Does your job ever change someone’s life forever?

The Coffee Shop
1

I love my job. I am lucky enough to have many specialties and work in all the area in the lab. My favorite is blood bank, mostly because of the large number of things you have to know.

I work in hematology a lot so I can be back up for blood bank if things go bad. We are a level 1 trauma hospital so things can go sour fast.

Last Saturday I was working in hematology, we had a young lady come into the ER complaining of abdominal pain. The ER physician ordered the normal battery of tests which included a complete blood count.

I’ve been doing this a long time and as soon as I saw the specimen I knew it wasn’t going to be good news. I made a slide and put the specimen on the instrument. A normal white blood cell count is roughly 5-10. It has units attached, but it’s not important. I get the print out off the machine and her white cell count is approximately 500. Not good.

I have 10 minutes to call a critical result so I quickly liked at the slide. ~80% blasts. (Very early/young cells) Blasts are usually inside the bone marrow and dint get into the peripheral blood until they have matured. I looked through the patients records to see if she had a history, she did not.

I would usually just call the nurse and give them the critical, but I wanted to be sure of my results so I called the ER doc. I discussed the case with him for a while and released the result.

By what I saw under the scope and the high white cell count, she has an acute leukemia. Her life as she knew it is over. Depending on the leukemia type, her life may be over.

In ten minutes I reported a result that will be devastating to her and her family. It’s my job, but it’s a part I hate. I cannot even imagine how the physician feels having to tell the patient.

2

That’s heavy for sure. For an individual such as yourself it’s probably pretty easy to get dragged down by a result but look at the upside: at least with the diagnosis she has a chance. Surely through the course of your career your work will contribute to health outcomes that allow people to see their kids grow up, get married, and have families of their own… and all the other good things in life.

3

There are the good times for sure.

Working in blood bank and have a massive trauma come in and just keep giving blood products like crazy. Hectic and deadly.

Then you come in the next day and hear they are still alive. I wasn’t in the OR saving the life, but my blood products were a large part.

Or seeing a kid that has gone through chemo finally have a normal result. You know that kid is gonna be just fine.

Like I said, I love my job.

4

I feel for you. I’m not in the medical field, but like you, I love my job: my official title is Controls Systems Engineer. And most of the time I get to help people: I make their jobs easier, safer, more efficient or I get their machinery back up and running, saving people a ton of headaches.

However, there are also plenty of times that we engineer people’s jobs extinct. That can change people’s lives in a horrible way. And it really sucks… especially when the people who will be losing their jobs are helping you do the install. I really don’t like that part of my job.

Thankfully, I don’t have to deal with life and death situations. Well… at least I hope I don’t. God bless you folks that have to.

  • Jeff
5

That’s tough, but as GP already noted, I’m sure there are good parts as well.

I had a sentencing hearing this morning. Client has 30+ prior convictions ranging from Agg Battery, Agg Escape etc. to Driving while suspended. This puts him in a presumptive prison box per the sentencing guidelines. 99% of the time someone in his position is going back to prison.

That said, his last serious charge was over 8 years ago and since the last time he was released from prison he’s really gotten his shit together. Acquired a stable family, kids, involved positively in the community and miraculously a good, legitimate job despite his prior history. The current charge is a felony, due to a somewhat ridiculous anomaly in local state law and is nonviolent.

He didn’t want to plead despite the odds of success at trial being slim because he felt that he would just be agreeing to go back to prison. We worked the hell out of his case and eventually the PA agreed that though she formally had to request he serve his sentence due to the number of priors, she would make sure the court understood that she wouldn’t be upset if the court departed to probation. In a case like this if the PA isn’t pounding on the table demanding prison it is a win.

I convinced him that pleading, and accepting responsibility, despite the likelihood of a prison sentence, would actually be positive element in the argument for probation. We filed our departure motion, argued it to the court and low and behold she granted him a contract of probation. So, he gets to keep his job, his family keeps their house, the kids keep their father and he can keep building the productive life he’s managed to put together despite being a felon many times over.

I do think my work changed his life for the better. For me, this was a good day.

