It was quiet, and gave me time to review files, figure out my day and have a quiet cup of coffee before the day turned frenzied.
A knock on my office door and in came a colleague's nurse, clutching a sheet of paper. She said she was getting a patient ready for the first appointment of the day and had done a pulmonary test, a flow-volume loop for Jeff to read. "I've done it several times, and it always looks like this!" she exclaimed.
Now, normally a FVL looks like this, at least in general terms:
I looked at the report she was holding. It looked like this:
I resisted the impulse to turn the sheet upside down. After a moment I looked up. "Judy" I said, "You've hit the jackpot. Jeff is going to present this at the next ATS conference, I'm betting. You've just diagnosed the one in a million patient." I paused for effect. "This patient's lungs are upside down inside their chest!" Her eyes were wide. "Take this back to Jeff and tell him what you've discovered. He'll probably give you a raise." I handed the report back. She hurried off.
Now, the test is done with a fleisch pneumotach. It looks something like this:
See the two tubes connecting to the port on the bottom? She had no doubt reversed them when she assembled it for the test.
I was just starting rounds when my pager went off (remember pagers?). It was one of those that messages could be sent via text. From Judy, it had only one word, an anatomical reference far south of my pulmonary specialty.
Perfect.
ReplyDeleteA bit low-brow, but fun.
DeleteDelightful story, Mike, and I love Judy's response.
ReplyDeleteShe was a character, a farm girl from eastern WA who was blunter than most RN's I knew.
Deleteand people think doctors have no sense of humor :)
ReplyDeleteThey should meet pathologists.
DeleteHaha. I wish I could show this post to the surgeon who removed my husband's left lung. He'd get a kick out of it, I'll bet! :)
ReplyDeleteWhy was his lung removed, CA? Hope it went well.
DeleteLung cancer.....huge tumor. That was over 3 years ago, and he's doing great! I see the surgeon occasionally at the bookstore where I work. He's a wonderful doctor and a very good man.
DeleteShe called you an ankle? That's pretty far south, after all.
ReplyDeleteOr a heel, more appropriate.
DeleteMy mind that has voids of medical knowledge smiled at this... Have you written about your time in Cambodia?
ReplyDeleteAh, in response to my comment on your blog. No, haven't written about that. Not sure what the statute of limitations are.....
DeleteRobbie Grey, I'm keeping an eye out for you. You're dangerous and I expect to see your name in lights someday.
ReplyDeleteHey, I love stories that start Back in the day. I make myself a pot of coffee, get in a comfortable chair with arm rests, put on a crash helmet and wait for the synapses to start popping and the room to light up.
Seriously, I'm enjoying experiencing we the baby boomers writing our own history. I'm interested to know what we think about what we've made of things.
Robbie is a good guy, with a very good, funny blog.
DeleteAh, the pepsi generation, how will we justify ourselves.......
Oh, Sirs...how ya'll do go on...
DeleteI love a medic with a sense of humor.
ReplyDeleteI can't wait to see the EKG she does!
ReplyDeleteThe most common tech error in doing EKG's is reversing the R & L arm leads. And the way to read it anyway is to hold it up to a light, looking from the back of the paper at the image on the other side, effectively reversing it again!
Delete