Sunday, November 28, 2010

Follow Your Nose, Lucky Charms

I remember reading an essay from "Surely, you must be joking Mr. Feynman," where good Richard himself describes a scientific publication on the superior olfactory sense of bloodhounds. Led by simple human hubris, he decides to test the olfactory powers of homo sapien, himself. At the time, his wife was in hospital (Is that the way the Brits use it? I hope so cause I really like it) with something serious. On his next visit to hospital, he described to her the publication and his belief that the human nose, when put to the test would outperform expectation. To test his theory, he asked his wife to choose one of the books from a stack of five or ten on the window sill while he was outside of the room. He would return and smell out which of the books she handled. And so it went that he was able to pick the right book. I don't know how many times. I can't even remember if I got all the details right, I'm just going on recall having read the essay one time five years ago. It stuck with me though because I've often noticed how powerful scents can be.

The other morning I was dramatically reminded of this as I walked onto the hospital floor. My resident enthusiastically greeted me, "Hey Jeff! Check out Mrs. W real quick. I think the nurse still has the bed pan. Let me know what you think!" The sun was no where near rising, the majority of the lights on the floor still hadn't come on. Roasters were still in deep slumber, and here I was catching an eye opener of Mrs. W's diarrhea. I dutifully inspected the soupy content for any signs of mal absorption, blood, or infectious process thinking the whole time, "Is this really what I want to do with my life? Seriously, who does this?"

Days have passed; Some days I don't have an answer to that question. And then there are moments, like the few I've experienced over the past couple of days that remind me that it is the uniqueness of our job that makes it so precious.

Ms S traveled to us, transferred by ambulance from a small hospital two hrs away. 39 yrs old, two kids at home, and her parents trailing the ambulance in the slow traffic that always ensues with the year's first snowfall. She left the outside hospital in a stable condition. When she got to us, she had all of the signs of sepsis--an infection that can quickly take the unsuspecting patient to the morgue. Two days later, I stepped into her room, examining a totally different patient. Her skin tone was back, her eyes had cleared, her breathing returned. It was apparent without a stethoscope or any exam that she was out of the storm. My team followed into the room and the parents kept pointing out what a miracle had been worked; going on praising us for the work we did and kindly reminding us that it was God and not the white coat behind it all.

In these instances, you know it is nothing that you did. Of course you did what evidence-based medicine dictates so you never feel like it was something, "you" did; but that still doesn't take away from how awesome you feel in those unique moments. You don't feel pride, you just feel luck. You feel the luck of the situation, that the medicine worked, that this patient is back, smiling along with everyone else in the room, and the luck you have to be a part of it all.