Friday, June 19, 2015

To residents and nurses,yesterday's 'space-wasters' are today's 'frequent fliers"

They are chronically ill, frequently even ER admission level seriously ill, are not going to ever get better, but yet are damn slow about dying and getting it done and over with.

Even worse, they are often much older, much poorer and much more foreign than the medical staff treating them.

They are the bane of hospitals administrators everywhere who seek a great cure rate to impress donors and government bureaucrats.

A bane to senior attending physicians seeking a constant quick turnover in ward patients - ever hopeful the new ward patients will come with many different, new, rare, acute diseases.

All to better train up residents, in a few brief hectic years, about all the possible diseases they might face alone as full MDs.

Residents and nurses in 1940s teaching hospitals tended to informally call them bed-wasters or space-wasters.

1940s Nazis tended to call them useless eaters or lives unworthy of life.

Today's current medical slang for this sort of patient calls them frequent fliers.

Dr Henry Dawson's SBEs, particularly in wartime - were the space-wasters par excellent.

They were usually poor and ethnic, too weak to get drafted or even to do hard work in war factories.

Everyone knew they weren't ever going to survive --- the disease was 99% fatal in the short term , 100% fatal in the medium term.

Yet they took their good old time dying.

Meanwhile, they uselessly 'wasted' valuable beds.

And above all, absorbed much scarce medical and auxiliary staff time, because during WWII, most peacetime doctors were either drafted or left as volunteers while the auxiliaries were leaving hospitals wholesale for much better paid war work.

And Dawson - despite being a decorated war hero of a previous war - was doing no real war medicine work but choosing instead to devote himself to saving the lives of these hopeless cases and even 'stealing' invaluable scarce penicillin to give to these bottom feeders.

All he would say in his defence was that 'we'd never beat the Nazis by emulating their practises'.

The nerve of him....

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