DIC and DOC: Is not blood the wine of life?

Being an oenophile, at one point in my life I wanted to be a sommelier, so I set myself on a path of self study of wines..

I rampaged through Rieslings
Barreled through Bordeaux,
Rootled through Riojas
And muddled through Merlot

When I first wrote that it was a sentence. But due to the scan and rhyme I decided they were lyrics.

Now that I live in Oregon, my studies continue as I partake in pilgrimages to the pastoral periphery of Portland where I pleasure my palate with a potpourri of provocative, peppery, piquant and poignant Pinots.

That sentence was brought to you by the letter P.

Previous to Portland, don’t worry those two ‘p’s were coincidental, the country whose wine’s really resonated with my palate was Italy. Perhaps because I am, ancestrally, Italian, but more than likely because they just taste so damn good. Italian wines have their quality regulated by the DOC, Denominazione di Origine Controllata.


Being an iatrophile*, at one point in my life I wanted to be a doctor, so I set myself on a path of self study of diseases.

I rampaged through Rabies
Barreled through Bronchitis,
Rootled through Rubella
And muddled through Metritis

Oops I did it again. Lyrics. Special props for connecting Barreled to Bronchitis. ‘Barrel’ works with both wine and obstructive lung diseases. I think I have a musical in the works here…

Now that  live in Oregon, my studies continue as I read, review, and reflect on the rambling range of ruthless and rampant respiratory riddles.

Note to self: Long form alliteration is much harder with ‘R’ than it is with ‘P’.

One of the rabbit holes I went down during my studies was identifying different forms of coagulopathy: Idiopathic Thromocytopenic Purpura (ITP), Thrombotic Thrombocytopenic Purpura (TTP), Hemolytic Uremic Syndrome (HUS), and notably Disseminated Intravascular Coagulopathy (DIC) which can be secondary to both liver failure and sepsis.

During my clinical rotations, while assisting a doctor putting in a central line in a patient with a multitude of comorbities including CHF, liver failure, renal failure and an acute infection that had led to sepsis, I noted purpura around the blood pressure cuff on the patient and the incision made for the line began to bleed more profusely than expected.

I exclaimed proudly, “Disseminated Intravascular Coagulopathy! DOC!”

“D *O* C”? questioned the Doc.

“Is not blood the wine of life?” I deflected pseudo-philosophically confusing everyone in the room including myself. “I’m pretty sure that’s from MacBeth” I explained.

They seemed satisfied with that justification. I’ve found you can resolve any tangent with a Shakespearean quote and people will nod like you’re smart.


*Iatrophile – A neologism I invented using Greek roots for “person who loves medicine”


 

I suggest reading this brilliant article from the NEJM by Dr. Beverly J. Hunt:

Bleeding and Coagulopathies in Critical Care

This publication is a great primer in the differentiation and management of the most common coagulopathies one might come across in the ICU.

Also I just searched MacBeth for the quote “Is not blood the wine of life?”.

Nope. I totally made it up.

 

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Author: elijoi

Humanist, Rationalist, Writer, Web Developer, Table Tennis Junky, Composer, Lyricist, Actor, Singer, and very recently with a mid-life career change, a Respiratory Therapist

One thought on “DIC and DOC: Is not blood the wine of life?”

  1. Ernest,
    Be careful what literary repast you recommend, for it may soon become a required reading for the Respiratory Therapist Students who follow your path. I agree with your blessing on the article. It satisfied a need for such an article in my “Journal Club.”

    Like

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