A good day in outpatient medicine

Its been a while and I need to catch up on blog entries (Not that my life is so exciting between studying for boards and being cooped up in the hospital).

Anyway, ongoing thoughts about outpatient medicine. I’m on my last day with Dr. H here in Claremont and its really been surprisingly good. There is a side of outpatient medicine that is attractive: getting to really know your patients and also being the first line to pick up really bad things when they could otherwise go unnoticed. One of the highlights during this rotation was finding a woman with a large retroperitoneal abscess likely either from a ruptured appendicitis or a appendiceal tumor who came in because she was just feeling lousy and looked kinda crappy and had some diffuse aches and pains and a tender belly and some pale eyelids. We got a stat white blood cell count which showed that she had 20,000 white cells (normal is less than 10k) and was anemic with a hemoglobin of 12, scanned her belly and found the abscess. She got the abscess drained and put on IV antibiotics. We probably prevented a life threatening blood infection in her and probably saved her life. In some ways it was kind of like the emergency which WE found and upgraded rather than the patient defined emergencies for which they go to the ER on their own initiative. Either way, you’re really saving a life which is very meaningful. A very different twist on Emergency medicine!

Of course my preceptor (this funny German guy who is VERY German, always on time, uber efficient, the ultimate task master who expects things to be done 10 minutes ago whose idea of fun is to rent a smart car instead of a taxi from the airport) think I ought to go into primary care because “its more important”.