One of the pitfalls of a profession where everything is meticulously documented is that sometimes what you write isn't exactly shakespear...maybe isn't even exactly english.
Actual writings from hospital charts: FUNNY, BUT SCARIER THAN HECK
1. The patient refused autopsy.
2. The patient has no previous history of suicides.
3. Patient has left white blood cells at another hospital.
4. She has no rigours or shaking chills, but her husband states she was very hot in bed last night.
5. Patient has chest pain if she lies on her left side for over a year.
6. On the second day the knee was better, and on the third day it disappeared.
7. The patient is tearful and crying constantly. She also appears to be depressed.
8. The patient has been depressed since she began seeing me in 1993.
9. Discharge status: Alive but without permission.
10. Healthy appearing decrepit 69-year old male, mentally alert but forgetful
11. Patient had waffles for breakfast and anorexia for lunch.
12. She is numb from her toes down.
13. While in ER , she was examined, x-rated and sent home.
14. The skin was moist and dry.
15. Occasional, constant infrequent headaches.
16. Patient was alert and unresponsive.
17. Rectal examination revealed a normal size thyroid.
18. She stated that she had been constipated for most of her life, until she got a divorce.
19. I saw your patient today, who is still under our car for physical therapy.
20. Both breasts are equal and reactive to light and accommodation.
21. Examination of genitalia reveals that he is circus sized.
22. The lab test indicated abnormal lover function.
23. Skin: somewhat pale but present.
24. The pelvic exam will be done later on the floor.
25. Patient has two teenage children, but no other abnormalities.
Wednesday, July 27, 2011
Thursday, July 21, 2011
A Clinic of Miracles
After my last post I feel obliged to post something happier, but the sad stuff is so much more frequent and potent. Being on the "cancer" rotation you would think everything is sad, but they do give you a glimpse at why these doctors do what they do, and you begin to see how it's viewed through their eyes.
Everybody hates inpatient-wards on this service, you see most of the attendings become grumps and worse ;) But every week we are given a half day of clinic and you might ask yourself what makes "cancer" clinic so special? Well could you imagine going to a place where cancer is curable? I try not to reference religion on here too much, but there are times in the Bible when Jesus healed people. It's hard to really understand the flood of relief, freedom, and gratitude that must have struck those people who had been miraculously cured, until you visit "cancer" clinic. This is a place where people's children have been GIVEN back to them and I've never seen such a happy work environment...honestly you need a better word than happy...like every person is appreciating every second of life they are given...it's a crazy level of happy. The doctors LOVE the patients, the patients LOVE the doctors, and it's like getting invited to be a part of a very tight knit loving family, they take you right in and you're allowed to take off your mask and beam with a ear to ear smile. That 5 hours a week is a patch of heaven in a month of pain, suffering, and hell.
Newbie Doc
Everybody hates inpatient-wards on this service, you see most of the attendings become grumps and worse ;) But every week we are given a half day of clinic and you might ask yourself what makes "cancer" clinic so special? Well could you imagine going to a place where cancer is curable? I try not to reference religion on here too much, but there are times in the Bible when Jesus healed people. It's hard to really understand the flood of relief, freedom, and gratitude that must have struck those people who had been miraculously cured, until you visit "cancer" clinic. This is a place where people's children have been GIVEN back to them and I've never seen such a happy work environment...honestly you need a better word than happy...like every person is appreciating every second of life they are given...it's a crazy level of happy. The doctors LOVE the patients, the patients LOVE the doctors, and it's like getting invited to be a part of a very tight knit loving family, they take you right in and you're allowed to take off your mask and beam with a ear to ear smile. That 5 hours a week is a patch of heaven in a month of pain, suffering, and hell.
Newbie Doc
Tuesday, July 12, 2011
A Real Goodbye
I'm on heme onc right now. I've seen a lot of patients since I've been on. I admitted one at the very beginning that's gonna stick with me. He's 20 years old, he reminds me a lot of my younger brother. During the short time I was his doctor we became good friends. He's a funny guy, he has a lot of good friends, doesn't take things very seriously...not even his leukemia...well not as serious as most, while I was admitting him we joked about all the stupid questions I had to ask him. In between questions we'd toss back and forth jokes and discuss movies and games. We talked about how he was enjoying the good college life, how he was having too much fun, how he was going to get his life together and two weeks into that plan, he's diagnosed with a death sentence. He's going to die from this.
Leukemia is a scary thing, just the word has broken men far stronger than me and I've watched in horror as it happened, covering my terror with my mask. That being said, it's something we've gotten more and more proficient at beating...did you know that a child diagnosed with acute lymphocytic leukemia (the most common type) has an 85% chance of cure in this age. I think that's wild, it's amazing that we can beat it that well...but my patient has too many risk factors, he's too old, he's got the wrong genetic markers, and the disease didn't behave "normally" when it first presented.
