Patient who has known me for 3 days and clearly has some early morning delirium.
super adorable old man who was disappointed that bacon was not included in his gastroenteritis diet.
- start the day with an unbelievably low census
- discharge 2
- tap a belly and get 5 Liters of
pale ale ascites off. Patient says we are “all right after all” as he jiggles his now loose belly. Hopefully we won’t have to put that third pressor back on.
- troll the ER for admits cuz my intern needs some practice.
- why do I care how many admits we get? I’m off this weekend.
- chest pain / Shortness of breath rule out. Yes please.
- pneumonia. Sure, also can.
- diarrhea / dehydration. Sounds good to me. Keep ‘em coming.
- Getting close to quittin’ time. Got some patients on the census without having to work too hard. Excellent.
- Hey you want this lady? Her hemoglobin is 2.8 but she’s doing surprisingly ok.
- There’s gotta be a catch. There’s always a catch.
- Anemic lady is chillin, eating a turkey sammich. She’s hungry because, you know, her cocaine and booze wore off. Not what I wanted to deal with an hour before check out.
- Discuss anemic lady while ER doc tells us we have another one ready for admission. Hurry though, because his Creatinine is SEVENTEEN (YES! a new record for the team!) and his potassium is 8.
- Can’t. Must. Blood. Also the blood pressure.
- Call ALL the nephrologists. Call the dialysis folks. Might as well call a code. Just get ready.
- Not expecting him to be on the census on Monday when I return.
- OTD, dinner, sleeeeeeps
Wayfaring to new patient and lady with her: Hey there, I’m doct—
Patient: Well I guess you can tell that we’re lesbians.
Wayfaring: Um, okaaay… nice to meet you too?
Midnight on a Tuesday…
A teenager, late in pregnancy, rolls into OB triage.
She is covered—face, pregnant belly, extremities—in road rash. An ATV accident apparently.
Nurse: You’re lucky. You and the baby are both going to be fine. I think this would be obvious, but I’m going to say it anyway: no more ATV rides until after you deliver.
Teenager: *sucks teeth* Man I never get to do anything!
Nurse: Oh I think you’ve done plenty.
OB attending (fast and kinda mumbling): Do you wanna epidural?
Patient: Whaddya mean do I wanna keep it if it’s a girl?!
Demented old white man: **sits quietly in a corner by the nurse’s station at his nursing home**
*African American nurse walks by*
Demented old man: *yells* I CAN’T TELL THE AGE OF BLACK PEOPLE!
A mom who now knows her daughter a bit too well, and prenatal care not quite well enough.
Mom who just delivered a nearly-10 lb baby without an epidural: Oh God! Did I rip?
Wayfaring: Yeah, you have a small tear, especially considering how big that baby was. We’re going to put some numbing medicine in it before we sew it up.
Grandma: It looks like you split clear down to ya butthole!
Mom: Oh God! Oh Jesus! I ripped my butthole! Did I? Did I rip my butthole? Help me Jesus! I won’t be able to poop!
Wayfaring to grandma:
Wayfaring: So tell me what’s been going on with little Johnny. How long has he been sick?
I’m sorry, what’s that?
Ma’am, I think I could understand you better if you stopped sucking your thumb for just a minute.
Mom: **removes shriveled pruney thumb from mouth** Oh my bad. I said he’s been having diarrhea for 4 days. **re-inserts thumb**
Wayfaring: Follows patient for her entire pregnancy, gets to know her family, etc. Hopes to count her as a “continuity” delivery.
Patient: Asks family medicine attending friend, who has not followed her pregnancy, to deliver her.
Wayfaring: Is on call when patient is in labor. Is glad when attending says please assist in delivery.
Patient: Stalls out at 8cm, baby starts looking bad, needs a c-section.
FM Attending: Does not do C-sections.
Wayfaring: Stays 4 hours late after her night shift ends. Scrubs in with OB attending, cuts the belly, dissects the tissue layers, cuts the uterus, pulls the baby out, sews it all back up.
Patient: Oh thank you sooooo much, *Family Medicine Attending* for taking care of me today and being there for me through this pregnancy!
FM Attending: Actually, Wayfaring did your surgery.
OB attending: It’s true. Wayfaring did it. I helped.
Patient: Oh Wayfaring, I’m glad you got to see my baby get born. *Family Medicine attending*, thank you AGAIN for taking such good care of me!
Patient: my baby’s got white stuff coming out of her hoo-hah!
Nurse whose first language is not English: her whaaat? What is dat? What hoo-hah?
Patient: you know, like in her diaper?
Nurse: Oh! You mean va-yiiina? It is not a hoo-hah!
Nurse: Doctor Wayfaring, I think you need to teach these mamas some anatomy ok?
**The following story has been adapted from real life events. The names and some details have been changed for our dear friend HIPAA.
Baby boy G’s mama was on drugs. Thanks to the wonderful folks at Social Services, he was allowed to go home with her after he was born.
Scratch that. He was allowed to go with her, but not home. She was homeless. They sent him back to live with her on a friend’s couch, in the very same house where he had been born on a filthy kitchen floor.
We as a team hated seeing him go back to that environment. That adorable, mild mannered, teensy little baby went home to a crack den, despite his and his mom’s positive urine drug screens at birth. Social services gave them one caveat: mom was not allowed to be alone with the baby.
Fortunately for our consciences and for Baby boy, mom screwed up. She showed up to an appointment with him unsupervised. His pediatrician acted quickly and had him admitted to the hospital. “Possible drug withdrawal,” he said.
Once in the hospital, we took emergency protective custody. For two days, Baby boy was the peds floor mascot. His given name was not to be uttered, as the emergency protective custody arrangement afforded him an extra layer of privacy. We nicknamed him Peanut. Nurses bought him clothes and toys from the gift shop. Attendings, residents, and nurses, unable to resist the baby fever, drew straws for who would get to manage his next feeding. We became attached.
We knew that a foster family would be coming soon. We collectively decided that if they were unacceptable to the group, we would figure out a way to keep him in the hospital until another family could be found. Everyone knows foster care is terrible, someone said.
Wayfaring’s Patient: My daughter just found out she’s diabetic.
Wayfaring: Oh, I’m sorry.
Patient: She just got a new job too and has insurance so she needs a doctor. She asked me if I knew of any good ones, so I told her about one I know.
Wayfaring: That’s good.
Patient: So she’s putting in an application to be one of your patients.
Nurse: Can I help you?
Baby Daddy of lady with an epidural: Yeah, uh, she’s gotta take a s***.
Nurse: Okay, I’ll bring a bedpan for her.
Baby Daddy: I mean, can’t she poop through the catheter tho?