(Yet another tale from my blog.)
“New consult for you,” the resident said. “2302. Name’s Gabbard. Old guy on the renal service with COPD. Vent management.”
Easy enough. I printed the records I could find on Mr. Gabbard, pored over them for a while, and headed off to the unit. I walked into room 2302 to find a little old man on a ventilator.
“Mr. Gabbard?” He grunted, sleepy with sedation. “Don’t try to talk; that’s the problem with these breathing machines–they make it hard for you to tell us much of anything.” Say what you will about Critical Care, long-winded patients are rarely a problem.
I introduced myself. “I’m with Dr. Simonds, the lung doctor. You know him, right?” He grunted. “We’re just here to manage this machine. I’m just going to look you over, if that’s OK.” He grunted in agreement. I pulled back the covers and carefully examined his feeble frame, decimated from years of cigarette smoking. I listened to his struggling heart; I thumped on his kettle-drum lungs. I checked for swelling in his shrunken limbs. For someone near death, he didn’t look that bad.
“Well,” I said, replacing my stethoscope on my neck, “looks like you’re doing pretty good. We might be able to get you off this machine tomorrow.” He grunted with what seemed like approval. “Take care, and I’ll see you later.” I walked out of the room and sat down at the desk to write his note, happy with yet another slam-dunk. As usual, I couldn’t find the chart.
“Have you seen Mr. Gabbard’s chart?” I asked the nurse, scribbling on a flow sheet beside me.
“Uh, it’s probably down there by his room,” she said.
I cocked an eyebrow at her. She handed me the chart for 2302. I examined the name on the spine. I took the chart in both hands and gave myself a firm whack on the forehead with it.
I calmly handed the chart back to the nurse and strolled into 2303, where I found a little old man on a vent. “Mr. Gabbard?”
