This week has been nuts. Not at home: our home life is at stable-chaos level. Not for anyone else in my office: my colleagues have been either envious or pitying of me and all the emergent/ acute cases I’ve managed this week.
Monday I saw a young woman with unintentional weight loss; I suspected nothing more than a young athletic woman who wasn’t eating enough, but I sent some labs anyways. Late that night, I got a page from the hospital: blood sugar 800, acidosis. This was new onest Type 1 diabetes, in mild DKA. I had to scramble to reach her and get her to our ER. She was much on my mind all week.
Then there was a lovely nurse with a terrible leg cellulitis and abscess; an older woman with an acute appendicitis; one of my favorite elderly patients with acute mental status change; another elederly patient with sudden severe weakness in both of her legs; a young mother with a terrible case of pneumonia, who ended up being admitted; a young patient with a fever and a severe headache, sent to the emergency room as a case of possible meningitis… I think I am forgetting some of the other acute/ sick cases from this week.
All week starting Tuesday I’ve been trying to get here early before clinic to visit with my inpatients; then clinic itself has been harrowing. The ER access nurse was tired of getting my calls. “I’m sending another one in,” I joked. “Keep ’em coming,” she joked back.
But you know, when my family commented that I was having a really bad week, I had to stop and think and then reassure them: It’s not bad at all. It’s actually been a pleasure. I feel pretty energized. THIS is medicine. My office days tend to be ALOT of weight loss counseling, dietary counseling, exercise counseling, lifestyle counseling. Eat less, exercise more. Stop smoking. Blah blah. I feel like I’m repeating myself. Because I am.
So, to be able to manage acute cases, to really make a difference in someone’s life in a moment of medical decisionmaking, Wow, THAT is practicing medicine.
Not that I’d want to practice this kind of acuity for long.
Today has been slower. Today I’m doing more blood pressure checks, followup visits. It’s like a breather.
The full moon crazy busy week is OK once in awhile- but not all the time.