Sunday, May 9, 2010

To Whom It May Concern

I did some moonlighting this weekend, which was much needed since I just signed up for my ID Boards - $2060. For a stupid test I don't even want to take. {serenity now...}

I had an interesting juxtaposition of patients this weekend, two in particular.

Patient 1 was a new admission. He's in his mid-20s, a student of some kind. I couldn't ask him because he came in unresponsive with a Glascow Coma Score of 6 (1+4+1). Why did he have no purposeful movements? He had been partying the night before with crystal meth and GHB. Oh, and his tox screen later revealed cocaine. GHB is often used as a date rape drug because it renders its users unconscious. However, before this end result, it can give a euphoric rush. So, his friend brought him in barely breathing, heart rate down to 50, body temperature a cool 94 degrees Fahrenheit. It's hard not to get angry at your patients in situations like this - a young kid, his whole life ahead of him, just spinning the Roulette wheel with his life.

Patient 2 is just over 60. Her lymphoma came back and isn't curable. She's actively dying. Her sister flew in from the Midwest and asked how long I thought she had. I guessed about 3-5 days. She asked if I could write a letter so she could go get herself instated as the patient's durable power of attorney. I know this is what the patient wanted, so I said sure. I wrote a simple letter, something like this...

To Whom It May Concern;

This woman is my patient, and she is unable to make her own decisions due to losing a long battle with a fatal disease. According to her wishes, her sister is to act on her behalf.

It made me want to write a letter to Patient 1.

To You, For Whom I'm Concerned;

Don't blow this life. Don't make the mistake of thinking you are invincible and immovable. You, like the rest of us, are made of frail skin and bones, and your heart is but a muscle that can only be stretched so far. Take this opportunity to get your life in order. You've been spared Death, just barely, this time. But, Death is fickle, and he may not be so forgiving next time.

1 comment:

DK said...

I have a twenty year old on my unit right now who's one of the most dysphoric people I've seen in a long time. He's had two serious suicide attempts already, and was plotting a third, but came to us instead. My attending said to him, "I know it's hard to hear 'you're so young' when you're the oldest you've ever been,'re so young." I'm just terrified for him. He's at such risk, and he's just so young...

Youth really is wasted on the young.