They say if all you have is a hammer, everything looks like a nail. I wonder, then, why my toolbox often seems so inadequate for fixing my patients.
I open one recent afternoon in clinic with a middle-aged man I’ve come to know well. He’s drunk. His breath smells of alcohol and he slurs his words. He tells me his brother’s in jail, his mother died, and he punched a neighbor who tried to steal his wallet. In the past year, he’s been admitted to the hospital countless times for everything from falling to getting injured in a fight to failing to take his medications.
“High risk for readmission,” an automated email plops into my inbox each time he’s admitted. Thanks, I’m on it.
I search for mental health and substance use resources we haven’t yet exhausted. I speak briefly with a psychiatrist and case manager and a social worker who is arranging transportation back to the housing he’s in danger of being thrown out of.
“Maybe we increase his mood-stabilizer?” I offer, mostly just to say something. When all you have is a hammer…
[For more of this story, written by Dhruv Khullar, go to http://well.blogs.nytimes.com/...ectionfront&_r=0]
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