Monday, April 12, 2010

Saturday night, on call

I'm sitting down to dinner with my family. My cell phone rings. It's the ER. A patient has just had a stroke, and is a candidate for the "clotbuster" drug, TPA. The drug MUST be given within 3 hours of symptoms onset. It's a serious emergency.

I leave my plate on the table, yell goodbye to the family as I run out the door. I race down the road, and onto the freeway.

I get to the hospital. I pull into one of the special "doctor emergency" slots by the ER entrance. I wave to Willy, the security guy who's been sitting there watching the lot for the last 40 years (he's rumored to be the last surviving veteran of the Spanish-American War of 1898).

I run in. I meet with the family as the patient is being wheeled to CT. He comes back. I look at the CT and call the radiologist. I examine the patient and go over the checklist for TPA, and explain the risks and benefits to them.

The family and patient are willing to throw the dice. The volatile drug is given as we watch. I re-examine him every few minutes. We get a bed in the ICU, and the patient is wheeled off. I write further orders and make phone calls to an internist and cardiologist.

Only time will tell.

And I walk out to my car, hoping to get home before the kids are asleep, and to have some dinner.

(click to enlarge)

41 comments:

  1. Oh, it's a just BS ticket from Willy. I'm not worried about it.

    It was just that it was such a perfect ending to a shitty day.

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  2. Why would he give you a ticket if he knows you and saw you tear-ass into the ER?

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  3. ok that's annoying!!

    In other news i'm starting to understand your addiction to Diet Coke...

    xx
    Jaxs

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  4. From the family of a stroke victim..thank you for misusing the ER space(even if you didn't).
    At least you didn't get towed..which would've sucked even more.

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  5. As soon as one of your kids gets sick of their "Perfect Petzz", which shouldn't be more than a few days, give it to Willy as a thank-you! :-)

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  6. No hospital sticker! Get one!

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  7. Gert- the hospital doesn't have stickers. Really. They got rid of them in the 1980's.

    ERP- because he can.

    Anon- if I'd gotten towed you'd likely have seen me on CNN by now.

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  8. We got one of those the day our second son was born. Apparently it is against hospital rules for one of the patients to need a parking space for more than 8 hours. Who knew?

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  9. Come ON, Dr. G...surely someone was there with something really important like vomickin and needed that spot to park!

    Patti, RN

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  10. Oh, that's nothing. I got a parking ticket from my university for parking in front of my house.

    It's still awaiting appeal.

    Glad yours was just fake, though.

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  11. Remember, no good deed goes unpunished.

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  12. Maybe Willy is a "Perfect Putz" that sits there and watches cars and his chest moves in and out powered by 4 D batteries.....Maybe some kid will take him home and get bored with him and dismantle him and turn him into a go-cart......

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  13. well crap, I'll bet Superman never had that problem, maybe you should wear your crusader cape when you're out and about saving lives like that!
    maybe Mr. Willy will be the reason you need to park in that space someday....

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  14. how many BS tickets has willy given you so far?

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  15. You need to print a copy of those old signs doctors used to put on their cars. You know the ones back in the day when they made house calls? Before my time...*shifty eyes*

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  16. Oh, NO! This will go on your permanent record!

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  17. Well, look at this way, you allowed the guard to serve his purpose in life.

    Which probably made him feel good.

    M

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  18. I got 2 tickets in 2 workdays in medical school. Was gone on away rotations for 6 weeks and the semester changed during that time. I needed a new parking sticker. My new rotation required me to be in the hospital at 5:30am and I didn't get out until 6-7pm. Parking office was open from 9am-5pm. There was no free parking anywhere near the hospital. If you parked in visitor or patient parking then you got a ticket. So I parked where I was supposed to and called the parking office. There was absolutely no way it could be done over the phone or via fax. They also wouldn't do it via proxy. While there was an appeal process, I never met a person who had been succesful.

    JustADoc

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  19. I also had an OVER-OFFICIOUS JERK PARKING GUY: if you can be bothered, see blog 3/18 cuz I don't know how to put it here http://sarahberardi.blogspot.com. And then a few days ago, he gave me a ticket, he was actually lying in wait for me. Arschloch. OVER-OFFICIOIUS JERK (Marv Levy quote.)

