So I've spent some time away from the VA and I've found that primary care can be pretty fun when away from old skool docs, although I've gotta admit, I miss the dirty jokes.
Yesterday I spent my morning watching physical therapy at the ACC. I saw a familiar 14 year old girl and my jaw literally dropped. She was a patient that I had seen around the pediatric floor when I was on service several months back. She had a traumatic brain injury because her mom mowed her over with her car and the patient was in a coma up until the week I came onto service. She wasn't under the care of my team, but I went to visit her once in a while because she couldn't move and was always crying. Now she is hobbling along on her own and can almost carry a conversation. Holy crap, kids are resilient. Working with kids yesterday reminded me just how much fun they are.
[soapbox time]
I worked in the county primary care clinic today. Some lady came in with a cough, so I figured that she'd be here with a cold or something like that. This lady had SOB for 5 days, h/o CHF, no runny nose, no sore throat, no fever. Shit, my lady had congestive heart failure. So we wrote her up for some lasix and sent her for her labs. We looked at her allergies...sulfa drugs. She had taken lasix before according to her charts, but we asked her just in case. It turns out the last time she had lasix, she was on a low dose, but had severe hypokalemia and almost died from cardiac complications. Shit, almost killed my patient. Seriously, lazy ass doctors who don't document complications in their notes or write it so that it's not legible. Seriously, a huge disservice. Don't be that guy.
Maybe ethacrynic acid? My preceptor had never heard of it. Anyhow, we just put her on spironolactone and sent her on her merry way. Just in case, I double checked to make sure that my patient had gotten her meds and was on her merry way. In the pharmacy, they had huge signs up saying that all drugs would not be available because the system was backed up due to strike.
I got a little riled up. Actually, I got fucking pissed off. I'm all for making sure that people get paid fair wages and that their rights are protected, but medicine isn't the fucking steelworker's union. Medicine isn't a job, it's a promise that we take on. When other people get off their jobs, it's their time. Once you're a doc, you don't just sit back and watch someone die from a heart attack or choke on their popcorn chicken because you're not technically at work. It's a promise that we make. We are given tools so that we can use them to benefit our fellow man. Doctors don't go on strike. Why? Because people always get sick and they need treatment. You can't shirk your duties and screw people over.
It's probably not gonna make a huge difference, but you know what? I don't give a damn about your worker's strike. Deal with it. Give my patient her fucking meds. Stop being a little bitch.
-bender
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