NHS Blog Doctor: Who breaks a butterfly upon a wheel? (Trackback link)
This past week, I clicked on the website of one of my favorite medical bloggers, Barbados Butterfly (http://barbadosbutterfly.blogspot.com), and to my dismay came to a page stating that the blog was only opened to invited readers, and I, completely unknown in the medical blogsphere was certainly not one of the elite. I was saddened. I read Barb's blog on almost a daily basis. As a newly graduated medical student, I virtually memorized her "Tips for Interns" because while I was not in a surgical field, these were vital tips for anyone fresh and green embarking into the medical world.
One of my faults is that I'm as curious as a monkey. I couldn't just let it rest that she had decided to close off her blog, I had to find out what happened to her. In a past life I must have either worked as a tabloid reporter or a sleuth (those skills do come in handy in medicine!). A quick google search revealed the above post. I guess that was my answer.
In interest of learning more, I clicked on the links that also discussed her disappearance and wished her farewell ... and quickly noticed something. Take a look at the various goodbye posts:
The Girl with the Stethoscope
Dust In the Wind
Dr. Dork
MSSP Nexus
Hmm.... there is one happy little anonymous around here! And the final link, that caused the secret to be revealed:
Tea at Ten
The same smiling anonymous who just happened to know all of the verses to "Call a Code." Coincidence? I think not.
I think I won't be deleting her from my list of bookmarks just yet, because I have a feeling that Barbados Butterfly will be unfurling a new set of wings.
:)
Tuesday, March 20, 2007
Saturday, July 15, 2006
Firsts
We mark our lives with milestones, tattoos of events on days that would otherwise slip into oblivion.
Today, I told my patient that he was going to die.
My resident told me that I did a great job. Professional and compassionate. I remembered my training, spoke in matter of fact terms, simplistic, realistic. No false hopes. Chemotherapy was an option, but only to provide comfort. The cancer that now riddled his insides could not be cured and he needed to discuss with his family what his end of life goals were. We would make him comfortable. I don't know how long it will be, how long he had. We have to wait for answers, for the biopsy results. The death word didn't pass between us; as much as I wanted to convey exactly what was going on, I couldn't bring myself to say it. He understood anyway. He took the news as his family had the day before when I first broached the subject. Stoic. Shocked. Asked the appropriate questions. Until I paused and said. "I'm sorry."
The sobs started then, and he clung to the hand of his relative beside him. In the stark hospital room, I could only stand there, touching his knee, without any kind of reassurance that it would be alright. He had fought cancer twice before and conquered... he had come to the hospital with the dreading thought that it had come back, but confident that it could be overcome, just like it had in the past. I dashed all of those hopes in a ten minute conversation. Ten minutes and I changed his life, put a stamp of expiration on his outlook on the future.
Ten minutes. I delivered the news and dashed off, another patient to see, another page to answer, another note to write.
Today, I told my patient that he was going to die.
My resident told me that I did a great job. Professional and compassionate. I remembered my training, spoke in matter of fact terms, simplistic, realistic. No false hopes. Chemotherapy was an option, but only to provide comfort. The cancer that now riddled his insides could not be cured and he needed to discuss with his family what his end of life goals were. We would make him comfortable. I don't know how long it will be, how long he had. We have to wait for answers, for the biopsy results. The death word didn't pass between us; as much as I wanted to convey exactly what was going on, I couldn't bring myself to say it. He understood anyway. He took the news as his family had the day before when I first broached the subject. Stoic. Shocked. Asked the appropriate questions. Until I paused and said. "I'm sorry."
The sobs started then, and he clung to the hand of his relative beside him. In the stark hospital room, I could only stand there, touching his knee, without any kind of reassurance that it would be alright. He had fought cancer twice before and conquered... he had come to the hospital with the dreading thought that it had come back, but confident that it could be overcome, just like it had in the past. I dashed all of those hopes in a ten minute conversation. Ten minutes and I changed his life, put a stamp of expiration on his outlook on the future.
Ten minutes. I delivered the news and dashed off, another patient to see, another page to answer, another note to write.
Thursday, May 26, 2005
Memorable
I watched her struggle for breath--short, rapid, gasping sounds, lips ashen. Her procedure had proceeded normally, but when she roused from the anesthesia, she couldn't breathe. We all knew the reason for it--a large tumor had grown across her lungs, collapsing the right and constricting the left by more than 50%. We gave her medications and prepared to intubate her. Within a few minutes, however, the meds worked; her airway opened enough that her one lung could receive the oxygen she needed and she was transported to the ICU for overnight observation before her operation the next day.
