I felt like a bad doctor today, or at least a lazy one. On weekend days when we're not on late call, we're allowed to leave whenever we're done, and in theory that can be as early as lunchtime. So I raced to get my work done this morning, hoping nothing would come up, hoping I could leave at noon and have the rest of the day off, hoping I wouldn't get any new patients assigned to me....
And then I got one patient's blood work back, and his hemoglobin was a little low. My reaction should have been, "oh, his hemoglobin is low, I should figure out why." Instead, my reaction was, "oh no, this is going to keep me here, it's probably nothing, maybe I can just ignore it." And I stood there for 90 seconds weighing what to do. A good doctor, or at least a conscientious doctor, shouldn't weigh what to do. A good doctor should just suck it up and deal with it and make sure there isn't a problem. Which is what I realized after the 90 seconds, and I went to see the patient, made sure nothing was wrong, checked in with the resident, and, okay, no one would have been harmed if I had done nothing, because he was fine, but obviously I would have felt terrible if I'd ignored it and it turned out to be something important.
So I'm about to sign out-- and then I get paged that one of my patients needed to be moved to the ICU. A good doctor would have stopped everything, gone over to deal with the patient, and wait for transport to come with the appropriate monitors to attach to him for transport. A bad doctor would have left and told the intern on late call to deal with it. And in between was me, who went to check the patient, realized the transport team was hours away from getting there and attaching all the monitors-- and so I just wheeled him to the ICU myself, hoped nothing bad would happen along the way, and then I could sign out and go.
On a normal day, at 1:00 everything is fine, you do what you have to do, you know you're there until at least 5:00 anyway, and usually later than that. But today I wanted my afternoon, I didn't want to wait two hours for transport, I wanted to leave. So I did what I had to do, and left. Should I have been more diligent, should I have double-checked everything? Probably. But there's always more you can do, there's always another patient to check on, there's always tests to order, test results to read, things you can do. We can't do everything. And sometimes you just need to decide this is a day when I'm going to do what I have to do and then leave. I was the first one on the team to leave. It's my pre-call day (I'm on late call tomorrow), so that's how it's supposed to work. And I didn't do anything wrong. I did my job. I still can't help but worry that a good doctor wouldn't be in such a rush to leave. A good doctor would want to stay. A good doctor would care more. Maybe.