Chronic Lymphocytic Leukemia is a rotten thing to find.  Last night's phone call from the lab with an alert value of 50.2 WBC's with smudge cells was unexpected .. as are most diagnoses of CLL.

Today's meeting with my otherwise healthy patient was challenging too. 

Here's a good patient information handout on CLL.

Next step is flow cytometry.  Here's a nice little  review of flow cytometry methods,  rationale and interpretation.

I'm so sad about this.  Most of this job is fun.  Delivering babies this weekend was exhausting but exciting .. and the "routine" work of seeing patients – primary care issues – hypertension, Diabetes, depression etc – is all fairly straightforward and fulfilling. 

But bearing the news of a chronic and likely deadly illness – even if it's very slowly progressing –  is just plain sad.   No – not an "interesting case" as the medical students seem to think.  Just Sad.