IM: Leaving AMA

This morning in the middle of rounds, I learned that our Budd Chiari patient left AMA yesterday afternoon. My first thought: "Oh crap, Jordan's going to be pissed." Nanette echoed the same thoughts when I told her about it later, and when I told Jordan (who'd been hoping that the "ID" by our patient's name was a mistake), his reaction was pretty much what I expected: "F***!!!" There was another FP resident in the room, and he and Jordan began discussing other patients they'd seen who were really sick but still left AMA ("the idiots"). Jordan's concern was that our patient's liver was really shot, and that he was going to die faster without more workup to see how we could treat him. He then talked about how he stayed behind an hour after everyone left to work up "that buttmunch" and how it was all worthless now. *sigh* Even still, he told me to expect our patient to come back as a bounceback, b/c once the liver starts failing worse, the patients become more frantic and in need of medical attention. Of course, seeing how he's been going to Mexico for all his treatments, maybe he won't come back after all. "Is JPS really worse than Mexico?" someone joked. Maybe; from what I saw in Ojinaga, if you have the money, you can get excellent care in Mexico.

Nanette got more details from the day nurse; it turns out the patient left b/c his family wasn't satisfied with his diagnosis and his sister wanted a second opinion. She said that she went to Harris once and was well taken care of there, so she wanted to take him to Harris for that second opinion. Apparently, however, Harris doesn't do well with patients without insurance or already have JPS connections, so if he doesn't get cared for there, hopefully he'll come back to JPS b/c with all his conditions he's a walking time bomb