"No," the resident replied. "He's to be discharged today or tomorrow."
"You really think so? He looks pretty bad."
"So what's my argument to the team? He's not going to improve any further, so there's not any reason for further hospitalization?"
During rounds I presented the patient to the team. The clinical findings I recounted couldn't mask the fact that the patient was in bad shape. Then I arrived at the portion where I present my assessment and plan: "My opinion is that the patient is ready for discharge because we cannot expect further improvement from continued hospitalization."
The attending physician (the head of our team) disagreed and started questioning me aggressively. What did I mean the patient wouldn't improve? Had I allowed enough time for the medications take effect? How could I send a patient out who's in such a condition? I didn't want to argue. The attending was right.
I looked pleadingly at my resident. Please help? The resident sat stone-faced and didn't say a word. I was on my own.
I didn't have an answer to the attending's questions. I grimly shook my head. "My mistake," I said. "We'll keep the patient for at least a few days and see how he does."