This week all the talk in the HSS Rheumatology Department was the Supreme Court's decision on Obamacare. Dr. Lockshin shared with me his experience as a young resident when Medicare and Medicaid were first enacted, it was an amazing story. I, being born only slightly over two decades ago, have no idea what it was like when there was no government support for healthcare.
This week I spent the majority of my week continuing to shadow Dr. Lockshin in his office visits. While I would say the normal visit is a followup just to see if someone's disease is active, this week I was able to see some patients in more devastating states than I had previously. For example, I saw a young girl with lupus nephritis, who is in complete renal failure, has to undergo blood transfusions because she is making no blood on her own, and to top it all off, now has a partially collapsed lung. But in spite of it all, she remains relatively upbeat and confident. She claimed that she is glad she is the one with the disease and not someone who can't handle it. She was very inspirational and extremely strong.
I also saw a woman who has sever rheumatoid arthritis whose joints in her hands and wrists are completely destroyed, and whose neck can no longer support her.
I have also discussed with Dr. Lockshin a lot about the board guidelines for care. He was telling me how the American Board of Rheumatology releases guidelines for treating the various diseases, but how it is hard to follow them to point with every patient. Every patient is different and many times the guidelines don't fit with the patient's needs or wants.
Next week I am looking forward to doing some ICU rounds and perhaps sitting in on some surgeries. Though, it will most likely be a slower week due to the holiday.
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