What the **** is wrong with some of our colleagues?!

[Zebra Hunter]

So below is a bizarre interaction I had with an anesthesiologist who is the daughter of a pt of mine.

So working a relatively normal shift, when I get word from my charge nurse that a doctor has parked in the ambulance bay reserved for priority 1 EMS and has wheeled in their father through this entrance demanding he be seen immediately by our “stroke team”. I ask the nurse if he has any deficits, which she replies “lol, no, the report she gave was that he was confused and now he is back to normal.”

They put him in one of our back rooms rather than putting him in one of our resus bays, which I am told infuriates her more.

So I purposely wait 20 minutes to see them because I want to establish that she will be seen on my time, not hers, also I had other pts to evaluate, as well.

I finally walk into the room to see this incredibly pleasant 80yo who is smiling at me as I walk in, and his 40 yo Karen of a daughter with her MD badge on that is pacing back and forth in the room.

I introduce myself to both of them and I quickly and thoroughly perform a full neuro exam that my med school neurologists would be proud of, sans tuning fork. Of course it is all normal.

The story is 40 minutes prior to arrival he began to have some word finding issues (while pt interjects “I was looking for my damn computer, but I briefly couldn’t remember what the name for computer was”.) He also apparently forgot the name of one of his grandsons (“I always forget his name” he interjects again). Because of this, his wife called their daughter who told them to rush him to the ER 30 minutes away from them (bypassing numerous ERs on the way), so that she has access to the hospital he goes to. This confusion episode lasts all of 10 minutes. He does have a hx CAD and HTN, so a CVA/TIA workup isn’t completely unreasonable, given I was not there when he was reportedly symptomatic.

I then state “I understand you are concerned for a CVA, you can rest assured that it is very unlikely he had a stroke based on the reported symptoms, the length of symptoms, and his current exam. Certainly TIA is possible, however, nothing that has been reported seems to be focal. I think it also could be delirium from something like medications or infectio…”

“ITS NOT DELIRIUM!!!”

“I’m not saying this is my definitive diagnosis, I’m just giving you my differential, and mild delirium can frequently presen…”

“I’M A DOCTOR, I KNOW WHAT DELIRIUM IS, THIS IS NOT DELIRIUM!! HE’S NOT SUNDOWNING, HE DOESNT HAVE DEMENTIA, HOW IS THIS CONSISTENT WITH DELIRIUM? His symptoms were ACUTE!”

“Ma’am, delirium typically presents acutely, I think you are confusing dementia with delirium.

“I ALREADY TOLD YOU IM A DOCTOR, I KNOW WHAT DELIRIUM IS! WHERE IS THE STROKE TEAM!?”

“You’re looking at it, and like I have already stated, he is not currently having a stroke. I think we are getting a bit ahead of ourselves, however, regarding diagnoses. I plan to get some cerebral imaging and some labs and we will reassess things in a bit. Now tell me, did he have any additional neuro findings at home like dysarthria, receptive aphasia, ataxia, facial droop, etc.?

“What’s aphasia and dysarthria? Like slurred speech?”

“Well dysarthria is slurred speech, yes. Aphasia is difficulty with communicating that comes in a receptive and expressive variety.”

“Well I wasn’t home with him, my mother was, she’s the one that drove him here, I just met them in the ambulance bay.”

“Okay, well how about we have you switch out with your mother, so I can get the story from her.”

“No, as a physician, I have more understanding of medicine and should be here with him instead of my mother. You can talk to her over the phone though.”

“What kind of doc are you again?”

“Anesthesiologist”

I proceed to give a not so subtle nod and a long and telling glance over to the pt’s nurse who knows me well and knows I am seconds away from breaking my currently civil demeanor.

I then speak with the pt’s wife (also very pleasant like the pt) over the phone who describes a very minimally concerning story, that doesn’t really sound anything like a TIA or CVA, but occasionally they present abnormally, so I’m not going to protest doing a TIA workup.

About 30 minutes later, a cardiac arrest comes in. The pt’s nurse finds me as I’m walking over to the cardiac arrest pt to tell me that the daughter is demanding to know what the pt’s ECG demonstrated (she says while rolling her eyes and says she’ll make sure the daughter knows I’m in a code).

I get ROSC back after about 15 minutes but still trying to get the pt stabilized. The nurse comes back to just give me a heads up that the daughter would like me to step out of the code to talk to her, which the nurse already informed the daughter I would not do (nurse mainly just telling me to vent).

Another 20 minutes go by as I’m placing lines. And getting the pt stable enough for scans, the pt’s nurse comes back to inform me the daughter is now demanding I step out to give her an update. The nurse then told the daughter that unless her dad is coding, he is not currently my first priority. I told the nurse that if she demands one more time for me to step out of a dying pt’s room, to have security escort her out of the ER.

I finally get this pt stable enough where I feel comfortable leaving his bedside. I decide rather than immediately going to see the daughter, I’m going to make her wait. So I make her wait another 30 minutes when all the work up is finally back, so I can go in there one more time and never step back in that room again.

I did not apologize for the delay. I let her know that he will be admitted to complete his TIA workup (mainly because I didn’t want to deal with the fight of discharging him) and that everything is normal so far. She asked that I make sure I get his MRI immediately which I told her would not happen. She then asked that a neurologist come and see him right now (at 11pm) which I told her also would not happen. She then left in a huff and switched out with her mother, who was an amazingly sweet lady. I don’t know how such wonderful people have such a “see you next Tuesday” of an offspring.

This is certainly not the first time I’ve dealt with ridiculous physician colleagues as a family member of a patient, but this was probably the most absurd. I never would have expected a ****ing doctor to be the one to demand I step out of a ****ing code to update them on their asymptomatic family member.

Sorry for the long post, I just needed an outlet to vent.

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[rokshana]

So below is a bizarre interaction I had with an anesthesiologist who is the daughter of a pt of mine.

So working a relatively normal shift, when I get word from my charge nurse that a doctor has parked in the ambulance bay reserved for priority 1 EMS and has wheeled in their father through this entrance demanding he be seen immediately by our “stroke team”. I ask the nurse if he has any deficits, which she replies “lol, no, the report she gave was that he was confused and now he is back to normal.”

They put him in one of our back rooms rather than putting him in one of our resus bays, which I am told infuriates her more.

So I purposely wait 20 minutes to see them because I want to establish that she will be seen on my time, not hers, also I had other pts to evaluate, as well.

I finally walk into the room to see this incredibly pleasant 80yo who is smiling at me as I walk in, and his 40 yo Karen of a daughter with her MD badge on that is pacing back and forth in the room.

I introduce myself to both of them and I quickly and thoroughly perform a full neuro exam that my med school neurologists would be proud of, sans tuning fork. Of course it is all normal.

