We have a 44-year-old woman who weighs 400 pounds. We can't even listen to her lungs because the fat is too thick for us to hear anything. She can barely fit in the bed, she can barely move, we can't examine her, she's complaining of non-specific pain. Of course she has non-specific pain, she's 400 pounds.
One of the things that makes this job so incredibly frustrating is that for pretty much everyone in a public hospital, we're seeing them way too late. We're seeing alcoholics who are dying of liver failure, we're seeing stage IV cancer patients who were never even diagnosed until it had spread throughout their bodies. There really is nothing to do to make these people better. There were things we could have done, years ago, but not now. So all we can do is watch them die.
If the 400-pound woman went to the doctor when she was 250 pounds, maybe there are things we could have done to help her, so she wouldn't be 400 pounds and suffering from mysterious pain that probably isn't very mysterious at all, we just haven't found it yet. (And, no, I don't necessarily blame her entirely for not seeing a doctor sooner-- I don't want to make this blog about the health insurance debate, and I don't know what her health insurance status has been over the course of her adult life, and I don't know when she gained most of the weight-- I'm just saying that I'm frustrated, and she's just an example of these kinds of patients, who we can't do anything for, and they're just here and they're dying.)