stories told and songs sung

Life is full of stories and songs. By sharing them, maybe we see a little more clearly how we are all connected.

Name:
Location: Deep South

I grew up in Texas and then went off to college in Tennessee. There I met my future wife in a great story you'll have to hear someday. Med school was back in Texas. We got married during my 2nd year. After med school, it was on to Neurology residency in the Deep South. Now that I'm a full fledged neurologist, I'm just trying to balance it all with a new baby on the way...

Thursday, November 12, 2009

Don't get sick in July

So this is an old story I was reminded of today. This occurred one fine July a few years ago. For those who don't know, July is when the brand new interns, fresh and green having just completed med school, start work on the hospital wards. Also, to facilitate a more uninterrupted story, all medical terms (for you non-medical folks reading this) will be marked with an asterisk and defined at the end of the story.

In this particular hospital, the internal medicine service employed a night float system* for cross cover* issues, and on this particular night, there was a patient with a GI bleed.* The primary team* had checked out* to the brand new cross-cover intern that the patient had an order for Q 2 hour* hematocrit* that needed to be followed and to transfuse the patient if necessary. Unfortunately the cross-cover intern had a slight mixup between 'hematocrit' and a similar-sounding word. When the primary team returned in the morning and asked how their patients had fared overnight, the cross cover intern responded, "well everything was fine except for that one patient who had the Q 2 hour hemoccults.* That was a big pain for all parties involved."

Primary team: "You did WHAT to our patient?"
Intern: "Q 2 hour hemoccult, just like you told me."
Primary team: "NO, we said Q 2 hour hematocrit not hemoccult."
Intern: "Oooh, well that makes more sense."
Patient, when the team came to apologize: "Sheesh, this place is literally a pain in my butt, and I'm never coming back here if I don't absolutely have to."

Moral: Don't get sick in July

Definitions:
1. Night float: system in which a doctor comes in at night to relieve the regular daytime doctors and takes care of the daytime doctors' patients
2. Cross cover: any medical issues overnight with patients who have already been admitted to the hospital
3. GI bleed: any bleeding from the GI tract, including everything from bleeding ulcers to bleeding hemorrhoids
4. Primary team: the daytime team of doctors who have primary decision-making responsibilities for the patients assigned to them
5. Check out: the process of handing off patient care to whoever is covering those patients by the primary team when they are leaving the hospital for the day
6. Q 2 hour: every 2 hours
7. Hematocrit: a blood test measuring concentration of red blood cells, if low indicates an anemia
8. Hemoccult: a test of the feces for presence of any blood, usually done by performing digital rectal examination to obtain a stool sample for the test