Wednesday, March 23, 2011

the twilight zone

write down room number, case number, name, age... waitaminute, she's 30? check birthdate. 1980. yep, that checks out. which doesn't really help the situation. i'm a damn pediatrician (or training to be one sigh). why do i have a 30-year-old patient? "she's 30?" i ask the nurse in confusion. she nods as if everything is right in the world. bewildered (and maybe a bit suspicious), i check for any people toting video cameras, ready to pop out screaming, "you've been punkd!" nope. i confirm the age again, as if asking repeatedly would remedy the situation. yes, m'dear, she's still 30, you're still a pediatrician, and SHE'S STILL BEING REFERRED TO YOU. so i did the most logical thing, i asked for the weight.

because even though she's 30, i'm still a damn pediatrician.

i knock on the patient's door, and request an interview because this peculiar referral must be explained. justified. "she's eating," the friend says apologetically. "maybe we can postpone it until after lunch?" i comply. i exit, still confused. i see the tcvs fellow. i confirm the referral, and he's just as confused. i ask about the case. he hasn't interviewed her yet. stuck, i head back to the callroom just in time to run into my senior and tell him about this reallyreallyreally weird referral. he gives me this strange look and asks me if i misread/misheard the age. i do my best not to look insulted. (i think i failed)

so after explaining everything, and checking the chart, the situation sinks in. an adult with an unknown heart disease for a possible cardiac-related procedure was referred to the pediatric service. "do i have to do a pediatric history on her?" i ask my senior. "what if her mom's not there? she probably won't know if she was born via SVD or CS. would she know if she was breastfed?" "how do you dose aspirin in adults again?" he shoots back. "clopidogrel? what about the developmental history? mommy... what can you do? run up and down the stairs? stack three blocks? ride a bicycle?" we're collapsing in laughter by this time. the nurses are looking at us like we're nuts, but the stuff keeps pouring out. "what about HEADSSS?" and we start running down the questions when my senior freezes and goes, "what's her murmur?" "no idea," i answer. "i haven't even talked to her yet." i won't hear it!" he panics. "my steth is too small!" we laugh some more until i feel the familiar breathlessness associated with an asthma exacerbation. "fluids at full maintenance?" "one liter to run for 8 hours," he answers. "it's easier for them." "but we're pedia," i whine like a brat. "i joined pedia because i don't want to manage adults. adults annoy me." i whine some more. we guffaw at more pedia jokes. in the end, we inform our consultant about the referral, and i go on duty.

hours later, the cardio fellow tells me that the patient's asthma might be acting up. she suggests a referral to a pulmo consultant.

a pedia pulmo consultant.

i start cracking up again. this day was just too weird.

1 comment(s):

OpenID justinetf rambled...

Love it! Found your blog through another young doctor. Please keep blogging about your experiences. :)

at October 09, 2011 12:46 AM  

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