11 March 2008

how 'bout patients like this?

Crazy day today, and not the worst I've had, by far, but... Seeing patients from 8-7:30 straight through, does not a happy surgeon make. 28 of them, to be exact, no breaks. And then the phone calls. Ugh. So, you finally get a chance to breathe... and reflect. 2 patients stand out. Although, my medical assistant is always amazed that I seem to have a knack for remembering everybody, and I do. There are some that just strike a chord.

Mrs.___, who came with her husband; she has DEBILITATING median and ulnar neuropathy--bilaterally, although it's worse in the right. I know I can get her better with surgery. Wanna know why she's refusing? Not because she's scared of surgery, or because her neighbor or church friend told her a friend of a friend's aunt's sister had a bad outcome... But because she thinks that if she gets better, her kids will start using her for their chores and babysitting again. She's convinced that that's why they want her better.  The fact that she is pleasantly confused, 70, and quite forgetful doesn't make things any better.  I wanted to put my arms around her and hug her, or maybe just cry. I couldn't decide, so I just looked at her and blinked. Her husband sat next to her and comforted her, "No, baby, that's not it, I'll help you. We want you better because we don't want you in pain..." And ya know, it's hard to say...

And then there are the ones that just, well, surprise you.  I did surgery (CTR) on a (retired) physician last week.  She called today, frantic, that her hand was swollen and she had a blue thumb.  OK, "please come right in."  Yup, the thumb was blue, alright, as in BLACK AND BLUE, and the hand WAS swollen, because she immediately affirmed that she had not been elevating it, as per my instructions.  I changed the splint, as I would have done, anyway, at her scheduled appointment on Friday.  Disposition:  please elevate the hand as instructed, and wait for the bruise to resolve, keep your appointment in 2 weeks.  
You can eat extra pineapple, if you like...

They just sometimes catch you off guard, is all.  And I have to say that working for 'the group' doesn't make things any easier.  If I was making my own hours, my own money, well, I think it would just make me happier.  All in good time, I suppose.

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