Not taking 'no' for an answer

One of the jobs of preventive medicine physicians is to tell colonels and generals--pretty much, people who outrank you by quite a lot--that they can't do something because it's too dangerous/stupid/etc. In other words, prev med docs aren't typically easily intimidated and don't really take no for an answer eaily. I guess I'm getting an early start on that.

Yesterday I was the only doc on the team (except the attending, who doesn't really count); the resident and other intern were both out. So I was taking care of all the patients, which fortunately, was only four, as well as our two new third year medical students. Unfortunately, I didn't have time to do anything educational, as I was spending most of my morning running aorund trying to get a patient discharged to a rehab facility. The transport was scheduled to come at 1400; at 1310, the nurse told me that the facility wouldn't take him. He still had a bed, but there was something about not having enough therapists. They social worker didn't bother arguing with them, so I called them and essentially said that I don't care about their therapists--if he has a bed, he's going. They had me write an order saying that it was okay if he didn't get therapy until Thursday, which I gladly wrote, and he got out of there.

I'm currently working on taking this not taking no for an answer to get the internship director to say that it's okay for me to go to Peru during my research month. Stay tuned for more details.

Anyway, it's been two and a half weeks on ward 75, and the vast majority of what I've done in that time is stuff that they don't teach in med school--social work. Talking on the phone with rehab facilities, setting up follow-up appointments, etc. For as exhausting as the MICU was, at least I didn't have to deal with any of this stuff associated with discharging patients. When we were ready to get rid of a patient, we just called the on-call medicine team and had them take the patients to their service, and then they could deal with all this discharge stuff.

Okay, enough of that. I'm going to go back to enjoying my day off, and by 'enjoying my day off', I mean waiting for my eyes to return to normal after being dilated for my eye exam, and then heading back to Bethesda in about an hour for another doctor's appointment. Fun, fun.