Miss Manners

As recently mentioned, I'm on the cardiology consult service right now. This means I don't admit any patients of my own; rather, primary (admitting) teams call me for help. And if we're being honest, we'll also mention that they really want my attending's opinion, not mine. But the idea is that you, as a consultant, opine on a specific issue. It is good consult etiquette to ask a "clinical question" and not just generically request that the consultant "come look at" or "get on board" with a patient.
Some people have trouble with questions. Like kindergarteners. You know Jen, right? My BFF who teaches the wee little ones? Well, I've heard her ask them if they have questions after giving instructions. A tiny voice will pipe up with, "Last night, when I was getting in bed, my dog ran in the room and jumped in bed, too." And she will respond with, "No, no. That's not a question. That's a story. Questions ask who, what, when, where, how or why. Can you ask that as a question?"
Consult-requesters frequently have the same problem. In the "reason for consultation" box the resident will put something like "79y/o man h/o HTN, CAD, ESRD on HD p/w SOB."* I seriously fight the urge to call back and say, "No, no. That's not a question. That's a story. Questions ask who, what, when, where, how or why. Can you ask that as a question?" But instead I'm diplomatic as can be and politely call the person back and inquire as to what specifically they want me to accomplish with the next hour of my life that will be spent digging through years of data on the guy.
And I invariably hear on the other end of the phone, "(pause) Well, you're cards. He has heart disease. We just want to get you on board early." But the best of the worst I've ever gotten is (I kid thee not), "We just don't really know what's going on. Can you come see her?"
At least they phrased it as a question.



*79 year-old man history of hypertension, coronary artery disease, end stage renal disease on dialysis presents with shortness of breath.