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tamingthemuseTitle: Crumbs
Author:![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-userinfo.gif)
spikespetslayer
Pairing: NONE
Fandom: NONE
Rating: General
Warnings: This might contain some medical terms that most people aren't familiar with--if you need more explanations, please don't hesitate to ask in comments.
Author's note: Usually I write fiction. Although this is fiction of a sort with names and situations changed, it is also a part of my life since I am a registered nurse. This is a fictionalized account of a doctor, but more than that, a fictionalized account of a patient, one of thousands that I see every year.
I can only urge each of you that if you have something wrong, don't put off going to see your physician. Early diagnosis can prevent many complications that otherwise can turn into bigger and more profound problems. Especially pain. Any kind of pain is the body telling you that something is wrong and should never be ignored.
Crumbs
Don’t ever let anyone tell you that medicine is an exact science. True, it’s a science, but there is nothing exact about it. It is trial and error, guesswork and scutwork, lots of critical thinking, sometimes a lot of luck. Nothing exact about that in any way, shape, or form.
Medicine is more like…well, like the trail of breadcrumbs in Hansel and Gretel. You do tests to rule out different things and turn around, expecting to find your way out of the woods and back to where you started, but instead there is nothing there but bare ground. You can do blood tests, CAT scans, colonoscopies and flex sigmoidoscopies until you are blue and straining for air, but in some patients, it does no more than muddy the water.
Take this one patient that I just had, for instance. They admitted her to the hospital for diarrhea and weight loss. That was all—until we found out that the weight loss was over fifty pounds in one month and the diarrhea had been going on for about six months before she ever decided to come and see me. I did every test I could think of, then asked for a surgeon to consult. The surgeon did everything that she could think of too, including scopes to look directly into the intestines.
We thought that we had an answer when we found something blocking the intestines. We shared the ‘aha!’ moment when we believed that we had found the problem. Unfortunately, our ‘aha!’ quickly turned into a sigh when another scope showed nothing more than inflammation of the colon and normal physiology.
You know, in med school, they teach anatomy and tell you that this is the way the human body is put together. They try to make it an absolute, but it isn’t. There is always something different in every one of us. I have a patient that has three ureters from each kidney, and one patient that has a ureter that connects one kidney to the other across the back like a jump rope and one ureter that descends into the bladder. I‘ve also had a patient that has three kidneys and one with her appendix on the left side instead of the right. This woman was no different; her sigmoid colon flipped the wrong way—instead of the normal left-right-down, it went right-left-down. And we thought our problem was solved when it just gave us more crumbs to follow.
When our resources ran dry, we decided to send her on to another hospital. A bigger one with specialties that have seen everything and then some, or so we thought. They called me today and they’re as flummoxed as we were.
Now she has fluid in her abdomen, swelling of both her legs, and her skin is so full of water that it weeps. (They call that third spacing, just so you know.) She’s sicker now than she was when we sent her up there and they are calling me asking me what to do with her.
I don’t know. The crumb trail that I was following petered out on me about two weeks ago and I don’t have a clue which way to go now.
I have the feeling that my patient will die and I’ll be left to try and pick up the pieces of her family that will want answers that I don’t have. We know that it isn’t cancer or colitis or any of the normal things wrong with her; we know that it isn’t one of the multiple bugs that infect the bowels and make diarrhea a way of life until you medicate them or the body fights back on its own. I don’t know what to tell them, to be honest, and I know that isn’t the answer they want to hear. They want to know why their wife, their mother, their grandmother is so sick and I don’t have an answer.
Maybe if she would have come in sooner and told me about the weight loss and diarrhea I would have had a clearer path and could have seen my way out of the trees and through the forest.
Being a doctor isn’t easy. Sometimes you start seeing your patients as diseases and not as people. I find myself doing that and I have to force myself out of that mindset. That isn’t the person that I am, nor someone that I want to become. Each person that I treat has a life, people who love them, careers, quirks, problems outside of their health, and sometimes I have to force myself to think of those things first and the disease last.
Sometimes, I don’t want to be a doctor anymore. Sometimes I think that my sister picked the easier job, being a veterinarian and treating animals. At least the animals are easier to lose than a human life, or sometimes I think that it is. My sister begs to differ.
Breadcrumbs—trails that we follow to try and help someone. That’s what medicine is at its best. Trails and trials and crumbs and errors that we hope will bring us a diagnosis that will help. Otherwise, we’re just as helpless as the next person is when it comes to death. It creeps up on us and catches us unaware just like it does regular people. It really doesn’t seem fair.
Maybe someday it will be different and medicine will be more than just that. I certainly hope so. Until it is, I’ll just have to keep following the crumbs that lead me to whatever it can and pray to God that I help someone today.
Author:
spikespetslayerPairing: NONE
Fandom: NONE
Rating: General
Warnings: This might contain some medical terms that most people aren't familiar with--if you need more explanations, please don't hesitate to ask in comments.
