well and the lessons I learned were that you know it's really good to ask
people's opinions you know and I think that's what I love about my institution it's very multidisciplinary and I love talking to my friends and advisors and mentors elsewhere but ultimately you know it's your patient it's your case
and you're responsible and so what we do not want to get into the habit of is like you're just throwing your hands up in there and be like well sorry why don't we put in a tunnel drainage catheter because that would have helped
her too but she's so much more grateful that I opened up the tips and believe it or not the bacteremia resolved as soon as the tips was covered and she finished her course of antibiotics and she's doing really well
so patient-centered care is also really important just because the you know papers and algorithms exist saying that you shouldn't do tips potentially in patients with communication of the biliary tree you
know you gotta you got to do what's right for the patient sometimes and if sometimes you have to go against algorithms and guidelines but you know but that's again a case-by-case basis thank you
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