So, I have this bad habit of logging in to the hospital computer from home to check up on my patients. Before I left this afternoon, my attending was grilling me on why I ordered a CT angiogram on a patient of mine this morning. I defended my actions to her, but could tell that she wasn't too impressed that I had ordered a test which will probably cost the hospital a few thousand dollars. At 7 a.m., when I ordered the test, I knew I would have to defend my actions. This patient, has been complaining of a pain, and we haven't found and the source. The pain is not due to kidney stones, nor due to a kidney infection, so based on the fact that she uses injection drugs, I was worried about disease in the lung. I figured she had a lung infection which hadn't shown up on a normal chest x-ray. So I ordered the CT angiogram, cognizant of the fact that this patient doesn't have insurance.
And guess what, it shows that she has multiple tiny infections in the lung. The best part, is that they called my attending with the results. I wish I could have been there to seen her face when she found out that the test, which she criticized, had proven exactly what I was looking for.
Intern =1, Attending =0
And like that, all of a sudden, my confidence is right back to where it was before this downward spiral began.