Cold Cold Heart

Every so often a patient subtly takes a grip of my hardened heart and twists it into
mush.

Sandra, a 50 y/o female presented with DIB for the last week. History of smoking, no etoh, no drugs. She looked like she'd had a hard life. Her color wasn't dusky, it wasn't pale, it was a chronic sick color, but there was not a choice in my EMR for that description. While I'm checking her over and talking to her, she's telling me that she hasn't had insurance for a long time but that she had a new job at BigBoxChain making $10/hr, she was paying $100 a week in insurance and now she felt that is was time to get the DIB checked out. And, oh by the way, she tells me, she has had this lump on her breast for a while, too.

I'm telling her that we don't normally do mammograms in the ED but we can give her a referral. She tells me alright, but will I look at the breast and tell her what I think?

When I saw the breast, I maintained my clinical poker face, but inside I was shocked. The entire left breast was eaten away and in it's place was a mess of green slime and holes with a foul smelling odor emanating from beneath the X-large band-aid she'd applied. The mass looked like the kind of cancer I used to see when I did a stint with Hospice.

My heart hurt for this nice lady. I was also really pissed off. She hadn't been to a doctor because she had no insurance, but everyday I see people who have no qualms about coming to the ED for their bullshit complaints, never intending to pay a dime.

I hate it when patients get to me like that. I don't like to think about them after I leave the hospital, no sir I don't. I learned a long time ago that one must hang their hat when arriving to work and to pick it back up when leaving. It saves a lot of heartache and it keeps one sane.

I'm home now, I've got my two precious Shih-Tzu's sitting next to me, I'm watching my favorite crime channel on TV and drinking a cold Diet Coke. I'm winding down so I can get up and do it all over again. I know I'll be tempted to look her up on the computer tomorrow to see what her dispo status was.

I also know that I won't. It's just too too hard to take on the pain of the world.

So tomorrow I'll clock in, hang my hat at the door and start the day anew.