Check out.

Towards the end of my shift last night an older man came in to the ED complaining of pretty significant abdominal pain. The differential in the elderly with abdominal pain, especially if they are hypotensive and have blood in the their stools, can be pretty scary. Fortunately for him, his pressure was stable and he was guaiac negative. The patient stated he had vague diffuse abdominal pain for the last few days that acutely worsened a few hours prior to arrival. He could have had anything from a busted appendix to a kidney stone to a torsed testicle.

I obtained some general belly labs, a urinalysis and got a CT scan. The end of my shift rolled around and my patient was still trying to drink the contrast for his CT. My replacement walked in and asked me if I was ready to check out my patients. Lucky for him the abdominal pain patient was the only person I didn't have a solid disposition on so there was going to be much work for him to do. I was tempted to stick around and wait for the results of the CT scan because I was curious to see what the problem on this guy was going to be, but after working 12 hours in the middle of night leaving the hospital is a sweet feeling as well. So I checked the patient out to the oncoming intern and left.

I felt a little disappointed not being the one to diagnose that guy with whatever it was that was going on. The sun was starting to rise when I was walking to the parking lot and I could see the morning round of medicine and surgery residents making their way inside. I could tell the ones that were coming on to a call shift because they were the ones that looked their dog had just died. Again, emergency medicine isn't perfect, but looking at the gloom on those guys faces, I'll take shift work any day of the week.