Of being non-judgemental....

I haven't forgotten to blog, really. It's just that the hospital has blocked certain sites on the server including the blogspots.

Thoughts usually come to me during the lull in between dawn and the end of the oncall period. I like to ponder upon the patients I saw and how I was with them. Not having an internet connection for me to put my thoughts in cyberspace has been such a damper.

I have to admit, I am not the friendliest doctor. I used to be, when I just joined the hoolabaloo about 7 years ago, all naive and innocent; sometimes I wonder whether it was really that bad that I have become so jaded and disillusioned by it all.

I had a patient last week, who had a history of heart problem. She had been followed up at the Physician's Clinic and had been advised for bypass grafting but she had refused.

She was brought into our casualty at 5 am severely distraught, literally screaming for every breath. Apparently she had had two days of on and off chest pains and had persevered at home. Fifteen minutes later she flatlined. Her son adamantly ordered us to stop our resuscitation efforts.

Later, her daughter approached us and told us that they had gone to the KK and no one responded. I wasn't really sure what she wanted to tell us actually. Was she implying that if someone at the KK had seen and attended to her, that maybe her mother could be saved? I told her I couldn't comment but she has to understand, by refusing the operation, her mother was simply a walking time bomb. The daughter did not look appeased, I have to say. I never had the magic way with words.

When I was working in the OPD, I met many patients who had been admitted time and time again for chest pains and was advised for angios and further work up of their heart problem. They would smile at me and say, "Takpe la doktor, berasa segar lagi nie.." and I would say, "No, it is when you are well that you should get everything checked out. When you are grabbing your chest and could not even lie still for an ECG, you are basically leaving your life to chance."

Yet, they would smile again and say thank you after I have written their monthly medications. Thank you for what I wonder. For letting you leave my room and wait for the next attack of chest pains?

In a way, I have a lot of respect for MOs who are in charge of OPDs - those who are really committed towards making sure that their patients are thoroughly educated and making an informed choice. How do you cope with stressing the same thing over and over again and still have your patients come in with hay wire blood pressures and blood sugars? At least when I plate a femur, I can see the proof in the check x-ray post operatively.

HTM's Ortho team have been pretty washed out the past week. We expected it to be bad, but not this bad. Broken femurs (thigh bones) have been wheeled in almost daily and my boss have resorted to doing them 2-3 days post trauma rather than have the patients on traction as we normally would. I can still feel the ache in my arms after reducing the fracture of this 80+kg man a few days ago.

Yesterday, a scrawny kid of 12 was riding his motorbike and collided with a jeep. He broke his femur rather badly and sustained a HUGE wound over his shin with his broken shin bone peeping nicely under all that mess. He was whining as I was changing his blood-soaked bandages; saying how I was rough and pulled his leg too hard. You can safely assume that I had many things to say at the tip of my tongue, all with complaint-letter-to-Pengarah inducing potential. I was rather proud when I left his bedside in silence. I honestly think one of the hardest things about being a doctor is to not be judgemental.

Never mind that another kid who broke his wrist last week was riding a motorbike and ran through a red light. I bluntly told him to run though another red light and get hit by a trailer next time; I attempted to soften my sentence with my sarcastic smile but it was lost on both kid and his mother.

Ho hum.

I'm sure there was a point of this blog entry but it seems to have gotten lost somewhere. Perhaps I will make better sense in my next entry, whenever that will be.