Crappy consults.

The bane of every physician’s existence is the crappy consult. Especially when they happen at 3:30 in the morning, especially when the patient has been sitting in Emerg since 3:30 in the afternoon, and especially when the consulting physician gets the unit clerk to call in the consult.

These are a few of the gems from the past month.

1. A consult by my attending to a urologist. And I quote:

“can’t pee. flomax don’t work.”

2. emerg doc: “i have a 76 yo retired surgeon for you to see, he had some RLQ abdominal pain that has now resolved spontaneously, and a normal CT.”
m: “ok, and what else?”
e: “ya thats it, but he’s a retired orthopedic surgeon”
m: “but he doesn’t have pain anymore?”
e: “no, but he’s a retired surgeon, so you should probably call your staff”

3. unit clerk: “hi, consult on unit 71″
*silence*
m: “hello?”
uc: “yes?”
m: “you have a consult?”
uc: “yes, here on unit 71″
m: “what are you consulting about?”
uc: “i dont know, i’m the unit clerk, let me get the nurse”
RN: “hello?”
m: “ya, go ahead”
RN: “who is this?”
m: “this is surgery”
RN: “oh! how can i help you?”
m: “you had a consult?”
RN: “yes, the unit clerk has the details, hold on let me get her.”

4. ED: “We have a guy with an ileus of some sort, dilated loops of bowel all the way to the rectum”
–on exam–
LARGE, obstructing mass in the rectum found on DRE.

5. ED: “lots of abdo pain, change in bowel habits, exam is normal.”
–on exam– (as per the 2nd year medical student)
non-reducible, tender, possibly incarcerated, right inguinal hernia, TEN centimeters in diameter.

‘sigh’

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