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The ER was aghast, and they would NOT do the LP or anything else for the patient. So STOP lamenting how primary care docs are responsible for all your ills. Part III in my next post, where I'll address the idea about what kind of patient gets referred to the ER from the office.

So this IM guy gowns up (even though he's busy as hell), does the LP, and guess what... So of course she has to go to the ICU, and he REFUSES to let them send the patient anywhere else. So that's a good example of where "completeness" might mean one thing to the ER doctor, and something else to an internist/generalist.

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Each time I passed through the green room, I couldn’t help but reach out to grab one (or three) of his nuts and pop them into my mouth.

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In he came wearing a bright reddish-orange jacket, with his wife close by.

I didn’t tell her that I had and would continue to eat her husband’s nuts throughout the evening. We put out cough drops for him in the green room (diagonal from his nuts) and he had one; the wrapper now sits on my kitchen counter.

ER residents are inundated with this advice from the moment they start residency. When I was a third year resident, a famous incident occured between the ER and our department.

I want to address specifically the complaint about these lazy internists/hospitalists upstairs and their desire for "completeness". It was a particularly busy winter evening, and during the night, there were so mnay patients in the emergency room, you could hardly walk without stepping over someone.

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