Friday, October 26, 2007

The Sickest of the Sick

Perhaps I hadn't completely realized it before starting fellowship...but in inpatient Nephrology (that is, patients who are sick enough to be admitted to the hospital--I'm not talking about the renal patients I see in clinic, who often have normal jobs and a good life), we are often dealing with the Sickest of the Sick. That is, patients who are so ill they are often at the very cusp of life and death. Their existence is dependent upon a series of tubes, machines and carefully adjusted infusions which take the place of their organs as they are failing. Sometimes, you make a save, and the patient comes out of the ordeal okay in the end, and you feel great about your contribution as a doctor. But often, there's not much you can do and, admittedly, morning rounds can be a tad on the depressing side when the vast majority of your patients are getting worse, not better, despite your best efforts. A quick tally of my current patient census reveals that I am able to have a conversation with only 7 out of my 16 patients: the majority are hooked up to ventilators, sedated, or worse.

Before I get to experience my weekend off in all its glory, I'm on-call tonight (Friday night), officially 'til around 5 in the am. To illustrate the point I was trying to make in the above paragraph, about having to deal with the sickest of the sick, I recently got woken up by a page saying that they needed me to start emergency dialysis on a new patient who had just arrived at the hospital. Her potassium was more than 9 and the level of acid in her blood was extremely high. After a few brief words with the resident taking care of the patient in the hospital, I rapidly ascertained that this was the real deal, called my attending, and hopped in my car to drive the 20 minutes or so to Mass General Hospital in downtown Boston. Just as I was pulling into the parking lot, I got another page: the patient had just died. These are indeed the sickest of the sick. Gave me something to think about on the lonely drive home.


Blogger oakleyses said...

soccer jerseys, chi flat iron, p90x workout, north face outlet, ghd hair, nfl jerseys, north face outlet, nike air max, beats by dre, herve leger, asics running shoes, valentino shoes, ferragamo shoes, nike roshe run, soccer shoes, new balance shoes, iphone 6 cases, timberland boots, giuseppe zanotti outlet, mcm handbags, baseball bats, nike trainers uk, bottega veneta, celine handbags, hermes belt, hollister clothing, babyliss, vans outlet, instyler, lululemon, mac cosmetics, mont blanc pens, insanity workout, wedding dresses, reebok outlet, longchamp uk, abercrombie and fitch, oakley, nike huaraches, nike roshe run uk, hollister, jimmy choo outlet

1:34 AM  
Blogger oakleyses said...

replica watches, juicy couture outlet, swarovski, links of london, marc jacobs, ugg boots, hollister, montre pas cher, gucci, converse outlet, ralph lauren, coach outlet, ugg,uggs,uggs canada, thomas sabo, ugg boots, karen millen uk, pandora jewelry, louboutin, juicy couture outlet, nike air max, pandora uk, ugg pas cher, ugg, uggs outlet, ugg,ugg australia,ugg italia, uggs outlet, lancel, ugg uk, wedding dresses, pandora charms, ray ban, swarovski crystal, supra shoes, toms shoes, vans, hollister, converse, uggs on sale

1:41 AM  
Blogger oakleyses said...

kate spade, longchamp outlet, kate spade outlet, replica watches, oakley sunglasses, christian louboutin shoes, true religion outlet, tiffany jewelry, nike air max, nike outlet, burberry outlet, longchamp outlet, polo ralph lauren outlet online, prada outlet, nike air max, michael kors outlet, ray ban sunglasses, burberry handbags, michael kors outlet, oakley sunglasses wholesale, michael kors outlet online, tory burch outlet, polo outlet, michael kors outlet online, jordan shoes, coach outlet store online, coach outlet, coach outlet, chanel handbags, gucci handbags, tiffany and co, christian louboutin, nike free, christian louboutin outlet, ray ban sunglasses, prada handbags, longchamp outlet, christian louboutin uk, michael kors outlet store, michael kors outlet online, oakley sunglasses, coach purses

1:43 AM  
Blogger oakleyses said...

michael kors pas cher, true religion outlet, guess pas cher, timberland pas cher, polo ralph lauren, louboutin pas cher, nike air force, vans pas cher, north face, nike tn, nike air max uk, abercrombie and fitch uk, nike free uk, oakley pas cher, north face uk, lululemon canada, hogan outlet, ray ban uk, sac longchamp pas cher, true religion jeans, true religion outlet, jordan pas cher, ray ban pas cher, air max, ralph lauren uk, converse pas cher, new balance, polo lacoste, longchamp pas cher, michael kors, hollister uk, sac vanessa bruno, nike free run, nike air max uk, hollister pas cher, sac hermes, nike air max, michael kors outlet, burberry pas cher, mulberry uk, nike roshe, nike blazer pas cher

1:45 AM  

Post a Comment

<< Home