Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Thursday, January 09, 2003
    Day Four

    Not quite as bad as yesterday but I still feel like I'm chasing my tail. It's never ending, rounding on the patients who are in the hospital and figuring out what to do with them... discharging the ones that you can... and new admissions.

    I have a story for you. I'm going to keep this as nonspecific as possible. There is a nice elderly lady in the hospital with an infection. She has a wacko family member who is a real pain (both the primary care physician and the doc who covered last weekend warned me about him). He has managed to get his hands on the lab results every single day and second-guesses everything I'm trying to do. Two days ago, her white blood cell count went up which concerned him greatly (me too, of course), and I rechecked her X-ray and added some respiratory therapy - but she was on top-flight broad-spectrum antibiotics, so I did not see the point in changing her meds. He wanted me to call a specialist who was recommended by some relatives of friends of his - I explained that I couldn't since this doctor was not contracted under her insurance plan and that, since she was clinically stable, I would like to wait one more day. Sure enough, next day she got better.

    The next day, at a different hospital, I was rounding when a doctor came up to me and turned out to be the specialist in question. Let's call him Dr. B. Dr. B informed me that the day before, the relative had called his office announcing himself as "Dr. X" and wanting to speak to him immediately. So of course Dr. B dropped everything and went to the phone. It turns out "Dr. X" is a chiropractor. You can imagine how well that went over with Dr. B.

    Dr. B told the relative that he knows me by reputation and from working on a committee with me (true), and that he saw no reason to change the treatment regimen I was following, and that he had no interest in butting in on the case. God bless him. I thanked him profusely and lost no time in phoning up the relative and making damn sure that he knew that I knew what he'd tried to do behind my back. Then I called the primary care physician and told her the story: she found it extremely entertaining.

    Onward to Day Five. Then just the weekend. Then I'm through. Aaah.



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