epsilonprodigy

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You can either choose to laugh or howl in despair. Me, I choose to laugh. Whether it's AT or WITH people is another story.

The other night, I got a 3 am call for a "possible bowel obstruction." Radiologist read "dilation of bowel." Pt having pain. OK, sounds legit so far. Tolerating PO? Yes. Hmm...okay. Passing gas? Well, more than gas actually. Profound diarrhea and stable pain for 5 months!

This is about when S.O., sleepily hearing half this conversation and quite done with being awakened in this way, barged through the bedroom door and said loudly, "DIARRHEA IS WHEN TOO MUCH COMES OUT. THIS IS THE OPPOSITE OF AN OBSTRUCTION, WHEN VERY LITTLE COMES OUT! Do we need to go over it again?!"

Of course I had to apologize profusely to the poor ED doc, (who heard the rant loud and clear) and go see the patient anyway, but...really?


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doc05

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What's funny is a junior resident taking call from home and still complaining.

And diarrhea in the presence of an obstruction happens. Fairly often
 
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ACSurgeon

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You can either choose to laugh or howl in despair. Me, I choose to laugh. Whether it's AT or WITH people is another story.

The other night, I got a 3 am call for a "possible bowel obstruction." Radiologist read "dilation of bowel." Pt having pain. OK, sounds legit so far. Tolerating PO? Yes. Hmm...okay. Passing gas? Well, more than gas actually. Profound diarrhea and stable pain for 5 months!

This is about when S.O., sleepily hearing half this conversation and quite done with being awakened in this way, barged through the bedroom door and said loudly, "DIARRHEA IS WHEN TOO MUCH COMES OUT. THIS IS THE OPPOSITE OF AN OBSTRUCTION, WHEN VERY LITTLE COMES OUT! Do we need to go over it again?!"

Of course I had to apologize profusely to the poor ED doc, (who heard the rant loud and clear) and go see the patient anyway, but...really?


Sent from my iPhone using SDN mobile

As an attending the call goes like this "we are admitting this patient to medicine, labs and vitals are normal, we are getting an NG tube in, and you can see him in the morning".
 
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Winged Scapula

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Not sure what your SO does but one of you should read about overflow diarrhea in obstruction.

BTW if he's tired of you getting calls at home 6 weeks into internship, how's the next 4.8 years ( not to mention the rest of your life ) going to play out?
 
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Gastrapathy

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As a PGY2 taking home consult call, the most dangerous thing you can do is adopt the arrogant attitude that the person calling you is incompetent, and minimize/deride a consult over the phone.

Is this a thing?

I've said before that the most dangerous doctor in the hospital is a bad surgery R2. But home call? Who knew.
 
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Dr.LeoSpaceman

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I've not seen it, and would agree that it seems like a bad idea.

Our hospital's volume of surgical consults overnight would make that completely untenable.

The chiefs took home call for the VA but that was with a junior in house.

We have 2 services where the 2nd year takes home call as the most senior person on service. It's a numbers/manpower issue, and one of them is fairly light while the other has significant attending involvement. Agree though that on any of our core general surgery rotations it would be impossible.

A couple of the surgical subspecialties at our hospital do take home call as a 2, however (plastics, ENT, uro). They cover multiple hospitals overnight, and it generally seems like a pretty terrible existence.
 

Dr.LeoSpaceman

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You can either choose to laugh or howl in despair. Me, I choose to laugh. Whether it's AT or WITH people is another story.

The other night, I got a 3 am call for a "possible bowel obstruction." Radiologist read "dilation of bowel." Pt having pain. OK, sounds legit so far. Tolerating PO? Yes. Hmm...okay. Passing gas? Well, more than gas actually. Profound diarrhea and stable pain for 5 months!

This is about when S.O., sleepily hearing half this conversation and quite done with being awakened in this way, barged through the bedroom door and said loudly, "DIARRHEA IS WHEN TOO MUCH COMES OUT. THIS IS THE OPPOSITE OF AN OBSTRUCTION, WHEN VERY LITTLE COMES OUT! Do we need to go over it again?!"

Of course I had to apologize profusely to the poor ED doc, (who heard the rant loud and clear) and go see the patient anyway, but...really?


Sent from my iPhone using SDN mobile

Sounds like nothing. Or a malignant obstruction that's been progressing for 6 months. Hilarious!
 
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TheFender

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Got a consult a couples years ago at the VA to remove a central line on a Friday night. Definitely gave the IM resident instructions over the phone on how to take it out himself
 

Winged Scapula

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We have 2 services where the 2nd year takes home call as the most senior person on service. It's a numbers/manpower issue, and one of them is fairly light while the other has significant attending involvement. Agree though that on any of our core general surgery rotations it would be impossible.

A couple of the surgical subspecialties at our hospital do take home call as a 2, however (plastics, ENT, uro). They cover multiple hospitals overnight, and it generally seems like a pretty terrible existence.
We took home call as a PGY2 on plastics which was a farce because you basically came in and stayed all night anyway.
 
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Winged Scapula

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Got a consult a couples years ago at the VA to remove a central line on a Friday night. Definitely gave the IM resident instructions over the phone on how to take it out himself
I was about to say,"doesn't the nurse take it out?" and then I remembered you said it was the VA.
 

vhawk

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We took home call as a PGY2 on plastics which was a farce because you basically came in and stayed all night anyway.
Yeah our entire pgy2 year was q3 "home call" with chief backup. What that meant was you never ever left the hospital and you only ever called the chief if you were taking something more complex than an appy to the OR. Oh and also that you sure better not even hint avout going home post call the next day. I mean, you were on HOME CALL what are you complaining about
 
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DoctwoB

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We have 2 services where the 2nd year takes home call as the most senior person on service. It's a numbers/manpower issue, and one of them is fairly light while the other has significant attending involvement. Agree though that on any of our core general surgery rotations it would be impossible.

A couple of the surgical subspecialties at our hospital do take home call as a 2, however (plastics, ENT, uro). They cover multiple hospitals overnight, and it generally seems like a pretty terrible existence.

Can vouch for this. Took home call from pgy2 on in uro covering 6 hospitals including triaging patient phone calls. No sleep, no post call day, driving between hospitals calling back pages using Siri. I envied my general surgery colleagues their q3-4 in house + post call day schedule.

It evens out though as our chief/back up call is a cakewalk in comparison. Most of our overnight issues, scoping foleys, stent for infected stone, priapism, etc. can be handled by the junior alone.
 

Buzz Me

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We took home call as a PGY2 on plastics which was a farce because you basically came in and stayed all night anyway.

I took "home call" for all three years of fellowship. There were also quite a few in-house calls as a junior fellow as well (sometimes as often as Q3). You can imagine how much time we actually spent at home.
 
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akwho

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I got a consult for "AT and TP trunk occlusion" in a patient with a BKA. WTF.

50% chance of being documented in the consulting services note as 2+ DP pulse (or the Deep Peroneal pulse which is what the idiots who wrote my Step 3 exam think DP stands for).
 
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ThoracicGuy

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