The rotation I'm on right now is a little too slow. I know, they're either too busy or too slow, there's never anything in between that's just right. I told the med student who's on my team to bring a book, there's just nothing to do. I have seven patients, but only two of them should even be in the hospital, the rest should be in a nursing home. I passed a patient lying on a gurney in the hall. He moaned, "am I on your list?" I said he wasn't. "People go to this place to die," he said, as I went to check his chart. No one had written a note on him in two days. I don't know whose patient he is or why they left him in the hall. I found his room, took him back, paged the resident who'd last seen him--
It's bizarre to go to the different hospitals in the system and realize the differences. Same doctors rotating through, but a different facility, different patient population, and different standards. If you need a scan here, it has to be a Monday or Thursday or it's not happening. Scans happen on Mondays and Thursdays. You need it on Tuesday, you're probably waiting until Thursday, emergency or not.
I went into one patient's room, I'm asking him about how he's doing-- and his roommate answers from behind the curtain. "I'm talking to Mr. [Patient], your doctor will be with you later." No matter, he just kept talking. I ask the guy how long he's been married. The roommate answers. I ask how his leg is feeling. The roommate answers. This would be merely annoying, except-- the patient has dementia and we haven't gotten a real answer from him since he came in. Somehow, he must have had a few moments of lucidity and had some sort of wide-ranging conversation with his roommate, where he told him about his family, about his medical problems, about his hobbies-- the roommate knew everything, we don't know anything, we've never been able to get a sensible answer out of this patient.
I have one patient, an African-American guy-- I feel bad for him-- he knows what year it is, he can count to ten, he knows the alphabet-- but he doesn't know who the President is, and when I say Obama, he just stares blankly, it doesn't ring a bell. He's probably been waiting 80 years for a black president, and now that we have one, he doesn't even know it. I know the mind doesn't work this way, but you'd hope something like that would have stuck. It's unfortunate.