A Grave Disease

Tonight as I was riding the subway home after being out with friends, I had an odd experience.  As I was stepping onto the platform for my home stop, I noticed a homeless man with a sign which stated:

"Thyroid disease.  Please help." 

He was holding a plastic cup out for money.  He had severe exophthalmos--the characteristic stigmata of Grave's Disease, which is an autoimmune disease that leads to overactivity of the thyroid gland.  It can be life threatening if not controlled due to a situation called "thyroid storm."  This is exactly what you'd think it is: such an overabundance of thyroid hormone that it revs up the entire body.

To anyone outside of medicine, this man's exophthalmos coupled with his poverty would probably be a source of fear or mockery.  I initially started walking away, remembering my personal policy to not give money to homeless people, and to give of my time and talent when I am done with my training.

But for some reason, I was drawn to this man. 

I found a dollar in my wallet, walked back to him, and put it in his plastic cup. 

He said thank you, and I almost turned and walked away again, but the physician in me stopped.

"Are you getting healthcare?  You have Grave's Disease, right?"

I was surprised by his eloquence.  He told me he went to the county hospital, that he was taking the medication methimazole.  I asked him how much it cost.  He said he was covered under Medicaid, but he was living on the street and he needed money for food and shelter.  He asked me if I was a doctor, how long I had been one, and that it was amazing.  He kept repeating that it was amazing. 

The poverty in this city is heartbreaking.  I wonder if the stigma of this man's physical appearance from a disease he can't control is the source of his poverty.  Call me a bleeding heart but with everything that's going on with the budget in Congress, how can we cut healthcare funding for people like him?

As I have been on research for the past eight months, at times I feel like a small part of my identity has wilted.  The part of me that is a physician first and foremost.  But tonight, this man reminded me why I am here and what I'm trying to do.  He's right, being a physician is something amazing. 

Palliative Care is Over, But What Next?

I recently met someone great.  I was on palliative care as usual, just minding my own business, working, socializing.  Doing the usual things that I do--the comfort measures.  I went to a house party thrown by a friend about a month ago, and I met him.  We'll call him Grad Stud.  We talked for nearly three hours.  We emailed back and forth for about a month, and then we went out.  Three times in one week.  They were the best dates I've been on in over a year.  I got nervous.  Nothing had been this good for so long.  I worried that I would screw something up.  And then I did.

Then, he told me he ran into his ex, and realized he wasn't over her.

I knew there had been a recent breakup, but based on how things were going, I was surprised.  I didn't know what to say, so I said the first thing that came to my mind.

"I'm not a rebound kind of girl."

Well, I'm not.

The date ended quickly after my statement.

I have to say, I've been a bit distraught after this.  I gotten a lot of advice from many people.  There have basically been two camps.   Camp #1: I screwed this up royally by not being empathetic and helping him through this as a cool girl would.  Camp #2: I made the right choice by not playing second fiddle to the ex.

My head is swimming with the amount of conflicting advice I've received from a myriad of people--both men and women--and I have no idea what to do.

This experience has made me realize that I don't want to spend the rest of my life on palliative care, and that there's a great guy out there that I may have screwed things up with.  A lot of the advice I've gotten is all about little games, but I don't want to go that route.  Some folks are masters, but I'm perhaps a bit too simple for it.  It always seems to blow up in my face.

No resolution yet.

Spiffy New Design for Springtime

For my regulars, you may have noticed a little spring cleaning here on sex.and.the.scalpel! 

As many of you know, I love spring and summer.  There is nothing better than casting off the down coat with furry hood, and donning a lighter coat and a lighter attitude.  To go with the warming weather and wardrobe change, I figured it was time to revamp the site.

I'd like to thank my creative and talented web ninja, Marion, for designing the site and making it more user friendly.  Marion is incredible and if you'd like to check out more of her great work or hire her (yes, this is a shameless plug for Marion's talents!), follow these links to her blog and Marion Hires a Boss site.

There's more revamping to come--including a fabulous new banner--so stay tuned!