That being said, I know he's been briefed as to what his prognosis is, that he and I both know that his chances of survival are very small. I know that when I discharged him today, in all likelihood we were saying one of those "real goodbyes" it was in the back of my mind as I shook his hand and wished him luck.
I don't know what to take from this..."Party it up, life is short?"..."Cherish what you have?"...I don't know what to think...I don't have any wise things to take from this. A friend is dyeing and in a way to me, because of what I know (that there is little hope), he is already dead.
Newbie-Doc
Leukemia is a scary thing, just the word has broken men far stronger than me and I've watched in horror as it happened, covering my terror with my mask. That being said, it's something we've gotten more and more proficient at beating...did you know that a child diagnosed with acute lymphocytic leukemia (the most common type) has an 85% chance of cure in this age. I think that's wild, it's amazing that we can beat it that well...but my patient has too many risk factors, he's too old, he's got the wrong genetic markers, and the disease didn't behave "normally" when it first presented.
That being said, I know he's been briefed as to what his prognosis is, that he and I both know that his chances of survival are very small. I know that when I discharged him today, in all likelihood we were saying one of those "real goodbyes" it was in the back of my mind as I shook his hand and wished him luck.
I don't know what to take from this..."Party it up, life is short?"..."Cherish what you have?"...I don't know what to think...I don't have any wise things to take from this. A friend is dyeing and in a way to me, because of what I know (that there is little hope), he is already dead.
Newbie-Doc
Monday, July 4, 2011
On not being Robo-Doc
Suddenly I find myself in a scary position. I'm a senior resident. I'm expected to know something. I have doctors under my command. When I have a question I look around for my senior only to realize that it's my time, I'm the man whose supposed to have the answers...HA!!
Now I'm on cancer service, a service reserved for "upper level" residents. I don't have the slightest clue what's going on with my patients...they are "complex". I read constantly...I thought I "read" before.
Last night I had 3 leukemics come in. One parent cried on me. These days it's like I feel the sadness waying in on me but it meets a wall. I know deep down I'm really sad, but it's like a callus on your hand. The first time it stings, after the one hundredth time, you still feel the pain, but it's dulled. Sometimes when I'm tired I have to make a conscious effort to put myself in their shoes, so I can relate and they don't feel like I'm robot-doc. It sounds cold but the "dulling" effect happens without trying, you might think it's awful, you might think you'd never feel that way, but I'd say roughly twice a week I have a parent cry on me and I have to comfort them, you become very good at it and you become very relaxed in situations where the person sitting a crossed from you is flipping out. The point is that this would happen to anybody, it's just one of those things you don't expect. The thing you never imagine is that the hard part is pretending to act like you haven't been in that situation a billion times and acting like each new crisis is actually a new crisis.
Why do you do this? There's the obvious reason, you don't want the parents getting hostile. There's the reason that you first imagine, the slimey doctor is trying to buddy up to the person in trouble. The reason I do it is because the family and you have to be on the same side. A patient won't get better if they don't take the treatment and they don't believe in you, so some of what I do is selling them on me. It sounds disingenuous, but it's for their own good. I believe at the end of the day a patient wants a human treating them, not a robot, not even necessarily a doctor.
Newbie Doc
Now I'm on cancer service, a service reserved for "upper level" residents. I don't have the slightest clue what's going on with my patients...they are "complex". I read constantly...I thought I "read" before.
Last night I had 3 leukemics come in. One parent cried on me. These days it's like I feel the sadness waying in on me but it meets a wall. I know deep down I'm really sad, but it's like a callus on your hand. The first time it stings, after the one hundredth time, you still feel the pain, but it's dulled. Sometimes when I'm tired I have to make a conscious effort to put myself in their shoes, so I can relate and they don't feel like I'm robot-doc. It sounds cold but the "dulling" effect happens without trying, you might think it's awful, you might think you'd never feel that way, but I'd say roughly twice a week I have a parent cry on me and I have to comfort them, you become very good at it and you become very relaxed in situations where the person sitting a crossed from you is flipping out. The point is that this would happen to anybody, it's just one of those things you don't expect. The thing you never imagine is that the hard part is pretending to act like you haven't been in that situation a billion times and acting like each new crisis is actually a new crisis.
Why do you do this? There's the obvious reason, you don't want the parents getting hostile. There's the reason that you first imagine, the slimey doctor is trying to buddy up to the person in trouble. The reason I do it is because the family and you have to be on the same side. A patient won't get better if they don't take the treatment and they don't believe in you, so some of what I do is selling them on me. It sounds disingenuous, but it's for their own good. I believe at the end of the day a patient wants a human treating them, not a robot, not even necessarily a doctor.
Newbie Doc
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