I wrote this reflection early in my 3rd year medicine rotation after taking care of my first CIWA patient. It seemed like no matter what we did, this man would return again and again for detoxification after a suicide attempt. I felt hopeless because all we could do for him was prevent a seizure and give him toothpaste and eyedrops. He needed so much more, but as an institution we weren’t able to connect him with consistent outpatient psychiatry, a stable living environment, or any of the myriad things that he lacked. I realized the critical role of outpatient preventative medicine and the limitations of hospital medicine to address incredibly complex psychosocial situations. I’m considering a residency in internal medicine, but I hope I can do more for these “frequent-flyer” patients than we were able to do that day.
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Giordano J. And The Bottle. Streams of Consciousness 2017; 1(1):1004. https://doi.org/10.7191/soc.2017.1004. Retrieved from https://escholarship.umassmed.edu/soc/vol1/iss1/4