It Starts With an H.....

So there I was , doing my regular doctor tasks when I got a call from the nurse that one of the patients was coming back to the floor from the OR after an appendectomy. When he arrived, he looked well, his abdomen had small bandages on them, his pain was well controlled, vitals were stable and was asking when he could eat. He was a tall lanky teenager, and although he was 12, he looked more like 18, accept for the soft immature features on his face. His mother who was pleasantly sitting at his bedside inquired about what year in training I was in, and I proudly answered that I was a first year intern knowing that I would soon be a second year. She worked in a hospital so she understood the hierarchy and was happy to see a young woman of color striving to become a pediatrician. We built a great rapport and as I was walking out, she asked me to remind her of my name.

"Dr. Ramsey" I stated first, and it felt silly because it felt so formal after the great convo we just had. "Or you can just call me Tasha." I clarified. Being the strong black woman she was, she wasn't having it.

"Nope, I'm gonna call you DR.RAMSEY, you earned it, so that's what I'm gonna call you." I blushed and accepted her complement and reminded her that if she needed anything at all she should let me know.

So I waltzed back upstairs to finish up the rest of my work with a grin on my face because of the pleasant interaction I just had. As I scooted my chair up to get comfortable at the computer, a call came in at the nurses station.

"Doctor taking care of patient in Room 432, the nurse is calling saying he is having altered mental status" the secretary announced. Of course, 432 was the room I just left. So I sprinted back down the stairs to touch base with the nurse. She's one of the best nurses I know, so when she calls about a patient I know she means business. She said he had no idea where he was, what day it was, and had mistaken his can of ginger ale for jello. So many things were running through my mind: was it the anesthesia? was he bleeding somewhere? was he dehydrated? was he having a stroke? did he have an infection?

I began to ask him basic questions and he answered as followed:

Where are you right now?

Uh...I don't starts with an H

What day is it?

Uh.......I'm not sure....

What year is it?

*stares blankly

He was unable to answer any of the questions I asked. So at this point I proceed the physical exam, I check his heart, lungs and belly. His belly is tender from the procedure and his heart is beating faster than I would like. And I do the best neuro exam I can while he is in bed. He's having a hard time following my commands and his pupils look slightly dilated. At this point I'm like shit, my heart is racing and I go in to straight up doctor mode. I ask the nurse to get a set of vitals, I'm preparing to give him some fluids, and call my senior resident to come and assess him too.

I really didn't want to call her down if it was unneccessary because she is pregnant as hell and would have to waddle down the steps. But I was worried about him and wanted to make sure we acted promptly. By the time I'm heading back to the nurses station, the nurse storms over to me with this strange look on her face. I'm like oh shit, what happened??? She rolls her eyes with her hand on her hip and says, " Guess what the patient just said to his mother? Psych, I was just playing!"

My heart drops and I feel my temper boiling like a thermometer in the dead of summer. I storm over to the room and he's lying in bed cracking up. His mom looks like she wants to kill him and sucker punch him in the gut right where his surgical scars lie. She covers her face in embarrassment and can't believe he would take a prank like that so far. My senior resident rolls into the room also in doctor mode. I explain that it was all a joke, a really bad joke and that he played all of us. Just to be sure, she asks him all the same questions we had just went over and of course he's as sharp as a tack. He even made a little joke about how he disliked our current president.

His mother who was holding back from smacking the black off him while we were in the room made him apologize profusely. We all then lectured him on the importance of not lying about things like that in the hospital. But it was all good, he was a typical immature 12 year old boy, who thought it was funny to play a trick on his mother, almost give me a heart attack, and almost send my senior resident into labor. I let out a sign of relief that he was OK and that we didn't need to escalate things.

But one thing is for certain, I definitely earned the Dr. Ramsey title today.