The depressing side of medicine...

Sorry for the brief hiatus... No medicine on the weekend means that I have more time to spend with Mike and I don't really blog. :)

So, today. Hm. The beginning of the day was okay. I am still learning medicine (go figure) and am still really frustrated that I don't know everything (go figure). I did have a typical small town clinic experience today. Just about right when my attending and I were going to go to lunch (literally) the nurse comes back to tell us that a guy just walked into the clinic with chest pain and wanted to know if the doctor could see him (instead of taking the drive to the ER which is a ways away). Le sigh. Of course, we saw the guy. He wasn't having a heart attack, but it looks like he MIGHT have had a heart attack a long time ago that he didn't know about. So the attending and I used that to try and scare him into quitting smoking. :) Yes, scare tactics are used everywhere, especially in medicine. How many people are going to respond to, "You should really quit, it will harm your health?"

The depressing part of the day was after clinic was done with. I did a home visit with the doctor to a woman who will probably die in about a week. If that isn't bad enough... Her story is super sad. About 1.5 months ago, she showed up to the clinic because of shoulder pain. The attending sent her to get an MRI and it showed that she tore her rotator cuff. When the orthopedic surgeon went to operate, he found the cause of the tear. A bone tumor that had grown into the rotator cuff. (The person reading the MRI had missed the tumor, but that is a different story and a detail that doesn't really matter) After the surgery, the patient came back to the attending with lower back and hip pain. Guess what? She had tumors in her spine and hip. She got an xray. It showed a tumor in her lungs (probably small cell lung cancer -- if you were to pick lung cancers, you would not want this one.... survival is measured in months). This patient had an even worse prognosis because of all the places that the cancer traveled to (officially called "metastasis" of the tumor). She was walking just fine until about 2 weeks ago when she fell and broke her leg (due to a tumor in her leg). So, she is now bed ridden and will really probably die within a week.

This is sad. The only nice thing about this story is that for some reason this woman had setup her "health affairs" ahead of time. Even before she had shoulder pain. So, it made caring for her a lot easier. Her power of attorney was picked out... She had told her power of attorney general things that she would want. And the family was very supportive. It just makes me wonder why all families don't have their sh*t together like that. It is like our own mortality is a taboo subject. We all know we are going to die at some point, so why not try and make it easier for yourself and for those that will need to take care of you.

I think that some people believe that as soon as they sign a medical durable power of attorney (or just a power of attorney) form, they are handing over their control to someone else and admitting that they are going to die soon. That isn't the case! It is there for those instances that you can't predict and that you wouldn't be able to plan for (yes, I just used a double negative).

Argh!

So enough about death... I need to go study.