Dr. Weanus is old friends with Dr. Sendemtoemerg, the GP, having roomed with him as undergraduates at the University of Toronto. When Sendemtoemerg asks for his help in getting a patient admitted not having privileges himself (and therefore by-passing all that pesky business of being seen by Emergency) Weanus is ready, even eager to oblige. The patient, in fact, is not really that sick, having had influenza; she’s a touch dehydrated, and maybe needs an IV. More importantly to this narrative, she plays golf with Sendemtoemerg’s wife.
No problem, says Dr. Weanus, who believes his skill in cutting through the red taper and health care bureaucracy is legendary. Just send the poor dear to the Emerg, and I’ll admit her.
When Dr. Sendemtoemerg calls the ward clerk about this “arrangement,” the health care bureaucracy, i.e. me, is singularly not very impressed by this attempted end-run around the usual procedure, especially when the ED is already filled with admitted patients. Dr. Weanus knows this care plan is highly, um, irregular, if for the simple reason if every GP sent their patients to the ED “for admission” in this way we’d be sunk. Up the creek. Dead in the water. Pick your cliché. Our role in the larger functioning of the hospital is to prevent unnecessary admissions. We’re gatekeepers. Back-door admissions short-circuit the process.
“Absolutely not,” I decree. If this patient shows up at triage, she will go through the normal ED workup.
A little while later Dr. Weanus phones me. He is intensely irritated. He rants. He raves. He threatens. Why is this patient being seen by Emerg? Why is she not in a bed, awaiting my consultation? You are doing nothing for her! She is desperately ill! And so on. Standard Dr. Weanus, all shouty, sarcastic discourse.
I yawn. I know her labs are normal, and after a courtesy IV bolus, mostly a nod to Dr. Sendemtoemerg, she will go home.
Sometime after that I’m working on the staffing and I look up to see Weanus hovering over the charge nurse desk.
“I owe you an apology,” he says. His face is red. “My behaviour on the phone was inappropriate, and what I tried to do was wrong. I’m sorry.”
To say I am gobsmacked would be an understatement. One thing to note is I had become so inured to Weanus’s outbursts that I had to actually stop and think if he was that awful. (He was.)
“If the fool would persist in his folly,” said William Blake, “he would become wise.” Is it possible Weanus is learning? He’s reflecting on his behaviour. He’s trying to be a better person. Golly, he’s human after all.