This isn't a story about Dr. Santell, but it illustrates why the memory of Dr. Santell is so important to me, and why sometimes I pretend he's still alive and only a phone call away. I know this is nothing more than childlike fantasy, but it gets me through some long days and--as this story shows--keeps me honest on the job.
Not that long ago I was at the end of a long run of night hospitalist shifts. "One guy is pretty sick," the day hospitalist told me at 7pm sign-out. "You know him, he came in with stroke symptoms but today he got completely obtunded and spiked a temp up to 101." A repeat CT of the brain showed evidence of progressive stroke on both hemispheres of the cerebellum. An earlier CT angiogram had shown extremely small-caliber basilar and vertebral arteries, and the patient's prognosis was considered pretty grim at that point, but nobody thought he'd decompensate so fast.