She became my patient, and I visited with her several times over the night. She was a school teacher and until a month ago had been doing pretty good. She had had this tumor for almost a decade, had undergone four rounds of chemotherapy, but in reality it changed her life very little. She continued to help out on their farm and did aerobics three times a week. But she stopped being able to sleep lying down. And a month ago, she started needing oxygen all the time and the aerboics classes were slowly weaned. We bonded over my red hair--her sister had red hair and was a nurse, so red headed people must be smart. Her husband was there, holding her hand, asking details about surgery, which I tried in my limited way to answer. She seemed more resigned to the surgery than anticipatory, and in fact, asked if she would still be going through with it now that she was "breathing better." I listened to her lungs and heart and dutifully noted the decreased breath sounds on the right, but otherwise "clear to auscultation," then wished her well with the surgery and left. By the time I returned from my teaching rounds, she had already been taking down.
Lunchtime came, and we were to present chest x-rays for the class to interpret, and with hers, boy, did I had a doozy. I even stumped the chief resident with it. It was great--I raved about the ICU and all of the interesting patients that I've seen and cared for. Then, being post call, I went home. I didn't know that the surgeons were finding her tumor to be inoperable. Or that the pulmonologists were struggling to maintain an airway. That I found out this morning, when we were looking at her scans, and the pulmonary fellow talked about all of the complications--the tumor was so large, it blocked them from opening up the stent, and they had a difficult time getting central access. It was an excellent story, one that an action film couldn't compete against and I listened with eagerness and wasn't prepared for the climax of the story: "We couldn't keep her airways open, so we went to talk to the family and withdrew care. She died in post-op."
*****
This is the first time that I've lost a patient that I had cared for and it's really hit me hard. I've been fighting back tears all day--I think I frightened the poor passengers on the train when the tears and sobs finally slipped out. Since being on the ICU, I've seen death, but it was to others' patients or to those that were so sick that they had hardly been alive. Only hours before she was smiling and laughing and looking forward to going back to her kids that she taught. And just as suddenly she was gone. She was dying from the tumor--without the operation, it would very slowly compress all of the air out of her lungs, but I wasn't prepared for the sudden failure.
You don't forget your first kiss, I'm told. As my first death, she will be as memorable.
She became my patient, and I visited with her several times over the night. She was a school teacher and until a month ago had been doing pretty good. She had had this tumor for almost a decade, had undergone four rounds of chemotherapy, but in reality it changed her life very little. She continued to help out on their farm and did aerobics three times a week. But she stopped being able to sleep lying down. And a month ago, she started needing oxygen all the time and the aerboics classes were slowly weaned. We bonded over my red hair--her sister had red hair and was a nurse, so red headed people must be smart. Her husband was there, holding her hand, asking details about surgery, which I tried in my limited way to answer. She seemed more resigned to the surgery than anticipatory, and in fact, asked if she would still be going through with it now that she was "breathing better." I listened to her lungs and heart and dutifully noted the decreased breath sounds on the right, but otherwise "clear to auscultation," then wished her well with the surgery and left. By the time I returned from my teaching rounds, she had already been taking down.
Lunchtime came, and we were to present chest x-rays for the class to interpret, and with hers, boy, did I had a doozy. I even stumped the chief resident with it. It was great--I raved about the ICU and all of the interesting patients that I've seen and cared for. Then, being post call, I went home. I didn't know that the surgeons were finding her tumor to be inoperable. Or that the pulmonologists were struggling to maintain an airway. That I found out this morning, when we were looking at her scans, and the pulmonary fellow talked about all of the complications--the tumor was so large, it blocked them from opening up the stent, and they had a difficult time getting central access. It was an excellent story, one that an action film couldn't compete against and I listened with eagerness and wasn't prepared for the climax of the story: "We couldn't keep her airways open, so we went to talk to the family and withdrew care. She died in post-op."
*****
This is the first time that I've lost a patient that I had cared for and it's really hit me hard. I've been fighting back tears all day--I think I frightened the poor passengers on the train when the tears and sobs finally slipped out. Since being on the ICU, I've seen death, but it was to others' patients or to those that were so sick that they had hardly been alive. Only hours before she was smiling and laughing and looking forward to going back to her kids that she taught. And just as suddenly she was gone. She was dying from the tumor--without the operation, it would very slowly compress all of the air out of her lungs, but I wasn't prepared for the sudden failure.
You don't forget your first kiss, I'm told. As my first death, she will be as memorable.
Subscribe to:
Posts (Atom)
