HIV and ID Observations

If you search “Are vacations good for you?,” you’ll find overwhelming support for time off.

It’s as if journalists and the travel industry were in cahoots, together trying to urge us to take vacations, the longer or more frequent the better.

Hey, I get it. Time to reconnect with family and friends, to recharge those batteries, to get a fresh perspective on both work and life, to explore new challenges … yadda yadda yadda. The list of benefits is so long that it seems cliched to write them, so I’m going to stop there.

But you know what? That pre-vacation scramble to make sure things are settled just right before you go — that’s no fun at all.

And if you’re a typical doctor/nurse/PA, you probably are plenty detail oriented. ID doctors in particular will know that “detail oriented” barely begins to describe their obsessive attention to the minutiae of their everyday practice and life — and that includes establishing whether the culture was positive for M. abscessus or M. abscessus subspecies bolletii, making sure the out-of-office message conveys just the right information about when/where/how long that time away will be, and whether they’ve left clear directions to the person they’ve hired to feed the cat.

After all, how can you go on vacation if you’ve still not figured out how to get Mrs. Smith’s vancomycin level between 15 and 20? Or informed Mr. Jones that the last viral load that came back at 23 copies/mL (instead of “not detected,” as usual) is no cause for alarm?

The Big Secret, of course, it that nothing is ever completely settled, whether we go on vacation or not. So we may as well take some time off, which is what I’m about to do (hence this post).

But it also gives me a chance to share this funny (at least I think it’s funny) text, sent to me by an ID colleague who runs the Antibiotic Stewardship Program at another hospital. For non-ID readers out there, these programs (generally run by ID doctors) aim to guide clinicians to the most rational use of antibiotics, in particular to avoid inappropriate use of broad-spectrum therapy, reducing the risk of bacterial resistance (a very bad global problem).

He was scurrying around trying to finish up some work before leaving on vacation, and received this series of messages from a hospitalist who was trying to consult him one last time before he left:

Safe to say he responded to her at 9:11!