Monday, September 13, 2010


A 20 year old man with left upper extremity cellulitis and an overlying bullous forming skin rash. An 82 year old female with diffusely metastatic colon cancer and an intra-abdominal abscess who refuses surgery and is not a candidate for chemotherapy. A 76 year old female with endstage idiopathic pulmonary fibrosis who was admitted for shortness of breath and subsequently developed acute pancreatitis, a particularly painful inflammation, whose only treatment is supportive. Luckily, morphine eases her pain and soothes her breathing.

Predicted mortality for all patients, 100%.

Two will likely die within 6 months. The twenty year old, who knows. But in the end, we will all die. The truth is, medicine cures very little. With the exception of some infectious diseases and disease and a few malignancies, there is little else. What we do is treat symptoms and hope they go away or that we find some excuse for them.

When did your doctor discuss a cure for your hypertension, hyperlipidemia, or diabetes? The truth is they didn't. There is no cure. When did your oncologist or nephrologist offer an atidote? At best you get remission and treatment.

It is common knowledge on the medical service that you can learn something from every patient. I believe that is true and say it at least once to every intern, resident and student I work with. What is learned is a purely unique experience. I would argue that the good physicians learn as much about themselves as they do about the case before them. It is a noble profession of which I am proud to be a part. That having been said, "Crazy people get sick too." You must keep an open mind.

For what it's worth, I am also a husband, father, and son.

I am a conservative republican who believes that gay marriage isn't a fight worth picking and that embryology will change the political landscape of abortion rights.

I am a hospitalist working in a rural upstate New York hospital. I am on the front lines of the coming healthcare catastrophe.

Over a year was spent on how best to insure an additional 30 million americans with no thought as to how best to care for them. There are not enough doctors, nurses, respiratory therapists, aides, nursing homes, rehabilitation centers or home care companies to care for the coming increase in demand of medical services. This is a disaster waiting to happen and all we here about is bending the cost curve down.

I am a voter!

I am mad as hell, Joe DioGuardi and I am speaking my mind.

Thanks Matt and Mr. K.

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