So I was on call yesterday.
And I'm sitting in the office upstairs when around 19:00 pm the nurse calls me from the ER and says:
"There's a man.. he had a car accident and afterwards he experienced strong chest pains"
So I reply
"Ok... do an ECG and I'm right there"
Because the way she said it seemed like his chest pains started AFTER the car accident and I thought there was a slight possibility of an MI, that I wanted to exclude before proceeding with the rest.
So I walk downstairs and I find a man in the surgery lying down and the ECG on my table labeled:
"Mr Sir Something, Age: ? "
and instead of asking what the heck the "?" was doing on a formal piece of paper I notice a right branch block.
I asked the patient where he was hurt and he said that just his knees hurt a bit.
My attending asked me in a casual manner to take the ECG to the cardiologist just so he sees it, to be on the safe side.
So I walk in the super-cool, super-smart, busy cardiologist's examining room with a smile on my face and he turns to me and says:
"Oh there's HIS ECG!!! And where is the x-ray?"
is he super-cool, super-smart, busy AND psychic too?
"This is the ECG of a man in a car accid- what? What x-ray?"
"Yeah, I KNOW. Where the hell is his chest x-ray?"
"Uhmmmm I don't have one ordered.."
"So a man gets hit in the chest and you don't have an xray ordered?? Don't you have pneumothorax or other trauma in your Δ/Δ???"
*now I'm totally lost*
"uhmmmm I don't think heeee"
*the usual nurse jumps in screaming AS USUAL:*
"HE TOLD ME HE GOT HIT ON THE CHEST WITH THE WHEEL! HE TOLD ME!"
*I look up to my friend fellow resident in Medicine, standing right behind the doctor- she is trying hard to fight back a laugh*
"uhmmm he's actually fine.... in fact he's leaving.."
"Get an xray."
*he's obviously pissed with me*
"Always get an xray"
*she can't hide her laugh anymore, she hides behind her hair*
"My attending is next door... you don't really think I can walk up to him and demand the patient stay till he gets an xray..?!"
"whatever. first you exclude surgical trauma, then you ask for a cardiologist's opinion"
*okay- something has happened in my absense and it's very wrong*
"I didn't.. they told me he had chest pains AFTER the accident and I just asked for an ECG to be safe.. was that wrong of me?"
"No.. YOU- did the right thing.."
*I tried to leave before he exploded*
After a couple of minutes I asked the Med girl what had happened.
She told me...
When I asked for an ECG, the nurses fired an MI alarm and had the cardiologist downstairs in no time...
The way it seemed, the "surgeon" hadn't bothered coming down for a car accident, instead, the surgeon"ordered" for a cardiology consultation.
She actually heard him protest outside in the corridor while she was sitting in her own examining room.
"So now the cardiologist is the first one to admit a car accident patient??"
If you work in a small hospital, on a small island town, where an MI is a rare event people talk about for a few days, then you'll know what I mean and why this is funny...
...she said his curly hair straightened up.
I spoke with him afterwards and explained myself.. he said:
"You did right, it's ok... no one can deal with the paranoia in this place."
... I don't think he or the nurse laughed as long as we two interns did last night before bed...