stories told and songs sung

Life is full of stories and songs. By sharing them, maybe we see a little more clearly how we are all connected.

Name:
Location: Deep South

I grew up in Texas and then went off to college in Tennessee. There I met my future wife in a great story you'll have to hear someday. Med school was back in Texas. We got married during my 2nd year. After med school, it was on to Neurology residency in the Deep South. Now that I'm a full fledged neurologist, I'm just trying to balance it all with a new baby on the way...

Sunday, January 27, 2008

A Tale of Two Cities

Dickens' famous opening line is "It was the best of times, it was the worst of times."

That applies to a day I had recently. It started with a young 15-year old boy who had come to the ER for some vague shoulder tingling and pain as well as some thigh numbness. He had a history of a stroke in the past due to a congenital heart problem that had required a heart transplant earlier in the year. So even though his symptoms did not resemble any stroke syndrome I know of, I admitted him to the hospital because of his history. The MRI showed no evidence of a new stroke, so I told the boy and his family that he would be going home. I went to prepare the discharge paperwork when I got a call from the heart transplant coordinator saying that the doses of his anti-rejection medications he said he was taking were not the same as what they had recorded that he was supposed to be taking. So she asked that I keep him overnight and check levels of his medications in the morning as well as check an echocardiogram to make sure the heart was doing okay. The next morning, I was again ready to send the patient home when I got another call from the transplant coordinator. She said that the echocardiogram I had ordered showed that he was rejecting his heart and that he would have to go straight to the cath lab and then have some special procedures done. Oh, and by the way, since she had to arrange all that, could I go and tell the boy and his mom. As I walked into his room, he had his bags packed and was expecting me to say that he was finally going home. Instead, I was the bearer of the worst possible news...

Later that day, I went to discharge a patient to rehab who had initially come in with a stroke causing weakness of the left side of his body. When I had first met this 70 year old man in the ER, he admitted that he had been smoking 2-3 packs of cigarettes a day in addition to 3-4 pints of liquor a day, and smoking crack. I told him that though he had had a stroke, it was a small stroke, and he should recover well. I also told him that this was his second chance at life. God had given him a wake up call to change his lifestyle, and he needed to do just that and quit all of the bad things he was doing. I give some permutation of that speech to many of my patients, but this particular patient really took it to heart. Every day, he would tell me all of the things that he had praying about and that God was laying on his heart that he still needed to do before his life was through. So when I went to discharge him and say goodbye, he thanked me from the bottom of his heart for "shooting it straight" with him and changing his life in doing so. He cried, and as we shook hands, I cried a little too, both for him and for my 15-year old patient too. I am humbled every day at what I get to do and call it my profession.

Sunday, January 13, 2008

A Plea

Sorry for not posting in so long. Who knew that 80 hour weeks and re-doing a kitchen on the side could be so much work. But I know everyone is busy. So here is my plea. Please, please check your blood pressure at some point in your life before, say age 40. Go to a doctor, or use the little machine at the grocery store. Anything. I literally am taking care of 10 patients right now who had no idea they had high blood pressure until they came into the hospital with varying symptoms related to huge hemorrhages in their brains. Take home message: the head is a closed box, and bleeding into it does not leave enough room for the brain, which (I know I'm a little biased) is pretty important.

When I told one of these 10 patients that he also needed to stop using cocaine, he said, "aw man, really?"
I replied, "Yes, really. You're lucky to be alive, and that is God telling you that this is your second chance - that it's time to quit."
"Well doc, I appreciate that you're shooting it to me straight. "
It was late in the evening, so I said goodbye and mentioned that I was going to meet my wife and then head home.
"Oh, your wife works here? Well maybe I'll have the occasion to tell her hello sometime."
"Actually, she's a psychiatrist on the locked-down psychiatric ward, so if you do get to meet her, then that will not be a good sign."
He laughed heartily and agreed.