The Heart Does Not Shit

Writing this post-call, I feel such relief at finishing the last cardiology call of my life. It has been infinitely boring dealing with issues of the heart for the last month, especially when most of the patients don't seem interested in preserving their own lives, depending on us instead to keep restarting their clogged-up hearts.

Sometimes I feel like sitting some of these patients down and explaining to them that if you keep flushing tampons down a toilet, the toilet will back up. And if the toilet backs up badly enough, you'll have to call in a plumber. And the plumber will unclog your toilet for you. But if you keep on flushing tampons down the toilet, eventually everything will be so impacted no plumber will probably be able to fix the toilet. And so instead perhaps someone might come and fit new pipes to bypass the (tampon)ade - pun entirely intended. And you would think - after spending all that money on your new bypassed toilet, you would stop flushing tampons down the toilet.

But no, no, not at all! God forbid that one should actually give up the convenience of flushing tampons down the toilet! Instead, they go right ahead and keep on doing the same old thing. And lo and behold, eventually the new pipes get clogged too. And because your plumber has sworn a stupid oath to preserve the state of your toilet, he keeps having to come back. But eventually, someday, the toilet will explode in your face and cover you in shit - and it ain't the plumber's fault. He told you so.

Ah well.

The last cardiology call of my life went fairly uneventfully. I got about three hours of sleep in short interrupted bursts, nobody died on my watch and there was only one stupid consult. Said stupid consult was for a lady with constipation who was given laxatives and developed diarrhea. Now, you don't need an MD to follow my line of thought here - it doesn't take a doctor to understand the following:

1. Constipation and diarrhea are problems of shit and the lack thereof.
2. Cardiology is a specialty dealing with the heart.
3. The heart does not shit.

I repeat: The. Heart. Does. Not. Shit.

Given that I'm expected to preserve "collegial relationships" with fellow professionals, I refrained from writing that in the consult, opting instead to point out that "there are no cardiac symptoms suggestive of cardiac disease - in addition, this patient has symptoms suggestive of an infectious cause and I would suggest consultation with a general internist instead."

But oh, what I would have given to simply write those 4 words on the consult. Because the physician - and God only knows how on earth he ever got an MD - sent this lady at three a.m to see me, making her travel two hours by ambulance, no less - to be told that her heart does not shit. In any case, it wasn't her fault so I buffed and turfed her off to general medicine where hopefully they will discover the source of her problems and treat her....

And that, is the end of Cardiology!