Guardian angels

Guardian angels are good to have around. Mine was quite busy in my misspent youth, given my proclivity for driving vehicles off roads and into trees.

As I began to acquire a little maturity and common sense, my angel kept track of me in different ways. I've noted that when I've been able to make an obscure diagnosis or use a novel form of therapy, the angel always seems to have put just the right medical article in my hands the week before.

Skeptics scoff at this. They'd say I'm not aware of what I've missed, or I wouldn't have missed it. I'll have none of it, though. It's occured too frequently to be happenstance.

The problem is what to make of times when the angel's not around. A hard working angel might just need to get away every now and then, dancing the night away on the head of a pin somewhere.

I once treated a man my age for heartburn and such. He was a bit of a malcontent, changing family doctors every two or three years. We got along well and he stayed with me for years.

While I was on vacation one summer, the gentleman developed signs of internal bleeding. For reasons I've never understood, instead of sending him to one of my erstwhile associates, the family doctor referred him to the Best GI Guy In Town, Maybe Even The State. The BGIGITMETS scoped the patient top and bottom, finding no significant pathology.

True to form, the patient took offense over some comment his family doc's receptionist made, so off he went to another family doctor, who in turn sent him back to me to repeat the studies performed by the BGIGITMETS. It wasn't clear to me why, given the short time that had elapsed (three months), so I dutifully reviewed all the scope records. The work-up looked to be thorough.

The patient returned several months later, this time demanding to have the scopes repeated. He just knew there was something lurking in his bowels somewhere.

I could have really used my angel's help just then. I reviewed the original work-up and the tests that had been performed in the interval and concluded that repeating the scopes didn't make sense. Medical costs are skyrocketing, and it seemed like a foolish waste of resources. And I told the patient so.

To be continued.