VA

Yesterday I had clinic in the morning, and four hours of lecture in the afternoon. I saw a few interesting patients, two of them were patients I had seen last week. Lecture was unremarkable.

This morning I went to nephrology clinic at the VA and saw five people with renal failure. It is a little strange there because one has to type up the progress note as one talks to the patient. And, since none of the patients have any idea what medical problems they have, why and when they had procedures done, and what medications they are on, one has to spend fifteen minutes searching through the chart on the computer. I think after a while I would get used to it, but it is rather frustrating right now. I asked one patient if he had high blood pressure, and he said no, it’s always good. I looked at his chart and saw that he was on three blood pressure medications. After asking several patients when they had certain (often very invasive) procedures done, and getting a blank look in return, I have learned to just look it up in the chart. It should be interesting when I have to do inpatient there next month.

I saw one patient who had one of his legs and half of his other foot amputated due to his uncontrolled diabetes. Now, his kidneys are going, and he is starting to lose his vision, but he still seems perfectly content to let his blood sugar go to three times normal. I can’t comprehend that.