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A Tale of Two Patients
How uncertainty cost an arm and a leg, and a leg.
Posted on August 20, 2016 by Andrew, CEO
Here is why I left neurosurgery before ever touching a brain.Names kept confidential.
Before Buoy, I wanted to wear scrubs, blast music, and do brain surgeries. Specific, I know. But I dreamed about this future for so long and shared it so widely that one day in college, when I sliced my hand on a broken window, my roommates couldn’t help but start with, “Is the dream over?” before realizing, “Oh! He needs a rag!” Luckily, it was only a scratch. I went to med school and did a one-year rotation at Massachusetts General Hospital (MGH), where I could try the various disciplines before planting myself among the neurosurgeons.
For four weeks, I rotated in the ER. My duties mainly consisted in interviewing incoming patients. I asked them about their symptoms and then reported back to a senior resident, who made a diagnosis. Ask, report, repeat. I was an infantryman on the front line.
One late night, a woman appeared in the queue complaining of finger pain. She wore a friendly smile and sat with a large stack of papers in her lap.
“I’m worried my finger might be broken,” she said.
It turned out she had jammed the finger two weeks earlier playing football at a picnic. It showed no swelling or bruising. I asked if she could bend it. She flexed the finger just as freely as the others.
“What makes you think that it’s broken?” I asked. She lifted the stack of paper, a ream of pages printed from the Internet and highlighted neatly in different colors.
“I found this information online,” she said.
After conferring with the senior resident, I assured the woman that her finger was fine, bade her farewell from the ER, and contemplated how much our conversation cost her insurer?—?at least $1000. I rushed on to my next patient.
He had five family members with him, all huddled around his foot, and he was nursing an oozing hole under his big toe.
His chart revealed he had diabetes, left unmanaged. Nerve damage from the diabetes caused numbing in his foot, allowing a small cut to fester and become infected. To save him from a larger complication, the foot needed to be amputated.
“The infection in your toe is major,” the senior resident explained. “And it looks like there’s not enough blood going there to fight the infection. To keep the bacteria from spreading everywhere, which is life-threatening, we’re going to have to amputate your leg.”
“But doctor, what about this?” The patient motioned for his wife to hand him a stack of papers, an opinion from another physician perhaps. It was a pile of printouts from the Internet.
The senior resident combed through the sheets. “Thank you for bringing these, but they won’t change what we need to do.”
The next morning, a team of surgeons removed his leg below the knee.
For the first time, I second guessed my dream. I wasn’t an infantryman on the front line. Not for these people, at least. I was further back, hidden behind a wall of printouts from health websites. I could only do my part when people decided to get help.
But the Internet misled people. It scared healthy people into the ER and gave unhealthy people an excuse to delay care. For the Internet to work, it needed to do what I was doing in the ER: ask about symptoms, collect data, and narrow the scope.
Rotations ended, and a new dream took hold in me: make a website that would’ve helped the two patients from that night. I hung up my brain surgery ambitions along with my white coat and set out to change the Internet for healthcare with Adam, Nate, and Eddie.
— Andrew, CEO