Doctor, Heal Thyself

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One thing I never thought about before I went to medical school was how much I would be exposed to various illnesses as a physician. I guess you could say it’s an occupational hazard, but it can be downright frightening when you are exposed to some of the most virulent microbes which circulate in communities and in hospital environments. You’re bound to catch something at intervals.

Most people think of hospitals as disease-riddled, and they’re pretty much correct. But there are other places which have the potential to make you too weak to whip a gnat.

One of the worst environments is the pediatric setting, in which walking Petri dishes, also known as children, traipse into the clinic and somehow fling their nasty germs onto you. Before you know it, you are struck with a horrific infection that require an army of medications before you begin to feel human again. I remember spending the majority of my time in every single pediatrics rotation I completed, whether it was as a student, intern, or resident, so ill that I spent my days feeling like I had been hit by a truck, with a pressure cooker for a noggin, fuzzy-brained and miserable from whatever pathogen those little brats had brought to me.

Another microbe-filled gathering place is urgent care, a setting in which I have worked regularly over the past couple of years. Last year, when I was working more shifts than ever, I contracted three upper respiratory infections which progressed to bronchitis, and developed acute gastroenteritis (stomach flu) twice. Thank goodness I always get a flu shot every fall, otherwise I am sure I would have been hit with influenza as well. I see patients who are so sick that they can barely stay awake during their exams, people who have no business being out in public.

I recently saw a young female patient with a 103 degree fever who looked very ill, so I tested her for strep throat and influenza A&B. The nurse on staff asked if I wanted both, to which I replied, “Absolutely. I wouldn’t be surprised if both tests lit up like Christmas trees.” And they did. She actually had both influenza A and streptococcal pharyngitis. Poor girl.

It’s my duty as a physician to care for others, and I take it very seriously. But I will admit that my attitude towards my own illnesses is similar to the attitude of the Black Knight. My attitude is that it’s “only a flesh wound”, or “just a scratch” when I am ill or injured, so when I finally break down and admit that I am ill or injured, I am definitely in a bad place physically.

I suspect this attitude is similar to that of other physicians. So keep that in mind when you see that your provider is under the weather. We are only human as well.

Antibiotic Resistance

antibiotic resistance

I cringe every single time I hear people say that they stopped taking an antibiotic after a day or two because they felt better. Those of you who are not trained in medicine, who flippantly decide that you won’t continue to take an antibiotic because you “feel much better”, should be aware that by engaging in this habit, you are making the issue of antibiotic resistance even worse.

Bacteria are quite crafty, because they constantly find ways to neutralize or block the effects of antibiotics. Most of the time, they acquire genetic mutations from the bacteria which have become resistant. So even if some of the more susceptible bacteria die, even one resistant bacterium can multiply rapidly and thus replace all the bacteria which were killed. Those new bacteria also have the same resistance which the original stubborn bacterium has. This is how things can get pretty ugly pretty quickly in the face of bacterial resistance.
it is a virus
Antibiotic resistance can occur even when patients follow instructions and take the full course of antibiotic therapy, but the chances are far greater when patients miss doses or stop taking the medication because a smaller proportion of the bacteria are killed or inhibited. Another situation in which antibiotic resistance can run rampant is when antibiotics are taken for viral infections such as the common cold. Specific antibiotics are used for specific types and strains of bacteria, and are not one-size-fits-all medications. Yet people continue to foolishly turn to an antibiotic (usually one which was prescribed for a bacterial infection, and which was abandoned before the full course was taken) when they have symptoms which they believe to be from a bacterial source. I have even heard friends freely admit that they took their child’s or spouse’s leftover antibiotic in hopes that it would make them feel better.

Please don’t be one of those people who contributes to antibiotic resistance by being irresponsible about antibiotic use!