CT, or not CT, that is the question:
Whether ’tis nobler in the brain to suffer
The blows and bumps of trauma wanton,
Or to take meds against a sea of migraines
And by opposing, end them.
To sleep, to die?
No more, no more.
And by a sleep to say we end
The headaches of concussive blows
and migraines mighty
That flesh is heir to: ’tis a consummation
Devoutly to be wish’d.
The sleep of migraine, perchance to dream;
To sleep post-trauma, perchance to die?
Therein to dwell upon our end at length …
For in that sleep of death, what obits there may be:
When we have shuffled off this mortal coil,
Must give us pause, give us pause …
Calumny, or praise,
Calamity, or eulogy.
For who would bear th’oppressor’s wrong, the proud man’s contumely,
Th’administrators’ scold, the righteous patient’s scorn,
Th’intrusive CME and MSO and EMR;
The barristers exclaim: “Delay of care, delay …
of care!”
… of caring?
Oh! For the pangs of dispriz’d medical arts,
Th’insolence and spurns
That doctors suffer of MBAs, every other?
When we ourselves away, our quietus to take?
Would burdens bear
To grunt and sweat, a life so wearing,
a work so weary?
Of care, of caring ….
Have we yet no more to give?
No more to give?
But that the dread of something after …
something after …
Retirement! The second death of self,
the second self of death!
Th’undiscovered country, from whose stream
No traveler returns, vexes the will.
And dare we rather hear those headaches “10”
Than fly to the risks of idle time retired, our future selves, of whom we know
… nothing?
Thus does reflection make hesitants of us all,
And duty give order to our days.
And even so, the native hue of resolution Rational,
Is sicklied o’er with the pale cast of second doubts,
Decision trees and algorithms, scoring systems by the score,
Frenetic, frenzied, sleepless nights of battles pitched,
And choices momentous: of death, of life.
This, then, we perceive, reflect, and Science turns awry,
We lose the will …
To say “no” ….
And CT, after all.

Dr. Boulet is a pediatric emergency department attending physician at Huntsville Hospital in Huntsville, Alabama.