Because the patient was sent in by a staff attending, I usually call the staff docs to let them know that there is nothing wrong with the patient before I send the patients back to the nursing home – just to make sure there are no other concerns the attending docs have. In this case, the nurse ordered a CXR when the patient arrived to look for aspiration (or a tooth in the right mainstem bronchus), and the CXR was abnormal, but the changes were no different from a previous CXR done the month before. Pulse oximeter was fine. There were also some chronic abnormalities on blood testing done the week prior. No acute changes. The patient felt fine and had no complaints. He wanted to go “home.”
So I asked the unit clerk to call the patient’s attending.
One of the nurses rolled her eyes. “Good luck with that. It’s Dr. NoReturnaCall”
Certain docs on the hospital staff have a tendency not to return phone calls from the emergency department on a timely basis. Once it gets to be mid-afternoon, some of the docs just don’t return the calls at all. You page them for a couple of hours and call their office, but they never call back. If you catch the nurse at the office, the standard line is “He’s in with a patient. He’ll call you back as soon as he’s finished.” Well, either the patient has a 2 hour appointment, the nurse doesn’t give the doctor the message, or the doctor is passive aggressive because often we just don’t get that call back. Then, after 5PM the on-call doctor gets stuck dealing with the problem. If you call the on-call doctor before 5PM, you get an earful because it isn’t 5PM yet. Then if you call some of the on-call docs just after 5PM, they’ll tell you to call the doctor who was on call before 5PM because the patients were ready to be admitted before 5PM. Sometimes patients just can’t win.
As the unit clerk started dialing the office number, I blurted out “I’ve got ten bucks that says he doesn’t call back before he leaves for the day.” His usual departure time was about 4:30 PM which was about 45 minutes away.
The unit clerk whipped out her purse and pulled out a crisp new $10 bill.
Then I felt bad. I didn’t want to take her money.
“How about we bet a soda instead?”
“Hell no. You said $10. Now get your money out.”
OK, you asked for it.
“Here. I’ll be in Room 5 if … er, um, when … he calls back.”
I was in the room for 10 minutes, came back to the desk, entered some orders and headed toward the next patient’s room.
“I’ll be in Room 8 when he calls back.”
After another 5-10 minutes … “I’ll be in Room 2 when he calls back.”
By that time I didn’t really care if Dr. NoReturnaCall did call back before 4:30. The looks I was getting from our unit clerk were worth $10 regardless of the bet. She’d squint her eyes, curl her upper lip, shake her head back and forth, and repeatedly look at the clock.
She muttered to one of the nurses “If he doesn’t call back in 10 more minutes. I’m going to kick his ballsack so hard it inverts.”
“Looking at the clock isn’t going to make him call back any quicker,” I said while darting into a patient’s room to avoid thrown objects.
At 4:25, there was a knock on the door.
One of the nurses had a smug little grin and said in her politest little voice while batting her eyelashes … “Sorry to interrupt, Dr. WhiteCoat, but Dr. NoReturnaCall is on the phone for you.”
Oh well, it was fun while it lasted.
Actually, it was fun after the fact as well. As I walked out of the room, the unit clerk was standing up, swinging her arms around over her head, pumping her hips, and shaking her thang like she was trying to do the hula hoop after last call at Smedley’s Tavern.
“Oh yeah. Uh huh. Oh yeah. Uh huh.”
Security guards watching the video feed from the ED must have thought that she was either having a standing seizure or that they were picking up some Bravo! Adult channel.
So I talked to Dr. NoReturnaCall, he had no other concerns with the patient and we called the taxi with the red spinning lights on top to bring the patient back to the nursing home.
Then an odd thing happened. Five minutes later Dr. NoReturnaCall called back and wanted to speak to a nurse. There was a short conversation. The nurse’s end went something like this:
“Yeah. We do odd things like that all the time. It keeps us from getting bored.”
“OK. Talk to you later.”
Turns out that the unit clerk had told Dr. NoReturnaCall that he just made her $10 in a bet. When he asked her what the bet was about, she told him that “Because we sometimes have a hard time getting ahold of you, Dr. WhiteCoat bet me that you wouldn’t return your call before you left for the day.” Apparently, he half-laughed before she transferred him to my phone.
After speaking with me, he called back and asked the nurse if we really bet on whether he would call back.
Was Dr. NoReturnaCall’s conscience bothering him?
Could this be a turning point in his career?
The next shift it was back to business as usual.
Still ended up being $10 well spent.
This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on WhiteCoat’s Call Room, please e-mail me.