Two pieces of chocolate cake, yes please

Since returning from my roadtrip, I've had a rough few weeks. Perhaps there was an influx of demanding inmates (or a release of some of the nice ones). Maybe it was the high drama of many people crying in the office due to pain, or the many people I have sent to the emergency room for evaluation. Regardless, I am feeling burned out and haven't been much up for blogging. So I couldn't pass up chocolate cake today when two pieces came my way. One of the nurses brought a chocolate cake made with sauerkraut, which was actually quite good. Then another nurse had me over for dinner and served a double layer chocolate cake. It was a nice treat.

Today I went searching for the results of a few studies I ordered. Unfortunately for me, but fortunately for the inmates, two of the ladies had been released to the community corrections program, where people are living in a half way house type setting. The medical file goes back to storage in Denver upon release so I may never see labs or studies I've ordered if the patient leaves before it can be reviewed. One particular patient had a complaint of a breast lump about a month before she left. I sent her for a mammogram and ultrasound, and she left prison two days later unbeknown to me. I requested the result today and it turns out she had a suspicious nodule that should be biopsied. I had to call her at her halfway house to break the news, and then send a certified letter with the results. They often have no insurance and very limited access to medical care once they are out of prison, so I have no idea how she will follow-up. It also frightens me to think what might have happened had I not remembered to check up on that result. I order a lot of studies here and can't be sure I always review the results before the patients disappear into the abyss of community corrections and the charts go back in to the ether. Sounds like a good way to get sued, which I am desperately trying to avoid. Yesterday a patient casually mentioned her ACLU medical malpractice lawyer during our visit. Not a good way to win over medical staff and impress others.