Glucometers for Everyone
Two weeks into the current rotation I find that the hardest thing about being a resident is keeping all these different patients and all their coexisting medical conditions straight in my head. As we round each morning through twenty to thirty patients for whom I am personally responsible, they all seem to blend together and become one big mega-patient. This one has Diabetes, this one has hypertension (high blood pressure), MS (Multiple Sclerosis), Chronic heart failure, chronic kidney failure, chronic chronic chronic. Whatever they have, it’s chronic!
To counteract the onslaught of mega-patient I have developed a new and seemingly effective “pre-emptive” response.
I now assume everyone has Diabetes, Hypertension, Hypercholesterolemia (high cholesterol) and snorts cocaine. The reason for this is obvious: Every patient in this hospital HAS Diabetes, Hypertension and Hypercholesterolemia and nearly everyone has snorted cocaine or is currently shooting it into their IV line. If they don’t have these conditions, then I’m sure they will at a later time anyways. This effectively cuts short the list of diseases and addictions I have to remember by four and usually will leave only one to two additional conditions.
Morning rounds now go something like this:
Intern: “Ms. D is a 34 year old woman who came last night complaining of severe pain in the abdomen, we think she has a urinary tract infection”.
Me: “What are we giving her”
Intern: “Bactrim” (A type of antibiotic).
Me: “How much insulin is she getting?”
Intern: “She’s not diabetic”
Me: “Won’t the Bactrim interfere with her Hypercholesterolemia?”
Intern: “She has a normal lipid panel, she’s doesn’t have high cholesterol”
Me: “Even with her Diabetes?”
Intern: “She doesn’t have Diabetes!”
Me: “What’s she getting for blood pressure control?”
Intern: “She’s not hypertensive!”
Me: “Even with her Diabetes and Hypercholesterolemia she’s not hypertensive?”
Intern: “Stop it”
Me: “Have we talked with her about rehab?”
Intern: “How many times do I have to tell you that she doesn’t do coke!”
Me: “Oh yeah, what’s that white stuff under her nostrils?”
Intern: “That’s a milk mustache from breakfast”
Me: “Who gave her cocaine for breakfast?”
Intern: “I give up”
Me: “It's about time!”
Poor Big H, she's a burning match in a world without oxygen.
She’ll understand next year.