Miracle Worker

I didn\’t expect it.

She walked into the exam room barely using her walker.  Her eyes were bright and her mind seemed sharp.

\”Do you see her?\” Her daughter asked as she walked into the room.  I smiled in amazement.

\"superman_returns\"

On the last visit she had low blood pressure and was vomiting as I tried to conduct the office visit.  She was a \”hospitalist dump,\” (sorry Happy and Rural Doc) coming from an extended stay in several hospitals without any notification to me about what went on.  I spend most of that visit trying to figure out what got done while she spent her weeks in the hospital(s).

She didn\’t look good.  I spoke to the daughter about the possibility of hospice, as she seemed to be more than a handful – despite the skill of the family.  She was combative during the evenings and groggy during the day.  I was going away for a week, so I told my partner about her, as I expected them to hear from her.

\"bath4\" I adjusted some medications and sent them out with trepidation.  It looked to me like she was \”spiraling\” – a term physicians use when people are making the inevitable decline toward the end.  The writing seemed to be on the wall.

Seemed.

\”I give you all the credit,\” her granddaughter told me. \”I told everyone you would get her fixed, and you did.\”

\”Truthfully, I am as surprised as you are.\”  I told her.  I tried to deflect any credit for this miraculous recovery.  Yes, I had made some changes, but it seemed to be no more than rearranging chairs on the Titanic.  Somehow the new chair-arrangement made the ship float.  Wow.

\"RabbitOutOfHat\" Am I happy?  Obviously.  It is gratifying to see someone make such an unexpected recovery, and to be part of what made it happen.  But I always get uncomfortable when given \”all the credit.\”  Sometimes good things happen and you press the right buttons.  Sometimes you seem to pull the rabbit out of the hat.  The woman is tough, the family is great; I don\’t deserve most of the credit.

I am not that good.

For my next trick I will solve all of the problems in healthcare….

12 thoughts on “Miracle Worker”

  1. “For my next trick I will solve all of the problems in healthcare….”
    That would make you a miracle worker!!!

  2. “For my next trick I will solve all of the problems in healthcare….”
    That would make you a miracle worker!!!

  3. Had a similar case a few years ago, was feeling really Cocky and Smart until I found out the patient never filled my new prescriptions…Oh well, sometimes the enemy of Good is “Better”. “Spiraling”? We called it “Circling” back in the Day..

  4. Had a similar case a few years ago, was feeling really Cocky and Smart until I found out the patient never filled my new prescriptions…Oh well, sometimes the enemy of Good is “Better”. “Spiraling”? We called it “Circling” back in the Day..

  5. We always call the primary on discharge. And our discharge summaries are expediated to a 24 hour turn around code especially for us. I can only imagine what it’s like to have a train wreck dropped on your door steps without the tracks.Happy.

  6. We always call the primary on discharge. And our discharge summaries are expediated to a 24 hour turn around code especially for us. I can only imagine what it’s like to have a train wreck dropped on your door steps without the tracks.Happy.

  7. This problem is a system problem, getting the summaries to the primary care doc, or even specialists.
    Best solution, a hospital EHR system with portals that the primary care docs can access.

    Next best…call (great unless some other urgent thing comes up.)

    Ask ward clerk to fax cover page and final notes with instructions to primary care doc.

    Do hospitalists have any clerical support for these tasks??

  8. This problem is a system problem, getting the summaries to the primary care doc, or even specialists.
    Best solution, a hospital EHR system with portals that the primary care docs can access.

    Next best…call (great unless some other urgent thing comes up.)

    Ask ward clerk to fax cover page and final notes with instructions to primary care doc.

    Do hospitalists have any clerical support for these tasks??

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