PMS

Those who know me well will tell you I am known for my moodswings. Monthly down-in-the-dumps, Touch-me-and-die sonofab*tch moods. Anyway. I suppose I started like that today.

With that disclaimer out, I swear I'm not really an asshole of a doctor. I'm not usually this judgmental.

Just got a bit irritated by some of the patients today.

People with severe peripheral arterial disease. Foot ulcers. Not surgical candidates. Failed arterial flow-pump therapy. Failed angioplasty and stenting. Transcutaneous oxygen saturation of 12 in the foot. Dropped to 5 on elevation. So much for wound healing potential.

Ulcers look like a meditteranean pizza topping; yellow-red with bits of olives (black from the dry gangrene).

Now almost demanding that we refer them to the vascular surgeons here for consideration of a bypass.

Except, they choose to remain smoking. Knowing all too well that that would impair wound healing.

Perhaps I was a wee bit too judmental. But come on. How can you expect your physicians to work miracles when you refuse to help yourself? Just cos we're a big medical center doesn't mean we can do anything. Quit wasting my time; if you don't wanna help yourself, don't expect others to wanna bend over backwards to help you.

I have other patients to look after.