I & D

One of the generally most recognized things in medicine is that an I and D procedure is one of the most rewarding experiences in it.  I and D stands for incision and drainage...of an abscess...I know...this sounds pretty disgusting...it is, but there is something so symbolic about removing the infection...draining it away.  It's like the puss and nastiness stand in one to one with the patient's pain and as you lance and remove the white curds and slime the patient's pain subsides and they are instantly better...like magic...few healing events in medicine come so quickly and with such little cost to all involved...all the patient must do is open up...literally.

The human immune system is quite an amazing thing.  It has an incredible built in memory, a cascading response system, and very few weaknesses...that being said it does have them and occasionally it runs into something which it can't fight off, kill, or digest.  When it does run into something such as this, it does a very logical thing, it creates a quarantine called an abscess.  The area around the infection or damage becomes so inflamed and swollen that the swelling (edema) closes off the blood vessels entering the area...effectively all routes in and out are cut off, leaving the invader to grow, multiply, and war with the white blood cells; but only in the area which the body has surrendered.  This counter measure of the body isn't a solution, it's a last ditch effort to keep the intruder from taking over the body and with it comes some untoward consequences.  The top three problems in forming one of these quarantine areas in the body is that, one, the bacteria isn't dead and there is still a high risk of "seeding" the rest of the body, two, if nothing comes out and the bacteria continues to grow a significant amount of pain can be caused by the ever expanding ball of puss inside your body, and three, the abscess protects the invader from blood born treatments such as antibiotics because if nothing can get out through the blood vessels, then nothing good can get in.  So in medicine and in life there comes a certain point where the pain is too great and the treatment hindered too much by the walls you put up around your embarrassments, your fears, and your failures and it's then that the site has to be opened and drained away or your risk loosing yourself, maybe your soul to it, of thinking only of that pain, and forgetting yourself and the love you have for those around you.

I hope that you never have to sit in front of loving parents and tell them that you don't know whats wrong with their son, that something is attacking his brain, and you don't know what it is.  All the tests I can offer, all the treatments that may become a possibility once we know what it is, none of that counts for anything against a child that looks like a walking skeleton, their child.  I walked out of the hospital this morning thinking I handled it very well....I did...but as the day went on I felt it eating on me, I felt the abscess growing and here I am typing this hoping this will afford me some comfort, maybe drain me of some of the poison in my veins...though I'm not sure I deserve it.

Newbie Doc