All Bleeding Eventually Stops

I thought of this phrase a few days ago, during a particularly difficult biopsy. Most of my procedures involve very little bleeding, but this one was giving me heartburn. No matter what I did, the patient continued to ooze. I even got some blood on my clothes “gasp!” Now, I recognize that the few cc’s of blood I’m talking about would make a trauma surgeon laugh. Those guys are used to gushers, arterial pumpers, being doused in some poor patient’s blood. But I’m just a quiet, bookish radiologist, and my procedures tend to be very safe and clean.
Of course, the bleeding did eventually stop. I would like to take credit with my clever use of pressure, ice, epinephrine, etc. But, I think the credit goes to the ago-old aphorism; “All Bleeding Eventually Stops.” Well, that and the patient’s natural clotting process.
I tried to remember when I first heard the phrase. It might have been during my surgery rotation in medical school, or it might have been while learning image-guided procedures during radiology residency. Or it might have been another time entirely. The wisdom of this phrase lies not in its literal meaning, which is like most medical sayings- one part reassurance and two parts dark humor. For those who have never heard the phrase, it has two meanings. The surface meaning is this; be calm, because you will follow your training, and stop the patient’s bleeding, saving the day. The “humorous” second meaning is that the patient will run out of blood, his heart will stop beating, and the bleeding will stop that way. Obviously, that is not an acceptable outcome for us.
The more appropriate use of this phrase is when applied to nonsurgical situations. Things like being on radiology call, when the ER is ordering stat CTs and MRIs as fast as they can. You are reading them as fast as you can, while performing lumbar punctures and placing Dobhoff tubes, and your list is thirty studies behind, and the referring doctors are calling you, irate that you are doing another doctor’s LP instead of reading his stat MRI of the knee on a 97-year-old. That’s when you take a deep breath, and remind yourself, “All Bleeding Eventually Stops.” It does make me feel better, because I will eventually be caught up. The demanding ER docs will be happy, and their ER will again be empty and quiet.
The odd thing about that previous example, is that there is no catastrophic outcome to make the phrase perfectly applicable. Outcome 1, the ordering of studies slows, and you catch up, is the ideal situation, and the one that always happens. Outcome 2 would be the hospital exploding, I suppose, and that only happens on TV.
Everyone has stress and problems in their lives, and I have to remind myself from time to time, that this too, shall pass. All bleeding eventually stops. If I’m worried about financial issues, well, I’ll either figure them out, sell the old house in Nebraska and pay off the student loans, or I’ll go bankrupt. Either way, it’s not worth worrying about every day. You can make yourself crazy and sick, pounding your head against a problem you can’t solve. Sometimes it just takes time.
Which leads me to another of my favorite old medical phrases: Tincture of Time. A tincture, for those of you who are not pharmacists in the 1910’s, is a concentrated liquid herbal extract, made from soaking plants with assumed medical properties in alcohol. So, Tincture of Time is the “medicine” of just waiting for a patient to heal themselves. Sometimes, that’s the best thing to do. Or the only thing to do. If you’ve already tried all the actual medicines.
I guess you’re hoping that somewhere in this pointless, rambling discourse, I have a point that ties all this together. And I do, sort of. It is this:
Try not to worry so much about things. You’ve done your best to deal with your problems, and now you have to trust the process. Whether it’s your finances, your health, your relationships, or whatever. Do your best and then quit worrying about it. Maybe this problem just needs a little tincture of time. After all, all bleeding eventually stops.