Labor day spent making rounds.
You wouldn’t believe the diagnoses I found!
It wasn’t quite call,
I avoided a brawl,
And sent four to their homes out-of-bounds.
Synopsis: I’m a family practitioner from Sioux City, Iowa. In May 2010, I left my position of 23 years, and honoring my non-compete clause, traveled for a year doing locum tenens work. In June of 2011 I joined up with the Community Health Center, which provides care for the underserved. I’m now working part-time, which, for a doctor, means 48 hours a week
Our hospital service has grown to the point where two docs get assigned every weekend, one each for a long call and a short call. I drew the short call this holiday weekend, not the same as the short straw. I requested, and received, assignment to my preferred hospital, where I’ve done morning rounds now for four days.
My natural tendencies wake me early, but today I ate a leisurely breakfast before Bethany dropped me in the deserted doctor’s parking lot. I printed my patient list in the doctor’s lounge at 6:58 AM and took the elevator to the 5th floor.
I returned to the doctor’s lounge, emotionally tired, at 11:30. I had rounded on 13 patients, each one a unique human being whose illness brings drama and irony to their lives and the lives of the people around them. Each has a marvelous story, rich with details, triumphs and tragedies enough for a series of novels.
While I can’t discuss patients in particular, I can talk about the patient population in aggregate.
Four patients carry the diagnosis of schizophrenia. Eight qualify as hard-core alcoholics requiring treatment for alcohol withdrawal. Bipolar disorder (previously called manic-depression)afflicts three.
Eleven of the thirteen didn’t quit smoking soon enough, such that they required treatment for nicotine addiction or emphysema or both.
More than one has chronic kidney failure necessitating dialysis.
Others had cancer, HIV, depression, gallbladder disease, broken bones, dementia, urinary infections, lupus, and coronary artery disease.
The nurses on the psych floor warned me about a violent patient after a near confrontation.
I didn’t even bother to count the number of patients with the garden variety problems of diabetes, high blood pressure, and high cholesterol.
I had to deal with two patients with adverse drug reactions, their hospitalizations complicated by the very medications their doctors ordered.
I discharged four patients and dictated their discharge summaries while leaning my back against the wall; I wrote prescriptions for three of them.
One of those represents a triumph of medical care; we cured the problem and sent the patient home in less than 72 hours. Such satisfaction comes rarely and I relish it when it does.
The doctors’ lounge stood deserted at noon on Labor Day, and I power napped ten minutes before the next task, reviewing transcriptions. I had 37 in my queue. After that I dictated six discharge summaries.
I left the hospital at 12:40PM, the rest of a fine summer day right in front of me, and headed home for lunch.
Tags: alcoholic, alcoholism, bipolar, broken bones, cancer, coronary artery disease, dementia, diabetes, discharge summaries, emphysema, gall bladder, gallbladder disease, high cholesterol, hypertension, lupus, nicotine addiction, power nap, schizophrenia, smoking