june in harbor
so we are well into July. I started second year. Last month was probably one of the hardest of my life. I have been cruising along for so long, eventually life is gonna make you struggle a bit. and so many things came into perspective.
AF, my patient on the wards. a Philipina woman, 73. she had chronic pain and i didn't know how much to give it credence. i hate the gatekeeper roll. i feel like i am always deciding, who is in pain and who is not. who deserves disability and who doesn't. who is addicted to IV dilaudid. AD told me today on the phone that she thought i have the personality of someone who would give in and prescibe pain meds to a patient who demanded and begged for it.
i disagreed. it is a tough line between being compassionate and not being soft. being aware but not cynical. there have been so many patients this year who i present to my resident as a warm great guy with a supportive family and when the urine tox comes back positive for coke, the resident asks me if the patient also smokes crack with his beautiful family. i know everybody has their sufferings but i am not trying to be a sucker.
so anyway, to the point- my patient was here to be placed and i saw her Hgb had dropped a point and a half since the day before. she had just came in. maybe dilution i thought. the next day, i saw on my computer that she had been discharged. i was surprised somebody had found a place for her to stay after i left.
then i ran into the senior resident. she said my patient had coded overnight and died. bled into her belly. i should have picked it up. maybe. the only way to describe it is similar to those you love who leave your life. like a kick in the stomach. a sinking feeling that stays for days.
sri
AF, my patient on the wards. a Philipina woman, 73. she had chronic pain and i didn't know how much to give it credence. i hate the gatekeeper roll. i feel like i am always deciding, who is in pain and who is not. who deserves disability and who doesn't. who is addicted to IV dilaudid. AD told me today on the phone that she thought i have the personality of someone who would give in and prescibe pain meds to a patient who demanded and begged for it.
i disagreed. it is a tough line between being compassionate and not being soft. being aware but not cynical. there have been so many patients this year who i present to my resident as a warm great guy with a supportive family and when the urine tox comes back positive for coke, the resident asks me if the patient also smokes crack with his beautiful family. i know everybody has their sufferings but i am not trying to be a sucker.
so anyway, to the point- my patient was here to be placed and i saw her Hgb had dropped a point and a half since the day before. she had just came in. maybe dilution i thought. the next day, i saw on my computer that she had been discharged. i was surprised somebody had found a place for her to stay after i left.
then i ran into the senior resident. she said my patient had coded overnight and died. bled into her belly. i should have picked it up. maybe. the only way to describe it is similar to those you love who leave your life. like a kick in the stomach. a sinking feeling that stays for days.
sri
posted by srijeeva at 12:00 AM
1 Comments:
You are still early in your career. I've been out a few years and I still get this feeling when I follow up on someone that I've admitted from the ED and find that they have had a poor outcome. I always search back to see if there was something I could have done different or better. It keeps you improving yourself. It's a sign of compassion and a sign that you will be a very thoughtful doctor.
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