Friday, October 29, 2010


One of the joys of medicine is that you get to work at being a detective. Problems present themselves, solutions some times present, but some times you have to dig.

In my normal life, I do rapid damage control. I try and make sure that people don’t die. I had a Doc explain it to me that medicine is the art of slowing the dieing process, that only fools think that they cure. I do not agree 100%, but I do agree quite a bit. I think he just said it to make you stop and think.

As of late, I have had to hold onto more of my patients. I have gotten to work harder on more specific, dig a little deeper. Try and nail down an elusive diagnosis. Despite my best efforts, I failed to find a specific problem. Some times things happen, the body hurts and we don’t have a specific answer. Its frustrating to both the patient and the provider.

The human body is not quite a helicopter that has a specific A+B=C algorithm. Not everything fits into a nice clean mold. Some days, you just put your hands up and say “I don’t know”. Never the answer that someone wants to hear, especially when they feel that something critical is going on.

I had a problem that I could not patch up with my insta fix methods that normally work, I had to dig a little. I read the full chapters on belly pain in two different and big books. Always a good thing, I studied for the whole night pondering and came up with an answer that was inspired by CMDT 2010.

Nortriptyline. Ever hear of it? Probably not, but perhaps yes. It’s a second line treatment and I tried it and it worked like a champ. Solved the whole belly pain issue over night. It was a small victory and I felt like a winner the whole day, well actually this is a week later and I still feel fairly good about it. It was not an easy answer, I had to work for it, I found it, I tried it, and it worked.


t. said...