So I guess I'm getting back into the swing of wards... Today was filled with conferences: EKG/Cardiology conference, 1 1/2 hour teaching conference, and then noon conference. Somewhere in between I rounded, and then from 1:00 PM until 11:00 PM was spent admitting patients and fielding multiple cross cover calls.
One of my patients--who happens to be deaf and hispanic--only speaks in Spanish sign language. (And here I'd thought it was an international language! Maybe not when you have to spell words.) He also has cerebral palsy. Anyway, a good part of my history was obtained by guessing his miming and my writing Spanish phrases on a note-pad to have him point to what he wanted to say. This was challenging!
I trooped over the cancer building with my resident to check in on a patient with metastatic breast cancer, placed on hospice today. This was by far the most meaningful part of my day, as the family was all in the room to say goodbye to their mother & grandmother. My resident doesn't expect this patient to live through the night, but she's being kept comfortable--though somewhat sedated--with morphine.
It's been said that sometimes easing suffering hastens death. I used to not understand this, until I saw situations like this one. Rather than have this patient be in pain, she is kept comfortable with morphine, which depresses her respiratory drive and keeps her more sedated and hypoxic. While her organs shut down, her drive to breathe becomes less and less...
This is a good side of medicine to see, the side that walks with the person to the very end, whether or not the disease has been conquered. This is practicing the art of medicine, when healing is a higher goal than cure.
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