Medicine Sub-I, Day 20

A long-call day. Nice that it is on a weekend, though, so we can concentrate on doing the work that needs to be done, uninterrupted by lectures. I picked up two new patients.

One is admitted with chest pain. A nice fellow, he's in a jolly mood answering my questions while eating dinner. I lay out the plan, and he's on board waiting for the test results as we do the 'Rule Out M.I.' Dance. A few hours later, he goes all bipolar on us, yelling at the nurses, yelling at me, ripping out his IV, and leaving the hospital against medical advice. It could have been worse, I suppose - while the scene wasn't particularly pretty, none of us felt physically threatened at any time. I did my duty as best I could trying to convince him to stay, but in the end he was dead set on leaving. Thankfully none of us are especially convinced that he was having a heart attack anyway.

My resident asks me if I feel like I've learned anything during the sub-I. "I've learned how to 'rule out' an M.I." I answer, "but I have no idea what to do next if someone is ever 'ruled in'." He doubles over in laughter.