as in-your-face as yours was! I'm jealous!

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