Monday, June 13, 2011

First, do no harm.

After only 6 weeks of medicine, I'm pretty sure that we as doctors do harm all the time. We see patient after patient get admitted to the floor for serious conditions (renal failure, heart failure, electrolyte abnormalities, etc.) brought on by the medications we're prescribing for the underlying serious condition already plaguing them. We put patients through painful and costly diagnostic tests to be able to tell them they have metastasized cancer, and that we can't do anything for. Urinary catheters and central IV access become hot zones for infection. The hospital itself breeds nosocomial madness of highly resistant bugs.

There is a lovely old lady who was in amazing health until a few days ago. Then she hit a wall. We treated her and sent her with many new diagnosis, and many more medications. Not even 24 hours later she came back in with the same symptoms. This time she's convinced it is the medication making her sick. I have to say that I am not entirely sure she's wrong.

I'm way to sleepy to make anything of this post currently, and I have a hunch that it's going to be an ongoing conversation as the years [and secrets] of clinical medicine unravel before me. Currently, I just hope that the good we're doing for this lovely lady, and everyone, outweighs the harm that is unintentionally done on the side. I also hope we're learned enough in our practice to properly educate our patients about the risks involved with everything that is done to them and for them.

In the humbling words of my attending: "We will do everything for her/him, but you need to know that there is nothing we can do."

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