IM Sub-I: Short Call A

This morning I saw three patients (a fourth one was supposed to leave, but she ended up staying because she had "grossly bloody stools" and we wanted to have GI look her over) and had plenty of time to kill before rounds. It turned out morning report was at 8 a.m. instead of the usual 9 a.m., but I missed the memo b/c I wasn't in the computer system (the drawback of being a visiting med student). Erin, one of the chief residents, added me to the list at my request, so next time I won't miss morning report (hopefully). My noncompliant patient was supposed to get an MRI yesterday, but he turned it down for the third time b/c he was claustrophobic and insisted on getting complete sedation before submitting to the MRI. Since his blood cultures were clean and his white count was falling, we decided to forgo the MRI; chances are he doesn't have osteomyelitis. Today was Short Call A, so Greg had to admit 4 patients to our service before noon (and he got all four in before morning report b/c they were "hand-offs.") Tomorrow is Zack's birthday so he asked to take the day off, but then we hit a rut: tomorrow is Short Stay B, when we admit 4 patients in the afternoon, and Yan has clinic in the afternoon, leaving our team without an intern to help admit patients. Zack looked really upset and said he'd cancel his birthday plans, but Greg said no and suggested that Zack find someone to cover for him. That definitely would have sucked if Zack had to come to work tomorrow after making all these plans (family was driving to Texas to see him, apparently), so I hope it worked out. For the rest of the afternoon (until about 3:00 pm) I helped Yan with writing prescriptions and transfer orders, getting to know more about her in the process. We managed to finish early while An and Zack were still working on their patients. One of An's patients, a bipolar guy with DKA, was supposed to go home today, but he didn't want to b/c he didn't feel as though his "psych" issues were treated. We had gotten a psych consult and they'd cleared him for discharge (the only adjustment they made was increasing his Lamictal) and he didn't think that was enough. "How can you discharge me without knowing if the medicine works?" he asked. "I don't like this. I really don't like this. This hospital is gonna get sued." Later on he threatened to commit suicide if he was discharged, and his death would be on his hands, so we had no choice but to let him stay. *sigh* He'd better not pull the same stunt tomorrow; every team caps at 19 patients and we currently have 16. We need to get some of these patients out of the hospital, soon. When I got home, I met Beth, the girl who's renting the room next to mine. She seems pretty nice so far, and I've already said I'd bring back some Odwalla drinks that I can get for free in the physician's dining room for the two of us to enjoy =) Nothing like bonding over drinks =P