Sick and Well

After just a few shifts in the emergency department, I've learned that I like taking care of the sicker patients. As I navigate diagnoses from the common cold to heartburn to overwhelming infection to the acute abdomen, I realize that I am drawn to the scarier, more high-stakes diseases. I have co-interns who like the primary care, healthy baby checks, and reassurance of generally well patients, and I think that is so, so important. But somehow, I am irresistibly drawn to the sicker patients. Yesterday, for the first time, I took care of a patient in early active sepsis. We learn about sepsis over and over - it is an overwhelming infection of the bloodstream that has a high mortality rate - but I rarely see the initial resuscitation because this happens in the emergency department. We had a young woman who was immunosuppressed due to cancer who presented with a high fever, rapid heart rate, and low blood pressure. It was quite exciting to recognize what needed to be done and follow her progress closely from the initial stages of treatment. Though the steps aren't hard - fluids, antibiotics, ICU consultation, labs - it was still incredibly educational for me to experience.