How to Not Miss Critical Info: Follow Safety Protocols Fully

𝗠𝗲: "I’ve got some life-altering news."

𝗛𝗲𝗿: "You're scaring me."

𝙋𝙤𝙞𝙣𝙩-𝙤𝙛-𝙑𝙞𝙚𝙬:
↳Be me.  2020. Junior Attending. Tuesday afternoon.

𝗠𝗲: "We’re going to have to cancel your case today."

She looks at me blankly.  She sighs.  She frowns.

“Why are you doing that?” she asks.
↳“I’ve waited months to have this surgery."

𝗠𝗲: “Would you like to have someone here with you?”

I can see she’s starting to get nervous.

She touches her face and rubs her hands together.

The pulse oximeter reads a heart rate of 126.
↳Nervousness confirmed.

She’s scheduled for a total thyroidectomy.

Papillary cancer.  Good prognosis after surgery.

Synthroid for life, but that isn’t a big deal.

𝗛𝗲𝗿: “NO, tell me why you’re canceling me.”

She’s 49, end-stage renal disease on dialysis.
↳Hypertension, diabetes, high cholesterol, migraines.

𝗠𝗲: “You’re pregnant ma’am.”

Surprise.  Fear.  Shock.  Confusion.  Disbelief.

𝗧𝘂𝗿𝗻𝘀 𝗼𝘂𝘁:

A urine pregnancy test was ordered by the surgeon.
↳She’s anuric, so no urine was collected in clinic.
↳She’s 49 with multiple serious co-morbidities.
↳But I caught the absence of pregnancy test.
↳Did not accept the absence of a result.
↳So, I delayed the case rolling back.
↳And rebuffed surgeon pressure.
↳By insisting on a blood test.
↳Because she's a woman.
↳Of reproductive age.

I tolerated the preop nurse’s stink-eye.  I insisted.

I call a maternal-fetal medicine consult on the spot.

Termination 𝙫𝙨 Chemo 𝙫𝙨 Surgery 𝙫𝙨 Postponing.

That’s a separate conversation for a different team.

I’m a part of the system and I’ve done my part.

Next patient.

𝗣.𝗦. - 𝗛𝗼𝘄 𝗱𝗼 𝘆𝗼𝘂 𝗽𝘂𝘀𝗵 𝗯𝗮𝗰𝗸 𝗮𝗴𝗮𝗶𝗻𝘀𝘁 𝗯𝗿𝗲𝗮𝗰𝗵𝗲𝘀 𝗶𝗻 𝗽𝗿𝗼𝘁𝗼𝗰𝗼𝗹 ... 𝗲𝘃𝗲𝗻 𝘄𝗵𝗲𝗻 "𝘦𝘷𝘦𝘳𝘺𝘰𝘯𝘦 𝘦𝘭𝘴𝘦 𝘥𝘰𝘦𝘴 𝘪𝘵?"