Every day has a high point and a low point.


Sometimes I do have to say

There is a low point in my day

            In a well child check

            The kid cried like heck

Refusing all efforts at play

How was your day? Bethany asks.

Well, I say, Hyperlipidemia, worse.  Fatigue and malaise.  Alcoholism. Abnormal CT scan of the abdomen. Abdominal pain. Abnormal liver function tests.  Hypertension, better.  Late pregnancy.  Diabetes.  Vitamin D deficiency recheck.  Abdominal pain.  Well Child Check.  Abdominal pain.  Codependency and a long talk about AA.  Anxiety.  Headache. Atrial fibrillation.  Bronchitis. Asthma. Post polio syndrome. Diabetes. High blood pressure. Vitamin D Deficiency. Osteoporosis. Headache.  Painful foot.  Growing pains. Night sweats. Erectile dysfunction. Aching muscles. Vomiting. Diabetes. Pharyngitis. Laryngitis. Cough. Cold.  Well woman exam.  Loss of libido.  Hypertension.  Well child check. Abdominal pain with diarrhea.  Malignant melanoma.  Diabetes.  Well child check.  Abdominal pain.  Four new cases of Vitamin D deficiency.

Twenty four patients in person.  Nine phone call decisions, including three decisions not to refill.  Twelve Hispanics.  Three French surnames.  Eight males.  Maximum in one family three.  Oldest age 69.  Youngest age 10 months.  Four facing unemployment.  One complete mystery.  No smokers. One antibiotic prescription, three inhaler prescriptions.

Ordered five ultrasounds and one CT scan.

Five drug reps, one with a new version of a very old drug, applying a high blood pressure medication to attention deficit.  I asked one rep why the company would send three sales representatives out for the same drug in 8 days.  The rep agreed there was no new information, so we talked about our kids.

I told seventeen patients that I would have my last day in that office on May 22.  Fifteen are sure they’ll follow me when I establish at the Community Health Center in 2011.

And yours? I ask.

I’m pretty good at examining children without restraining them, but I had to have the parent of a fifteen month old hold the patient so I could examine the ears.  The child started crying when I came into the room.  Most of the time I can calm the kid down and get the exam without the use of force.  Fifteen month olds are usually easy; they like to imitate the parent, and if Mom or Dad plays otoscope enough times, pretty soon the child wants to play, too.  This baby started crying harder when I touched the parent’s knee with the lighted otoscope.  It was the low point of my day.

I can’t give details about the high point of my day, but it concerns an esoteric lab result and the chance to make someone feel a lot better.

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