Crappy Job

Clostridium difficile is another "superbug" (like MRSA) keeping hospitals on their heels and taking its toll on patients. My friend's mother recently had a terrible bout of this in a Florida hospital and the infection hastened her death. A recent article in the WSJ states that there are now 500,000 cases annually which is up from 150,000 cases annually in 2001. I always ask patients who come to me with diarrhea whether they received antibiotics when they were in the hospital. Normally our body's own good bacteria keep C. difficile under control but antibiotic use upsets that balance unleashing this possible lethal infection. Here is the crazy thing. Life is not perfect. Wasn't it JCAHO who started demanding antibiotics quickly in the ER for patients with possible pneumonia? I believe it was the "4 hour rule"? This rule, by the way, has not shown to improve outcomes but who needs evidence when JCAHO is involved. Anyway, as you can tell, overuse of antibiotics can lead to this epidemic of C. diff. To make things crazier, this infection is on the "never event" list which means Medicare and insurance companies are not going to pay for care when patients get it. Doctors are stuck between a rock and a hard place deciding whether to make JCAHO happy or risk causing a "never event". Ridiculous.

The only thing that lightened my mood when reading the WSJ article was the ending. They casually mention the use of fecal transplants. It seems you can harvest stool from a relative and place it in the patients colon and it may help treat C. diff. Wow! Now that is a field I can sink my teeth into. Competition has got to be minimal for this. I could specialize as a fecal transplantologist. They could fly me around in a special medical helicopter with my coolers filled with stool ready to help patients with their C. diff. Maybe I could discover some genetically designed stool that I could grow in the lab and be the world's biggest stool supplier for the treatment of C. diff? Don't they do that with yeast starter kits where they keep the same original yeast bud for people who bake break? Think about it. I would not only be the foremost stool transplant surgeon but also own the material as well. I could take over the world! It may be a crappy job, literally, but I would be famous and rich.