The nurses named the baby "Jezebel." I hope her mom, even with her limited English will give her a name today. Yesterday, the mom, brought to the hospital by an ambulance, was too sick to name her. Growth restricted by her mother's hypertension, "Jezebel" only weighs 5 pounds even though she is full term. Her mother had been on medications for the high blood pressure but felt these medications were not working so she did not go back to the clinic for more. I am hoping in three days with my limited Spanish and the translator, I can help her understand.
Mom has many reasons to stay healthy. A single mother with two other children to feed, clothe, and get to school every day (one is elementary age, the other middle school), Jezebel's mom was working cleaning houses until she got sick with feet and hands too swollen to work and a terrible headache. I am just happy someone called the ambulance before a stroke or a seizure occurred. I also feel pretty good about the fact that Jezebel's blood gases and Apgar scores at birth were good. Now, I only have to worry about how to convince mom that her blood pressure is a problem even when she is not pregnant. How do I know? I appears she has the early signs of kidney disease probably secondary to her long standing, untreated high blood pressure.
I am remembering I live in that great land where we pay for care if you are in renal failure and need dialysis but we don't cover patients who are not pregnant with hypertension that could cause renal failure. At least not yet. I hope, as a country we are at least getting there.
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Musings of a physician in private practice for 24 years, now teaching in a residency program and working as an ob-gyn hospitalist in a large metropolitan hospital.
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The Local MD
Having now been a physician in private practice for twenty-one years, twenty-six days and about an hour and twenty minutes, it occurs to me that I have become what in medical school was often a derogatory term, the local MD.The presentation on rounds often went something like: "This 45 year old Caucasian male was seen last week by his LMD, and diagnosed with a viral upper respiratory infection..." At that point everyone knew that the LMD had missed the diagnosis. Otherwise the poor patient would not have ended up in a tertiary medical center with three consulting specialist, a fellow, a resident and four medical students at his bedside.What we, the medical students, the resident, the fellow and even the attending hospital physicians did not realize is that we would never know John Smith as well as the LMD. We would never speak to his wife using her first name. We would never be able to recall the names of all his children and know where they were in the world. We would never remember his favorite hobby let alone joke with him about it. Nor would we shed a heart felt tear when we gave him the diagnosis of the aggressive small cell carcinoma of the lung that had landed him in our midst and would kill him in less than three months despite our aggressive treatment that was the best medical science has to offer.At that point in my life I was very proud to be even the lowest ranking person on the team that was on the cutting edge of the diagnosis and the treatment of the gravest of conditions that plagued mankind. I felt so very lucky that I was being initiated in to this sacred fraternity. That I would soon be able to write "MD" after my name. I am still proud of my vocation yet I believe there is a wisdom that has only come with those twenty-years of practice.Today I realize what people want most of their physician is that he or she is someone who cares.Yes, we all want "everything medical science has to offer." Yet, what most of patients need is someone who will listen with their heart as well as with their head. Physician eyes are important, not only for seeing signs of disease in the body but for making contact with the patient's eyes where we are often allowed to see into their soul. All of the technology in the world will not replace a warm clasp of the hand or sitting at the bedside to share a few moments of the day along with the test results.So, I have created this blog. In large part it is a place for me to put my feelings. My hope is that at least some of these posts will resonate with others out there. Not just physicians, but others in caregiving vocations and even those for whom we care. If we are not here for each other then why are we here?
3 comments:
Love, love, love reading your blog. Another Anne Lamott in the making...
I really enjoyed reading the posts on your blog. I would like to invite you to come over to my blog and check it out. God's blessings. Lloyd
Thank you, Anonymous. I just finished "Imperfect Birds" Anne Lamott I am not. Her books scare me more than my stuff and I appreciate her voice.
Lloyd, I made a small trip over to your blog and I will be back. Thank you for the invitation.
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