When the doctor really f—– needs to see the doctor
That f — can mean many things… freaking, finally, or… other things.
I showed up at my primary care’s office yesterday waving the white flag. It was two weekends ago that Babygirl woke up with 102 degrees temp and exploding snot; it’s been ten days since Babyboy and I got it; it’s been ten days that I’ve been wheezing and coughing like an eighty-year-old-lifetime-four-pack-a-day-smoker.
I’ve continued to see patients in clinic, fever be damned. I’ve been escalating my own treatment to ridiculous levels.
Why?
Hey, this is what doctors are EXPECTED to do, what we are pushed to do throughout training, what we are admired and congratulated for as tough-as-nails, badass attendings.
No one wants us to cancel. Not the patients who will be massively inconvenienced, not the staff who will have to make all the calls to reschedule, not the department who will lose out on revenue, not me who will have to make up ALL those visits.
So last week, when I was feverish, chilled, woozy, congested, and COUGHING ALOT, naturally, as per normal ingrained doctor culture, I sucked it up and did my clinic.
I wore a mask some of the time, but not all the time… I made it through the week, and I saw ALL my patients.
But by last Friday, my breathing was so bad, I couldn’t make it through an encounter without leaving the room to use my Albuterol. My patients were reaching into their purses to give ME cough drops, and offering ME sips of their water. My nurse set me up with a neb mid-clinic, and that bought me some time; I got through the day and got home.
All weekend I was using my puffer waaaay too much: three, four puffs every two, three hours, including multiple awakenings overnight.
By Sunday my chest felt packed tight with steel wool. It HURT to breathe. And of course Hubby was traveling, at a conference, and it was storming snowing out, to boot. I was alone with the kids and I realized I needed a higher level of care.
So naturally, as per normal ingrained doctor AND MOTHER culture, I called my friend and colleague who very kindly called me in a course of oral steroids.
I took more than she prescribed (of course) and went to bed. Monday dawned and I felt 75% better.
But it started creeping back, the steel wool in the chest, the coughing spasms, the nighttime awakenings and desperate puffing…
So yesterday, I showed up at my Primary care’s office waving the white flag, and she put me through my paces. She pointed out several things: I had a fever. My oxygen saturation was abnormally low. I was using accessory muscle of breathing. I was wheezing. My peak flow was lower than normal.
I got a chest xray. A flu swab. A neb.
The flu swab came up positive. Influenza A.
We realized: I’d been seeing patients (and taking the train… and going to church…) while infected with Influenza A and coughing all over the place, spewing viral particles.
It’s been a bit of an Occupational Health disaster. We had to notify all the staff. They’re going to notify the patients. I had to notify my church. If people develop a febrile illness, they need to know that it might be flu. They can get tested, and can get Tamiflu. Or, they may want to take prophylactic Tamiflu.
What a mess.
Me? I’m on mega-high-dose steroids, nebs, inhalers, et cetera, and I feel great.
Dumb, and guilty, but great. Because I f—- f—- saw the f—- doctor.
Lesson learned.
Get well soon! (By the way, heard you on NPR this morning speaking about Vit D. 😁)
Yes! Barely made it to my desk and the phone from urgent care! LOL!
Same thing just happened at our clinic. We all had the flu shot. One of our nurses got sick with fever, cough and cold. She dutifully came in (we told her she did not have to but we were already short), wore a mask, did telephone triage and kept away from the patients. She made it 1/2 a day and finally had to go home and get seen by her MD. Guess what, + flu. Advised by her MD no work for 5 days (which of course we told her was fine) By Friday, I started with chills. Saturday night fever and cough/cold symptoms. I went to urgent care Sunday and I had the flu as well. Had to tell my clinic to cancel my clinics for the week as I could not come in (they were a little unhappy but oh well). Ended up with a nasty bronchitis by the end of the week and needed antibiotics and steroids too. We HAVE to take care of ourselves. Its hard to do because it is ingrained in us to suck it up and just work through getting sick. Some of my coworkers made comments to me (as they were a we bit miffed but our Chief was not), did you REALLY have the flu? No I just made it up. I purposefully trucked by febrile sick butt to an urgent care, sat in a waiting room with a mask on for over an hour just to get flu tested. If I did not have the flu, I was going to suck it up and work with a mask. I would not have missed work for a week unless I was sure!!! Sheesh!!!
Oh dear but good for you for doing it the right way!! You got seen and diagnosed and didn’t spread it around. Pat on the back!!
Yeah tell my coworkers that!
I feel your pain reading your post. I truly hope you will get better. You deserve to rest well for once. Stop thinking about everyone else… of course it is easier said than done. Get well soon!!!!!
Spring of 2015 something similar but without the flu. I did meds, did steroids, did nebulizer during the clinic, etc. Thought I was better. Kept seeing patients and every time they coughed so did I. My desk looked just like your picture. Then one evening came home from clinic feeling really bad, went to bed and woke up with a fever, pleuritic chest pain and rusty sputum…crap sounds like lobar pneumonia, then realized I could NOT breathe lying down. Nothing to do but the ER, which neatly ensured I made the (very large) deductible for the insurance for the year. I talked my way out of admission (ER doc and I go back 20 years) and missed a week of work. Our attendings have a lot to answer for. Wonder how many people have died because of the tough as nails badass nonsense? Never again. Be sure you rest and get ALL the way over this before you jump back in there and start slaying dragons again
Oh dear, I hope you at least stayed home after the pna dx!!!!!!
Hope you feel better soon!
I hacked up half a lung last night on my ED shift as an MS4 because I’d already taken my one sick day. It was gross and pathetic for everybody around me (and I am super pregnant). My attending sent me home! Yippee! … But I had already used up my one sick day (the prior day). And so the culture is set. Even in my case – when I am not as a student integral to patient care.
Oh dear! It’s almost worse as a trainee because you’re at the mercy of the chiefs and attendings, and there’s no guidelines nor consistency. Ugh and pregnant too!!! I hope you are able to rest and get better.