Beringer White Zinfandal

Beringer White Zinfandel...whose tasting notes read "Beringer’s winemakers highlight Zinfandel’s characteristically bright, fruity characteristics to create a light, refreshing blush wine. Immediately following gentle destemming and crushing, the must (pulp, juice and skins) is quickly chilled to preserve its fresh strawberry, raspberry and orange peel aromas and flavors. Just as a slight rose hue develops, the juice is pressed off the skins and fermented at carefully controlled, cool temperatures. To impart a slightly creamy texture and round out the vibrant berry and citrus flavors with notes of pear, apple and nutmeg spice, Beringer’s winemakers blend in approximately twenty-percent barrel-fermented Chardonnay" (http://www.beringer.com/)

Ah, this all sounds very nice and can be quite enjoyable on a hot summer day or evening in Phoenix when we are living in temperatures in the 100's. And everyone knows that I enjoy a nice glass of wine and appreciate it for what it is; however, when I am at work alcohol, wine, drugs, etc are NOT tolerated, by my hospital or by me!

This all leads me into the ridiculous story I have to share about this inexpensive wine. I had a patient (who I had been warned earlier that the friends were a little "suspicious"). She was on the floor but had developed a high fever, increased HR, and decreased blood pressure and they were worried she was going septic. They wanted to watch her overnight in the ICU...give her some good 1:1 care...watch her vitals, give her fluids, antibiotics, etc. No problem. Well, around 1 am her friends start arriving (would you visit your sick friend at 1am in the morning if they were at home??) and I noticed this one kid acting really boisterous and arrogant. I go to get her antibiotic drip and when I come back I see the curtain is completely closed....uhhh....thats a no-go in here. Unless there is a reason that has been discussed with the nurse, curtains aren't closed like that in the ICU. So as I walk in, the kid tries to keep me from coming in (that wasn't happening!) and as I walk around the side of the bed to the IV pole...what do I see open on the side table?

I went from 0 to 10 immediately on the anger scale. There are so many reasons why, the first being the idea you are trying to develop trust with your patient and vice versa...well, that was a big slap in the face and out of the question now. Second, I am giving this patient IV narcotics every hour for her pain and now I have the suspicion she could be consuming alcohol? And the audacity of these people to not respect the environment they are in. Not only are you in a hospital, you are in an Intensive Care Unit! I told them it was completely inappropriate, I couldn't believe they had the nerve to bring this in and that now I am under suspicion my patient may have been drinking. It was absolutely not tolerated, they needed to leave and I escorted them out.

Guess that is just one more night in the Trauma ICU....sure this won't be my first go-around with something like this!

Medical Ethics: Truth Telling

Had my first case where I was confronted with an ethical dilemma, to share the news of a diagnosis with a patient or to honor the wishes of his mother which was to tell him he was "okay" and "going to get better". In this case, he was a permanent paraplegic and yes, he would probably get "better" but not in terms of ever walking again. I stumbled upon this situation when he asked me why he couldn't move his legs and I explained to him what happened...only to find out this kid who had been in the hospital 2 weeks had not been informed of his diagnosis (or at least he was still under too much medication to comprehend what happened). In the end, after I talked to him about his diagnosis his attitude changed to one of defiance, anger and frustration from what I now see as being confused and knowing something was wrong with him but no one telling him to a cooperative, grateful kid who was facing his future head on. He went from pulling out tubes (PEG tube, self extubating, pulling out IV's, etc!) to brushing his own teeth, suctioning his own mouth and helping to reposition himself as best he could. I think in this case, it was better to talk with him in a kind, gentle yet honest manner instead of acting like nothing was wrong.

http://depts.washington.edu/bioethx/topics/truth.html