I am almost done with residency for the second time, unless another unexpected life event happens (for the third time amirite!?). And I thought about writing this post as a resident in the midst of studying for my boards. Let me rephrase that— as an immunocompromised resident in the midst of studying for my boards. So this one is for the residents out there. <3

We learn about rare diseases all of the time. And usually, they are no big deal for The Regular Population. The Immunocompetent.

But Cryptococcus in an immunocompromised patient? They could die.

You don’t have to worry about the treatment of mild Salmonella, well, unless your patient is immunocompromised.

And remember, if you come across a patient with the flu, they’re likely safe to discharge. Unless they’re immunocompromised.

Generally speaking, if a patient comes into the Emergency Department with a fever and no other symptoms, recheck their temperature. Reassure them. PO hydration. Discharge. UNLESS that patient is immunocompromised. They need blood cultures and the whole work-up. Admit to the ICU.

My friends laugh with me during lectures every time I roll my eyes when I hear something about how “immunocompromised” are at risk for XYZ. And then I remind them that “immunocompromised” doesn’t just refer to patients with organ transplants. There are a lot of people— including healthcare professionals— who are on various immunosuppressants. They just don’t blog their lives out like I do.

People ask me how I work in such a high-risk environment with “germs everywhere” (as if germs aren’t anywhere else, as if I walk out of the hospital into Sunshine Heavenly Sky City made of cigarette-smoke-free and Tuberculosis-free air). How do I deal with the anxiety of constantly being reminded of how quickly I can get sick and die, whether it be through my environment or through my textbooks? I don’t know how I do it. I guess I’m a little bit strong. I guess I find some humor in it all. Life’s too short for all the anxiety we give it; it deserves less anxiety and more serenity.

I will admit one thing, though: I love continuing to work in the ER because I know that if something were to suddenly happen to me, I would already be in the BEST place I could POSSIBLY be in. In the whole entire world. By chance.

To end this little post — a reminder to everyone that February is Heart Month. Know your risk for heart disease, don’t smoke cigarettes, eat your fruits & vegetables, and remember to try to exercise for at least 150 minutes per week (hey, even walking counts)!

Liz and me at the American Heart Association VIP Kick-Off Party for AHA Philly at The Ritz Carlton earlier this month.