It was just one of those weeks where every day consisted of some very challenging medical cases so much so that I wondered if there had been a full moon (nope it was a new moon). Many days, my schedule is liberally peppered with fairly run-of-the-mill illnesses generally upper respiratory illnesses, low back pain, rashes – things of that nature. I will usually skim my list of patients to get a sense of what the day may bring but even so, the reasons given for the patient visit can be so misleading. I have to be open to the unexpected.

But this one particular week seemed to tip the scale in terms of grossly abnormal lab results needing immediate attention, bizarre medical complaints and truly distressing/worrying mental health issues.

Like the 96 year old woman who looked astonishingly 25 years younger with the confidence and assurance of a woman in her prime whose blood work had me scrambling to set her up with a specialist asap…or the frantic 87 year old I agreed to see spur of the moment who had pulled off multiple ticks from her chest. I’m not 100% sure, but I think she had been using tweezers to pull off skin tags and moles.

But somehow, it’s the mental health cases that are so distressing like the angry, young bipolar patient who was so upset and ashamed by this diagnosis years earlier that  we didn’t even know about that part of the history until the patient presented to me on this particular day – in crisis.  This patient was standing at the precipice of disaster scared by the thick, black, violent rage within. By the time I was able to speak to other family members, the ED,  the crisis intervention people, and of course the patient, I was running almost an hour behind….

Someone recently asked how I debriefed from that session. I was a little startled because of course, I didn’t – I was too backed up. I simply had to see the next patient until gradually, I became caught up in the next story, the next illness. Some days, I struggle to remember all the cases I had that day.

What I do is not unusual – all my colleagues have days like this. Juxtaposed against these sometimes intense days and the constant reminders of  human frailty is the phone call asking me to pick up milk on the way home or the empty bird feeder that is waiting to be filled or the ride Jacob needs from his friend’s house. It’s these reminders of my outside-of-work life that nourish me in a different way from the work that I do – and for that I am grateful.

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