Monday, July 6, 2009
Tonight was a tough evening. We had an attending call off at the last minute, and we were swamped. Tons of minor emergencies, on top of lots of serious and complicated patients. One of the minor emergencies was a guy who had gotten a three pronged fish hook in his thumb and then decided it would be a good idea to cut it off down to skin level. What could have been a simple extraction turned into an incision and lots of digging around. The strangest part of his story was that he said he was home alone and would have been stuck in his building if he hadn't have cut the hook. This makes no sense at all, but all patients are lying about something, for some reason. The low point of the evening was this 87 yr old guy who was fairly lucid, but who was on his last leg and who i had to change from full code to DNR and ship back to the nursing home to die. I had to explain all this plan to him, even though his daughter was the power of attorney and he didn't really make the decision. He cried a little, but then seemed ok and just wanted some water, on which he nearly aspirated and died right there soon after I had revoked his full code status! At least he was not totally aware of the situation.