Thursday, March 12, 2009

A Tale of Chloe, Gone With the Wind, and a Confusing Diagnosis

I have a new favorite patient! Today was my first visit with "Meryl," a spunky 79 yo with liver cirrhosis of unknown origin. I could tell that Meryl and I would get along splendidly from the moment we said hello. Her cute Westie named Chloe (sue me, HIPAA, I'm using the real name- I don't think privacy laws apply to animals...yet) was perched at her feet and came over to greet me. Meryl asked if I liked dogs and when I said, "yes," she said, "I already knew it from the way you smiled. You probably like cats too!" I confirmed that I loved both dogs and cats, completely taken with Meryl's ability to read people. RN Beth was there for the visit too, which added to the fun. Meryl told me about a recent unpleasant MD visit, which included an unfortunate rectal exam. I'll spare you the details but mostly because I don't think I could write it as humorously as Meryl told it. She said the MD never told her the diagnosis, only her daughter. This is frustrating because Meryl is clearly alert, oriented, and capable of making all health-related decisions. And consequently, she thought she had liver cancer, not cirrhosis. We cleared up the miscommunication (confirmed by her daughter by phone- Meryl had forgotten what her daughter had told her. Understandable to think you have cancer after all those tests and since Meryl never drank any form of alcohol, cirrhosis would not be a likely guess.) While Beth was on the phone with the daughter, Meryl and I covered all manner of topics, eventually resting on one of my favorites: books. Meryl's favorite books are Gone With the Wind and Rebecca, definite classics that everyone should read at some point. Discussion of their merits led to us contrasting the classics against today's literature. Absolutely fascinating! I haven't had a good literature conversation in some time. (This does not include Book Club where we discuss the merits of one novel. I'm talking a good overview of literature conversation.) If I hadn't already moved Meryl to the "favorite patient" category, this would have tipped her over for sure. She told me within the first 15 minutes that she could tell I was interested in people and this is likely what makes me good at my job. And then 10 minutes after that she told me she hopes I'll visit every week. And you know what? I'm definitely taking her up on that offer!

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