I got a psych consult the other day for "patient refusing insulin." Now, our consult service is simply too large, too overworked, too busy that we don't have the time to see routine capacity issues. Every physician can do it, so we usually defer those things to the primary team. But, before I call up the primary team to refuse a consult, I always go see the patient to see if there's something else going on.
So I walk into the room, and meet this very sweet and pleasant 63 year old lady, and ask her why she's in the hospital.
"Well, I have an umbilical hernia, and I started to have a lot of pain..."
Hm, this all seems rather non-crazy and straightforward.
"...and so I went to the bathroom, and there was a lot of blood!"
Oh crap, did they mean to call surgery? Why was psychiatry called?
"...and then my head started to hurt..."
Still plausible.
"...and then a baby was born from my head!"
Ah. That's why I'm here.
P.S. I kept the consult.
3 years ago
