Tuesday, November 06, 2012

Little Pleasures

Perhaps some timely reminders after my last post, of the simple things I enjoy in playing a doctor.
I saw Mrs. D for follow up of her thyroid cancer. Really, it wasn't an issue anymore; she had a subtotal thyroidectomy for her papillary cancer 8 years ago. Her thyroglobulin markers had been unmeasurable for years. So, it was just a routine annual visit. But, at that 720AM appointment, I sensed something was bothering her, and asked her if she wanted to share anything.
And so, for the next 10 minutes, she bawled. She told of her husband who was losing his job. Of her daughter's troubles with the law and her substance abuse issues. I just listened; she came early so I had plenty of time. At the end of the visit, she seemed better after having vented. And I was reminded of the privilege we doctors sometimes have- having our patients share their troubles with us. Though there was little I could do for her medically, it felt good being able to listen to her.
Later this morning, I saw Kara. I got to know her when she first presented for management of her uncontrolled type 1 diabetes. Her hemoglobin A1c was 11.9%. And she was also 9 weeks pregnant.
Several times over the next few months I was worried she was going to lose the baby. Her diabetes was uncontrolled, with wild fluctuations between hyperglycemia, to hypoglycemic seizures. And yet, she persevered, and brought her A1c down to 6.3%. She came back today for her first postpartum diabetic follow up, and brought baby Isaac. He appeared to be healthy, with the most beautiful blue eyes. When I walked her, Kara and her mother gave me hugs. And then she let me carry Isaac for a few moments, before my hordes of nurses whisked him away and ooh-ed and aah-ed at him.
Sometimes, we all need days like these, to be reminded of the simpler pleasures of work.