A Day in the Life
By Kelly O’Brien, MD, FACP, CCHP
Posted on February 12, 2012 – I can’t decide if I should put the dress in Goodwill. It’s a lovely sparkly deep purple, given to me on my very first Mother’s Day. Things have shifted [on me, not the dress] and it doesn’t quite fit. The shoulder pads give away the decade. Even if I take them out, it still won’t zip [how do things shrink just hanging in the closet?] I put it in the bag, then I take it out. You’d think I’d be too busy to be dinking around like this. Besides I have a keen professional mind—you’d think I could just make a decision already. But it represents so many years and phases and events—the child now a young man in another city. Can you give away something like that?
Instead of milling around my old clothes, I should be reading a journal or planning CQI projects. I should go in early and ask for that backlog of patients to be brought down. There are really very few spontaneous cures so there’s nothing to be gained by stalling. If the original problem clears up, there’s always another one when the patient’s comfortably ensconced in your office. “By the way, Doc, while I’m here, I’ve had this left sided numbness for three years. What do you think it is?”
She’s on the morning schedule for “acne check up.” Yes! I can get through this and stay on schedule. The medication’s working, her skin’s clearing. I think we’re in the home stretch as I start to sign the orders but wait…she has urinary incontinence [she’s 24]…and a deep ache where her appendix almost ruptured. And could a kidney stone come back if a person wasn’t hardly eating or drinking? Then she starts crying. And her migraines are coming back but she doesn’t want Excedrin after all because she knows she has an addictive disorder…and she cries some more. I put down my pen, not running the risk of premature signage. I re-check the name. No, I don’t recognize her as one of the patients that regularly makes me question my career choice. For want of anything else to do I wait, vainly searching for a unifying diagnosis.
“Today I go to court to put my daughter up for adoption.”
Ah. She may be a good mom who realizes that this child will be better off with someone else. She may be an indifferent mother realizing her inadequacy. It really doesn’t matter. This is going to leave a mark. I make some soothing sounds and stall around about a work-up. I pre-schedule her for “unexplained pain” in the coming week. And I leave the dress in my closet for a while yet. I’ve got the room and there’s not really a need to rush these things.
Dr. O’Brien is the Associate Medical Director for the Wisconsin Department of Corrections. Readers may contact her at kellym.obrien@wisconsin.gov.
