Friday, July 27, 2012

PART 2: A brief interruption on Tomas' biology; in which I make the resident doctor wake the attending at 11:00pm

Shortly after the resident left (and she did not come back) the night nurse walked in. I told her about the lab values and she said that made know sense; what she was told at shift change was they were waiting on an improvement in results before he could go home. That's what I took away from the morning rounds as well, so nice to know I am not yet certifiable.

Forty-five minutes later (now roughly 10pm) the senior resident walks in.
"So are you ready to go home?"
"What do you know about what is going on with Tomas?"
After a microscopic pause, "Well, that we were waiting on an EKG to get read, for TPN to be delvered to your home, and for the results of the urinalysis. I'm sorry that all took so long."
"The TPN was delivered around 5, the EKG was confirmed already read at 6, and the rest of this time we have been waiting to see what the results of the UA were, why?"
"We wanted to make sure he wasn't getting any worse."
"That is not at all my understanding of what the doctor ordered. She told me this morning that she wanted to make sure his lab values were trending down and that he was getting better before she let him go."
"Well, someitmes the lab values aren't perfect and they can be off a little here and a little there and sometimes as much as by half a point."

I told a friend that this is like dealing with a used car salesman. You ask how many miles are on the car and they tell you about how great it handles.

"So if I understand you correctly, your lab - the one I trust to run my son's bloodwork isn't necessarily reliable? Not to mention the fact that if you are trying to make me think that, in fact, his urine ph could at this moment really be an 8.5, could it not also be a 9.5; or does the lab only make errors in one direction? What I need to understand and make sense of before I take my son home is why we waited all day to make sure this lab value was trending down. It is not, and aside from the passage of time nothing else has changed so why is it ok for him to go home. What is different."

"You've got me."
"Well, do I "got" everyone in the hospital? Is there not one person who can explain this to me?"
"I could go call the on-call nephrologist back and see what they say."
"I think that is a good idea."

and so exits player two. I have to go again - this time to go pick up my girls from day camp and watch their end of the week show. Be back for part three later. No news on this mornings labs yet.

1 comment:

  1. Alison MulderrigJuly 27, 2012 at 3:00 PM

    Omg I love you! Seriously come give me lessons! Tomas is one lucky boy you are fighting in his corner!
    I have to say you are making me laugh though!