cranquis:

doctorkintsugi:

pervocracy:

I’m starting to appreciate more just how scary it is to be a doctor.

You have a patient come in with a stomach ache, nausea, feels tired and sort of generally miserable, no other obvious characteristic symptoms.

Out of 100 patients like this, 90* will be a minor gastroenteritis or whatever, maybe you ate something bad, here’s some nausea medication, go home and eat bland foods and get enough fluid and sleep it off.

And 7 will be appendicitis or gallstones or pancreatitis and need to be admitted to the hospital, 1 will be a heart attack with atypical symptoms, 1 will be the first sign of cancer, and 1 will be some weirdo disorder with a name like “Coleman’s 4268py deletion snydrome, Type II”** that you never heard of.

If I were a doctor, this would make me terrified to ever tell a patient “maybe you ate something bad, go home and sleep it off.”  Even though that’s usually the right answer, and even though it’s a waste of time and money to do an EKG and CT and 4268py test on everyone with a tummy ache–it’s got to be anxiety-provoking to not be certain that you aren’t missing something.  And at some point you will send someone home only to get a call the next day that they collapsed and now they’re in the ICU (or the morgue).  And it’s got to be really hard to go back to work after that and say “go home and sleep it off” to your next patient, even though that’s still usually the right answer.

I’m understanding more these days how tough it is to live with that kind of risk and responsibility.

*not actual statistics

**not an actual thing

Accurate.

These kinds of sobering thoughts almost made me quit during 1st year of medical school multiple times. And the times when the 1-in-100 (or 1000, or 10,000) “worst outcome” has happened, in the many years since then, has certainly tested my resolve.

But I have learned to learn from those times. I refine my differential diagnosis, I sharpen my senses. I vow to avenge that death/bad outcome like a father over his murdered son’s grave, while also vowing not to start ordering CT scans for every stomach ache.

That’s what doctors do. Must do, to survive with our souls intact.