Friday, April 8, 2016

Primary care has a dual meaning

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One year ago (read: before intern year), pretty much the most exciting part of my fourth-year emergency medicine rotation was having my pager go off. BZZZZ! I leapt into action, excitingly reading the text page: “Leg lac in E9.” I was on it.

Suture kit in hand, I burst through E9’s thin emergency department curtains with abandon; I was going to fix this. The “leg lac” turned out to be a wonderful 95 years old, Mrs. F, who had fallen onto her wheelchair. The skin on her lateral lower leg was pushed aside, leaving exposed subcutaneous fat (of which she did not have much) and the fascia of the muscle below.

Accompanying Mrs. F was her daughter, her husband and Mrs. F’s other daughter’s daughter; suffice it to say, it was a crowded curtain-room. Two hours and 30 sutures later, I knew the family’s story; how Mrs. F, great-grandmother of four, had been living independently but recently was hospitalized due to difficult to control hypertension, how Mrs. F’s daughter and son-in-law wanted Mrs. F to live with them, but she fiercely wanted her independence (“I can get around!”) and how the same stubbornness that had gotten her through 95 bitterly cold Minnesota winters had now come to this, a crossroads.

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