Consult-Liaison Education Lessons Medicine Observations

Red Herring (VI).

She was still standing on the scale. 93 pounds. The rest of the team looked at her.

“What should we do?” someone asked.

We all looked at each other.

“Well,” I offered, “this isn’t an emergency—there’s nothing to do right now. She just left the hospital. They won’t take her back right now. Did That Hospital schedule any follow-up medical appointments for her?”

After flipping through the discharge papers, The Worker said, “Nope.”

Unable to restrain myself, I mumbled, “First they don’t call to discuss her care prior to discharging her, then they don’t schedule any follow-up.”

I probably shouldn’t have said that out loud.

Turning to the patient, I said, “I know you just left the hospital. But if your weight drops any more, we’re going to take you back. I’m still worried that there is something happening to your body that is making you lose weight. Does that make sense?”

“I don’t want to go back to that hospital,” she said as she stepped off the scale. “The food doesn’t taste good there.”

“Where would you rather go?”

“I can go to That Other Hospital.” She suddenly flashed a bright smile. “The food there is delicious!”

“Okay, we’ll keep that in mind. Hopefully, though, you won’t have to go back to any hospital at all.”

At our request, she came to the office every day. Two days later, the nurse asked the patient to step on the scale. The nurse then knocked on my door and said, “Come look at this.”

The three of us then peered at the numbers on the scale: 87 pounds.

Alarmed, I looked at the nurse. She nodded.

“I’m sorry,” I said to the patient, “but we need to get you back to a hospital.”

Unlike the last time, she did not protest. She only nodded.

“Which hospital do you want to go to?”

“The Other Hospital. The food tastes better there.”

The Worker joined the nurse, the patient, and me.

“She shouldn’t go back to The Hospital She Just Came From. They weren’t good to her there,” The Worker opined.

“Fair, but there are advantages to sending her back there. They already know her recent history, they are less likely to put her through repeat testing, they may take this problem more seriously—”

“Right, but they didn’t take good care of her.”

The patient looked at me with those eyes that looked too large and sunken for her head.

“Okay. Let’s try to get her to The Other Hospital. I can’t go with her—”

“We’ll call an ambulance this time. That way we’ll know that she’ll get to the emergency room.”

And so we went through the circus again. Poor woman: An ambulance was summoned, the medics helped her tuck her spindly limbs into the back of the car, and I again scribbled out a note with her treatment history. It now included a two-plus week hospital stay and subsequent weight loss. Just six months ago she weighed over 120 pounds! I finished the letter with a plea that she be admitted to the hospital.

The medic took the sheet of paper from my hands. We hoped for the best.

Thankfully, she was admitted to The Other Hospital.

Two days later, doctors started calling me.

(Part six of an ongoing series.)