Unintended Consequences

One of the great things of being in a group practice is meeting and taking care of patients who may not necessarily be on your own personal patient panel. Walking into the room, I hear the patient say, "Doc, you gotta help me." I see a red right forearm and on the "complaint" section, the nurse wrote "burn."

So, I ask, "Well how did you burn your arm?" "Well, doc, I got cancer." Hmm, that's interesting. I didn't make the connection until the next sentence. "It was my last treatment with chemotherapy about 2 weeks ago and for some reason, the needle slipped and the stuff went all over my arm. The cancer doc prescribed these pills, but they don't seem to be helping. I asked the pharmacist about some salves and this is what they said." He showed me a handful of creams and ointments purchased at the pharmacy.

Since I didn't know this patient at all, I was leafing through a very thick paper chart to try to catch up. "Yeah, I've been coming to see Doc [name] for a long time now. I'm glad you were able to see me today since his schedule was full." This very pleasant patient then told me about how they diagnosed his cancer - a tear came to his eye - it's like he was re-living that moment again.

I shifted the topic to his treatment, and he told me all about the cancer center he's been at and about his cancer doctor. "They told me all I needed was one more treatment, and this happens to my arm." "Well," I said, "unfortunately, this is something that sometimes happens during any kind of cancer treatment."

Together we came up with a treatment plan and I asked him to keep his appointment with his regular doctor for next week. "Thanks Doc," he said as I saw him walk carefully out to the front desk with his cane. Cancer therapy, whether it be chemotherapy, radiation, and/or surgery, can be tricky stuff sometimes. The goal is clear - elimination of the cancer. However, in trying to reach the goal, sometimes things get sidetracked....