After a nice long vacation, I'm back. Well, technically I'm still on vacation till next week, but I stopped by work today anyways to start clearing up some stuff. And came across a note on a patient.
Sometimes you're damned if you do, and damned if you don't. In this case of a young man, we started a medication a few months ago; I had offered several treatment options with him and but in the we picked the meds since this was simplest for him. The side effects, though rare, were discussed. Sometimes though, even if a side effect occurs extremely rarely, when it does occur, it's like a punch to the stomach. And you feel like crap about it eventhough you had mentioned to the patient it can occur. It's one of those things that 99.9% of patients do well with it, but when you see that 0.1% it's enough to make you swear off that route completely. I'm reminded of that case of tension pneumothorax I saw as an intern; years later even until I was a senior resident I still had this intense fear of putting a line in a patient.
I rationalize and tell myself it wasn't my fault, but rather an idiosyncratic pharmacologic reaction, but deep inside, a part of me refuses to believe that since I was the prescriber.
I wonder, will we ever have a medication or a procedure, that truly is 100% complication-free? In this case, we've stopped the medication and he should recover completely with time, but it still leaves a bad taste in the mouth.