Posts tagged patient
I Do Not Fear Death by Roger Ebert
“I will pass away sooner than most people who read this, but that doesn’t shake my sense of wonder and joy.”
The essay is from Roger Ebert’s Life Itself: A Memoir and was published to Salon as a memorial of sorts for a recently deceased critic and friend. It is a beautifully written essay about that final threshold to which we all find at the end of our days.
He Who Inspires…
Recently, I had the great pleasure of working with a specialist. While I found him to be an excellent doctor and teacher of his field, he impressed me more with his mastery of the art of medicine.
Watching him work reminded me of the heart it takes to work with patients.
After spending a morning with him, I can honestly say without hesitation: I have never been more inspired about medicine.
There was nothing complicated or mysterious about his interactions with patients. There was no parlour tricks or unnatural question structure. It was just him, his patient, and the problem. His language was simple, his examples relevant, and his explanations honest.
We often talk about empathy as a tool to help us connect to a patient. In my hands, it is an embarrassingly clunky, yet unrefined hammer of “it must be frustrating,” or that “I see you are upset.” His was the precision cut scalpel that sliced to the core issues and emotions.
Patients simply opened up to and connected with him. And I, sitting in my seat, even felt the transference of emotions at times as well. It was a powerful and beautiful display of the art of medicine at work.
To his patients, it was an overwhelming sense of feeling human in the eyes of a stranger, to not feel like a bag of meat at the mercy of a probe and a blade. To him, it was just the way medicine had always been and would continue to be.
For me, it was the revelation of what it is to truly practice great medicine.
The Everyman Patient.
Almost every day, I see a patient that has such a large spectrum of co-morbidities that to consolidate the information neatly and concisely is an undertaking in itself. There are patients who have allergies or complications to most of our treatment medications, leaving us few options. There are the frequent history or physical findings that do not match up with my attending’s findings. And yes, there are fall risks.
This is a small sample of the common trends I see on the ward but you know, with a bit more tongue-in-cheek humour.
The Michael Jackson Drug
- Anaesthesiologist: Alright, it is time to put you to sleep.
- Patient: Sounds good.
- Anaesthesiologist: And here comes the Michael Jackson drug.
- Patient: *Laughs*
- Anaesthesiologist: This is propofol. You will feel a sting.
- Patient: I do not mind a slight sting but will I wake up after?
- Anaesthesiologist: Of course. We are not letting you off the hook that easily.
- Patient: Ha! Very well. Proceed.
- Anaesthesiologist: Sweet dreams.
Not on my White Coat
- While doing a physical on a volunteer patient, noticing he could not keep still.
- Me: How are we doing here, sir?
- Pt: Not so good. I think that stomach upset from this morning...I think it's back.
- Me: Back?
- Pt: I think I'm going to throw up.
- Me: ?! Hold on, let me grab the bin for you.
- After a vomiting bout, the patient starts to feel an urge to use the washroom. With some help from a nurse, we help him out but were unable to reach the washroom after he becomes dizzy. A doctor passes by and notices.
- Dr: Whoa, what's going on here. Sir, are you okay?
- Pt: I don't know, I really don't feel good.
- Dr: We should get you checked out just to make sure you're okay.
- While the patient is put into a bed and taken to the emergency department, my tutor returns.
- Tutor: Tom...what did you do?
- Me: Um...
- Tutor: I said take a history and physical, not send him to the ER.
A well person is a patient who has not been completely worked up.
A resident’s answer to the question: what is a well person?
Clifton K. Meador, MD. The Last Well Person. New England Journal of Medicine 1994, 330(6): 440
Rediagnosis
- Doctor sees a person in a public space with telltale signs of a rare but treatable endocrine condition. After much debating over the ethics, decides to approach the person.
- Doctor: I am very sorry to intrude and this might come off a little odd, but I am an endocrinologist. I noticed you while passing by and I think you might have an undiagnosed, rare endocrine condition.
- Person: ...Yes, I know. Do you not remember? I am one of your patients.
- Doctor: *Awkward silence*
My tumor is situated in the pelvic girdle inside the bone and growing out into the pelvis, and I find it difficult to imagine what it really looks like. I feel that it is an uninvited guest in my body and when I started this cytotoxic treatment I thought: Now this is for you.
Urgent care at the end of the universe
- Cranquis: Well, I'm sorry your panic disorder was aggravated by the "End of the World" stuff this past weekend. I think the Xanax will help you sleep better for the next couple of nights, and you should get back in to see your counselor soon, ok?
- Patient #1: Ok thanks doc.
- (Leaves Patient #1's room, goes on to Patient #2)
- Cranquis: So, how can I help you today?
- Patient #2: Well, I have anxiety, and I had a really bad panic attack this weekend...
- Cranquis: Oh good grief. Let me guess: rapture anxiety?
- Patient #2: How did you know?!
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