Medicine is Cool

[docB]

Medicine in general and EM in particular leads to some really intensely emotional encounters. For the sadness, hopelessness and downright heart wrenching times there's the Medicine Sucks thread:

http://forums.studentdoctor.net/showthread.php?t=154841

But there are also the cases that make you feel good to be a doctor, good to be alive and like you really made a difference to someone. While reading a post by Annette it occurred to me that we should have a place for those stories too.
Quote:
Originally Posted by Annette
81 year old lady with a >7cm AAA, leaking. Said she didn't want surgery. Just wanted to be comfortable with her family nearby. She passed later that day. Got a note from the family thanking me for making their mother's death comfortable and peaceful.
I had a 22yo F who came into the ED with the I might be pregnant and I'm having vomiting and pelvic pain story. She was different in that she and her husband (who was at bedside) really wanted her to be pregnant. I know they shouldn't have been in the ED for what amounted to a prenatal visit but that's contemporary America for ya. Anyway, I got to tell them that the work up looked good and they will be having twins. They were really happy and it made my day. I never get to tell people stuff like that.

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[keeping-it-real]

so do you not want us posting in this thread?

edit: my post now makes no sense taken out of the duplicate thread

 

[DrQuinn]

I havne't had many feel good incidents like that lately.... although I have had quite a few very nice patients, but as I tell my residents, if the patient is really nice they usually have some bad pathology.

Q

 

[Wackie]

8 y/o male after a fall from dirt bike with extremely concerned parents. Multiple contusions, lacs, one chipped front tooth. He was in moderate pain. The look of relief on the parents' faces as the doc I was working with told them, "Nothing's broken, his head CT was negative. He looks bad but he's okay" was priceless. I don't think they took a breath until "...he's okay" came out of the doc's mouth.

I'd venture to say that you docs get the most out of telling someone their child will be just fine.

 

[Chronic Student]

I've had two good ones recently.

1. Had an oilfield worker who was hit in the head by a high-pressure fitting and sustained an epidural, comminuted skull fx (read shattered), dural tear and orbital fx's. GCS of 3 on arrival and was immediately taken to the OR for evacuation of the epi and we pieced his skull back together with lots of mini-plates and put in a camino. More responsive after surgery but goes into ARDS. Eventually found out he had aspirated chewing tobacco. Anyway he was in the ICU and tubed for six weeks or so. Then within a week span, he got extubated, got out of the unit and to the floor. He starts working with PT, OT and speech therapy. He eventually went to TBI rehab. Before he left he played his guitar for me, too cool.

Not too long ago he walked into our office with his wife and kids, very neat.

2. We had a lady involved in the worst rear-end collision I've ever heard of. She was a 45 YO, backseat passenger in a car stopped at a red light on a semi-rural highway. Some guy in an eighteen wheeler wasn't paying attention and hit the car doing 70 MPH. She came in with a subdural with >15 mm of midline shift, was intubated in the field as she was not breathing. We got her into surgery quickly and she was really unstable during the case. Once she was out of the OR we ordered some cardiac enzymes and they were elevated, as were the next two sets and rising. She started tanking and was on lots of pressors. Called in the cardiologist and she gets put on IABP and is diagnosed with a severe cardiac contusion. Never a good sign. Head CT the next morning shows good decompression of the subdural, but contusions are coming up and there is some hypoxic looking areas there too.

All through this time people are stopping us in the halls asking us about her. Doctors, nurses, other patients. Apparently the husband and wife have many, many friends and are very well-liked. They are also very active in the community (Church, food bank,etc).

Anyway, back to the story, patient is utterly non-responsive although she still has gag and corneal reflex. On the pump for about a week and makes it off. Another week or so and she gets off the vent. She has slowly been getting more responsive. We get her off all the pressors and eventually to a regular floor. She is awake enough by this time that you can see her personality coming out and you can see why people are drawn to her. Just a happy, electric person. She goes to rehab and then comes back to see us in our office last week and there is her mom and her husband just smiling and shaking their heads. They are just amazed that she is alive much less walking and talking with some memory loss as her major lingering problem. Simply amazing.

Helps to make up for some of the crappy cases.

-Mike

 

[ttac]

I've had two good ones recently.

<snip>

-Mike

Holy crap... if I ever get really sick, tell me what hospital you're at...

ttac

 

[USAF MD '05]

Those sound like all around awesome cases. Good to see good outcomes every now and then. Keep up the good work.

By the way, what is your name and where do you work? We might drop by later to have a little chat. Love, your friendly neighborhood HIPAA representative

Steve

 

[Chronic Student]

Those sound like all around awesome cases. Good to see good outcomes every now and then. Keep up the good work.

By the way, what is your name and where do you work? We might drop by later to have a little chat. Love, your friendly neighborhood HIPAA representative

Steve

Oh, how I hate even the mention of HIPAA. One of the most misunderstood issues in healthcare.

BTW, my name is Mixelpic and I currently reside in another dimension. Look me up anytime.

-Mike