Against complacence


Three new patients today, three others new to me.

I feel terrible that my medical service to my newest patients will be short. I enjoy watching the soap opera unfold, the interplay of drama and irony.

Of those six patients, two, one young, one much older, obviously suffer from over-medication.  They both have problems focussing, and I’ll have a great time cutting down their medications.

Another almost certainly has rheumatoid arthritis and had come in for an antidepressant. I have many lab tests pending, but another doc will be following up on the problem.

Knowing my own complacence keeps me from being judgemental of other docs. A fresh perspective never hurts, and frequently brings a significant diagnosis.

A young person came in with a basically psychiatric diagnosis but with a white count of 18,000: well over the usual limit of 10,000 for normals, 11,000 for a little virus, 14,000 for a rip-roaring strep throat, and well into the range I’d expect for a serious pneumonia. Nonetheless the patient doesn’t look sick. While the patient may have mental problems, I know those don’t cause that kind of white count.

At a GSK sponsored lecture this evening on immunizations I sat next between a Jordanian/Moslem pediatric cardiologist and a Biafran FP resident who considers himself Jewish. We had a great discussion. The peds cardiologist asked me my retirement plans. I told him to ask me Friday. It’s only fair my partners know before the rest of the world.

Bethany remains a little freaked, though I’ve had intimations of Going Walkabout for years. We talked about the recruiters that have already started lining up to call me.

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