Unexpected Findings

As some of you might have noticed, I'm NOT the world's best person at hand-holding...as the man friend would say "this is one of those times when you hug the person" The patient was 55ish. male. two pack a day smoker for...30 ish years. laid off a year ago. now he's got a cold foot- NOOOOO problem! we fix those in our sleep! except one thing... We did a pre-op x-ray to look for where all the clots were in his legs, pre op. Because it's important. We found out something important...but not what we were expecting- we found out that he has a 13 cm by 13 cm mass on his adrenal gland. So...differential is cancer, cancer or cancer. and it's on the adrenals. so this poor man, who worked HARD for 30 plus years, and got laid off through no fault of his own (economy, yanno) is without insurance, and now he has vascular issues AND CANCER. And at 13 cm, i dont know if we can save him. We should be doing better as a nation. Because otherwise we have guys like this- YES he smoked. YES he shouldn't have- but...would you doom him for that? would you tell him "no sorry...you're broke and laid off, and you need to DIE NOW"... I couldn't bear to tell him that...but we might not have a choice... THIS is when i'm so glad I have ManFriend- he's a biologist, and i can tell him ANYTHING about my work, and he'll just hug me, and remind me why i need to go back in again...if I didn't have him, i'd have quit. I dont practice in an urban area, but TRUST ME when I say our rural poverty can take your urban poverty hands down some days. We've got so many people without hot water, without electricity, without ANY kind of services. And they live in log cabins tucked into the woods, no access to public buildings for showers, or internet. There IS NO CHANCE for them to take advantage of public programs. They just...die