BOSTON, MA – Dr. Johnny NoSleep, a local vascular surgeon, was sailing his way through his Friday afternoon post-op clinic until he was derailed by his 74-year-old patient, Mr. Unfiltered Camel, who was returning for his two week follow-up appointment from a fem-distal bypass for toe gangrene.
NoSleep, who has been under the hospital microscope for his 15% 30-day readmission rate, was chagrined to find out that Mr. Camel had a focal area of wound opening and some redness that would need antibiotics and wound care to avoid further surgery.
The good doctor, fully aware that another hospital readmission could potentially jeopardize his annual $16.00 “pay-for-performance” bonus metric, was nervously reaching for the phone to call admissions when he was struck by a brilliant idea. After briefly negotiating with Mr. Camel that he would only be allowed to smoke in the family driveway and not in the actual living space, he was able to coax his patient into his 2008 Dodge Caravan where he safely delivered him to the NoSleep residence in time for dinner.
After a brief family discussion over some shepherd’s pie it was decided that Mrs. NoSleep, a piano teacher, would be in charge of twice daily wet-to-dry packing of Mr. Camel’s medial calf vein harvest site as well as antibiotic administration. The couple’s oldest daughter Susan, a 17-year-old aspiring accountant, would be in charge of medication reconciliation and TV station changing.
Billy, the 12-year-old avid baseball player, would be in charge of whacking Mr. Camel’s back intermittently when he mucous-plugged as well as continually squeezing Mr. Camel’s non-operative leg as a means of DVT prophylaxis. Finally, Rusty the golden retriever would be in charge of keeping Mr. Camel’s open toe amputation site “clean of debris” with his incessant licking.
All was going smoothly until Mr. Camel’s baby-monitor-turned-telemetry showed he was in rapid afib and despite two attempts at cardioversion with a lawnmower battery and jumper cables he ultimately had to be returned to the hospital and readmitted.