A medical audit is exactly that—you present a mortality in front of bloodthirsty people and they will audit every single misstep that you did and pour sacks of salt on your already gaping cavity of guilt. Let’s cut this crap about learning, although it is an important aspect in some cases, but let’s cut this crap about learning—you killed someone and everyone should know what ancient weapon you used. There are various reasons to get audited—the management is questionable, the case is interesting, the consultant who ordered it to be audited was fascinated by the case’s supposed rarity unaware that the ward is littered with leukemia patients with pneumonia, no one is scheduled for that day (Hello, Aloyloy, congratulations on that record-breaking 5-day notice to present), there is an autopsy that will supposedly clarify things, and my favorite: that you failed to get enough money to buy antibiotics for the patient and should therefore be exposed for the irresponsible crass that you are. In any case, there are always decapitations galore.
Last year I had the, err, privilege of being the only one in the batch to be audited twice, both of which were brought upon under circumstances which were relatively, let’s say, unorthodoxed. I had four or five straight months of proud mortality-less streak of which I couldn’t shut up about and then wham! Lucky for me the ones usually wielding the sharpest cleavers weren’t there to—all together now—drag me to hell. And that my cases had actual points for discussion, because let’s face it, some cases suck. Not the presentations, but the cases themselves. In my two audits when the questions were geared towards a shortcoming, whether they be fair or not, I discovered that the best way to respond is to just nod or give some incomprehensible grunt. None of that “in hindsight” or “thank you for that point” or “point well taken” crap, because they don’t make you look any smarter, and in any case, who the heck cares if you can spew elaborate platitudes anyway.
My first audit was a fascinating case of a woman who had stayed in the hospital for more than two months for her horrible, disfiguring facial infection, who eventually died… from complications from the treatment itself–the most expensive antibiotics which were even completely subsidized by the infectious committee. Thanks to the autopsy we saw the disgusting pseudomembranes that eventually ate her up. By the time I had my 2nd audit I was more confident and cared less and TT, who was my designated powerpoint clicker, noted before I took the podium that my presentation had no “objectives”. “Walang objective-objective,” I growled, “dahil ang objective ay matapos ito!!!” TT also noted that I wasn’t wearing a necktie, that my shirt had short sleeves, and that I was wearing brown, informal shoes. He offered me his necktie. “Wala!” I growled further, “walang necktie-necktie na magaganap!!!” I wasn’t trying to be cute—I just wanted to be free from unnecessary crappy trappings.
For all its fault-finding nature, though, an audit is not free of entertainment. My favorite moments are those when the superiors ask questions that have just been answered, showing that their minds were drifting to what they would have for lunch. More than twice I had to restrain myself from starting my response with, “As I’ve already said, you attention-deficit, overrated windbag, the CT scan is normal!” I had said “as I’ve already said”, however, when someone arrived 45 minutes into my presentation and he asked me to repeat everything. I repeated everything happily, to eat up the time and bore everyone else. My 2nd favorite moment is when an unfamiliar voice suddenly bursts into a question, and we look at him, and nobody knows who the heck he is. Just recently someone did this, and for all his toxic questions he turns out to be a spankin’ brand new fellow. New, as in just employed 3 days ago. Not that he doesn’t have the right to make pa-toxic just because he’s new, but the common perplexed look of the crowd is fun.