Friday, November 18, 2005

No Neruda quotes

My email inbox is a revelation. A cursory look shows two threads - one from my high school class, reveling at the newfound (first) romance of the nicest girl in class. The other one is a feverish exchange of information between my US-based medical school classmates, regarding residency positions, interviews, and the 'Match'. Minor threads concern those so-called 'Fraternity concerns', as well as some employment opportunities for doctors abroad.

Someone stumbling upon (or hacking into) my inbox could conclude that I had been a high school personality, who later came to medical school, joined a Fraternity, and is now joining the exodus of doctors abroad.

But, for those who know me, well...
  • Bespectacled me has never been a high school personality, unless you call a moody antisocial 2 years younger than his peers a 'personality
  • Enrolling in medical school and joining a Fraternity were flukes
  • I would have joined the exodus of doctors, if only I could afford it

With this blog, what you read is what you get. No Neruda quotes. Errors in spelling and grammar are painfully kept to a minimum. And you would see my high school editorial prowess all over this blog. Meaning, all content are sanitized as much as possible.

Sorry to disappoint you if I am still holding out on launching a tirade on my working conditions, and my experience as a lowly surgical resident. In due time...

I recall a mini-dilemma we had during pre-residency. Well, it was not really much of a problem because I was so used to it anyway.

[Hypothetical case alert! Disclaimer: all references to any person, place or condition, real or imagined, are coincidental.]

50-odd plus male with a 2 week history of nonhealing wound on the left leg. Known diabetic, uncontrolled. Edema and serous discharge around the area of the wound.

Common practice is to wrap the offensive, rotting fruit smell typical of these patients in a garbage bag. Yes, dear friends, your black plastic garbage bag.

Patient sees this as an affront to his remaining dignity, which is assumed to have been ceded to the hospital once you fill up that PIC form, and tells us that it'll keep swelling if we cover it up.

Normally, I would be so eager to explain why we need to cover the nonhealing wound. (Or at least give a nonthreatening excuse.) But it was 4AM and it was not really disturbing my catnap or any of my seniors'. So the disposition was left to the Medicine team when we finally endorsed the non-DKA, nonseptic patient at 800AM.

Dear reader, what would you do? Tell this patient that we are covering up his leg with a garbage bag because
  • The odor disturbs our other charity and the sole pay patient, and we do not want that
  • We would be cutting your leg off anyway and so get used to putting it in a garbage bag
  • It would be actually helpful because of some vague reason that, on hindsight, you would never actually believe

Personally, given the circumstances, the third one is acceptable. Let Medicine and Orthopedics break the bad news. Besides, you can always allay his apprehension regarding your flimsy reason with the confidence that you are a licensed physician.

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