Wednesday, December 16, 2009

What am I supposed to do with this?

That's all I can ask at this place sometimes. Last night I get this ambulance. Dude in his early 60s. Hasn't been to a doctor in, no joke, over 45 years. Admits to drinking a GALLON of whiskey a day, and has the most yellow skin I've ever seen. And.. he's been puking and pooping blood a lot for the past few days but this has been going on for the last 2-3 years off and on.
So I see he's pretty sick- I start a couple of big IVs and get blood work started. His platelet count ends up being a very small fraction of what it should be, his other blood counts looks like crap, he's on the fast track to liver failure. The doctor comes in and takes one look at him and admits him to ICU even before any tests came back.
This guy does not care. He does however, care about the fact that he can't have anything do drink when he's puking blood. He cares about having to leave this stupid pulse oximeter on his finger. He cares that we keep taking his blood for all these damn tests. I tell him we're going to transfuse two units of blood and his response is to scoff and say, " A blood transfusion? I hope they test it for AIDs!"
Really? AIDs? Wow. I don't know why, but that really blows my mind. I guess the whole idea that someone would think about the very remote risk of getting AIDs from a blood transfusion but not consider the very real and immediate risk of drinking a freaking gallon of whiskey daily! But hey, priorities, right?
But seriously. What am I supposed to do with someone who has absolutely zero involvment in his own care other than to complain about the things I need to do to save his life? I swear. Sometimes these patients make ME want to drink a gallon of whiskey a day.

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