Sunday, March 09, 2008

No salt

Part of medicine residency is seeing at least one half day of clinic a week. And though my patients have generally been pretty good, this is by far the least popular part of the program among the interns. Here's a direct quote from one of my more humorous classmates:

"I woke up this morning and realized I had clinic. And I'm not gonna lie, I had a bit of suicidal ideation at that point."

Maybe that's too dark to appreciate outside this place. But I had another bleak clinic experience a short time ago. One of my patients showed up to see me complaining of shortness of shortness of breath and left sided chest pain. The (hopefully) future cardiologist in me was instantly interested.

"How long has this been going on?" I asked, trying to keep the excitement out of my voice as I planned for an EKG, and possibly a hospital admission.

"About three years," came the measured reply.

At this point my interest flagged a bit. It turns out that my patient, who has congestive heart failure and ought to be keeping to a low sodium diet, ate a McDonald's sausage and biscuit for breakfast. And not just this breakfast, but a fairly steady line of breakfasts stretching back, you guessed it, about three years. But, he responded, "it's only a little, little piece of sausage, and I'm not adding any salt."

I saw another patient upstairs, actually admitted for heart failure, who told an even funnier story. We asked him what a typical meal was for him, and he responded "I ate a pound of bacon and a can of green beans for dinner last night." When we told him that "that's a lot of salt, and you really need to eat less than 2g of sodium a day" his cheerful response was "oh don't worry doc, I don't put any salt on the bacon."


Anonymous said...

Hello, great blog. I have a friend who is a diabetologist. He experiences this kind of patient attitude all the time. His most hilarious story is when an old man told him that he takes his statins with home-made sausages. I believe that if a person does not study medicine it is hard to understand the gravity of these ilnesses. I have already explained to my grany the complications of diabetes at least a hundred times but I still manage to catch her stealing cookies. This is frustrating. Good Luck in Your profession. Arpad

Alice said...

lol, Nathan, that's awful. I had a patient with severe peripheral vascular disease explaining to me last night, "I do smoke, but never more than 1 pack a day; and I walk a lot."

Doc's Girl said...

I bet all of these people drink "diet" soda as well. :-P