"Dammit, Jim... I'm a Merck manual jockey, not a doctor!"
Preface: I am still slogging through organic chemistry and prepping for the MCAT for entry to medical school. I have my EMT-Basic license, a little experience in a veterinary ER, a copy of the Merck manual, and way too many episodes of ER and Trauma: Life in the ER under my belt.
Tony calls frantically yesterday afternoon, saying that his young nephew (~7-8 years old), Tyler, is being taken to the hospital for tests after his mother found strange bruising unrelated to injury on his body. The general practitioner found that he had a low platelet count, but Tony couldn't provide any other (important!) details, such as WBC/RBC count, other than he thought there was something "wrong" with his WBC count (no details as to whether it was elevated or depressed). Tony's mother (Tyler's grandmother) was actively freaking out because her good friend had experienced this sort of bruising and shortly afterward died of leukemia. I assured Tony that his mother was overreacting, given that Tyler was not feeling sick, and that there are hundreds of explanations for low platelets, most of them quite benign. I explained that bruising can occur from simple things like blood-thinning medications (aspirin!), iron deficiency, etc... and he calmed down after a half-hour or so...
...or so I thought...
...90 seconds after we hung up, he called again in a panic: "If it's no big deal, why is the doctor telling them to go see another doctor at Baystate right away?!"
I was probably a little too harsh: "Anthony, I am not a doctor. I can't tell you anything helpful, other than not to worry until he's had other tests. Leukemia is not the logical thought progression from unexplained bruising, and your mom's freaking out prematurely. Let the doctor handle this, and try to calm yourself so you can help your mom calm down."
As of this morning, Tyler stayed overnight, but is feeling well, so chances are the problem isn't as dire as leukemia. Tony says he recently had strep throat and the flu, which explains a little more. I do not understand the general distrust of doctors that is so common in the people around me. If anyone should have issues with them, I should:
1) My gallbladder disease went undiagnosed for 6 months, despite 5 ER visits. They insisted it was acid reflux. It was so full of stones when I finally changed hospitals that it had to be taken out immediately, and I got a supercool morphine drip for 3 days.
2) A sebaceous cyst on my neck was misdiagnosed as some sort of infected lymph node, for which I took antibiotics. It swelled to the size of half a walnut in a week's time, and had to be removed. It hurt like a bitch, and I looked like the elephant man.
3) The doctor who removed the cyst was a rude bastard, and kept telling me not to cry while he cut my neck open. Asshole. He also left portions of the cyst wall inside the incision, so it returned shortly after.
4) I went to the ER for a hand laceration (cut through a tendon, nicked another, destroyed two arteries and two nerves, required months of physical therapy), and the same doctor from the cyst incident treated me. He has the bedside manner of Hitler, and seemed annoyed that I was worried about the function of my hand. I came in on the ambulance, squirting arterial blood, and had to wait 2 hours to be seen (no pain meds. The lady seen before me had aggravated her TMJ because her dentures needed to be refitted). The doc sewed up the wound, gave me a couple of vicodin and two for the morning, a couple of antibiotic pills, and told me he would set up a consult with an orthopedic surgeon for tendon repair for the next morning. He didn't splint me or give me a tetanus shot.
Well, the surgeon's office had never heard of me, and I was out of meds around noon the next morning, and home alone. The receptionist at the hospital told me I'd have to come into the ER again, where I waited for an additional 4 hours, was charged another ER visit, and finally splinted/given enough meds to last until my new, real surgeon appointment in a couple of days by another, more pleasant doctor. He was horrified I hadn't been splinted, since one tendon was only nicked, and any flexing of my hand could have resulted in snapping the tendon back up into my wrist and arm (think rubber band snapping).
But despite all of this, I trust a doctor's judgement, even as I do my own research for other possibilities. I guess I just assume they're far more knowledgable than I am, and accept them as falliable human beings making the best diagnosis they can. Then I realize that if all goes correctly, I'll be the one making the diagnoses one day... maybe I should be a little less trusting :)
Tony calls frantically yesterday afternoon, saying that his young nephew (~7-8 years old), Tyler, is being taken to the hospital for tests after his mother found strange bruising unrelated to injury on his body. The general practitioner found that he had a low platelet count, but Tony couldn't provide any other (important!) details, such as WBC/RBC count, other than he thought there was something "wrong" with his WBC count (no details as to whether it was elevated or depressed). Tony's mother (Tyler's grandmother) was actively freaking out because her good friend had experienced this sort of bruising and shortly afterward died of leukemia. I assured Tony that his mother was overreacting, given that Tyler was not feeling sick, and that there are hundreds of explanations for low platelets, most of them quite benign. I explained that bruising can occur from simple things like blood-thinning medications (aspirin!), iron deficiency, etc... and he calmed down after a half-hour or so...
...or so I thought...
...90 seconds after we hung up, he called again in a panic: "If it's no big deal, why is the doctor telling them to go see another doctor at Baystate right away?!"
I was probably a little too harsh: "Anthony, I am not a doctor. I can't tell you anything helpful, other than not to worry until he's had other tests. Leukemia is not the logical thought progression from unexplained bruising, and your mom's freaking out prematurely. Let the doctor handle this, and try to calm yourself so you can help your mom calm down."
As of this morning, Tyler stayed overnight, but is feeling well, so chances are the problem isn't as dire as leukemia. Tony says he recently had strep throat and the flu, which explains a little more. I do not understand the general distrust of doctors that is so common in the people around me. If anyone should have issues with them, I should:
1) My gallbladder disease went undiagnosed for 6 months, despite 5 ER visits. They insisted it was acid reflux. It was so full of stones when I finally changed hospitals that it had to be taken out immediately, and I got a supercool morphine drip for 3 days.
2) A sebaceous cyst on my neck was misdiagnosed as some sort of infected lymph node, for which I took antibiotics. It swelled to the size of half a walnut in a week's time, and had to be removed. It hurt like a bitch, and I looked like the elephant man.
3) The doctor who removed the cyst was a rude bastard, and kept telling me not to cry while he cut my neck open. Asshole. He also left portions of the cyst wall inside the incision, so it returned shortly after.
4) I went to the ER for a hand laceration (cut through a tendon, nicked another, destroyed two arteries and two nerves, required months of physical therapy), and the same doctor from the cyst incident treated me. He has the bedside manner of Hitler, and seemed annoyed that I was worried about the function of my hand. I came in on the ambulance, squirting arterial blood, and had to wait 2 hours to be seen (no pain meds. The lady seen before me had aggravated her TMJ because her dentures needed to be refitted). The doc sewed up the wound, gave me a couple of vicodin and two for the morning, a couple of antibiotic pills, and told me he would set up a consult with an orthopedic surgeon for tendon repair for the next morning. He didn't splint me or give me a tetanus shot.
Well, the surgeon's office had never heard of me, and I was out of meds around noon the next morning, and home alone. The receptionist at the hospital told me I'd have to come into the ER again, where I waited for an additional 4 hours, was charged another ER visit, and finally splinted/given enough meds to last until my new, real surgeon appointment in a couple of days by another, more pleasant doctor. He was horrified I hadn't been splinted, since one tendon was only nicked, and any flexing of my hand could have resulted in snapping the tendon back up into my wrist and arm (think rubber band snapping).
But despite all of this, I trust a doctor's judgement, even as I do my own research for other possibilities. I guess I just assume they're far more knowledgable than I am, and accept them as falliable human beings making the best diagnosis they can. Then I realize that if all goes correctly, I'll be the one making the diagnoses one day... maybe I should be a little less trusting :)