Author's note: Usually I write fiction. Although this is fiction of a sort with names and situations changed, it is also a part of my life since I am a registered nurse. This is a fictionalized account of a doctor, but more than that, a fictionalized account of a patient, one of thousands that I see every year.
I can only urge each of you that if you have something wrong, don't put off going to see your physician. Early diagnosis can prevent many complications that otherwise can turn into bigger and more profound problems. Especially pain. Any kind of pain is the body telling you that something is wrong and should never be ignored.
Crumbs
Don’t ever let anyone tell you that medicine is an exact science. True, it’s a science, but there is nothing exact about it. It is trial and error, guesswork and scutwork, lots of critical thinking, sometimes a lot of luck. Nothing exact about that in any way, shape, or form.
Medicine is more like…well, like the trail of breadcrumbs in Hansel and Gretel. You do tests to rule out different things and turn around, expecting to find your way out of the woods and back to where you started, but instead there is nothing there but bare ground. You can do blood tests, CAT scans, colonoscopies and flex sigmoidoscopies until you are blue and straining for air, but in some patients, it does no more than muddy the water.
Take this one patient that I just had, for instance. They admitted her to the hospital for diarrhea and weight loss. That was all—until we found out that the weight loss was over fifty pounds in one month and the diarrhea had been going on for about six months before she ever decided to come and see me. I did every test I could think of, then asked for a surgeon to consult. The surgeon did everything that she could think of too, including scopes to look directly into the intestines.
We thought that we had an answer when we found something blocking the intestines. We shared the ‘aha!’ moment when we believed that we had found the problem. Unfortunately, our ‘aha!’ quickly turned into a sigh when another scope showed nothing more than inflammation of the colon and normal physiology.
You know, in med school, they teach anatomy and tell you that this is the way the human body is put together. They try to make it an absolute, but it isn’t. There is always something different in every one of us. I have a patient that has three ureters from each kidney, and one patient that has a ureter that connects one kidney to the other across the back like a jump rope and one ureter that descends into the bladder. I‘ve also had a patient that has three kidneys and one with her appendix on the left side instead of the right. This woman was no different; her sigmoid colon flipped the wrong way—instead of the normal left-right-down, it went right-left-down. And we thought our problem was solved when it just gave us more crumbs to follow.
When our resources ran dry, we decided to send her on to another hospital. A bigger one with specialties that have seen everything and then some, or so we thought. They called me today and they’re as flummoxed as we were.
Now she has fluid in her abdomen, swelling of both her legs, and her skin is so full of water that it weeps. (They call that third spacing, just so you know.) She’s sicker now than she was when we sent her up there and they are calling me asking me what to do with her.
I don’t know. The crumb trail that I was following petered out on me about two weeks ago and I don’t have a clue which way to go now.
I have the feeling that my patient will die and I’ll be left to try and pick up the pieces of her family that will want answers that I don’t have. We know that it isn’t cancer or colitis or any of the normal things wrong with her; we know that it isn’t one of the multiple bugs that infect the bowels and make diarrhea a way of life until you medicate them or the body fights back on its own. I don’t know what to tell them, to be honest, and I know that isn’t the answer they want to hear. They want to know why their wife, their mother, their grandmother is so sick and I don’t have an answer.
Maybe if she would have come in sooner and told me about the weight loss and diarrhea I would have had a clearer path and could have seen my way out of the trees and through the forest.
Being a doctor isn’t easy. Sometimes you start seeing your patients as diseases and not as people. I find myself doing that and I have to force myself out of that mindset. That isn’t the person that I am, nor someone that I want to become. Each person that I treat has a life, people who love them, careers, quirks, problems outside of their health, and sometimes I have to force myself to think of those things first and the disease last.
Sometimes, I don’t want to be a doctor anymore. Sometimes I think that my sister picked the easier job, being a veterinarian and treating animals. At least the animals are easier to lose than a human life, or sometimes I think that it is. My sister begs to differ.
Breadcrumbs—trails that we follow to try and help someone. That’s what medicine is at its best. Trails and trials and crumbs and errors that we hope will bring us a diagnosis that will help. Otherwise, we’re just as helpless as the next person is when it comes to death. It creeps up on us and catches us unaware just like it does regular people. It really doesn’t seem fair.
Maybe someday it will be different and medicine will be more than just that. I certainly hope so. Until it is, I’ll just have to keep following the crumbs that lead me to whatever it can and pray to God that I help someone today.
no subject
Date: 2006-10-28 07:59 pm (UTC)*hugs*
I wish that I could heal the world...
no subject
Date: 2006-10-30 04:24 pm (UTC)I also loved that yours is the first story I have read here, so far (including my own) which uses the prompt properly - because that was the problem with the trail of breadcrumbs, the birds ate them and Hansel and Gretel couldn't follow them back.