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    Monday, September 20, 2004

    Satisfaction: Sometimes, when my hospital caseload is high, I find myself drifting toward the temptation to give up my hospital practice and hand it over to hospitalists. It would make my life so much easier. I could sleep later. My working hours would be more reliable, my on-call days easier. But then, something happens that reminds me why I hold on to my hospital practice.

    Like this morning. One of my patients has spent the past two weeks in intensive care with an infection so toxic it left her in shock. It was touch and go for many days for her. But she's much better now, and out of the intensive care unit. When I saw her today, the first time she's been able to talk to me, she apologized for "being disrespectful." I couldn't fathom what she meant. Then she explained. She remembered her first day in the hospital when she grabbed my hand and said, "Dr. Smith, my friend!"

    Except that never happened. Until today, she was on a ventilator, deeply sedated, her hands tied down to keep her from pulling out her endotracheal tube. I went to see her every morning, but the intensivists were running the show. I made no contribution to her care. In fact, I did so little, I can't even charge for those visits. All I did, from a medical standpoint, was review her chart every day so I would be prepared to take over when - and if - she left the intensive care unit. But there was one other thing I did every morning. I would touch her hand and call her name. I never got a response. Not the slightest flicker of an eyelid or twitch of a finger. She was too sedated. Too ill.

    But obviously, something got through. On some level of consciousness she must have heard me, recognized me, and been profoundly relieved and grateful to hear a familiar voice amongst all the strangers. And I, in turn, am honored to be called "friend." I think it will be a long time before I give in to that hospitalist temptation.

    posted by Sydney on 9/20/2004 07:36:00 AM 0 comments


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