What to do?

I can't stop thinking about the last patient I saw today in clinic.

From an objective viewpoint, this middle aged man was in a wheelchair, over 400 pounds, had severe lymphedema (he was retaining tons of water in his legs), and, he radiated a painful odor. I've never experienced anything like it. He was in atrial fibrillation, and the reason for his visit was to monitor whether his coumadin level was still within a therapeutic range. So, that's what we checked. His INR. But unfortunately, the only thing most of the medical team talked about during his time in the office was the odor. It quite literally would take your breath away. But, as we saw him, talked with him, and rushed out of the room, I couldn't help but wonder why the most obvious clinical finding, the one everyone was talking about, was being medically ignored. 

It broke my heart. Because from a subjective, humane viewpoint, he was kind. Verbally expressing his desire to not cause difficulties and seemingly cheerful despite his current state.

I wondered, who was going to take care of his smell? Who was going to investigate it? Who was going to touch him or help clean him? Yeah, the schedule said INR check, but was that really his chief complaint?? It wouldn't be mine...I asked the resident who was supposed to take care of the patients sores that had begun to ooze and smell, a complication of his lymphedema and immobility. I wondered if maybe it should be mine.

In a world of specialties, we are so quick to assume it is someone else's responsibility to tend to problems we either feel inadequate to address or simply don't want to address.

I don't know this gentleman's story. But, I wonder what he'd say if I asked. He is a modern day Leper in our world today. I have to figure out how to be a third year medical student, with limited capabilities and a chain of command, in which, I am at the bottom, while still being the hand of Christ, filled with compassion, that reached out and healed the leper. Where and when can I treat patients the way my heart tells me to and where and when do I just do as I am told? And am I making the distinction more complicated than it needs to be? I don't think I can just stand back for two more years, though. With a little creativity I hope I won't need to.

God doesn’t require us to succeed; he only requires that you try.

- Mother Theresa