The Hospitalist’s Story
- Audrey Young, MD
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auyoung@u.washington.edu
- Anneliese M. Schleyer, MD, MHA
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Seattle, Washington
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- PIECE OF MY MIND (YOUNG RK, ED)
Over the telephone, the patient sounds typical of our county hospital clientele: a homeless drinker with an ejection fraction of 19% and a triad of recent hospitalizations for his failing heart. He stays at a shelter near the city's fashionable bars. Three days ago he began coughing and developed a fever, the emergency department physician tells me. The last discharge note had him taking the usual cocktail of cardiac medications, but like many of our recurrently hospitalized patients, he hasn't filled the prescriptions or visited a primary care physician.
The emergency physician coaxes: “He's a real nice guy. How about dry him out and send him on his way.” I check the x-rays on the computer as I listen, noting the pleural effusion and pulmonary edema, neither of which are new.
The patient's name is Marv. I meet him when he arrives on the hospital floor. He is bone thin …
