29 March 2006

A Win for the Home Team!

I just got the discharge report for the little boy I posted about here. Not only did he survive, he did very well. It's amazing. I thought he was a goner for sure. He has some neurologic deficits, a partial hemiparesis of some sort, which is a pity but it sure beats a very small coffin! Most importantly, the rehab report describes him as "alert, oriented, and conversational"! Woo-hoo!

So often, what I doo seems pointless -- most of the folks I see have no actual disease, or the trajectory of their disease is going to continue regardless of any intervention I perform. And of course, it is too rare for me to get feedback on the outcomes in cases. Thus, the job can seem to be reduced to . . . moving meat. So it's really a thrill to hear about a truly terrible, tragic case that had a happy ending. Not that I did anything too earth-shattering in it, but I was the inflection point in the arc of his illness where the trajectory turned from moribund to improving, so I feel justifiably proud and part of the miracle.


  1. That's awesome. Good job, Doc.

  2. Nice work, my friend. Sometimes it may be moving meat, but there is no doubt that you do something where you have a very real and profound impact on people's lives.

  3. It is kind of heartening in a backwards way to hear you feeling angst about the relevance of your work. As advisor to the judge, I've felt pretty pointless often. I suppose it is a by-product of a deep burning desire to make the world a better place.

  4. That's great bro! It really is great to hear stories like that! Pretty soon, I'll understand how you feel; I have my first clinical tonight and I get assigned my residents for the next 10 weeks! I just hope some can have a happy ending like this one!

    Don't ever trivialize what you do, for then it will lose what made it special to you in the first place.

  5. In a similar vein, we have recently taken care of a 5 month old girl who was saved by "vitamin R."
    She had been sick for one day with high fevers, and was seen in the ER with no obvious source of infection. She was given a slug of Rocephin and sent home. The next morning she came back to the ER with a rash, which the parents attributed to the antibiotic. In fact she had palpable purpura, and not 3 hours afterwards the blood culture from the previous evening reported N. meningitidis growth.
    I know that we sometimes complain about indiscriminate use of Rocephin. A case like this little girls', though, shows the impact of the single example that justifies the other 999 healthy "number needed to treat."

  6. Excellent job, and thanks for posting.

    I recently had a nurse come up to me and tell me a family was requesting me to be their doctor. It turns out I had cared for their 70 yr old father a few months ago when he came in for "just not feeling right". A vague chief complaint, a negative review of systems and a normal neurologic exam later, I felt that something just wasn't right and got a head CT which reviewed huge bilateral subdurals. Needless to say, he was whisked off to surgery and spent the next few months rehabilitating but had done amazingly well.
    When the wife arrived and recognized me, she asked if I could be their doctor again, since she felt that I had saved her husband's life some months ago.
    This touched me in a profound way. Our patients, although often sick and frequently grateful for their care, never really request us. We're just the person that picks up the chart. It meant so much to me (although frankly, it can be boiled down to one of those times when you thank your stars for a bit of luck).

    It can be hard to express things like this to those who don't know what we do for a living.


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