6

Well, yes, I would say. I work in a hospital (physio) where most patients have had a hip, knee or shoulder replacement. We see them a day after surgery, sometimes the same day. We get them up, do exercises, walking etc. In few days, they go home to resume their life with new joint and without pain. They can get back to most activities they did before. Although it is the surgeon that did the acctual joint replacement, I am part of the rehab team. Always a pleasure to see patients starting to walk and then go home.

7

I’m actually just downstream on a story like yours. I’m the clinical pharmacist on the cancer floor at the hospital here. Whenever I am reviewing new admits and I see a new acute leuk patient I feel for them. They’ve got a long battle in front of them that usually starts off with a 30+ day stay in the hospital. I always try and go in and talk to them for a little bit about their cancer (what it is what symptoms they have any why) and the treatment that we are going to give them (how it works, side effects, etc). I find that the doctors will sometimes be so focused on the plan or have so much to go over or sometimes use a little too much medical lingo that the patients don’t have a super great understanding of what all is going on. Not to say that the oncologists I work with are not great, because they are. But I try and simplify what the cancer is and why/how it is affecting them, why we think this treatment will help, etc so that they can understand it better. My theory is if they feel like they understand what is going on they might feel a little more empowered and a little more ready to take on the challenges that lay ahead

8

One day 15 years ago I saw a kid about 6 years old with Down’s syndrome with petechiae all over. Down’s syndrome people are prone to a number of things including leukemia so I had a pretty good idea what was going on. Sent off the blood sample and yup the poor kid and family has leukemia. That kid was cured I remember seeing him in emerg years later for something else.

Another memorable one. Mom brings ten year old into office with temp of 39C and petechiae all over. This is me one year into independent practice. Aside from the fever and rash the kid doesn’t look very sick but I was pretty sure this was meningococcemia. So I call local pediatrician mom drives kid to emerg they ram in some antibiotics before they even send off the tests. Kid had meningococcemia and was transferred to local teaching hospital and spent a week there but no complications. Six years later the kid is reffing soccer in a game my daughter is playing in.

Most of the time it is sore throats coughs and “I’m tired” but over the long haul lots of memorable events.

9

I love these stories.

I guess I never think about how much everyone else’s job affects everyone else. Pretty selfish of me.

Thanks for sharing and opening my eyes.

10

Quite a few people–yes

Usually very shorty after you hear “rifle” over the comms system.

/r

11

I wrote (part of a team of four) and led the team implementing a national oncology strategy

Encompassing total continium, from awareness and public health through to hospice care and a research strategy

Established patient Pathways, rapid access to diagnostics and treatments

Recruited surgeons, physicians, clinical nurse specialists, admin, psychologists and patient pathway coordinators.

Workes with all the specialities and departments, consolidated all oncology activity on to specific teams.

On a micro level I met patients occasionally, sat in on MDT’s but at a more macro level from the moment someone presented in primary care in the public or private sector anywhere in the country, with a suspected cancer they went on to Pathways I developed and implemented - and for the first two years they were Pathways my wife or I implemented.

It will take years for the benefits or otherwise to be seen in the data in terms of outcomes

What we did know was that we measured from receipt of first referral all the way through to first treatment that we monitored every aspect of their care and give prior to this work we had people arriving with coughs in stage 4 I suspect that simply implementing all the operational processes will have had a meaningful impact

I’m not a clinician, pharmacist, lab employee but have a pretty good grasp of the ops processes and that’s what we did.

I’d bet that we were seeing people earlier, getting diagnoses and starting treatment earlier. Time will tell if that’s the case

As an aside the first piece of work I ever did like this reduced call to dispatch times for blue light first responders by x seconds. The work made the papers and journals in the uk. It was a straight up process change. I never met any of the million callers that call London ambulance per annum. I was assured getting a vehicle on the road faster improves outcomes.

12

ED RN so yeah I take those critical results. But the doc is the one who has to go into the room…

13

I once (part) designed and implemented the global computer network for a major manufacturer of soft drinks and unhealthy snacks…

I’m sure i slightly helped make the world a fatter, less healthy place.

Mostly my current job is pointless. In fact today i quit, so my mood is slightly elevated. I haven’t told my wife yet…

14

I once (part) designed and implemented the global computer network for a major manufacturer of soft drinks and unhealthy snacks…

I’m sure i slightly helped make the world a fatter, less healthy place.

