​This patient had been in a prior accident and was being treated for an ankle wound. I was chart checking the medics and saw he had fevers for 6 days despite being on antibiotics (Cloxacillin is their gram positive med and they had him on IV Metronidazole too). He would be a Sepsis Alert in a bigger hospital. Yesterday was my second clinical day this week and he had been admitted last Friday after I left. I saw all medical patients 2 days ago and then saw all the trauma patients yesterday, along with the sicker medical patients again. So I went to examine him for the first time, already intending to tweak his antibiotics with some I bought from India. His ankle was warm and tender but not swollen or oozy. He said it felt a lot better but his ipsilateral thigh was hurting a lot. I noted a warm, swollen, and tender thigh. He had a healed surgical scar there. I grabbed the ultrasound and discovered a big fluid collection all along the top 2/3 of his femur. One portion was encapsulated. SO, he got started on Vancomycin. It was the nursing staff’s first time to administer Vanc, and all went well other than patient itching which resolved with Benadryl. I asked the surgical procedure staff to see him first in the morning. Today, I happened to be looking for procedure supplies and walked in on them I&D-ing this patient. Ultrasound didn’t lie. Check out this luxurious, silky pus streaming out of that thigh 😁 300cc’s today. Patient feeling better today. I was soooo happy the surgical team told me “Good job, Teacher!” Because it can take a long time to win over staff in this type of environment. They call me “Rah-moon,” which literally means Teacher in Karen/Kayin  language but is what they call the doctor.

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