Attending: So GI recommends a neuro consult, huh? Do you want to get one?
Me: Well, the patient actually has neuro outpatient follow-up scheduled in two weeks and no acute issues. The relevant genetic labs were drawn yesterday and will likely be pending for at least a week. And after speaking to the GI fellow, I believe he recommended we consult neuro as a way of tacitly implying that he thinks the GI consult was dumb.
Attending: Neuro wouldn’t want an MRI or anything? Nothing we could do inpatient?
Me: Well, a head ultrasound was normal, all he has are diffuse LMN signs without any focal abnormalities on exam – and dysmorphism alone isn’t an indication for a head MRI, especially with pending genetic labs… so…. honestly, definitely not.
Attending: Well, at least curbside neuro – if they agree, the family can go home today.
Me: So, sounds like we’ve gotten all the worrying symptoms under control! Do you feel comfortable going home, or would you prefer to stay another night?
Mother: No, I feel great! So relieved about the new medication. My ride should be here this afternoon!
Attending: Actually, GI floated the idea that we should get Neuro involved – they might want an MRI or something! We could get that done inpatient for you. What do you think?
Mom: … well, I don’t know… would it help? Do you recommend it?
Attending: Well, it couldn’t hurt! Here’s how the MRI would go: he likely wouldn’t have to be sedated, cause he’s so small, and I bet we could get you on the schedule for today!
Mom: Well… okay then!
Status-post Family-Centered Rounds:
Neuro Fellow: Okay, so the kid has no acute issues and outpatient neuro follow-up already scheduled. What are you guys consulting us for?
Me: …. the question of whether a head MRI would be indicated.
Neuro Fellow: …
Me: Today. Stat.
Neuro Fellow: Without any focal abnormalities or UMN signs? Really? You’re consulting us for a head MRI for diffuse hypotonia?
… Hey, wait a minute – aren’t you supposed to be in our program in 2 years?
Me: …. that’s… that’s another intern. I’m someone else entirely. Please forget my name immediately, thanks.