Wednesday, February 10, 2010

It Comes Back

We're learning about G.E.R.D this week, or G.O.R.D --as it's called here thanks to the (o)esophagus.  I am reading about adenocarcinoma tonight when suddenly a patient's face comes sharply into focus in my mind.

A 41 year old male who was about 7 days post-op from a partial gastrectomy due to stomach cancer.

He was brought in by his wife because he hadn't slept for 2 days due to extreme abdominal pain. He was obviously very fit before this ordeal had started but now the weight loss had sunken his large dark eyes into the sockets, his cheek bones pressed upwards under the skin. His tanned skin had changed to greyish.

He never made a sound while I removed the dressings on his abdomen, which was rigid with pain. He just stared at me. Both of them were so afraid, it was unsettling. When you see fear like that you never forget it.

I am again reminded that these diseases don't only exist on histology slides in my Robbins and Cotran Pathologic Basis of Disease textbook.


Bongi said...

it's good to start the journey of being a doctor with that insight and not need to pick it up on the way. well done.

OMDG said...

And.... he died. Right?

Esophagus cancer sucks.

Albinoblackbear said...

Thanks Bongi--it's something I have to keep coming back to, it's easy to get caught up in the Na+/K+ pumps and the glutamine and the seratonin and forget the macro view of it all.

For that I am grateful--for all the patient contact that I have had up to this point.

Albinoblackbear said...

OMDG--I don't know actually because it was a travel contract but, yeah, he was in bad shape and the surgeon just sorta shook his head sadly when he came out of the room.

It was hard on the staff because he was very well known and very respected in the community. I only met him and his wife twice and it was totally heartbreaking.

Bostonian in NY said...

yep...your heart is gonna be broken more than a few times in medicine. Mine has, that's for sure. But the good you'll do will outweigh the bad outcomes.

Ugh...Robbins is the devil

Maha said...

That poor man. It's incredibly humbling to be able to learn so much and to also be able to witness raw emotions that can't be qualified in textbooks. You're going to be a great doctor.

Albinoblackbear said...

BINY--That is my hope! Sometimes I think I want to do sports medicine or something to avoid all of that. But then I remember that it is also the sad events that often give our work meaning.

But I have to disagree...Robbins is NOT the devil...Guyton and Hall (Med Phys) are the devils!!! At least Robbins has snazzy photos.

Maha--I agree, it is a privilege. And I do complain a lot about being older and feeling limited with my options post-MD as a result--but the trade off with my age is that I have a completely different appreciation for what we are learning. And for that I feel very lucky.

I hope your prediction comes true! :)