Late entry secondary to patient care

The patient, whom we will call H.P., delivered a healthy baby something-or-other sometime during the early morning of August 14th. OBGYN intern, Dr. James Logan, was now twenty hours into a thirty hour shift and this was the fifth delivery he’d done. Feeling increasingly queasy at the prospect of rounding on eighteen patients by himself in a few hours – the day intern had called in sick – he opened the 3-ring binder chart, willing himself to knock out a quick a delivery note. He wrote, “On August 16th, patient H.P. delivered a viable –”

He was interrupted by the frantic call of a nurse from down the hall. “Dr. Logan, chi can bree!” Dr. Logan slowly put down his pen, for, while he didn’t understand what the Filipina nurse on the post partum floor was trying to tell him, he had the sense that it was of some urgency. Again came the nurse’s cry, bordering on hysteria this time, “Dr. Logan! Come kweek, chi can bree!” Turning the words over and over, upside down and sideways in his mind, James Logan made his way over to Post-Partum. Slowly at first, then more quickly as meaning began to take shape in these strange syllables. He arrived at the patient’s room to find her awake, sitting up in bed and taking quick, shallow breaths. The look on her face was one he recognized well, as he frequently would see it on his fellow interns – panic.

The next several hours were a blur. James’s chief resident, Jen, came by to help out with the lady who “couldn’t breathe.” It took about twenty minutes for everyone to reassure themselves that the patient was just having an anxiety attack. Shaken but relieved, James got to the business of rounding on his eighteen patients, a task that would have exhausted him on the best of days. Today, crying babies and new moms’ discourteous taking of showers before he’d had a chance to examine them sapped the last few ounces of his strength. There were still notes and orders to write before he would be allowed to leave. While he contemplated these things, Jen popped by the nursing station where James was buried under a pile of charts with a friendly reminder. “Did you ever get to that delivery note?” He hadn’t. The look on his face must have indicated to Jen the need for quick, empathetic intervention.

“Yeah,” she said. “I know it sucks. I was an intern once too.” She smiled encouragingly. “Hey, I’ve got a joke for you! An OBGYN resident walks into a bar.” James waited.

“Where’s the punch line?”

“That is the punch line! When does an OBGYN resident ever have time to go to a bar?” She laughed, slung her purse over her shoulder and made her way to the parking garage.

Fighting back tears, James reopened the 3-ring binder chart, tore out the old, unfinished note and began anew. “Late entry secondary to patient care. On August 16, patient H.P. delivered a viable…” But, he had forgotten the details. The official record of the delivery of H.P.’s baby whatever-it-was would be one of historical fiction.

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