Jack of all Medicine

Sometimes when I’m tired and sad from doing medicine (usually on hospital rotations) I look at discoveries like insulin, vaccines, and antibiotics, and just marvel at how far we come.

So here’s a list of things we don’t have to deal with

- children in wards of 50 or above dying of diabetic ketoacidosis while their parents watch helplessly because we don’t have insulin

- thousands of people dying or becoming paralyzed due to polio, because of the persistence of one 

- people dying from something as simple as otitis media as it caused mastoiditis, and eventually abscess formation which could form in the brain itself and cause seizures (yup, this guy used to be untreatable and cause death!)

- the possibility of us not biting our nails waiting for LP cultures to oh god grow something let’s just hope it actually does for things like meningitis (obviously not limited to this - we can now do it for blood cultures and even URI symptoms. Expensive as all hell but incredibly useful)

- The tragedy of Rinaldi in a Farewell to Arms

There’s this colleague of mine who badmouths literally every patient on service. It’s getting to the point where it’s pissing me off. She will paint every patient as a whiny little turd who doesn’t belong on our service and should go home, even if they are genuinely sick and have a terrible genetic disease that just might make them feel a little down. I don’t know if she even likes taking care of people, because it sure doesn’t from her signout every day to us. 

I once admitted a patient who died later and it still bothers me. She is from a large city and she became sick but her husband asked her to come to this lonely city in a sparsely populated state. I can only imagine that she dragged herself in, yellow and feverish, took a flight and shivered all the way to this desolate place. Her husband was concerned so they went from hospital to hospital seeking care. She received augmentin and tylenol #3 at one hospital despite her yellow eyes and her groans. They finally come here. She looks sick. Of course I have gotten this down by now. She needs to be admitted. But her labs are puzzling. She has no leukocytosis, no hyperbilirubinemia. I puzzle this out with the gastroenterologist on call. He is a nice and knowledgeable man but he is also confused. We both write this off as a ‘passed stone.’ He agrees to see her tomorrow. 

It is late for me, so we sign out to the night team. She’s sick, she’s yellow, keep an eye on her. 

She dies two hours later. She dies before a rapid response can be initiated, febrile and yellow. 

I overlooked that her hemoglobin dropped three points from the previous hospital to this one. I wonder if a blood transfusion would have saved her. My attending assures me that there probably wasn’t much that could be done. She also had uncontrolled diabetes and per him, “the sugar makes the antibodies not stick.” But it still bothers me. I talked to her kids on the phone, told them she was sick and she needed to come in. This woman died alone, in a strange city in a sparsely populated state. 

1: You look like a china doll. So cute!

2: Oh, you know who you remind me of? This one Japanese nurse when I was stationed in the Phillipines and let me tell you she was a nice nurse. I can't imagine you're a doctor because you keep reminding me of that nurse. (conversation diverges into rumination about his life. Which is sad. So I forgave him.)

3: Oh you're Chinese? I like Chinese food.

4: Huh, you're an oriental?

5: repeat #4 ad nauseum. No points if the patient is over 60.

6: Oh, you have ____ last name? I know an Asian guy with ___ last name, do you know him?

- every time my Medical society announces its 207th, or 216th inaugural session, it blows my mind how many years people have been elected to essentially party and maybe hand out a free Oxford clinical handbook once in a while. But mostly party and now take pictures of themselves being drunken partiers.

B-b-but Pottermore said I was gryffindor.