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Published online by Cambridge University Press: 05 February 2015
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CASE
“The camouflaged patient”
I was on a surgical rotation and the patient was an elderly woman who had developed a severe postoperative infection after undergoing a cholecystostomy. The surgical residents were terrorized as to what the attending physicians would say on rounds. In an attempt to camouflage the patient's condition, the residents staged a scene in which they propped her up with pillows and put a breakfast tray in front of her to make her look better than she really was.
CASE
“Didn't you write that order?”
A very sick patient on the cardiac care unit was waiting for a heart transplant. Hospital routine was such that, beginning on Thursday, residents or interns on call left the care of their patients to others over the weekend, often during critical periods of hospitalization. As an intern, it fell to me to cover this particular cardiac patient for another intern on his weekend off.
Before he signed out, the intern stated his concern that despite high doses of potassium the patient's level remained low. Because there was no apparent renal insufficiency, I decided to increase the potassium dose and scheduled a dose of 3 times a day, assuming it would be monitored in my absence. The next morning the level was normal, so I continued him on that dose.
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