The story is 40 minutes prior to arrival he began to have some word finding issues (while pt interjects “I was looking for my damn computer, but I briefly couldn’t remember what the name for computer was”.) He also apparently forgot the name of one of his grandsons (“I always forget his name” he interjects again). Because of this, his wife called their daughter who told them to rush him to the ER 30 minutes away from them (bypassing numerous ERs on the way), so that she has access to the hospital he goes to. This confusion episode lasts all of 10 minutes. He does have a hx CAD and HTN, so a CVA/TIA workup isn’t completely unreasonable, given I was not there when he was reportedly symptomatic.

I then state “I understand you are concerned for a CVA, you can rest assured that it is very unlikely he had a stroke based on the reported symptoms, the length of symptoms, and his current exam. Certainly TIA is possible, however, nothing that has been reported seems to be focal. I think it also could be delirium from something like medications or infectio…”

“ITS NOT DELIRIUM!!!”

“I’m not saying this is my definitive diagnosis, I’m just giving you my differential, and mild delirium can frequently presen…”

“I’M A DOCTOR, I KNOW WHAT DELIRIUM IS, THIS IS NOT DELIRIUM!! HE’S NOT SUNDOWNING, HE DOESNT HAVE DEMENTIA, HOW IS THIS CONSISTENT WITH DELIRIUM? His symptoms were ACUTE!”

“Ma’am, delirium typically presents acutely, I think you are confusing dementia with delirium.

“I ALREADY TOLD YOU IM A DOCTOR, I KNOW WHAT DELIRIUM IS! WHERE IS THE STROKE TEAM!?”

“You’re looking at it, and like I have already stated, he is not currently having a stroke. I think we are getting a bit ahead of ourselves, however, regarding diagnoses. I plan to get some cerebral imaging and some labs and we will reassess things in a bit. Now tell me, did he have any additional neuro findings at home like dysarthria, receptive aphasia, ataxia, facial droop, etc.?

“What’s aphasia and dysarthria? Like slurred speech?”

“Well dysarthria is slurred speech, yes. Aphasia is difficulty with communicating that comes in a receptive and expressive variety.”

“Well I wasn’t home with him, my mother was, she’s the one that drove him here, I just met them in the ambulance bay.”

“Okay, well how about we have you switch out with your mother, so I can get the story from her.”

“No, as a physician, I have more understanding of medicine and should be here with him instead of my mother. You can talk to her over the phone though.”

“What kind of doc are you again?”

“Anesthesiologist”

I proceed to give a not so subtle nod and a long and telling glance over to the pt’s nurse who knows me well and knows I am seconds away from breaking my currently civil demeanor.

I then speak with the pt’s wife (also very pleasant like the pt) over the phone who describes a very minimally concerning story, that doesn’t really sound anything like a TIA or CVA, but occasionally they present abnormally, so I’m not going to protest doing a TIA workup.

About 30 minutes later, a cardiac arrest comes in. The pt’s nurse finds me as I’m walking over to the cardiac arrest pt to tell me that the daughter is demanding to know what the pt’s ECG demonstrated (she says while rolling her eyes and says she’ll make sure the daughter knows I’m in a code).

I get ROSC back after about 15 minutes but still trying to get the pt stabilized. The nurse comes back to just give me a heads up that the daughter would like me to step out of the code to talk to her, which the nurse already informed the daughter I would not do (nurse mainly just telling me to vent).

Another 20 minutes go by as I’m placing lines. And getting the pt stable enough for scans, the pt’s nurse comes back to inform me the daughter is now demanding I step out to give her an update. The nurse then told the daughter that unless her dad is coding, he is not currently my first priority. I told the nurse that if she demands one more time for me to step out of a dying pt’s room, to have security escort her out of the ER.

I finally get this pt stable enough where I feel comfortable leaving his bedside. I decide rather than immediately going to see the daughter, I’m going to make her wait. So I make her wait another 30 minutes when all the work up is finally back, so I can go in there one more time and never step back in that room again.

I did not apologize for the delay. I let her know that he will be admitted to complete his TIA workup (mainly because I didn’t want to deal with the fight of discharging him) and that everything is normal so far. She asked that I make sure I get his MRI immediately which I told her would not happen. She then asked that a neurologist come and see him right now (at 11pm) which I told her also would not happen. She then left in a huff and switched out with her mother, who was an amazingly sweet lady. I don’t know how such wonderful people have such a “see you next Tuesday” of an offspring.

This is certainly not the first time I’ve dealt with ridiculous physician colleagues as a family member of a patient, but this was probably the most absurd. I never would have expected a ****ing doctor to be the one to demand I step out of a ****ing code to update them on their asymptomatic family member.

Sorry for the long post, I just needed an outlet to vent.

That is ridiculous! And this from a physician daughter of a surgeon father that was sick the last few years of his life and went to the hospital fairly frequently the last year of his life…I made a point of not being that person…did I let them know I was a physician… yes( though I did some hospitalist work there and it was the hospital my father worked at for over 30 years, so a bit different)… because let’s face it, when it’s known that there is a physician in the family, there is a difference.
Is she hospital employed? Would consider talking to her chair…she is using her professional status to get preferential care and frankly is making their group look bad.

And how much of a doctor is she that she doesn’t know what dysphasia and aphasia are?? And to step out of a code?? Seriously…

 

[Groove]

So below is a bizarre interaction I had with an anesthesiologist who is the daughter of a pt of mine.

So working a relatively normal shift, when I get word from my charge nurse that a doctor has parked in the ambulance bay reserved for priority 1 EMS and has wheeled in their father through this entrance demanding he be seen immediately by our “stroke team”. I ask the nurse if he has any deficits, which she replies “lol, no, the report she gave was that he was confused and now he is back to normal.”

They put him in one of our back rooms rather than putting him in one of our resus bays, which I am told infuriates her more.

So I purposely wait 20 minutes to see them because I want to establish that she will be seen on my time, not hers, also I had other pts to evaluate, as well.

I finally walk into the room to see this incredibly pleasant 80yo who is smiling at me as I walk in, and his 40 yo Karen of a daughter with her MD badge on that is pacing back and forth in the room.

I introduce myself to both of them and I quickly and thoroughly perform a full neuro exam that my med school neurologists would be proud of, sans tuning fork. Of course it is all normal.

The story is 40 minutes prior to arrival he began to have some word finding issues (while pt interjects “I was looking for my damn computer, but I briefly couldn’t remember what the name for computer was”.) He also apparently forgot the name of one of his grandsons (“I always forget his name” he interjects again). Because of this, his wife called their daughter who told them to rush him to the ER 30 minutes away from them (bypassing numerous ERs on the way), so that she has access to the hospital he goes to. This confusion episode lasts all of 10 minutes. He does have a hx CAD and HTN, so a CVA/TIA workup isn’t completely unreasonable, given I was not there when he was reportedly symptomatic.

