IM Sub-I: The "New" Blue Team

This week, with Greg moving on to the ICU and Dr. C on vacation, we gained a new attending and resident, both of them female (making Zack the only male on the team). The attending, as I mentioned before, was one of the chief residents last year; she introduced herself as Amy so I guess that's what I'll be calling her. Our resident, Angela, was late, way late; despite numerous pages, she didn't even show up until after we were finished rounding (almost 90 min after we started). Amy said that Angela's lateness was nothing new (apparently she's not punctual at all), but this was ridiculous.

We had two patients who needed biopsies today: a liver biopsy (my patient) and a FNA on a neck mass (An's patient). Before rounds, one of the nurses told Yan and me that our liver lady's biopsy would have to be ultrasound-guided instead of CT-guided because CT-guided biopsies require the presence of a mass (which our lady doesn't have; we think she has hemochromatosis). Yan had to change the orders. Later we went down to the radiology department after it looked like the FNA on the neck mass would be cancelled, and we made sure the order was put in. The radiologist offhandedly mentioned that the CT scanners were empty and that these cases should proceed quickly, and for some reason Angela thought that my liver lady's biopsy would be CT-guided.

"No, it's ultrasound-guided," I corrected, and An said, "No, the FNA is ultrasound-guided. The liver biopsy is CT-guided." I said, "No, it's not!" and Yan looked confused. I knew I was right, and I didn't understand why An and Angela thought the biopsy would be CT-guided. This was my patient. I came very close to losing my temper (something that never happens on rotations), but I kept my cool and muttered, "Fine, I'll keep my mouth shut." Angela said, "No, we have to clear this up. There's too much confusion." So once again, I said, "The nurse on the floor said that her biopsy can't be CT-guided because she doesn't have a mass. It has to be ultrasound-guided." Another nurse walking past us heard me and confirmed that I was right, and I couldn't help but say, "See?" *sigh* Greg was right when he said that we'd miss the way our team used to be. The "old" Blue team really was a dream team. At the very least, there was never any confusion or arguing because Greg was always on top of everything. He always had his facts straight. Yan felt the exact same way; she, An, and I (not sure about Zack) all miss Greg.

We were on call today, and I got my first patient around 4:00 pm. Yan said that we'll have to see him together b/c he was apparently "very sick" and yet ICU rejected him. Speak of the devil, Greg walked into the dining room just as Yan and I were discussing our patient, and Yan asked him why ICU turned the patient away. "It'll be a good learning experience for you," said Greg, and we soon learned what he meant. Our patient had a LONG list of medical problems (i.e. DM, CAD, bilateral AKAs, A-fib, to name a few) and presented with something vague like fever and weakness. His lungs sound like crap, and he definitely has a pleural effusion. An didn't get her first patient until 7:00 pm, so to be fair, Angela decided to let us go after one patient each. This was the earliest I've ever left on a call day, so I was happy =)