* * Anonymous Doc

Thursday, April 1, 2010

Sorry for the delay in new posts. Outpatient service, combined with the family stuff-- just haven't had much to say. Should change as the schedule does-- I start in the ICU this weekend. Every 4th night overnight. Can't wait.

No, I'm serious. Part of me can't wait. Outpatient is boring. If I had a life, maybe it wouldn't be. But I don't, so it is.

Forgot to mention another reason for the slowdown. I was seeing someone. Another intern. I liked her. Thought she liked me. She broke it off yesterday, said she didn't have time for a relationship, thought I'd figure out soon enough that she wasn't worth my time. It's weird, to be a doctor you need some degree of confidence on the academic side, some degree of accomplishment, drive, motivation. On the social side? Not so much. She thought I'd figure out it wasn't worth my time? That's a cop-out. I can decide for myself whether something's worth my time or not. But what can I do? We a few nice weeks. I almost felt like an adult, with a job and a relationship-- not really anything in the extra-curricular department, but still, almost a life. Now, back to the ICU and back to the job being the only thing I've got going. So I figured I ought to return to the blog, right? Posting every day in April, I'll make that a promise.

I had a patient in clinic today, crazy high blood pressure. "It's because I walked all the way from the parking lot," she said. People don't understand blood pressure. "It's high because I'm nervous." / "It's high because I just ate lunch." / "It's high because I have to go to the bathroom." I've heard all of them. They don't make sense. We have this strange compulsion to be able to explain things. It's fine if you have knowledge. Smart people can make educated guesses and sometimes they're right. But if you have no background, no understanding of how the body works-- like most of the patients in clinic-- you're just about never going to make any sense, no matter how much you think you do. A patient came in earlier in the month, ended up hospitalized with anemia. She comes back for a follow-up today, she isn't taking her iron supplements. "Why not?" "I'm drinking tea. The Internet said tea is good for anemia." "Your iron is still really low." "I didn't drink the tea today." "Please take the pills." "I don't need them." "No, you do. I promise, you do. I'm the doctor. Please listen to me. I know what I'm talking about." Trust me, trust your doctor. Not blindly, of course. We're human. But the easy stuff? We do know things. Medication, we're pretty good at. We tell you that you need something, you probably do. Ask questions, fine. I'm happy to explain, to a point. But take the pill. Please. Just take it. Don't worry about it, don't stress-- just take it, be happy, and get on with your life. Patient recovering from surgery comes in, "I'm in terrible pain." "Taking the pain pills?" "No, I don't like taking medicine." Medicine's all I got. I gave you the pain pills to take away the pain. You don't want them, it's your choice, I guess-- but then you can't complain about the pain. I gave you an answer. You're just choosing to ignore it. And then you blame me for not making you better. Ugh.

3 comments:

  1. Date someone of a different profession with a forty hour work week.

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  2. My former doctor's office used to be at the top of a very long (quarter mile or so) steep hill. One day, I hiked up that hill and arrived exactly on time for my appointment, and surprisingly there was no wait. I was brought in to the room and immediately subjected to having my vitals taken.

    "That's odd," the nurse remarked. "Your blood pressure is high. Perhaps it was the walk to the office."

    She left, came back 10 minutes later (when my pulse had calmed to its usual resting state) and re-took my blood pressure. Came back my usual normal low.

    Can exercise raise blood pressure? Based on your post above, I'd think no. But how to make that jive with my experience ...

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