I then state “I understand you are concerned for a CVA, you can rest assured that it is very unlikely he had a stroke based on the reported symptoms, the length of symptoms, and his current exam. Certainly TIA is possible, however, nothing that has been reported seems to be focal. I think it also could be delirium from something like medications or infectio…”

“ITS NOT DELIRIUM!!!”

“I’m not saying this is my definitive diagnosis, I’m just giving you my differential, and mild delirium can frequently presen…”

“I’M A DOCTOR, I KNOW WHAT DELIRIUM IS, THIS IS NOT DELIRIUM!! HE’S NOT SUNDOWNING, HE DOESNT HAVE DEMENTIA, HOW IS THIS CONSISTENT WITH DELIRIUM? His symptoms were ACUTE!”

“Ma’am, delirium typically presents acutely, I think you are confusing dementia with delirium.

“I ALREADY TOLD YOU IM A DOCTOR, I KNOW WHAT DELIRIUM IS! WHERE IS THE STROKE TEAM!?”

“You’re looking at it, and like I have already stated, he is not currently having a stroke. I think we are getting a bit ahead of ourselves, however, regarding diagnoses. I plan to get some cerebral imaging and some labs and we will reassess things in a bit. Now tell me, did he have any additional neuro findings at home like dysarthria, receptive aphasia, ataxia, facial droop, etc.?

“What’s aphasia and dysarthria? Like slurred speech?”

“Well dysarthria is slurred speech, yes. Aphasia is difficulty with communicating that comes in a receptive and expressive variety.”

“Well I wasn’t home with him, my mother was, she’s the one that drove him here, I just met them in the ambulance bay.”

“Okay, well how about we have you switch out with your mother, so I can get the story from her.”

“No, as a physician, I have more understanding of medicine and should be here with him instead of my mother. You can talk to her over the phone though.”

“What kind of doc are you again?”

“Anesthesiologist”

I proceed to give a not so subtle nod and a long and telling glance over to the pt’s nurse who knows me well and knows I am seconds away from breaking my currently civil demeanor.

I then speak with the pt’s wife (also very pleasant like the pt) over the phone who describes a very minimally concerning story, that doesn’t really sound anything like a TIA or CVA, but occasionally they present abnormally, so I’m not going to protest doing a TIA workup.

About 30 minutes later, a cardiac arrest comes in. The pt’s nurse finds me as I’m walking over to the cardiac arrest pt to tell me that the daughter is demanding to know what the pt’s ECG demonstrated (she says while rolling her eyes and says she’ll make sure the daughter knows I’m in a code).

I get ROSC back after about 15 minutes but still trying to get the pt stabilized. The nurse comes back to just give me a heads up that the daughter would like me to step out of the code to talk to her, which the nurse already informed the daughter I would not do (nurse mainly just telling me to vent).

Another 20 minutes go by as I’m placing lines. And getting the pt stable enough for scans, the pt’s nurse comes back to inform me the daughter is now demanding I step out to give her an update. The nurse then told the daughter that unless her dad is coding, he is not currently my first priority. I told the nurse that if she demands one more time for me to step out of a dying pt’s room, to have security escort her out of the ER.

I finally get this pt stable enough where I feel comfortable leaving his bedside. I decide rather than immediately going to see the daughter, I’m going to make her wait. So I make her wait another 30 minutes when all the work up is finally back, so I can go in there one more time and never step back in that room again.

I did not apologize for the delay. I let her know that he will be admitted to complete his TIA workup (mainly because I didn’t want to deal with the fight of discharging him) and that everything is normal so far. She asked that I make sure I get his MRI immediately which I told her would not happen. She then asked that a neurologist come and see him right now (at 11pm) which I told her also would not happen. She then left in a huff and switched out with her mother, who was an amazingly sweet lady. I don’t know how such wonderful people have such a “see you next Tuesday” of an offspring.

This is certainly not the first time I’ve dealt with ridiculous physician colleagues as a family member of a patient, but this was probably the most absurd. I never would have expected a ****ing doctor to be the one to demand I step out of a ****ing code to update them on their asymptomatic family member.

Sorry for the long post, I just needed an outlet to vent.

Kudos for handling yourself so well. No doubt I would have snapped and generated a complaint to admin and then gotten a call from the FMD shortly thereafter.

 

[Lexdiamondz]

Hats off for dealing with that in a professional manner (and while simultaneously managing a code, no less)

Most physicians who don't work in the ER and don't interact with EM physicians don't understand (or care to understand) the realities of our practice environment. This is doubly true if you work in an ivory-tower environment and triply-true if you work in an academic environment in a hoity-toity neighbourhood.

Generally I admit these patients, punt the consults to other services and let someone who doesn't have 20 pts in the waiting room deal with the bull****. I know these people generally don't respect ER docs so I don't care to interact with them longer than I need to.

 

[WilcoWorld]

Sounds like the daughter had acute fear exacerbating a chronic sense of entitlement.

But I'm not an Anesthesiologist, so...

 

[lymphocyte]

So below is a bizarre interaction I had with an anesthesiologist who is the daughter of a pt of mine.

So working a relatively normal shift, when I get word from my charge nurse that a doctor has parked in the ambulance bay reserved for priority 1 EMS and has wheeled in their father through this entrance demanding he be seen immediately by our “stroke team”. I ask the nurse if he has any deficits, which she replies “lol, no, the report she gave was that he was confused and now he is back to normal.”

They put him in one of our back rooms rather than putting him in one of our resus bays, which I am told infuriates her more.

So I purposely wait 20 minutes to see them because I want to establish that she will be seen on my time, not hers, also I had other pts to evaluate, as well.

I finally walk into the room to see this incredibly pleasant 80yo who is smiling at me as I walk in, and his 40 yo Karen of a daughter with her MD badge on that is pacing back and forth in the room.

I introduce myself to both of them and I quickly and thoroughly perform a full neuro exam that my med school neurologists would be proud of, sans tuning fork. Of course it is all normal.

The story is 40 minutes prior to arrival he began to have some word finding issues (while pt interjects “I was looking for my damn computer, but I briefly couldn’t remember what the name for computer was”.) He also apparently forgot the name of one of his grandsons (“I always forget his name” he interjects again). Because of this, his wife called their daughter who told them to rush him to the ER 30 minutes away from them (bypassing numerous ERs on the way), so that she has access to the hospital he goes to. This confusion episode lasts all of 10 minutes. He does have a hx CAD and HTN, so a CVA/TIA workup isn’t completely unreasonable, given I was not there when he was reportedly symptomatic.

I then state “I understand you are concerned for a CVA, you can rest assured that it is very unlikely he had a stroke based on the reported symptoms, the length of symptoms, and his current exam. Certainly TIA is possible, however, nothing that has been reported seems to be focal. I think it also could be delirium from something like medications or infectio…”

“ITS NOT DELIRIUM!!!”

