Never had a thing wrong with him

A man was admitted for pneumonia. He was in his 90's with absolutely no PMH. All of his organs are intact, he doesn't get vaccinated. No family doctor, no home meds. You know the type.

I get report from the day shift nurse that the attending ripped him a knew anus because he felt he wasn't notified in a timely fashion that the second and third sets of enzymes were positive. Both sets showed up on the computer system at the exact same time, says the day shift nurse.

The doc says the nurse failed.

The doc writes no new orders and leaves after a very public tongue lashing regarding the "nurse's negligence."

The lab is supposed to call when troponins are high. The first troponin was in the 30's. The lab failed.

The second troponin was in the 50's. Again, the lab failed.

Back to night shift. I receive report from the nurse who is bitter and can't walk out the doors fast enough.

I draw new enzymes and the troponin is now in the 60's.

The intern steps on the floor and we are in agreement: they all failed. The pt had T wave changes in the ER, along with chest pain, and the pneumonia seemed to be more of a coincidental finding. However, the doc dropped all of the chest pain and EKG changes part of the admitting diagnosis and admitted him with plain old pneumonia. Whoops.

The patient was informed that he had an MI.

At first he was okay. His enzymes dropped and then spiked again before morning. He became increasingly anxious.

I've never had anything wrong with me, he tells me.

Cardiology sees him the next day and decides that 90 year olds get medically managed.

The patient was discharged s/p myocardial infarction. Determined to live life to his fullest, he went back to his farm to live his simple life the way he done for the past 90+ years.

Medically managed, he died the next morning.