Patient 12 hours post-surgery, and we're trying to be extra-vigilant about possible bacterial infection causing altered mental status. Which is hard when baseline mental status is a little eccentric.
"How are you doing?"
"I'm fine, but how are my plants?"
"What plants?"
"I went to therapy two days ago and potted a plant. I want to see him."
"Him?"
"I want to know how he's doing. I don't know what happened to my plant."
"Sir, can you tell me what year it is?"
"2012. I want the plant."
"What month?"
"Is it still January? Is there someone I can call to track down my plant?"
"I'm concerned about how concerned you are about this plant. It's making me worry about your mental status and whether it may be affected by your infection. Can you try and disregard the plant for a moment, and let's talk about something else? Which doctors have you seen today?"
"I don't know. Some doctors. None of them knew about the plant."
"Are you feeling any pain?"
"I don't know. When I sit up, a little. But what I'm really worried about is the plant."
"Why are you so concerned about the plant?"
"The plant is very important to me."
"Why?"
"I don't know."
"I'm going to have the nurse draw a fresh set of labs. You're not doing a good job of convincing me that there isn't something going on here."
I feel like Altered Mental Status: The Game Show could be a real hit. Panel of celebrities, they meet a patient, vote on what they think, I'm not sure of the logistics, but I think it could work.
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Shouldn't a baseline mental status have been established pre-op?
ReplyDeleteare you sure you aren't examining a med student prepping for step 1?
ReplyDeleteMore importantly, what did you do with the plant?
ReplyDeleteI want to know about the poor plant, too!
ReplyDelete- KrisW