A patient calls his family doctor and gives a history of having chest pain on and off for the past few days. Pain worse with activity. Not having any now. Of course, you know that the family doc is going to send the patient to the Emergency Department. You just know it.
So the patient gets to the emergency department and of course the EKG is normal … and the labs are normal … and the chest x-ray is normal.
Because the patient has no history of chest pain workups, of course you know we have to recommend that the patient stay overnight and have a stress test in the morning.
“You’re kidding. I really have to stay? Everything is normal. Can’t I just go home and do it later? ”
“Well … no … not really. We can’t force you to stay in the hospital, but we really think that it would be a good idea.”
Then you start to second guess yourself. This guy’s in good health. He’s not having pain now. Of course the insurance company is going to call this an unnecessary admit.
Fortunately for everyone, you found a reason to justify the admission.
About 15 minutes later, the alarm goes off.
It seemed like several minutes, but it ended up being more like 35 seconds until this happened.
Had the patient not called his doctor, had the doctor not sent the patient to the hospital, had the patient not been brought right back and place on a monitor, or had the patient decided to leave AMA, he probably wouldn’t be here right now.
Triple vessel disease with a CABG.
Every once in a while those useless workups end up saving a life.
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.