Come in pairs...

I've always noticed that my cases - on call or in the OPD - always usually come in pairs. Not the usual hum drum HPT, DM type 2 cases, 'sakit urat' or demam selsema routine; but the out of the ordinary, once in a while cases.

Like for instance, one morning in OPD, I had two cases of per vaginal bleeding. I had other examples too, but I can't remember them now....

But anyway, my call last night started quite busy after five. A family brought their mother who had been unconscious since 10 am okay? I understand la korang takde kenaikan and all, but 7 hours? Seriously?

She was breathing alright but was as if in a deep trance. Her arms were making random movements but she didn't respond to my calls. She DID however respond to me rubbing my knuckles on her sternum (the bit of bone in the middle of your chest. Cuba try tekan situ - sakit woo). When a case of unconsciousness like this comes into your A&E, if you're lucky, it's a case of hypoglycaemia (low blood sugar), kalau kurang sikit itu nasib baik, it's a case of haemorrhagic stroke and if you're really unlucky, it's something else.

I wasn't feeling very lucky that night, so of course, her blood sugar was normal. Her oxygen saturation and blood pressure remained stable. I was sure it's a haemorrhagic stroke but must have something to back my story up, yeah? Nanti susah aa MO Neurosurgical in USM nak terima...:) Then, after checking her pupils for the second time, I noticed that the right one is oval in shape. When I reported this to the MO on call, he accepted my case and off she went to HUSM.

As I was having my dinner and Maghrib prayers, I wondered if there would be a 'twin' of the earlier case. and I was not disappointed. At about 8, came in this case of a 71 y.o. male who apparently overdosed on his schizophrenia medication. After vomiting once and had some loose stool, became unconscious. He was actually snoring like a baby when he arrived. His pupils were pin point. Besar sikit je dari saiz noktah at the end of this sentence. Off he went to HRPZII. Selamat.

The rest were MVAs, fevers and the run of the mill epigastric pains.

Woken up at three for a bronchopneumonia. Mother actually surprised I admitted the 3 year old. What...? You come at three in the morning, must be something serious kan? Of course need admission la! :)

Laid my head for a split second (or so it felt) and it was already half five. A case of G4P0+3 (means currently pregnant for the fourth time, yet no live deliveries. +3 means three abortions) at 31 weeks complaining of having contraction pains. She had cervical circlage done (meaning stitches were made in her cervix to keep her baby inside) but I guess that isn't working. My prayers went with her as she boarded the ambulance. I'm not sure I would be as strong if I were in her shoes.