Monday, August 10, 2009

Too bad

A few hours ago, a junior resident, with a huge smile on her face and a glimmer in her eyes, walked up to me and said, "Ma'am we saw you before, walking with a man in Robinson's. We were so intrigued we stared at you until you completely disappeared. Uyy ma'am, sino sya?"

I was writing on a chart of a toxic new patient, so instinctively and with a smile as huge as hers, I replied, "Oh, so you saw us. That was my very good friend." "Really, ma'am? Everybody in show business says that." "Honestly, he's a very good friend. I've gotten drunk with him, traveled with him, even brought him home to my parents in the province already." "OK, ma'am."

I think I convinced her.

I kept on writing on my chart. Focus. Work. Patient is dying. Arrhythmia, hypotension, crackles, systolic failure. Re-entry, ischemia, defibrillate, myocardial infarction, heart failure. Damn. All heart. I have to run away. Stop working and just brood.

Too much for amnesia. It wouldn't come if you want it to, just when you want it to. Too bad, to not have a chance to explain, to elaborate. Too bad, to have to say anything at all.

Back to earth, "Ma'am what do we do about her?" "Oh, just keep on cardioverting. Nothing much we can do about the scars anymore. She'll have arrhythmias until she dies. So cardiovert again and again. Cardiovert and pray."

Too bad. Sometimes our worst patients have better prognosis than we do.

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