Future Doctor

I am a first year osteopathic medicine student working hard to become the best doctor I can be

[anancientheart]

ok universe, i’m ready to feel good things. make me feel good things.

[anancientheart]

whenever i post this it works  reblog if u want to feel good things & the universe will bring u something sweet 

[dointhemaking]

me: [has an emotional breakdown]

everyone in my life: ✔️Read 10:15pm

[sweeterthanabumblebee]

[aplaceforart]

[marvelsmostwanted]

Turns out that healthcare is more expensive than one (1) iPhone

[patanu102]

[iam-r0sibel-blog]

this is my face every day upon waking

[collegiate-confession]

[theawesomeadventurer]

[dointhemaking]

friend: wymd? (what u mcdoing?)

me: hamb (having a mcbreakdown)

[lovelysuggestion]

i feel terrible, and then i feel beautiful, and i wonder which one is real

[thr0atmistress-deactivated20191]

[bunrobot]

Doctors Hate Her! Local woman is "just really mean to doctors", says one

[pagingmedicine]

Intern Tales: Trust Yourself

His face twitched and his tooth was infected - and that is all that mattered to this older gentleman sitting across from me in my clinic. This had been going on since mid-December, and recently he had been seen in the emergency department. Penicillin helped, but the twitch was still intermittent and he was adamant that his tooth was still infected. All he wanted was a prescription for an antibiotic and to be sent to a dentist. 

As I listened to his story, I watched him talk. The opposite side of his face from the tooth ache was drooping. Why is his face drooping? I thought, then asked. “Sir, your face is drooping a bit, have you noticed this?” He shrugged my question off and return to his tooth. His physical exam revealed a right sided facial droop - and cranial nerve VII weakness - forehead wrinkle spared. An intermittent tic, similar to tardive dyskinesia and a very abscessed lower molar. 

I scratched my head and went to discuss him with my clinic attending. I wanted to give him Augmentin and send him to oral surgery. I couldn’t reconcile his facial droop. My differential diagnosis at this time: he has a history of cancer - is this a recurrence of his cancer with metastasis to the brain? Yikes. Is this a brain abscess seeded from his tooth abscess. (He’d probably look sicker.) Is this a stroke? Most likely. Hopefully bell’s palsy despite the facial sparing, but less likely.  I wanted to scan him obviously…but how soon was the question? STAT. A resident overheard that I wanted a stat CT scan and implored me to send him to the ED. I sighed. He’d been there twice without a scan. The fellow resident urged me - the insurance could take two weeks to approve a STAT CT scan. Okay yeah - he needs to go to the ED. My attending whole-heartedly agreed. 

I went back into the clinic room. He didn’t want to go. He’d been twice without assistance. I practically begged him and gave him my reasoning. I explained that I would call and let them know he was on his way and we wanted/needed a CT scan. He agreed. 

His imaging didn’t look much different than this. A Mass. Midline shift. Enough to get neuro surgery to take him to surgery in the morning.

It was the first time - or at least the first time I felt like I saved someone’s life. He did well and recovered from surgery. It was his cancer - which is devastating. But he is so thankful to have an answer and some precious time. 

Out of everything I learned from this case, trust your physical exam. Trust yourself. I second guessed myself while watching his face droop. This isn’t happening - I thought. Oh yes. Yes it was. One thing I’ve learned from intern year is trust your gut. If something is unsettling, if your differential includes “scary” diagnoses, act on it. Don’t wait. 

[cranquis]

On the art of practicing medicine.

[stability]

[dancewithmydemons]

[oomshi]