Scared Of Healing

A lot to talk about

I walk into my office, knowing that I have rounds in half an hour. I am intending on going to Ellie last on my rounds so I can send the students out after and continue talking with her. I sit at my desk and almost the second my body falls into my seat, my phone rings. I pick it up, "Dr Clifford speaking" I answer. "Hello Dr Clifford this is Dr Horan, we have located your patient's file" the man on the other end of the call says. "My patient Ellie?" I clarify, "yes, your patient Ellie Smythe" he replies. I nod to myself, quickly grabbing a pad and pen, ready to take down some notes. "Ellie has been a patient at SCH since she was three days old when she was diagnosed with Cystic Fibrosis. Our records state that she has missed her last two appointments but as far as we know, her parents are alive" he says. I nod to myself again before Dr Horan continues, "our last record shows that her FEV1 is on a steady decline from 57%" he speaks and I sigh, holding my head in my hand, knowing that an FEV1 of that low is not ideal, and that was at least three months ago, only leading to further decline. "What was her last sputum culture result?" I ask, wanting to know about her infection history. "Last we know she had incubated S. aureus and P. aeruginosa. She has had a history of recurring A. fumigatus as well as the others. She has had recurrent admissions to treat these as well" he answers, "as far as we know, she has isolated P. aeruginosa and has been struggling with a recurrent hemoptysis" I inform him. "Yes, recurrent hemoptysis is on her file" he says, "ok, is there anything else urgent I should know?" I ask. "It is on her record that she has anaphylaxis to codeine and an allergy to Orkambi, but there is nothing else that seems pertinent currently, I'm waiting for the go-ahead from legal to send the whole file soon" I am informed. "Thank you, we will continue treating her to the best of our ability and let you know if we believe she should be transferred down to you in Sydney" I say.

I'm wracking my brain trying to figure out what Orkambi is and suddenly remember that they have started rolling out gene modulators for people with Cystic Fibrosis and there is definitely one of those that starts with an "O". I quickly type the drug into my computer, taking a few shots in the dark with the spelling but eventually getting it. I see that Orkambi is a gene modulator for people with CF and is supposed to be life-changing. It is a real shame that she is allergic to it because it could have saved her so much of the struggles she is going through currently.

I walk out of my office ready to go through rounds with my interns.

After most of my rounds, we are walking towards Ellie's room. I have a lot to talk to Ellie about today and I don't know what is the priority. I walk into my patient's room and over to the sink to wash my hands, "good morning sweetheart" I say, drying my hands as interns flood the room. "Good morning" Ellie mumbles, smiling politely at the interns. "I've got a few things I want to talk to you about today" I say as I move to sit on a stool next to her. Ellie nods, waiting for me to continue. "We're just gonna let my friends do a quick assessment and we might talk after, would that be ok?" I suggest, wanting to buy myself some more time to prioritise our topics of conversation.

From the interns' assessment, my patient is still sick and I think the best thing for her at the moment is for us to actually go and look in her lungs with a scope. We will probably do a clean out as well and get all the mucus out so we can see properly. I know it's a very uncomfortable operation, but it's minor and will help us in the long run, it's just about getting her consent. Another thing to add to the list of priorities.