Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Wednesday, May 12, 2004

    It's been two weeks of high drama here in Primary Care Land. (A place as wondrous as Disneyland, but much less fun.) I'll list the highlights briefly:

    - two elderly demented female patients dying of aspiration pneumonia. Slowly. I have been feverishly trying to convince the families concerned to withdraw aggressive care, so that they can die quickly. (Those are their only two choices at this point.)

    - a patient with hypereosinophilia, possible Loeffler's syndrome, and an elevated troponin. Her eosinophil count is over 25,000 and I have absolutely no idea what's going on. I have referred her to Rheumatology, Pulmonology, Cardiology and Hematology and am fielding their multiple requests for special studies as fast as I can.

    - a patient who wound up in the hospital with massive abscesses from shooting crystal meth, HIV positive, who's calling me up complaining that he's hungry and tired of being kept NPO (nothing by mouth) and the surgery isn't happening fast enough. From somewhere I dredge up some empathy and diplomacy and convince him please, please to stay in the hospital and be patient, it'll just be a few more hours.

    - I'm off to the Pri-Med conference in the morning so may not be posting much for the next few days (surprise, surprise). I will try to get back to a more regular blogging schedule ASAP - I feel guilty when I don't post!

    I leave you with a few links you might enjoy. First, Steve Almond is interviewed here about his book Candyfreak, which is indeed about his addiction to candy, any kind of candy, and his travels across the U.S. seeking same. This looks like a must-read. (via Bookslut.) Second, via Ernie, an adorable new anime character that trumps Hello Kitty anytime; lastly, via GruntDoc, say hello to my hero Doctor Id! (And look at all the other Scutmonkey Comics while you're there!)

    More later... I'll try to tell you about the wonders of the Pri-Med convention. Especially the free stuff you get...



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