Good things continue to brew in the background for the Shroom, but it continues as a work in progress, so... shhh...
As a Doctor, part of the deal, maybe most of the deal, maybe ALL of the deal is being the patient's advocate. With all the privilege it entails, patients expect, deserve, demand that we do our best for them; that we do our best, even when others disagree with us.
And this morning I failed my patient; I missed what would turn out to be the crucial detail in her history, although I did not fail to see how ill she was. But I was unable to convince my colleagues of this fact; allowed myself to be pushed around; I could not convince myself to step up for her and force others to help me treat her.
I find this incredibly frustrating; especially when, as this case did, a patient straddles the day / night boundary. With the dawning of the day, the Hospital stirs itself to life, and suddenly everyone is interested in your case, and mostly in criticising your management thereof.
I'm not sure the delay will affect outcome; but I was stung to the quick, having spent 2 hours trying to attract speciality assistance, to have them phone me and 'pass comment' on the delay I was causing.
Sometimes, I hate my job.
For the record, the case was, I suspect, Boerhaave's Syndrome. The patient presented with abdominal pain, following vomiting. Radiograph showed a pneumothorax, possibly pneumomediastinum, and loculated effusion in the left chest, producing a degree of mediastinal shift.
I never cease to be amazed how quickly my colleagues disavow themselves of potential responsibility; all hail Specialisation.
I promised her husband we'd get to the bottom of it, and see her right. I couldn't look him in the face on my way out.