Huntsville Hospital has seen a large number of H1N1 influenza patients. Some have died. The sickest patients are relatively young (in their 20s and 30s) and have no previous illness.
Caring for the sickest patients puts great emotional stress on all health care workers. House officers have always found such situations particularly distressing. You meet a patient who seems to have many productive years ahead, and watch them spiral downhill over hours. You make the right diagnosis, start the proper medications, yet the patient still dies.
You begin to dread caring for such patients. We physicians can do a wonderful job caring for many patients and many diseases, but some diseases, and particularly some infections defeat our efforts. So for the next few days we second guess ourselves. What else could we have done? Did we miss something?
We physicians tend to “beat ourselves up” over all bad outcomes, and hang on the belief that we might have done something different. Unfortunately, in this epidemic, we will have some deaths regardless of our skills and enthusiasm. That does not make us feel any better. Doing our best just does not feel good enough.
db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Regional Associate Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds over 100 days each year. This post originally appeared at his blog, db's Medical Rants.