by Danielle Ofri
New York Times Op-Ed
It was probably our eighth or ninth admission that day, but my intern and I had given up counting. I was midway through my medical residency, already a master of efficiency. You had to be, or you’d never keep up. This one was a classic eye-roller: a nursing home patient with dementia, sent to the emergency room for an altered mental status.
When you were juggling patients with acute heart failure and rampant infections, it was hard to get worked up over a demented nonagenarian who was looking a little more demented.
The trick to surviving in residency was to shuttle patients to another area of the hospital as quickly as possible. This patient was a perfect candidate for the intermediate care unit, a holding station for patients with no active medical issues who were awaiting discharge. First we just had to rule out any treatable medical conditions — get the labs, head CT scan and chest X-ray. But the docs at the intermediate ward left at 5 p.m. and it was 4:45. I quickly scanned through the labs, called the ward’s doctor and ran through the case — demented patient, still demented, return to nursing home tomorrow.
I remember the doctor’s voice so clearly: “You’re sure the labs and everything are normal?” Yes, yes, I said, everything is fine. She hesitated, then said O.K. The intern and I high-fived each other, and bolted back to our other admissions. (read the full New York Times Op-Ed)