Swanky black tie event, for some reason a second year resident Dr. Okefor is there, and now, for the show on patient dumping! Again a great topic and complex issue. Are they planning on having an intelligent and nuanced episode on the unfunded mandate that is EMTALA? Nah.
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Realistically, the surgical resident would stay at the party once the medicine resident and NP took the confused lady to the ED. We will not pass up the opportunity to destroy a shrimp plate.
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Our heart transplant patient has returned by wandering into the ED. One of the realities of modern hospitals is security, especially in the ED. How is it that this guy is able to walk back into patient care areas? Especially where you're taking trauma victims?
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Now for a true realism test. There is a patient with eye trauma. Will it somehow become Okefor's problem, or like all general surgeons, is she creeped out by eyeballs? (It's a pet theory I have because I hate eyeballs) This is the only time I'm grossed out watching TV.
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The confused lady presents a dispo problem for the sociopath and the NP, they need to treat her but worry she won't take care of herself if dc'd. Solution? Fabricate a complaint on the medical record. Not contact social work or case management, straight to lying.
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And here is where the dumping comes in. The NP recognizes the EKG lead! It must have come from a specific hospital she knows dumps patients because...only one hospital uses that kind of EKG lead? Seems fishy. Nurses what do you think? Aren't they all kind of the same?
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The chief of surgery and random oncologist for some reason become involved in an admission decision. Not, the ED attending? The admitting service? Some other lowly administrator? Ahhh eyeballs! The intern would not be pulling glass out of eyeballs!
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Do they not have optho to come in lugging a suitcase full of fancy tools? I always spot optho by their carry-on baggage. And now the NP has gone from the ED to the heart transplant clinic to see our transplant guy. Seriously, they need more than 3 staff in this hospital.
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Confused lady who was dumped now GI bleeding? Hemoptysis? They have no idea what happened to this lady. Conrad intubates her easily despite airway full of blood, and pulls the stylet himself (ask for an assist to do that so you don't lose it).
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You also don't need to turn it 90 degrees to mainstem it. You just keep pushing, it will go right. Conrad somehow manages to say bronchoscopy funny.
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Okefor uses a rigid biopsy forceps through a flexible scope. Yeah. Not a clever bunch.
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The intern is doing a great slit-lamp exam of eye-injury guy's cheek. The optho should really be doing this stuff.
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I didn't realize the intern was related to Raj on Big Bang Theory.
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I love that actor though, he does grumpy dad really well.
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Wow, they've already extubated the Confused/Dumped/Hemoptysis lady. All in the time this party is going on they've admitted, intubated, bronched, and extubated her and have planned her discharge back to Atlanta Gen. Chastain Memorial is reaching god-like efficiency here.
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Eye guy is charming. But somehow has developed tension PTX from esophageal perforation after vomiting? Not likely, more likely missed lung injury from their half-assed trauma workup, you're not going to get tension from the esophagus. And he needs a chest tube, not a CT.
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Capturing your tension pneumothorax on a chest CT is poor form.
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Conrad (sociopath MD) and NP don't like that the parents want to check out the Confused/dump/hemoptysis lady. I agree, she was coughing up blood like 5 minutes ago. Rather than discuss with the family though they immediately go to lying and undermining family wishes.
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Most people are pretty reasonable, and if you at least explain your reasoning they'll give you an hour. I don't know why it's admirable that the constant recourse of our hero is lying and fraud.
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This is the stupidest dramatic conflict ever, the patients parents can't wait a single minute more to discharge her because they have to treat her schizophrenia this minute. Said no one ever.
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The writers of this show seem to think it's cute when men can't take no for an answer. I find it rapey, not charming. Okefor was very clear why she is not into heart transplant dude. His response, "you can't just leave me here." Yes she can. She said no. Go away.
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Apparently this patient passes out when she sees bad art.
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Wegeners. Of course. And again, the most unrealistic thing about this show is their pathology service. They did immunofluorescence in the middle of the night? Seriously, 5 business days minimum.
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Esophageal perf guy has already had surgery, the same night, and is awake and talking? Like in the same hour. His dressing is on his neck but he seemed to be having a tension pneumo before with crepitus on his R chest and SOB. I feel like I'm taking crazy pills.
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This show is happening in a parallel universe where time is frozen, so all procedures and tests can be completed during a swanky party. Or... This party has been going on for 7 days.
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I think everything that happened in this episode could have been accomplished without Conrad constantly lying. This is the worst aspect of this show. Conrad is a bad person and a bad doctor.
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And they didn't go into dumping at all, why it happens, why hospitals do it, why EMTALA is an unfunded mandate, really superficial coverage of a serious problem. This show sucks. But it looks like denouement is next episode, the end is in sight!
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