Monday, March 05, 2007

Come Back One Day and say ‘Hello’

Tonight, Bob Woodruff appeared on The Daily Show. Funny I should start my first post back with this one particular fact. But it is one that stands out tonight. I will get back to it soon.

I promised to tell you about the life of a Hospitalist in a community hospital and that I shall do.

Medicine in a community hospital is a little different than in Academia. During residency, the patient belonged to an internist if he/she was on the medicine floor. But if things turned for the worse and that same patient was transferred to the ICU he would then be under the care of a new attending, the ICU attending serving in the unit.

But things in a community hospital are a little different. Here, I am your attending in the ICU as well as when you improve. I will be your doctor on the medicine floor too. And sometimes, if you go to the rehab floor here, I’ll still see you from time to time, just to make sure the old ticker is still ticking. Of course I consult with an intensivist if my patient is in the ICU, however, the final call on what goes in and what stays out remains mine, my responsibility, my decision.

In my short nine months as a Hospitalist I’ve accompanied many patients through their journey in this community hospital. I recall many whom I can honestly say would not be alive today if it wasn’t for something I did or didn’t do for them, whether they know it or not.

Some of you may misunderstand and figure I managed to pick up a god complex during those months too but that’s not what I’m driving at.

I guess the biggest drawback to the Hospitalist life is what dawned on me tonight. Looking at Bob Woodruff, I was looking at a man dressed in a suit, handsome, intelligent, well spoken, interesting, a man with a family who loves him and who seems to care much for his family. The entire time, I really mean this, the ENTIRE time I watched him I imagined the way he must have looked in that ICU in Bethesda. I saw him intubated, on a respirator, bandages across his head, half his scull removed. I saw lines, feeding tubes and urinary catheters. I saw nurses hanging IVs and getting CVPs. I saw the tears in his family’s eyes as physician after physician told them that their father was ‘critical’. Lucky if he makes it.

The single BIGGEST drawback to the Hospitalist life is this moment. When your patient has walked through the shadows of hell and has come out alive. And not just alive, Intelligent, Handsome, well spoken and a real family man, even dresses well.

This moment would have never happened if not for those same doctors and nurses in Bethesda. But if not for television, they would never have gotten to see what it was all for. Because patients almost never return as their true, every day selves. Only in another hospital gown.

I am still waiting for just one of my patients to come back to say hello. I hope one day one will.

Hope he comes dressed in a suit.

222 Comments:

Blogger Suzi said...

After my sons and I went home following very traumatic emergency C-sections and stays in NICU, I went back to say thank you. No one I found cared.

We didn't go back after my husband's recovery from pneumonia. It's too late now, but if there is a next time, we'll go back in a suit.

5:42 AM  
Anonymous Ishsheleg said...

After a recent hospital stay I went back to say hello to my PCP and his nurse would not allow me to say hello. She said he was just too busy.
Go figure.

12:05 PM  
Blogger radioactive girl said...

I always wonder if my thank you notes mean anything to the doctors I write them to. They mean a lot to me, so I continue to write them, but I often wonder if they get tossed in the garbage or what the doctors do to them.

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Anonymous xiaonanok said...

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6:24 PM  
Blogger Eyes said...

Great post! I love it.

My mom had a perforated ulcer a year ago and ended up in emergency surgery. I have thought about her surgeon many times. I didn't think he'd care to see her/us again. But I did send him a heart-felt card at Christmas thanking him for giving us my mom back! I hope it made his afternoon.

2:06 PM  
Anonymous Anonymous said...

After having an MI, I went back to ER and CCU and delivered candy and thank you's, hugs too. I saw the internist on a regular basis but I honestly don't know if I said a simple "thank you"...I sure hope so for he meant the world to me.

Loved your post! Hope there's more to follow :)

8:42 PM  
Anonymous Ryan said...

I think this scenario plays out in many medical practices - not just hospitals. At our rehab clinic it's not uncommon for patients to disappear at or just before the completion of their therapy because they are "feeling well enough, now." These are people who have been through every step of the healthcare system and found relief only in our clinic ... and as soon as they find recovery, gone.

I can assure you, Radioactive & Eyes, that every note, every letter and every email we receive goes straight to Dr Kahn and warms his heart. My point is that although not every doctor or therapist will appreciate every note of thanks, some do - and for those, it is the recovered patient that they live & work for.

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Anonymous Peggy said...

I had emergency surgery for an accidental bone break, and was operated on by a surgeon I didn't know. I didn't have a primary care doctor. The surgeon was so wonderful. He checked the wound twice a day and I knew if I'd had any questions (didn't have) he would have taken the time to respond. The hospital staff also were terrific. Even the food was great.

I thanked the surgeon each time I saw him for followup care (three times), and sent a Christmas card to his office thanking him again.

I don't know whether the card mattered to him, he's a busy man, but I think his office staff probably appreciated it. They seemed to think a lot of him, too.

5:44 PM  
Anonymous Dean Moyer said...

I did a blog post a while back that relates to this subject. It was about how to get more attention from your doctor.

The consensus is that patients who are a pain in the neck usually get less attention from the doctor than the ones who are friendly and show their appreciation.

