Sunday, October 31, 2010


I had a patient last week who came on a gurney. This is odd, since I work in a clinic and people are usually ambulatory. But, after my nurse told the ambulance drivers to wait in the waiting room, I went in to see the patient.

He was mid-60s with a history of high blood pressure. I had read in his chart that he had both legs amputated due to some sort of chronic wounds. I skimmed over an operating room report that mentioned a hip disarticulation - where the leg was removed completely from the hip socket. That's a pretty disfiguring operation, but one I've seen before. What I didn't read, but noticed immediately when I walked into the room, was that both hips had been disarticulated. The man was lying on his stomach, propped up on his elbows. He had long hair and a beard, like the pictures of Jesus always show. He was just a torso and pelvis. I blinked and went to the computer, smiled and introduced myself.

We had a wonderful visit, he is quite funny and talked a lot about his various art projects. He has a piece in a museum - as a part of the permanent exhibit! Quite exceptional.

He said he would probably be depressed if he just sat and looked out the same window all day. Instead, he taught himself wood whittling, knitting, and other arts and crafts. He has friends that peddle them at various festivals and fairs around town. He gets asked to show his work in art exhibits around the country. I was amazed - he's very talented, and it's always inspiring to talk to someone about their work. But, more than that, he didn't let his limited mobility make him hopeless. He recognizes what he can't do. He said he wished he were able to get around more freely. But, he also said that he wasn't going to let that stop him from doing what he likes to do.

He showed me how life is all about perspective. You might not always be able to dictate your situation or circumstances, but how you respond to them is always within your control.

Sunday, October 10, 2010

On My Own

I've finished two weeks of my first real job. So much has happened, yet so much is the same. My life is a cliche.

I took my Infectious Diseases boards, which nearly killed me. I am not sure if I passed. It was extremely difficult, and I left there feeling like I missed more than I got right. That's a normal feeling, I know, but it's still unsettling. It's not the end of the world if I don't pass. It would be embarrassing and a pain to have to study again, but I could take it again next year. Needless to say, it would be much better if I didn't have to. I should know in the next 2 months.

The job has been good. I've realized that out-patient infectious diseases is much more difficult than in-patient ID. In the hospital, people are super sick, and you do your best to help them get through their infection. But, in the clinic, these people are, for the most part, pretty well. They might have a non-healing wound or a weird rash, but they can walk and talk. They want a diagnosis. They aren't just going to be happy to survive, like the patients who are in the hospital. Those patients don't need a name for their infection, they just want to live; for the most part, they do. So, out-patient ID has been unexpectedly challenging.

Most of my patients, so far, are general medicine patients. They have diabetes and arthritis. They need pap smears and colonoscopies. Those patients are not as interesting to me medically, but they are quite interesting people. I enjoy talking to them and hearing about their lives. I do wish I had more HIV patients. I have one set to come in next week, and I'm supposed to meet with the ladies at the health department about referring any new HIV patients to me. I have gotten a fair number of Hepatitis C patients, which has been good. I hope to get everything set up to do liver biopsies in the next few months. So, all in all, the last 2 weeks have gone pretty smoothly.

I have had some interesting patients. I hope to get diagnoses and then post about them soon. It's always more interesting when I can figure out what's going on.