Lightning Rounds!
The following comments were surreptitiously taped sometime in the recent past by a medical student who shall remain anonymous. They are reproduced below in their entirety as a reminder to doctors who endeavor to shine at the art and science of medicine but find themselves under the constraints of time and are tempted to take a short cut through the woods on their way to Grandma’s house (or the golf course).
“Good morning, gang. For those of you who don’t know me I am a medical oncologist in a four-doctor practice here in town. Before we get started on rounds I want to tell you a little story about what happened to me while I was on call last weekend. As you all are well aware, being on call as a resident means you’re trapped in the hospital, so eventually through force of habit you become used to being confined to quarters while your family and pals are out hitting the county fair. When I’m on call though all I have to do is round on the inpatients and then skip out of here and enjoy the sunshine, and since nobody in their right mind wants to spend all day Saturday cooped up on a hospital ward, like most doctors I have taught myself the Jedi master skills of fleet-footed weekend rounding - or so I thought.
“You’ve all come across doctors who blow through their weekend rounds like a Cigarette boat on the lake at sunrise. This unfortunate focus on brevity tends to leave behind patients and families who have no idea what is going on, not to mention progress notes that bear an uncanny resemblance to line twenty-six of the Rosetta Stone. My own technique is to divide the patients into two groups: those who are in the middle of a crisis, and everyone else, designated as ’stable.’ My first responsibility as the on-call doctor is to manage patients who are acutely ill. Until these folks are stabilized I must stick around and make sure the right tests and treatments have been ordered [e.g., heparin-induced thrombocytopenia -Ed.], that the diagnosis is correct [vide thrombotic thrombocytopenic purpura -Ed.], and that the patient’s family has been counseled appropriately. This can put the kibosh on starting my other important weekend responsibilities, but that’s just tough. Whether I’m their primary oncologist or not, unless I fulfill my obligation to these patients I might as well put on a clown outfit and march in the Fourth of July parade for all I’m good for.
“Nevertheless, like most members of my profession I am subject to moments of weakness, and last weekend while rounding on a patient of my partner’s I decided, in the interest of efficiency, to see her without wasting any time reading her chart. I just strolled into her room with my little list of names and diagnoses and found her resting quietly, eyes open, in no identifiable pain or suffering. This looked like a quick ‘how-de-doody-adios’ visit to me. Not wanting to appear uncaring though I decided to break the ice with a little friendly gambit. The dialogue proceeded as follows:
‘Hi, I’m Dr. Hildreth, Dr. So-and-So’s partner, here to check on you. How are you feeling?’
‘Fine.’
‘Good! Have you been walking the halls yet?’
(staring at doctor): ‘I only have one leg, you know.’
“That, Ladies and Gentlemen, concludes my story. I think I can safely say that when it comes to filling out ballots for the All Stars of Medicine I lost one vote that day, not to mention the sheepish grin that hung across my face for the rest of the visit like bunting. I don’t need to remind you all of the lesson I learned, and if you have any sense of mercy you will not repeat this story to your colleagues slumbering blissfully at home on their day off.
“Now let’s start rounds - and may we all use the forward compartment of our highly evolved central nervous systems to restrain the impetuous twaddling of our tongues.”
