chief complaint and end point

I am now trying to explore my new mac.  In the busy-ness of the day. 

Today I was up from 730 am tending to so many items on my to do list.  First order of business was fixing the pay roll of the house staff.  I then cancelled clinic first thing in the morning as the patients were late and headed straight on to the hospital.  I was rushing to do this and that, see this and that patient, attended a conference, attended to patient with chills, answered phone calls.  During the conference, my patience was tested because I felt that the resident physicians weren’t managing the case to par.  I was so frustrated.  First time I was frustrated actually.  I usually laugh the whole thing off and accept that this is why the things are the way they are.  But today, I couldn’t wrap myself around the idea.  There were so many competencies I so believed that people should be getting but they weren’t.  like referring to a cardiologist a patient who is bradycardic with a heart rate of 37 at that.  37!  And I was just in the middle of everything.  And in the middle of everything, I asked my mentor if this was really something I should accept or struggle to change in order to meet the standard.  She accepted mediocrity 25 years ago.  Go figure.

 Before I knew it, I was driven out of the conference because I had to rush again and go see a patient.  I scooted to my clinic and there was the doctor before me who was over time-ing again.  Man, I was guilty of that myself in the other clinic but for this physician to do this consistently.  But for whatever it was worth, I just smiled, stepped inside and quickly saw the patient, tried my best to appear unhurried to the patient and then give her a quick peck on the cheek.  She was a lola.  As I stepped out, I hurriedly collected my 500 pesos for checking on her blood sugar.  And again rushed to east avenue where there were hordes of more patients looking for me.  And doled out P1200 for blood cultures of a patient with recurrent chills.  Negative earning for today.  Again. 

Another resident was there wanting my input, so I provided it and left.  Feeling that I provided by godly duty to the patient to somehow try to make her life better.  By the way, the most valuable thing I did for the patient was to check her blood sugar which came out as 7 mmol per dl.  Lowest I ever saw in my life.  No wonder she was not reacting.   The patient I mean, not the resident.

After that, I rushed to two dialysis units which were quite opposites as far as opposites would get.  I buried myself in policies, emails, professional fees.  As if it weren’t enough, after calling on all friends asking how they did it….I got a pay referral.  From another charity hospital.  And I went.  And saw the patient.  And hurried home.

All throughout the day, I was thinking…why was I running this amazing race?  What for?  Or should I give it up?

Call it a hodge podge day.   

I reflect now. on end point.  the concepts of chief complaint and end point were the two most important concepts I learned in internal medicine.  Quite useful in life.

Amidst all the hodge podge, the amazing race, the mess, the chaos.

What is my chief complaint now?  What is my endpoint?

Pause.  Sinus pause.  Or maybe second degree AV block.  with a dropped beat.

Chief complaint: everything is too fast.  Too fast that I miss my friends.

End point:

1. Doctoring everyday.  Check.
2. Being less busy.  Hm.  I have to decide my priorities.  
3. social life.   

let's work on this, shall we?