One of my commentors mentioned that she often takes pies or cookies back as thank-you gifts. She never has to wait to get appointments.

Hope you get back to blogging soon.

- Dean

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Blogger Thirumal said...

i was from india and i had several occasions where the patients came back to me thanking how much they were helped out but trust me,it can get on to u r nerves sometimes especially with the ones who keep coming back with relatives etc with more problems seeking some free advice off the hook.

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Anonymous Alpha Source said...

It's an interesting way to look at health care, and too often people forget about who was treating them and the experience they provided them with.

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Blogger cube (six) said...

Agree with dean - patients who are a pain in the neck usually get less attention from the doctor than the ones who are friendly and show their appreciation. Subconsciously i end up doing the same in the clinic too

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When I went for my 1 year checkup after a hip replacement I told my doc all the ways the new hip had improved my life (like "I can go to the grocery store now. Or to a movie.") and how happy I was now that I wasn't in pain all the time. He said that hearing how pateints' lives changed was the best part of his job. I had an untreated SCFE and didn't get it fixed until my mid forties. I am a different person without the pain.

But what I really wish I had done was send a card to his parents thanking them for getting him up everyday to go to school and making him do his homework, and feeding him good food so he'd be smart and healthy and not messing up his head. I'm sure they did it so he could have a good life, but it gave me one too.

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Anonymous Teletext Flights said...

It is great the work that some doctors do compared with others, I had surgery a few months months back (minor) but my doctor was fun, caring and overall made the experience a good one, no fear or anxiety was felt by me and this with the friendly nurses assistance meant the procedure was smooth and if I could use the term pleasant.

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Anonymous Online Doctor said...

I found this touching. As a doctor, I have seen this story replay itself many times. However, this is true for many professions.

My wife is a teacher and apon graduation, most students never come back to see the teachers or counselors of the school either.

Most people don't want to think back to their tough times or the people who helped them through them.

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i think it's about time that you came back to say hello, Joseph. I miss reading your blog.

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işlemleri yapması beklenemez).Akıllı sınıflar,

6:48 AM  
Anonymous projeksiyon said...

Fiziğin optik olarak adlandırılan kısmı hitachi lambaışığın davranışını inceler. Işığın uzayda izlediği yolu
inceleyen optiğe geometrik optik diyoruz. Geometrik optiğin içinde de kırınım, girişim ve yansıma-kırılma
olayları bulunmaktadır.hp lamba Önce basit olan olaydan başlarsak; yansıma ve kırılma günlük hayatta çıplak gözle
görülebilen olaylardır. Örneğin, yarısı su ile doldurulmuş bir bardağın içine bir çubuk koyarsak çubuğu
bir doğru şeklinde göremeyiz. Bunun nedeni ışığın kırılma epson lamba indisleri farklı bir ortamdan diğerine geçmesidir.
Snell Yasası ile ifade edilir.
Düz bir aynanın karşısına geçtiğinizde neden odanın içindeki her şeyi değil de bazı şeyleri görebiliyoruz?
Bunu da yansıma özelliği ile açıklayabiliriz. Düzgün bir yansıtıcıya gönderilen ışık, düzlemin normaline
hangi açı ile gelirse o açı ile geri döner. panasonic lamba Demek ki odanın içinde gördüğünüz cisimlerin gönderdiği ışınlar,
aynadan yansıdıkları zaman gözünüze samsung lamba geliyordur.
Girişim olayı üst üste binme ya da yok etme ile sonuçlanır. Girişim yapan toshiba lamba dalgalar arasındaki faz farkı
180 derece ise ve dalga boyları eşit ise son dalga genliği iki kat artar. Eğer 0 derece ise birbirlerini
yok ederler.Kırınım olayı bir dalganın engellere yamaha lambaçarparak kenarlarından sanyo lambabükülmesidir. Herhangi bir yarıktan
geçen dalga dsina = + ? kadar yol alır. sagem lamba (burada x geçen dalganın dalgaboyudur.)
Girişim, kırınım ve kutuplanma (polarizasyon) olayları ışığın dalga yapısını desteklerken fotoelektrik
olay, Compton olayı ve kara cisim ışıması philips lamba ışığın tanecikli yapıda olduğunu gösterir. Işık çift karakterli
olup, hem dalga hem de tanecik özelliği taşır.

6:49 AM  
Anonymous projeksiyon said...

