BUFFALO, NY – In a stunning turn of events last night at Sacrebleu Memorial Hospital, Pulmonary & Critical Care fellow Damien Dunlope earned headlines by forever changing the often-stressed ED/ICU dynamic.
According to witnesses, it was a typical night in the 28-bed ICU: nurses’ eyes glued to The Bachelor, residents’ eyes glued to the ED trackboard, and patient’s eyes glued to the ceiling. While Dr. Dunlope was making his way from the physician workroom to the nearest window to improve his cellphone download speeds for the newest Clash of Clans update, he was stopped in his tracks when he heard a scream from patient room 18.
“I didn’t know what to do,” Dunlope posed. “In my 6 years of training, I’d never heard anything like it. The scream was loud, shrieking, bone-chilling… but I knew their airway was obviously intact and my download was at 97%. I did what anyone would have done.”
When he made his way into the room 4 minutes later, Dunlope was again thrown for a loop with a zebra presentation he never encountered during his 3 years of internal medicine (IM) residency at Harvard and 3 years at Sacrebleu Memorial. The patient, #18, a 63-year-old woman with COPD, CHF, CML, HTN, DM2, PCOS, OSA, and BPD was sitting up in bed with the hospital menu on her lap. “I thought she might of fell out of bed or was perhaps having a sentinel pseudoseizure,” Dunlope said looking down at his phone.
The patient’s nurse, Marcy Inchargcy, made it to the room 2 minutes later during the Bachelor’s commercial break. “When Dr. Dunlope asked the patient what was wrong, I’ll never forget the look on his face when patient #18 responded. It was… it was like he just saw the ghost of Osler palpating a thyroid from the front.”
“The patient asked me for a turkey sammich,” Dunlope said with a shrug. “I had no idea what that actually is. I’ve never heard of one, seen one, let alone eaten one. Sure enough, when I went over and helped #18 browse the menu ‘turkey sammich’ was nowhere to be found. I checked all the order sets and UpToDate. Nothing.”
Nurse Inchargcy noted that she quietly suggested that they “make the patient NPO” so that they could ignore the patient’s now tearful requests with clear conscience. “The patient told me that the ED gives her a Turkey Sammich ‘whenever she requests one’ and reminded me that they are ‘open for business 24 hours’ a day. At first I was hesitant about how to approach this situation, but when the patient mentioned that she was also having pain, my ears perked right up!”
“I asked her how bad her pain was ‘from 1 to 10,’ she told me 11! …Honestly, I’m just not trained to manage that sort of pain. My management scale as a Pulm/Critical Care doc stops at 10.”
Allegedly, the night float intern popped her head in the room and mentioned that 1 of 120 ED beds was open. “Suddenly, everything just clicked.” Dunlope continued on as he feverishly mashed on his phone answering pages, “The best thing I could have done for me… uh, the patient… for the patient and I in managing her situation, was to admit her to a service where I knew she would get the attention and specialization she deserved. I wasted no time, wheeling her down to the waiting room myself. I mean it’s the ED’s skill set, they know the management intricacies of ‘turkey sammich’ and ’11 out of 10 pain’ way better than I ever will.”
Amazingly, over the course of the past 24 hours, nationwide reports are that ED wait times have quadrupled as intensivists have begun to perfect the “Dunlope maneuver.” When asked how things turned out for patient #18, ED staff pointed out that she was still in the waiting room awaiting to be seen.