Iatrogenic

This is a case that I'm going to describe in very general terms. Unfortunately, we were consulted on a patient who had an iatrogenic infection. An iatrogenic problem is one that results from medical advice or treatment. It is the thing physicians dread the most. "First, do no harm." We order all interventions - from diagnostic tests to medications to procedures to surgery - with the intention of helping someone. But everything has its risks and benefits, from the discomfort of an abdominal exam to the radiation of a CT scan to potential allergies to medications to the complications of surgery. Medicine is not a risk-free enterprise. And over the course of a rotation, a year, a career, we will do things that harm people. They may not be mistakes. They may not be due to wrong clinical judgment. But they will nevertheless happen and we must learn to deal with the consequences.

An ID consult was obtained on someone who, as a result of a medical intervention, may now require life-long antibiotics. The patient is in his 50s. Committing this person to life-long antibiotics is a travesty; it comes with so many dangers and side effects. And yet, due to an iatrogenic complication, he has an infection that his immune system may never be able to clear. We were all devastated to hear about this case, but now that it has happened, we are helping the primary team figure out what to do.