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Teaching and Learning Moments

The Overhead Page

Donato, Anthony A. Jr MD

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It was the final day of my weekend call. Sundays aren’t usually too bad, since I have been able to see most of the patients on the previous day and already understand the salient issues. But this Sunday, things just didn’t seem to go as planned. Any time I got into some rhythm, another page came, forcing me to abandon the work at hand to address another crisis.

When the crises finally seemed to reach a lull, I stopped in to see one of my partner’s patients for the first time. “Emma” had been admitted with urosepsis, but was nearly ready for discharge back to her nursing home. A quick review of the chart confirmed that she had been recovering well, so I headed to her room to confirm this. I was surprised to find her sobbing uncontrollably when I arrived. After I introduced myself, she proceeded to tell me that she had been left sitting in a chair for two hours and her bottom had begun to hurt, but her call bell had fallen out of her reach. She described yelling for help a number of times before someone arrived to help her back into bed.

The desperation of her story was palpable, but I sensed by her response to the morning’s events that there may have been deeper issues. I asked her to tell me more about herself. She talked about many people in her life, delving deeper into the details of those with whom she was more intimately connected. She briefly highlighted the resumes of each of her three sons in order of societal worth, accentuating the extensive work hours of each as the reason for their infrequent visits. She talked for some time about her only daughter who died in a tragic accident. But she spent the most time talking about her personal aide at the nursing home, describing his family, schooling, and aspirations in vivid detail, intermixed with stories of how well he treated her.

Her final thoughts were interrupted by the overhead intercom—I was being paged. I attempted, but failed, to hide my frustration with yet another derailment of this unusually busy Sunday.

“I apologize—I am wanted,” I sighed, pointing to the speaker in the ceiling as I reached for her bedside phone.

“That must be nice,” she replied.

I had no immediate response. I had been trying to empathize with her, but I did not fully understand her situation until I realized that the most frustrating part of my day would have been delightful to her.

The overhead pages haven’t bothered me as much since then.

Anthony A. Donato Jr., MD

Dr. Donato is an academic staff internist at The Reading Hospital and Medical Center, West Reading, Pennsylvania.

© 2006 Association of American Medical Colleges