MDD

Last night I was on call and was hanging out in the doctor's lounge waiting for the next time I needed to go check on my laboring patient. When I realized that watching "The Bachelorette" was a poor use of my time I decided to go through some of my charts on our electronic medical records that were in desperate need of updating. Once my documenting and billing were caught up (and, trust me, that is the worst part of my job but is so much better if you stay on top of it), it was a good time to check on a few of my clinic patients. Some I had sent to see specialists, were scheduled for procedures, or were just interesting cases that I was curious to know what has happened since I saw them last.

I came across one patient who I had been seeing every few weeks this spring. I realized I hadn't seen her for a little while even though I remembered having her schedule a follow up because we weren't yet satisfied with our results. Maybe what we tried the last time was doing the trick, and she was feeling better. Maybe she had gone to see someone else to get a different perspective. (Which by the way, I totally, 100% respect and sometimes even encourage. Medicine is an art and sometimes it just takes finding the right artist.) However, when I clicked on her record I saw the dreaded "History & Physical" note that had been entered since I had seen her last. A few notes later was one titled "Discharge Note." My patient had been hospitalized. Instantly, I feared the worst. Had I missed something? Had I done something that made the problem worse or even created a new one? Hopefully, it was completely unrelated like she fell and broke her leg or something. (Not that I would ever literally hope a patient would break their leg.)

My fears became reality when I opened the notes and saw her reason for admission - suicide attempt. If that wasn't bad enough, she'd tried to take her own life with medications that I had prescribed. Talk about a sock in the gut! I felt terrible. I felt like a failure. Why didn't she come to see me before it got that bad? If she had, what would I have done? What could I have done differently in the first place? My mind raced with questions. I wanted to know more. I wanted to call her or go see her and make sure things were okay. I wanted her to know that I still cared, that I still want to help. Oh how I hope she comes back to clinic, or even that I run into her at Walmart, just to say "hi" and so that I can know that she still smiles.

Sadly, by far the most common disease that I have seen and treated in my clinic has been depression. It is everywhere. Sure, sometimes people just have stressful lives which we try to fix by incorrectly labeling it as depression. However, this terrible disease strikes the least and most suspecting without a second thought. Honestly, sometimes when my clinic is busy and I'm getting behind I hesitate to screen my patients for it for fear that I'm opening a can of worms. Even so, I have never regretted asking. It makes it all worth it for the times that someone comes back for follow-up after their depression is being treated, and instantaneously I know they are feeling better just by the glow on their face from across the room. You can't miss the happiness in their voice or the sparkle in their eyes. It's wonderful.

Although, I wish I could have done more in this case, I also know that I won't, and can't, fix everything. This will not be the last time I come across this when I'm updating my medical records on a long call night. Hopefully, we all learned a little something and can be better people for it.