It was a great day. It was a bit of a mad house. Lots going on and I just kind of flew solo for a most of the day. Rounding on kids. Discharging kids.
I've learned a few lessons in the past few days.
-don't ignore my nagging gut feeling
-ask smart people when you're stuck
I've had 2 teens lately with unusual medical problems. While they have both been on my team, I haven't been rounding on them directly. For reasons that are not worth mentioning.
One of them went home, better.
One of them is still in the hospital, getting worse.
And it has just been pissing me off.
Part of it has been the pedi mentality, taking time, not being aggressive in work up and treatment. And I just wasn't going to be able to leave work until I felt like we were finally getting a clue as to what the hell is going on with this person. There are specialist on the team already, but things just weren't moving along. I decided this morning that I was going to cross a fine line and go to some of my adult medicine attendings for ideas. It's taboo to consult adult docs for pedi patients. But I'd reached my limit of being passive and waiting for badness to happen and decided I'd deal with the consequences later. My plan had been to pop into the Chair Of Medicine's office (who is likely smarter than Dr House) and bow my head in disgust that we'd done a sub-par work-up thus far. Her health is worth a lot more than my pride.
But at the last minute I decided to ask another adult specialist his opinion, and he had some ideas. We talked for a while. He was a bit concerned about our lack of progress, and asked if he could see the patient, as a formal consult. That's pretty unusual. Nobody looks for more work.
He saw the patient, and likely has figured out what's going on, and gave treatment plans as well. All of this starting at what should have been the end of his day.
I feel good tonight. I don't feel good because I think we finally have a clue. I feel good because this patient is finally getting the care they should have been getting.
And I'm a bit embarrassed. This medicine attending stay late today to help. Why haven't we-the resident taking care of her-worked as hard the past few days to figure out what's going on???
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