While we were playing with a laser light with our dogs, I was reminded of a story about how I was accused of causing a patient’s pneumothorax with a laser light while I was a resident.
During our internal medicine training, senior residents had to run the intensive care unit for several months out of the year. One resident had responsibility during the day on weekdays, several other residents switched off taking call during the nights, and a resident with two interns shared 24 hour call on weekends.
Students often used to jockey for calls based upon which resident was working. Some residents were bears to work with at night, whining about everything and yelling at the medical students. Others did a lot of teaching and let the students assist performing lots of procedures.
So one fateful morning during grand rounds, I happened to notice that one of my fellow residents was falling asleep and doing the head-bobbing thing.
I grabbed a laser light out of my back pack and shined it on his nose. That made everyone around him start giggling. His head bobbing then caused the laser light to hit his eye, which startled him out of sleep and caused him to gasp loudly, let out a muffled yell, and swat his arms around his head as if a killer firefly was attacking his face.
The lecture stopped momentarily while he bent back over and said “Ahhhh. My contact lens!”
When he retrieved his contact lens from the floor, it had been torn and was unusable.
So what does any of this have to do with the pneumothorax?
It just so happens that the sleeping resident was scheduled to be on call that evening. He was one of the residents that the medical students were not especially fond of.
With a ripped contact lens, he wasn’t able to do call, because he couldn’t see without his contact lens.
The only resident that was able to take his call that evening was one of the “nice” residents that liked teaching medical students.
Later that evening, while the “nice” resident was taking call, a patient needed a central line. The resident was teaching one of the interns how to insert the central line and the intern accidentally hit the lung with the needle, causing a pneumothorax – a known complication of central line insertions.
Of course, guess whose “damn laser light” got blamed for screwing up the call schedule and putting the nice resident on call who assisted the intern who caused the pneumothorax.
After that, I just stuck to using spitballs.