Good morning from the top of the world!
Surviving two weeks of heavy call was celebrated by a sunrise adventure with Jake this morning. It's always rough to hit the ground running into a call week. The transition from Ixtlan to hospital call went much smoother this time (versus last December) thankfully as my flight actually left on time from Guadalajara. The rest was a matter of taking it one patient at a time, and trusting the Lord to provide the opportunity to sleep. Which He did, and I recovered within a day or two.
The overlying common theme presented by patients I came into contact with the past two weeks seemed to be a tendency to teeter on the fuzzy gray line of to operate or not to operate. Not my favorite cup of tea, as there is no wrong or right decision in those situations. It instead boils down to just the recommendation you make to the patient and the decision that you collectively come to. Mentally and emotionally much more involved than the standard textbook appendicitis. Then, despite all of the agonizing over your decision, in the end, there's no real way to know if it was the best decision; leaving you with minimal satisfaction with your work, if any at all.
I am thankful to look back, and see thus far, patients content with their outcomes. It helps when the decision is collaborative, and they can claim some semblance of ownership of that outcome. One patient I had been called for needed an amputation. When I walked in, the room wreaked of the putrid gangrenous flesh that I knew composed what was left of his foot underneath the pretty white dressings which he had in place. I took a seat in preparation of the forthcoming difficult discussion and explanation of not only the need for amputation, but also his need to let go of his dead foot. Ultimately, letting him make the decision to proceed, has thankfully resulted in a happier, and much better smelling result for everyone involved.
Much Love.
