Pulm: Damn Birds...

Argh...for some reason last night a group of birds set up roost in a tree outside our cabin and chirped at each other ALL FREAKING NIGHT. Lisa and I lay down at about 11:30 pm, but I did not actually fall asleep until sometime between 2 and 3 a.m. I spent a good chunk of that time trying to sleep and also thinking of ways to get rid of those birds (i.e. throwing stones, spraying them with a hose). Those things had better not be singing all night is all I'm saying.

I paid another visit to our TB patient this morning after the pulmonary conference, and he commented on how much he'd love to go outside since he's been cooped in his room since he's been here. It really WAS beautiful and sunny outside. While talking to him, I realized that no one had told him yet that he was due to get a bone marrow biopsy tomorrow, and when he asked about his pancytopenia, I had to play stupid. It was not my duty to tell him that someone was going to stick a needle in him and drain him of some marrow (it was the hematologist's)

There was one patient today whose case was really sad. She was a 75-year-old woman with mild dementia who was recently hospitalized for pneumonia. In the hospital, both a CXR and a chest CT revealed a huge mass in her left lung, and it practically screamed lung cancer (especially since she had a long history of smoking). She was also a Longhorn fan and had her doubts about Dr. JS b/c he graduated from A&M, so the nurse stuck a Post-It to her chart that read: "To all Aggies: Patient is a Longhorn." Dr. JS burst out laughing when he saw the note, which came at a pretty inopportune time b/c he was in the middle of telling the patient's husband how dire her prognosis was. Given her poor health and dementia, everyone agreed that chemo and surgery were not the best option for her, and that palliative care was the best option. The patient seemed to understand what was going on, and as the couple left the office they were holding hands and trying to keep from crying. =(