Ethical Dilema

The awesome thing about working on a Transplant unit is that you get to see all these really sick, dying people recover from their illness after receiving a transplant. The not-so-awesome thing is when you see noncompliant people essentially waste the organ they've been given because they are too stubborn to make the necessary lifestyle adjustments needed following a transplant. Whats even worse? When we work up a patient for a possible transplant evaluation and the patient is already noncompliant - before any of the hard stuff has even begun.

We have this one kid (yes, kid. He's 19yo) and he's already had a pretty rough life -- pancreatic Ca, surgery to cure it, and b/c of the surgery, he has all these small bowel complications, thus he's being worked up for a small bowel transplant. Obv you feel for the kid b/c his situation sucks, but you would think that if he has the opportunity to get transplanted and possibly solve his problems (granted it definitely wont be easy), he would be grateful and willing to do whatever it takes. Instead, he refuses to have labs drawn, refuses to have his dressings changed (his PICC line dressing hasnt been change in a month! Hello, infection?!), he manipulates the nurses and doctors, he refuses to listen to anyone, and he is completely stubborn and noncompliant. And THIS is the guy you want to give an organ to?? Unfortunately the doctors/researchers are so concerned with the numbers that they just want to get as many transplants done as possible. It's a shame, isnt it? I'm not quite sure how performing a transplant that has a fairly decent probability of failing is good research, but what do I know. It seems like such a waste to give an organ to someone who is so unappreciative and unwilling to do the work. (Let me clarify: If this kid doesnt get a transplant, he wont die, unlike those in need of, say, a liver. Although not ideal, he can live with supplemental nutrition. So its not as if not giving him a transplant is a death sentence.)

Well the problem with this particular patient is that they recently found possible mets in his abdomen, which means if he does in fact have cancer again, he is no longer eligible for a transplant. Now, of course I dont wish cancer upon anyone. ...But I also don't want this kid to get a bowel...

Lent?!

How is it already Lent?? Wasnt New Year's like, a week ago?? I cant believe how quickly the last month and a half has gone! I was having a hard time coming up with something to give up for Lent...

• Chocolate? I dont eat enough of it that it would really be a sacrifice.
• Snacking? I would never make it through a night shift
• Coffee? Not unless you want me to be mean and miserable
  
• Alcohol? Ha.
• Maybe just giving up wine? Then that just means I'd come home and have a beer instead.

Well after much debate I think I got it: For Lent I'm giving up complaining about work -- not to be confused with venting. So no more bitching and whining about obnoxious patients, indecisive doctors, pain-in-the-ass med students, the worthlessness of our pharmacy, etc etc. We'll see how this goes..... :-p

Feb. 14

"...General opinion's starting to make out that we live in a world of hatred and greed, but I don't see that. It seems to me that love is everywhere. Often, it's not particularly dignified or newsworthy, but it's always there - fathers and sons, mothers and daughters, husbands and wives, boyfriends, girlfriends, old friends... If you look for it, I've got a sneaking suspicion... love actually is all around."

Happy Valentine's Day. :)

Snow - part 2

Isnt it funny how you take away the option/ability to do something and suddenly thats all you want to do? For example, I spend quite a few of my days off just relaxing and bumming around the apt and it usually quite enjoyable and much needed/deserved rest. Esp when its a fake day off, aka I worked the night before, and esp when my most recent shift was as crazy as the one I had last night. But of course today we have yet another blizzard warning for the DC area (and believe me, it is ridiculous out there) and thus I am stuck inside the apt and all I want to do is go out and do something. But alas I've been laying in bed under the covers about to go stir crazy because I'm afraid either my car wont make it 5 ft without getting stuck, OR mother nature will eat me alive in the snow storm.

Leaving the hospital at 0800 following a crazy night shift. Already blizzard-like conditions:


Streets were empty...


Probably b/c there was barely any visibility. Driving across the Key Bridge - you cant tell from the picture, but normally you would see tons of high rise buildings at the other end of the bridge:


My apt complex at approx 0830



But I do still love the snow! I'm pretty sure I'm the only one on the east coast who is excited its STILL snowing. :-p

Snow!

Snow is so pretty!! :) looking out my window - just a couple inches on the ground:


Crossing over the key bridge looking at Georgetown (yep, on my way to work):


Snow covered trees:



...Then "Snowpocolypse/Snowmageddon" happened Friday through Saturday. ...And I worked Friday night, so getting home Saturday morning right smack in the middle of the blizzard was quite the challenge. I actually didnt make it all the way home, I had to take the GUH shuttle to the metro then walk to my friend Lisa's apt. Yeah, walking during the blizzard was not so much fun. But it turned out pretty well. We hung out all day (way better than being stranded home alone) and then ventured out in Arlington on Saturday night where there were tons of people out. So much fun! (aside from getting shoved into a snow bank for no reason thanks to Matt :-p).

Pics from Sunday, once the snow started to melt and you could finally see the streets:


overlooking the Key Bridge with the Washington Monument in the background:


Look how pretty!: