To treat the patient, communicate first . . .

One of the great things about medicine is that you meet so many different kinds of people, and your job requires that you learn something about them.

When I was on call recently, I went down to the ER with the intern on my team to see a man who needed to be admitted for new onset diabetes. Diabetes is one of the most common diseases to see in medicine, certainly top 5 at least. What is less common is to meet a grown man who is deaf (from birth), mute, illiterate, and who does not know American Sign Language (ASL). Think about that for a minute. This man neither hears words nor sees their written representations. Can he have any conception of language? When I met him he was with a "patient advocate", a social worker who also happens to be deaf. They were able to communicate somewhat, primarily through gestures and picture cards, but since he was mute, his interpretation of what the patient said was communicated to me through writing. I found this situation sort of intriguing, but it's also frustrating because he was a sick man with the onset of a new chronic disease which requires complex management for the rest of his life. How do you explain to someone who communicates through gestures and pictures that the cells in his body have become insensitive to insulin, which is required for those cells to utilize glucose, which are needed to make energy? What are cells? What is glucose? What the hell is energy?

People sometimes ask me, half-joking, if my life is anything like what they see in Grey's Anatomy. Rest assured, it is not. I have not seen anyone making out in the on-call room, my scrubs are not tailored just for me, and not every patient I see requires surgery. But I have seen some cases that are strange or interesting enough to be on tv, and I have met some people who I just as easily could have seen on tv.

One final important note:
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