There is always something to learn in medicine

I have been in practice so long, that I sometimes get the illusion that I actually know what I am doing.  Big mistake!  Despite my long experience in geriatric medicine, one family this month has outwitted me continuously in keeping their mother in hospital.  The number of family meetings to discuss disposition seems to have hit double figures.  Each ends with a decisive and reasonable plan that the family is able to sabotage the next day.  Perhaps this week’s meeting will produce some results! I had the unfortunate experience of admitting a lovely young police officer with recurrent, and untreatable, osteosarcoma.  I learned from my oncology colleagues that there has been a mini epidemic of osteosarcoma in police officers in Ontario.  The connecting link is radar guns that are kept on and cradled in the officers’ lap between possible speeders.  If you think you are the one who suffered the most from a speeding ticket, think again. We admitted a 91 year old man with an ischemic leg who developed complication after complication post amputation.  There was obviously no reasonable hope for his survival despite his family’s optimism.  He has bounced back and is now doing very well while awaiting rehab to master independent transfers before going home.  So much for my erudite prognostications. I am also continuously astounded by the grace and courage that many patients exhibit despite their grim outlooks.  The police officer mentioned above was a particular example of grace under fire.  She seemed to spend more time comforting the hospital care-givers about her prognosis than we did comforting her.  Another 80 year old man who was diagnosed with metastatic colon cancer (including liver metastases) explained to us that he understood his impending death, but just needed to regain enough strength to be able to die at home. Heading back to the wards now, where I undoubtedly will learn even more. Regards, Barry