127. Tears

A nurse came to my office in tears the other day asking me to see a patient also in tears.  No, she repeatedly said, her tears had nothing to do with the patient, this was just a "very emotional day."

22 yr old Lacey presented because a much respected previous doctor told her she needed to be seen after an abnormal Pap smear and with concerns about not being pregnant after 4 months of unprotected intercourse.  My partner couldn't make sense of the patient's explanations and since records were not available, told the patient that she couldn't be helped that day. Regrettable words were said on both sides.  The perceived infertility never came up.

My goal was to provide a blanket apology and to see if I could piece together explanations and plans for both issues.  It's a tricky ground because my partner may have simply been ambushed by someone on edge, unhappy over having to abandon her other doctor, unwilling to consider that the latter might have been wrong, or unhappy that the Pap smear overrode the more important infertility issue. Overtreatment is common with abnormal Pap smears and I assume that my partner didn't want to pursue a previously recommended but inappropriate treatment.

Well, I failed on both counts, the patient unsatisfied with my words, leaving in tears and insisting that she would simply go back to the other doctor.  As for the nurse, her 20-something daughter had experienced a similar encounter with an urgent care doctor a few months ago, an open wound it appears.

Fact or factoid:  a healthy couple requires an average of 7 months of unprotected intercourse prior to conception?  Perhaps a factoid, but helpful in encouraging patience, especially for a 22 year old.

126. Anxiety Dreams

According to Forbes (my top source for workplace issues, yours too I'm sure) lists the top ten work-related anxiety dreams, which include various tech frustrations or being late/chased/naked at work.

Here's mine:  for unclear reasons, I leave the operating room in the middle of surgery. Then I can't find my way back.  I wander inside and out, through rooms and corridors, up and down stairs, and just can't find the OR.  I know it's not good for the patient to be under anesthesia for a prolonged period of time, especially with an open abdomen, so I keep on looking, my sense of unease and distress ever increasing until I wake up.