Wednesday, November 23, 2011

Tales From Residency: Shut-up, Medicine!

I think evidence-based medicine is important. But there are also times when I just want the medicine consult and I don't want to hear the 30 years of research behind the consultant's recommendation. You know a lot, I get it. Just tell me what to do.

During residency, Medicine was consulting on a patient of mine who required an angiogram. I called them while I was on call on a Saturday and they returned the call while I was eating lunch:

Me: "So how much Mucomyst should we give to protect the patient's kidneys?"

Medicine consult: "Well, historically, we've given 600mg in four doses, but...."

Me: "Uh huh...."

Medicine consult: "...there was a randomized controlled study done in 2006 which showed that a dose of 1200mg compared to 600mg is more effective in cases where..."

Me: (thinking) "Oh my god, just tell me how much Mucomyst to give so that I can eat my Philly cheesesteak!"


  1. But Fizzy, in 1953 they did a study comparing arguing vs. not arguing with consultants about the benefits of straight vs. pointless answers, and in a recent double meta-analysis of the data using chi-squared technique, and then doing urinalysis (to calculate a p value) they found that...

  2. I think I should go into internal medicine.

  3. This reminds me of when I was on ICU and we wanted an opinion about whether a patient should go to the cath lab. He had elevated trops and ECG changes, but was not anticoagulated because of a recent retroperitoneal bleed. Cardiology's answer was that he should be cathed, but that there would be a trade off with the risk of bleeding, as he would surely need anticoagulation for the cath. And that we should weigh these in making any decision.... which we already knew, we just wanted them to say whether doing the cath would be worth the risk for him!

  4. HILARIOUS!!! & that is what I have to look forward to when Im done.

  5. Have you ever taken this drug? As one who has..and maybe you should try it....600 is enough...