We began the process of giving her diuretics to remove extra fluid, cleaning and dressing her wounds, using mechanical lifts to be able to lift the skirt of fat and fluid to care for the skin underneath. Virtual Heart Failure Care No Substitute for the Face-to-Face Visit. There are also letters and announcements and educational sections for doctors or patients, even poems, but the part I like to read all the way through is called A Piece of My Mind. We fuss and connive about how we might move them out of our hospitals and eventually, for most of them, this happens. So what do we do about patients like this, ones who can’t go home? The image of 'Bedlam' The Bethlem has long been associated with scandal and abuse in the public mind - although this was in fact intermittent rather than a permanent feature. She could barely breathe and was so heavy and weak that she could only just move her arms. This can be good all around. We die in much the same way. Bedlam’s history of patient abuse has been the inspiration for a number of horror tales, including the 1946 Boris Karloff film BEDLAM and the 2011 BBC TV series BEDLAM starring Theo James. It’s time we stop saying “black cloud” and “black weekend”, Physicians are tired of being judged based on their gender, The impact of COVID-19 on resident burnout and how we can combat it, We’re not trying to survive, but to humanize. < Previous post Inpatient vs. observation: We have created a monster of our own making. He was treated with the proper antibiotics, but ended up with abscesses in his brain, which made him confused and difficult to handle. Physical therapy worked with her daily and by the time of discharge, she could climb stairs and walk the halls alone. How can you be in a relationship with someone if you don’t speak the same language? This started decades ago when health care costs were first starting to be alarming to payers, especially Medicare. When she got to our emergency department, it was difficult to maintain her oxygen level. It is time to acknowledge the caretaking abilities of men. The most shocking aspect of Bethlem was how the hospital ran tours of their patients which were open to the general public in the 17th century. The most recent title was “A Place to Stay,” written by Benjamin Clark, an internist at the Yale-New Haven Medical Center. How physicians can be activists [PODCAST], Medical students: The work you do matters, Adjuvant RT Not Needed in Most Men With Prostate Cancer. In actual fact, we all do. Rural America in Trouble; Remdesivir Evidence, iMedicalApps: ASNC Guidelines and Standards, Behavioral Health Faces Challenges During and After the Pandemic, The Rise of the 'Payvider' and Other Healthcare Trends to Watch, MEDIOLA Examines Triplet Therapy in Ovarian Cancer, Novel Denervation Tx May Correct Fluid Imbalance in HFpEF. Over the course of 5 weeks, she was able to lose nearly 200 pounds of primarily water weight, with daily attention to replacement of rapidly depleted electrolytes. During their stays, we feel frustration and experience dread as we repeatedly fail to do our job as hospitalists which is to get them better and get them out. He needed at least six weeks of intravenous antibiotics. We stew. Get free updates delivered free to your inbox. JAMA is primarily a research journal, filled with new scientific or semi-scientific studies and comments on those, plus reviews of the literature and editorials on science or politics. He had a long-term central intravenous catheter (PICC line) that we placed in hopes that he might be able to get antibiotics as an outpatient, but his parade of misfortunes made it impossible for him to survive outside of an actual hospital and the temptation to inject heroin into his pristine PICC if he were on the outside made it unwise once he stabilized.