Wednesday, May 30, 2012


     We all have different priorities. We value things differently. I am never going to buy shirt for $100. But I will not hesitate to spend as much as it takes for the education of my kids. I see this in medical practice all the times . Patients will have no problem spending $10 for smoking or $100 for name brand shoes, but they will have problem with co pay of $40 for buying an inhaler. So it does not surprise me when I see priorities which are different than mine . But sometimes I am also amazed.
    I was called from ER on one weekend . There was a 31 years old female who came to ER for the shortness of breath. She had breast augmentation done a day before . Her X -ray showed  partial collapse.of the lung. She was not in any distress but the collapse of the lung was significant and which meant that she would need chest tube to re-expand the collapsed lung. When I went to see her and examined her I realised that her recent breast augmentation was saline implant  and it was not yet 'localised' and was quite spread . I was not sure about the  extent of the implant . I was afraid that if I happen to make 'cut' to close to it or puncture it bu accident it would rupture and I would have more problem than the collapse of the lung.
    I decided to to call a chest surgeon. The chest tube was put in with no problem and she did fine.
    When I looked at the health insurance information I was not too surprised to know that she had no health insurance and so no doctor would get paid for his or her services. So the question was who paid for the breast augmentation?I asked her that question . The answer was some what surprising . This patient was a strip club dancer and one of the 'patron ' of the club was very 'happy ' with her and had paid for the surgery. So the breast augmentation was the 'priority ' for her and him and not getting ahead in life or get health insurance.

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