I got there early as usual. God, I hate being here this early. No one in his or her right mind would wake up this early and make everyone else suffer while doing it. Oh well, I might as well get started. I went to the computer to print out the patient census for the three residents and myself and quickly jotted down the vitals, ins and outs, and new labs for each of teh ten patients on our service. By this time it is 5:30 and I only have half an hour to see as many patients as possible before that horrid intern gets here. I’ve never met anyone so nasty, I think as I gather up the charts. I guess since they make him suffer, he wants me to suffer, too. He really stresses me out. But that’s OK, only three more weeks of this inhumane torture.
Let’s see…Room 401…Mr. Smithe. He’s always pleasant. This should go pretty quickly. How did you sleep last night? Are you in any pain? No bowel movements? Are you passing flatus yet? Good. Make sure you’re using your incentive spirometer and try to get up and walk more. I know that NG tube is a pain, but as soon as you pass flatus or have a BM, we can take it out.
I quickly jot down my note and stick his chart on the counter for the intern’s signature. So far, so good. One down, nine to go and it’s only 5:35. Room 406 Window. Hmmm, he’s new. Mr. Gupta, status post left hemicolectomy. He must have been done last night after I left. OK, this should be pretty simple.
Hi Mr. Gupta. I’m the student doctor on the colorectal team. How are you doing today? Why is he looking at me that way? Did you sleep well last night? Maybe he’s just sleepy. After all, it is 5:37 a.m. How’s your pain? Mr. Gupta? Could you talk a little slower Mr. Gupta? I can’t understand what you are saying. That’s exactly what I don’t want him to do. I only have 22 minutes left. He pointed to his belly. Your abdomen hurts? Oh, you have to use the PCA, I mean the button. See…press on it to feel better. Have you been using your incentive spirometer? Wonderful…another confused look. Part of yoru colon was removed last night. No, don’t touch that!! We can’t take the NG out until you pass flatus or have a BM. 5:41. Mr. Gupta, I have to listen to your lungs, heart, and abdomen. OK, only 15 minutes left. I look up and give him the news. No rales or crackles, regular rate and rhythm, hypoactive bowel sounds. Just then, I noticed something very different about Mr. Gupta. Part of his jaw is missing. On first glance I thought maybe he just didn’t have his dentures in or his accent was too thick to understand. I took a quick look through his chart. There it was in big bold letters: Pt. does not speak much English. 5:49.
I didn’t get much further before he slowly gummed to me in a hoarse, slurred voice, “I was a phyzthithan many yearsss ago in my country.” I immediately felt like a fool. He understood everything that was going on. “A sssurgeon.” He went on to tell me that no one seemed to want to listen to him long enough to find out “how I wasss filling.”
He told me how six years ago his right mandible was removed for a cance rthere. Since then, only his family had had the patience to listen to him, and sometimes not even them. 5:55.
By the time we finished talking, it was 6:03 and I just caught sight of my intern’s coat as he walked toward the nurse’s station. I was sure he would stop by the patient nourishment station to get some juice first, so I quickly wrote down my findings and promised Dr. Gupta that I would be back to talk to him later in the morning.
Are you just getting here? Disgusted with his assumption, I handed the intern the list of vitals and the two charts to sign. He looked over them and seemed to be impressed that I was able to communicate with Mr./Dr. Gupta. Funny I couldn’t get a word of English out of that old guy yesterday. I smiled to myself and off we went to see numbers three through ten.