Friday, August 6, 2010

Complete H&P

So I did my first H& P today on a real patient. It went amazing only because my M.D. is very easy going and wants us to get the most out of this experience while understanding the current load that we are under. So, Dr. Grier is an ER doctor who works part time in the ICU. She is amazing and her patients love her.

She assigned a my patient who she had admitted to the hospital from the ER for a severe asthma attack that require intubation. It was a very enlightening experience. In our report we have to say who the historian is and if they are reliable or not. Dr. Grier asked me what I thought. I said that she was completely reliable. Well...the patient claimed that she had an asthma attack after smoking a cigarette on Saturday. Her lungs continued to get worse until she began vomiting on Tuesday and had to be rushed to the ER and intubated. For the most part, she was truthful. The only snare is that she was smoking crack instead of a cigarette. So, according to the drug test, the patient was not reliable.

But the most interesting thing about the case that I learned was not about the patient or about medicine. It was about me. When that woman came into the ER, no one cared what had happened to get her into her current situation or whose fault it was. No one cared her race, her economic status or her political views. The only thing anyone was focused on was saving this woman's life. The moment she entered the ER, she was a human being whose body was failing to function.

So many times, in all areas of life, we look at people based on stereotypes. This is not a horrible trait, this is the way we were made. Stereotyping is our way of classifying data in an effecient matter. If we know that one red stove is hot and you should not touch it, you stereotype all red stoves as hot. The evil in stereotypes is not that they exist but it what our stereotypes are.

From this experience and from medical school in general I am learning some valuable lessons:
1. everyone suffers their own battles. everyone is suffering from something. our bodies have ways of adapting to our environment but very very few of us have absolutely no health problems whatsoever. so cute everyone some slack, you have no idea what they are going through.
2. everyone has experiences in their past. we can complain about these experiences as some do or learn from them and become wiser from them, as we see in others we admire.
3. the most important thing that I am oh-so-slowing getting in my thick skull is that not everyone is like me and that is a good thing. Not everyone will think the way I think or vote the way I vote. That doesn't make them any less amazing. I also cannot expect everyone to have the same morals and values that I do. The lady today did crack cocaine and has never had a job. She is lost and looking for something in her life. She's not a bad person. She's a lost person who needs help. Non-Christian people probably will not have Christian values. And if they do, what do they need Christ for?

We all need a Savior. We are all fearfully and wonderfully created. And we all have an incredible amount to offer. The lady in the ICU bed that I spoke with was one of the most easy going, fun loving people. Open hearted and encouraging me, we laughed together as I ask about every manner of her life.

A patient has to trust you for you to treat them. I cannot judge the person while I am trying to treat them. I can alway judge actions as right or wrong, but never ever people. As the bumper sticker says: Even God waits till the end of a person's life to judge.

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