It’s really an impossible feat, eh?
Last night when I arrived, we were about 16 patients and four hours behind. Sometimes it’s easy for a fresh doc to arrive and crank out 5 or 6 patients in a row and get the waiting time down to a more reasonable 1 or 2 hours or even…gasp…eliminate the wait altogether. But my very first patient was an older, but fiercly independent lady who had thrown an arterial embolism to her leg. It sounds easy enough to make the diagnosis , call a surgeon and get her on her way, but imagine trying to convince a vascular surgeon at 11pm that you have a nanogenarian who needs immediate surgery. Because this lady had no known health problems, lived alone, took care of herself and had no disabilities, he finally agreed (wisely, I “led” him to the conclusion). “It sounds like she needs an embolectomy. Call the OR for me and let them know she’s arriving.”
So that was pretty cool, but it didn’t help me catch up on the rest of teh pile. The remainder of the night brought two simultaneous acute MIs (heart attacks), they went to the cath lab one after the other, and a lady with bright red blood, clots adn urine coming out of her rec tum. It was pretty gross. I had to call another surgeon (colorectal), order a nuclear study (at 2AM), and get her admitted as well. We were so busy that several patients left (they weren’t that sick), then an idiot came in who was drunk, got punched in the face, adn split his upper lip completely open. The PA stayed to sew it, thankfully, and she spent about 2 hours putting it back together.
I finally called in back up at 5AM, who arrived by 6:15 and got the rest of the department cleared out for the 7am shift.
It was a pretty wicked night, but at least no one died on me.