I See You

After a week and a half of scrubbing into surgeries lasting for less time than it takes to scrub in AND providing as much entertainment and education as an old bandage, I finally get to witness a big case: a total colectomy with ileoanal pullthrough.

After scrubbing in for a total of 5 minutes, Senior Resident Spidermonkey tells me to scrub out and help Intern Teddybear.

WTF?

Intern Teddybear sends me off to do a consult because he "needs to leave and doesn't want to be stuck here all day".

Up in the ICU, I find a chart 6 inches thick. After an hour of wading through indecipherable handwriting, I reach the tentative conclusion that Patient has PNA, got a chest tube, but nothing's coming out. IR had written, "start tPA if not draining after 1-2 days". It's been 3 days.

A resident wanders by. She happens to be part of the primary team. However, she has no idea what's going on. "We didn't consult you, why are you here?" she asks.

Eh?

After much confusion and frantic pages to Intern TB, she finds the order in the chart. "Oh," she says.

She doesn't know anything about the tPA. "Can I assume you're not giving it?" I ask.

"Yeah."

The rest of her team wanders up. "What's going on with the tPA?" I ask, "Maybe we can try that before we proceed with something surgical?"

"It's not going to work, we're not going to give it."

Intern TB's long gone by now, so I chief to Resident Buschka and Dr. Flowerchild.

Resident Buschka, "The ICU team here is useless."

Dr. Flowerchild, "We're gonna start tPA."