Something had just happened that I didn’t understand. A man had stared death in the face and winked. But more than that, the life he had exuded, even in the moment of dying, seemed to still  be present. His son was different. I was different. More alive. More human.

I love it when the lecturers say the same thing: “Take a good history…” They act as if we don’t know what questions to ask. Don’t they get it? The right questions are written on the template. But sometimes I just didn’t know what to do with what the patient told me. Let me give you an example

altAs I entered the room my eyes went immediately to the elderly lady sitting halfway off the chair beside the bed. She appearing as if she was about to slip off onto the floor at any moment. I introduced myself and reached out to shake her hand, but her hands were occupied gripping the seat in an attempt to support her weight while lifting her hip off the chair.

alt“Can we pleeease feed that little girl in room two,” the nurse pleaded. “Her mother is driving me craaazy asking if she can go down to the vending machines and get something. I think she needs to smoke and needs an excuse to leave the baby with the dad. All she has is a bladder infection.”

alt“Hey sweetheart,” I said, interrupting my wife’s thoughts as she concentrated on writing her blog. “How would you rate me? You know, as a husband.”

altIt had been a long day when I sat down by the roaring fire to enjoy a glass of red wine. My father-in-law, who lives with us now, sat down nearby and began to describe his worsening, but stable angina. While attempting to pay close attention to his story I began to notice something strange that I initially mistook for the effects of the wine.

alt“That’s it! I’ve had it!” I shouted to the air, throwing the envelope on the floor.
“What is it now?” my less-than-sympathetic wife said, dramatically emphasizing now.
“They’re already hiking our taxes, that’s what,” I said, rising from the breakfast table and starting to pace.

altOne of the greatest benefits of being the executive editor of Emergency Physicians Monthly is that I get to read Greg Henry’s column before any of you do. I get to laugh at his unending wit, look up all the Latin phrases I’ve never heard before, and occasionally censor some of his more bawdy phrases. But I never cease to be challenged. This month, Greg’s column on “maturing the physician career” is so important that I want to use this editorial space to give a resounding “Amen!”

altLast month, I wrote about the innovative treatment that cured my mother-in-law of her C. diff. infection (you can read about our “elegantly icky solution”). We were singularly thrilled when she recovered, happily overlooking the fact that her problem was caused by my own overdiagnosis of infection and overtreatment with a broad spectrum antibiotic.

altI’d love to shield the identity of the patient in this story. But I can’t, and you’ll understand why in a minute. It’s not that I’m worried about a HIPAA violation or a law suit. After all, the patient was my mother-in-law. She and my father-in-law – Pop Pop – have moved in with us . . . so they aren’t going to sue anybody. And while I hesitate to embarrass my soft-spoken “Mom Mom” with the details of this tale, I have to tell this story straight. Here goes.

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