In psychiatry residency training, perhaps no rotation has as much folklore and wisdom passed along as that in the consultation/liaison (C/L) service. Each year, residents and attendings share guidance with “newbie” trainees—everything from how to interact effectively with consulting teams and how to evaluate patients to where to get free coffee.
As we considered some common C/L tips and tricks, we saw parallels elsewhere. Although the rules below are not the only ones found in popular culture, we thought they were particularly applicable to our work on the C/L psychiatry service.
“THE BRO CODE” (How I Met Your Mother) ARTICLE 122: A bro is always psyched. ALWAYS.
C/L RULE: A resident is always prepared. ALWAYS.
HOUSE OF GOD RULE #3: At a cardiac arrest, the first step is to take your own pulse.
C/L RULE: At a behavioral code, the first step is to remain calm.
NCIS RULE #3: Never be unreachable.
C/L RULE: Always carry a working pager.
WEDDING CRASHERS RULE #16: Always have an up-to-date family tree.
C/L RULE: Always have an up-to-date medication list.
NCIS RULE #4: Don’t believe what you’re told. Double check.
C/L RULE: Never trust what you’re told or what you see in documentation. Always verify for yourself.
HOUSE OF CARDS RULE: This trip may take longer than I thought.
C/L RULE: This consult will take longer than you thought.
WEDDING CRASHERS RULE #62: No more than two weddings a weekend. More and your game gets sloppy.
C/L RULE: No more than two teams involved in a case. More and everyone (patient included) gets confused.
NCIS RULE #10: Never get personally involved in a case.
C/L RULE: Don’t work harder than the primary team.
HOUSE OF GOD RULE: If you don’t take a temperature, you can’t find a fever.
C/L RULE: If you don’t check a urinalysis, you can’t find a urinary tract infection.
NCIS RULE #7: Always be specific when you lie.
C/L RULE: Always be specific when you recommend.
FIGHT CLUB RULE #1 & 2: You do not talk about Fight Club.
C/L RULE: Do not talk about patients in public areas.
WEDDING CRASHERS RULE #105: Know when to abandon ship if it ain’t floating.
C/L RULE: Know when to walk away if there’s nothing left to do.
“THE BRO CODE” (How I Met Your Mother) ARTICLE 104: Bros don’t stop to smell flowers.
C/L RULE: Always stop to eat lunch. If you have time, smell the flowers too.
HOUSE OF CARDS RULE: If you want to earn my loyalty, then you will have to offer yours in return.
C/L RULE: If you want to earn a primary team’s respect, then you will have to offer yours in return.
NCIS RULE #15: Always work as a team.
C/L RULE: Always work as a team. ■
