Tuesday, November 28, 2006

Lunchbreak?

Mood: Huh?!
Drinking: Capri Sun
Listening to: people here outside
Eating: my black ballpen


I'm...
Well, I don't know what I am.
Or what I feel.
Therefore my mood is only described as Huh?!

Maybe I'm pissed.
Maybe I'm sad.
Maybe I'm still disgusted and now pissed.
Maybe I'm just a dumb dweeb.
But I can't help it.

I uploaded the new post to my blog and almost immediatley afterwards found out that Jim read it. Uh-oh, I thought, he'll sure want to talk about it after discussing the case. I wanted to wait until evening to tell him. Yeah, I know it was dumb then to publish it on my blog...No need to tell me.

I had a look at Jim's blog and spotted his new post. A photography of our new colleague Samuel Danby. First I just commented Yes, he's nice and thought of the bottle of Oban he handed me this morning. Then I had a second look and saw that Jim took this photo during his lunchbreak.
Well...I asked him if we had lunch together again today and he just told me he was 'busy'....So I went to the Chinese snack bar down the road with Foreman and had to pay for myself.
I'm not complaining about paying for myself!
I'm complaining about...well...I...
He said he was busy and seemed to have had a laid-back lunchbreak with Danby.
Thoughts were racing through my head and I felt...mulish.

So I phoned Jim and only barked "No need to come here, I'll figure that out alone!" into the phone, grabbed my coat, my bag, the file, the results and the laptop and went outside.
Now I'm at Community Park, Scotts Corner Road, watching passers-by and people walking their dogs, thinking about the case.
It seems to be Polycystic kidney disease - a progressive, genetic disorder of the kidneys.
Autosomal dominant PKD to be precise. This is the most common inherited form. Symptoms usually develop between the ages of 30 and 40 - my patient is 38, this fits. He has pain in the back and the sides (between the ribs and hips), and headaches.
Now I should ask one of the ducklings to strengthen my diagnosis by a family history of autosomal dominant PKD. We already know that there are cysts in other organs, but he'll get a CT scan as well.
If there's no family history, so what. In the absence of a family history of ADPKD, the presence of bilateral renal enlargement and cysts, with or without the presence of hepatic cysts, and the absence of other manifestations suggestive of a different renal cystic disease provide presumptive, but not definite, evidence for the diagnosis.

I think I'll phone them with my mobile and instruct them what to do.
I don't feel like going back to hospital now.

3 Comments:

Blogger Dr. James Wilson said...

You are mulish!

And be sure if I wouldn't have to speak with a patient in about three minutes I would come to that park and tell you right away what I am thinking about being blockheaded!

A laid-back lunchbreak, huh?! We talked about cases and Dr. Grinshold and Dr. Stern accompanied us - what a laid-back lunchbreak this was!

I am expecting you in my office in about half an hour and you'll better be there!

November 28, 2006  
Blogger Dr. Gregory House said...

Otherwise?
I'm not sure if I manage to get there in about half an hour.
You know, I'm packed with things, could take me a bit longer.

November 28, 2006  
Blogger Dr. James Wilson said...

You'll better hurry up then!

November 28, 2006  

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