Dr. Allan Whitman

Junior (College 3rd year) ・Healthcare&Medicine ・MLA

Life as a practicing doctor offers many opportunities to build relationships and restore hope to pessimistic souls. The medical journey of Dr. Allan Whitman began at a youthful age of 27 years right after graduating from medical school. His dream of changing lives through scientific knowledge had become a reality as he reported to the hospital was assigned for his internship. Everyone seemed to realize the new face around as they fixed their awed gazes on Dr. Whitman who responded with a wide smile. His heavenly white lab-coat reflected his pure and utmost eagerness to take on the practice after years of theoretical studies in lecture halls and laboratories. One of the major things he did on that morning was report to the Hospital’s Administrator who later referred him to his supervisor, Dr. Alfonse Riley. With that, he was set to begin his morning rounds. 
The first hospital ward that Dr. Whitman worked in was the surgery department. On attending to the first patient, who was receiving post-operative care after an ileostomy, Dr. Whiteman was intrigued to realize that the patient’s digestion had been impaired due to cancer which had attacked the ileum. Due to this, the villi and microvilli of the patient were ineffective in absorbing the products of digestion. Excretion of the by- products had also been hampered due to the large mass that clogged the ileum at the jejunum. Although the patient could ingest, masticate and swallow all foods, most of the chyme just accumulated in the rugae of the stomach without proceeding to absorption. Dr. Whiteman scribbled a few opioids for the patient to help alleviate the pain as he proceeded on with his ward rounds. 
The morning was proving to be a success for Whitman as he left the surgical ward to have a beverage at the café. On his lone walk, his mind went over the treatment plans he had written for the patients. He smiled and chuckled when he remembered how back in medical school he would struggle to understand how digestive enzymes and digestive hormones interacted to bring about food breakdown. Substances like ghrelin and leptin, which are involved in increasing and reducing appetite respectively, were rocket science to him. To make matters worse, neuropeptide such as neuropeptide Y, whose role in digestion he came to understand after flopping in his end term paper, increased his hormonal confusion. Despite his struggles during lectures and exams, Whitman was able to overcome all barriers due to his drive and unquenchable desire to save humanity through his skill.
While at the café, Dr. Whitman decided to have some white coffee. He sat next to a young lady whose name tag read Dr. Maria. Since he had not talked to any other doctor the whole morning, Dr. Whitman decided to initiate a talk with the lady.
Hello there. You look like you are experiencing hypernatremia due to the constant number of times you keep looking at your wrist watch, joked Dr. Whitman.
“Are you sure am not experiencing hypokalemia and hypercalcemia,” replied Dr. Maria with a wide smile on her face. 
The two looked at each other intently as they burst out into laughter. Dr. Whitman extended out his hand to make a handshake with Dr. Maria. Medical jokes were rare in her line of work. She was an internist and was doing her third year of residency as Whitman came to discover from the little exchange they had. Apart from that, he also leaned a bit about her personal life. Dr. Maria had lost her husband who worked as a doctor in the army. She said that he might have possibly been under a respiratory acidosis after the gas cylinders in the military base in which the husband was based exploded due to a hidden leak. On hearing this saddening news, Dr. Whiteman's throat ran dry, as though his segmental contractions and peristalsis in his food pipe had ceased functioning momentarily.  He came to learn that she was waiting for her psychiatrist for her daily reviews. The two continued to converse as Dr. Whitman offered to keep her company.
Time was running out as it clocked noon without the two realizing it. Dr. Whitman offered to accompany Dr. Maria to the clinic where she was seeing some patients. On their way, she hinted on a case where she had a patient with a dysfunctional small intestine. The patient came reporting of adnominal pains and loss of appetite. On physical exam, Dr. Maria noted that the patient seemed to be suffering from severe malnutrition. She almost categorized it under starvation due to the extent of body wasting visible. The patient reported to how the pain began made it difficult for him to pass out urine. Micturition for him was the hardest thing. His body lacked the essential nutrients it needed to run its processes and meet its basal metabolic rate. Although the beta-oxidation was not hampered as evidenced by the metabolic acidosis seen in the blood gas analysis, imaging showed a large mass in the colon. Accumulated unabsorbed food in the large intestines caused the lacteal system and the microvilli to fail thus depriving critical nutrients of the patient. The finding was compounded by the discovery of low levels of ketone bodies in the patient’s blood. Dr. Whitman was amazed at the diagnosis since he had been attending to similar cases during his ward round. The two bid each other a good day when Dr. Maria got to the clinic and promised to meet up later. 
The afternoon was a seemed to drag itself. As it clocked evening, Dr. Whitman finalized his notes in the surgery ward. After a day of residency, the striking truth of the severity of intestinal malignancies made him vow his commitment to a healthy lifestyle. All he had to do was ensure that his intake of calories, proteins, vitamins, and minerals were balanced. He was so serious about his new eating habits that he even wrote down a list of possible food combinations on getting home. His list was so detailed to the point of even identifying classes of foods under water soluble and fat soluble vitamins. The principle was rather straightforward: garbage in, garbage out. All he had to do was watch the quality and quantity of the foods he took to ensure a healthy life with minimal illnesses. He prepared one of his heavenly white lab coats for wearing the following day. Day one had taught him so much already.
As usual, the alleys of the hospital were packed with eager faces of people who were in need of medical intervention, but that did not stop Dr. Whitman from wearing his usual smile. He made his way to the internal medicine ward. On this morning, the ward was booming with activity as the senior doctor in the internal medicine department led a major ward round. Dr. Whitman quickly joined in with a clipboard ready in his hands. The patients appeared to be less interactive than the ones he had met in the surgical wards. Intravenous lines and catheters punctuated every bed. One of the patients was experiencing kidney failure secondary to heart failure. From patient's file revealed that the urea levels were abnormally high with failing juxtaglomerular apparatus due to poor regulation of afferent blood flow by renin hormone. Again Dr. Whitman encountered hormones. This time round, he was well armed with information.
“Who can guide us on how to calculate the tubular load in this patient,” asked the head doctor who was a consultant. 
Without wasting a single minute, Dr. Whitman pressed forward and began the elucidation, thank you, sir. The tubular load is a product of plasma concentration of solutes and the glomerular filtration rate. An impairment in kidney function and the filtration process would lead to an imbalance in the level of tubular secretion or tubular function. Consequently, solutes would end up being abnormally retained or excreted leading to pathologies.”
Everyone was dead silent as Dr. Whitman explained his theory. The patient’s plasma clearance and tubular maximum needed to be considered before administration of the medications which would help improve his cardiac and kidney functions. Surprisingly, Dr. Maria was also in the same ward round. Immediately after Dr. Whitman finished his explanation, she approached him, tapping his back as she smiled at him. The two had joked together again as they moved on to the next patient. The cooperation between them was very efficient as they managed to answer most of the questions from the consultant, to the dismay of all the other doctors.
The last patient was a 29-year-old man, who was under respiratory support due to respiratory alkalosis. From his files, his body's homeostasis was tampered due to impaired levels of electrolytes in his intracellular and extracellular fluid. Evidently, the patient had hyperkalemia and hyponatremia. The two began discussing the possibility of the patient's calcium levels being high, but the report showed that he had hypocalcemia. Dr. Maria placed a bet with Whitman. After formulating their hypothesis, they approached the consultant. That's how the relationship between the two young doctors began.

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