How often we forget this adage in medicine. I remember when I was a cocky Straight
Internal Medicine Intern functioning as the Internal Medicine Resident on Call at
the dearly beloved and sadly demised Queen Elizabeth Hospital in Montreal. I admitted
a patient from the emergency department to the intensive care unit in cardiogenic
shock. Although his presenting symptom was constipation, I noted severe pulmonary
congestion, neck veins to the angle of the jaw, sky-high liver enzymes, severe hypotension,
and oliguria. I poured all my energies into taking care of him overnight, barely sleeping
a wink, and brooded over him for the next few days. Approximately 1 week later, he
was ready for discharge, nice and pink, neck veins down, good blood pressure, and
liver enzymes normalized. I proudly told him about his imminent departure and asked
him how he was feeling. How disappointed and shocked I was when he responded “I dunno
doc, I still have that CONSTIPATION.” From his point of view, I had done little for
his real problem.
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Reference
- Notes from cardiology clinic: when our responsibilities extend beyond the patient.Can J Cardiol. 2019; 35: 1294-1295
Article info
Publication history
Published online: August 21, 2019
Accepted:
May 22,
2019
Received:
May 18,
2019
Footnotes
See article by Waters, pages 1294–1295 of this issue.
See page 1264 for disclosure information.
Identification
Copyright
© 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Notes From Cardiology Clinic: When Our Responsibilities Extend Beyond the PatientCanadian Journal of CardiologyVol. 35Issue 10
- PreviewOne day, in the late 1970s, I was called to the emergency department to see a patient with chest pain. Although I had only been practicing for a couple of years, I secretly prided myself on my ability to discern cardiac from noncardiac symptoms. The patient was a gaunt-looking man in his early 60s, with sad, deep-set eyes. He reported retrosternal chest discomfort with physical activity for about 2 years, relieved by rest. The discomfort radiated down his arms and sounded like typical angina. His symptoms had worsened in the past week because of increasing anxiety and now were occurring at rest.
- Full-Text
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