Mostly my current job is pointless. In fact today i quit, so my mood is slightly elevated. I haven’t told my wife yet…

Eek.

Good luck

15

Here is one that I share because it illustrates some important things.

Mom brings a infant into office. Cannot remember age something like ten months old. My wife’s patient but it is her afternoon off so I see the kid. Mom says one of his pupils is white. At this point the kid has seen my wife numerous times and a pediatrician shortly after birth and had a comprehensive exam with documented normal eye exam. My wife has also documented normal pupils.

I look at the kids pupils with eye scope and they look normal. So I say, “When are you seeing the white pupil?” Mom says she was holding him in her arms outside. Pull up the blinds in the exam room let the sun shine in and viola one pupil looks white. Off to the eye doc and then to Toronto to have eye removed because the kid has an eye tumor that will kill him if not done. Another few months he could have had a different outcome. Before she left I explain that I wouldn’t have seen it if she had not and that no one before me did anything wrong.

  1. I was lucky to have a world class medical education at a center that specialized in the type of tumor. We got overkill lecture hours on that eye tumor. Dumb luck

  2. If you listen to people instead of blowing them off sometimes you find stuff out you otherwise wouldn’t. But the scary thing is sometimes esp when you are busy you don’t think to ask the right questions.

16

Here is one that I share because it illustrates some important things.

Mom brings a infant into office. Cannot remember age something like ten months old. My wife’s patient but it is her afternoon off so I see the kid. Mom says one of his pupils is white. At this point the kid has seen my wife numerous times and a pediatrician shortly after birth and had a comprehensive exam with documented normal eye exam. My wife has also documented normal pupils.

I look at the kids pupils with eye scope and they look normal. So I say, “When are you seeing the white pupil?” Mom says she was holding him in her arms outside. Pull up the blinds in the exam room let the sun shine in and viola one pupil looks white. Off to the eye doc and then to Toronto to have eye removed because the kid has an eye tumor that will kill him if not done. Another few months he could have had a different outcome. Before she left I explain that I wouldn’t have seen it if she had not and that no one before me did anything wrong.

  1. I was lucky to have a world class medical education at a center that specialized in the type of tumor. We got overkill lecture hours on that eye tumor. Dumb luck

  2. If you listen to people instead of blowing them off sometimes you find stuff out you otherwise wouldn’t. But the scary thing is sometimes esp when you are busy you don’t think to ask the right questions.

Great story.

Tumor name please.

17

I’m sure i slightly helped make the world a fatter, less healthy place.

I work for the real Stark Industries

Our new SiL is retired Marine; her 2 boys are active Marines. So when I said “Yeah I like where I work. Not too thrilled with what our products do, though” She reminded that the planes, and drones, and missiles and radars and such we build are for US to keep the “bad guys away, and preserve democracy & freedom around the world” and we’re not the aggressive invaders

OK, sure; I replied “Yeah, I have to remind myself of that. Thanks”

That’s what I told her, anyway, just to put an end to the discussion; my opinion hasn’t changed

18

I am a Project Manager for a Virtual Behavioral Health initiative the Navy is funding. After my Doctor saw her second patient she texted me “we are saving lives”.

In a previous life I was a U. S. Navy Chief Independent Duty Corpsman, I served on Ships, in an ER and with the USMC in and out of combat. The worst case I am willing to share is when one of my staff walked into my clinic after a lunch time run where he was out breath. I saw large bruises dark purple bruises on both deltoids. "Dwayne how long have those bruises been there? “Two weeks”. I immediately walked in him to see the Doctor. The lab called the Doc at home that night with Critical Results and for the patient to report immediately to the Medical Center, initial diagnosis was Idiopathic Lymphocytosis. That was the last day he worked for us, from that point on it was all Medical for him. A year and a half later he lost the fight to A-Plastic Anemia.

19

In the end your illustration is the perfect example of where the most value is added by clinicians. Doing exactly what the training prepares them for. Most failures are process. Though the number of times I’ve seen people not referred when they should have been is astonishing really when combined with the psychological value of being told by their medical profession they don’t need anything and it turns out they did

20

Everyday, but not on a specific person to person basis. My equipment gets delivered and used in water and waste water treatment plants nation wide! Every time you flush, you can thank me.