Please share your most interesting case with a patient
The most interesting case that I’ve had occurred approximately four months ago. It was a young female patient that had come to the Ridge Meadows emergency department with extreme bilateral lower extremity pain and intermittent hallucinations. I had gotten some collateral information from the paramedics that she had struggled with cocaine and methamphetamine use in the past. The patient was actually able to disclose to me that she had tried new synthetic methamphetamine provided to her by any unknown individual. It had resulted in her having extreme electrolyte derangements, extreme heart failure, and severe bilateral lower extremity rhabdomyolysis. Needless to say, she was very sick. She required urgent transferred to Royal Columbian Hospital to undergo ECMO and bilateral lower extremity fasciotomies to save her life. What was outstanding about that case was that her heart function dropped down to approximately 5% which I had never heard of before. Interestingly, I received a phone call about four or five days later after having transferred the patient. The intensivist mentioned that the patient had actually survived, when her initial prognosis was extremely guarded. It was my first case of synthetic drug overdose in a patient, and one that I hope to never see again.
What was the best advice you were given during your time in medical school that has had a lasting impact on your practice?
The best advice that I have received during medical school was to take advantage of any opportunity that was presented to me, regardless of the time, place or situation that I was in. Even if it was towards the end of my day and I was handed the opportunity to do something cool – like a procedure, or to see an interesting case, I would always try to take that opportunity. I never knew when I would be given the chance to see that same thing again.
What are you doing currently/working on/interested in that is helping to impact our local medical community and/or local patients?
The one thing that I’m working on right now is how to better streamline the referral system from our emergency department to our local specialists such as – internal medicine, the orthopedic surgeons, general surgery, etc. As one can imagine, some referrals may fall through the cracks or end up on our specialist’s office much later than what we had hoped. What I am hoping for is uniformed, more efficient, and effective way to streamline these referrals from the emergency department.
What is some advice or wisdom you would like to share with your medical staff peers, or any new physicians joining our community?
I would encourage any new physician to engage with other physicians outside of their immediate surroundings. I would encourage them to seek out resources they have at their disposal to help care of the patient in front of them, and that when help is needed, there will always be someone on the other end of the phone.