“I’m not saying this is my definitive diagnosis, I’m just giving you my differential, and mild delirium can frequently presen…”

“I’M A DOCTOR, I KNOW WHAT DELIRIUM IS, THIS IS NOT DELIRIUM!! HE’S NOT SUNDOWNING, HE DOESNT HAVE DEMENTIA, HOW IS THIS CONSISTENT WITH DELIRIUM? His symptoms were ACUTE!”

“Ma’am, delirium typically presents acutely, I think you are confusing dementia with delirium.

“I ALREADY TOLD YOU IM A DOCTOR, I KNOW WHAT DELIRIUM IS! WHERE IS THE STROKE TEAM!?”

“You’re looking at it, and like I have already stated, he is not currently having a stroke. I think we are getting a bit ahead of ourselves, however, regarding diagnoses. I plan to get some cerebral imaging and some labs and we will reassess things in a bit. Now tell me, did he have any additional neuro findings at home like dysarthria, receptive aphasia, ataxia, facial droop, etc.?

“What’s aphasia and dysarthria? Like slurred speech?”

“Well dysarthria is slurred speech, yes. Aphasia is difficulty with communicating that comes in a receptive and expressive variety.”

“Well I wasn’t home with him, my mother was, she’s the one that drove him here, I just met them in the ambulance bay.”

“Okay, well how about we have you switch out with your mother, so I can get the story from her.”

“No, as a physician, I have more understanding of medicine and should be here with him instead of my mother. You can talk to her over the phone though.”

“What kind of doc are you again?”

“Anesthesiologist”

I proceed to give a not so subtle nod and a long and telling glance over to the pt’s nurse who knows me well and knows I am seconds away from breaking my currently civil demeanor.

I then speak with the pt’s wife (also very pleasant like the pt) over the phone who describes a very minimally concerning story, that doesn’t really sound anything like a TIA or CVA, but occasionally they present abnormally, so I’m not going to protest doing a TIA workup.

About 30 minutes later, a cardiac arrest comes in. The pt’s nurse finds me as I’m walking over to the cardiac arrest pt to tell me that the daughter is demanding to know what the pt’s ECG demonstrated (she says while rolling her eyes and says she’ll make sure the daughter knows I’m in a code).

I get ROSC back after about 15 minutes but still trying to get the pt stabilized. The nurse comes back to just give me a heads up that the daughter would like me to step out of the code to talk to her, which the nurse already informed the daughter I would not do (nurse mainly just telling me to vent).

Another 20 minutes go by as I’m placing lines. And getting the pt stable enough for scans, the pt’s nurse comes back to inform me the daughter is now demanding I step out to give her an update. The nurse then told the daughter that unless her dad is coding, he is not currently my first priority. I told the nurse that if she demands one more time for me to step out of a dying pt’s room, to have security escort her out of the ER.

I finally get this pt stable enough where I feel comfortable leaving his bedside. I decide rather than immediately going to see the daughter, I’m going to make her wait. So I make her wait another 30 minutes when all the work up is finally back, so I can go in there one more time and never step back in that room again.

I did not apologize for the delay. I let her know that he will be admitted to complete his TIA workup (mainly because I didn’t want to deal with the fight of discharging him) and that everything is normal so far. She asked that I make sure I get his MRI immediately which I told her would not happen. She then asked that a neurologist come and see him right now (at 11pm) which I told her also would not happen. She then left in a huff and switched out with her mother, who was an amazingly sweet lady. I don’t know how such wonderful people have such a “see you next Tuesday” of an offspring.

This is certainly not the first time I’ve dealt with ridiculous physician colleagues as a family member of a patient, but this was probably the most absurd. I never would have expected a ****ing doctor to be the one to demand I step out of a ****ing code to update them on their asymptomatic family member.

Sorry for the long post, I just needed an outlet to vent.

I'm sorry it happened to you. I think you handled it very well.

I had a 38 year old lady with a unilateral headache, jaw claudication, tenderness over the superficial temporal artery, and an ESR of 80. I told her about the possibility of GCA, needing an US and getting a biopsy organised. Her brother, who is an opthamologist, called and reamed me out over the phone; he told me this was an impossible diagnosis in somebody so young. Didn't even have the story straight but basically called me incompetent. Anyways. US turned out to be very suggestive, and the biopsy clinched the diagnosis.

Presenting complaint was headache. Needle in a haystack but you can't miss the needle. And the waiting room is out the door. And the really sick ones show up whenever they damn well please.

I think there's an element of stress being a family member. I also think there's an element of Dunning-Kruger.

But some of our colleagues forget that EM physicians are also specialists; specialists in resuscitation and acute, undifferentiated medicine. Sick vs not sick. Diagnostic uncertainty. Breakfast, lunch, and dinner. There's comfort in not always knowing the right diagnosis but always nailing the right disposition.

No matter what, though, some doctors will always need the MRI right now.

 

[RustedFox]

I'm sorry it happened to you. I think you handled it very well.

I had a 38 year old lady with a unilateral headache, jaw claudication, tenderness over the superficial temporal artery, and an ESR of 80. I told her about the possibility of GCA, needing an US and getting a biopsy organised. Her brother, who is an opthamologist, called and reamed me out over the phone; he told me this was an impossible diagnosis in somebody so young. Didn't even have the story straight but basically called me incompetent. Anyways. US turned out to be very suggestive, and the biopsy clinched the diagnosis.

Presenting complaint was headache. Needle in a haystack but you can't miss the needle. And the waiting room is out the door. And the really sick ones show up whenever they damn well please.

I think there's an element of stress being a family member. I also think there's an element of Dunning-Kruger.

But some of our colleagues forget that EM physicians are also specialists; specialists in resuscitation and acute, undifferentiated medicine. Sick vs not sick. Diagnostic uncertainty. Breakfast, lunch, and dinner. There's comfort in not always knowing the right diagnosis but always nailing the right disposition.

No matter what, though, some doctors will always need the MRI right now.

Great catch.
Any visual field symptoms on presentation?

 

[WilcoWorld]

I'm sorry it happened to you. I think you handled it very well.

I had a 38 year old lady with a unilateral headache, jaw claudication, tenderness over the superficial temporal artery, and an ESR of 80. I told her about the possibility of GCA, needing an US and getting a biopsy organised. Her brother, who is an opthamologist, called and reamed me out over the phone; he told me this was an impossible diagnosis in somebody so young. Didn't even have the story straight but basically called me incompetent. Anyways. US turned out to be very suggestive, and the biopsy clinched the diagnosis.

Presenting complaint was headache. Needle in a haystack but you can't miss the needle. And the waiting room is out the door. And the really sick ones show up whenever they damn well please.

I think there's an element of stress being a family member. I also think there's an element of Dunning-Kruger.

