Q. How do you hide a $100 dollar bill from a surgeon?
A. Put it in a book with no pictures.
Q. How do you hide a $100 dollar bill from an internist?
A. Put it under a dressing.
It's meant as a joke, of course, but there's a bit of truth to it still. And I'm ashamed to say, I lived out the second half of it today. Last night I did a post operative check on a patient who had spine surgery. And I'm getting into the swing of neurosurgery, so I check his reflexes, muscular strength, etc, which is all they really care about usually.
Except this patient was a bit different. Because of some special conditions with his surgery, he had a drain sewn into the wound, one which was important to check. So this morning, on rounds, my chief asked "how much did the drain put out?" My only answer could be "I don't know, but I'll check." So the intern and I dropped a few notches in the estimation of our team. The problem is, we hadn't known to look for a drain, because there had been no mention of it in the operative note. Not an excuse, but it showed how mistakes get propagated up the chain. Fortunately, the patient was fine.
So, this afternoon I was asked to do another pre-op check. And to ward off any reminding corrections, I said "sure, I'll do it. And this time, I'm stripping the patient naked before I write the note."
This guy didn't have a drain. But I won't make that mistake again.