A Piece of My Mind Section Editor: Roxanne
K. Young, Associate Editor.
I first learned that Mr B was my patient when the radiologist called
me early one morning. "We can't do the barium swallow," he said, "because
Mr B keeps spitting it out on the table."
"Okay," I replied. "Send him back to his room." I am an attending physician
in a teaching hospital. Late the night before, Mr B had been sent from the
local veterans home to our emergency department, and the resident on my team
had admitted him.
Outside Mr B's room, I looked over his records. Three days earlier he
had stopped taking anything by mouth, including liquids and his medication
for hypertension, depression, and agitation. Last night the veterans home
staff hadn't been able to arouse him and had sent him to our ED. They suspected
that he had had a stroke.
Mason C, Givler A. Name Brand Medically Necessary: Do Not Substitute. JAMA. 2004;291(13):1541-1542. doi:10.1001/jama.291.13.1541