But some of our colleagues forget that EM physicians are also specialists; specialists in resuscitation and acute, undifferentiated medicine. Sick vs not sick. Diagnostic uncertainty. Breakfast, lunch, and dinner. There's comfort in not always knowing the right diagnosis but always nailing the right disposition.

No matter what, though, some doctors will always need the MRI right now.

That warrants a case report. Sounds like the Ophtho doc needed a Urology consult, but he wasn't wrong that GCA is practically unheard of at that age.

 

[RustedFox]

That warrants a case report. Sounds like the Ophtho doc needed a Urology consult, but he wasn't wrong that GCA is practically unheard of at that age.

Yeah, I remember the mnemonic: "50 over 50" being taught for the board exams.
That is; "ESR of 50 in a patient over age 50" being pathognomonic.

 

[lymphocyte]

Great catch.
Any visual field symptoms on presentation?

No visual symptoms but she almost offhandedly said "I can't even chew gum." "What happens"? "It hurts." "Does it take time before the pain comes on"? "About a few minutes." Off we went.

This is literally what's been described as the chewing gum test. Delayed onset of pain. One of those interesting things I read 5 years ago and stored away.

https://www.nejm.org/doi/full/10.1056/NEJMc1511420

That warrants a case report. Sounds like the Ophtho doc needed a Urology consult, but he wasn't wrong that GCA is practically unheard of at that age.

There's a fair number of case reports already, especially if you include juvenile arteritis. But there's a demographic twist that will up its chances of getting published in something reputable. It's already been submitted.

The ACR diagnostic criteria actually includes age > 50. But there you go.

 

[Birdstrike]

So below is a bizarre interaction I had with an anesthesiologist who is the daughter of a pt of mine...

First of all, I'm sorry this happened to you. That's a tough moment and a tough shift. I've been there, more times than I wish to remember.

As far as the anesthesiologist daughter, when it's one of your own, rational thought goes out the window. Being a physician doesn't make it any better. It makes it worse. You have enough knowledge to think you know, when really it's only enough to make you fear the worst more vividly. It's nothing you did. It's the way humans are made; some more than others. The Medicine is only 5% of what makes our jobs hard. The human drama and antics, is 95% of it.

Emotionally charged, demanding family members pulling you in 10 different directions while patients are dying around you, all while you're at maximal exhaustion. That's Emergency Medicine.

Thank you for doing what you do.

 

[Vandalia]

First, this is the classic example of why you should never take care of family members.

Second, if I had a $1 for everything I saw in my career that "couldn't happen" I could pay for my lunch.

 

[dadaddadaBATMAN]

Cool case of temporal arteritis. It’s important to remember the rules, but it’s equally important to remember when to break them (pt with all classic features save age). All of us have seen “ridiculous” presentations. We aren’t playing a fair game.

As for the family member, I agree that this is a ludicrous situation and likely an emotional moment for that person, though I doubt she’s much better on a Good day.

A lot of people are talking about how she could complain about your care. That might be true, if she’s right and you are wrong. But if you’re following standard of care, and she’s impeding care or attempting to demand special treatment, she is actually the one who is breaching ethics and she is putting herself in a VERY vulnerable position. If she was impeding other patient care or mistreating nurses I would pull her aside and bluntly tell her to cut the shi*. This stuff (parking in ambulance bay intentionally, demanding you abandon traditional triage, etc) is obviously unprofessional and would get her torn apart if given to admin.

My personal approach to this pt is to tell her that it could have been a stroke (lie) or tia (maybe, probably not) but that regardless he is obviously not a tpa candiate (true) both due to rapidly resolving/non-disabling symptoms and due to nihss of 0 (prism trial and common sense) or candidate for large vessel revascularization. It takes the wind out of the argument: it doesn’t matter. Plan is ct/cta and admit mri Neuro in am, neuro will not give recs without mri so we’re not calling here’s the asa goodbye

 

[thegenius]

So below is a bizarre interaction I had with an anesthesiologist who is the daughter of a pt of mine.

So working a relatively normal shift, when I get word from my charge nurse that a doctor has parked in the ambulance bay reserved for priority 1 EMS and has wheeled in their father through this entrance demanding he be seen immediately by our “stroke team”. I ask the nurse if he has any deficits, which she replies “lol, no, the report she gave was that he was confused and now he is back to normal.”

They put him in one of our back rooms rather than putting him in one of our resus bays, which I am told infuriates her more.

So I purposely wait 20 minutes to see them because I want to establish that she will be seen on my time, not hers, also I had other pts to evaluate, as well.

I finally walk into the room to see this incredibly pleasant 80yo who is smiling at me as I walk in, and his 40 yo Karen of a daughter with her MD badge on that is pacing back and forth in the room.

I introduce myself to both of them and I quickly and thoroughly perform a full neuro exam that my med school neurologists would be proud of, sans tuning fork. Of course it is all normal.

The story is 40 minutes prior to arrival he began to have some word finding issues (while pt interjects “I was looking for my damn computer, but I briefly couldn’t remember what the name for computer was”.) He also apparently forgot the name of one of his grandsons (“I always forget his name” he interjects again). Because of this, his wife called their daughter who told them to rush him to the ER 30 minutes away from them (bypassing numerous ERs on the way), so that she has access to the hospital he goes to. This confusion episode lasts all of 10 minutes. He does have a hx CAD and HTN, so a CVA/TIA workup isn’t completely unreasonable, given I was not there when he was reportedly symptomatic.

I then state “I understand you are concerned for a CVA, you can rest assured that it is very unlikely he had a stroke based on the reported symptoms, the length of symptoms, and his current exam. Certainly TIA is possible, however, nothing that has been reported seems to be focal. I think it also could be delirium from something like medications or infectio…”

“ITS NOT DELIRIUM!!!”

“I’m not saying this is my definitive diagnosis, I’m just giving you my differential, and mild delirium can frequently presen…”

“I’M A DOCTOR, I KNOW WHAT DELIRIUM IS, THIS IS NOT DELIRIUM!! HE’S NOT SUNDOWNING, HE DOESNT HAVE DEMENTIA, HOW IS THIS CONSISTENT WITH DELIRIUM? His symptoms were ACUTE!”

“Ma’am, delirium typically presents acutely, I think you are confusing dementia with delirium.

“I ALREADY TOLD YOU IM A DOCTOR, I KNOW WHAT DELIRIUM IS! WHERE IS THE STROKE TEAM!?”

“You’re looking at it, and like I have already stated, he is not currently having a stroke. I think we are getting a bit ahead of ourselves, however, regarding diagnoses. I plan to get some cerebral imaging and some labs and we will reassess things in a bit. Now tell me, did he have any additional neuro findings at home like dysarthria, receptive aphasia, ataxia, facial droop, etc.?

