Monday, May 16, 2005

Morning Rounds

It’s 7 AM, and my trauma call weekend is, over, done with, consumado, accompli, perfetto, законченный. Nothing exciting over the past few days, just the usual assortment of folks who like to mix their alcohol with internal combustion engines, and one fellow who didn’t get off the roof in time to avoid a lightning strike (he was very lucky – only a few flash burns). Monday morning brings a day in the OR for me, followed by a few carefully chosen olives spiking my favorite adult beverage.

One of my partners is out of town, so I saw his patients again on morning rounds, including one who has been here for about 4 weeks. She has been exceedingly ill (ARDS, dead bowel, etc.) but has rallied and is making a remarkable recovery. Extubated a few days ago, she is eager to talk about what the hell has gone on the past month – “Why was I so sick? When can I go home?” I had to explain to her that there was a time when many felt she would not leave the hospital with a pulse.

The next patient I saw was a cantankerous little old lady recovering from a GI bleed (Coumadin is one of my least favorite drugs); fortunately, she didn’t require surgery. When I rounded on her yesterday, she was just starting the Sunday NY Times crossword puzzle, a temptation I yield to weekly. Knowing of my crossword addiction, she blurted out “what is 68 across?” before I could even ask how she was doing! The clue was “Like electrical signals in the body [Toyota],” with the name of a Toyota vehicle as part of the answer. I told her I’d give her a clue --- Tercel --- if she’d promise to get her INR checked a wee bit more frequently.

Some time when I was in college, my closest friend’s father, a nephrologist, took us on weekend rounds, as we were both thinking about medical school. I was captivated by the ease with which he cared for patients of different ages, with different backgrounds, all with different problems. I now understand that only part of that ease came from the confidence of knowledge and training. Just as much came from the ability to talk to people in a truly defenseless position who are at the mercy of their caregivers. Sometimes, I think that skill requires more practice than anything in medicine, but it yields the most rewards.

By the way, his son got smart and decided to avoid the whole “patient contact” thing and spends his days looking at pictures in the dark.