"The patient needs the unit. She's sick, and she's definitely not surgical!" said Diane, the surgical resident, as she finished up her consultation note. Kendrick, one of my internal medicine residents, stood by, looking distressed. I had just come into the emergency department for my evening shift.
"What's going on?" I asked, and Kendrick gave a quick rundown of the case.
"Mrs. Hom. Sixty-five-year-old Chinese woman. Sick for two or three weeks. Cough, runny nose, very fatigued. Got antibiotics and allergy pills from her doctor a week ago. Today she was so weak, she couldn't get out of bed. Almost passed out when her daughter stood her up. No fever, but a very fast heart rate. And abdominal pain."
"Abdomen is benign," Diane said. "Not a surgical problem."