* * Anonymous Doc

Monday, September 27, 2010

Somehow I had a three day weekend. I don't know how. I sometimes have nightmares that I misread the schedule and I've missed work and a patient dies because of it. It's more likely a patient will die because I'm there than because I'm not there. But I guess those thoughts are too dark even for my nightmares.

I had a 94-year-old patient in clinic. He used to be an alcoholic. (Not too many alcoholics seem to make it to 94, but this one just got lucky, I guess.) He was unable to stop drinking for decades. Until. Until he began to experience the early signs of dementia. His family sent him to a facility for 30 days where he wouldn't be able to drink. When he got out, he had forgotten he liked to drink. He had a new routine. He forgot he would go to the liquor store every day. He forgot the allure. He hasn't had a drink since.

Amazing. If I believe the story at least. Here we have a benefit of dementia. Astonishing.

I had another patient, end-stage lung cancer, still smoking and insisting that there's no proven connection between smoking and cancer. "Have you read the original study?" he asked me. "No, I haven't." Well, if you do, you'll realize there is no link. "Sir, you have lung cancer." "Yes, I know. It's not related to the smoking, I'm sure of that." I don't care, dying patients can believe whatever they want to believe. I guess.

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