Bear mountain

I enjoyed the wine, chips and gummy worms at the top.

From a birthday stroll through a graveyard.

My future coffee shop.

Happy fish smiles

Barry and Buster

No right answer for things.

Today, a daughter and mother had to decide whether to give the unresponsive elderly father a feeding tube through his abdomen into his stomach or whether to bring him to hospice care. Before coming to the hospital he had advanced dementia but would sing songs to his family. When he came to the hospital he has been sleeping and has minimal brain activity. The mom, elderly, only speaks Italian and during the family meeting today we weren’t sure if she didn’t understand the situation or if she wasn’t absorbing it. The daughter, who is the health care proxy, was at one point made it very clear that he was full code. But today, crying, she thought perhaps keeping him alive for as long as possible no matter what may not be the best decision. I remember the first time I saw the patient in the emergency room. His elderly wife next to him, so little small and seated in the plastic chair, waiting for her firey daughter to finish reprimanding the medical team for not keeping her in the loop at the start so that her daughter could translate everything that was going on to her. When everything had been smoothed out with the attending and the daughter, the attending asked if the daughter or mom had any other concerns. The mother reminded the daughter of something and the daughter translated that the mother was concerned because her husband, hypoglycemic and unresponsive, still hadn’t had his flu shot. I felt so sad that moment.

New new

When I was in Surgery I would see the kids in internal medicine rotation and think “Weenies.”

They were laughing, happy, so young and free. At least, that’s how it seemed through my eyes, burning from weeks of waking up at 4:30am to stay at the hospital until 6pm.

Now I’m in medicine myself and I don’t feel bad at all. I like IM.