From Pairodocs-Laura
From Pairodocs-Laura
Ross,
Not that it even remotely excuses anything, but there is always supposed to be an attending physician to back up the resident, and they are supposed to come in under certain circumstances and when the resident requests assistance. When I was a first-year resident, the chief resident or senior resident backed us up, followed by notification of the attending for any admissions, surgeries, or deliveries. I guess that residents don't stay in-house any more, and get to go home after eleven so they aren't working more than 80 hours per week. I must admit that some of the most interesting things happened in the wee hours of the night, and the scariest, too. I know I did some things wrong, but by the Grace of God nothing that would have killed anyone; the few serious errors were avoided by discussion with the back-up docs. I had great training; I trained at Cook County Hospital and then small rural hospitals where you were "it". And yes, I have had to deal with a lot of coagulopathies because of it, including several "rat poison" intentional overdoses in suicide attempts.
I was always scared when I had to do things that were beyond my training or abilities. It felt like I was jumping out of an airplane with a parachute that someone else had packed and wondering, every time, if the 'chute was going to open and if it would open correctly. Perhaps your resident had never dealt with anyone with your problem. He was probably worried that he would give you a stroke if he gave you too much plasma, or a pulmonary embolus. It is much easier to transfuse someone than to resuscitate someone suffering from a pulmonary embolus. There is a lot of precedent in the medical field, including "first, do no harm", followed by "alleviate pain and suffering." The whole thing about "doing nothing is the worst thing you can do" is considered a cowboy attitude these days, and courts take a dim view of it.
If you must blame someone, blame it on the attending physicians, who are responsible for their residents, or "greenhorns". In my opinion, they dropped the ball seriously in your case. No one likes to take ER call; if it's been days since you've gotten a full night's sleep, it's pretty difficult to be civil. But you still come in. It's better to be rude but present than to let the resident take the fall. It's been a major sticking point at every hospital where I have been an attending physician. There is a huge shortage of physicians, and no wonder. The guys in my group are nearing retirement age, and can't retire because of the stock market, but also because there are no replacements. I don't know how to fix the problem.
I've detailed my ER experiences previously, and I AM a doctor. I was literally begging them to admit Chris, and because all of our doctors had either retired, moved away, or changed jobs, we were considered "drop-ins", of all humiliations, and no one wanted to admit us. Fortunately, the hospitalist on call was a friend and used to see Chris years ago, and agreed to do it. The rest is history.
Chris and I are praying that your recovery is rapid and all is smooth sailing from now on. Ross, you're a good guy and people need your expertise and, and, well, they just need you.
Another Warm and Beautiful Fall Day in Idaho,
-Laura
Once again I am not surprised by the lack of morals that some doctor's have. As you said, if you are in over your head, then man up right away and go find someone to give you help. God Bless the doctor who stuck up for you regarding the anti-coagulation issue. I sincerely hope that you will be able to put this behind you and get back on the road to a speedy recovery. You and your family are in my prayers.
