Work and Pleasure
These are the things that made me happy during a recent shift:
1) The three patients who not only thanked me for helping them, but also told me that they felt sorry for me that I was the only doctor on duty and had to work so hard. Really.
2) Removing the sac from the infected sebaceous cyst. Oooooh, yeah.
3) Learning about metacarpophalangeal dislocations. They are much different than interphalangeal joint dislocations, I discovered.
4) The perfect spinal tap: one stick, 0 RBCs, 0 WBCs, 100% lymphs. A benzodiazepine-laden patient is a still patient.
5) Suturing the second-grader's foot without making him cry, as he told me about catching his first big fish. Watching his dad's apprehension vanish when he saw his son was comfortable.
6) Seeing the brave little girl whose abscess I drained skip away happily, stickers in hand. One for her brother.
7) Sitting down with my last patient of the night, an elderly retired nurse, and hearing her life stories. A two time cancer survivor, she's too tough to let her bad heart slow her down much. Her bad knee is the only thing that keeps her from driving, and if her doctor would OK the surgery she'd lick that problem too. She doesn't like to have to depend on her family to drive her around. Her husband was a Cardiologist, she said, and he used to make house calls. As she prepared to go home, she thanked me and said "I hope you get everything you want out of life."
It's patients like her that help make it so.
Things that frustrated me:
Only that dislocated finger. I was not much consoled to read that many MCP dislocations require open reduction in the OR. It looked like it should have popped right back in. I hate failed procedures, but I did the best that I could. It still bugs me.
1) The three patients who not only thanked me for helping them, but also told me that they felt sorry for me that I was the only doctor on duty and had to work so hard. Really.2) Removing the sac from the infected sebaceous cyst. Oooooh, yeah.
3) Learning about metacarpophalangeal dislocations. They are much different than interphalangeal joint dislocations, I discovered.
4) The perfect spinal tap: one stick, 0 RBCs, 0 WBCs, 100% lymphs. A benzodiazepine-laden patient is a still patient.
5) Suturing the second-grader's foot without making him cry, as he told me about catching his first big fish. Watching his dad's apprehension vanish when he saw his son was comfortable.
6) Seeing the brave little girl whose abscess I drained skip away happily, stickers in hand. One for her brother.
7) Sitting down with my last patient of the night, an elderly retired nurse, and hearing her life stories. A two time cancer survivor, she's too tough to let her bad heart slow her down much. Her bad knee is the only thing that keeps her from driving, and if her doctor would OK the surgery she'd lick that problem too. She doesn't like to have to depend on her family to drive her around. Her husband was a Cardiologist, she said, and he used to make house calls. As she prepared to go home, she thanked me and said "I hope you get everything you want out of life."
It's patients like her that help make it so.
Things that frustrated me:
Only that dislocated finger. I was not much consoled to read that many MCP dislocations require open reduction in the OR. It looked like it should have popped right back in. I hate failed procedures, but I did the best that I could. It still bugs me.
Labels: patients
posted by scalpel at 5:30 AM
8 Comments:
That's a gratifying record and lovely mix of patients.
Any plans to hand out praline alongside the stickers in the future (mmm, hazelnut or pecan praline)?
Regards - Shinga
I once performed a perfectly clean tap in residency with 0rbc and 0 wbc and my attending bought me a bottle of champagne. Seems like you deserve one to!
There's nothing that makes you feel cooler than getting a procedure on the first shot. I'm rotating through the ICU right now. It's a combo Med-Surg ICU. I follow the Surg patients (as an anesthesia resident) but I do procedures for the Med teams (art lines, central lines, etc).
Earlier in the week there was a DKA patient who needed a blood gas. Both the 4th year student and the nurse in the room made several sticks without success. I was walking by and they asked me if I wanted to give it a try. One shot, 2 cc of arterial blood, the patient barely felt a thing. I love that feeling.
Nice list, nice work. The bottom of the foot is the worst, in terms of applying local painlessly.
That you get those compliments means you are doing more than taking care of the problem: you're taking the time and have the skill to connect.
I always enjoy reading about someone who loves their work. If I'm ever a patient in an ER, I hope my doctor enjoys his/her work, too.
It's always that one case or one patient, isn't it? I know exactly what you mean. There are times when I have a great day at the office, then something happens in the last hour or last half and hour to keep me thinking all night of how I could have dealt with it differently. It doesn't keep me up at night.. But, like you said, it bugs me.
The one thing more frustrating than not getting that reduction is not getting the procedure you've done a hundred times before. Like having trouble with a simple Colles reduction that seemed so easy.
I've had a MCP joint that I couldn't reduce, and it was (probably) interposed tendons. You are not alone.
GruntDoc
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