From the monthly archives:
I imagine we have all experienced doctors who do not seem compassionate, perhaps because they are burned out. This seems to be an increasing trend, and there are many reasons why.
This article from Kevin MD on doctors losing compassion provides more insight.
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Case of the day:
An ER patient recently set a record for shortest period of time to elapse between drunk driving arrests. He clocked in at just over 12 hours. In addition, he was arrested after crashing his car both times.
When you think about that, it’s actually kind of incredible. He had to crash his first car, come into the ER, get checked out, be arrested, go to jail, make bail, then go get drunk again, drive another car, and crash again.
Now I firmly believe that alcoholism is a disease, and I truly sympathize with patients who are struggling with addiction. But when I think about how incredibly dangerous this man is, and how little he regards the safety of other people, it makes me angry.
The nurses often make jokes when we have patients who behave this poorly, and I think it helps them deal with the stress of the ER. This patient certainly increased their stress substantially, especially when he started to sober up, and made a point to give each of them the middle finger and some accompanying profanity. He then tried to make a break for it, running down the hallway when the police turned away briefly. His hopes for freedom were quickly dashed when the police wrestled him to the ground, and cuffed him. The patient was quick to complain of police brutality, and threatened them with “I’ll have all your badges.â€Â  Somehow, I think their badges will be just fine.
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Q:
My son is a high school football player. He’s in excellent health and does well at the game but all season long he gets repetitive bruises on his arms from the hitting. Clearly this must happen to many football players – but I am wondering if multiple bruises are something I need to be concerned about.
 A:
This is a great question, and it is tempting to simply say that the bruises are from football, and leave it at that, but let’s think about bruises a little bit.
Normally bruises form when small blood vessels at the surface of the skin break, usually from an injury. This could happen during football quite easily.   The blood leaks out of the vessels and darkens the skin. Eventually the body reabsorbs the blood. As we age, the bruising gets more common, and some people just bruise more than others.
Sometimes medications or dietary supplements can cause bruising more easily, especially ones that reduce the body’s ability to form clots. However, high school students are not usually on these substances.
Occasionally, bruises indicate something more serious going on, such as a problem with the body’s ability to form blood clots, or a blood disease. This is especially true if large, or painful bruises develop, if they occur for now known reason, or if there is any bleeding occurring elsewhere, such as gums, nose, or intestines.
If you’re concerned about it, then the bruises warrant an evaluation. A physician can examine your son for signs of bleeding problems, and perform additional testing as indicated.
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