Tuesday, October 23, 2012

Memories...

When I was in residency, there was a married couple in the program, Peter and Stephanie. They were often on call together, one supervising ICU and the other wards, or vice versa. Both were seniors, and I was just starting out.

One night when I was working with Peter, there was a code. Both on-call teams ran to it. Since I was the junior resident my job was to stay out of the way, but look like I was doing something important. Like leaning against a wall to keep it from collapsing.

Peter and Stephanie were at the head of the bed. She was setting up to intubate the patient, and Peter was watching the heart monitor and calling for meds (they were REALLY into this sort of shit. Another resident once told me that codes were probably their idea of foreplay). At one point Peter tore off a rhythm strip, handed it to me, turned back to the bed and yelled, "Sweetie! Can you intubate him now?"

There was a (pardon the phrase) dead silence.

The code stopped for a few seconds and all eyes were on the married couple. Finally, Stephanie said (with icicles on every syllable):

"Don't call me 'Sweetie' during a code."

Then she intubated the guy, and the code continued.

I don't remember if the patient made it, but I know I almost lost it.

20 comments:

jimbo26 said...

Ouch .

Allison said...

Awesome. I knew I could count on you for a good story before my exam today :)

Maya Resnikoff said...

So this is what a double-doctor marriage needs to navigate. (Is'm rather more familiar with double-clergy marriages, myself.) I guess some issue (home-work boundaries) are universal, when you and your spouse are in the same field...

Ms. Donna said...

LOL. I am glad everything went normally after that. Was the PT OK?

brent said...

At least three women didn't turn to intube the patient (we hope).

Crazy RxMan said...

Better it was said at work instead of the bedroom...

Packer said...

So they were really into this shit, oh, you mean like really into saving the life of someone checking out or am I missing something there. I kind of like doctors who are into that kind of shit. But hey that is just me....

C said...

Awww, oops.

Mari-Ann said...

I wonder if they are still married. I guess a two physician married couple has better than average odds for their marriage surviving.

Anonymous said...

Excuse me, but everyone is missing the point. What did the rhythm strip show?

Brent - that was the best. It would have been very funny if one of the nurses (male or female) said, "OK, honey."

In medicine, people who "like that kind of stuff" are people who enjoy sheer panic interupting their otherwise busy, but humdrum routine. These people go into critical care or emergency medicine. Not everyone enjoys these moments of panic and terror. They go in to neurology.

Tricia

legalalien said...

Brilliant. I hope he had the mick taken from every doctor and nurse for a good while after that!

Anonymous said...

Reminds me of a 9-1-1 dispatcher who was working fire one night. The dispatcher was speaking with his wife on the phone. The radio squawked, "Engine twenty two in quarters, available." The dispatcher pressed the push-to-talk and said, "Just a minute, honey."

Anonymous said...

Peter and Stephanie might have become cardiologists or CT surgeons, if they liked that constant code and Life Flight emergency procedure, high adrenaline stuff. Thankfully, some people do like that, although I can't imagine why people do.

Charles said...

wow. Doc, I know that you meant this post to be funny. BUT, what was her tone of voice?

Is there anyway that this could have an impact on the patient? What if just a couple of seconds delay, while the couple "debate", caused harm to this or any patient?

As a patient, I am somewhat annoyed when a dentist or doctor and the assistant have a casual conversation as if I am not even present. In an emergency situation ALL of their attention should be on the patient. ALL of their attention, not just some.

Perhaps, it is best if partners, spouses, etc, do NOT work together in an emergency situation to avoid this kind of crap.

Or am I asking/expecting too much?

Anonymous said...

@ Charles; Reality isn't like TV. Look at the actual success rates for CPR and ACLS before you assume that harm was done to the patient because on doctor took a couple of seconds to talk with another. Far more harm would be done if both doctors had showed up for the code along with a butt-hurt admin type who said 'OK, everything on hold. Dr A and Dr B can't work the patient together because they're married. Everyone just take five while we get Dr C'. On the up side though, Dr A or B wouldn't have been married to Dr C and couldn't have accidentally made small talk...

Charles said...

Wow Anon @5:01, are you ever putting words in my mouth!

I didn't say nor was I suggesting that someone "wait while we get another doctor up here." (and WFT? I assumed nothing, merely asked a question)

I was just wondering if - from the get go - it would be best if folks who have such a relationship should not be assigned to work together.

The fact (if it is fact and not artistic license on Dr Grumpy's part) that this person took a second to say something contentious and unrelated to the emergency work at hand could be problematic.

It would have been better for her to wait until AFTER to say something. "Picking a fight" in the middle of an emergency strikes me as a bit unprofessional (and that is part of what makes Dr. grumpy's story funny, isn't it?)

P.S. and reality is like TV; I saw a show on TV last week that said so!

Anonymous said...

@Charles - yes, you are asking way too much. We do codes in the ER on a routine basis, of which the great majority are unsuccessful. Most of the time we are just going through the motions. We do this day in and day out many hours a day. We are human and we do have casual conversations many times and it has absolutely no impact on our routines that are very routine and monontonous- we are often coding the older person with chronic hypertension, high cholesterol, diabetes, etc,. It is highly unlikely we are going to fix them no matter what tv makes the public like to think.

Volunteer at your local ER and you will likely change your view of this.

Anonymous said...

I'm only the pharmacist at the CODE and while I might be busy recording information, or mixing a drip on some CODEs, far more the majority are routine in the way that a trained person evaluates responses, looks at patient, clock, monitor, and attendees, focusing on protocols, and we can use a casual observation to cut the tension generated.

Personally, I use a few good Our Fathers to settle my nerves, but in the CODE situation, we are all hyper-alert, on the same page, and it's not unlike a challenge (I was going to say the highest form of a game in which the patient is a participant, but some might take offense) where we're all reading each others' minds about what is needed next.

Several CODEs I've participated, we all broke into Amazing Grace at the point of transition, with tears streaming whether the CODE went one way or the other. I prefer to think of the patient as my relative for whom I've come to help at a critical time.

Vicki said...

Talking of mutually married doctors, the neurologist who told me it was better to commit suicide when I was in so much pain from my constant migraine that I went to the ER for morphine (she refused to give me anything, ever, as an abortive ) was actually married to the famously-loved neurologist who was the seizure specialist at the hospital. Later, after too many complaints (including mine), she was fired, but he is still going strong and as popular as ever!

Anonymous said...

I'm betting that the patient didn't make it that day.....and that he wasn't the only one.

 
Locations of visitors to this page