“What’s aphasia and dysarthria? Like slurred speech?”

“Well dysarthria is slurred speech, yes. Aphasia is difficulty with communicating that comes in a receptive and expressive variety.”

“Well I wasn’t home with him, my mother was, she’s the one that drove him here, I just met them in the ambulance bay.”

“Okay, well how about we have you switch out with your mother, so I can get the story from her.”

“No, as a physician, I have more understanding of medicine and should be here with him instead of my mother. You can talk to her over the phone though.”

“What kind of doc are you again?”

“Anesthesiologist”

I proceed to give a not so subtle nod and a long and telling glance over to the pt’s nurse who knows me well and knows I am seconds away from breaking my currently civil demeanor.

I then speak with the pt’s wife (also very pleasant like the pt) over the phone who describes a very minimally concerning story, that doesn’t really sound anything like a TIA or CVA, but occasionally they present abnormally, so I’m not going to protest doing a TIA workup.

About 30 minutes later, a cardiac arrest comes in. The pt’s nurse finds me as I’m walking over to the cardiac arrest pt to tell me that the daughter is demanding to know what the pt’s ECG demonstrated (she says while rolling her eyes and says she’ll make sure the daughter knows I’m in a code).

I get ROSC back after about 15 minutes but still trying to get the pt stabilized. The nurse comes back to just give me a heads up that the daughter would like me to step out of the code to talk to her, which the nurse already informed the daughter I would not do (nurse mainly just telling me to vent).

Another 20 minutes go by as I’m placing lines. And getting the pt stable enough for scans, the pt’s nurse comes back to inform me the daughter is now demanding I step out to give her an update. The nurse then told the daughter that unless her dad is coding, he is not currently my first priority. I told the nurse that if she demands one more time for me to step out of a dying pt’s room, to have security escort her out of the ER.

I finally get this pt stable enough where I feel comfortable leaving his bedside. I decide rather than immediately going to see the daughter, I’m going to make her wait. So I make her wait another 30 minutes when all the work up is finally back, so I can go in there one more time and never step back in that room again.

I did not apologize for the delay. I let her know that he will be admitted to complete his TIA workup (mainly because I didn’t want to deal with the fight of discharging him) and that everything is normal so far. She asked that I make sure I get his MRI immediately which I told her would not happen. She then asked that a neurologist come and see him right now (at 11pm) which I told her also would not happen. She then left in a huff and switched out with her mother, who was an amazingly sweet lady. I don’t know how such wonderful people have such a “see you next Tuesday” of an offspring.

This is certainly not the first time I’ve dealt with ridiculous physician colleagues as a family member of a patient, but this was probably the most absurd. I never would have expected a ****ing doctor to be the one to demand I step out of a ****ing code to update them on their asymptomatic family member.

Sorry for the long post, I just needed an outlet to vent.

It's alright man you can vent. I would too. We have all had sad and frustrating encounters with patients or with family members in the medical community. Doesn't matter that she was with anesthesiology, could have been cardiology, allergy, or vascular surgery. The upsetting thing is this notion that a patient who is now barely alive has less priority than a living patient with no current symptoms

 

[thegenius]

That is ridiculous! And this from a physician daughter of a surgeon father that was sick the last few years of his life and went to the hospital fairly frequently the last year of his life…I made a point of not being that person…did I let them know I was a physician… yes( though I did some hospitalist work there and it was the hospital my father worked at for over 30 years, so a bit different)… because let’s face it, when it’s known that there is a physician in the family, there is a difference.
Is she hospital employed? Would consider talking to her chair…she is using her professional status to get preferential care and frankly is making their group look bad.

And how much of a doctor is she that she doesn’t know what dysphasia and aphasia are?? And to step out of a code?? Seriously…

Even that doesn't even bother me. I bet if she thought about it she would have answered the question correctly...but she was obviously in a tizzy for some reason and not thinking straight.

So obvious there was something else going on in this anes's life at the time. Who knows. Maybe she was just served divorced papers.

 

[thegenius]

First, this is the classic example of why you should never take care of family members.

Second, if I had a $1 for everything I saw in my career that "couldn't happen" I could pay for my lunch.

Is this a $6 mcdonalds lunch, or a $15 Panera lunch?

 

[Vandalia]

Is this a $6 mcdonalds lunch, or a $15 Panera lunch?

Slightly more expensive Bonefish Caesar salad with salmon.

I am 500+ miles from salt water. Beggars can't be choosers.

 

[RustedFox]

Is this a $6 mcdonalds lunch, or a $15 Panera lunch?

$15 McDonald's lunch. Inflation.

 

[pkwraith]

I hate "VIP" patients. Studies even show they get worse care due to overtesting and overtreatment.

 

[GassYous]

Is this a $6 mcdonalds lunch, or a $15 Panera lunch?

Since when is mcdonalds only 6 dollars

 

[thegenius]

Since when is mcdonalds only 6 dollars

Aren't there 1 dollar sandwiches?
little sandwiches?

(haven't been there in many years)

 

[Pigg-O-Stat]

I had an old retired surgeon once bring his wife in for a chronic skin lesion, demanding the on-call surgeon come in immediately to perform a biopsy. I told him nicely that wasn't going to happen. Then he squared up with me and clenched his fists like he wanted to fight. It was bizarre.

 

[aafisahar]

Since when is mcdonalds only 6 dollars

Mcdouble and medium fries is 3 bucks.

 

[bronx43]

I'm sorry it happened to you. I think you handled it very well.

I had a 38 year old lady with a unilateral headache, jaw claudication, tenderness over the superficial temporal artery, and an ESR of 80. I told her about the possibility of GCA, needing an US and getting a biopsy organised. Her brother, who is an opthamologist, called and reamed me out over the phone; he told me this was an impossible diagnosis in somebody so young. Didn't even have the story straight but basically called me incompetent. Anyways. US turned out to be very suggestive, and the biopsy clinched the diagnosis.

Presenting complaint was headache. Needle in a haystack but you can't miss the needle. And the waiting room is out the door. And the really sick ones show up whenever they damn well please.

I think there's an element of stress being a family member. I also think there's an element of Dunning-Kruger.

But some of our colleagues forget that EM physicians are also specialists; specialists in resuscitation and acute, undifferentiated medicine. Sick vs not sick. Diagnostic uncertainty. Breakfast, lunch, and dinner. There's comfort in not always knowing the right diagnosis but always nailing the right disposition.

No matter what, though, some doctors will always need the MRI right now.

I'm a rheumatologist and I would have said no way to GCA. Vast majority of my GCA patients are in their 70s, youngest I've had was 50s. There's probably only a handful of reported cases in their 30s. I'm at a large tertiary care academic center and I don't think any of our older faculty have seen a JTA.
Great pickup.