LCD teknolojisi ile birlikte gelişen projeksiyon onarım transparan LCD üzerinde oluşan görüntünün kuvetli bir projektör ışığı ile
merceklere yansıtılarak istenilen mesafedeki bir perde üzerinde görüntünün odaklaştırılarak görsellik elde etme
tekniğine verilen genel projeksiyon onarım addır.Genellikle büyük şirketlerde idari kadronun eğitimi için sunumlarda kullanılsada
daha sonra toplu gösterim amacı projeksiyonolarak yaygınlaşmış ve son kullanıcı tabir edilen ev kullanıcısının bile
alabileceği projeksiyon kadar fiyatları makul düzeye düşmüştür.
Elektronik, serbest projeksiyon lambası elektronların hareketi'nin denetimini konu edinen bilim dalıdır.Bütün elektronik
cihazlarda, bilgisayar cep telefonu vs hepsinde temel çalışma projeksiyon lamba satışıprensibi iletken üzerinden akan elektronları
kontrollü bir şekilde sony lamba ilgili elektronik parçalara iletmektir.projeksiyon lamba teminiprojeksiyon lambaElektronik cihazlar binary sayı sistemi
mantığı benq lambaile çalışır.Binary ingilizce bir barco lamba sözcüktür ikili sayı demektir.Lakin binary mantığı sadece
insan ve cihaz arasındaki lg lamba iletişimi sağlamak için üretilmiş bir tekniktir.Elektronik cihazlar
için geçerli kural,elektirik canon lamba akımının varlığı veya yokluğu'dur.

6:50 AM  
Anonymous projeksiyon said...

LCD teknolojisi ile birlikte gelişen projeksiyon onarım transparan LCD üzerinde oluşan görüntünün kuvetli bir projektör ışığı ile
merceklere yansıtılarak istenilen mesafedeki bir perde üzerinde görüntünün odaklaştırılarak görsellik elde etme
tekniğine verilen genel projeksiyon onarım addır.Genellikle büyük şirketlerde idari kadronun eğitimi için sunumlarda kullanılsada
daha sonra toplu gösterim amacı projeksiyonolarak yaygınlaşmış ve son kullanıcı tabir edilen ev kullanıcısının bile
alabileceği projeksiyon kadar fiyatları makul düzeye düşmüştür.
Elektronik, serbest projeksiyon lambası elektronların hareketi'nin denetimini konu edinen bilim dalıdır.Bütün elektronik
cihazlarda, bilgisayar cep telefonu vs hepsinde temel çalışma projeksiyon lamba satışıprensibi iletken üzerinden akan elektronları
kontrollü bir şekilde sony lamba ilgili elektronik parçalara iletmektir.projeksiyon lamba teminiprojeksiyon lambaElektronik cihazlar binary sayı sistemi
mantığı benq lambaile çalışır.Binary ingilizce bir barco lamba sözcüktür ikili sayı demektir.Lakin binary mantığı sadece
insan ve cihaz arasındaki lg lamba iletişimi sağlamak için üretilmiş bir tekniktir.Elektronik cihazlar
için geçerli kural,elektirik canon lamba akımının varlığı veya yokluğu'dur.

6:51 AM  
Anonymous projeksiyon said...

According to the theory of persistence projeksiyon of vision, the perceptual
processes of the brain and lamba satışı the retina of the human eye retains an
image for a brief moment of time. This theory is said to account for
the illusion of motion which projeksiyon results when a series of film images is
displayed in quick succession,projeksiyon rather than the perception of the
individual frames in the series.
Persistence of vision projeksiyon should be compared with the related phenomena
of beta movement and phi movement. A critical part of understanding
these visual perception phenomena projeksiyon is that the eye is not a camera, i.e.:
there is no "frame rate" or "scan rate" in the eye. Instead, the eye/brain
system has a combination of motion detectors, projeksiyon onarımdetail detectors and pattern
detectors, the outputs of all projeksiyon onarımof which are combined to create the visual experience.
,Art is the product or sanatprocess of deliberately arranging items
(often with symbolic çevirmensignificance) in a way that influences and
affects one or more of the satınal senses, emotions, and intellect.
It encompasses a diverse range of Haber human activities, creations,
and modes of expression, includingdua music, literature, film,
photography, sculpture, and paintings. The meaning of art is explored in a branch of philosophy reklamknown as aesthetics, and even
disciplines projeksiyon such as history and psychology analyze its relationship
with humans rüya tabiri and generations.

6:51 AM  
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This is such an interesting experience for practicing doctors.

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5:45 PM  
Anonymous projeksiyon said...

San Diego Toshiba Lamba Eyalet Üniversitesi'nin
eğitim alanında artan talepleri doğrultusunda 1990'ların Epson Lamba ortalarında ITS tarafından
hayata geçirilmiştir. Bilgisayarların ve multimedya Acer Lamba ekipmanlarının eğitim alanında
yaygınlaşmasıyla beraber üniversite Akıllı Tahta bu ekipmanların eğitime sağlayabileceği katkıların
farkına varmıştır. 1997'de fakülte, akıllı sınıf konsollarını kampüs genelinde daha küçük
sınıflara uygulama talebinde bulunmuştur. Teknolojinin ilerlemesiyle birlikte ortaya çıkan
akıllı sınıflar günümüzde gelişimlerine devam etmektedir
Psychological projection or hithachi projeksiyon projection bias is a psychological defense
mechanism where a person unconsciously benq projeksiyon denies his or her own attributes,
thoughts, and emotions, which are projeksiyon bakımıthen ascribed to the outside world,
such as to other people. Thus, acer projeksiyon projection involves imagining or projecting
the belief that others have sony projeksiyon those feelings.[1]
Projection reduces canon projeksiyon anxiety by allowing the expression of the
unwanted unconscious impulses or projeksiyon makaleleri desires without letting the conscious

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