Scene: We have just finished a case in the OR and the resident is watching me write the admission orders.
Me: I’ll write for an ADA diet.
Resident: Good. Now, there’s 3 kinds of ADA diets – 1800 calories, 2000 calories, and 2200 calories. I’m going to let you decide which one the patient gets.
Me: … It really doesn’t matter to you?
Resident: No, I trust your judgement.
Me: Okay, 2200 calories.
Resident: Good. Now, why’d you decide that?
Me: Well, I know it’s a bit high, but the patient will only be admitted for a day. And I guess I’m just feeling sympathetic because we cut their face open.
Me: … No?
Resident: *facepalm* Oh god.
Scene: Me on phone, later that day.
Me: I don’t think I’m cut out for surgery.
MS-4: Why? What’d you do?
Me: A resident asked why I was writing for an ADA-2200 diet, so I told him it was because we cut the patient’s face open.
MS-4: *stunned silence*
Me: I was feeling sympathetic. I retracted the skin flaps for 3 hours. Can you imagine how that will feel when the patient wakes up? How does that not justify extra gravy or whatever?
MS-4: *silence* Ok, I can see his point. You’re not cut out for surgery.
Me: Listen, I’m just advocating for my patient. It’s called HUMANISM in MEDICINE..
MS-4: Humanism in medicine? Yeah, I think I got a pin for that.
Well, what WAS the right answer? ‘Cause I sure as heck don’t know. Was the patient a big dude or something?
HAHAHA I would have done the same thing. But ditto on what OMDG said, what was the right answer? Was his BMI too high or something?
Yeah, high BMI. My theory was one day won’t make a caloric difference, so I can safely say “screw it, give this person the extra serving they’re used to!”
Love it! I want you as my doctor 🙂
I probably would’ve said what you said. Or, high metabolic need post op
Haha, yeah, I also would’ve gone for the 2200. =D