I’m tired of my patients dying. Can we just not do that anymore?

You people won’t believe this, but I really am too nice. Even when my attending isn’t on call, the medicine people go out of their way to consult me on things – things which ought to be directed to half a dozen of the other surgical services before they got to me. I take that as a very backhanded compliment, because I know I always consult two cardiologists, because they’re nice and explain things, one pulmonologist because he discusses the plan and doesn’t extubate or intubate your patient without fair warning, one endocrinologist because he’s always available, one GI doctor because he does a very good job. And on those services, I’m afraid there are about four medicine residents that I always call because we play well together, and trade favors back and forth. Especially neurology: I set up a trach and peg on a difficult case, and he writes helpful notes on brain-damaged patients. Give and take.

But I could stand not to get interminable calls from medicine when it’s not my day to be taking consults, just because they know I won’t bite their heads off about how they should be consulting colorectal surgery for colon cancer, or vascular surgery for leg lesions caused by poor circulation, and so on. I’ll just take the call, figure out how sick the patient is and which surgeon they really need to be seen by, and pass it along to the right resident. One of these days, in about two more months by my estimation, I’ll snap, and start not being patient about it.

At least it’s encouraging that when I get into practice I might be able to build a referral base quickly (but perhaps not for very exciting cases).