Oct 16, 2012

The Page

I hate getting paged at home.

I feel obligated to call it back, but don't really want to answer any hospital-related questions once I leave.  I'm away from the hospital computers and feel disorganized and unable to give good advice.  Just the sound of the pager in my bag at home gives me a quick palpitation and anxiety.  I would leave it in the car, but then I'm anxious about it going off in the car and me missing something important.

Like tonight.

6:03pm  Pager goes off

6:05pm  I begrudgingly call it back

6:07pm  "Oh Dr. Kennard.  I'm so glad you called back.  There was a code with your patient."

"What?  A code??  So what's going on?"

"Well we were coding I guess, but not anymore.  I really don't know.  I'm actually just helping the secretary out."

Soooo...does that mean the patient is dead?  Alive?

"Well, can I speak to somewhat that does know what's going on?"

A nurse picks up the line, and here is the story:

The patient that I operated on earlier that day was wheeled back to the recovery room after surgery.  Around this time, a nurse notices that the bathroom door has been locked shut, for an indeterminate amount of time.  They decide maintenance should open the door.  And there is the patient's boyfriend, dead on the toilet, after an overdose of heroin.

They call a code (and call me).  The ICU team comes down, and then intensivist says what everyone knows- this person has been dead for at least six hours, and there is no point in resuscitation.  He suggests to call a priest.

At this point I am imagining the transport team removing the patient from the bathroom to the morgue.  I mean, he probably has rigor mortis at this point.  Is he stuck in a seated position then, and should go down in a wheelchair because he can't lie flat on the gourney?

Meanwhile, the patient is still pretty groggy.  Another resident and I look at each other.  We weren't planning to do a full hysterectomy, but the laparoscopy was so bad that she needed it.  What should we tell her first?  "What do you think is the worse news, the boyfriend's death or the hyst?"  I ask the other resident.  (The attending is long gone by this point).

"The hyst" she says, without missing a beat.

Later that night, the patient decides to leave against medical advice, but she doesn't sign the necessary paperwork.  Security finds her padding down a major street in her hospital gown and booties.  They bring her back, not for readmission but to sign release paperwork.  And probably get the hospital gown back.

I don't really know what happened to her.  I do know that we thought this patient would be unreliable to follow up, and closed her with dissolvable stitches instead of staples for this reason.

And I will always leave my pager on at home.

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