On meeting the President and ED VIPs

I'm not a huge fan of the concept of VIPs in the ED. As far as I'm concerned, the only categorization should be based on severity/stability (“sick” vs. “not sick”). Perhaps this makes me too much of a socialist? But it's also true that any time as a health professional you're asked to see someone as a favor, you run a significant risk of the interpersonal/social situation informing and overwhelming the clinical aspects. One will almost always end up doing too much or two little when emotionally involved. And besides, I think the motto of the Osler firms (the medical service at Hopkins) was “aequinamitas,” or “equanimity” pretty much sums it up. It's the characteristic of a physician to maintain composure and remain un-impassioned or prejudiced no matter what or whom came to him/her. I'm glad you're powerful/influential, but if you're not sick or in pain you have to wait. One of the errors providers make is to think that patients or their families are being “annoying” when they keep pestering you about their case. It's like the survival mode-- if you don't speak up, you could be forgotten. If you don't push yourself to the front of the line, someone else will and you'll get left behind. It's understandable, especially when people don't understand what part of their care is important and what part isn't (Ok, guilty on this one-- I really don't care that there's some blood backing up in your iv tubing. It's gravity and the most benign thing likely to happen to you during your ED stay. Besides, if you're conscious enough to tell me, you may not even need it).

It's a two-way street, though. I mean, I'll let you know when I get the labs back-- every time you ask me is time I can't use to do something about those results, if need be. (Trust me, your ED doc would love to discharge you-- really, no matter how cute you think you are, we'd rather you be home. But constantly checking to see if you can go home will in no way change the order of things we have to do in a shift such that you'll go home before I get that child over there breathing again. Just try to understand that, and I'll try to understand when you don't. One of the things ED providers always fantasize about is going to each of their patients' places of work (ok, big assumption there) and following them around asking questions implying they don't know how to do their jobs. :) One of my favorite responses that I think every time but have rarely said is to ask the insistent/entitled patient to get a note signed by all the other patients that they should be seen first, and I'd be happy to do so... Goes over better in my head than in real life.

Anyway, got called over to the hospital on a “day-off” by one of the Pas to help with a patient. So, I should never really get called to the hospital, and so when the call came I threw on some clothes (was about to take a shower) my flip flops and grabbed my stethoscope. I saw her, in the VIP room up on the floor, and made a few recommendations. Turns out, though, that she is a former head of the interim government of Liberia and close personal friend of Ellen Sirleaf. And it turns out the President wanted to visit that afternoon. So, t-shirt, flip-flops, jeans, bed-head and all, I met a woman whose historical significance (as the first elected female head of an African nation) is certainly in the same range as President Obama's. Yeah, I made a winning impression, I'm sure. ;)