The .Plan

Nodding off while writing an admission note at 06:30.

[beep beep beep]

“Hi Doctor Chai, thanks for calling back. This is Theresa on Third East. Can you come see patient Smith?” [*]

“Sure, what’s up?”

“I was turning him when he coughed up a little blood. I also noticed that he was very sweaty. He didn’t complain of any chest pain. Respiratory rate in the 30s, systolic in the 90s. He also desatted to the mid 80s–”

I was already tachycardic myself.

“Uh. Please put a face mask on him. And have someone get an ABG syringe for me. Also EKG, CBC, Chem 10, cardiac enzymes. Call radiology for a stat portable chest. I’ll come on up. Oh, and please have someone page my senior.”

To make a long story short, my favorite non-medically complex ortho dump turned out not to have a heart attack; but when I sent him downstairs for a CT-angiogram, he turned out to have a very large pulmonary embolus lodged in his right pulmonary artery. He’s doing fine now with a bit of oxygen and a heparin drip.

Later this afternoon, I read the second funniest ortho note I have ever read in my entire life:

“Subjective:
NEON.” [no events overnight]

My goodness, I am so toxic right now. Only 55 days to go.

–
[*] All names, dates, and other HIPAA non-compliant details have been confabulated.