 

[Apollyon]

I'm a rheumatologist and I would have said no way to GCA. Vast majority of my GCA patients are in their 70s, youngest I've had was 50s. There's probably only a handful of reported cases in their 30s. I'm at a large tertiary care academic center and I don't think any of our older faculty have seen a JTA.
Great pickup.

Yeah, but, you also would not be an insulting, dismissive d*ck about it.

 

[deleted813736]

i will scour the anesthesia SDN blogs to find her side of the story before i come to a final conclusion. ty for sharing

 

[thegenius]

Yeah, but, you also would not be an insulting, dismissive d*ck about it.

That's the key. There's no point in hearing an optho or rheum say "it's impossible" and "why did you work that up" and other stuff. It's like diagnosing a 28 yo with an MI. It's extraordinarily rare but what is an ER doc going to do when a 28 yo guy comes in with crushing substernal chest pain? Not order an EKG and trops?

 

[s109442]

why not just order the CT/CTA, give asa blah blah, make the pt and family happy - same dance we do with everyone else. Then calmly explain in your elementary voice what a stroke is

 

[Zebra Hunter]

why not just order the CT/CTA, give asa blah blah, make the pt and family happy - same dance we do with everyone else. Then calmly explain in your elementary voice what a stroke is

Did you not read the post? That is exactly what she got. Not sure how I can make her happy while I'm in the middle of a code, but the patient got a CT/CTA, aspirin, and an unnecessary hospital admission and that clearly was not enough for her.

 

[betamale]

Some of these stroke syndromes can be very subtle, so very worrying especially if some of us don't see it often. I've had several that were missed by neurologists. I had a patient with hippocampal stroke whose only deficit was acute recent memory loss, two with homonymous hemianopsia who had occipital strokes (both post-op), confused pt with large temporoparietal stroke, fluent aphasia from temporal stroke. No LVO signs. None were tPA candidates but still with debilitating deficits.

 

[bravotwozero]

Some of these stroke syndromes can be very subtle, so very worrying especially if some of us don't see it often. I've had several that were missed by neurologists. I had a patient with hippocampal stroke whose only deficit was acute recent memory loss, two with homonymous hemianopsia who had occipital strokes (both post-op), confused pt with large temporoparietal stroke, fluent aphasia from temporal stroke. No LVO signs. None were tPA candidates but still with debilitating deficits.

…and in how many of those cases were symptoms temporary with the patient returning to baseline in the ED?

Again, It’s not like the OP discharged the patient. Being worried for your family member is not an excuse to be an irascible a-hole. Doubly so if you’re a physician. Professional courteousy is a thing, people.

 

[doctalaughs]

Did you not read the post? That is exactly what she got. Not sure how I can make her happy while I'm in the middle of a code, but the patient got a CT/CTA, aspirin, and an unnecessary hospital admission and that clearly was not enough for her.

I don’t think it has anything to do with the specialty or EM. I’m a dermatologist and once had another dermatologist call and yell at me for their mother’s (my patient’s) very appropriate workup for a rare tumor. Of course, this happened to be an academic dermatologist and he quieted down very quickly when I casually mentioned I was friends with his chairman (which I was).

Some people are doucheba**gs - and physicians are not excluded.

 

[Zebra Hunter]

How can a physician not know what dysarthria and aphasia are? That alone set off alarms that perhaps this was a crna and not an anesthesiologist. I’ve ran into an uncomfortable number of crnas who are calling themselves “anesthesiologists” after their governing body changed their name (still not sure how it’s legal..)

Nope, she was wearing her hospital badge. She was indeed a physician. I presume it is from not having to consider the eval and symptoms of stroke in likely the last 15 years. My father who just retired as an OB/Gyn had no clue what a STEMI was (although, in his defense, when he graduated medical school, STEMI wasn't a thing).

 

[GassYous]

Nope, she was wearing her hospital badge. She was indeed a physician. I presume it is from not having to consider the eval and symptoms of stroke in likely the last 15 years. My father who just retired as an OB/Gyn had no clue what a STEMI was (although, in his defense, when he graduated medical school, STEMI wasn't a thing).

That's about par for the course for those guys

 

[thegenius]

How can a physician not know what dysarthria and aphasia are? That alone set off alarms that perhaps this was a crna and not an anesthesiologist. I’ve ran into an uncomfortable number of crnas who are calling themselves “anesthesiologists” after their governing body changed their name (still not sure how it’s legal..)

again if it were a test and she could think about it for 30 seconds she would get it right, but she was all discombobulated and couldn't think straight

 

[Birdstrike]

It's like diagnosing a 28 yo with an MI.

I've seen it. 28 year old female. Developed classic, crushing, substernal chest pressure. Felt short of breath. Broke out into a sweat. Vomited. EKG showed a classic STEMI. Troponins were normal (but eventually went up slightly). The heart cath ended up showing no occlusions, because it was due to vasospasm. But it was a true STEMI and was life threatening. She needed lifetime meds to prevent vasospasm.

You'll see 5,000 BS chest pains in young people before you see that one. And everyone will be telling you, "It can't be!" including yourself. The only way you're going to find it, is to do the workup. In the 4,999 BS chest pains, it doesn't matter what you do. Only in that 1 in 5,000, does it matter, and it matters a lot.

 

[betamale]

I've seen it. 28 year old female. Developed classic, crushing, substernal chest pressure. Felt short of breath. Broke out into a sweat. Vomited. EKG showed a classic STEMI. Troponins were normal (but eventually went up slightly). The heart cath ended up showing no occlusions, because it was due to vasospasm. But it was a true STEMI and was life threatening. She needed lifetime meds to prevent vasospasm.

You'll see 5,000 BS chest pains in young people before you see that one. And everyone will be telling you, "It can't be!" including yourself. The only way you're going to find it, is to do the workup. In the 4,999 BS chest pains, it doesn't matter what you do. Only in that 1 in 5,000, does it matter, and it matters a lot.

Heh, have had these too, 20ish guy with STEMI from meth induced Prinzmetal, 20ish guy with STEMI from an anomalous LAD coming from the pulm artery, preteen kid with a STEMI vs myocarditis, 30ish guy who had a saddle PE then a STEMI, 40ish guy with a "normal EKG" turns out to be Brugada...point is, these people are showing up in your ER...and always err on the side of caution

 

[KnuxNole]

If she worked at the same hospital, I(and other nurses) would immediately turn her into our intake registry. I sit in MEC and if I heard this I would place her on a remediation plan.

 

[xaelia]

Heh, have had these too, 20ish guy with STEMI from meth induced Prinzmetal, 20ish guy with STEMI from an anomalous LAD coming from the pulm artery, preteen kid with a STEMI vs myocarditis, 30ish guy who had a saddle PE then a STEMI, 40ish guy with a "normal EKG" turns out to be Brugada...point is, these people are showing up in your ER...and always err on the side of caution

We have a few young frequent attenders who had STEMI from SCAD (spontaneous coronary artery dissection) – they are understandably anxious folk nowadays ....

