August 29, 2015

good, part II

The following is not FACTUALLY accurate. Details have been changed, things deleted, stuff made up, all to protect identity. But it is 100% absolutely true.

Staring at me is a text message from my upper level resident saying, "GOOD call on the CT. It's likely cancer."

     Implied is that I did good by correctly assessing the patient and ordering the best test to cut to the chase. But, good? I was off the next night so I did not have the opportunity to speak with patient. And the following shift I was off to take care off my own health problems by getting my bone marrow biopsy. Insert a two day training course on advanced life support for obstetrics and I've missed the patient for days now. I finally come back on only to find out the patient went downhill rapidly and ended up in the ICU.

     A sense of regret washes over me. I only performed HALF of my job. I was there to diagnose the ailment. But I was not there to console the patient. The rule of thumb is that is the job of the day team, not the night team. But not one of them knows pain like I do. And I hope they never do. But I still feel as if I let the patient down. So before it gets too late into the evening, I stroll into the ICU where it is no longer my domain. I stand and watch the patient breathing with a ventilator and say a silent prayer asking for a good death and peace for the patient and the family. The nurse looks at me a bit strangely and asks who I am. So I answer honestly. I admitted the patient and just wanted to do right by the patient by following up, no matter how too late it is.

So, did I do good? I honestly don't know. But I know how I will do it differently next time.


Abe said...

Wow, training is hard.

Isaac van Sligtenhorst, MD said...

It is hard. Even more so when you care emotionally for your patients. But more meaningful, too.