1/25/11 just chillin with D-Will

1/25/11

Dr. Williams was back in the office today, so I was to linger around with him. I noticed that I need to be quicker on my feet because the Doc is always on the move, but I still managed to keep up. I was more involved today with minor procedures such as injections and the removal of sutures and stitches. As routine as these procedures may seem, it may get very stressful for a doctor when the patient struggles to remain calm and allow him to do his job. One of the patients felt that the injection was too painful and unbearable. At one point this patient broke off into tears due to the pain she was suffering despite the numbing agent Dr. Williams has introduced. Dr. Williams then tried another approach by injecting the shot elsewhere and the patient was able to tolerate the pain better [D]. This experience showed me how important for a doctor to be patient and remain calm. It also gave me an idea of how to evaluate a patient’s pain tolerance and how to work around their inability to endure pain [A].

Another notable case I witnessed was that of an older gentleman who had his leg amputated due to poor circulation caused by diabetes. Dr. Williams was the one who performed the operation. The patient was coming for a postoperative checkup, when Dr. Williams noticed that the patient was lagging in the healing process. There was inflammation and swelling of the patient’s stub, or remaining part of his leg, and Dr. Williams assessed it as an infection. Dr. Williams said this was due to inadequate circulation because the patient was a smoker and the operation required the loss of large amounts of blood and body mass as well as tight compression of the wound. This compression would alter the pressure applied on the arteries thus bringing an inadequate blood supply to the healing wound. Dr. Williams was very concerned and wished to take action as soon as possible. He suggested that he revise the operation by opening the infected site and cleanse the wound from the inside. He would then leave part of the wound open in order for puss and excess fluid to leave the body [D]. It was very disheartening to see the pain the patient was going through as well as the worries of his loved ones [F]. Dr. Williams explained that it was part of the job to be weary and understanding of a patient’s emotions but it is within a physician’s duty to keep the patient optimistic in these circumstances [A].