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LIGHT ELEMENTS
Year : 2003  |  Volume : 4  |  Issue : 1  |  Page : 9 Table of Contents     

On-Call Bad Luck


Date of Web Publication22-Jun-2010

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How to cite this article:
. On-Call Bad Luck. Heart Views 2003;4:9

How to cite this URL:
. On-Call Bad Luck. Heart Views [serial online] 2003 [cited 2021 May 11];4:9. Available from: https://www.heartviews.org/text.asp?2003/4/1/9/64508

I was recovering from my cold, but when I went on call again, it got worse, so I figured, I should rest. Interns are human, too, and when they get sick, they need to rest, like everyone else. But how could an intern rest? Being on call is very exhausting, especially if you're sick . . . and they wake you up for an admission. Last time I was on call, they woke me up at 6:30 A.M. for an admission . . . the nurse was telling me "New admission" but I was in denial. I heard her, but I kept on saying, "What?" I wanted to make sure I wasn't having a nightmare . . . then I got up . . . the patient had COPD; talking made him breathless, therefore he spoke slowly and delayed me further. It took me a long time to finish the history . . . and so I was late for the morning report . . . which was my turn to present that day.

While I was presenting, my bleep kept on ringing and interrupting me. I ignored it; it rang several times but I did not touch it. Finally, my specialist came barging into the room looking for me. He wanted the patient's file, which I was using for presentation. "Where is the "new admission" file?", he inquired with some irritation. I handed him the file. He seemed determined to make my life harder. He wrote an order for the intern (me) to do ABG TID !!! The patient was an old man, fat, fragile with very weak pulse . . . how in the world was I expected to do ABG TID in such conditions and for how long?

Usually, post-call for me is the worst day ever. Other days, I finish earlier but now, 3 times in a row, I have been finishing late, working continuously without time to rest or sit! Usually, post-call interns and residents go home earlier than other days, but for me it's the opposite.

Once, the day after my call duty, when I was supposed to go home early, all my colleagues, including the resident, disappeared early. I was the only intern still working in the ward from my team. Every few minutes, the nurses came to me with lab results and complaints of patients under the care of other doctors. I helped with some, but others were beyond my skill and knowledge. I recommended calling the resident on call. I was also exhausted and tired and sleepy.

To make matters worse, I seem to have Bad Luck. All my patients are either admitted with complications or get complicated later. Even if it seems a simple diagnosis on admission, complications just have to happen- sooner or later.



For example:

  • The Aortic Dissection patient looked OK, but where did the dissection reach? - all the way down to the mesenteric arteries. I hope he survives.
  • I had a patient with COPD, who went into Hypoxia and was shifted to MICU for intubation and respirator. He improved later, fortunately.
  • I had Pyrexia of unknown origin. His bed was located in "no man's zone." Each team assumed on the first day that he belonged to the other team. The nurse told me that I should take over his care. I agreed. All the work up was negative. His fever settled spontaneously after two weeks. He went home against medical advice, without finding out what caused his pyrexia.
  • I had a Bedouin patient with simple diabetes who, with his whole aggressive, impatient, and demanding family bugged me every minute with thousands of complaints. They gave me a headache, which did not respond to 500 mg of Paracetamol. He converted the room into his own private majilis (living room), and was always packed with visitors. Even though he was under my care, I never could examine him because his room was full of men who refused to get out of the room for me to examine the patient. I finally asked one of my male colleagues to examine him and complete the file. He had 7 pots of coffee and 4 pots of tea on the floor. He was entertaining guests with dates and fruits. His blood sugar was hard to control with all the sweets he ate with his guests. He disappeared from the room daily, but some of his relatives stayed in the room waiting for him. They told me he goes to visit family and friends. Once, his wife told me that he went to say good-bye to his mother. "Is his mother traveling?" I asked. She said: "No, but he thinks that he may die in the hospital without saying good-bye to his mother." He stayed in the hospital only 4 days, then, left against medical advice because he wanted to go with friends to hunt for "Hobara" birds.
  • A-V Fistula, which is supposed to be very simple, had soooooooo many problems. His hospitalization is prolonged, and still isn't discharged.
  • An old lady was admitted at 11:30 P.M. with hemiplegia to our team. She also had shortness of breath and ST-T changes on EKG. Then, there was a dispute between the cardiology registrar and our registrar on whether the patient should be under cardiology or medicine. This discussion went on until 3 A.M. My friends on call wanted to go to sleep at 1 A.M. They blamed me for the delay. Finally, the cardiology team agreed to take over the care of the patient, but there was no vacant bed in cardiology. The patient stayed in our ward under cardiology care.
  • A geriatric bedridden patient with Pneumonia and grade 4, foul smelling, deep bed sores was admitted to my team. His infection reached the bones. He died of sepsis in two weeks.


I never had a patient whose hospital course and care I was satisfied with. My friends don't have problems like mine. In fact, they tell me to stay away from their cases! Because whenever I looked at them, they get problems. Do I have the "bad eye"? I will consult my grandmother. She is a strong believer in the "bad eye."

I once went with one of my friends to Radiology department; one of her patients needed CAT scanning and the radiologist was upset. He said, This patient has this and that and this and that. . . bla. . . bla. . . bla. He asked my friend, "Who are you?" My friend answered, "Intern." And he said, "I don't want to discuss this problem with an intern. Interns are useless. Send me your consultant or specialist to come here." My friend felt insulted. She cried. She complained to our senior staff but she was told, "Ignore him, he is always like that!"

Another friend had to go on a trip for a week but she had some patients. I agreed to cover for her until she came back. She had 2 bedridden patients, one patient with renal failure, and one patient with pancreatitis. "The Pancreatitis maybe discharged soon", she told me before she left. When she came back I gave her the bad news, "Your pancreatitis patient is still with us. He has more than pancreatitis. He has metastatic cancer." My friend was shocked. I felt sorry, not only for the patient, but also for my friend. I continued updating her about her patients anyhow, "Your renal failure patient isn't doing well either." To lift up her moral, I told her that one of her bedridden patients was discharged. Unfortunately for her she got a very complicated case immediately after her return. So, I am not the only intern with bad luck. She also has the Bad Luck spell cast upon her. Now she is like me. All her patients are complicated. I wonder which one of my colleagues will have the Bad Luck next week.




 

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