Anthony Accurso, MD
As I looked at the glossy white dry-erase board and read the name of my new consult patient, written in crisp royal blue letters, I straightened my tie. I was ready to meet a new patient with a life-threatening cancer. I was ready to instill hope in someone who feared the end. Could I help cure this patient? I was confdent that, at the very least, I could offer this person more time managing the disease and a better quality of life.
“Please evaluate this patient’s anemia” was noted on the chart. I exhaled slowly and rolled my eyes. I reviewed the laboratory workup, which had previously been obtained by the referring physician.
- Hemoglobin is 1 point below the reference range
- Normal mean corpuscular volume
- Normal renal function
- Normal peripheral blood smear
- Normal white blood cell count
- Folate is borderline
I proceeded to review the patient’s medication list.
I paused and shook my head. “So, it takes a hematologist to know that psychiatric medications and folate defciency can cause anemia? I chose this feld to take care of people with life-threatening illness—what a waste of time!” I thought.
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