Episode 6: If tomorrow never comes

Well, I must admit that this was quite a bad week. I was still on service, and my week consisted of arguments and difficulties with surgeons and consultants, and ended with me giving feedback to a medical student who spent the entire meeting crying. I felt bad, but I wasn't saying anything all that inflammatory. I was merely trying to make her a better doctor and I was nice about it. I swear.

But back to Grey's. After seeing Grey and McDreamy making out in a car, Grey's resident is intent on not letting McDreamy favor Meredith. I find this plotline dull, but not nearly as dull as George's ridiculous crush on Meredith. For one, his hair is terrible. I can't possibly take someone with this haircut seriously. Sadly, my hair looked a lot like his until 1:30 today when I finally got it cut. It's shorter now, and more shapely, I hope.

A good portion of the episode centers on a woman with a 60 pound tumor who is being cared for by Frat Boy until he accidentally leaves a microphone on while the patient is getting a CT scan and she overhears him wondering how she ever let a tumor get that large. It's a reasonable question, but as a doctor who was nearly crippled from rheumatoid arthritis before I finally broke down and saw a rheumatologist, I can understand how these things get away from a person. Ex is a doctor, too, and it was nearly two years of me saying "My hands were so stiff this morning but seem to be better now" before she finally said, "Do you possibly have RA?" Even then, I said, "No way. No way." Her response: "Yeah, no way. (pause) You know, if you have fibromyalgia, we're breaking up." 

In contrast to the character in the show who was afraid to seek help because she was sure she was dying, Ex was trying to say (in a very unpolitically correct and now-ironic way) that her fear (and, honestly, my fear, too) was not that I had a horrible illness but that what was wrong with me was going to be of unclear etiology. I was so scared that I had developed some chronic pain condition without a clear pathology that I didn't want to see a doctor. Getting a diagnosis of a serious disease sucked, but on some level it was a relief to not be "crazy." As Meredith says in this episode, "Sometimes, knowing is better than wondering."

Seeing Ellen Pompeo in jeans for the first time was a truly scary sight. Please, someone, hand that girl a sandwich. Her legs are like little toothpicks.

Two medical points to be made:

1. Burke says to Frat Boy, "You are 60% more likely to be sued if you’ve offended a patient" This has actually been studied: I couldn't find the 60% number, but respondents were more likely to sue if the communication from providers was unsatisfactory for the patients, particularly if no assurance was given that the mistake would be prevented in the future. 

I definitely use this theory for working with my patients-I made a special effort this week to spend time explaining things my patients who'd had problems because I believe that schmoozing/reassurance makes a difference. If I'm wrong, I'll have at least made the effort.

2. The cardiac surgery outcomes in this hospital are truly terrible. This is episode six. In episode 1, a CABG patient died; in episode 5 a patient ruptured her heart wall, bled into her chest, and had to go back to the OR. In this episode, a patient developed tamponade and PEA post op. Turns out that CABG outcomes are now published for many hospitals. If Seattle Grace, were a real hospital, it would likely not look as good as its competitors.

Best quote:

“Seriously? You’re equating your  pathetic lovelife with my record-breaking tumor? Seriously?”