Trust Your Gut! And other lessons I learned when I swapped a lab coat for a hospital gown

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Twas the night before a shift, and I felt like crap. Nauseated, bloated, and uncomfortable. Having had no booze or inappropriate food to ‘earn’ such discomfort, I was mildly suspicious that something was brewing in my unhappy abdomen. I slept with a bowl beside my bed and set my alarm for my shift early the next morning. I arrived on time and worked the entire shift. After shift change, I moseyed over to a smart, talented, and ultrasound badass colleague coming in on afternoon shift, asking her to ultrasound a patient with a really tender abdomen. When she asked which room, I replied, “Any room you will see me in.”

My gallbladder looked fine. We were unable to visualize my appendix, but the adjacent bowel looked “angry” per her report. Soon we were interrupted by a trauma patient, and then it was time to go and put my kids to bed. Once again, I put a bowl beside my bed and tried to get comfortable before the butt crack of dawn alarm went off the next morning.

At 5 a.m., I was less uncomfortable, but I hadn’t challenged myself with food much since the onset of the symptoms. So I ate breakfast, not being the type to go 10 hours—much less three!—without eating. But the damn breakfast made it worse. My ultrasound-savvy colleague figured if I didn’t perf by shift change, she could re-check me. It seemed like a legit plan. I continued to see patients and tried to keep my whining to a minimum. After all, nobody likes a whiny coworker!

By end of the second shift, I was exhausted. I foolishly decided against the repeat ultrasound (secretly being a huge baby because it hurt to touch my abdomen at this point). Besides, I had to get to my Grandma’s 86th birthday party! I have only had one living grandparent for many years, and I didn’t want to miss celebrating her big day. I tried to hide my affliction, but turning down steak and homemade chocolate cake made my family suspicious, and I’m a rotten liar. Even my Grandma with severe macular degeneration wondered out loud why I looked like crap. Busted!

I stayed until the end of the party. Then I took my kids home and put them to bed. Then I took a shower and tried to talk myself out of my obvious diagnosis. Finally, I let my EM Doc husband (did I mention him before?) palpate my abdomen, and I nearly threw up. THEN I finally agreed to go get evaluated.

But wait…It’s Sunday night. Can’t I just wait until tomorrow and have my PCP order an outpatient scan? Nope. Ugh, fine! With my husband needing to stay home with the kids, I drove myself to the ER. You know, instead of calling on my large social support group, any one of whom I would gladly drop everything for and help. Nope, drove my stubborn self. The bumps did not feel great.

For insurance reasons, I couldn’t just go to my own ER, so I went to one in a different health system where I didn’t know anyone. I even brought my laptop, figuring I could get some work done while waiting for my PO contrast to percolate through my bowels. Everyone there was very kind and efficient. I didn’t announce my doc status at triage, but my husband had called ahead and the attending saw me pretty quickly. I’m not trying to abuse the system, but I love that we take care of our own tribe. I would do the same.

My CT was somewhat equivocal, according to the radiologist. This is the one time in my life that I cursed my paucity of visceral fat. The original suggestion was to get another CT in 4 hours…ugh! Fortunately, instead of making me glow with radiation therapy, the awesome EM Doc consulted with a surgeon who came in in the wee hours to examine me. My CT might have been equivocal, but my exam was decidedly not. He called in the OR team. Can’t this wait until morning? Nope. Well, damn.
My post-op diagnosis was acute appendicitis with a significant amount of free fluid. Quite frankly, I’m glad I didn’t perforate out of stubbornness and denial. Turns out knowledge of disease processes does not protect you from them!

I didn’t want to “bother” anyone until morning, and of course, everyone harassed me with “What the hell? Why didn’t you call me sooner?!” Of course, this was followed by an outpouring of well wishes and offers for assistance of all kinds. This was a big fork-in-the-road moment for me. I love helping others but kind of suck at asking for and/or accepting help. I decided to do something uncharacteristic – I decided to surrender and go all in. I said yes to every helpful offer! And guess what? I didn’t burst into flames!

What I gained from losing my appendix

Stop suffering unnecessarily!

We are waaaaay too macho in medicine! I am hardly advocating for calling in for a hangover or hangnail but seriously, why do we work when we are demonstrably sick? I have worked with gastro, hyperemesis, the flu, and have had two close family members die while I was on shift. THERE IS NO TROPHY FOR SUFFERING! Seriously! Putting ourselves and/or our patients at risk is not selfless; it is selfish and rather reckless. As much as we love a good “I’m the biggest badass” story, can we all please agree that this helps no one? Let’s create an environment where we support each other at our worst, so no one is afraid to call in and works two days with appendicitis, as I did!

It is OK to ask for help!

Accepting help does not diminish me in any way. In fact, it was a great bonding opportunity with my friends and family. I got flowers, homemade meals, babysitting help, and a bunch of hilariously inappropriate texts and memes that made me laugh so hard it hurt my stitches. It made people feel good to help, and they know I would do the same for them in a heartbeat. More than one person talked about how I had helped them, and they were glad to return the favor. I had always hated the idea of “burdening” anyone with my problems, but now I realize I was denying people the opportunity to connect with me. Want to visit? Great! Come see me at my disheveled, sore, post-op messy best, and I don’t even mind. The outpouring of love was wonderful, and I am so grateful that I was not too stubborn or stupid to let it warm my heart and soul.

Let Someone Else Be Your Doctor

I knew our pediatrician was the most amazing doc ever when she introduced herself with compassion and love and pointed at my newborn daughter and informed me, “You are not her doctor.” We all need an objective person in our lives! Kind of like the one who thought I needed to go to the OR when I was secretly hoping it was just indigestion. Get a doctor. Have check-ups. Because as a caretaker, the first person you need to take care of is yourself!

ABOUT THE AUTHOR

Dr. Hope is an attending physician at Beaumont Health System, Royal Oak campus and an Clinical Medicine Professor at Oakland University William Beaumont School of Medicine.

1 Comment

  1. Hear, here!
    Although we all know that a physician who treats him or herself has a fool for a patient, we nonetheless do it out of the exact same motivations you describe. So we are, in effect, all fools.
    Thanks for sharing the benefit of your newfound wisdom. Some MIGHT listen and learn…

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