Family Med Hospital Week: Rewards

Rounding in the hospital has become very routine now. I spend an average of 30 minutes with each patient, so with morning report ending around 8:00 a.m. and Dr. T not arriving until after 11:00 a.m., I had more than enough time to see my four patients. My favorite patient has to be CH, the man I admitted to the ER on Monday with acute cholecystitis; he had an ERCP done yesterday to remove one of the stones in his CBD and tomorrow he'll have a lap vs open chole to remove his gallbladder. He's eager to get the surgery over with since his wife will be having a knee replacement in a week or two and he needs to be able to take care of her when that happens. My other male patient, JC, is pretty much just waiting to get a brain biopsy for his lesion since there was no cancer to be found anywhere else in his body. My patient who had MRSA in the nose is finally off the nasal cannula and can probably go home in the next day or two. My 84-year-old patient in the CDU is a slightly sadder case; she spent some time today talking to me about how she wants to stay at PMC as long as she can since she has nowhere else to go (she can't move back to her own apt and the nursing home that she came from was not to her liking). This is her third hospitalization this year, and she has hinted that with her husband and daughter already dead, she's at peace knowing that she may not have terribly long to live. This made me sad, but Dr. T is trying to find a good hospice program that will take care of her.

The FP resident comes back tomorrow, and Andie is relieved to go back to becoming a normal med student again (instead of working like an intern as she has been this past week). She did, however, warn us that she won't be proofreading our notes to make sure we put in all pertinent details in tomorrow, so we'll be on our own. I'm not too worried; she's told me tw ice today that my notes are well-written, and I'm glad =) Mani is another story; he asked today how he was supposed to look up labs from the previous day, and Lauren was kind enough to show him. Andie and I exchanged looks that said, "How can he not know?!" I've seen his notes; they're pretty bare except for a few scattered lab values (other values are written in by Andie). Granted, maybe he never learned how to write a note properly b/c he never did a rotation at JPS, but still, this was ridiculous. He wouldn't last long at JPS without knowing how to write a note.

I later found out I didn't do a review of systems when I dictated CH's H&P, so after Dr. T dismissed us around 5:30, I went back to CH's room to ask him the required questions. He wouldn't have been in a state to answer them on Monday b/c he couldn't stop vomiting, but he sure was able to answer them now. "I like talking to you," he said. That made me feel good about what I'm doing =)