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AUSTIN, TX – After admitting a patient with end-stage congestive heart failure, third-year internal medicine resident Amanda Cummings consulted the cardiology service to help with management.  Cardiology was happy to see the patient, and dropped a prompt and helpful consult.  But the final line of the consult note took Cummings aback: Please don’t hesitate to call back with any questions.  She is now hesitant to call back with any questions.

hesitate hesitation hesitating hesitant
Damn you, Cardiology, now I’m hesitating!

“Damn it, why did they have to say that?” Cummings asked, admitting to her teammates and Gomerblog that now she is extremely reluctant to call back cardiology for any reason.  “I was actually going to call them back because I had a lot of questions to ask.  Now I don’t know if I should.  What could they possibly mean by that?  What a jerk.  I think he’s playing mind games.”

Eric Martinez was the cardiology fellow who wrote the consult note, and Gomerblog reached out to him for comment.  Why did he write that?

“Uhhh… so that if they have any questions, that I’m happy to answer those questions,” a genuine and seemingly nice Martinez replied, not exactly sure what the problem was.

“Hogwash!” exclaimed Cummings, totally convinced the Martinez was, in her words, “full of sh*t.”  “Everybody knows that the final lines of a consult note are coded in meaning.  ‘Thank you for the interesting consult‘ means ‘Your consult was crap.’  And ‘We will continue to follow’ means that ‘Yeah, we’re not following along.’  There is no way that ‘Please don’t hesitate to call back with any questions’ should be taken at face value.”

Cummings plans to retaliate with a passive-aggressive progress note tomorrow morning.  “Normally I’d write ‘Appreciate help from Cardiology‘ but I think I’m not even going to appreciate them.  Let’s see how they like it.”

Risk management has been alerted to the possibility of a chart war.  Gomerblog will continue to update as more details emerge.

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