I was at the beginning of my ED shift taking care of a man who I spent 30 minutes with taking a thorough history and performing a complete physical exam including a real, full, neuro exam (which any good medical student will tell you takes 15 minutes to properly perform start to finish) for his complaint of new-onset headaches...when I simultaneously get chewed out by the attending for taking too long because "we're just going to scan his head anyways" and paged by our clinic administrator frantically wondering where I've wandered off to this morning because I have a list of patients waiting for me in clinic. (note to self: evidently there are two clinic schedules and one is not correct).
--Whereas in any normal job telling your supervisor that you are in the Emergency Room will surely get you some sympathy--
I go to clinic.
First patient is an extremely complicated morbidly obese woman with a sad history and recurrent infections in her pannus (look it up--urban dictionary). And...not really my patient. She sees another resident who is on vacation (note to self: thank the residents seeing my patients when I am on vacation). But she is nice enough.
Second patient is the mother of a 3 year old with recurrent scabies. Because we all know that the real patients in peds are often the moms, let's be honest. And she was kind of mean about it when I told her the whole family needed to be treated again and for crying out loud wash the stuffed animals! Only after I told her my diagnosis did she offer up information about how, oh yeah, their cousin has scabies and hasn't been treated. Also their house has a cockroach infestation and could that possibly be causing the rash? Do cockroaches bite? Let's just say I wore gloves in there. And for the record, only Philippine cockroaches bite. That is purely anecdotal, but I believe it to be true. Please leave a comment if you know otherwise.
Have I mentioned I haven't pumped all day? At least my poor nipples got a break from all that biting this morning. Ahhh motherhood.
Back to the ER and some guy who's not very sick and not very emergent is going berserk because he was told at urgent care that he needs a surgery to pin his wrist in place and he wants it NOW. Can I call the head of ortho? Oh and by the way, no pain meds work on him EVER for ANYTHING and he's in 10/10 pain. He proceeds to laugh at some joke he makes that I do not find funny. I'm pretty sure that when I was in 10/10 childbirth pain I was not laughing. Just for the record.
I spend the next 1.5 hours trying to find someone--anyone--in radiology (where are those doctors anyways? Have they all moved to Hawaii?) who will be willing to load his x-ray from urgent care. Evidently there is a protocol for that and paperwork yada yada. So can I get the patient to sign the financial consent form that he might be charged for a re-read? Oh he's going to love that.
I am just now realizing while typing this that my patient had narcissistic personality disorder.
All's well that ends well though. I got to come home to Boyd and Edie and plenty of smiles and babbles. She is scooting around pretty successfully these days which proves to be quite amusing as she discovers all sorts of treasures on the floor. She loved eating the little cubes of beet I roasted for her for dinner. And I got to snuggle her and put her to bed in her pink fish jammies.