So we had a patient come in with an ankle fracture that was a polytrauma, intubated in the ED. I went up to do the secondary exam, walked in the room and introduced myself to a teary eyed family. I explained that I was the bone doctor, and that I didn't know a lot about the other systems, but knew a lot about the bones and needed to do an exam to make sure nothing was dislocated or frankly broken. I examined the still intubated patient, ranging all the joints, etc. At the end, I told the family that the patient did have an ankle fracture, but that we would be managing it without surgery and that they had (and i quote verbatim) "other priorities that are higher on the list than their ankle." They nodded and I walked out.

And that's when the nurse informed me that the patient expired 30 minutes ago...