Stunned in a sea of infection

I am stunned in a sea of infection.

No, I do not have a delirium.  I just happen to be rotating through Infectious Diseases (herein ID).

I haven’t felt this dumb in a few rotations.

Image via escapeinabook.blogspot.com.

Okay, I haven’t been on a new rotation in a few rotations, so I guess that it is fair game.

But still… Last time I felt this stunned was Bone Marrow Transplant and prior to that, Cardiology.

I wish it was as cool as running around in hazmat suits trying to ward off the next pandemic superbug.  And some days, it feels a tiny bit like that.  Most of the time, it involves looking at stinky post-op wound infections (oh boy, did I ever smell a doozy today) and trying to sort our prolonged febrile neutropenias.

I like the detective work that can come from ID.  Sometimes, you have to piece together the presentation and patterns in fevers or bacteria to figure out the cause.  Sometimes, you get to find that kind of rare, super cool cause of something.  Just like on  House, MD but without the overqualified and giant team who can do whatever they basically want around the hospital… So, not really like that at all.

Image from housemdconfessions.tumblr.com.

I love the problem solving side of consult-based medicine.  The swoop in a problem solve is cool, but as I think I have said before, I much prefer the continuity of care that is being the prirmary caregiver.

But back to my feeling stunned…

I have never been a big one for microbiology and things.  Antibiotics are a big black box.  I know the go to antibiotic for the common problems and beyond that, I look it up or, well, call ID.  And anything beyond your common yeast infection or virus is basically outside of my comfort zone.

Thus, I find it challenging to sort out a lot of these cases.  It isn’t in my natural knowledge base and sometimes, I struggle even to know how or where to look it up.I get that this is the reason why we do this rotation.

I just hate that floundering feeling of seeing consults and follow-ups and sometimes not really having a clear grasp of what the plan is or will be.  And yes, that happens on most rotations at times, but as you learn, it happens less and less.  It just seems that hopping to this rotation, it is currently happening more and more.

It all comes with time and experience and reading. But until then, it also comes with a lot of, “I’ll look that up” or “I need to talk to my staff doctor about this” and, of course, the “I don’t know.”  Oh, and a lot of changes to my “assessment and plans,” which make me cringe a little.

That is the thing with medicine, the more you learn, the more you learn you don’t know.  This is yet again another area where I clearly don’t know a lot… At least I figured out that much.

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7 thoughts on “Stunned in a sea of infection

  1. I thought of you today and remembered you were on an Infectious diseases rotation. Have you ever noticed that if adults contract infectious diseases that usually are more common in children, that it is usually much worse?

    My husband contracted Fifth’s disease many years ago and was so ill with fever, joint pain, and achiness. The docs couldn’t figure out what was wrong with him– it was our pediatrician (who is brilliant by the way) who diagnosed him in casual conversation. Yesterday we learned our 21 year old college student has Hand Foot and Mouth disease and boy is he sick. We had to take him to the ER today as his tongue was so swollen. He can’t talk or eat and was dehydrated so had to have IV fluids. I feel so bad for him. The ER doc told us that adults usually get it much worse than the pediatric patients and usually only the mouth is involved and not the hands and feet. I find all this stuff so interesting. I do wonder why adults are affected worse than the little guys.

    • I have noticed that adults contract “childhood” diseases and often get more sick than they would have as kids. I wonder if part of it is that kids are just so resilient and if part of it is because of how our systems are built and when the natural progression of things should have had us contract those diseases.
      Kids aren’t just little adults, so it kind of makes sense. They are metabolically a bit different.
      It can also go the reverse, small children who contract the herpes virus that gives cold sores can get a really severe gingivostomatitis that lands them in hospital requiring IV fluids and pain meds. Same with infants who pick up STIs in utero or at birth.
      Your poor son. Hopefully, he will feel better soon.

  2. Now that antibiotics are “practically obsolete”, have you started looking at the studies on essential oils and antibiotic properties? I have used medical honey very successfully for MRSA on my daughter when nothing else worked. I believe there is a plethora of essential oils out there that could be used now successfully if more research dollars were allocated for them. Oregano oil alone has a powerhouse of antibiotic and antifungal properties. Great Britian is big into research on essential oils, you may want to take a look.

    • Actually, we were talking on rounds about some “novel” agents the other day and how more research is going in to some essential oils with antibiotic properties. When you think about it, many antibiotics are based on naturally occurring substances… Penicillins from molds, etc. But, there is lots left untapped.
      Our bigger problem is to stop hammering everyone and everything with antibiotics, anti-bacterials and such unless absolutely necessary, so that we stop gaining resistance patterns that force us to have to keep changing tactics.

      • You are right, I don’t go to the Dr or an antibiotic consult unless I have had fever for 5 days. And that hasn’t happened in a long time. Otherwise I use appropriate OTC meds to relieve the worst of the symptoms and grin and bear the self limiting ailment. And use oregano oil, it kills virus’s too. Good stuff! Glad to hear that providers are looking more earnestly over the essential oils. The amazing thing about them is the number of constituents in them. Many have over 300 antioxidant or anti-bacterial/fungal constituents. Most antibiotics have only a couple, hence the conversion of bacteria to superbugs. Dr Valnet is the father of the antibiogram and a lifelong researcher of antibiotics. He is a great person to read about.

  3. Ah, yes, ID. I’ve been (un?)fortunate enough to have two peds rotations and one internal rotation where the team leader was an ID specialist. Like you, I enjoy the investigative aspects, but the micro is just… it’s micro. Good luck – I’m sure you will feel less out of your element soon!

    • Haha… It is starting to feel a bit better already.
      I have somehow avoided working with ID specialists until now. Just by chance of who I worked with on my rotations.

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