{"id":3478,"date":"2013-04-25T14:59:00","date_gmt":"2013-04-25T18:59:00","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=3478"},"modified":"2015-06-04T15:39:59","modified_gmt":"2015-06-04T19:39:59","slug":"in-praise-of-the-diversity-of-being-an-infectious-diseases-specialist","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/in-praise-of-the-diversity-of-being-an-infectious-diseases-specialist\/2013\/04\/25\/","title":{"rendered":"In Praise of the Diversity of Being an Infectious Diseases Specialist"},"content":{"rendered":"

\"\"<\/a>I have a friend who is a thoracic surgeon.<\/p>\n

Imagine his daily agenda:<\/p>\n

5:00 AM: \u00a0Oops, slept late.
\n5:30 AM: \u00a0Drive to hospital; not much traffic.
\n6:00 AM: \u00a0Round on inpatients. They’re all doing great! Wonder why they’re not more talkative.
\n6:15 AM: \u00a0Coffee, gossip with other surgeons.
\n7:00 AM: \u00a0Get in scrubs, prepare for first case.
\n7:15 AM: \u00a0First case. Remove this person’s esophageal tumor.
\n11:00 AM: \u00a0That was fun! Another person saved.
\n11:15 AM: \u00a0Next case — bronchoscopy\/mediastinoscopy; darn, non-small-cell lung cancer. Cigarettes are bad.
\n1:00 PM: \u00a0Time to get lunch.
\n1:10 PM: \u00a0Finish grant proposal. Give feedback to army of office staff, nurses, and PAs, who work for us.
\n2:00 PM: \u00a0Next case. Remove this person’s lung nodule.
\n4:00 PM: \u00a0Granulomas on frozen section? Great, it’s not cancer! Call ID consult.
\n5:30 PM: \u00a0Start new grant proposal
\n7:00 PM: \u00a0Time to head home. I wonder what part of the chest I get to remove tomorrow?<\/p>\n

Now I don’t really<\/em> know what his day is like. He might as well be piloting a hovercraft in the Everglades, periodically pausing to shoot crocodiles — that’s about how close the ID doctors’ daily life is to this imagined Thoracic Surgery life.<\/p>\n

But I was thinking about this the other day when I was talking to him during a neighborhood party, because he implied mystification about what we do. In fact, he quickly acknowledged he couldn’t do what we do in a million years. “You guys know everything,” he said.<\/p>\n

(Thank you. I didn’t disabuse him of this view.)<\/p>\n

And while we might not — okay, don’t — know everything, it’s true we get to see absolutely everything that’s going on in the hospital. It really is quite extraordinary how diverse the cases we ID doctors see. On rounds or during clinic recently, I saw or heard about individual patients with the following medical\/surgical\/social\/miscellaneous histories:<\/p>\n

    \n
  1. Shot a raccoon.<\/li>\n
  2. Weight > 700 pounds. [Unable to verify exactly.]<\/li>\n
  3. Weight = 83 pounds.<\/li>\n
  4. Adult with complex congenital heart disease.<\/li>\n
  5. Six total joint replacements — of the same joint.<\/li>\n
  6. Just arrived here from Mali.<\/li>\n
  7. Has a cat, two dogs, two birds, a guinea pig, and a rabbit. [All completely unrelated<\/a> to his ID problem, but interesting nonetheless.]<\/li>\n
  8. Retired New Orleans chef, now sells pickles from his van.<\/li>\n
  9. CD4 = 6.<\/li>\n
  10. CD4 = 660.<\/li>\n
  11. Reported vodka consumption: 1-2 liters\/day. [They say always double what people report.]<\/li>\n
  12. Fever > 107\u00a0Fahrenheit.<\/li>\n
  13. Tattoos\u00a0on her ears — just her ears.<\/li>\n
  14. Started smoking at age 11 in Venezuela.<\/li>\n
  15. 80% surface area burn.<\/li>\n
  16. Speaks only Hmong.<\/li>\n
  17. Sells real estate on the Baja Peninsula, lives in Boston.<\/li>\n
  18. Regular\u00a0Tough Mudder<\/a> participant.<\/li>\n<\/ol>\n

    Note I deliberately left out specifically why<\/em> they needed ID consults, but you can probably imagine in most of the cases. (Maybe not the pickle guy.)<\/p>\n

    But ID issues aside, isn’t it incredible what we learn about medicine — and people — just from doing our job? What a privilege.<\/p>\n

    Almost<\/em> makes me regret whining about what we get paid.<\/p>\n","protected":false},"excerpt":{"rendered":"

    I have a friend who is a thoracic surgeon. Imagine his daily agenda: 5:00 AM: \u00a0Oops, slept late. 5:30 AM: \u00a0Drive to hospital; not much traffic. 6:00 AM: \u00a0Round on inpatients. They’re all doing great! Wonder why they’re not more talkative. 6:15 AM: \u00a0Coffee, gossip with other surgeons. 7:00 AM: \u00a0Get in scrubs, prepare for […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,8],"tags":[498],"class_list":["post-3478","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-patient-care","tag-infectious-diseases"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/3478","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=3478"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/3478\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=3478"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=3478"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=3478"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}