While I carry the consult pager this month, I also have my primary patients to take care of on the Thoracic Surgery service. One such patient kind of reminds us all of a flower child. I'm almost tempted to say that he can actually pull off his mullet, the one and only capable, but then... let's not get carried away. He's always cracking jokes, so he gets along well with everyone. Even in pain he's making jokes. Due to all the past surgery on his belly, he had come to us (Thoracic surgery) as a last option. What would typically be done through the belly, we instead opened the side of the chest and got access that way. His lungs are just taking their time remembering how to be lungs again, instead of shriveled sponges. We've put chest tubes in. Taken them out. And then put them back in again. His pain doesn't help either. I dosed his narcotics so high, it would have been enough to completely halt my respiratory drive, but turns out...wasn't even enough for him. It's the first time I've ever seen someone's arterial blood gas actually improve by increasing narcotics.
And then on the consult side of things, we got another breast cancer gone far too long and literally eating away at the poor lady's chest. It's horrifying. Professional on the outside, screaming on the inside I continued with the interview. How did you go to work everyday? "I just put gauze on it, I thought it would go away." On exam I ask her if she's having pain. While squeezing her eyes tight and holding her breath, she tries to be brave,"no, that's not bad."
Honey, that's not bravery... that's denial.
Much Love.
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