 

[thegenius]

Heh, have had these too, 20ish guy with STEMI from meth induced Prinzmetal, 20ish guy with STEMI from an anomalous LAD coming from the pulm artery, preteen kid with a STEMI vs myocarditis, 30ish guy who had a saddle PE then a STEMI, 40ish guy with a "normal EKG" turns out to be Brugada...point is, these people are showing up in your ER...and always err on the side of caution

It's not even erroring on the side of caution. If a particular disease has symptoms A,B,C,D,E, and F....and a person comes in with symptoms A,B,C,D,E, and maybe F....what are you going to do? Ignore it because they are not the right age group?

 

[WorkNoteEmergency]

Nope, she was wearing her hospital badge. She was indeed a physician. I presume it is from not having to consider the eval and symptoms of stroke in likely the last 15 years. My father who just retired as an OB/Gyn had no clue what a STEMI was (although, in his defense, when he graduated medical school, STEMI wasn't a thing).

Ha yeah, I think it was called a transmural MI BITD.

Barring other more pressing patients, I wouldn’t have let her simmer for 20 minutes. I’d have played along through the initial exam, give her some validation, start the work up and move on. If the dooshbaggery persists, dooshbaggery management is one of our particular skills and with this person, unlike most of our other patients and their families, word will filter back to the CMO/VPMA and she will get some feedback.

 

[emergentmd]

Its not just bc they are docs, but some just do not know how to socialize/take social cues.

Had a pt come to my FSER sent by their old Fart pulmonologist renowned to be incompetent in the community. She looked great, pos covid, no risk factors but mild/well controlled asthma sent for IV Regen.

We were running short, so i told her I would give it bc she was sent but said she didn't really fit high risk.

Got a call 5 min later from said pulmonologist, yelling at me b/c I told the pt she was not high risk. Kept yelling at me after I clearly told him she was getting it right now. Kept yelling about high risk whatever and I juts told him he was inappropriate. That triggered him more, and I just hung up. Guy called back and I told the staff Just put him on an eternal hold.

Must have ticked him off that some lowly Er doc would hang up on him. I am sure if it was the hospital, he would have went to admin complaining about me. Too bad for him I am an owner.

 

[The Knife & Gun Club]

There’s a decent cadre of physicians out there who really don’t have a good understanding of what EM training is in either its breadth or its goals. I’m married to a surgical subspecialty resident, so am privileged to a lot of the casual musings of other specialists who don’t realize I’m EM. A small but substantial number of them still believe EM docs are “physicians who went back to become mid levels.” And we spend our days ace wrapping ankles and ordering imaging which is not in their preferred modality for their operative planning.

Ive met residents who had no idea EM docs knew how to use pressors/place lines, run traumas, get Tox training, etc. I remember an anesthesia resident who was dumbfounded to realize we intubated our own patients. He “thought we just admitted and then the floor would call an airway emergency.” You can’t make this stuff up.

One of my wife’s co-workers was berating my intern on the phone for a subpar interpretation of an abdominal exam. Had to take the phone and kindly explain to her that we’re doing the best we can, and to remember that while we’re doing your patients work up I’m talking to radio about a stroke alert, have a person in bay 1 in hemorrhagic shock from a GIB, a bad anaphylaxis in bay 2, and and a gentleman with COVID who’s intubated on 3 pressors in an isolation room down the hall. So I am sorry We didn’t appreciate the subtleties on exam that you did, but you’re welcome to come down and manage any one of these critical patients yourself if you’d like my intern to have more time for their exam.

 

[nexus73]

I'm a psychiatrist. I'd echo what others have said, that other MDs don't really know what other specialties do. When did this anesthesiologist last do emergency medicine, 1st year residency for 4 weeks?

I'd wager there are some unconscious parent child dynamics playing out here, with a surgeon father, and an anesthesiologist daughter. She can now finally show the family she's a real doctor, just like her dad, and help out with an acute medical problem. Of course she's grossly ill equipped to do this because her day to day is putting people to sleep and waking them up without killing them....not exactly a useful skill in the realm of urgent care or emergency medicine. Her demands to have the ED doc leave the code, is really her saying "see dad, I'm good enough and I love you."

Or maybe anesthesiologists are just jerks.

 

[GassYous]

I'm a psychiatrist. I'd echo what others have said, that other MDs don't really know what other specialties do. When did this anesthesiologist last do emergency medicine, 1st year residency for 4 weeks?

I'd wager there are some unconscious parent child dynamics playing out here, with a surgeon father, and an anesthesiologist daughter. She can now finally show the family she's a real doctor, just like her dad, and help out with an acute medical problem. Of course she's grossly ill equipped to do this because her day to day is putting people to sleep and waking them up without killing them....not exactly a useful skill in the realm of urgent care or emergency medicine. Her demands to have the ED doc leave the code, is really her saying "see dad, I'm good enough and I love you."

Or maybe anesthesiologists are just jerks.

The sheer hypocrisy in this post lmao

 

[WilcoWorld]

I don't find it hypocritical. I can see why it could be triggering, but I think @nexus73 said nothing disparaging of Anesthesia as a specialty. (I assume the "Or maybe anesthesiologists are just jerks" was meant in jest)

 

[nexus73]

The sheer hypocrisy in this post lmao

well don’t explain or anything

 

[RustedFox]

I'm a psychiatrist. I'd echo what others have said, that other MDs don't really know what other specialties do. When did this anesthesiologist last do emergency medicine, 1st year residency for 4 weeks?

I'd wager there are some unconscious parent child dynamics playing out here, with a surgeon father, and an anesthesiologist daughter. She can now finally show the family she's a real doctor, just like her dad, and help out with an acute medical problem. Of course she's grossly ill equipped to do this because her day to day is putting people to sleep and waking them up without killing them....not exactly a useful skill in the realm of urgent care or emergency medicine. Her demands to have the ED doc leave the code, is really her saying "see dad, I'm good enough and I love you."

Or maybe anesthesiologists are just jerks.

I love this.
It's analytical, not hypocritical.

 

[evilbooyaa]

The sheer hypocrisy in this post lmao

Found the daughter from OP's post

/s

 

[Candidate2017]

I'm a psychiatrist. I'd echo what others have said, that other MDs don't really know what other specialties do. When did this anesthesiologist last do emergency medicine, 1st year residency for 4 weeks?

I'd wager there are some unconscious parent child dynamics playing out here, with a surgeon father, and an anesthesiologist daughter. She can now finally show the family she's a real doctor, just like her dad, and help out with an acute medical problem.

Stop projecting. Everyone knows the only specialty that doesn't have "real doctors" is psychiatry. Just kidding. Sort of.