I'm not a huge fan of getting screamed at~ particularly when I did nothing wrong. This was my day on Wednesday. The patient had refused a rectal exam when we admitted her ('cause really who wants to get a rectal exam?) and it wasn't too important with her presenting symptoms so I didn't encourage it ('cause really, who wants to give a rectal exam?). When her Hgb dropped 2 points the next morning, I bit the bullet and told her that we really needed to rule out a GI bleed before we discharged her later that afternoon~ make sure it was just dilutional. So began my search for a hemoccult card. For those of you who haven't had the joy of being a surgical medical student, these card are simple little pieces of cardboard that you smear stool on, turn it over, and then squirt some chemical fluid on. If the paper/cardboard turns blue, there's blood in the stool. Really, really basic 'technology' and really really standard for the physical exam (depending on your attending...). Anyways, I asked the floor nurses for one, because at my last hospital they usually had them on the floor and would grab one for you out of their secret stash. I was met with an indignant "We don't keep those on the floor!" No problem, I thought, I'll just order them up to the floor (another standard option at the hospital I was at before, and what one of the residents told me to do). 3 hours later, there was no hemoccult card to be found. I cheerfully asked the unit secretary where I would find it if it got sent up, only to be literally yelled at~ telling me that they weren't ALLOWED to have hemoccult cards up on the floor. I went back into my patients room to do some diabetes education and could hear this woman complaining about my request to everyone around her. I ended up having to go to the lab, in the far corner of the hospital and literally BEG them to give me one. "I guess I will," the lab tech eventually told me, "but put in in your pocket and don't let anyone see that I gave it to you!"

Frustrated, I asked my resident why they keep such basic material in the dungeons under lock and key. It boils down to money. It's so frustrating when the bureaucracy and money game gets in the way of patient care. I know this was a taste, but I have a feeling that those moment of unrelenting frustration will only multiply as I progress through my education. I want to take care of my patients. I want to do the best thing by them. I want them to not live in the hospital, but I want to be as thorough as I know how to be as a medical student. Now I'm starting to realize that I'll be battling uphill to maintain this philosophy and I'll be fighting against a system that has to put other things first.