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So many lawyers, so little time...

"The prospect of hanging focuses the mind wonderfully"--Samuel Johnson

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Location: Louisville, KY, United States

Gastroenterologist, cyclist, cellist, Christian, husband, father, grandfather.

Sunday, August 14, 2005

The benefits of low dose aspirin

All bleeding stops, sooner or later.

I was reminded of this aphorism earlier in the week as I stood in the operating room watching a citizen do his best to bleed to death. The gent turned up in the ER with a low blood pressure and had barfed up a very scary-looking amount of blood, so we made the decision to take him into the OR and have the anesthesiologist intubate him. I would then run an endoscope down and see if I could identify the bleeding site, and, if we were all lucky, get the bleeding lesion to stop. I didn’t think this was likely to succeed, and the surgeon stood at my shoulder, ready to take matters into his hands when I failed.

As I was waiting for the anesthesiologist to do his thing, I was struck by the marvelous efficiency of the American healthcare system. The whole OR was filled with folks doing exactly what needed to be done: the anesthesiologist figuring out how to put the fellow to sleep while keeping him from bleeding to death, one of his aids holding the hand of the frightened citizen assuring him that he had nothing to worry about, the endoscopy team setting up my equipment, the OR nurses setting up the surgical trays, and the surgeon and I trading aphorisms.

“All bleeding stops, you know, sooner or later.”

As I pondered this, I realized that with just a little modification this would be the perfect epitaph for my gravesite:

“All problems go away, sooner or later.”

And it’s true, if you’re willing to wait ‘em out. It may take Eternity to dispose of some problems, and that can be a little impractical, such as the time I developed biliary colic and collapsed in my office. Eternity would have taken care of that one, to be sure, but Eternity can be a long time, especially towards the end of it (per Woody Allen), and having a surgeon fix me up seemed like a better approach.

It isn’t necessarily a good thing to elevate one’s avoidant tendencies to an art form, but that’s what I’ve done. Biking has been my means of escape lately, and although I’m grateful that I’ve avoided the lesser diversions such as alcohol, women, etc, I’m not sure my current obsession is any safer.

Yesterday my son and I went back to our Boonieville bike trail, but we didn’t get out early. This time we waited until late morning, with the temperature gauge pushing 90 and the humidity running around 80%. Any child of Ma Gaia with a nanogram of sense to it stayed out of the heat. No deer or chickens, not even the giant goat-eating spiders were to be seen. It was just too flaming hot.

That didn’t deter us initially, but it caught up with us very quickly. My athletic performance is shabby to begin with, but when I get overheated my body goes into frighteningly random motion, which can be very inconvenient on a mountain bike. Before long I had ridden off the trail and into a tree, the bark of which felt like a cheese grater as it tore into the tender flesh of my left forearm. I dragged back to the trail, looking like I had been savagely raped by Mr. Mestofeles (Trey Parker and Matt Stone).

“Lucky!” my son exclaimed. “You always get the cool injuries!”

I looked down and noticed that a cut on my arm was bleeding profusely, thanks to the low dose aspirin I had put myself on. It looked like I might bleed to death, although the blood loss probably didn’t exceed one ounce. It provided a great excuse to call it a day. And the bleeding stopped, as it always does.

My patient’s bleeding also stopped, courtesy of some metal clips I was able to attach to a blood vessel in the base of a stomach ulcer. I was glad I could help him, especially as I had to send an office-full of patients home without being seen in order to free me up for the procedure. Did I mention free? The patient had no insurance (he was in town on a job interview) so I don’t plan on getting paid. No money could replace the satisfaction of saving a person’s life, especially when the Federal penalty for refusing to see patients in the ER is up to $2 million per infraction.


Blogger Judy said...

I was afraid you were going to say your patient was bleeding courtesy of low-dose aspirin.

I've had to cut back to 3 times/week myself. I tend to get really ugly bruises when I take it every day. I never have a problem getting a sample for blood sugar checks, though.

11:02 AM  
Blogger JusPasenThru said...

My patient's guilty culprit was Mobic.

3:56 PM  

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