Saturday, May 23, 2009

Homesick and a Patient's Course

Sometimes, as I start to write a new blog post, I wonder if I'm not just saying the same few things over and over. I hope not. However, I try not to go back to reread my posts, as I'm sure I'd be aghast at what I've written and vow to never blog again. As it stands, I will keep writing and naively think that what I'm saying is having an impact on people. :)

I was recently back in the Midwest for a wedding. It was a college friend, and it was a lot of fun. It really made me miss the Midwest. Now, it's not perfect back home, but I miss the simplicity of life there. I also miss seeing my siblings. I'm jealous of people who can drive 20 minutes and hang out with their brother or sister. Not that moving back home would allow me to see them more (since they are equally spread out), but I'd at least be in the same time zone. Well, close to the same time zone.

Fortunately, I'll see everyone in July which will be awesome. I can't wait.

To add a medical side to this post, I saw a patient recently who is HIV+. She is close to 50 and really rebelled against taking any medications for a long time. She weighs about 75lb. Her daughter brings her to clinic every week so we can check on her. We often get frustrated at patients who so blatantly refuse life-saving treatment. I wonder what her daughter goes through. Is she frustrated with her mom's condition, is she tired of spending her entire Thursday at our county clinic? Is she the driving force behind her mom now staying adherent to the regimen? Next time, I think I'll ask her how she's doing. I'm sure her role as care taker is stressful, and we doctors don't do enough to recognize that.

Sunday, May 10, 2009


Today is Mothers' Day. I need to say thanks to my mom for doing an awesome job raising 4 very independent, very ambitious kids.

As I get older and I realize how much my mom really has hit me that I can't adequately say thanks. Not that she'd want that, but I know that there's no way to repay all of the sacrifice, the tears and the headaches. Sure, I caused some joy and laughter. I just hope the good memories outweigh the bad!

So, Happy Mothers' Day - to my mom and all the moms out there.

Saturday, May 2, 2009

When You Can't Move On

I had a patient on Friday in my Hepatitis C clinic who was coming in to be evaluated for treatment. Not everyone with Hep C needs treatment, and it's not an easy treatment to tolerate.

To get right to the point, he had problems with depression before so I asked him how he was feeling. He said that this week marked the 10 year anniversary of his mother's death. He's the 2nd oldest of many many children. His mom had some sort of head bleed and was on life support. His dad was having a rough time of it and was quite elderly himself.

The other children (all grown adults) kept saying that the decision to withdrawal life support was the dad's. This was clearly wearing on the dad, and my patient couldn't understand why the oldest didn't step up and make the decision -- one way or another -- to help the dad out. So, my patient took the burden and stood up for withdrawing care.

He tearfully said that decision has weighed heavily on him ever since. He'll hear of someone "waking up" from a year-long coma and wonder if he did the right thing. I tried to reassure him that a 22 year old waking up from a few months after a car accident and an 80-something waking up after a ruptured aneurysm are very different things. I tried to explain that the young people aren't usually vent-dependent -- they have their brainstem intact, whereas his mother didn't. I don't think I helped him too much.

I hope he can find some peace soon, it's been 10 years that he's been torturing himself with this. I referred him to Psychiatry, where hopefully he can get in with a therapist and make some progress. His Hep C is definitely taking a backseat to his mental health. I hope the next time I see him he'll have been able to move on.