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  20. Captain FoulenoughApril 12, 2010 at 2:23 PM

    Just a tip of the cap'n's hat to Dr Phil for "Perfect Putz." Well played.

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  21. My car was once towed out of my apartment building's lot. I'd been living and parking there for four weeks already. On top of that I had already seen the towing vulture in the lot several times a night every night.

    Needless to say after chewing out the landlord for that he hasn't tried to talk to me going on 19 months now...

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  22. Hope Willie never needs a neuro consult or a favor for a family member...he might just have to wait like the rest of the pts. Willie lose his 'gold card' to office visits for that one.

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  23. Apparently, you were a very bad boy. :-)

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  24. I get one of those daily... apparently, Ms. Grumpy doesn't like the fact that I place OLD parking tickets on my window because I'm TOO FREAKING POOR TO PAY TO WORK. The university cannot double ticket someone.

    It'd been working for months.

    'Til she found out.

    Since then, I've gotten one per day.

    Yours is contestable. Mine, not so much.

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  25. AD2B- Mrs. Grumpy hasn't written you a parking ticket. She swears.

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  26. When I was a resident, we did an ICU rotation at a community hospital in another city. Other than a lone ER doc, we were the only one in the hospital at night, managing all the ICU patients and anyone else who happened to crash in the hospital at night.

    After a particularly grueling 24h shift, I came out to find a similar ticket for parking in a doctor spot. I was the only freaking doctor in the hospital all night. And I had the sticker, he just didn't see it. (Didn't look for it?) I was pissed, but a well placed phone call had it wiped off with many apologies.

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  27. I love how most people these days would get rid of the important info in MS Paint or Photoshop and you have used the instant liquid paper stuff. ;D

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  28. Prissi- I'm not that technically advanced.

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  29. had a peds postop as a resident who belonged in the picu. the parents hated the unit, so the attending assured them the floor would be fine, and insisted. the peds residents called in the middle of the night to say the child was turning blue. poor lighting was to blame, but i got a ticket for hauling ass to the hospital. the attending knew the judge, so i asked him to support me with a letter. it said he thought i thought i was doing the right thing. i paid the fine and took the points.

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  30. How nice of Willy. Perhaps you should get him a gift in return.

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  31. There might actually be enough of his hand writting there to get it analysed. Might be some good stuff there.

    I used to work overnights. Parking was free to night staff if they got out before 0715. My "Willy" would see me coming, even if I was early and close the gate so I had to pay the $2 minimum to get out. Most people liked him and had a protest when his job was replaced by a card reader. I on the other hand, still call him the "Parking Nazi".

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  32. Ah HA - its all coming out now - you really aren't a doc at all are you? When's the big reveal for your 'actual'job Janitor boy??!! (:

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  33. parking lot attendants are just failed IRS assessors.

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  34. Maybe Willy is thinking of retiring soon and wants to make sure he tickets everyone he loves before he leaves?

    I got ticketed last summer for parking in front of the campus library while I walked across Prexy's Pasture to chat with one of the few remaining people I knew at my alma mater and see the new pharmacy building for the first time in ~ 25 years! The *>&# school sent me the $10 ticket with an notice that all fines must be paid before graduation... (It's not like I kept up with my alumnus donations or anything.)

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  35. I just laugh because it means you took the effort to actually find that stuff, scan it in, and upload it for all of us to enjoy, whereas I take pictures of stupid stuff all the time and never can be bothered to upload it ;P Let it never be said that you spare effort at our expense!

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  36. I think this was an act of compassion. "Gee, Doc Grumpy is here for something bad, he looked really stressed. What can I do to take his mind off of medical problems?"

    Well, perhaps not likely, but it *did* accomplish that.

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  37. You should see if you can find an old hospital sticker (or create a fake one), and get it enlarged to about 3x6 ft, then park where Willy can see you - place the humongous "sticker" on your windshield and nonchalantly walk past Willy, wishing him a good day!

    Subtle yet devious! :)

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  38. clearly the guy was perturbed by your choice of "grandpa gold" car paint. ;-)

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So wadda you think?