Nice guys die first.

I read somewhere before intern year started that “they can always hurt you more, but they cannot stop the clock.” That is kind of how I am looking at this year. I just plan to take whatever is dished on me, and keep my head down. That clock will just keep ticking ticking ticking. So far, I haven’t directly killed anyone yet. Several of my patients have died, but for most of them there was nothing that could be done. Each of them had a terminal cancer. One poor guy, a farmer, came in because he was just so short of breath for the last two weeks. Of course he was short of breath, his entire abdomen was filled with fluid because his liver was invaded with tumor. It looked like the tumor had spread from his from his skin, to his lungs, and then to his liver. He started out with a pea-sized knot at the top of his neck that grew and grew until it was the size of a golf ball. He never had it checked out by anyone. He said he couldn’t take the time off of the farm to get looked at. Two days later he was gone. So so sad. I just don’t understand how he thought that knot was going to shrink on it’s own. I cannot get around that. 

It seems like the good guys are always the ones that get the shitty diagnosis. Nice guys get lung cancer, with mets to every imaginable place. The jerks who complain about the quality of hospital food checkout two days later with antibiotics for whatever infection they have. It just doesn’t seem fair sometimes. I mean, I’m not wishing a terminal diagnosis on anyone, but it just sees like the nice guys get the worst news. 

Random medical humor… I’m talking to one of my patients while he is in dialysis, and I am explaining that he needs to have a biopsy of some of the masses that we found on his spleen. The spleen really likes to bleed on its own, so I go over the need for interventional radiology to get the biopsy. I’m telling him how he is going to have another CT scan, and they are going to zero in on the exact location of the mass, then slowly insert a needle into the middle of it to get a sample. He says he gets the general idea and I ask if he has any questions. So he asks me if I have ever seen one, and I say that I have and add, “It’s actually really really cool to watch, as long as it’s not happening to you.” I really hadn’t realized what I had said until the dialysis nurse doubled over laughing. It was pretty funny, but um yeah you might have had to have been there.  Good story.