The CABG patch

(Note: Not to be confused with "The Cabbage Patch" which refers either to a) a nursing unit in which all the patients are vented, trached, comatose = "vegetables" or b) those scary looking dolls that were all the rage back in the eighties, and have somehow made their insidious way back onto the kiddie market, evil minions of Satan than they are).

So, three of my four patients last night were of the "chest pain/ROMI/ACS/USA/status-post cardiac cath/pending CABG" variety. It was hard to remember which one of them actually ruled in for an MI, versus the one which one ruled out but was found to have multi-vessel coronary artery disease anyhoo on cardiac cath... oh wait, they all did.

You see, I have learned my lesson. Never ever shall I assume that because one day on the unit is peachy-keen, that thou shalt have another similar day. Especially in a row. Because lo, I got only one of my patients back yesterday (the last day of my scheduled run of days) and lo, one of my patients had "9/10 chest pain." All chest-clutching and red-faced chest pain to boot. With the family at the bedside.

Jesus Christ. Don't you love it when that happens, because then you're not only trying to stablize the patient, you also have to dislodge distraught and terrified family members from the bedside without looking like some kind of hard-hearted uber-Nazi. Meanwhile, the poor teary-eyed wife in the hallway needs some hand-holding and reassuring, so you have to try to have your "healing hands" moment with her too. Or, in this case, leave it to one of your sucker co-workers who gets roped into the deal while you are trying to fight Pyxis for the damn sublingual nitro bottle, paging the house officer, taking vitals, administering the hard won prised-from-the-jaws-of-Pyxis sublingual nitro tablet, and grabbing a stat EKG.

Short and the long of it, the sublingual nitro did the trick, thank God. Meanwhile, the floor got a bomb of an admission who responded poorly to IVP Cardizem and had to be put on a drip, some one else's BP took a dip, and we got three admissions on the floor at the same time, wait no, four, but my poor guy had to wait in the hallway while housekeeping did the bed, because apparently three hours worth of paging them to come and clean the bed just isn't enough.

So, so glad today is my day off, because really, I've had enough excitement this week, thank you.