Diaries worth sharing

Sometimes I didn't realise the value of appreciating the nature or natural phenomena that goes through be it our body or the universe

I've always been fond of nervous system it's uncertainty and its beautiful feature of plasticity,the way it naturally tries to mold to adjust and make us the better ones 

Could we really be any btr without its plasticity ?!!

Few patient's have taught us how life happens and takes a sudden course of downhill , how some go uphill y is d life so uncertain.

Could we as physicians bring any difference to their or so called our lives!!?

When do we know if it's early or late ?! Who could decide this for?!

I've had few cases not just academically but has taught me life worth lessons

1- A case of elderly male with diagnosis of multiple myeloma,  journey to the diagnosis made me realise how uncertain ones lives are and how unpredictable course could be 

In the beginning we tried ruling out infective cause--- but then still q remained the same of WHY??

We've pondered, reviewed, discussed it's correlation with cns features making me realise it isn't always one organ u deal with we deal with HUMAN BODY as a whole 

we've then found through biopsy that the patient developed multiple myeloma with extrapyramidal features suggesting it could be ? Mets or ? Carcinomatous meningitis? PNS 

Questions remained unanswered , questions left unasked with no .(pullstop)But only a , (comma)as the journey for such patients still continue may be not this patient though as he expired few days of his diagnosis

2-  A young female who developed postpartum Hypertension( eclampsia) during her 2nd pregnancy landed requiring dialysis for her renal failure , pres  

A young joyful female who is supposed to look after her child post delivery was stuck struggling for her own breath in our icu for 10 days , getting dialysis done, coughing her heart out with pinkish sputum

Thinking , reviewing regarding her made me realise things weren't always the same no matter how same the situations are 

Could it autoimmune ?!! Infectious??!!

Did the diagnosis really mattered to her!! All she would want is to stay by her child and family as happy as before

But diagnosis couldve helped us have a way out of this uncertainties and could throw light on her management 

These questions were answered may be infectious ! But what's the certainty!

3- 35 male , ambulance driver was brought with jaundice ,anaemia, skin lesions

History of ? Herbal medication intially thought to be hepatitis ---> toxin mediated 

Through the journey of identifying the toxin made me realise how uncertain/atypical presentations could be

How could we get Labs at our own hands- smears,  Biochem tests , estimation of proteins,electrolytes

How fun labs actually are especially pathology 

But still our question remained unanswered 

4- 19F with catastrophic APLA , lupus nephritis 

How uncertain and unpredictable her journey was, which was enlightening and joyful 

Realised value of autoimmunity how suppression could easily rever these changes back to normal , may b thanks to plasticity

Being vigilant in monitoring and following up these cases made me realise how responsible as a Physician one should be 

That cute little girl with bright smile on her face as she always calls me Deepakka just gives a pure sense of joy and happiness , may be it's all afterall we r working for??!!!

5- 47 year old female with lupus nephritis 

What a wonderful journey through out her hospital course-

From Tb---> nephrotic syndrome-->chylous ascitis--->autoimmune (scleroderma)

Through out her journey I've learnt clinical signs --though looks deceiving could actually help us 

Reading , pondering ,penning our thoughts on casesheets making them to reality wasn't always an easy thing 

Making contacts does help ( haha )for sending biopsy 

Finally report showing lupus nephritis just gave a small sense of honour to the team I've worked 

6-Elderly male when brought with chronic vomiting with weakness of lower limbs 

Attenders were really apprehensive about his diagnosis despite his multiple trips to various hospitals no diagnosis was made 

All they were left with were those burdensome medical bills 

Questions left unanswered

Realised through this journey the value of History and importance of clinical examination

Irony is that the diagnosis which they are waiting for isn't always the one ,one would want to have !!

Hoping those answers answered as cerebellar lesion in left side were cured and patient led his life the way he wanted

On followup found the patient having grade 4 astrocytoma and was operated for the same

Later post surgery patient expired,

having his diagnosis helped him? Having him not operated would have made live longer??!!

Was knowing cause for his death at the cost of his life worth it?!!

Sometimes somethings are better left unanswered!