21 June 2010

altered mental status

although i owe the interwebz a decent post about my glorious month on the famed (and often infamous) tinsley harrison internal medicine service, today i will whet your appetite with an anecdote.

every patient who comes in to the hospital has recorded a "chief complaint" which is the reason for coming in his or her own words ("chest hurts" or "short of breath" etc). the best chief complaint from my personal annals: "this bitch just slapped me" (true story! courtesy of a psych patient). however, if the patient is unconscious or otherwise unable to give a CC, "altered mental status" is written.

enter: tonight's anecdote's patient. altered mental status, but doing much better. as we were rounding this past weekend, post call (read: having been awake for 30hrs straight) our attending entered the room and began questioning the patient with some typical orienting questions "what day is it? what's your name?" etc. the patient feigned sleep, rolled around in bed, then her eyes popped open.
"where are you?" my attending prodded.
"yoooou tuuuube." the patient drawled.
i smirked; bit my tongue hard. my attending unfazed.
"and what's your name?" she continued.
"charlotte," the patient started, seeming to collect herself. we all looked at our rounds papers to see if she had gotten the answer right.
"charlotte's web." the patient finished with a grin.
"oh, ok. get some rest." we quietly exited the room with our lips pressed together. the door shut behind us, and i lost it, totally rolling in hilarity. everyone was smiling.
she'll get better... but until then, her child-like confidence in her imaginary location and identity will help us get through the day. and on tinsley - that's all we can ask for.

No comments: