Infectious Disease and Long Goodbyes

Infectious Disease:

If this past week had a theme, it would be infectious disease.  It was my first time seeing HIV/AIDS and tuberculosis patients and really, the first thing you notice is that they're just average people just like you who happen to be sick.  I see no reason why these patients should be treated from a 10-foot radius if you have the proper PPE and do universal precautions.  These patients struggle on a daily basis and what is hard for the patient and me is seeing how they've become thin and not as strong as they used to be.

Chronic diseases so far have been draining for me, largely because you can't go in and fix it.  I sometimes wonder if I should continue to be a smiling, positive and friendly face 100% of the time with my patients, or show that I also feel sad.  But you only have so much room, you have to stay strong and positive for the patients, not only for yourself to prevent too much drain, but in hopes it also is therapeutic psychologically to the patient.  Every disease has a psychological component.

Long Goodbyes:

I've seen almost double the amount of terminal patients over this past week than I have in my first set of patients. Sometimes I think I'm getting used to the poor prognoses constantly talked about and delivered to the patient and family, but I still feel sad each and everytime.  I then wonder how I'll feel years from now, like if I'll be made less sad by it and just treat it as a thing that happens.

I've noticed a little bit of a change already: there's organ failure and dying all around us and I feel slightly more "ready" to face these situations.  You can do every procedure and give every medicine but there are limits.  However, don't ever forget there's someone suffering and afraid, and their family and loved ones are likely feeling the same thing.

Who knows if the patient and the visitors they have cry when your team leaves the room, if they can't sleep at night because they're afraid and worried.  

I called this section what I did because I'm watching a patient's organ systems worsen, and this patient was just doing better days before.  There's no escape for this patient, everything has been tried and there's no cure.  I wish we could help them and get them back to their old self of years ago, but we have to change focus.

What really makes medicine feel so very human is reaching a limit, we're not masters of life and death or immortals.  We're just flawed beings thrown into existence trying to feel better or doing everything we can to achieve a cure or at least improve quality of life.