I had a really good day at work yesterday. I saved a mans life. I don't save lives every day, even though my friends and family think I do like they do on ER, but I do save fingers and toes and prevent people from having ugly scars by my perfection in suturing. However yesterday I seriously saved someone from the grave and it felt so good.
Mr. 74 year old was put over in the fast track by the cocky triage nurse who told me that the man just tweaked his back. Keep in mind this nurse had previously put a person over there telling me it might be a dislocated shoulder, which didn't belong over there either. I admit I never smile when this nurse comes around because he drives me nuts. Back to Mr. 74...I ask him about why he is there and after he tells me this long story about how he was trying to see if his cat got a hold of his wives jewelry he eventually tells me that he had some pretty severe mid back pain 40 minutes later that radiated around to his chest, but he took a percocet and was feeling better. Back pain radiating to his chest in a 74 year old immediately makes me think of an aortic aneurysm. On exam I'm unable to reproduce any pain except for the epigastric/lower chest region.
I get an EKG and blood work which are normal and a few hours later I get the results of the CT scan which shows a hemorrhage of the descending aorta with an ulcer into the diaphragm. I've never seen this in my entire career. I go in to talk to this man and tell him that I saved his life. I was pretty much jumping for joy and Mr. 74 year old was shedding tears and so grateful. It totally made my day. I told him that everyday I pray that I'll be in tune with the needs of my patients, that I won't miss anything important or life threatening. I talked with him about my belief in God and that He hears prayers. My attending thanked me for not sending diagnosing him with a back spasm and sending him home with flexeril. Ah, I love my job!