So, my knee is still clicking which means no running for me. I continue to try to at least walk a lot, but it’s not the same. A few years ago, I would have spent hours online trying to find an exact diagnosis for my condition, but now I know that it’s simply an overuse injury (on only 15 miles a week?! hard to believe) that will get better with rest, ice, stretching and NSAIDs. It doesn’t particularly matter which tendon, muscle or ligament is inflamed. Although, based on the location of the clicking and pain, visions of “pes anserinus” are flashing through my head.
On another note, coolrunning has sold out and switched over to active.com, which is a horrible, horrible website for logging runs. I’m very annoyed. I don’t like all these new-fangled things. Actually, it’s more that the website stinks. They have horrible ways of viewing and classifying your runs, and they don’t let you export the data to excel so if the website goes, so does your data on years of running. Don’t ask me why this data is important, it just is.
Further proof that I have an implacable competitive streak is that it’s very hard for me to hear about Eddie’s running now that I can’t run. Argh. He’s aiming to hit 1000 miles run this year, and it kills me that I won’t make that.
On a very different note, I find it hilarious that the Celtics have a player named “Big Baby!” How ridiculous is that?! How many non sequitors can I fit in one blog? My husband is now happily pointing out “Big Baby” to me, as we watch the Celtics attempt to crush the Pistons.
I read an interesting article in JAMA about the trade off between medical education and patient care. I think it’s something with which most residents struggle. I think this is especially true when you deal primarily with kids. Obviously we need to learn, but I’m sure that most parents don’t want their kid to be my first attempt at an IV, an LP or a urine cath. And I know my parents were horrified to discover that I had assisted quite a bit during a partial knee replacement as a 3rd year medical student. The question, at least for me, is whether we are obligated to explain to all patients our level of training and give them the option to refuse our care. The real problem comes in when we treat another medical professional who knows the system and requests to only be treated by an attending. If they can request that, shouldn’t all people be given that option? Or does coming to a teaching hospital mean that a patient can’t refuse treatment by a resident?
Of course, I think that sometimes there are benefits to being seen by a resident. Two heads (and sometimes three, if there’s a medical student involved) are often better than one. And residents are frequently more aware of recent research and new clinical practices. Plus, I think residents early in training may be more likely to look at a problem from outside the box or to consider alternative explanations. This doesn’t mean, of course, that I don’t go to sleep every night doubting some decision I made during the day. Wondering whether that slightly hazy chest xray was atelectasis or pneumonia or increased interstitial fluid. Whether I missed an ear infection because the kid was screaming, and it was impossible to see. Whether I should have done a urine cath on a febrile 2 year old. The list goes on and on.
I’m sure these musings are not comforting to the general population. And some of my ponderings probably haunt the minds of more experienced practitioners as well. After all, doctors are only human, and perhaps it is this constant wondering which will help make me a good pediatrician and a conscientious doctor.
