Another post call musing

The thing I love most about my job is that, you never know what is going to happen.

Yes, I come into work, expecting to see another case of mat rempit wannabe with a few broken bones, or a makcik with severe OA of the knees and clinics will usually consist of advising patients to take care of their casts and to not weight bear etc etc.

But, it is the things in between that can make my day so interesting. Like the pakcik who brought us huge durians from his orchard, or the makcik with the diabetic foot who brought a gunnyfull of buah salak or the sweet little kid who says bye-bye with that toothless cheeky smile.

Also, there is this patient who cried when her operation did not yield the result she wanted or the parents who wanted surgical corection for the deformed elbow due to a neglected fracture.

Something happened during last night's call which made me wonder about the difference in expectations of us medical providers and the patients (+relatives). What the relatives perceive as fine or stable or improving may not be the same as doctors. Though he or she may look OK, but I am sure the MO must have noted the persistant CO2 buildup or the increasing respiratory distress which has been left unnoticed by the people around the patient.

To what extent does an MO have to update a patient's condition to the relatives, especially when the case suddenly deteriorates and the MO only has a split second to decide whether or not to aggressively resuscitate?

Does one wait and explain EVERYTHING to the relatives while the patient is gasping and getting bluer by the second, and with that, wasting precious time?

I would like to think that the words came out due to the stress and concern; perhaps that patient's son may be a reasonable and even considerate person had the situation been different but when one knows that one has done one's best, being told that a relative is highly dissatisfied with you can be so demoralising.