A Shout Out For Skills

You know that feeling....that feeling where you make a decision because you think it is the right one and then everyone comes down on you and wants you to change your mind? That's not a good feeling...especially on your first day as a hospitalist in a new hospital. It's better when the decision is to not have dessert and then everyone tells you you're silly for cutting calories and you should enjoy life and just eat the freakin' dessert. Much better. But I digress...

To set the stage in the vaguest possible way, I decided based on the clinical history and the impression of my colleagues when this particular baby was admitted, that I would treat for 14 days with an intravenous medication. I stress relying on the impression of my colleagues because it was a situation where I came on the scene on day 4 of admission and the baby looked very different to me than she did when she was admitted. I have faith in my fellow physicians and it does take a leap of faith to base a difficult treatment decision on a physical finding no longer present. For various reasons, this baby had to complete the entire 2 weeks of therapy in the hospital. You can imagine how the family received that news. Here is a rough approximation of how that conversation went as if you were only listening to my end...

"Unfortunately, the baby has to stay in the hospital getting this medicine intravenously for the next 9 days."
"Yes, I know all the tests were negative."
"Yes, I agree she looks great and has a normal exam today."
"I do feel strongly that this is the necessary treatment course for your baby."
"I know it is a hardship for you to drive here when you live an hour and a half away."
"You have a 2 year old at home? Wow, yes that will be tough for you."
"No, I won't change my mind on this."

It was difficult hearing the nurses whisper about what an inconvenience that was for the family and how sorry they felt for them. Difficult because I felt responsible for that hardship, it was ultimately my decision to make. A comment on a recent post of mine mentioned celebrating "the moments when I own my skills". I read that comment on the night that this happened and it reminded me that my responsibility is to ensure, as best I can, the health and safety of that baby. I own that responsibility and am grateful everyday to have the opportunity to practice my skills in this awesome career that I chose. That is something to celebrate. Thanks for the reminder.